DEPARTMENT of 

HEALTH

and HUMAN 

SERVICES 

Fiscal Year 

2024 

Substance Abuse and Mental Health

Services Administration

Justification of Estimates for 

Appropriations Committees
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Letter from Assistant Secretary 

 

I am pleased to present the FY 2024 President’s Budget Request for the Substance use And Mental 

Health Services Administration (SAMHSA). The FY 2024 President’s Budget includes a total of 

$10.8 billion. As the primary Federal agency responsible for leading public health and service 

delivery efforts that promote mental health, prevent substance misuse, and provide treatments and 

supports to foster recovery while ensuring equitable access and better outcomes, SAMHSA takes 

seriously our responsibility to ensure that the best evidence-based care reaches the millions of 

people in communities across America who are affected by mental illness and substance use 

disorders. 

The FY 2024 President’s Budget for SAMHSA demonstrates a commitment to addressing pressing 

public health challenges, including America’s overdose and mental health crises, and aims to 

improve the lives of people across the United States and its territories. This Budget supports, 

among other efforts, the U.S. Department of Health and Human Services’ (HHS) 2022-2026 

Strategic Plan, the SAMHSA Interim Strategic Plan, the Biden-Harris Administration’s inaugural 

National Drug Control Strategy and Unity Agenda, and the Bipartisan Safer Communities Act. 

This Budget also reflects SAMHSA’s principles of prioritizing equity, applying trauma-informed 

approaches, supporting recovery, and demonstrating a commitment to data and evidence-informed 

practices as we address our five key priorities:

1. Preventing Overdose, 

2. Enhancing Access to Suicide Prevention and Crisis Care, 

3. Promoting Resilience and Emotional Health for Children, Youth, and Families, 

4. Integrating Behavioral and Physical Health Care,

5. Strengthening the Behavioral Health Workforce. 

 

The FY 2024 Budget includes investments to: 

 

• Address the overdose crisis by expanding programs that support prevention, harm 

reduction, treatment, and recovery support services. SAMHSA plans to do this, for 

example, through providing resources to prevention professionals like the Strategic 

Prevention Framework, which serves as a comprehensive guide to planning, 

implementing, and evaluating prevention practices and programs. The Budget also 

includes funding to support programs that bridge harm reduction and low-threshold 

treatment of opioid use disorder through a new Community Harm Reduction and 

Engagement Initiative. SAMHSA also aims to increase access to overdose reversal 

medications and Food and Drug Administration (FDA)-approved medications for the 

treatment of opioid use disorder through expanding the State Opioid Response program, 

and bolstering community recovery services through expanding programs like the 

Building Communities of Recovery and the Treatment, Recovery, and Workforce 

Support programs; 

• Continue transforming America’s behavioral health crisis care system into one that saves 

lives by serving anyone, at any time, from anywhere across the nation by significantly 

expanding the 988 and Behavioral Health Crisis Services program; 

• Provide America’s youth and families with accessible, affordable, and appropriate mental 
SAMHSA

ii

health and substance use prevention, intervention, treatment, and recovery services in 

communities and schools through expanding programs like the Infant and Early 

Childhood Mental Health program, the Children’s Mental Health Initiative the Project 

Advancing Wellness and Resiliency in Education (Project AWARE), and the Resiliency 

in Communities After Stress and Trauma (ReCAST) program; 

• Provide effective community practices and mental healthcare services for children and 

adolescents exposed to traumatic events by expanding programs like the National Child 

Traumatic Stress Initiative (NCTSI).

• Create healthy environments across the country, including in historically underserved 

communities and populations, through expanding programs like Mental Health 

Awareness Training (MHAT), Project Linking Actions Unmet Needs in Children Health 

(Project LAUNCH), Healthy Transitions, and Tribal behavioral health programs;

• Further integrate behavioral and physical health care through expanding SAMHSA’s 

Primary and Behavioral Health Integration and Certified Community Behavioral Health 

Clinic (CCBHC) programs; 

• Strengthen the behavioral health workforce, address workforce shortages, reduce health 

disparities, and improve behavioral health care outcomes for minority populations by 

expanding programs like the Minority Fellowship Program and further developing the 

pipeline through Mental Health Practice Improvement and Training efforts; and

• Address homelessness among individuals at risk for mental health conditions and 

substance use disorders through the Projects for Assistance in Transition from 

Homelessness and Substance Use Services Targeted Capacity Expansion-General 

programs. 

In FY 2024, SAMHSA maintains a strong commitment to enhancing the accessibility of 

evidence-based, effective behavioral health care services. SAMHSA continues to streamline its 

business operations while expanding access to mental health and substance use disorder services, 

including through the provision of technical assistance and training, to optimize service delivery 

across all of the United States’ communities. The work that SAMHSA does and the services we 

provide to Americans with mental health and substance use disorder needs are vital to the health 

of our Nation. I am confident that this budget supports our shared vision that people with, affected 

by, or at risk for mental illness and substance use disorders receive timely and appropriate care, 

are able to thrive, and achieve wellbeing. 

 

 

 

 

Miriam E. Delphin-Rittmon, Ph.D. 

Assistant Secretary for Mental Health and Substance Use 
SAMHSA

iii

Table of Contents

Fiscal Year 2024 Budget Page

Letter from Assistant Secretary ................................................................................................... i

Table of Contents ......................................................................................................................... iii

Organizational Structure ............................................................................................................ vi

Performance Budget Overview Executive Summary ................................................................ 1

Introduction ......................................................................................................................... 1

Mission ................................................................................................................................ 2

Vision .................................................................................................................................. 2

Overview of the Budget Request ........................................................................................ 3

All-Purpose Table ............................................................................................................. 12

Budget Exhibits ........................................................................................................................... 13

Appropriation Language Guidelines ................................................................................. 14

Language Analysis ............................................................................................................ 19

Amounts Available for Obligation.................................................................................... 26

Summary of Changes ........................................................................................................ 27

Budget Authority by Activity ........................................................................................... 28

Authorizing Legislation .................................................................................................... 29

Appropriations History ..................................................................................................... 32

Appropriations Not Authorized by Law ........................................................................... 33

Mental Health .............................................................................................................................. 34

Summary of the Request ................................................................................................... 35

Programs of Regional and National Significance (PRNS) ............................................... 37

Project AWARE ....................................................................................................... 38

Mental Health Awareness Training ........................................................................ 42

Healthy Transitions ................................................................................................. 44

Children and Family Programs .............................................................................. 47

Consumer and Family Network Grants .................................................................. 49

Project LAUNCH .................................................................................................... 51

Mental Health System Transformation and Health Reform .................................... 55

Primary and Behavioral Health Care Integration .................................................. 58

Suicide Prevention Programs .................................................................................. 62

Mental Health Crisis Response Partnership Program ........................................... 79

Homelessness Prevention Programs ....................................................................... 81

Minority AIDS ......................................................................................................... 83

Criminal and Juvenile Justice Programs ................................................................ 86

Practice Improvement and Training ....................................................................... 90

Consumer and Consumer-Supporter TA Centers.................................................... 92

Disaster Response ................................................................................................... 94

Seclusion and Restraint ........................................................................................... 98

Assertive Community Treatment for Individuals with Serious Mental Illness ...... 100

Tribal Behavioral Health Grants .......................................................................... 103

Minority Fellowship Program ............................................................................... 106

Infant and Early Childhood Mental Health .......................................................... 109

Interagency Task Force on Trauma-Informed Care ............................................. 112

National Child Traumatic Stress Network ...................................................................... 114
SAMHSA

iv

Assisted Outpatient Treatment for Individuals with Serious Mental Illness .................. 117

Children’s Mental Health Services ................................................................................. 120

Projects for Assistance in Transition from Homelessness .............................................. 125

Protection and Advocacy for Individuals with Mental Illness (PAIMI)......................... 130

Community Mental Health Centers (CMHC) ................................................................. 135

Certified Community Behavioral Health Clinics (CCBHC) .......................................... 137

Community Mental Health Services Block Grant (MHBG)........................................... 144

Substance Use Prevention Services ......................................................................................... 171

Summary of the Request ................................................................................................. 172

Programs of Regional and National Significance (PRNS) ............................................. 173

Strategic Prevention Framework .......................................................................... 174

Federal Drug-Free Workplace.............................................................................. 180

Sober Truth on Preventing Underage Drinking Act (STOP Act) .......................... 183

Tribal Behavioral Health Grants .......................................................................... 187

Minority AIDS Initiative ........................................................................................ 190

Center for the Application of Prevention Technologies ........................................ 193

Minority Fellowship Program ............................................................................... 196

Science and Service Program Coordination ......................................................... 198

PRNS Mechanism Table ................................................................................................. 201

Grant Awards Table ........................................................................................................ 204

Substance Use Services ............................................................................................................. 205

Programs of Regional and National Significance (PRNS) ............................................. 208

Opioid Treatment Programs/Regulatory Activities............................................... 209

Screening, Brief Intervention, and Referral to Treatment .................................... 213

Targeted Capacity Expansion-General................................................................. 217

Pregnant and Postpartum Women ........................................................................ 224

Improving Access to Overdose Treatment ............................................................ 229

Building Communities of Recovery (BCOR) ......................................................... 232

Recovery Community Services Program ............................................................... 236

Children and Families ........................................................................................... 240

Treatment Systems for Homeless........................................................................... 244

Criminal Justice Activities .................................................................................... 248

Minority AIDS Initiative ........................................................................................ 255

Minority Fellowship Program ............................................................................... 258

Addiction Technology Transfer Centers ............................................................... 260

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths .............. 263

Peer Support Technical Assistant Center .............................................................. 266

Treatment, Recovery, and Workforce Support ...................................................... 269

Emergency Department Alternatives to Opioids................................................... 272

Comprehensive Opioid Recovery Centers............................................................. 275

First Responder Training – Comprehensive Addiction and Recovery Act ........... 279

Youth Prevention and Recovery Initiative ............................................................. 286

PRNS Mechanism Table ................................................................................................. 288

Grant Awards Table ........................................................................................................ 294

State Opioid Response Grants ........................................................................................ 295

Substance Use Prevention, Treatment, and Recovery Services Block Grant ................. 304
SAMHSA

v 

Health Surveillance and Program Support ............................................................................ 317

Summary of the Request ................................................................................................. 318

Health Surveillance ............................................................................................... 319

Performance and Quality Information Systems (PQIS) ........................................ 324

Drug Abuse Warning Network (DAWN) ............................................................... 328

Program Support ................................................................................................... 330

Public Awareness and Support ............................................................................. 331

PRNS Mechanism Table ................................................................................................. 335

Supplementary Tables .............................................................................................................. 336

Budget Authority by Object Class .................................................................................. 337

Salaries and Expenses ..................................................................................................... 346

Details of Full-Time Equivalent Employment................................................................ 348

Detail of Positions ........................................................................................................... 349

Physicians’ Comparability Allowance Worksheet ......................................................... 350

Resources for Cyber Activities ....................................................................................... 351

Drug Control Programs .......................................................................................................... 352

Significant Items........................................................................................................................ 382

Proposed Law ............................................................................................................................ 386
vi 

Organizational Structure

CENTER FOR SUBSTANCE USE 

PREVENTION CENTER FOR SUBSTANCE ABUSE 

TREATMENT 

OFFICE OF MANAGEMENT, 

TECHNOLOGY & OPERATIONS 

OFFICE OF THE CHIEF MEDICAL

OFFICER

Neeraj Gandotra, M.D.

Chief Medical Officer

(MAD)

OFFICE OF 

INTERGOVERNMENTAL AND 

PUBLIC AFFAIRS

Anne Herron

Director

(MAC)

BEHAVIORAL HEALTH CRISIS

OFFICE (988)

Monica Johnson, M.A.

Acting Director

(MA3)

OFFICE OF RECOVERY

Paolo del Vecchio, M.S.W.

Director

(MA4)

NATIONAL MENTAL HEAL TH & SUBSTANCE 

USE POLICYLABORATORY 

Brian Altman. J.D. 

Acting Director 

Rebecca Zornick, J.D. 

Deputy Director 

(MA2) 

OFFICE OF THE ASSISTANT SECRETARY 

Miriam Delphin-Rittmon, Ph.D. 

Assistant Secretary for Mental Health and 

Substance Use 

Tom Coderre 

Acting Deputy Assistant Secretary 

for Mental Health and Substance 

Use 

Sonia Chessen. M.A. 

Chief of Staff 

I 

OFFICE OF FINANCIAL RESOURCES 

Kurt John, Ed.D., M.P.A, M.S.F. 

Director 

Pamela Hubbard, M.S .. M.B.A. 

Deputy Director 

(MG1) 

(MA) 

Paolo del Vecchio, 

M.S.W Acting Director 

Joella Gibbs, MLS 

Deputy Director 

(MB1) 

CENTER FOR MENTAL HEAL TH 

SERVICES CENTER FOR BEHAVIORAL HEALTH STATISTICS & 

QUALITY 

Yngvild Olsen, M.D., 

M.P.H. Director 

Karran Phillips, M.D., M.Sc. 

Deputy Director 

(MT1)

Anita Everett, M.D. 

Director 

Tison Thomas, MSW 

Acting Deputy 

(MS1) 

Naomi Tomoyasu, PhD 

Director 

Lindsey Gonzales 

Acting Deputy Director 

(MC) 

CAPT Jennifer Fan, J.D. 

Acting Director 

CAPT. Michelle Leff, 

Acting Deputy Director 

(MP1) 
1 

Performance Budget Overview Executive Summary

Introduction

In these unprecedented times, individuals, families, and communities across the nation are

experiencing the challenges of living with mental and substance use disorders. In 2021, National

Survey on Drug Use and Health (NSDUH) data estimated 21.9 percent (or 61.2 million people) 

used illicit drugs in the past year. In addition, among adults aged 18 and older 22.8 percent (or 

57.8 million people) had any mental illness (AMI) and 5.5 percent (or 14.1 million people) had 

serious mental illness (SMI). In his 2023 State of the Union Address, President Biden provided 

an update on the progress made in advancing efforts to tackle the mental health crisis and beat the 

opioid and overdose epidemic - two of the four pillars of his Unity Agenda. This Budget builds on 

the progress made and outlines ways to sustain and grow SAMHSA’s efforts to strengthen system

capacity, connect more Americans to care, and create a continuum of support that aims to

transform our health and social services infrastructure to address mental health and substance use 

holistically and equitably. 
2 

Mission

SAMHSA’s mission is to lead public health and service delivery efforts that promote mental 

health, prevent substance misuse, and provide treatments and supports to foster recovery while 

ensuring equitable access and better outcomes. 

Vision

SAMHSA envisions that people with, affected by, or at risk for mental health and substance use 

conditions receive care, thrive, and achieve wellbeing. 
3 

Overview of the Budget Request

The FY 2024 President’s Budget Request is $10.8 billion, an increase of $3.3 billion from the 

FY 2023 Enacted level. The Budget Request supports, among other efforts, the HHS 2022-2026 

Strategic Plan, the SAMHSA Interim Strategic Plan, and the Biden-Harris Administration’s 

inaugural National Drug Control Strategy and Unity Agenda. 

The Budget also reflects SAMHSA’s principles of prioritizing equity, trauma-informed 

approaches, recovery and a commitment to data and evidence as well as five key priorities:

1. Preventing Overdose 

2. Enhancing Access to Suicide Prevention and Crisis Care 

3. Promoting Resilience and Emotional Health for Children, Youth, and Families 

4. Integrating Behavioral and Physical Health Care 

5. Strengthening the Behavioral Health Workforce 

Preventing Overdose

SAMHSA’s FY 2024 Budget proposals prioritize preventing overdose and support the HHS 

Overdose Prevention Strategy, which outlines four pillars: Primary Prevention, Harm Reduction, 

Evidence-Based Treatment, and Recovery Support. The Strategy is built on the principles of 

maximizing health equity by using best available data and evidence to inform policy and actions, 

integrating substance use disorder (SUD) services into other types of health care and social 

services, and reducing stigma. The Budget proposals address the full continuum of integrated care 

and services needed to help prevent substance use, expand quality treatment, and sustain recovery 

from SUD, all while emphasizing HHS’ commitment to helping historically under-resourced 

populations. 

The FY 2024 President’s Budget Request includes $50 million for a new Community Harm 

Reduction and Engagement Initiative program, an increase of $50 million from the FY 2023 

Enacted level. Harm reduction approaches, such as distribution of naloxone and fentanyl test strips 

to those at high risk for overdose, their family members and first responders are a key component 

in addressing the overdose crises. The American Rescue Plan (ARP) Act afforded SAMHSA the 

opportunity to launch a dedicated harm reduction grant program. SAMHSA’s budget seeks to 

build off the ARP program with this proposed Community Harm Reduction and Engagement 

Initiative that will bridge harm reduction and low-threshold treatment of opioid use disorder 

(OUD). 

The FY 2024 President’s Budget Request includes $28.0 million for Grants to Prevent Prescription 

Drug/Opioid Overdose Related Deaths (PDO) and increase of $12.0 million from the FY 2023 

Enacted level. The purpose of the PDO grant program is to reduce the number of prescription 

drug/opioid overdose-related deaths and adverse events among individuals by training first 

responders and other key community sectors on the prevention of prescription drug/opioid 

overdose-related deaths and implementing secondary prevention and harm reduction strategies, 

including the purchase and distribution of naloxone to first responders. 
4 

The FY 2024 President’s Budget Request for the First Responder Training for Opioid Reversal 

Drugs program is $77.5 million, an increase of $21.5 million from the FY 2023 Enacted level to 

enhance linkage to care for people at risk for opioid overdose through purchasing, training, and

equipping first responders and community members with naloxone and other FDA-approved 

overdose reversal devices. SAMHSA anticipates an additional 71,975 overdose reversal devices 

will be distributed and an additional 14,310 First Responders will be trained. 

 

The FY 2024 President’s Budget Request for the Building Communities of Recovery program is 

$28.0 million, an increase of $12.0 million from the FY 2023 Enacted level, and the Budget request 

for the Recovery Community Services Program is $5.2 million, a $717,000 increase from the FY 

2023 Enacted level. Community recovery services support individuals as they address their 

substance use and other life challenges and help them to achieve and sustain recovery. The 

increased funding for these programs will further invest in peer led recovery community 

organizations and recovery support services and provide career services for people in recovery 

from substance use disorder through partnerships with local organizations.

The FY 2024 Budget Request for the Targeted Capacity Expansion program is $157.9 million, an 

increase of $35.5 million above the FY 2023 Enacted level. Within this increase, the budget 

proposes $10 million for a new Low-Threshold Housing First Pilot Project, which will address 

service needs and housing instability for people with SUDs and/or CODs. This program will 

combine services that span the continuum of public health-focused harm reduction, treatment, and 

recovery supports with housing and intensive case management, delivered based on individualized 

needs assessments, at home and in the community. This request also includes $136.5 million for 

the Medication Assisted Treatment for Prescription Drug and Opioid Addiction program. 

SAMHSA expects to serve between 12,000 and 14,000 people with substance use disorders. 

 

The FY 2024 President’s Budget Request for the Strategic Prevention Framework for Prescription 

Drugs (SPF-Rx) is $140.5 million, an increase of $5.0 million from the FY 2023 Enacted level. 

This increase will advance primary prevention and provide services to underserved populations 

and decrease prescription drug misuse. 

 

The FY 2024 President’s Budget Request provides $13.1 million for Opioid Treatment Programs 

(OTPs)/Regulatory Activities. This is a $2.4 million increase from the FY 2023 Enacted level. 

The FY 2024 President’s Budget Request also provides $9.0 million for Emergency Department 

Alternatives to Opioids, an increase of $1.0 million from the FY 2023 Enacted level and maintains 

funding for several additional recovery-related programs to ensure continued programmatic 

improvement, including $9.0 million for the Addiction Technology Transfer Centers and $6.0 

million for Comprehensive Opioid Recovery Centers. 

The FY 2024 President’s Budget Request for Substance Use Services Targeted Capacity 

Expansion-General program is $157.9 million, an increase of $35.5 million from the FY 2023 

Enacted level. These funds will support $136.5 million for MAT for Prescription Drug and Opioid 

Addiction which is $25.5 million from the FY 2023 Enacted level. 
5 

The FY 2024 President’s Budget Request for Criminal Justice is $124.4 million, an increase of 

$31.0 million from the FY 2023 Enacted level. This includes $105 million for SAMHSA’s Drug 

Court Program, which is $31 million from the FY 2023 Enacted level. The Criminal Justice 

activities portfolio includes several grant programs that focus on diversion, alternatives to 

incarceration, drug courts, and re-entry from incarceration for adolescents and adults with alcohol 

and other drug use disorders and/or co-occurring alcohol and other drug use disorders and mental 

illness. This program supports the Adult Treatment Drug Court (ATDC), Family Treatment Drug 

Court (FTDC), and the Adult Reentry (AR) programs. 

The FY 2024 President’s Budget Request for Substance Use Services Targeted Capacity 

Expansion-General program is $157.9 million, an increase of $35.5 million from the FY 2023 

Enacted level. This additional funding includes $10 million to create an innovative pilot program 

to address housing needs for people with substance use disorder and those with other mental health 

conditions who are at risk for homelessness. This program will combine services that span the 

continuum of public health-focused harm reduction, treatment, and recovery supports with housing 

and intensive case management, delivered based on individualized needs assessments, at home 

and in the community. 

The President’s 2024 Budget Request includes $20 million for the Drug Abuse Warning Network 

a $7.0 million increase from the FY 2023 Enacted level, to expand data collection capacity and 

improve data collection on emergency department visits related to substance use. 

The 2024 President’s Budget Request for the Substance Use Prevention, Treatment, and Recovery 

Services Block Grant (SUPTRS BG) includes $2.7 billion, an increase of $700.0 million from the 

FY 2023 Enacted level. The goal of the SUPTRS BG program is to ensure that individuals, their 

families, and communities have access to the range of substance use-related prevention, treatment, 

public health interventions and recovery support services necessary to improve individual 

outcomes and reduce the impact of substance use on America’s communities. The Budget request 

includes a 10 percent set-aside within the SUPTRS BG for recovery support services to 

significantly expand the upstream and downstream continuum of care. The Budget request also 

uses Human Immunodeficiency Virus (HIV) cases as opposed to Acquired Immunodeficiency 

Syndrome (AIDS) cases to calculate the HIV-set aside.

The FY 2024 President’s Budget Request includes $2.0 billion for the State Opioid Response

(SOR) program, an increase of $425.0 million from the FY 2023 Enacted level. Of this amount, 

$75.0 million is set-aside for tribes. The budget request addresses the overdose crisis by providing 

resources to states and territories for increasing access to Food and Drug Administration (FDA)-

approved medications for the treatment of OUD, and for supporting the continuum of prevention, 

harm reduction, treatment, and recovery support services for OUD and other co-occurring SUDs. 

The SOR program also supports the continuum of care for stimulant misuse and use disorders, 

including for cocaine and methamphetamine. 

Enhancing Access to Suicide Prevention and Crisis Care

Suicide is a serious public health problem in the United States. After 2 consecutive years of 
6 

declines in suicide (47,511 in 2019 and 45,979 in 2020), 2021 data indicate an increase in suicide 

to 48,183, nearly returning to the 2018 peak (48,344) with an age-adjusted rate of 14.1 suicides 

per 100,000 population (versus 14.2 in 2018). Enhancing access to suicide prevention and crisis 

care is a priority for SAMHSA. By improving the nation’s efforts in this area, individuals 

experiencing suicidal ideation and other behavioral health crises can thrive and achieve wellbeing. 

The FY 2024 President’s Budget Request for SAMHSA’s suicide and crisis-related programs is 

$1.0 billion in total an increase of $417.4 million from the FY 2023 Enacted level. Within this 

level, the FY 2024 President’s Budget includes $836 million to support the 988 Suicide and Crisis 

Lifeline, an increase of $334.4 million from the FY 2023 Enacted level. This increase will fund 

local crisis call centers, support network operations, enable critical media campaigns, and maintain 

the 988 coordinating office operations. Additionally, funds within the network operations budget 

will be invested in services for specialized populations, including people who are LGBTQI+, and 

services for Spanish speakers. Also, the FY 2024 President’s Budget includes $100 million for 

the mobile crisis program, an increase of $80 million from the FY 2023 Enacted level. This critical 

investment will expand access to mobile crisis services so that individuals in communities across 

the country have someone to respond when a behavioral health crisis arises. The Community 

Mental Health Services Block Grant includes a 10 percent set-aside for crisis services. The setaside funds a set of core crisis care elements including centrally deployed 24/7 mobile crisis units, 

short-term residential crisis stabilization beds, evidence-based protocols for delivering services to 

individuals with suicide risk, and regional or State-wide crisis call centers coordinating in real 

time. SAMHSA continues to partner with states on the crisis set-aside through the provision of 

technical assistance on the use of funds, requests for information on specific allocations of funding 

across the crisis continuum of care, and recommended changes to the data reporting systems. 

The Mental Health Block Grant continues to represent a significant “safety net” source of funding 

for mental health services for some of the most at-risk populations across the country. The FY 

2024 President’s Budget includes $1.7 billion, is an increase of $645.0 million above FY 2023 

Enacted. 

SAMHSA also proposes permanent mandatory funding for Community Mental Health Centers 

(CMHCs) work to expand and improve the quality of services available to people with mental 

illness. The funding will be provided through 50 states and 6 territories by utilizing the Mental 

Health Block Grant formula. This request totals is $412.5 million annually, starting in 2024, and 

will be used to further develop the quality and continuum of behavioral health services in CMHCs, 

and expand access to crisis care, integrated care, and other recovery support services in 

communities across America. It is estimated that these services will directly benefit at least 20,000 

individuals per year, providing an improved level of treatment and support to meet the increase 

behavioral health services needs in local communities. SAMHSA is requesting that this be funded 

as a mandatory grant program. 

Certified Community Behavioral Health Clinics (CCBHCs) transform community behavioral 

health systems and provide comprehensive, coordinated behavioral health care. SAMHSA’s FY 

2024 Budget requests $552.5 million for the CCBHC Expansion program, which is a $167.5 

million increase above the FY 2023 Enacted level. This Budget proposes to establish an 

accreditation process which would ensure consistent adherence to the CCBHC model and create 
7 

capacity to confirm adherence to the criteria and the model. 

Promoting Resilience and Emotional Health for Children, Youth, and Families 

Nearly 1 in 5 young people had a diagnosable mental health condition, and 1 in 10 had a serious 

emotional disturbance that negatively impacted their ability to function at home, in school, or in 

the community1,2. In 2021, there were 2.2 million adolescents aged 12 to 17 with a SUD3, and 

death by suicide was the second leading cause of death for individuals ages 10-34 in the United 

States.4 Unfortunately, many young people do not receive the treatment supports they need. 

SAMHSA’s vision for youth behavioral health is that all children, youth, young adults, and their 

families thrive in their homes and communities. SAMHSA will achieve this through a tiered public 

health approach that matches each child with the right intervention at the right time by working 

upstream and acting early in the risk trajectory through a system of care. Significant investments 

are proposed that span the promotion, prevention, and treatment continuum and emphasize equity, 

trauma-informed approaches and recovery. 

The FY 2024 President’s Budget is $244.0 million, a $104.0 increase above the FY 2023 Enacted 

level for Project AWARE. The funding for this program will support Project AWARE State 

Grants, ReCAST grants, Trauma-Informed Services in Schools grants, and technical assistance on 

the provision of school-based mental health services. Additionally, this investment in Project 

AWARE will continue to expand access to broader populations, including college students and 

adults, as well as non-traditional settings. 

The FY 2024 President’s Budget for Mental Health Awareness Training (MHAT) is $64.0 million, 

a $36.0 million increase above the FY 2023 Enacted level. MHAT grants train school personnel, 

emergency first responders, law enforcement, veterans, armed services members, and their 

families how to recognize the signs and symptoms of mental disorders such as serious mental 

illness and/or SED. The budget will also expand eligible populations for this program to include 

college students and adults, and to broaden applicable settings for trainings to include noneducational, non-health care settings.

Project LAUNCH promotes the wellness of young children by addressing the physical, social, 

emotional, cognitive, and behavioral aspects of their development. The FY 2024 President’s 

Budget is $35.4 million, an increase of $9.8 million from the FY 2023 Enacted level. The proposed 

funding increase will provide continued screening, prevention, early intervention for behavioral 

health issues and referrals to high quality treatment for children and families in 30 communities 

across the U.S.

1 Bitsko RH, Claussen AH, Lichstein J, et al. Mental Health Surveillance Among Children - United States, 2013-2019. 

MMWR Suppl. Feb 25 2022;71(2):1-42. 2 Williams NJ, Scott L, Aarons GA. Prevalence of Serious Emotional Disturbance Among U.S. Children: A MetaAnalysis. Psychiatr Serv. Jan 1 2018;69(1):32-40. 3 Center for Behavioral Health Statistics and Quality. https://www.samhsa.gov/data/sites/default/files/2022-

12/2021NSDUHFFRHighlights092722.pdf Accessed February 13, 2023.

4

National Institute of Mental Health. Suicide. National Institute of Mental Health. Available at: 

https://www.nimh.nih.gov/health/statistics/suicide#part_2585. Accessed August 15, 2022. 
8 

The FY 2024 President’s Budget is $46.9 million for Tribal Behavioral Health Grants, an increase 

of $500,000 above the FY 2023 Enacted level. Consistent with the goals of the Tribal Behavioral 

Health Agenda, this program addresses the high incidence of substance use and suicide among 

tribal populations. The increase will further support tribal entities with the highest rates of suicide 

by providing effective and promising strategies that address substance use, trauma, and suicide 

and by promoting the mental health of Native American youth. 

The FY 2024 President’s Budget is $37.5 million for Infant and Early Childhood Mental Health 

which is an increase of $22.5 million above the FY 2023 Enacted level. This grant program seeks 

improve outcomes for children, from birth to 12 years of age, who are at risk for, show early signs 

of, or have been diagnosed with a mental illness, including a serious emotional disturbance (SED). 

This funding will increase access to a range of evidence-based and culturally appropriate infant 

and early childhood mental health services. 

The National Child Traumatic Stress Network (NCTSN) is a national network of grantees who 

develop and promote effective community practices for children and adolescents exposed to a wide 

array of traumatic events. The President’s FY 2024 Budget Request is $150.0 million for the 

National Child Traumatic Stress Initiative, an increase of $56.1 million above the FY 2023 

Enacted level. The Budget will support the NCTSN efforts to improve of mental disorder 

treatment, services, and interventions for children and adolescents exposed to traumatic events. 

The Healthy Transitions program provides grants to states and Tribes to improve access to mental 

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

or are at risk of developing, a serious mental health condition. The FY 2024 President’s Budget is 

$61.4 million for Healthy Transitions, an increase of $30.9 million above the FY 2023 Enacted

level. 

 

The Children’s Mental Health Initiative (CMHI) provides "systems of care" (SOC) for children 

and youth with SED and their families. The FY 2024 President’s Budget is $225.0 million for 

Children’s Mental Health Services, a $95.0 million increase above the FY 2023 Enacted level. 

This funding would increase access to services to prevent the development of psychosis for youth 

and young adults who are identified to be at clinical high risk for developing a first episode of 

psychosis. 

The FY 2024 Budget is $49.4 million for the Pregnant and Postpartum Women (PPW) program, a 

$10.5 million increase from the FY 2023 Enacted level. The PPW program uses a family-centered 

approach to provide comprehensive residential substance use disorder treatment, prevention, and 

recovery support services for pregnant and postpartum women, their minor children, and other 

family members. The proposed increase will provide an array of services and supports to pregnant 

women and their families. 
9 

Integrating Behavioral and Physical Health Care 

Improving health holistically for people with behavioral health conditions can be addressed 

through the integration of behavioral and physical healthcare to improve comprehensive care in 

all settings. A whole-person approach considers the individual at the center of care regardless of 

treatment setting, integrates their goals and priorities into a person-centered care plan, is culturally 

informed and appropriate, and aims for the creation of health and well-being – not just the absence 

of disease. A key to achieving a whole-person care approach is advancing the bi-directional 

integration of behavioral health with all other health care services and systems. 

SAMHSA is committed to advancing the bi-directional integration of behavioral health with all 

other health care services and systems. Programs that will help us achieve this goal include the 

Primary and Behavioral Health Care Integration (PBHCI) Grant program. The FY 2024 

President’s Budget for the PBHCI program is $102.9 million, an increase of $47.0 million above 

the FY 2023 Enacted level. 

Strengthening the Behavioral Health Workforce 

Growing the nation’s workforce of mental health and SUD providers is critical to providing 

Americans with access to essential health care services. Prior to the pandemic, there was already 

a projected shortage of behavioral health care providers, with acute shortages predicted for 

psychiatrists and addiction counselors through 2030. 5

SAMHSA’s Minority Fellowship Program (MFP) aims to reduce health disparities and improve 

behavioral health care outcomes for minority populations. The FY 2024 President’s Budget is 

$36.7 million, an increase of $17.2 million above the FY 2023 Enacted level. The proposed 

doubling of the MFP will significantly advance access to care. This proposal will provide 

additional mentoring opportunities and pathways for individuals from minority communities to 

further diversify the behavioral health workforce. The Budget also proposes to add a service 

requirement to ensure participants are supporting communities in need, as well as to add addiction 

medicine, and sexual and gender minority populations as participants in the Minority Fellowship 

Program. 

SAMHSA’s FY 2024 President’s Budget Request is $15.8 million for Mental Health Practice 

Improvement and Training efforts, an increase of $8.0 million above the FY 2023 Enacted level. 

This increase creates a training pipeline from institutions of higher education that reach 

underserved populations. This proposed investment will build upon the existing Historically Black 

Colleges and Universities Center of Excellence.

The Projects for Assistance in Transition from Homelessness (PATH) program addresses this issue 

through local homeless outreach workers who provide sustained engagement and trust building

with the population of individuals with SMI or SMI and a co-occurring SUD experiencing 

homelessness, many of whom are chronically homeless. The FY 2024 Budget Request for the 

PATH program is $109.6 million, an increase of $43.0 million above the FY 2023 Enacted level. 

5 Health Resources and Services Administration. Behavioral Health Workforce Projections, 2017 – 2030. Behavioral 

Health Workforce Projections, 2017-2030: (hrsa.gov). 
10 

The increase will ensure the program is sufficiently funded to meet the intended level of service 

of this formula grant and restore the number of providers to 2012 levels and result in contacting 

212,000 individuals. 

SAMHSA’s FY 2024 President’s Budget for the Center for the Application of Prevention 

Technologies is $12.0 million, an increase of $2.5 million above the FY 2023 Enacted level. The 

increase in funding will be used for the Prevention Fellowship program – approximately 20 fellows 

will be chosen for a new FY 2024 cohort, allowing them to spend one year in intensive training. 

Individuals with a mental illness are more likely to experience homelessness than those without 

mental illness, and they experience homelessness longer than the rest of the homeless population. 

Conclusion 

SAMHSA’s FY 2024 President’s Budget Request is central to advancing President Biden’s Unity 

Agenda. Through new programs and increased investments to prevent overdose; enhance access 

to suicide prevention and crisis care; promote resilience and emotional health for children, youth, 

and families; integrate behavioral and physical health care; and strengthening the behavioral health 

workforce, SAMHSA will ensure people with, affected by, or at risk for mental health and 

substance use conditions receive care, thrive, and achieve wellbeing. 
11 

Overview of Performance

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

Substance use And Mental Health Services Administration (SAMHSA) continues to refine its use 

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

reviews help SAMHSA leadership analyze outcome data and learn the extent to which strategies 

work or need improvement. As impact is measured and reported, SAMHSA seeks to identify the 

conditions that foster success, address barriers, enable collaboration across programs, and promote 

overall efficiency. 

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

services programs include diagnoses, abstinence from substance use, mental health functioning, 

overall physical health, criminal justice involvement, stable housing, social connectedness, and 

employment. Data is also collected on the number of people served, the number trained, and the 

number of training events held. 

Additionally, SAMHSA collects data on key measures to monitor and manage discretionary grant 

performance, improve the quality of treatment, prevention, and mental health services. Data 

collected are in line with the Government Performance and Results Act (GPRA). SAMHSA 

grantees submit these data into the SAMHSA Performance Accountability and Reporting System 

(SPARS). Data collected and analyzed through SPARS allow SAMHSA to monitor the progress 

of discretionary grants, support data-informed decision-making for funding, and provide an 

understanding of the services delivered through the programs. 

SAMHSA implements the requirements of 21st Century Cures Act through continuously 

monitoring key performance. Monitoring staff work with SAMHSA Center and Program Officers 

to enhance the system to be more user friendly with greater data visualization strategies. 

The Center for Behavioral Health Statistics and Quality’s (CBHSQ) Office of Evaluation (OE) is 

responsible for providing centralized planning and management of program evaluation and 

performance management activity across SAMHSA. In this role, OE provides support and 

oversight to SAMHSA’s centers by supporting evaluation proposals, performance management 

and monitoring and quality improvement activities. 

Additionally, SAMHSA established an Evidence and Evaluation Board (SEEB) comprised of 

representative from all Centers and Offices. The purpose the SEEB is to serve as the agency’s 

principal evaluation and evidence forum for managing SAMHSA’s evaluation portfolio, 

evaluation and evidence data, and as a strategic asset to support the agency in meeting its mission 

and agency priorities, including implementation of the Evidence Act. 
12 

All-Purpose Table

(Dollars in millions) FY 2022 FY 2023 FY 2024 CJ

Final Enacted President's 

Budget

FY 2024 +/- 

FY 2023

CMHS

Programs of Regional and National Significance $577.616 $1,044.033 $1,778.269 $734.236 

National Child Traumatic Stress Network 81.887 93.887 150.000 56.113 

Assisted Outpatient Treatment for Individuals with SMI 21.420 21.420 21.420 -- 

Children's Mental Health Services 125.000 130.000 225.000 95.000 

Community Violence Pilot (non-add) -- -- -- -- 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add) 12.500 13.000 22.500 9.500 

Projects for Assistance in Transition from Homelessness 64.635 66.635 109.635 43.000 

Protection and Advocacy for Individuals with Mental Illness 38.000 40.000 40.000 -- 

Community Mental Health Centers -- -- 412.500 412.500 

Community Mental Health Services Block Grant 857.571 1,007.571 1,652.571 645.000 

Budget Authority (non-add) 836.532 986.532 1,631.532 645.000 

PHS Evaluation Funds (non-add) 21.039 21.039 21.039 -- 

Certified Community Behavioral Health Clinics 315.000 385.000 552.500 167.500 

Total, Mental Health 2,081.129 2,788.546 4,941.895 2,153.349 

Budget Authority (non-add) 2,048.090 2,755.507 4,496.356 1,740.849 

Prevention and Public Health Fund (non-add) 12.000 12.000 12.000 -- 

PHS Evaluation Funds (non-add) 21.039 21.039 21.039 -- 

Community Mental Health Centers -- -- 412.500 412.500 

CSUPS

Programs of Regional and National Significance 218.219 236.879 245.738 8.859 

Subtotal, Programs of Regional and National Significance 218.219 236.879 245.738 8.859 

Total, Substance Use Prevention Services 218.219 236.879 245.738 8.859 

Budget Authority (non-add) 218.219 236.879 245.738 8.859 

CSUS

Programs of Regional and National Significance 521.517 574.219 755.008 180.789 

State Opioid Response Grants 1,525.000 1,575.000 2,000.000 425.000 

Set-Aside for Tribes (non-add) 55.000 55.000 75.000 20.000 

Substance Use Prevention, Treatment, and Recovery Services Block Grant 1,908.079 2,008.079 2,708.079 700.000 

Budget Authority (non-add) 1,828.879 1,928.879 2,628.879 700.000 

PHS Evaluation Funds (non-add) 79.200 79.200 79.200 -- 

Total, Substance Use Services 3,954.596 4,157.298 5,463.087 1,305.789 

SAT Budget Authority (non-add) 3,873.396 4,076.098 5,381.887 1,305.789 

SAT PHS Evaluation Funds (non-add) 81.200 81.200 81.200 -- 

Health Surveillance and Program Support

Health Surveillance and Program Support 130.123 135.123 137.795 2.672 

Program Support 81.500 84.500 84.500 -- 

Health Surveillance (non-add) 48.623 50.623 53.295 2.672 

Budget Authority (non-add) 18.195 20.195 22.867 2.672 

PHS Evaluation Funds (non-add) 30.428 30.428 30.428 -- 

Subtotal, Health Surveillance and Program Support 130.123 135.123 137.795 2.672 

Congressional Earmarks 127.535 160.777 -- -160.777 

Data Request and Publications User Fees 1.500 1.500 1.500 -- 

Public Awareness and Support 13.000 13.260 13.260 -- 

Budget Authority (non-add) 13.000 13.260 13.260 -- 

Performance and Quality Information Systems 10.000 10.200 10.200 -- 

Budget Authority (non-add) 10.000 10.200 10.200 -- 

Behavioral Health Workforce Data and Development 1.000 1.000 1.000 -- 

PHS Evaluation Funds (non-add) 1.000 1.000 1.000 -- 

Drug Abuse Warning Network 10.000 13.000 20.000 7.000 

Total, Health Surveillance and Program Support 293.158 334.860 183.755 -151.105 

HSPS Budget Authority (non-add) 260.230 301.932 150.827 -151.105 

HSPS PHS Evaluation Funds (non-add) 31.428 31.428 31.428 -- 

Data Request and Publications User Fees(non-add) 1.500 1.500 1.500 -- 

TOTAL, SAMHSA Program Level 6,547.102 7,517.583 10,834.475 3,316.892 

Nonrecurring Expenses Fund (NEF) -- -- -- -- 

Less Funds from Other Sources:

Community Mental Health Centers -- -- -412.500 -412.500 

Prevention and Public Health Fund (non-add) -12.000 -12.000 -12.000 -- 

PHS Evaluation Funds -133.667 -133.667 -133.667 -- 

Data Request and Publications User Fees -1.500 -1.500 -1.500 -- 

TOTAL, SAMHSA Budget Authority 6,399.935 7,370.416 10,274.808 2,904.392 

TOTAL, SAMHSA FTE 577 725 865 140 
13 

Budget Exhibits

Table of Contents

Budget Exhibits ........................................................................................................................... 13

Appropriation Language Guidelines ................................................................................. 14

Language Analysis ............................................................................................................ 19

Amounts Available for Obligation.................................................................................... 26

Summary of Changes ........................................................................................................ 27

Budget Authority by Activity ........................................................................................... 28

Authorizing Legislation .................................................................................................... 29

Appropriations History ..................................................................................................... 32

Appropriations Not Authorized by Law ........................................................................... 33
14 

Appropriation Language Guidelines

MENTAL HEALTH

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

and Advocacy for Individuals with Mental Illness Act, and the SUPPORT for Patients and 

Communities Act, [$2,693,507,000] $4,496,356,000: Provided, That of the funds made available 

under this heading, [$93,887,000] $150,000,000 shall be for the National Child Traumatic Stress 

Initiative: Provided further, That notwithstanding section 520A(f)(2) of the PHS Act, no funds 

appropriated for carrying out section 520A shall be available for carrying out section 1971 of the 

PHS Act: Provided further, That in addition to amounts provided herein, $21,039,000 shall be 

available under section 241 of the PHS Act to supplement funds otherwise available for mental 

health activities and to carry out subpart I of part B of title XIX of the PHS Act to fund section 

1920(b) technical assistance, national data, data collection and evaluation activities, and further 

that the total available under this Act for section 1920(b) activities shall not exceed 5 percent of 

the amounts appropriated for subpart I of part B of title XIX: Provided further, That of the funds 

made available under this heading for subpart I of part B of title XIX of the PHS Act, [at least 5 

percent] not less than 10 percent shall be available to support evidence-based crisis systems: 

Provided further, That up to 10 percent of the amounts made available to carry out the Children's 

Mental Health Services program may be used to carry out demonstration grants or contracts for 

early interventions with persons not more than 25 years of age at clinical high risk of developing 

a first episode of psychosis[: Provided further, That section 520E(b)(2) of the PHS Act shall not 

apply to funds appropriated in this Act for fiscal year 2023]: Provided further, That 

[$385,000,000]$552,500,0000 shall be available until September 30, [2025] 2026 for grants to 

communities and community organizations who meet criteria for Certified Community Behavioral 

Health Clinics pursuant to section 223(a) of Public Law 113–93: Provided further, That none of 

the funds provided for section 1911 of the PHS Act shall be subject to section 241 of such Act: 

Provided further, That of the funds made available under this heading, $21,420,000 shall be to 

carry out section 224 of the Protecting Access to Medicare Act of 2014 (Public Law 113–93; 42 

U.S.C. 290aa 22 note). Provided further, That notwithstanding sections 1911(b) and 1912 of the 

PHS Act, amounts made available under this heading for subpart I of part B of title XIX of such 

Act shall also be available to support evidence-based programs that address early intervention 

and prevention of mental disorders among at-risk children and adults: Provided further, That each 

State shall expend at least 10 percent of the amount it receives for carrying out section 1911 of the 

PHS Act to support evidence-based programs that address early intervention and prevention of 

mental disorders for at-risk youth and adults: Provided further, That notwithstanding section 1912 

of the PHS Act, the plan described in such section and section 1911(b) of the PHS Act shall also 

include the evidence-based programs described in the previous proviso pursuant to plan criteria 

established by the Secretary.
15 

SUBSTANCE [ABUSE TREATMENT] USE SERVICES

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

and title XIX of such Act with respect to substance [abuse] use treatment and prevention, section 

1003 of the 21st Century Cures Act, and the SUPPORT for Patients and Communities Act, 

[$4,076,098,000] $5,381,887,000: Provided, That [$1,575,000,000] $2,000,000,000 shall be for

[State Opioid Response Grants for carrying out activities pertaining to opioids and stimulants 

undertaken by the State agency responsible for administering the substance abuse prevention and 

treatment block grant under subpart II of part B of title XIX of the PHS Act (42 U.S.C. 300x–21 

et seq.)] carrying out section 1003 of the 21st Century Cures Act: Provided further, That of such 

amount [$55,000,000] $75,000,000 shall be made available to Indian Tribes or tribal 

organizations[: Provided further, That 15 percent of the remaining amount shall be for the States 

with the highest mortality rate related to opioid use disorders: Provided further, That in allocating 

the amount made available in the preceding proviso, the Secretary shall ensure that the formula 

avoids a significant cliff between States with similar overdose mortality rates to prevent unusually 

large funding changes in States when compared to prior year allocations: Provided further, That 

of the amounts provided for State Opioid Response Grants not more than 2 percent shall be 

available for Federal administrative expenses, training, technical assistance, and evaluation]: 

Provided further, That of the amount not reserved by the previous [four] provisos, the Secretary 

shall make allocations to States, territories, and the District of Columbia according to a formula 

using [national survey results] data that the Secretary determines [are] to be the most objective 

and reliable measure of drug use and drug-related deaths[: Provided further, That the Secretary 

shall submit the formula methodology to the Committees on Appropriations of the House of 

Representatives and the Senate not less than 21 days prior to publishing a Funding Opportunity 

Announcement]: Provided further, That prevention and treatment activities funded through such 

grants may include education, treatment (including the provision of medication), behavioral health 

services for individuals in treatment programs, referral to treatment services, recovery support, and 

medical screening associated with such treatment[: Provided further, That each State, as well as 

the District of Columbia, shall receive not less than $4,000,000]: Provided further, That in addition 

to amounts provided herein, the following amounts shall be available under section 241 of the PHS 

Act: (1) $79,200,000 to supplement funds otherwise available for substance use treatment 

activities and to carry out subpart II of part B of title XIX of the PHS Act to fund section 1935(b) 

technical assistance, national data, data collection and evaluation activities, and further that the 

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

amounts appropriated for subpart II of part B of title XIX; and (2) $2,000,000 to evaluate substance 

[abuse] use treatment programs: Provided further, That for purposes of calculating the HIV setaside under subpart II of part B of title XIX, the rate of cases of HIV shall be used instead of the 

rate of cases of AIDS: Provided further, That each State that receives funds appropriated under 

this heading in this Act for carrying out subpart II of part B of title XIX of the PHS Act shall expend 

not less than 10 percent of such funds for recovery support services: Provided further, That none 

of the funds provided for section 1921 of the PHS Act or State Opioid Response Grants shall be 

subject to section 241 of such Act. 
16 

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

[$236,879,000] $245,738,000. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

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

headings "Mental Health", "Substance [Abuse Treatment] Use Services", and "Substance [Abuse] 

Use Prevention Services" in carrying out titles III, V, and XIX of the PHS Act and the Protection 

and Advocacy for Individuals with Mental Illness Act in the Substance [Abuse] use And Mental 

Health Services Administration, [$301,932,000] $150,827,000: Provided, That [of the amount 

made available under this heading, $160,777,000 shall be used for the projects, and in the amounts, 

specified in the table titled "Community Project Funding/Congressionally Directed Spending" 

included for this division in the explanatory statement described in section 4 (in the matter 

preceding division A of this consolidated Act): Provided further, That none of the funds made 

available for projects described in the preceding proviso shall be subject to section 241 of the PHS 

Act or section 205 of this Act: Provided further, That] in addition to amounts provided herein, 

$31,428,000 shall be available under section 241 of the PHS Act to supplement funds available to 

carry out national surveys on drug abuse and mental health, to collect and analyze program data, 

and to conduct public awareness and technical assistance activities: Provided further, That, in 

addition, fees may be collected for the costs of publications, data, data tabulations, and data 

analysis completed under title V of the PHS Act and provided to a public or private entity upon 

request, which shall be credited to this appropriation and shall remain available until expended for 

such purposes: Provided further, That amounts made available in this Act for carrying out section 

501(o) of the PHS Act shall remain available through September 30, [2024] 2025: Provided 

further, That funds made available under this heading (other than amounts specified in the first 

proviso under this heading) may be used to supplement program support funding provided under 

the headings "Mental Health", "Substance [Abuse Treatment] Use Services", and "Substance 

[Abuse] Use Prevention Services”. 
17 

General Provisions 

SEC. 240. (a) The Public Health Service Act (42 U.S.C. 201 et seq.) is amended – 

(1) by striking "Substance Abuse and Mental Health Services Administration" each place it 

appears and inserting "Substance use And Mental Health Services Administration"; 

(2) by striking "Center for Substance Abuse Treatment" each place it appears and inserting 

"Center for Substance Use Services"; and 

(3) by striking "Center for Substance Abuse Prevention" each place it appears and inserting 

"Center for Substance Use Prevention Services".

 (b) Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended – 

(1) in the title heading, by striking "SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION" and inserting "SUBSTANCE USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; 

(2) in section 501 – 

(A) in the section heading, by striking "SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION" and inserting "SUBSTANCE USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; and 

(B) in subsection (a), by striking "(hereafter referred to in this title as the Administration)" and 

inserting "(hereafter referred to in this title as SAMHSA or the Administration)"; 

(3) in section 507, in the section heading, by striking "CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR SUBSTANCE USE SERVICES"; 

(4) in section 513(a), in the subsection heading, by striking "CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR SUBSTANCE USE SERVICES"; and 

(5) in section 515, in the section heading, by striking "CENTER FOR SUBSTANCE ABUSE 

PREVENTION" and inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

(c) Section 1932(b)(3) of the Public Health Service Act (42 U.S.C. 300x–32(b)(3)) is amended in 

the paragraph heading by striking "CENTER FOR SUBSTANCE ABUSE PREVENTION" and 

inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

(d) Section 1935(b)(2) of the Public Health Service Act (42 U.S.C. 300x–35(b)(2)) is amended in 

the paragraph heading by striking "CENTER FOR SUBSTANCE ABUSE PREVENTION" and 

inserting "CENTER FOR SUBSTANCE USE PREVENTION SERVICES". 

(e) The Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 

2401 et seq.) is amended by striking "Substance Abuse and Mental Health Services 

Administration" each place it appears and inserting "Substance use And Mental Health Services 
18 

Administration". 

(f) The Social Security Act is amended in sections 1861, 1866F, and 1945 (42 U.S.C. 1395x, 

1395cc–6, 1396w–4) by striking "Substance Abuse and Mental Health Services Administration" 

each place it appears and inserting "Substance use And Mental Health Services Administration". 

(g) Section 105(a)(7)(C)(i)(III) of the Child Abuse Prevention and Treatment Act (42 U.S.C. 

5106(a)(7)(C)(i)(III)) is amended by striking "Substance Abuse and Mental Health Services 

Administration" and inserting "Substance use And Mental Health Services Administration". 

(h)

(1) Except as provided in paragraph (2), any reference in any law, regulation, map, document, 

paper, or other record of the United States to the Substance Abuse and Mental Health Services 

Administration, the Center for Substance Abuse Treatment of Such Administration, or the Center 

for Substance Abuse Prevention of such Administration shall be considered to be a reference to 

the Substance use And Mental Health Services Administration, the Center for Substance Use 

Services of such Administration, or the Center for Substance Use Prevention Services of such 

Administration, respectively. 

(2) Paragraph (1) shall not be construed to alter or affect section 6001(d) of the 21st Century 

Cures Act (42 U.S.C. 290aa note), providing that a reference to the Administrator of the Substance 

Abuse and Mental Health Services Administration shall be construed to be a reference to the 

Assistant Secretary for Mental Health and Substance Use. 
19 

Language Analysis 

Language Provision Explanation 

Provided further, That notwithstanding section 

520A(f)(2) of the PHS Act, no funds appropriated 

for carrying out section 520A shall be available for 

carrying out section 1971 of the PHS Act: Provided 

further, That in addition to amounts provided herein, 

$21,039,000 shall be available under section 241 of 

the PHS Act to supplement funds otherwise 

available for mental health activities and to carry 

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

to fund section 1920(b) technical assistance, 

national data, data collection and evaluation 

activities, and further that the total available under 

this Act for section 1920(b) activities shall not 

exceed 5 percent of the amounts appropriated for 

subpart I of part B of title XIX:

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority for 

programs for mental health activities and 

programs authorized under titles XIX as 

well as under tit III and V. 

Provided further, That of the funds made available 

under this heading for subpart I of part B of title XIX 

of the PHS Act, [at least 5 percent] not less than 10 

percent shall be available to support evidence-based 

crisis systems:

Increases the set-aside in the Community 

Mental Health Services Block Grant for 

crisis services to 10 percent. 

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

PHS Act shall not apply to funds appropriated in this 

Act for fiscal year 2023

Language not necessary as States cannot 

hold more than one grant at any time. 
20 

Language Provision Explanation 

Provided further, That notwithstanding sections 

1911(b) and 1912 of the PHS Act, amounts made 

available under this heading for subpart I of part B 

of title XIX of such Act shall also be available to 

support evidence-based programs that address early 

intervention and prevention of mental disorders 

among at-risk children and adults: Provided further, 

That States shall expend at least 10 percent of the 

amount each receives for carrying out section 1911 

of the PHS Act to support evidence-based programs 

that address early intervention and prevention of 

mental disorders for at-risk youth and adults: 

Provided further, That notwithstanding section 1912 

of the PHS Act, the plan described in such section 

and section 1911(b) of the PHS Act shall also 

include the evidence-based programs described in 

the previous proviso pursuant to plan criteria 

established by the Secretary.

Includes a 10-percent set-aside for 

evidence-based programs that address 

early intervention and prevention of 

mental disorders for at-risk youth and 

adults. 

For carrying out titles III and V of the PHS Act with 

respect to substance [abuse] use treatment and title 

XIX of such Act with respect to substance [abuse] 

use treatment and prevention, section 1003 of the 

21st Century Cures Act, and the SUPPORT for 

Patients and Communities Act, [$4,076,098,000] 

$5,381,887,000:

Adds authorization of the State Opioid 

Response program. 

Provided, That [$1,575,000,000] $2,000,000,000 shall 

be for [State Opioid Response Grants for carrying out 

activities pertaining to opioids and stimulants undertaken 

by the State agency responsible for administering the 

substance abuse prevention and treatment block grant 

under subpart II of part B of title XIX of the PHS Act (42 

U.S.C. 300x–21 et seq.)] carrying out section 1003 of the 

21st Century Cures Act: Provided further, That of such 

amount [$55,000,000] $75,000,000 shall be made 

available to Indian Tribes or tribal organizations[: 

Provided further, That 15 percent of the remaining 

amount shall be for the States with the highest mortality 

rate related to opioid use disorders: Provided further, 

Adds authorization of the State Opioid 

Response program as amended by 

Section 1273 of the Consolidated 

Appropriations Act, 2023 and removes 

duplicative language. Set-aside $75 

million for the Tribal Opioid Response 

program. Provides increased flexibility 

to use the most accurate data. 
21 

Language Provision Explanation 

That in allocating the amount made available in the 

preceding proviso, the Secretary shall ensure that the 

formula avoids a significant cliff between States with 

similar overdose mortality rates to prevent unusually 

large funding changes in States when compared to prior 

year allocations: Provided further, That of the amounts 

provided for State Opioid Response Grants not more than 

2 percent shall be available for Federal administrative 

expenses, training, technical assistance, and evaluation]: 

Provided further, That of the amount not reserved by the 

previous [four] provisos, the Secretary shall make 

allocations to States, territories, and the District of 

Columbia according to a formula using [national survey 

results] data that the Secretary determines [are] to be the 

most objective and reliable measure of drug use and 

drug-related deaths[: Provided further, That the 

Secretary shall submit the formula methodology to the 

Committees on Appropriations of the House of 

Representatives and the Senate not less than 21 days prior 

to publishing a Funding Opportunity Announcement]: 

Provided further, That prevention and treatment 

activities funded through such grants may include 

education, treatment (including the provision of 

medication), behavioral health services for individuals in 

treatment programs, referral to treatment services, 

recovery support, and medical screening associated with 

such treatment[: Provided further, That each State, as 

well as the District of Columbia, shall receive not less 

than $4,000,000]:

Provided further, That in addition to amounts 

provided herein, the following amounts shall be 

available under section 241 of the PHS Act: (1) 

$79,200,000 to supplement funds otherwise 

available for substance use treatment activities and

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

PHS Act to fund section 1935(b) technical 

assistance, national data, data collection and 

evaluation activities, and further that the total 

available under this Act for section 1935(b) 

activities shall not exceed 5 percent of the amounts 

appropriated for subpart II of part B of title XIX; and 

(2) $2,000,000 to evaluate substance [abuse] use

treatment programs:

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority 

available for programs and activities 

authorized under title XIX, titles III and 

V, and substance abuse treatment 

activities. 
22 

Language Provision Explanation 

Provided further, That for purposes of calculating 

the HIV set-aside under subpart II of part B of title 

XIX, the rate of cases of HIV shall be used instead 

of the rate of cases of AIDS: 

Uses HIV cases as opposed to AIDS 

cases to calculate the HIV set-aside in the 

Substance Use Prevention, Treatment, 

and Recovery Services Block Grant. 

Provided further, That each State that receives funds 

appropriated under this heading in this Act for 

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

PHS Act shall expend not less than 10 percent of 

such funds for recovery support services: 

Sets-aside 10 percent of the Substance 

Use Prevention, Treatment, and 

Recovery Services Block Grant for 

recovery support services. 

For program support and cross-cutting activities 

that supplement activities funded under the 

headings "Mental Health", "Substance [Abuse 

Treatment] Use Services", and "Substance [Abuse 

Prevention] Use Prevention" in carrying out titles 

III, V, and XIX of the PHS Act and the Protection 

and Advocacy for Individuals with Mental Illness 

Act in the Substance [Abuse] Use and Mental 

Health Services Administration, [$301,932,000] 

$150,827,000: 

Updates names of SAMHSA accounts.

[Provided, That of the amount made available 

under this heading, $160,777,000 shall be used for 

the projects, and in the amounts, specified in the 

table titled "Community Project 

Funding/Congressionally Directed Spending" 

included for this division in the explanatory 

statement described in section 4 (in the matter 

preceding division A of this consolidated Act): 

Provided further, That none of the funds made 

available for projects described in the preceding 

proviso shall be subject to section 241 of the PHS 

Act or section 205 of this Act]

Funding for this activity is not included 

in the Budget. 
23 

Language Provision Explanation 

SEC. 245. (a) The Public Health Service Act (42 

U.S.C. 201 et seq.) is amended – 

(1) by striking "Substance Abuse and Mental 

Health Services Administration" each place it 

appears and inserting "Substance use And Mental 

Health Services Administration"; 

(2) by striking "Center for Substance Abuse 

Treatment" each place it appears and inserting 

"Center for Substance Use Services"; and 

(3) by striking "Center for Substance Abuse 

Prevention" each place it appears and inserting 

"Center for Substance Use Prevention Services". 

(b) Title V of the Public Health Service Act (42 

U.S.C. 290aa et seq.) is amended – 

(1) in the title heading, by striking "SUBSTANCE 

ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION" and inserting "SUBSTANCE 

USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; 

(2) in section 501 – 

(A) in the section heading, by striking "SUBSTANCE 

ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION" and inserting "SUBSTANCE 

USE AND MENTAL HEALTH SERVICES 

ADMINISTRATION"; and 

(B) in subsection (a), by striking "(hereafter referred 

to in this title as the Administration)" and inserting 

"(hereafter referred to in this title as SAMHSA or the 

Administration)"; 

(3) in section 507, in the section heading, by striking 

"CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR 

SUBSTANCE USE SERVICES"; 

Changes the name of the Substance 

Abuse and Mental Health Services 

Administration to the Substance use And 

Mental Health Services Administration.

Changes the name of the Center for 

Substance Abuse Treatment to the 

Center for Substance Use Services.

Changes the name of the Center for 

Substance Abuse Prevention to the 

Center for Substance Use Prevention 

Services.
24 

Language Provision Explanation 

(4) in section 513(a), in the subsection heading, by 

striking "CENTER FOR SUBSTANCE ABUSE 

TREATMENT" and inserting "CENTER FOR 

SUBSTANCE USE SERVICES"; and 

(5) in section 515, in the section heading, by striking 

"CENTER FOR SUBSTANCE ABUSE 

PREVENTION" and inserting "CENTER FOR 

SUBSTANCE USE PREVENTION SERVICES". 

(c) Section 1932(b)(3) of the Public Health Service 

Act (42 U.S.C. 300x–32(b)(3)) is amended in the 

paragraph heading by striking "CENTER FOR 

SUBSTANCE ABUSE PREVENTION" and inserting 

"CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES". 

(d) Section 1935(b)(2) of the Public Health Service 

Act (42 U.S.C. 300x–35(b)(2)) is amended in the 

paragraph heading by striking "CENTER FOR 

SUBSTANCE ABUSE PREVENTION" and inserting 

"CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES". 

(e) The Indian Alcohol and Substance Abuse 

Prevention and Treatment Act of 1986 (25 U.S.C. 

2401 et seq.) is amended by striking "Substance 

Abuse and Mental Health Services Administration" 

each place it appears and inserting "Substance use 

And Mental Health Services Administration". 

(f) The Social Security Act is amended in sections 

1861, 1866F, and 1945 (42 U.S.C. 1395x, 1395cc–

6, 1396w–4) by striking "Substance Abuse and 

Mental Health Services Administration" each place 

it appears and inserting "Substance use And Mental 

Health Services Administration". 

(g) Section 105(a)(7)(C)(i)(III) of the Child Abuse 

Prevention and Treatment Act (42 U.S.C. 

5106(a)(7)(C)(i)(III)) is amended by striking 

"Substance Abuse and Mental Health Services 

Administration" and inserting "Substance use And 

Mental Health Services Administration". 
25 

Language Provision Explanation 

(h) Except as provided in paragraph (2), any 

reference in any law, regulation, map, document, 

paper, or other record of the United States – 

(1) to the Substance Abuse and Mental Health 

Services Administration shall be considered to be a 

reference to the Substance use And Mental Health 

Services Administration; 

(2) to the Center for Substance Abuse Treatment of 

such Administration shall be treated as a reference 

to the Center for Substance Use Services of such 

Administration; and 

(3) to the Center for Substance Abuse Prevention of 

such Administration shall be treated as a reference 

to the Center for Substance Use Prevention Services 

of such Administration. 

(i) Paragraph (1) shall not be construed to alter or 

affect section 6001(d) of the 21st Century Cures Act 

(42 U.S.C. 290aa note), providing that a reference 

to the Administrator of the Substance Abuse and 

Mental Health Services Administration shall be 

construed to be a reference to the Assistant 

Secretary for Mental Health and Substance Use.
26 

Amounts Available for Obligation 

(Whole dollars)

FY 2022

 Final

FY 2023

Enacted

FY 2024

President's Budget

General Fund Discretionary Appropriation: 

Appropriation................................................. $6,399,934,998 $7,370,416,000 $10,274,808,000 

Across-the-board reductions................................ --- --- --- 

Subtotal, Appropriation ................................. 6,399,934,998 7,370,416,000 10,274,808,000 

Rescission .................................................... --- --- --- 

Subtotal, adjusted appropriation........................ 6,399,934,998 7,370,416,000 10,274,808,000 

Total, Discretionary Appropriation.............. 6,399,934,998 7,370,416,000 10,274,808,000 

Mandatory Appropriation: 

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

Community Mental Health Centers (CMHC)........... --- --- 412,500,000 

Subtotal, adjusted mandatory appropriation......... 12,000,000 12,000,000 424,500,000 

Offsetting collections from: 

Federal Source.................................................. 133,667,000 133,667,000 133,667,000 

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

Unobligated balance, start of year........................... --- --- --- 

Unobligated balance, end of year............................ --- --- --- 

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

Total obligations........................................... $6,547,101,998 $7,517,583,000 $10,834,475,000 
27 

Summary of Changes 

(Whole dollars) 

2023 Enacted...................................................................................... 

Total estimated budget authority............................................................... $7,370,416,000 

(Obligations)...................................................................................... 7,370,416,000 

2024 President's Budget.........................................................................

Total estimated budget authority............................................................... 10,274,808,000 

(Obligations)...................................................................................... 10,274,808,000 

Net Change.................................................................................... +$2,904,392,000

FY 2023 Enacted

FY 2024 President's 

Budget FY 2024 +/- FY 2023

BA FTE BA FTE BA FTE

Increases:

A. Built-in:

1. Annualization of 2022 commissioned corps pay increase..... $98,557,528 --- $125,723,105 --- +27,165,578 --- 

2. Annualization of 2022 civilian pay increase.................... 5,844,452 --- 8,531,277 --- +2,686,825 --- 

Subtotal, Built-in Increases..................................... 104,401,979 --- 134,254,382 --- +29,852,402 --- 

B. Program:

1. Mental Health..................................................... 2,742,085,390 137 4,473,492,105 184 +1,731,406,716 +47

2. Substance Use Prevention....................................... 222,451,727 80 230,013,806 83 +7,562,078 +3

3.Substance Use Services.......................................... 4,059,097,509 130 5,356,428,403 175 +1,297,330,894 +45

4. Health Surveillance and Program Support................... 81,602,395 378 80,619,305 423 -983,090 +45

Congressional Earmarks.........................................

Subtotal, Program Increases................................. 7,105,237,021 725 10,140,553,618 865 3,035,316,598 +140

Total Increases................................................ 7,209,639,000 725 10,274,808,000 865 3,065,169,000 +140

Decreases:

A. Built-in:

1. Absorption of built-in increases ............................... --- --- 

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

B. Program:

4. Health Surveillance and Program Support................... 

Congressional Earmarks........................................ 160,777,000 --- --- --- -160,777,000 --- 

Subtotal, Program Decreases............................... 160,777,000 --- --- --- -160,777,000 --- 

Total Decreases.............................................. 160,777,000 --- --- --- -160,777,000 --- 

Net Change................................................. +$2,904,392,000 +$140
28 

Budget Authority by Activity

(Dollars in thousands) 

 FY 2022 

Final

FY2023 

Enacted

FY2024 

President's 

Budget

Mental Health 

Programs of Regional and National Significance...................................... $577,616 $1,044,033 $1,778,269 

National Child Traumatic Stress Network............................................ 81,887 93,887 150,000 

Assisted Outpatient Treatment for Individuals with SMI........................ 21,420 21,420 21,420 

Children's Mental Health Services....................................................... 125,000 130,000 225,000 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add)..................... 12,500 13,000 22,500 

Projects for Assistance in Transition from Homelessness...................... 64,635 66,635 109,635 

Protection and Advocacy for Individuals with Mental Illness................. 38,000 40,000 40,000 

Community Mental Health Centers (CMHC)........................................ -- -- 412,500 

Community Mental Health Services Block Grant.................................. 857,571 1,007,571 1,652,571 

Budget Authority (non-add).............................................................................. 836,532 986,532 1,631,532 

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

Certified Community Behavioral Health Clinics.................................... 315,000 385,000 552,500 

Total, Mental Health .......................................................................... 2,081,129 2,788,546 4,941,895 

Substance Use Prevention Services 

Programs of Regional and National Significance...................................... 218,219 236,879 245,738 

Total, Substance Use Prevention Services........................................... 218,219 236,879 245,738 

Substance Use Services 

Programs of Regional and National Significance...................................... 521,517 574,219 755,008 

State Opioid Response Grants............................................................. 1,525,000 1,575,000 2,000,000 

Set-Aside for Tribes (non-add)....................................................................... 55,000 55,000 75,000 

Substance Use Prevention, Treatment, and Recovery Services Block Grant 1,908,079 2,008,079 2,708,079 

Budget Authority (non-add).............................................................................. 1,828,879 1,928,879 2,628,879 

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

Total, Substance Use Services............................................................. 3,954,596 4,157,298 5,463,087 

Health Surveillance and Program Support 

Health Surveillance and Program Support 130,123 135,123 137,795 

Program Support (non-add).................................................................. 81,500 84,500 84,500 

Health Surveillance (non-add).............................................................. 48,623 50,623 53,295 

Budget Authority (non-add).............................................................................. 18,195 20,195 22,867 

PHS Evaluation Funds (non-add)..................................................................... 30,428 30,428 30,428 

Subtotal, Health Surveillance and Program Support 130,123 135,123 137,795 

Congressional Earmarks................................................................... 127,535 160,777 

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

Public Awareness and Support............................................................ 13,000 13,260 13,260 

Budget Authority (non-add).............................................................................. 13,000 13,260 13,260 

Performance and Quality Information Systems...................................... 10,000 10,200 10,200 

Budget Authority (non-add).............................................................................. 10,000 10,200 10,200 

Behavioral Health Workforce Data and Development ........................... 1,000 1,000 1,000 

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

Drug Abuse Warning Network............................................................. 10,000 13,000 20,000 

Total, Health Surveillance and Program Support............................... 293,158 334,860 183,755 

HSPS Budget Authority (non-add)....................................................................... 260,230 301,932 150,827 

HSPS PHS Evaluation Funds (non-add).............................................................. 31,428 31,428 31,428 

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

TOTAL, SAMHSA Program Level....................................................................... 6,547,102 7,517,583 10,834,475 

Nonrecurring Expenses Fund (NEF)...................................................................... -- -- -- 

Less Funds from Other Sources: 

Community Mental Health Centers (CMHC)................................................... -- -- -412,500 

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

PHS Evaluation Funds...................................................................................... -133,667 -133,667 -133,667 

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

TOTAL, SAMHSA Budget Authority................................................................... $6,399,935 $7,370,416 $10,274,808 

FTEs 577 725 865 
29 

Substance use And Mental Health Services Administration

Authorizing Legislation

(Whole dollars) 

Activity

FY 2023 

Amount 

Authorized

FY 2023 

Amount 

Appropriated

FY 2024 

Amount 

Authorized

FY 2024 

President's 

Budget

1. Grants for the Benefit of Homeless $ 41,304,000 $ 37,114,000 $ 41,304,000 $ 37,114,000 

PHS Act, Section 506.................................... 

 

2. Residential Substance Use Services Programs for 

Pregnant and Postpartum Women

$ 29,931,000 $ 38,931,000 $ - $ 49,397,000 

PHS Act, Section 508.................................... 

 

3. Priority Substance Use Services Needs of Regional 

and National Significance

$ 521,517,000 $ 572,219,000 $ 521,517,000 $ 753,008,000 

PHS Act, Section 509.................................... 

 

4. Substance Use Services for Children and Adolescents $ 29,600,000 $ 30,197,000 $ 29,600,000 $ 30,197,000 

PHS Act, Section 514.................................... 

 

5. Priority Substance Use Prevention Needs of Regional 

and National Significance

$ 218,219,000 $ 236,879,000 $ 218,219,000 $ 245,738,000 

PHS Act, Section 516........................................ 

 

6. Sober Truth on Preventing Underage Drinking $ 14,500,000 $ 14,500,000 $ 14,500,000 $ 14,500,000 

PHS Act, Section 519B..................................... 

 

7. Priority Mental Health Needs of Regional and National 

Significance

$ 599,000,000 $ 1,044,033,000 $ 599,000,000 $ 1,778,269,000 

PHS Act, Section 520A..................................... 

 

8. Suicide Prevention Technical Assistance Center $ 9,000,000 $ 11,000,000 $ 9,000,000 $ 11,000,000 

PHS Act, Section 520C................................... 

 

9. Youth Suicide Early Intervention and Prevention 

Strategies

$ 40,000,000 $ 43,806,000 $ 40,000,000 $ 43,806,000 

PHS Act, Section 520E.................................. 

 

10. Mental Health and Substance Use Disorder Services 

on Campus

$ 7,000,000 $ 8,488,000 $ 7,000,000 $ 11,488,000 

PHS Act, Section 520E-2................................. 

 

11. 988 and Behavioral Health Crisis Services $ 101,621,000 $ 501,618,000 $ 101,621,000 $ 836,000,000 

PHS Act, Section 520A..................................... 
30 

Authorizing Legislation (continued)

(Whole dollars) 

Activity 

FY 2023 Amount 

Authorized

FY 2023 Amount 

Appropriated

FY 2024 Amount 

Authorized

FY 2024 

President's 

Budget

12. Grants for Jail Diversion Programs $ 14,000,000 $ 11,269,000 $ 14,000,000 $ 56,394,000 

PHS Act, Section 520G........... 

 

13. Mental Health Awareness Training $ 24,963,000 $ 27,963,000 $ 24,963,000 $ 64,000,000 

PHS Act, Section 520J............ 

 

14. Integration Incentive Grants and 

Cooperative Agreements

$ 60,000,000 $ 57,868,000 $ 60,000,000 $104,868,000 

PHS Act, Section 520K........... 

 

15. Adult Suicide Prevention $ 30,000,000 $ 28,200,000 $ 30,000,000 $ 28,200,000 

PHS Act, Section 520L........... 

 

16. Assertive Community Treatment Grant 

Program 

$ 9,000,000 $ 9,000,000 $ 9,000,000 $ 9,000,000 

PHS Act, Section 520M.......... 

 

17. Projects for Assistance in Transition 

From Homelessness

$ - $ 66,635,000 $ - $109,635,000 

PHS Act, Sections 521-535(a). 

 

18. First Responder Training $ 36,000,000 $ 56,000,000 $ - $ 77,500,000 

PHS Act, Section 546............. 

 

19. Building Communities of Recovery $ 5,000,000 $ 16,000,000 $ - $ 28,000,000 

PHS Act, Section 547............. 

 

20. Community Mental Health Services for 

Children with Serious Emotional 

Disturbances

$125,000,000 $130,000,000 $125,000,000 $225,000,000 

PHS Act, Sections 561-565(ff). 

 

21. Grants to Address the Problems of 

Persons Who Experience Violence Related 

Stress

$ 63,887,000 $ 93,887,000 $ - $150,000,000 

PHS Act, Section 582............. 
31 

Authorizing Legislation (continued)

(Whole dollars) 

Activity 

FY 2023 

Amount 

Authorized

FY 2023 

Amount 

Appropriated

FY 2024 

Amount 

Authorized

FY 2024 

President's Budget

22. Community Mental Health Services Block 

Grants

$ 

857,571,000 

$ 

1,007,571,000 

$ 857,571,000 $ 1,652,571,000 

PHS Act, Section 1911-

1920......................................

 

 

23. Substance Abuse Prevention and Treatment 

Block Grants

$ 

1,908,079,000 

$ 

2,008,079,000 

$ 1,908,079,000 $ 2,708,079,000 

PHS Act, Section 1921-

1935......................................

 

 

24. Assisted Outpatient Treatment Grant Program 

for Individuals With SMI

$ 

22,000,000 

$ 

21,420,000 

$ 22,000,000 $ 21,420,000 

Section 224 of the Protecting Access to Medicare 

Act of 

2014......................................................... 

 

 

25. Protection and Advocacy for Individuals with 

Mental Illness*

$ - $ 

40,000,000 

$ - $ 40,000,000 

Section 117 of the Protection and Advocacy of 

Mentally Ill Individuals Act of 

1986..................... 

 

 

26. Heath Surveillance $ 

135,123,000 

$ 

135,123,000 

$ 137,795,000 $ 137,795,000 

PHS Act, Section 501, 

505.........................................

 

 

27. Public Awareness and Support $ 

13,260,000 

$ 

13,260,000 

$ 13,260,000 $ 13,260,000 

PHS Act, Section 501, 509, 516, 

520A.......................

 

 

28. Performance and Quality Improvement 

Systems

$ 

10,200,000 

$ 

10,200,000 

$ 10,200,000 $ 10,200,000 

PHS Act, Section 501, 509, 516, 

520A.......................

 

 

 

29. Drug Abuse Warning Network $ 

13,000,000 

$ 

13,000,000 

$ 20,000,000 $ 20,000,000 

PHS Act, Section 505................................................

 

* Sunset date: 2003 
32 

Appropriations History 

(Whole dollars) 

 

Budget Estimate 

to Congress

House 

Allowance

Senate 

Allowance Appropriation

FY 2015 

General Fund Appropriation: 

Annual (P.L. 113-235)................................................................. $3,297,669,000 --- $3,431,878,000 $3,474,045,000

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

FY 2016 

General Fund Appropriation: 

Annual (P.L. 114-113).................................................................. $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000

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

FY 2017 

General Fund Appropriation: 

Supplemental (21st Century Cures Act)...................................... $500,000,000

Annual (P.L. 115-31).................................................................. $3,488,783,000 $4,211,603,000 $3,739,577,000 $3,611,003,000

Subtotal........................................................................................ $3,488,783,000 $4,211,603,000 $3,739,577,000 $4,111,003,000

FY 2018 

General Fund Appropriation: 

Supplemental (21st Century Cures Act)...................................... $500,000,000

Annual (P.L. 115-141)................................................................. $3,770,668,000 $4,193,936,000 $4,279,092,000 $4,513,327,000

Subtotal...................................................................................... $3,770,668,000 $4,193,936,000 $4,279,092,000 $5,013,327,000

FY 2019 

General Fund Appropriation: 

Annual (P.L. 115-245)................................................................. $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000

Subtotal........................................................................................ $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000

FY 2020 

General Fund Appropriation: 

Supplemental (CARES Act P.L. 116-136)................................ --- --- --- $425,000,000

Annual (P.L. 116-94).................................................................. $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000

Subtotal....................................................................................... $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000

FY 2021 

General Fund Appropriation: 

Supplemental (American Rescue Plan Act of 2021 P.L. 117-2).. --- --- --- $3,560,000,000

Supplemental: 

(Coronavirus Emergency Reponse and Relief Act P.L. 116-

260). --- --- --- $4,250,000,000

Annual (P.L. 116-260)............................................................ $5,597,651,000 $5,830,829,000 $5,853,840,000 $5,869,841,000

Subtotal................................................................................ $5,597,651,000 $5,830,829,000 $5,853,840,000

$13,679,841,00

0 

FY 2022 

General Fund Appropriation: 

Supplemental (Bipartisan Safer Communities Act P.L. 117-

159)...... --- --- --- $312,500,000

Annual (P.L. 117-103)........................................................... $9,586,844,000 $9,014,610,000 $8,957,412,000 $6,399,935,000

Subtotal................................................................................. $9,586,844,000 $9,014,610,000 $8,957,412,000 $6,712,435,000

FY 2023 

General Fund Appropriation: 

Annual (P.L. 117-328).......................................................... $10,137,487,000 $9,024,713,000 $9,002,834,000 $7,370,416,000

Subtotal................................................................................. $10,137,487,000 $9,024,713,000 $9,002,834,000 $7,370,416,000

FY 2024 

General Fund Appropriation: 

Base.......................................................................................... $10,274,808,000 --- --- --- 

Subtotal........................................................................................ $10,274,808,000 --- --- --- 
33 

Appropriations Not Authorized by Law

(Whole dollars) 

Program

Last Year of 

Authorization

Authorization 

Level

Appropriations 

in 

Last Year of 

Authorization

Appropriations 

in FY 2024

Protection and Advocacy for Individuals with Mental Illness Act

P.L. 99-319, Sec. 117 2003 $ 19,500,000 $ 19,500,000 $ 40,000,000

TOTAL, SAMHSA Budget Authority $ 19,500,000 $ 19,500,000 $ 40,000,000
34 

Mental Health

Table of Contents 

Mental Health .............................................................................................................................. 34

Summary of the Request ................................................................................................... 35

Programs of Regional and National Significance (PRNS) ............................................... 37

Project AWARE ....................................................................................................... 38

Mental Health Awareness Training ........................................................................ 42

Healthy Transitions ................................................................................................. 44

Children and Family Programs .............................................................................. 47

Consumer and Family Network Grants .................................................................. 49

Project LAUNCH .................................................................................................... 51

Mental Health System Transformation and Health Reform .................................... 55

Primary and Behavioral Health Care Integration .................................................. 58

Suicide Prevention Programs .................................................................................. 62

Mental Health Crisis Response Partnerships Program .......................................... 79

Homelessness Prevention Programs ....................................................................... 81

Minority AIDS ......................................................................................................... 83

Criminal and Juvenile Justice Programs ................................................................ 86

Practice Improvement and Training ....................................................................... 90

Consumer and Consumer-Supporter TA Centers .................................................... 92

Disaster Response ................................................................................................... 94

Seclusion and Restraint ........................................................................................... 98

Assertive Community Treatment for Individuals with Serious Mental Illness ...... 100

Tribal Behavioral Health Grants .......................................................................... 103

Minority Fellowship Program ............................................................................... 106

Infant and Early Childhood Mental Health .......................................................... 109

Interagency Task Force on Trauma-Informed Care ............................................. 112

National Child Traumatic Stress Network ...................................................................... 114

Assisted Outpatient Treatment for Individuals with Serious Mental Illness .................. 117

Children’s Mental Health Services ................................................................................. 120

Projects for Assistance in Transition from Homelessness .............................................. 120

Protection and Advocacy for Individuals with Mental Illness (PAIMI)......................... 130

Community Mental Health Centers (CMHC) ................................................................. 135

Certified Community Behavioral Health Clinics (CCBHC) .......................................... 137

Community Mental Health Services Block Grant (MHBG) ........................................... 144

 
35 

Mental Health

Summary of the Request

(Dollars in thousands) 

 

FY 2022 FY 2023 FY 2024 

Final Enacted

FY 2024 

President's 

Budget

FY 2024 +/- 

FY 2023 

Enacted

Programs of Regional and National Significance......................... $577,615 $1,044,033 $1,778,269 $734,236

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

National Child Traumatic Stress Network.................................... 81,887 93,887 150,000 56,113 

Assisted Outpatient Treatment for Individuals with SMI............. 21,420 21,420 21,420 --- 

Children's Mental Health Services................................................ 125,000 130,000 225,000 95,000 

Projects for Assistance in Transition From Homelessness.......... 64,635 66,635 109,635 43,000 

Protection and Advocacy For Individuals with Mental Illness..... 38,000 40,000 40,000 --- 

Certified Community Behavioral Health Clinics.......................... 315,000 385,000 552,500 167,500 

Community Mental Health Services Block Grant........................ 857,571 1,007,571 1,652,571 645,000 

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

CMHS Mandatory Programs........................................................ 

Community Mental Health Centers........................................... --- -- 412,500 412,500 

Total, Mental Health......................................................................... 2,081,128 2,788,546 4,941,895 2,153,349 

FTE..................................................................................................... 121 137 184 47 

The Mental Health FY 2024 President’s Budget Request is $4.9 billion, an increase of $2.2 billion 

from the FY 2023 Enacted level. 

SAMHSA’s Center for Mental Health Services (CMHS) Manages over 40 formula and 

discretionary grant programs, with approximately 2,500 grant and technical assistance programs 

throughout the US. The programming, which covers individuals’ lifespan, funds interventions 

across the full range of the public health model, from mental health promotion, prevention, case 

identification/screening, early intervention, treatment, and recovery support services. A portion of 

CMHS’ programming, particularly the programming focused on mental health promotion, 

prevention, and case identification, apply to children and adults experiencing Any Mental Illness 

(AMI). However, much of CMHS’ programming is targeted towards supporting and treating adults 

with Serious Mental Illness (SMI) and children with Serious Emotional Disturbance (SED). 

CMHS’s grant and technical assistance programs are a critical response to our nation’s mental 

health crisis. The programs increase access to quality services that include prevention, early 

intervention, treatment, and recovery supports for individuals across the lifespan. CMHS grants 

support direct services, infrastructure development, capacity building, and technical assistance to 

enhance the behavioral health system for all Americans. SAMHSA programs meet people where 

they are through supporting services beyond office based behavioral health systems, such as in 

primary healthcare clinics, schools, child welfare, criminal and juvenile justice, and supported 

housing services. 

In designing and maintaining these programs, CMHS collaborates with federal partners and often 

requires grantees to engage with related state or community providers to ensure alignment and 

impact. This cross-agency collaboration also contributes to SAMHSA’s overall efforts to address 

the need for an integrated, comprehensive crisis response and intervention system, as charged by 

Congress. CMHS programs also advance the HHS Strategic Plan FY 2022-2026 objectives to 

bolster the health workforce, strengthen early childhood development, expand access to high-
36 

quality services and resources, support those who have experienced trauma or violence, and 

prioritize evidence-based practices.
37 

Mental Health

Programs of Regional and National Significance (PRNS) 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted 

 

President's 

Budget

FY 2024 +/- 

FY 2023 

Enacted

Capacity 

Project AWARE............................................................................................................. 119,984 140,001 244,000 103,999 

Project AWARE: State Grants(non-add).................................................................... 100,484 110,501 213,250 102,749 

Project AWARE: Civil Unrest(non-add).................................................................... 12,500 17,500 18,750 1,250 

Project AWARE -School-based Trauma-Informed Care (non-add)............. 7,000 12,000 12,000 - 

Mental Health Awareness Training................................................................................ 24,946 27,963 64,000 36,037 

Healthy Transitions......................................................................................................... 29,434 30,451 61,400 30,949 

Children and Family Programs....................................................................................... 7,212 7,229 7,229 - 

Consumer and Family Network Grants........................................................................... 4,937 4,954 4,954 - 

MH System Transformation and Health Reform............................................................. 3,762 3,779 3,779 - 

Project LAUNCH........................................................................................................... 23,588 25,605 35,408 9,803 

Primary and Behavioral Health Care Integration............................................................ 52,860 55,877 102,877 47,000 

Suicide Prevention Programs.......................................................................................... 196,979 617,043 1,034,425 417,382 

988 and Behavioral Health Crisis Services ................................................................ --- 501,618 836,000 334,382 1

Suicide 

Lifeline................................................................................................................... 101,621 -- - 

National Strategy for Suicide Prevention..................................................................... 23,183 28,200 28,200 - 

Zero Suicide (non-add)........................................................................................... 18,783 22,800 22,800 - 

Zero Suicide AI/AN(nonadd)............................................................................ 2,400 3,400 3,400 - 

All Other NSSP (non-add)....................................................................................... 2,000 2,000 2,000 - 

GLS - Youth Suicide Prevention - States..................................................................... 38,789 43,806 43,806 - 

Budget Authority (non-add).................................................................................... 26,789 31,806 31,806 - 

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

GLS - Youth Suicide Prevention - Campus.................................................................. 6,471 8,488 11,488 3,000 

Suicide Prevention Resource Center........................................................................... 8,983 11,000 11,000 - 

AI/AN Suicide Prevention Initiative............................................................................ 2,931 3,931 3,931 - 

MH Crisis Response Grants........................................................................................ 10,000 20,000 100,000 - 

Behavioral Health Crisis Coordinating Office............................................................ 5,000 -- -- - 

Homelessness Prevention Programs............................................................................... 30,679 33,696 35,696 2,000 

Criminal and Juvenile Justice Programs......................................................................... 6,252 11,269 56,394 45,125 

Assertive Community Treatment for Individuals with SMI............................................. 8,983 9,000 9,000 - 

Minority AIDS................................................................................................................ 9,207 9,224 9,224 - 

Seclusion & Restraint..................................................................................................... 1,130 1,147 1,147 - 

Tribal Behavioral Health Grants.................................................................................... 20,733 22,750 23,250 500 

Infant and Early Childhood Mental Health...................................................................... 9,983 15,000 37,500 22,500 

Interagency Task Force on Trauma-Informed Care......................................................... 1,000 2,000 2,000 - 

Subtotal, Capacity 551,671 1,016,988 1,732,283 715,295 

Science and Service: 

Primary and Behavioral Health Care Integration TTA................................................... 1,974 1,991 1,991 - 

Practice Improvement and Training................................................................................ 7,811 7,828 15,828 8,000 

Consumer and Consumer Support TA Centers................................................................ 1,901 1,918 1,918 -- 

Disaster Response.......................................................................................................... 1,936 1,953 1,953 -- 

Homelessness................................................................................................................. 2,279 2,296 2,296 -- 

MH Minority Fellowship Program................................................................................. 10,042 11,059 22,000 10,941 

Subtotal, Science and Service 25,944 27,045 45,986 18,941 

Total, PRNS 577,615 1,044,033 1,778,269 734,236 1/ The Suicide Lifeline was realigned to the 988 and Behavioral Health Crisis Services program in FY 2023.
38 

Project AWARE

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024+/ 

2023

Enacted

Project AWARE...................................................................................................... $119,984 $140,001 $244,000 $103,999 

 Project AWARE State Grants (non-add).............................................................. 100,484 110,501 213,250 $102,749 

 Project AWARE - Civil Unrest (non-add)............................................................ 12,500 17,500 18,750 $1,250 

Project AWARE -School-based Trauma-Informed Care (non-add)...................... 7,000 12,000 12,000 $0 

Authorizing Legislation .. Sections 520A and 520J of the Public Health Service Act; Section 7134 

(42 USC 280h-7) of the SUPPORT Act for Patients and Communities Act (P.L. 115-271) 

FY 2024 Authorization ................................................................................................$599,000,000 

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

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

.................Local Governmental Entities, Community Organizations and Provider Organizations, 

..............Community Colleges, Networks, National Non-Profit Organizations, States and Tribes 

Program Description 

According to the CDC Web-based Injury Statistic Query and Reporting Systems Leading Causes 

of Death Reports, suicide was the second leading cause of death among individuals between the 

ages of 10-14, and the third leading cause of death among individuals between the ages of 15-24 

in 2020 6

. In 2021, 42% of high school students felt so sad or hopeless almost every day for at least 

two weeks in a row that they stopped doing their usual activities. Female students were more likely 

than male students to experience persistent feelings of sadness or hopelessness.7 In 2021, 22% of 

high school students seriously considered attempting suicide during the past year. Female students 

were more likely than male students to seriously consider attempting suicide. LGBTQI+ students 

and students who had any same-sex partners were more likely than their peers to seriously consider 

attempting suicide. Multiracial students were more likely than Asian, Black, and White students 

to experience persistent feelings of sadness or hopelessness. LGBTQI+ students and students who 

had any same-sex partners were more likely than their peers to experience persistent feelings of 

sadness or hopelessness.8

Project AWARE (Advancing Wellness and Resiliency in Education) is made up of three 

components: Project AWARE; ReCAST (Resilience in Communities after Stress and Trauma); 

and Cooperative Agreements for School-Based Trauma-Informed Support Services and Mental 

Health Care for Children and Youth (Trauma-Informed Services in Schools). All three programs 

are a part of a comprehensive mental health project that focuses on building infrastructure within 

schools and communities to provide trauma-informed, developmentally appropriate, and culturally 

competent services to children and youth, their families, and their communities. 

 

6 Web-based Injury Statistics Query and Reporting System. (2020). Retrieved from the Center for Disease Control 

and Prevention: https://wisqars.cdc.gov/data/lcd/home

7 https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf 8 Ibid.
39 

Project AWARE

Established in 2014, Project AWARE grantees develop collaborative partnerships that include the 

State Education Agency, Local Education Agency, Tribal Education Agency, the State Mental 

Health Agency (SMHA), community-based providers of behavioral health care services, school 

personnel, community organizations, families, and school-aged youth. Award recipients will 

leverage their partnerships to implement mental health related promotion, awareness, prevention, 

intervention, and resilience activities to ensure that school-aged youth have access and are 

connected to appropriate and effective behavioral health services. SAMHSA expects that this 

program will promote the healthy social and emotional development of school-aged youth and 

prevent youth violence in school settings. 

ReCAST

Established in 2016, ReCAST grantees support efforts in high-crime, high-poverty communities 

that have experienced civil unrest, community violence, and collective trauma within the previous 

24 months. ReCAST grantees are guided by a community-based coalition of residents and 

community-based, non-profit organizations, in partnership with other entities (e.g., health and 

human service providers, schools, institutions of higher education, faith-based organizations, 

businesses, state and local government, law enforcement, and employment, housing, and 

transportation services agencies). ReCAST grantees work to create more equitable access to 

trauma-informed community behavioral health resources and strengthen the integration of 

behavioral health services and other community systems to address the social determinants of 

health. Through these community-based coalitions, ReCAST grantees build a foundation to 

promote well-being, resiliency, and change that promote community and youth engagement. 

School-Based Trauma-Informed Support Services and Mental Health Care for Children 

and Youth (Trauma Informed Services in Schools)

Established in FY 2022, Trauma-Informed Services in Schools grantees increase students’ access 

to evidence-based, culturally relevant, and trauma-informed mental health care by developing 

innovative initiatives, activities, and programs to link local school systems with mental health 

systems and support, including those under the Indian Health Service. The COVID-19 pandemic 

has increased the need for school and community-based trauma-informed services for children and 

youth, and their families. The collaborative efforts of this program will create and/or improve 

identification, referral, early intervention, and treatment, and support services for students that 

need specialized support. With this program, SAMHSA aims to further enhance and improve 

trauma-informed support and mental health services for children and youth.

Budget Request

The FY 2024 President’s Budget request is $244.0 million, an increase of $104.00 million from 

the FY 2023 Enacted level. Funding for this program will support 87 continuations for Project 

AWARE grants, award 52 new AWARE grants, 12 continuations for School-based Trauma grants 

and 17 continuations for ReCAST grants. The funding will expand the programs’ population of 

focus to include college students and adults and expand the program’s training settings to include 
40 

non-educational and non-health care sites. It is expected that this funding for the three Project 

AWARE grant programs will help to identify and refer approximately 120,000 school-aged youth 

to mental health and related services; and to train approximately 500,000 mental health and mental 

health-related professionals on evidence-based mental health practices. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount Supplemental 

Funding 

FY 2020 $102,001,000 

FY 2021 $105,117,728 $80,000,000 

FY 2022 Final $119,984,000 

FY 2023 Enacted1 $140,001,000 $60,000,000 

FY 2024 President's Budget1 $244,000,000 $60,000,000 

1/Supplemental funding represents BSCA advanced appropriations in 

2023 and 2024.

Program Accomplishments

Project AWARE

In FY 2022, SAMHSA supported 46 Project AWARE grant continuations and awarded a new 

cohort of nine grants (five grants with base budget authority and four grants American Rescue Plan 

Act funds). In FY 2022, Project AWARE grantees trained 252,498 individuals in mental health 

and related practices; screened 254,001 children and youth for mental health related concerns; and 

referred 62,748 children and youth for mental health services and treatment. 

In FY 2023, SAMHSA anticipates funding 39 continuation grants (35 grants with base budget 

authority and four grants with American Rescue Plan Act) and award a new cohort of 44 grants 

(21 new grants with base budget authority and 23 grants with Bipartisan Safer Community Act). 

In FY 2023, it is estimated that the number of individuals trained in mental health-related practices 

will increase to 440,000; that the number of children and youth screened for mental health-related 

concerns will increase to 450,000; and that the number of children and youth referred to mental 

health and related services will increase to 120,000. 

ReCAST

In FY 2022, SAMHSA awarded 11 grant continuations and awarded one new grant. In FY 2022, 

the ReCAST grantees trained 7,664 individuals; reached 198,915 community members with

mental health messaging addressing trauma-informed practices; and provided evidence-based 

mental health-related services to 9,395 individuals. The percentage of individuals receiving 
41 

mental health services after referral 

In the FY 2023, SAMHSA anticipates funding 10 continuation grants and 17 new awards (7 new 

grants with base budget authority and 10 grants with Bipartisan Safer Community Act). SAMHSA 

anticipates that ReCAST grantees will train 8,200 individuals; will reach 190,000 community 

members with mental health messaging addressing trauma-informed practices; and provide 

evidence-based mental health-related services to 9,900 individuals. 

Trauma-Informed Services in Schools

In FY 2022, SAMHSA awarded a new cohort of seven grants. 

In FY 2023, SAMHSA anticipates funding 7 grant continuations, and awarding a new cohort of 

13 grants (5 with based budget authority and 8 with Bipartisan Safer Communities Act funding). 

SAMHSA anticipates that grantees will screen approximately 62,400 children and youth for 

services and will serve nearly 57,500 children and youth. 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.2.21 Percentage of 

individuals receiving 

mental health 

services after 

referral.

FY 2022: 70.0 

Target:

74.5 

(Target Not Met)

74.5 74,5 Maintain

3.2.39 Number of 

individuals who have 

received training in 

prevention or mental 

health promotion 

(Outcome)

FY 2022: 266,096 

Target:

226,000.0 

(Target Exceeded)

300,000 500,000.0 +200,000 

3.2.51 Number of 

individuals referred 

to mental health or 

related interventions 

(Output) 

FY 2022: 63,998 

Target:

43,000.0 

(Target Exceeded)

64,000 120,000 +56,000 
42 

Mental Health Awareness Training

(Dollars in thousands) 

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

FY 2024 Authorization ..................................................................................................$24,963,000 

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

Eligible Entities...............State and Territories, Political Sub-divisions of States; Tribes or 

..............................................................Tribal Organizations; and Non-Profit Entities

Program Description 

Established in 2018, the purpose of the Mental Health Awareness Training (MHAT) program is to 

(1) train individuals (e.g., school personnel and emergency services personnel including fire 

department and law enforcement personnel, veterans, armed services members and their families, 

etc.) to recognize the signs and symptoms of mental disorders and how to safely de-escalate crisis 

situations involving individuals with a mental illness and (2) provide education on resources 

available in the community for individuals with a mental illness and other relevant resources, 

including how to establish linkages with school and/or community-based mental health agencies. 

The MHAT program uses several evidence-based activities and programs to ultimately increase 

the number of individuals prepared and trained on how to respond to individuals appropriately and 

safely with mental disorders, particularly individuals with serious mental illness (SMI) and/or 

serious emotional disturbance (SED). These programs include but are not limited to: Mental Health 

First Aid and its associated specialty curriculums, Question, Persuade, Refer; Applied Suicide 

Intervention Skills Training; and Crisis Intervention Training. With the MHAT program, 

SAMHSA aims to increase the number of individuals prepared and trained on how to respond to 

individuals with mental disorders appropriately and safely.

Budget Request

The FY 2024 President’s Budget request is $64.0 million, an increase of $36.0 million from the 

FY 2023 Enacted funding level for this program will support 197 continuation grants and 277 new 

grants. The budget will enable populations to be trained, including college students, veterans and 

armed services personnel and their family members, and to broaden applicable settings for 

trainings to include noneducational, non-health care settings. With this funding, it is estimated the 

number of individuals referred to mental health and related services will near 325,000 and the 

number of individuals trained to recognize the signs and symptoms of mental illness will be 

approximately 600,000. 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Mental Health Awareness Training......................................................................... $24,946 $27,963 $64,000 $36,037 
43 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount Bipartisan Safer 

Communities Act/1

FY 2020 $22,963,000 

FY 2021 $23,963,000 

FY 2022 Final $24,946,200 

FY 2023 Enacted $27,963,000 $30,000,000

FY 2024 President's Budget $64,000,000 $30,000,000 1

/Funds are in advance of Appropriations in 2023 and 2024.

Program Accomplishments

In FY 2022, SAMHSA awarded 159 grant continuations and awarded a new cohort of 30 grants. 

The grantees trained 118,911 individuals in mental health awareness, out of which 76.50 percent 

demonstrated an improvement in their knowledge and beliefs related to prevention and mental 

health treatment; and referred 78,816 youth to mental health and related services and activities. 

In FY 2023, SAMHSA anticipates funding 175 continuation grants and awarding a cohort of 260

new grants (22 grants with base budget authority and 238 grants with Bipartisan Safer Community 

Act). In FY 2023, the MHAT grantees are expected to train 21,772 individuals in mental health 

awareness, out of which 90.5 percent demonstrated improvement in their knowledge and beliefs 

related to prevention and mental health treatment; and referred 25,328 individuals to mental health 

and related services and activities. 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.6.1 Number of 

individuals trained in 

prevention or mental 

health promotion 

270,000 600,000 Increase

3.6.2 Number of 

individuals referred 

to mental health or 

related interventions

179,000 325,000 Increase
44 

Healthy Transitions 

(Dollars in thousands)

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

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

Territories; Political Sub-divisions of States; Indian Tribes or Tribal Organizations; Health 

Facilities Operated in accordance with the Indian Health Service. 

Program Description 

The Healthy Transitions Program has comprised several iterations of the program since its creation 

in 2022. The program began with the Partnership for Youth Transitions in 2002-2004, followed 

by the Healthy Transitions Initiative (2009-2014), and the Healthy Transitions: Now is the Time 

(NITT) from 2014-2019. The current program’s iteration is called the Healthy Transitions 

Initiative (HTI) which began in 2018. 

The purpose of this program is to improve and expand access to developmentally, culturally, and 

linguistically appropriate services and supports for transition-aged youth and young adults (ages 

16-25) who either have, or are at risk for developing, serious mental health conditions. One of the 

risks affecting transition-aged youth is that it coincides with the age of onset for most mental and 

behavioral health challenges. Most mental health challenges emerge in the late teens to early 20’s, 

with roughly 50 percent of mental health challenges beginning by the early 20s.9

 Serious mental 

illness or diagnosable mental health challenges that substantially interfere with or limit major life 

activities, are more prevalent during the transition age than at any other period.10 

Since 2018, the Healthy Transitions program has provided states, territories, and tribes with 

resources to improve access to mental health treatment and related support services for youth and 

young adults ages 16-25 with serious mental health conditions. Grantees use these funds to provide 

direct services and supports to address serious mental health conditions, co-occurring disorders, 

and risks for developing SMI among young people ages 16-25. This is accomplished by improving 

awareness, outreach and engagement strategies, screening and assessment, referrals to treatment, 

coordination of care, and evidence-based/informed treatment for youth and young adults. Grantees

also develop formal partnerships with child and adult serving organizations to promote seamless 

and coordinated care, develop sustainable policies, and provide needed training both at the state 

and community levels to effectively engage and serve this unique population. Appropriate 

outreach and engagement processes are imperative to create access to effective behavioral health 

9 Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a 

review of recent literature. Curr Opin Psychiatry. 2007;20:359–364. 10 Zajac, K., Sheidow, A. J., & Davis, M. (September 2013). Transitional Youth with Mental Health 

Challenges in the Juvenile Justice System. Juvenile Justice Resource Series. Retrieved from 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Healthy Transitions.................................................................................................. $29,434 $30,451 $61,400 $30,949 
45 

interventions and supports. With the Healthy Transitions program, SAMHSA aims to improve 

emotional and behavioral health functioning so that this population of youth and young adults can 

maximize their potential to assume adult roles and responsibilities and lead full and productive 

lives.

Budget Request

The FY 2024 President’s Budget request is $61.4 million, an increase of $30.9 million from the 

FY 2023 Enacted level This budget will support 14 continuation grants and fund a new cohort of 

44 grants. Funding will improve access to mental disorder treatment and related support services 

for young people, aged 16 to 25, who either have, or are at risk of developing a serious mental 

health condition. It is expected that this program will serve approximately 5,800 young people 

and provide quality supports and services needed to engage this population. 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 28,951,000 

FY 2021 29,451,000 

FY 2022 Final 29,433,536 

FY 2023 Enacted 30,451,000 

FY 2024 President's Budget $61,400,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 27 grant continuations. In FY 2022, 3,199 youth and young adults 

were served by the Healthy Transitions grant program. The FY 2022 outcome demonstrated that 

at 6 months, 56 percent of youth and young adults reported positive everyday functioning, 73 

percent reported positive social connectedness, 68 percent of youth and young adults reported that 

they were attending school or employed, and 76 percent reported no serious psychological distress. 

In FY 2023, SAMHSA anticipates funding 18 grant continuations and awarding a new cohort of

11 grants. It is expected that 3,200 youth and young adults will be served by this program. 
46 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.2.34 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6 month followup. (Outcome) 

FY 2022: 56 % 

Target:

58.6 % 

(Target Not Met) 

58% 58% Maintain

3.2.35 Percentage of 

clients receiving 

services who had a 

permanent place to 

live in the 

community at 6 

month follow-up. 

(Outcome)

FY 2022: 49 % 

Target:

35 % 

(Target Exceeded)

Discontinued Discontinued N/A

3.2.36 Percentage of 

clients receiving 

services who are 

currently employed 

at 6 month followup. (Outcome) 

FY 2022: 43 % 

Target:

65 % 

(Target Not Met) 

Discontinued Discontinued N/A
47 

Children and Family Programs 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Children and Family Programs................................................................................ $7,212 $7,229 $7,229 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

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

Program Description 

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

that provides tribes and tribal organizations with the tools and resources to plan and design a 

family-driven, community-based, and culturally and linguistically competent system of care. A 

system of care is “a spectrum of effective community-based services and supports for children and 

youth, with or at risk for mental health or other challenges, and their families, that is organized 

into a coordinated network, builds meaningful partnerships with families and youth, and addresses 

their cultural and linguistic needs, in order for them to function better at home, in school, and 

throughout life.”11 

AI/AN children face major difficulties from birth that stem from historical trauma, health 

inequities, socioeconomic barriers, and racism.12 When compared with the general U.S. child 

population, AI/AN children have higher levels of obesity, obesity-related cardiovascular issues, 

mental health concerns, suicide, toxic stress, substance use disorder, injury and violence, and 

exposure to environmental hazards.13 More specifically, AI/AN children and adolescents have the 

highest rates of lifetime major depressive episodes and the highest self-reported depression rates.14 

They begin to use and abuse alcohol and other drugs at younger ages and at higher rates than other 

ethnic/racial groups.15 With the Circles of Care program, SAMHSA aims to increase resilience 

and improve emotional health for American Indian/Alaska Native (AI/AN) children, youth, and 

families 

Budget Request

The FY 2024 President’s Budget request is $7.2 million, same level with the FY 2023 Enacted 

level. This funding will support 19 Circles of Care continuation grants and award a new cohort 

of three grants. Funding will enhance and improve the quality of existing services and promote 

11 https://gucchd.georgetown.edu/products/Toolkit_SOC_Resource1.pdf 12 https://www.aap.org/en/patient-care/native-american-child-health/ 13 ibid

14https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-HealthDisparities/Mental-Health-Facts-for-American-Indian-Alaska-Natives.pdf 15 https://www.mhanational.org/issues/native-and-indigenous-communities-and-mental-health 
48 

the use of culturally competent services and support for children and youth with, or at risk for, 

serious mental health conditions, and their families. SAMHSA will maintain the FY 2023 

targets: 1,500 mental health professionals trained in mental health-related practices; develop 

collaborative partnerships and shared resources with nearly 2,500 organizations; and contact 

28,000 individuals through program outreach efforts. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $7,229,000 

FY 2021 $7,229,000 

FY 2022 Final $7,212,200 

FY 2023 Enacted $7,229,000 

FY 2024 President's Budget $7,229,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 20 continuation grants and the Circles of Care grantees have 

already surpassed the number of individuals contacted in FY 2021 through program outreach 

efforts (40,075). The program is expected to exceed the target of contacts in FY 23. 

In FY 2023, SAMHSA anticipates funding 3 continuation grants and a new cohort of 19 grants. 

It is estimated that in FY 2023, Circles of Care grantees will provide training to 1,500 mental 

health professionals, developed collaborative partnerships and shared resources with nearly 

2,500 organizations, and contact 40,075 individuals through program outreach efforts. 
49 

Consumer and Family Network Grants

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 

+/- 2023 

Enacted

Consumer and Family Network Grants.................................................................... $4,937 $4,954 $4,954 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities......................................................................................Domestic public or private 

non-profit organizations; States and Territories; Political Sub-divisions of States; AI/AN tribes and 

tribal organizations 

Program Description 

Across the health care arena, there is growing recognition and evidence that client-centered care

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

received, and provides feedback to drive service and systems improvements.

16 As with other 

health disciplines, people with serious mental illness (SMI) and their family members should have

meaningful involvement in all aspects of their health care and treatment, including behavioral

health care.

The Consumer and Family Network Programs provide consumers, families, and youth with 

opportunities to participate meaningfully in the development of policies, programs, and quality 

assurance activities related to mental health systems across the United States. The Consumer and 

Family Network Programs support two primary grant programs: the Statewide Consumer Network 

(SCN) Program and the Statewide Family Network (SFN) Program.

The SCN program was first funded in 1997. SCN grants focus on the needs of adults (18 years and 

older) with SMI or serious emotional disturbance (SED) by strengthening the capabilities of 

statewide consumer-run organizations. These entities serve an important role in engaging 

consumers of mental health services, caregivers, policy makers, and providers in improving and 

transforming the mental health and related systems in their states. This network is a sustainable 

mechanism for integrating the consumer voice in state mental health and allied systems to: (1) 

expand service system capacity; (2) support policy and program development; and (3) enhance 

peer support. This program promotes skill development with an emphasis on leadership and 

business management, as well as on coalition/partnership-building and economic empowerment, 

as part of the recovery process for consumers. 

Initiated in 1993, SFN grant program provides education and training to increase family 

organizations’ capacity for policy and service development. This is accomplished by: (1) 

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

16 Edgman-Levitan, S., Schoenbaum, S.C. Patient-centered care: achieving higher quality by designing care through 

the patient’s eyes. Isr J Health Policy Res 10, 21 (2021). https://doi.org/10.1186/s13584-021-00459-9
50 

leadership skills among families of children and adolescents with SED; and (3) identifying and 

addressing the technical assistance needs of children and adolescents with SED and their families. 

The SFN program focuses on families, parents, and the primary caregivers of children, youth, and 

young adults. 

Budget Request

The FY 2024 President’s Budget request is $4.9 million, level with the FY 2023 Enacted level. 

Funds will be used for 20 continuation grants and 8 new grants that promote consumer, family, 

and youth participation in the development of policies, programs, and quality assurance activities 

related to mental health systems reform across the United States. It is expected that in FY 2024, 

SCN will train 16,000 individuals in the mental health and related workforce and SFN will train 

25,500 individuals in prevention, mental health promotion, and mental health-related 

practices/activities, 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $4,954,000 

FY 2021 $4,970,508 

FY 2022 Final $4,937,200 

FY 2023 Enacted $4,954,000 

FY 2024 President's Budget $4,954,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 24 continuations (13 SFN and 11 SCN) and awarded a new cohort 

of 19 new grants (13 SFN and 6 SCN). The SCN grantees trained 5,564 individuals in the mental 

health and related workforce and SFN grantees trained 10,877 individuals in the mental health and 

related workforce. 60.4 percent of the SCN grantees advisory boards were comprised of consumers 

and family members. The SFN grantees trained 25,573 people in prevention, mental health 

promotion, and mental health-related practices/activities, including those in the mental health and 

related workforce; and involved 7,178 consumers and family members in ongoing mental healthrelated planning and advocacy activities.

In FY 2023, SAMHSA anticipates funding 43 continuations (26 SFN and 17 SCN) and awarding 

a new cohort of one SFN grant. In FY 2023, SAMHSA will maintain the target outputs for both 

SCN and SFN programs. 
51 

Project LAUNCH

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Project LAUNCH ................................................................................................... $23,588 $25,605 $35,408 $9,803 

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

Eligible Entities..........................States and Territories; Political Sub-divisions of States; 

...................................Indian Tribes or Tribal Organizations; Health Facilities or program 

....................................................operated in accordance with the Indian Health Service

Program Description 

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

promotes the wellness of young children, from birth to 8 years of age, by addressing the social, 

emotional, cognitive, physical, and behavioral aspects of their development. High quality early 

care and education benefits all children, especially those from disadvantaged backgrounds. 

Children of color experience unequal behavioral health treatment beginning at an early age, which 

contributes to inequalities in learning and development. However, based on state eligibility 

parameters, roughly 79 percent of eligible Black children, 92 percent of eligible Hispanic/Latino

children, and 95 percent of eligible Asian children under 13 years old lack access to childcare 

subsidies. 17

Project LAUNCH is designed to build the capacities of adult caregivers of young children to 

promote healthy social and emotional development; to prevent mental, emotional, and behavioral 

disorders; and to identify and address behavioral concerns before they develop into serious 

emotional disturbances (SED). This program also serves to address these inequities among 

children and families of color and to create programs and services to broaden access to high quality 

education and care. The grant awards provide local communities or tribes resources to disseminate 

effective and innovative early childhood mental health practices and services. 

Symptoms of historical trauma—including poverty, substance abuse, and disproportionate 

representation in the child welfare system—are evident in many Native American communities. 

And while many of the traumatic events happened decades ago, the impact can be passed from one 

generation to another as American Indian/Alaska Native (AI/AN) children grow up in challenging 

circumstances in their homes and communities. In addition, parenting practices, which are shaped 

by parents’ own upbringing, play an important role in child development. AI/AN children who 

face excessive stress without the buffer of supportive caregivers are at risk for having learning 

difficulties and long-term health problems.18 The current approach to early education also 

segregates children by family income and race, enrolls only one percent of Hispanic/Latino and 

four percent of Black three- and four-year-old children in high-quality state pre-K settings, and 

disproportionately disenfranchises students of color, especially Black boys, through punitive 

17 https://www.newamerica.org/education-policy/collections/equity-ece/ 18 https://www.minneapolisfed.org/article/2017/the-promise-of-early-childhood-development-in-indian-country
52 

discipline practices.

19,20 

Established in FY 2017, Indigenous Project LAUNCH (I-LAUNCH) promotes the wellness of 

young children from birth to eight years within tribes, territories, and Pacific Island jurisdictions. 

This program provides local communities or tribes the opportunity to disseminate effective and 

innovative early childhood mental health practices and services, ultimately leading to better 

outcomes for young children and their families. Through Indigenous LAUNCH, children can 

thrive in safe, supportive environments and enter school ready to learn and succeed. With these 

Project LAUNCH programs, SAMHSA aims to promote resilience and emotional health for 

children, youth, and their families.

Budget Request

The FY 2024 President’s Budget request is $35.4 million, an increase of $9.8 million from the 

FY 2023 Enacted level. This funding will support 13 continuation grants, award a new cohort of 

17 grants and the Center of Excellence for Infant and Early Childhood Mental Health Consultation 

(CoE-IECMHC) to improve health outcomes for young children and support children at high risk 

for mental illness and their families to prevent future disability. This funding will provide 

continued screening, prevention, early intervention for behavioral health issues and referrals to 

high quality treatment for children and families in 30 communities across the U.S. through the 

CoE-IECMHC. It is expected that approximately 29,000 young children will be screened for 

mental health disorders, and about 8,500 children will be referred for mental health and related 

services. 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $23,605,000 

FY 2021 $23,508,709 

FY 2022 Final $23,588,200 

FY 2023 Enacted $25,605,000 

FY 2024 President's Budget $35,408,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 26 grant continuations and the CoE-IECMHC. In FY 2022, 

LAUNCH grantees trained 6,328 people in mental health-related workforce in mental healthrelated practices/activities; 17,447 children were screened for mental health or related 

interventions; 5,577 children were referred to mental health or related services; 4,602 children 

received evidence-based mental health-related services; and 213 organizations collaborated, 

19 https://www.newamerica.org/education-policy/collections/equity-ece/ 20 https://www.americanprogress.org/article/new-data-reveal-250-preschoolers-suspended-expelled-every-day/
53 

coordinated, and shared resources with other organizations. 

 I-LAUNCH grantees achieved the following outcomes in FY 2022: trained 4,178 people in the 

mental health and related workforce in mental health-related practices/activities; 7,539 children 

were screened for mental health or related interventions; 915 children were referred to mental 

health or related services; 4,602 children and 265 organizations collaborated, coordinated, and 

shared resources with other organizations. 

The CoE-IECMHC advances the implementation of high-quality infant and early childhood mental 

health consultation across the nation through the development of tools, resources, and mentorship 

to the infant and early childhood mental health field. In FY 2022, the CoE-IECMHC work resulted 

in 2,238 people in mental health and related workforce receiving training in mental health-related 

practices/activities and 37 programs/organizations/communities implementing evidence-based 

mental health-related practices/activities. 

In FY 2023, SAMHSA anticipates funding 17 continuation grant; and awarding a new cohort of 

13 grants and the CoE-IECMHC. In FY 2023, SAMHSA estimates that the number of individuals 

in the mental health and related workforce who are trained in mental health-related 

practices/activities will near 10,500; that the number of children screened for mental health or 

related interventions will near 22,000; that the number of children referred to mental health or 

related services will near 6,500; that the number of children receiving evidence-based mental 

health services will near 9,600, and that the number of organizations collaborating, coordinating, 

and/or sharing resources with other organizations will near 540. 
54 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.3.94 Number of 

persons served 

(Output) 

FY 2022: 9,637 

Target:

5,700 

(Target Exceeded)

9,600 12,600 +3,000 

2.3.95 Number of 

persons trained in 

mental illness 

prevention or mental 

health promotion 

(Outcome)

FY 2022: 11,024 

Target:

8,200 

(Target Exceeded)

10,500 14,500 +4,500 

2.4.00 Number of 0-8 

year old children 

screened for mental 

health or related 

interventions 

(Outcome)

FY 2022: 25,427 

Target:

8,500 

(Target Exceeded)

22,000 29,000 +7,000 

2.4.01 Number of 0-8 

year old children 

referred to mental 

health or related 

interventions 

(Outcome)

FY 2022: 6,881 

Target:

3,600 

(Target Exceeded)

6,500 8,500 +2,000 
55 

Mental Health System Transformation and Health Reform 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Mental Health System Transformation and Health 

Reform........................................................................... $3,762 $3,779 $3,779 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

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

Program Description 

Mental Health System Transformation and Health Reform funding supports the Transforming 

Lives through Supported Employment Program (SEP). There is a significant gap between the 

number of people with serious mental illness (SMI), such as schizophrenia, bipolar disorder, and 

major depression, who want to work (66 percent) and the number of these individuals who are 

employed (less than 20 percent).21 The benefits of steady competitive employment for individuals 

with SMI are substantial and include increased income, improved adherence with treatment for 

mental illness, enhanced self-esteem, reduced use of substances, and improved quality of life.22 

In FY 2014, the Transforming Lives through Supported Employment (SEP) Grant program was 

initiated to help states foster the adoption and implementation of permanent transformative 

changes in how public mental health services are organized, managed, and delivered throughout 

the United States. This program aimed to enhance state and community capacity to provide 

evidence-based supported employment programs for adults and youth with SMI or serious 

emotional disturbance (SED). In FY 2023, the program continued to support state and community 

efforts to refine, implement, and sustain evidence-based practices but altered its population of 

focus to include both adults with SMI or co-occurring disorders (COD). The end goal is the same 

– for individuals to achieve competitive employment and build paths to self-sufficiency and 

recovery. With this program, SAMHSA aims to increase state and community capacity to 

implement and sustain SEP models and integrated supports to improve competitive employment 

outcomes. 

Budget Request

The FY 2024 President’s Budget Request is $3.8 million, level with the FY 2023 Enacted level. 

Funding will support one continuation grant and 3 new SEP grants that will enhance state and 

community capacity to provide evidence-based supported employment programs and mutually 

compatible and supportive evidence-based practices for adults and youth with SMI/SED and cooccurring mental and substance use disorders. It is estimated that 800 individuals will be served.

21 IPS Supported Employment: The Evidence-based Practice for Employment. (n.d.). Retrieved August 4, 2015 22 IBID 
56 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $3,779,000 

FY 2021 $3,779,000 

FY 2022 Final $3,762,200 

FY 2023 Enacted $3,779,000 

FY 2024 President's Budget $3,779,000 

Program Accomplishments

In FY 2022, SAMHSA funded four grant continuations. In FY 2022, 59.9 percent of participants 

were competitively employed at six-month follow-up, compared to 18.4 percent at intake 

(baseline), representing a 45.6 percent positive change. Additionally, 57.7 percent reported having 

a stable place to live at follow-up compared to 39.1 percent at intake, and 89.4 percent were 

retained in the community compared to 59.9 percent at intake. 

In FY 2023, SAMHSA anticipates funding three continuation grants and awarding one new grant 

to support state and community efforts to refine, implement, and sustain evidence-based supported 

employment programs and mutually compatible and supportive evidence-based practices (e.g., 

supported education) for adults with SMI or co-occurring mental and substance use disorders. In 

FY 2023, SAMHSA will maintain the performance measures targets. 
57 

Outputs and Outcomes 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.2.11 Number of 

persons in the mental 

health and related 

workforce trained in 

specific mentalhealth related 

practices/activities as 

a result of the grant 

(Outcome)

FY 2022: 290 

Target:

350 

(Target Not Met)

Discontinued Discontinued N/A

1.2.21 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6-month followup. (Outcome) 

FY 2022: 72.5 % 

Target:

62.7 % 

(Target Exceeded)

70.0% 70.0 % Maintain

1.2.22 Percentage of 

clients receiving 

services who had a 

permanent place to 

live in the 

community at 6-

month follow-up. 

(Outcome)

FY 2022: 57.7 % 

Target:

54 % 

(Target Exceeded)

56.0 % 56.0 % Maintain

1.2.23 Percentage of 

clients receiving 

services who are 

currently employed 

at 6 month followup. (Outcome)

FY 2022: 59.4 % 

Target:

31.6 % 

(Target Exceeded)

55.0 % 55.0 % Maintain
58 

Primary and Behavioral Health Care Integration 

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 

+/- 2023 

Enacted

Primary and Behavioral Health Care Integration..................................................... $54,834 $57,868 $104,868 $47,000 

Primary and Behavioral Health Care Integration................................................ 52,860 55,877 102,877 $47,000 

Primary and Behavioral Health Care Integration TTA......................................... 1,974 1,991 1,991 $---

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

FY 2024 Authorization ..................................................................................................$60,000,000 

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

Eligible Entities ............................................................................................. States or State Agency

Program Description 

The Primary and Behavioral Health Care Integration (PBHCI) grant program was established in 

FY 2009 to address the intersection between primary care and treatment for mental illness and cooccurring disorders, and PBHCI was replaced by the Promoting Integration of Primary and 

Behavioral Health Care (PIPBHC) grant program in FY 2017. Adults with SMI experience high 

rates of morbidity and mortality. These rates are due, in large part, to elevated incidence and 

prevalence of cardiovascular disease, obesity, diabetes, hypertension, and dyslipidemia.

23 People 

with SMI and physical health problems have decreased quality of life and are at higher risk for 

premature death. In fact, mortality among people with SMI and substance use disorders are higher 

and are often exacerbated by fragmented and poor-quality physical health care.24, 25 People with 

SUDs also are at an increased risk of a range of physical health problems. Beyond tragic and 

prevalent overdose risk, SUDs are associated with increased rates of smoking and related physical 

health problems; cardiovascular disease; infectious disease, including HIV and viral hepatitis; 

organ damage; and cancer.26 As a result, there is a need to improve whole-person health by 

increasing capacity and access to treat mental and substance use disorders and co-occurring 

physical health conditions in bi-directional primary and behavioral health care settings. 

The purpose of PIPBHC is to (1) promote full integration and collaboration in clinical practice 

between behavioral healthcare and primary/physical healthcare; (2) support the adoption and 

improvement of integrated care models for behavioral healthcare and primary/physical healthcare 

to improve the overall wellness and physical health status of: adults with a serious mental illness 

(SMI); adults who have co-occurring mental illness and physical health conditions or chronic 

23 Forman-Hoffman, Muhuri, Novak, Pemberton, Ault, and Mannix (August 2014) CBHSQ Data Review: 

Psychological Distress and Mortality among Adults in the U.S. Household Population.

24 Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., Druss, B., Dudek, K., Freeman, M., Fujii, 

C., Gaebel, W., Hegerl, U., Levav, I., Munk Laursen, T., Ma, H., Maj, M., Elena Medina-Mora, M., Nordentoft, M., 

Prabhakaran, D., Pratt, K., ... Saxena, S. (2017). Excess mortality in persons with severe mental disorders: a multilevel 

intervention framework and priorities for clinical practice, policy and research agendas. World psychiatry: official 

journal of the World Psychiatric Association (WPA), 16(1), 30–40. https://doi.org/10.1002/wps.20384. 25 Druss, B.G., & Goldman, H.H. (2018). Integrating health and mental health services: A past and future

history. American Journal of Psychiatry, 175:1199-1204; doi:10.1176/appi.ajp.2018.18020169. 26 Schulte, M. T., & Hser, Y. I. (2014). Substance Use and Associated Health Conditions throughout the Lifespan. 

Public health reviews, 35(2)
59 

disease; children and adolescents with a SED who have a co-occurring physical health conditions 

or chronic disease; individuals with a substance use disorder (SUD); or persons with co-occurring 

mental health and substance use conditions; and (3) promote the implementation and improvement 

of bidirectional integrated care services, including evidence-based or evidence-informed 

screening, assessment, diagnosis, prevention, treatment, and recovery services for mental and 

substance use disorders, and co-occurring physical health conditions and chronic diseases. In FY 

2022, the PIPBHC program was reauthorized to include a focus on implementation of the 

Collaborative Care Model in primary care settings. In FY 2023, Congress directed that up to 10 

percent of new grants be awarded to states that proposed to partner with primary care practices 

and providers implementing the Collaborative Care Model. 

In FY 2019, SAMHSA established The National Center of Excellence for Integrated Health 

Solutions (CoE-IHS), to advance the implementation of high quality, evidence-based treatment for 

individuals with co-occurring physical and mental health conditions including substance use

disorders. The program complements the PIPBHC program by offering technical assistance and 

training for communities, individual practitioners, providers, and states on evidence-based 

strategies that address the integration of primary and behavioral health care for individuals with 

mental and substance use disorders and co-occurring physical health conditions and chronic 

diseases. 

Budget Request

The FY 2024 President’s Budget Request is $104.9 million, an increase of $47.0 million from the 

FY 2023 Enacted level. Funding will support the continuation of 21 PIPBHC grants and a new 

cohort of 29 PIPBHC grants. SAMHSA anticipates that this increase in funding will enable the 

PIPBHC program to greatly expand its reach across the U.S. and enable the program to advance 

the integration of physical and behavioral health care, through evidence-based models, including 

the Collaborative Care Model. It is expected that this increase in funding will also enable the 

program to reach approximately 40,000 people with treatment and services. 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 $51,868,000 

FY 2021 $54,368,001 

FY 2022 Final $54,834,400 

FY 2023 Enacted $57,868,000 

FY 2024 President's Budget $104,868,000 
60 

Program Accomplishments

In FY 2022, SAMHSA supported 24 PIPBHC grant continuations, and awarded one new PIPBHC 

grant. All active PIPBHC grants collected data on program recipients to demonstrate favorable 

outcomes on critical domains. These outcomes included: improvement in mental health 

functioning; reduction in substance use; reduction in homelessness, and reduction in criminal 

justice system involvement. For example, 77.9 percent of assessed individuals reported no 

psychological distress at the six-month reassessment in comparison to 67.8 percent at baseline. 

Together, these outcomes comprise measurement for an improvement in overall quality of life. 

Also, the CoE-IHS provided training to 62,806 people across the country, further advancing an 

integration framework that defines and measures the uptake of integrated care in future years. 

In FY 2023, SAMHSA anticipates funding 12 PIPBHC grant continuations, awarding a new cohort 

of 15 grants, and continuing to support the CoE-IHS. SAMHSA anticipates that these grants will 

provide care to 24,000 people. 
61 

Outputs and Outcomes 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024 

Target

FY 2024 

Target

+/-FY 2023 

Target

3.2.41 Increase the 

percentage of clients 

receiving services 

who report positive 

functioning at 6-

month follow-up. 

(Outcome)

FY 2022: 60.9 % 

Target:

63 % 

(Target Not Met)

63 % 63 % Maintain

3.2.42 Increase the 

percentage of clients 

receiving services 

who are currently 

employed at 6month 

follow-up. 

(Outcome)

FY 2022: 40.1 % 

Target:

40 % 

(Target Exceeded)

40.1 % 40.1 % Maintain

3.2.43 Increase the 

percentage of clients 

receiving services 

who had a permanent 

place to live in the 

community at 6-

month follow-up. 

(Outcome)

FY 2022: 67.9 % 

Target:

75 % 

(Target Not Met)

75 % 83 % N/A

3.2.54 Number of 

clients served

12,028 24,000 40,000 +16,000 
62 

Suicide Prevention Programs

Summary of the Request

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Suicide Prevention............................................................................................. $196,979 $617,043 $1,034,425 $417,382 

988 and Behavioral Health Crisis Services....................................................... - 501,618 836,000 334,382 

Suicide Lifeline ................................................................................................ 101,621 - - - 

National Strategy for Suicide Prevention (non-add)......................................... 23,183 28,200 28,200 - 

 Zero Suicide (non-add).................................................................................... 18,783 22,800 22,800 - 

 Zero Suicide -AI/AN (non-add)....................................................................... 2,400 3,400 3,400 - 

 All Other National Strategy for Suicide Prevention (non-add)....................... 2,000 2,000 2,000 - 

GLS - Youth Suicide Prevention - States (non-add)......................................... 38,789 43,806 43,806 - 

 Budget Authority (non-add)............................................................................. 26,789 31,806 31,806 - 

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

GLS - Youth Suicide Prevention - Campus (non-add)...................................... 6,471 8,488 11,488 $3,000 

Suicide Prevention Resource Center (non-add)................................................ 8,983 11,000 11,000 - 

AI/AN Suicide Prevention Initiative (non-add)................................................ 2,931 3,931 3,931 - 

MH Crisis Response Grants............................................................................. 10,000 20,000 100,000 $80,000 

Behavioral Health Crisis Coordinating Office....................................................... 5,000 - - - 

Program Description 

From 1999 through 2019, the overall age-adjusted suicide rate increased by over 30 percent from 

10.5 to 13.9 per 100,000.27 Rates among youth aged 5-24 in 2020 were highest among American 

Indian/Alaska Natives, followed by suicide among white youth.28 Non-Hispanic White persons 

experienced a 4.5 percent decline in suicide rate.

29 Suicide increased in 2020 among youth and 

young adults aged 10-34, but decreased among those older than 35, except for an increase in those 

over 85.

30 Approximately 47,646 Americans died by suicide in 2021.31 The 2021 National Survey 

on Drug Use and Health reported that approximately 1.7 million Americans ages 18 and older 

attempted suicide over the previous 12 months, 12.3 million seriously considered suicide, and 3.5 

million made a plan.32 Among youth ages 12-17 in 2021, 892,000 attempted suicide, 3.3 million 

seriously considered suicide, and 1.5 million made a suicide plan33. 

Research has shown that implementing comprehensive public health approaches that make suicide 

prevention a priority within health and community systems can reduce the rates of death by suicide 

27 ibid 28 Ehlman DC, Yard E, Stone DM, Jones CM, Mack KA. Changes in Suicide Rates — United States, 2019 and 2020. 

MMWR Morb Mortal Wkly Rep 2022;71:306–312. DOI: http://dx.doi.org/10.15585/mmwr.mm7108a5external icon. 29 Ehlman DC, Yard E, Stone DM, Jones CM, Mack KA. Changes in Suicide Rates — United States, 2019 and 2020. 

MMWR Morb Mortal Wkly Rep 2022;71:306–312. DOI: http://dx.doi.org/10.15585/mmwr.mm7108a5external icon. 30 https://www.cdc.gov/injury/wisqars/index.html. 31Curtin, S.C., Garnett, M.F., and Ahmad, F.B. Provisional numbers and rates of suicide by month and demographic 

characteristics: United States, 2021. Vital Statistics Rapid Release; no 24. September 2022. DOI: https://dx.doi. 

org/10.15620/cdc:120830.

32 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health 

indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. 

PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report 33 ibid
63 

as well as suicide attempts. Accordingly, SAMHSA supports a comprehensive portfolio of suicide 

prevention programs including the 988 and Behavioral Health Crisis Services (which subsumes 

the Suicide Lifeline); the National Strategy for Suicide Prevention and Zero Suicide grant 

programs; and interventions that focus on youth suicide prevention such as the Garrett Lee Smith 

and the AI/AN programs. 
64 

988 and Behavioral Health Crisis Services

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

988 and Behavioral Health Crisis Services............................................................ $--- $501,618 $836,000 $334,382 

Suicide Lifeline ...................................................................................................... $101,621 $--- $--- $---

Authorizing Legislation....................Section 520A and 520E-3 of the Public Health Service Act

FY 2024 Authorization.........................................................................$106,621,000 

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

Eligible Entities..............................................States, Tribes, Community Organizations 

Program Description 

Individuals need rapid access to suicide prevention and crisis intervention services to prevent death 

and injury as the result of suicide attempts,. Implementation of the 988 Lifeline has been and 

continues to be a once-in-a-lifetime opportunity to strengthen and transform America’s behavioral 

health crisis care system to one that saves lives by serving anyone, at any time, from anywhere 

across the nation. Planning for the 988 program was accelerated on July 16, 2020, when the Federal 

Communications Commission issued a final order designating 988 as the new, three-digit number 

for suicide prevention and mental health crises. On October 17, 2020, the National Suicide Hotline 

Designation Act of 2020 (Public Law 116-172) was signed into law, incorporating 988 into statute 

as the new number for individuals in crisis. On July 16, 2022, the U.S. transitioned from the 

previous 10-digit hotline to the 988 Suicide & Crisis Lifeline. 

In FY 2022, SAMHSA established and began implementation of a national 988 strategy, with 

critical performance targets to ensure 988 meets national demands. The key performance indicators 

and target outcomes include, but are not limited to, monthly and as-needed reports on the total 

number of call, chats, and texts contacts received; monthly and as-needed reports on the total 

number of call, chats, and texts contacts answered—with a 90% or greater target for local centers 

and a 95% or greater target for the full network; and monthly and as-needed reports on the speed 

to answer call, chats, and texts—with a 95% answered in 20 seconds full target for the full network. 

In addition, SAMHSA monitors abandonment rate and rollover contacts from the local to backup 

centers and provide action plans for improvement of responses as required. 

The new 988 hotline builds directly on the original Lifeline that was established in 2005. The 988 

system operates 24 hours per day, 7 days per week and contains three primary elements: 

• A network of independently local call centers, including chat, text, and Spanish language 

centers;

• A network of national backup centers; 

• A single system administrator; and 

• The Federal 988 & Behavioral Health Crisis Coordination Office
65 

Budget Request 

The FY 2024 Budget Request is $836.0 million, an increase of $334.4 million from the FY 2023 

Enacted level. This funding level will increase capacity for 988 to respond to 100 percent of the 

estimated 9 million contacts in 2024. In FY 2024, SAMHSA will invest in the following essential 

areas: 

• Supporting network operations and specialized services. Network operations include 

centralized network functions, such as: staffing for backup call centers; core chat/text 

centers; data and telephony infrastructure; standards, training, and quality improvement; 

evaluation and oversight. Specialized services include services for LGBTQ+ youth and 

Spanish language services.

• Enhancing local capacity through partnerships in behavioral health crisis response. Local 

center capacity is critical to ensuring that individuals in crisis receive responses that are 

tailored to the service system where they are located and that services across the 

continuum are linked and coordinated. 

• Maintaining the 988 and Behavioral Health Crisis Coordination Office. Coordination 

activities include technical assistance to states, and crisis centers; strategic planning, 

performance management, evaluation, and oversight; and formal partnerships, 

convenings, and cross-entity coordination. 

• Enhancing public awareness with targeted 988 national messaging. A research-based 

campaign will save lives through the use of preferred and effective communication 

channels and messengers to promote help seeking behavior.
66 

Funding History Table - Suicide Lifeline

5 Year Funding Table

Fiscal Year Amount

COVID-19 

Supplemental 

Funding 

FY 2020 $19,000,000 

FY 2021 $24,000,000 $32,000,000 

FY 2022 Final $101,621,000 $150,000,000 

FY 2023 Enacted $--- 

Suicide Lifeline was realigned to 988 and Behavioral Health Crisis Services in 2023 

Funding History Table - 988 and Behavioral Health Crisis Services 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $---

FY 2021 $---

FY 2022 Final $---

FY 2023 Enacted $501,618,000 

FY 2024 President's Budget $836,000,000 

Program Accomplishments 

The development of operational targets strengthened the performance of the system, with notable 

improvements in handled volume of contacts, response rates across all communication channels 

and average speed to answer. In addition, SAMHSA has undertaken a number of strategies to 

drive system improvement, including dissemination of performance targets, technical assistance, 

and publication of operational tools to advance readiness, and engagement with state governors 

and commissioners. The extent and sustainability of local investments will continue to be essential 

to overall system performance. 

The 988 Suicide & Crisis Lifeline has received more than 2 million contacts since the transition 

on July 16 to 988 as the easy-to-remember number to reach trained crisis counselors for help with 

suicide, mental health, and substance use-related crises. From July to December 2022, the 988 

Lifeline answered 2,134,735 contacts, not including 327,319 calls routed to the Veterans Crisis 

Line. Compared to the same six-month timeframe in 2021, the 988 Lifeline answered 892,867 

more contacts -- calls, chats, and texts -- and significantly improved how quickly contacts were 

answered. 
67 

The historical challenges in system response due to insufficient funding in previous years have 

been noted in prior SAMHSA reports. In December 2021, the Lifeline only had sufficient capacity 

to address approximately 82% of calls, 52% of texts, and 24% chats. With increased FY 2022 

investments and federal leadership, by December 2022, the number of calls, chats and texts

answered increased by 43 percent, 224 percent, and 1,145 percent, respectively. The average speed 

to answer across all contacts decreased from 2 minutes and 46 seconds to 49 seconds. While these 

are significant gains, there remain gaps in access to care, particularly local response to chat and 

text. Additionally, more work is required to further reduce average speed to answer to the 20 

second target. With expected increases in volume in FY 2024, there is risk of losing these gains 

without increased investments. 

In FY 2022, the 988 Lifeline launched a pilot program to offer specialized call, text, and chat 

supports for lesbian, gay, bisexual, transgender, queer, questioning, and other sexual and gender 

minority (LGBTQI+) youth and young adults. The program aims to support people under the age 

of 25 who reach out to the 988 Lifeline and want the option of connecting with a counselor 

specifically focused on meeting the needs of LGBTQI+ youth and young adults. Since it began in 

September of 2022, the demand for LGBTQI+ youth and young adult services (calls, chats, texts) 

accounted for about 5% of calls routed in the network and 9% of routed chats and texts, or about 

111,000 contacts total. 

In FY 2023, SAMHSA will continue efforts to strengthen the 988 Lifeline and Crisis Coordination 

in a number of key areas, as Lifeline volume is expected to increase to 6 million contacts over the 

course of FY 2023. Strategic actions will be taken to:

• Strengthen network infrastructure, training, technology and security for the Lifeline 

administrator, along with support for national backup centers and Spanish subnetwork 

services. This includes new videophone services for people who are deaf and hard of hearing; 

• Expand the current pilot program providing specialized service to LGBTQI+ youth and 

young adults; 

• Enhance language access through Spanish text and chat; 

• Strengthen capacity for local response within states and territories, particularly for text and 

chat, and will expand partnerships with 911 centers and first responders to promote 

diversions to 988 where appropriate; 

• Further expand implementation of an evidence-based practice shown to reduce suicide risk; 

• Enhance technical assistance to grantees and partners to promote access, quality and 

sustainability of services; and

• Focus efforts to better understand communications preferences for populations at higher risk 

of suicide and to expand awareness and education on 988 services. 
68 

Output and Outcomes Table 

The table below highlights some of the key performance indicators and target outcomes. 

Key Performance 

Indicators**

Definition Target Action

Calls, Chats, Texts 

Received

Total number of 

contacts received

n/a Monthly report out and ad hoc

Calls, Chats, Texts 

Answered

Total number of 

contacts answered

90% or greater (local) 

95% or greater (full 

network) 

Monthly report out and ad hoc, track 

state transition rates and provide action 

plans for improvement of response as 

required

Phone, Chat, Text 

Average Speed to 

Answer**

Speed to answer 

contact 

95% answered in 20 

seconds (full network 

target)

Monthly Report out and ad hoc

Abandonment Rate Percentage of contacts 

received vs 

disconnected prior to 

answer

Less than 5% Monthly report and ad hoc

Direct/Rollover calls 

to Backup Centers

Total number of 

phone contacts sent to 

the Lifeline Centers

Less than 10% Monthly report and ad hoc
69 

National Strategy for Suicide Prevention

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

National Strategy for Suicide Prevention.......................................................... $23,183 $28,200 $28,200 $---

Zero Suicide (non-add)..................................................................................... 18,783 23,674 23,674 $---

 Zero Suicide -AI/AN (non-add)....................................................................... 2,400 3,400 3,400 $---

 All Other National Strategy for Suicide Prevention (non-add)..................... 2,000 2,000 2,000 $---

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

FY 2024 Authorization ..................................................................................................$30,000,000 

Allocation Method ............................................................................................ Competitive Grants

Eligible Entities .........................................Community –based primary care or behavioral 

health entity, Federally Recognized, American Indian/Alaska Native tribe or tribal organizations, 

State mental health or public health agency

Program Description 

In January 2021, the Office of the Surgeon General issued a Call to Action to implement the 

National Strategy for Suicide Prevention (National Strategy). With the rising rates of suicide 

among adults, reducing suicide among adults is necessary to reduce suicides nationally. The baby 

boomer generation has had high rates of suicide throughout the generational lifecycle34 and is 

entering the stage of life that has historically had the highest rate of suicide35. Very limited suicide 

prevention work has been directed toward older adults who have the highest rates of suicide. 

Established in FY 2014, the National Strategy for Suicide Prevention (NSSP) grant program is 

intended to address the Call to Action’s broad-based public health approach to suicide prevention 

by enhancing collaboration with key community stakeholders (e.g., county health departments, 

workplace settings, criminal justice settings, senior-serving organizations, community firearm 

stakeholders36), raising awareness of the available resources for suicide prevention, and 

implementing lethal means safety. While the NSSP addresses all age groups and populations with 

specific needs, the goals, and objectives of the NSSP grants focus on preventing suicide and suicide 

attempts among adults who comprised more than 40,000 of the more than 47,000 suicides in the 

United States in 2021.37

Established in FY 2017, the Zero Suicide program funds a comprehensive, multi-setting approach 

to suicide prevention in health systems, including tribal health systems. The purpose of this 

program is to implement suicide prevention and intervention programs by systematically applying 

34 Phillips. J.A. A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United 

States Social Science Medicine 2014 August

35 Ismael Conjero, Emilie Olie, Philippe Courtet &Raffella Calati (2018) Suicide in older adults : current perspectives 

,Clinical Interventions in Aging ,13,691-699 36 Community firearm stakeholders include firearm safety instructors, members of law enforcement, firearm retailers, 

and gun owners.

37 Curtin SC, Garnett MF, Ahmad FB. Provisional numbers and rates of suicide by month and demographic 

characteristics: United States, 2021. Vital Statistics Rapid Release; no 24. September 2022. DOI: https://dx.doi. 

org/10.15620/cdc:120830.
70 

evidence-based approaches to screening and risk assessment, developing care protocols, 

collaborating for safety planning, providing evidence-based treatments, maintaining continuity of 

care during high-risk periods, and improving care and outcomes for individuals who are at risk for 

suicide being seen in health care systems.

Budget Request

The FY 2024 President’s Budget Request is $28.2 million, level with FY 2023 Enacted level. This 

funding will support 42 Zero Suicide continuation grants, and support five NSSP grants. It is 

expected that 98,000 individuals will be referred for services. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

COVID-19 

Supplemental 

Funding 

FY 2020 $18,200,000 

FY 2021 $23,200,000 $18,000,000 

FY 2022 Final $23,183,200 

FY 2023 Enacted $28,200,000 

FY 2024 President's Budget $28,200,000 

Program Accomplishments

In FY 2022, SAMHSA supported the continuation of five NSSP grants, and 40 Zero Suicide 

continuation grants. In Fiscal Year 2022, the NSSP program contacted 49,678 people through 

program outreach efforts and screened 16,781 people for mental health interventions with a focus 

on suicide risk. The Zero Suicide grant program screened 982,268 people for mental health 

interventions with a focus on suicide risk and referred 97,344 individuals for mental health services 

with 63.3 percent receiving services after referral. 

In FY 2023, SAMHSA anticipates funding 25 Zero Suicide grant continuations, awarding a new 

cohort of 17 Zero Suicide grants and five NSSP grants, and anticipates slight increases in contact

and outreach targets from FY 2022 for both programs. 
71 

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

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

GLS - Youth Suicide Prevention - States...................................................... $38,789 $43,806 $43,806 $---

 Prevention & Public Health Fund (non-add)............................................. 12,000 12,000 12,000 $---

GLS - Youth Suicide Prevention - Campus................................................. 6,471 8,488 11,488 $3,000 

Authorizing Legislation ..................... Sections 520E and 520E-2 of the Public Health Service Act

FY 2024 Authorization ..................................................................................................$47,000,000 

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

Eligible Entities...............................................................................................................Private\ and 

public non-profit institution of higher education, including Tribal colleges and universities; States 

and territories; public organizations of private non-profit organization designated by a State; or a 

federal recognized Indian tribe, tribal organization, or an Urban Indian organization.

Program Description 

In the fall of 2003, Garrett Lee Smith, son of Sen. Gordon and Sharon Smith, died by suicide in 

his apartment in Utah where he attended college. He was one day shy of 22 years old. In his 

memory, the Garrett Lee Smith Memorial Act was signed into law.

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant youth 

suicide prevention grant programs and one resource center. Since its inception in 2005, the GLS 

State/Tribal Youth Suicide Prevention and Early Intervention Grant Program has awarded 256 

grants to 50 states and the District of Columbia, 67 unique tribes/tribal organizations, and two 

territories. These grants develop and implement comprehensive youth suicide prevention and early 

intervention strategies including public-private collaboration among youth-serving institutions. 

Since 2005, the GLS Campus Suicide Prevention grant program has implemented a comprehensive 

public health approach to suicide prevention across an array of institutions of higher education 

include state university systems, private colleges, community colleges, and historically black 

colleges and universities. The goals of this grant are to engage the entire college community to 

enhance protective factors, identify risks, and promote an array of suicide prevention initiatives. 

This comprehensive approach identifies students at risk, increases help-seeking behaviors, 

provides substance use disorder and mental health services, and promotes social connectedness. 
72 

Budget Request

The FY 2024 President’s Budget request is $55.3 million, an increase of $3.0 million from the 

FY 2023 Enacted level. Funds will support the continuation of 25 GLS State/Tribal grants and 

award a new cohort of 30 new grants. Funding will also support 44 GLS Campus continuation 

grants and award a new cohort of 54 grants. The program will continue developing and 

implementing youth suicide prevention and early intervention strategies involving public-private 

collaboration among youth serving institutions as well as to support suicide prevention among 

institutions of higher learning. It is anticipated that 125,000 individuals will be served. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

COVID-19 

Supplemental 

Funding 

FY 2020 $41,915,000 

FY 2021 $42,915,000 $20,000,000 

FY 2022 Final $45,260,200 

FY 2023 Enacted $52,294,000 

FY 2024 President's Budget $55,294,000 

Program Accomplishments

In FY 2022, SAMHSA supported 46 GLS State/Tribal grant continuations, 49 GLS Campus grant 

continuations (41 grants with base budget authority and eight grants with American Rescue Plan 

Act) and awarded a new cohort of 11 GLS State and Tribal grants (four grants with base budget 

authority and five grants with American Rescue Plan Act) and awarded 21 new GLS Campus 

grants (22 grants with base budget authority and one grant with American Rescue Plan Act). In 

FY 2022, the GLS State/Tribal program screened 51,362 youth for suicide risk and referred 12,706 

to services, of which 71.0 percent received services after referral. In FY 2022, the GLS Campus 

program provided services to 66,310 youth and reached 2,066,374 individuals with awareness 

activities.

In FY 2023, SAMHSA anticipates funding 56 GLS State/Tribal grant continuations (51 grants 

with base budget authority and five with American Rescue Plan Act), 55 GLS Campus grant 

continuations (46 grants with base budget authority and nine grants with American Rescue Plan 

Act) and awarding a new cohort of five GLS State and Tribal grants and 23 GLS Campus grants. 

It is expected that in FY 2023, the GLS State/Tribal program will screen 53,300 youth for suicide 

risk and refer 13,000 to services, of which 72 percent will receive services after referral. In FY 

2023, the GLS Campus program will provide services to 69,000 youth and reach 2,200,000 

individuals with awareness activities.
73 

Suicide Prevention Resource Center

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Suicide Prevention Resource Center....................................................................... $8,983 $11,000 $11,000 $---

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

FY 2024 Authorization ....................................................................................................$9,000,000 

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

Eligible Entities...................................................Domestic Public and Private Nonprofit Entities

Program Description 

SAMHSA supports the Suicide Prevention Resource Center (SPRC), first funded in 2002. The 

SPRC’s purpose is to build national capacity for preventing suicide by providing technical 

assistance, training, and resources to assist states, tribes, organizations, and SAMHSA grantees to 

develop suicide prevention strategies (including programs, interventions, and policies that advance 

the NSSP), with the overall goal of reducing suicides and suicidal behaviors in the nation. This 

work includes support for the National Action Alliance for Suicide Prevention which is a publicprivate partnership and working to advance high-impact objectives of the NSSP. 

The SPRC has played an important role in transforming suicide prevention and treatment across 

the lifespan, particularly for those at high risk for suicide. Efforts to advance suicide prevention 

include: 

• Developing and promoting the adoption of evidence-based resources, tools, and 

online trainings to support strategic, comprehensive, best practice suicide prevention 

programs around the country. 

• Building the capacity of suicide prevention programs nationwide by providing 

consultation, training, and resources to states, AI/AN communities, colleges and 

universities, health systems, and organizations serving groups at higher risk for 

suicide.

• Improving care for those at risk for suicide, including promoting the Zero Suicide 

model for safer suicide care in health and behavioral health care systems; and

• Providing leadership and operational support, which brings together more than 250 

national partners from the public and private sectors to advance implementation of 

the goals and objectives of the National Strategy. 

In addition, the SPRC collaborates closely with national and regional technical assistance (TA) 

centers that focus on issues related to suicide prevention, such as mental health, injury prevention, 

substance use prevention and treatment, and violence prevention. SPRC’s collaborations include 

contacts with the coordinating offices of SAMHSA’s Mental Health Technology Transfer Centers 

(TTCs), Prevention TTCs, and Addiction TTCs; Service Member, Veterans, and their Families TA 

Center; Center for Integrated Health Solutions; and Health Resources and Services Administration 

(HRSA)’s National Center for Fatality Review and Prevention.
74 

Budget Request

The FY 2024 President’s Budget Request is $11.0 million, level with FY 2023 Enacted to support 

one continuation grant. The SPRC will provide states, tribes, government agencies, private 

organizations, colleges and universities, and suicide survivors and mental health consumer groups 

with access to information and resources that support program development, intervention 

implementation, and adoption of policies that prevent suicide. The funding will expand youth 

suicide prevention and early intervention strategies involving public-private collaboration. It is 

estimated that the number of individuals served will remain approximately at 13,000. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $7,988,000 

FY 2021 $9,000,000 

FY 2022 Final $8,983,200 

FY 2023 Enacted $11,000,000 

FY 2024 President's Budget $11,000,000 

Program Accomplishments

In FY 2022, SAMHSA supported one SPRC grant continuation, which provided free online 

courses to prepare the clinical workforce to address suicide risk in effective ways. In FY 2022, 

10,964 individuals had received training through the SPRC. Trainings included “Locating and 

Understanding Data Online Suicide Prevention Course” and the “Strategic Planning for Suicide 

Prevention Online Suicide Prevention Course,” among others. SPRC delivered six webinars 

focusing on the needs of the clinical workforce and two webinars focused on aspects of the Zero 

prevention efforts through telehealth to improve care provided during the COVID-19 pandemic. 

SPRC is currently developing courses on safety planning for youth and lethal means intervention 

for crisis workers. 

In FY 2023, SAMHSA anticipates supporting this grant continuation and increasing the 

performance targets as FY 2022. 
75 

American Indian/Alaska Native Suicide Prevention Initiative

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

American Indian/Alaska Native Suicide Prevention Initiative................................ $2,931 $3,931 $3,931 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description 

Established in FY 2013, the Tribal Training and Technical Assistance Center (Tribal TTA Center)

is an innovative training and technical assistance project that helps tribal communities facilitate 

the development and implementation of comprehensive and collaborative community-based 

prevention plans to reduce violence, bullying, substance misuse, and suicide among American 

Indian/Alaska Native (AI/AN) youth. These plans mobilize tribal communities’ existing social 

and educational resources to meet their goals. 

Additionally, in FY 2018, SAMHSA awarded a Mental Health Transfer Technology Center 

(MHTTC) grant for Tribal Affairs to develop a collaborative network to support resource 

development and dissemination, training and technical assistance, and workforce development to 

the field and SAMHSA grant recipients; at this same time, SAMHSA’s Centers for Substance Use 

Prevention and Substance Use Treatment also funded their own TTCs for Tribal Affairs. In FY 

2023, SAMHSA merged the three Tribal Affairs TTCs into one Center to coordinate and manage 

SAMHSA’s national efforts to ensure that high-quality, effective mental health disorder treatment 

and recovery support services, and evidence-based practices are available for all individuals with 

mental disorders including those with serious mental illness. 

Budget Request

The FY 2024 President’s Budget Request is $3.9 million, level with the FY 2023 Enacted level. 

This funding will provide funding for the Tribal Affairs Center and continuation of the contract to 

provide comprehensive, broad, focused, and intensive training and technical assistance to federally 

recognized tribes and other AI/AN communities to address and prevent mental illness and 

alcohol/other drug addiction, prevent suicide, and promote mental health through the contract 

continuation. 
76 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $2,931,000 

FY 2021 $2,931,000 

FY 2022 Final $2,931,000 

FY 2023 Enacted $3,931,000 

FY 2024 President's Budget $3,931,000 

Program Accomplishments

In FY 2022, SAMHSA funded the Tribal TTA Center contract and the continuation of the MHTTC 

Tribal Affairs Center. From September 2018 to March 2022, 296 tribes or tribal serving 

organizations received 1,870 days of virtual TTA and 375 days of on-site TTA, for a total of 2,245 

days of TTA. A total of 28,982 participants received specialized TTA and support in suicide 

prevention, substance abuse prevention, and mental health promotion. Interventions included 

Gathering of Native Americans/Gathering of Alaska Natives; Mental Health First Aid; Question, 

Persuade, Refer; and Applied Suicide Intervention Skills Training. In FY 2023, SAMHSA 

anticipates maintaining all performance targets.
77 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.3.59 Number of 

individuals trained in 

youth suicide 

prevention 

(Outcome)

FY 2022: 198,449 

Target:

118,000 

(Target Exceeded)

210,000 220,000 +10,000 

2.3.60 Number of 

youth screened 

(Output) 

FY 2022: 98,352 

Target:

64,000 

(Target Exceeded) 

105,000 110,000 +5,000 

2.3.61 Number of 

contacts answered by 

the 988 Suicide and 

Crisis Lifeline

(Output) 

FY 2022: 2,396,885 

Target:

2,186,000 

(Target Exceeded)

6,000,000 9,000,000 Increase

3.1.01 Number of 

individuals screened 

for mental health or 

related interventions 

(Intermediate 

Outcome)

FY 2022: 1,791,874.0 

Target:

1,350,000.0 

(Target Exceeded)

1,500,000.0 1,500,000.0 Maintain

3.1.02 Number of 

individuals referred 

to mental health or 

related services 

(Intermediate 

Outcome)

FY 2022: 136,569.0 

Target:

81,000.0 

(Target Exceeded)

136,000 136,000 Maintain
78 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.1.03 Number of 

organizations that 

establish 

management 

information/informati

on technology system 

links across multiple 

agencies 

(Intermediate 

Outcome)

FY 2022: 17.0 

Target:

10.0 

(Target Exceeded)

Discontinued Discontinued N/A

3.1.04 Number of 

organizations or 

communities that 

demonstrate 

improved readiness 

to change their 

systems 

(Intermediate 

Outcome)

FY 2022: 14.0 

Target:

71.0 

(Target Not Met but 

Improved) 

Discontinued Discontinued N/A

3.2.37 Number of 

youths referred to 

mental health or 

related services 

(Output) 

FY 2022: 96,342 

Target:

76,000 

(Target Not Met)

96,000 96,000 Maintain

3.5.11 Percentage of 

respondents who say 

calling the lifeline 

stopped you from 

killing yourself a lot 

or a little (Outcome)

FY 2021: 86.0 

Target:

76.0 

(Target Exceeded)

86 86 Maintain
79 

Mental Health Crisis Response Partnership Program

(Dollars in thousands) 

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

FY 2024 Authorization...........................................................$10,000,000 current level 

Allocation Method................................................. Competitive Cooperative Agreements

Eligible Entities............................States, Territories, Local Governments, Tribes, and CBOs

Program Description 

In FY 2022, SAMHSA established the Cooperative Agreements for Innovative Community Crisis 

Response Partnerships (ICCRP) program. In the FY 2023 Omnibus, Congress authorized this 

program under Section 520F “Mental Health Crisis Response Partnership Program.” The purpose 

of this program is to create or enhance existing mobile crisis response teams to divert adults, 

children, and youth experiencing mental health crises from law enforcement in high-need 

communities. The program uses SAMHSA’s National Guidelines for Behavioral Health Crisis 

Care: Best Practice Toolkit as a guide for best practices in the delivery of mobile crisis services. 

Mobile crisis team services (including co-responder teams) will offer community-based 

intervention to individuals in need wherever they are, including at home, work, or anywhere else 

in the community where the person is experiencing a crisis. These grants will enable communities 

across the country to leverage the implementation of the 988 system and improve mobile crisis 

response systems through partnerships with law enforcement, emergency medical services, 911 

Public Safety Answering Points and 988 call centers. 

Historically, mental health crisis services in the United States have been inconsistent and 

inadequate, resulting in the overuse of law enforcement, jails, hospital emergency rooms, and 

psychiatric hospital beds. In some communities, law enforcement agencies have been the mental 

health crisis responders by default and over the past years, law enforcement agencies have reported 

increases in police contacts with individuals experiencing mental health challenges.

38 This can 

result in drawing valuable police resources away from public safety priorities, increasing stigma 

and trauma for those experiencing a crisis, and may even result in tragic outcomes if law 

enforcement does not have the specialized training required to successfully de-escalate behavioral 

health crises. However, strong partnerships between crisis care systems and law enforcement (and 

other first responders) are essential for public safety, including suicide prevention. 

ICCRP recipients employ a wide array of required activities to help achieve 24/7 coverage of 

mobile crisis response services, dispatch times standards, increased professional response 

capacity, incorporation of telehealth when appropriate, improved service access in rural and 

remote areas, community-based stabilization with coordinated referrals to mental health services 

38 https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf

Program Name

FY 2022 

Final

FY 2023 

Enacted

FY 2024 

President's 

Budget

 

FY2024 +/- 

2023 

Enacted

MH Crisis Response Partnerships Program............................................................. $10,000 $20,000 $100,000 $80,000
80 

and supports, and minimization of law enforcement involvement and involuntary transport 

whenever possible. Additionally, recipients ensure that crisis response and follow-up services are 

delivered in a culturally responsive and developmentally appropriate manner, and that partnerships 

and training opportunities are established with first responders, law enforcement, 988 call centers, 

public safety answering points (911 call centers), and other relevant stakeholders. 

Budget Request

The FY 2024 President’s Budget Request is $100.0 million, an increase of $80.0 million from the 

FY 2023 Enacted level. In FY 2024, the program will support 26 grant continuations and award a 

new cohort of 107 grants. These projects will support communities across the country to improve 

crisis response capacity and integrate community 988 and crisis systems. It is estimated that in 

FY 2024, 24,000 individuals will be screened and 15,000 will be referred for services. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $---

FY 2021 $---

FY 2022 Final $10,000,000 

FY 2023 Enacted $20,000,000 

FY 2024 President's Budget $100,000,000 

Program Accomplishments

In FY 2022, the first cohort of 12 grants was funded in September 2022 and was required to begin 

service delivery by the end of December 2022. In FY 2023, it is estimated that 8,000 individuals 

will be screened, and 5,000 individuals will be referred for mental health and related services.
81 

Homelessness Prevention Programs

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Homelessness......................................................................................................... $32,958 $35,992 $37,992 $2,000 

Homelessness Prevention Programs...................................................................... 30,679 33,696 35,696 $2,000 

Homelessness......................................................................................................... 2,279 2,296 2,296 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

Eligible Entities.......................................States, Domestic Public and Community Organizations, 

............................Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description 

In FY 2018, SAMHSA initiated the Treatment for Individuals Experiencing Homelessness (TIEH) 

program to support the development and/or expansion of local implementation of an infrastructure 

that integrates behavioral health treatment and recovery support services for individuals, youth, 

and families with a serious mental illness (SMI), serious emotional disturbance (SED), or cooccurring disorder who are experiencing homelessness. The goal of the TIEH program is the 

development and/or expansion of an infrastructure that integrates behavioral health treatment, peer 

support, recovery support services, and linkages to sustainable permanent housing. 

Homelessness continues to be a significant challenge for communities across the nation, further 

exacerbated by COVID-19. Between 2020 and 2022, the overall number of people experiencing 

homelessness increased by less than one percent (1,996 people). This increase reflects a three 

percent increase in people experiencing unsheltered homelessness, which was offset by a two 

percent decline in people staying in sheltered locations. However, between 2021 and 2022, 

sheltered homelessness increased by seven percent, or 22,504 people. 39 Many factors contribute 

to homelessness, such as lack of affordable housing, foreclosures, rising housing costs, job loss, 

underemployment, domestic violence, mental illness, and addiction. According to HUD, 582,462 

individuals experienced homelessness on any given night in 2022 in the United States.

40 In 

addition, the number of individuals experiencing chronic homelessness was 138,361.41 The 

number of veterans experiencing homelessness was 33,129.42 Over 122,000 individuals 

experiencing homelessness have a SMI and over 95,000 struggle with chronic substance use.43 

39 Exchange, H. U. D. (2022). The 2022 Annual Homeless Assessment Report (AHAR) to Congress. Available at 

https://www.huduser.gov/portal/sites/default/files/pdf/2022-AHAR-Part-1.pdfExchange, H. U. D. (2021). The 2020 

Annual Homeless Assessment Report (AHAR) to Congress.

https://www.huduser.gov/portal/datasets/ahar/2020-ahar-part-1-pit-estimates-of-homelessnessin-the-us.html

40 The U.S. Department of Housing and Urban Development, 2022 CoC Homeless Populations and Subpopulations 

Reports. Available at https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2022.pdf 41 Ibid. 42 Ibid. 43 Ibid.
82 

Budget Request

The FY 2024 President’s Budget Request is $38.0 million, an increase of $2.0 million from the 

FY 2023 Enacted level. With this funding, SAMHSA will support 37 TIEH continuation grants, 

25 TIEH new grants, one Housing and Homeless Resource Center (HHRC) continuation grant, 

and one SSI Outreach Access and Recovery (SOAR) contract to increase capacity and provide 

accessible, effective, comprehensive, coordinated, integrated, and evidence-based treatment 

services, peer support and other recovery support services, and linkages to sustainable and 

permanent housing. Grantees will expand access to treatment and connect homeless individuals 

experiencing SMI with safe, secure housing. The number of individuals served is estimated to 

increase to approximately 9,000 individuals. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $32,992,000 

FY 2021 $32,992,000 

FY 2022 Final $32,958,400 

FY 2023 Enacted $35,992,000 

FY 2024 President's Budget $37,992,000 

Program Accomplishments

In FY 2022, SAMHSA supported 48 TIEH grants, one HHRC grant, and one SOAR contract. In 

FY 2022, 5,132 individuals were served by the TIEH program, achieving 133.3 percent of the 

annual goal. FY 2022 data also show a 23 percent improvement in housing stability, from 37.7 

percent at 6-month reassessment compared to 17.4 percent at intake (baseline), and a 51.2 percent 

improvement in social connectedness, from 61.9 percent at 6-month reassessment compared to 

47.9 at intake. Additionally, 51.0 percent of individuals served by the TIEH program reported that 

they were functioning in everyday life compared to 33.2 percent at intake. 

In FY 2023, SAMHSA anticipates funding 24 TIEH grants, one HHRC grant, one SOAR contract, 

technical assistance activities and a new cohort of 32 grants. This will expand access to 7,000 

individuals with SMI, SED, SUD, or co-occurring disorders, who are experiencing homelessness

or at imminent risk of homelessness. 
83 

Minority AIDS

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Minority AIDS......................................................................................................... $9,207 $9,224 $9,224 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

Eligible Entities....................................Community and faith-based organizations, Tribes, Urban 

..............................Indian organizations, Hospitals, Public and private universities, and colleges 

Program Description

Initiated in FY 2017, the Minority AIDS Initiative – Service Integration (MAI-SI) grant program 

provides resources to help reduce the co-occurring epidemics of HIV, hepatitis, and mental health 

disorders through accessible, evidence-based, culturally appropriate mental and co-occurring 

disorder treatment that is integrated with HIV primary care and prevention services. SAMHSA 

expects that this program will help reduce the incidence of HIV and improve overall health 

outcomes for those at-risk individuals with a mental health disorder or co-occurring disorder 

(COD). The population of focus is individuals, ages 18 and over, of racial and ethnic minorities 

(e.g., black/African American, Hispanic/Latino, American Indian, Alaska Native, Native 

Hawaiian, and Asian and Pacific Islander populations) with a mental health disorder or COD with 

or at risk for HIV and/or hepatitis. These at-risk populations are disproportionately impacted by 

HIV and hepatitis44. Grantees provide evidence-based mental, and substance use disorder (SUD) 

treatment and practices that are trauma-informed and recovery-oriented. 

In 2019, Black/African Americans represented 13 percent of the US population, but 40 percent of 

people with HIV.45 Hispanics/Latinos represented 18 percent of the population, but 25 percent of 

people with HIV.46 Similar disparities are seen in the latest incidence of HIV among 

Blacks/African Americans representing 40 percent of new HIV cases while Hispanics/Latinos 

represent 25 percent of new HIV cases.47 Three quarters of new HIV cases in the United States are 

among racial and ethnic minorities.48 

Budget Request

The FY 2024 President’s Budget Request is $9.2 million, level with the FY 2023 Enacted level. 

SAMHSA will support 19 continuation grants focused on individuals with mental disorders and/or 

co-occurring disorders living with or at risk for HIV/AIDS. SAMHSA will also maintain its 

44 https://www.hiv.gov/hiv-basics/overview/data-and-trends/impact-on-racial-and-ethnicminorities

45 https://www.cdc.gov/nchhstp/newsroom/fact-sheets/hiv/black-african-american-factsheet.html 46 https://www.cdc.gov/nchhstp/newsroom/fact-sheets/hiv/hispanic-latino-factsheet.html 47 ibid 48 https://www.hiv.gov/hiv-basics/overview/data-and-trends/impact-on-racial-and-ethnic-minorities
84 

performance measure targets for FY 2024 except for the percentage of clients receiving services 

who are currently employed at six-month follow-up which is projected to increase by 9.6 percent. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $9,224,000 

FY 2021 $9,224,000 

FY 2022 Final $9,207,200 

FY 2023 Enacted $9,224,000 

FY 2024 President's Budget $9,224,000 

Program Accomplishments

In FY 2022, SAMHSA awarded a new cohort of 19 new grants. In FY 2022, 84.2 percent of 

individuals receiving services were not experiencing serious psychological distress at six-month 

follow-up, compared to 78.9 percent at intake (baseline), and 85.0 percent of individuals were 

retained in the community at six-month follow-up, compared to 50.0 percent at intake. 

In FY 2023 SAMHSA expects to support 19 grant continuations focused on individuals with 

mental disorders and/or co-occurring disorders living with or at risk for HIV/AIDS. SAMHSA 

expects to maintain the FY 2022 performance targets. Starting in FY 2023, SAMHSA will begin 

collecting the number of organizations collaborating, coordinating, and sharing resources with 

other organizations as a result of the grant, as well as the number of individuals screened for mental 

health or related interventions. 
85 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.5.02 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6-month followup. (Outcome) 

FY 2022: 61% 

Target:

66.0 

(Target Not Met)

66% 66% Maintain

3.5.03 Percentage of 

clients receiving 

services who had a 

permanent place to 

live in the 

community at sixmonth follow-up. 

(Outcome)

FY 2022: 62.3

Target:

62.0 

(Target Exceeded)

62 62 N/A

3.5.04 Percentage of 

clients receiving 

services who are 

currently employed 

at six-month followup. (Outcome) 

FY 2022: 46.1

Target:

38.7 

(Target Exceeded)

38.7 38.7 N/A

3.5.45 Number of 

clients served

2,000 2,000 Maintain
86 

Criminal and Juvenile Justice Programs

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Criminal and Juvenile Justice Programs.................................................................. $6,252 $11,269 $56,394 $45,125 

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

FY 2024 Authorization ..................................................................................................$56,394,000 

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

Eligible Entities...........................................................................States and Territories; Political 

Sub-Divisions of States; Indian Tribes or Tribal Organizations; Health Facilities or Programs 

Operated in Accordance with a contract or award with the Indian Health Service.

Program Description 

SAMHSA’s Behavioral Health Partnerships for Early Diversion grants commenced in FY 2013. 

The purpose of this program is to establish or expand programs that divert adults and/or youth with 

a mental illness or a co-occurring disorder (COD) from the criminal or juvenile justice system to 

community-based mental health and substance use disorder services (SUD) and other supports 

prior to arrest and booking. 

Data indicate that a significant number of individuals who come in contact with law enforcement 

and the criminal justice system have a mental or substance use disorder. The U.S. Department of 

Justice, Office of Justice Programs, reported that 1 in 7 state and federal prisoners (14 percent) and 

1 in 4 jail inmates (26 percent) reported experiences that met the threshold for serious 

psychological distress.49 Approximately 383,000 individuals with serious mental illness (SMI) are 

incarcerated at any given time50 and more than 90 percent of arrests for people with SMI are for 

non-violent offenses51 such as trespassing or disorderly conduct. 

Additionally, high rates of incarceration disproportionately impact communities of color, 

especially among African American, Hispanic/Latino and LGBTQI+ populations. Black 

Americans are incarcerated in state prisons nationally at nearly five times the rate of whites and 

Latino people are 1.3 times as likely to be incarcerated than non-Latino whites.52 According to 

data from the National Survey on Drug Use and Health, in 2019, gay, lesbian, and bisexual 

individuals were 2.25 times as likely as straight individuals to be arrested within the last 12 months. 

This, like the imprisonment rates of LGBTQI+ people, is largely the result of disparate arrests of 

lesbian and bisexual women who were arrested at 4 times the rate of straight women. Gay and 

49 Bronson, J. and Berzofsky, M. (2017). Indicators of Mental Health Problems Reported by Prisoners and Jail 

Inmates, 2011-12. Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12 (ojp.gov) 50 Center, T. A. (2016). Serious mental illness (SMI) prevalence in jails and prisons. Arlington, VA: Treatment 

Advocacy Center. https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3695 51 Compton, M. T., Zern, A., Pope, L. G., Gesser, N., Stagoff-Belfort, A., Tan de Bibiana, J., ... & Smith, T. E. (2022). 

Misdemeanor Charges Among Individuals With Serious Mental Illnesses: A Statewide Analysis of More Than Two 

Million Arrests. Psychiatric Services, appi-ps. 52https://www.sentencingproject.org/reports/the-color-of-justice-racial-and-ethnic-disparity-in-state-prisons-thesentencing-project/ 
87 

bisexual men were arrested at 1.35 times the rate of straight men, according to the survey.53

Sixty-five to seventy percent of children in the juvenile justice system have a diagnosable mental 

health condition, and children in the juvenile justice system have substantially higher rates of 

behavioral health conditions than children in the general population. At least seventy-five percent 

of youth in the juvenile justice system experienced traumatic victimization, and ninety-three 

percent reported exposure to adverse childhood experiences including child abuse, family and 

community violence, and serious illness. Unfortunately, children are often involved in the juvenile 

justice system because of a lack of community-based treatment options and are detained or placed 

in juvenile facilities for minor, nonviolent offenses. 54 Moreover, “when a student is suspended or 

expelled his or her likelihood of being involved in the juvenile justice system the subsequent year 

increases significantly.” African American students are disproportionately affected by this school 

to prison pipeline.55 There is a clear and largely unmet need for effective behavioral health services 

and supports that are accessible before, during, and after incarceration as needed for this high-risk 

population. 

Budget Request

The FY 2024 President’s Budget Request is $56.4 million, an increase of $45.1 million from the 

FY 2023 Enacted level. In addition to funding thirty-one grant continuations, SAMHSA expects 

to award up to 71 new Justice Behavioral Health Community Collaborative (JBHCC) grants to 

help individuals who are already involved in the criminal justice system. SAMHSA estimates the 

total number of individuals served by both programs will increase to 28,000.

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $6,269,000 

FY 2021 $6,269,000 

FY 2022 Final $6,252,200 

FY 2023 Enacted $11,269,000 

FY 2024 President's Budget $56,394,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 17 grant continuations and conducted technical assistance 

53 https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health

54 Mental Health America (2022). Position Statement 51: Children With Emotional Disorders In The Juvenile Justice 

System, 2015. https://www.mhanational.org/issues/position-statement-51-children-emotional-disorders-juvenilejustice-system 55 Justice Center: The Council of State Governments, Public Policy Research Institute (2020). Breaking Schools’ 

Rules: A Statewide Study of How School Discipline Relates to Students’ Success and Juvenile Justice Involvement, 

2011.
88 

activities and served 513 individuals. In FY 2022, after 6 months of receiving grant services, 9.8 

percent of individuals served by this program reported that they were hospitalized for mental health 

care in the past 30 days, compared with 23.5 percent at baseline. Similar improvements were seen 

in homelessness, from 10.2 percent at 6 months compared to 24.5 percent at baseline. Additionally, 

after 6 months of receiving grant services, 3.9 percent of individuals served by this program 

reported spending time in a correctional facility compared with 7.8 percent at baseline, 76 percent 

reported being retained in the community compared with 42 percent at baseline, and 34.6 percent 

reported improved functioning in everyday life compared with 26.9 percent at baseline. 

In FY 2023, SAMHSA anticipates funding 6 grant continuations and awarding a new cohort of 25 

grants and conduct technical assistance activities that will expand access to people with mental 

illness across local criminal justice and court systems. SAMHSA expects that 1,800 individuals 

will be served through this program in FY 2023. 
89 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024 

Target

+/-FY 2023 

Target

3.5.06 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6-month follow-up 

(Outcome)

FY 2022: 32.7

Target:

40.0 

(Target Not Met)

40.0 40.0 Maintain

3.5.07 Percentage of 

clients receiving 

services who had a 

permanent place to 

live in the community 

at six-month followup. (Outcome) 

FY 2022: 45.1

Target:

40.0 

(Target Exceeded)

45.0 45.0 Maintain

3.5.09 Number of 

individuals screened 

for mental health or 

related interventions. 

(Output) 

FY 2022: 4,103.0 

Target:

2,700.0 

(Target Exceeded)

7,200 28,000 +20,800 

3.5.40 Number of 

clients served

1,800 6,000 +4,200 
90 

Practice Improvement and Training

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Practice Improvement and Training......................................................................... $7,811 $7,828 $15,828 $8,000 

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

Eligible Entities....................................States and Territories; Political sub-divisions of 

States, Indian Tribes or Tribal Organizations; health facilities or programs operated in accordance 

with the Indian Health Services; 105 Nationally Recognized Historically Black Colleges and 

Universities 

Program Description 

The Practice Improvement and Training (PIT) programs address the need for disseminating key 

information, such as evidence-based mental health practices, to the mental health delivery system. 

Three programs are funded with PIT: Historically Black Colleges and Universities Center of 

Excellence (HBCU-COE); Transforming Lives through Supported Employment Program (SEP); 

and the Clinical Support Services Technical Assistance Center. 

The purpose of the HBCU-COE program is to network the 105 HBCUs throughout the United 

States and promote behavioral health workforce development by expanding knowledge of best 

practices, developing leadership, and encouraging community partnerships that enhance the 

participation of African Americans in substance use disorder treatment and mental health 

professions. The comprehensive focus of the HBCU-COE program simultaneously expands 

service capacity on campuses and in other treatment venues. 

Established in FY 2014, the purpose of SEP is to support state and community efforts to refine, 

implement, and sustain evidence-based practices but altered its population of focus to include both 

adults with serious mental illness (SMI) or co-occurring disorders (COD). Please refer to Mental 

Health System Transformation and Mental Health Reform for more information on this program. 

In FY 2018, SAMHSA strengthened its clinical and science-based approach to addressing SMI 

through the establishment of the Clinical Support System for Serious Mental Illness Technical 

Assistance Center. The purpose of this program is to provide technical assistance (TA) for the 

implementation and provision of evidence-based treatment and recovery support programs for 

individuals living with SMI. 

Budget Request

The FY 2024 President’s Budget request is $15.8 million, an increase of $8.0 million from the 

FY 2023 Enacted level. The proposed funding increase responds to HHS priority goal of 

expanding and diversifying the behavioral health workforce. The proposed funding increase uses 

existing SAMHSA authorities to support the creation of a training pipeline from institutions of 

higher education that reach underserved populations. Aligning with the White House Initiative 
91 

Executive Order 14041 on advancing educational equity, additional funding to HBCUs will 

increase the capacity to recruit and expose HBCU students to evidence-based practices and current 

trends in behavioral health. The request also will continue to support continuation of the Clinical 

Support Services TA Center for SMI and will support five grant continuations and award a new 

cohort of 11 Transforming Lives through Supported Employment Programs (SEP). 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $7,828,000 

FY 2021 $7,828,000 

FY 2022 Final $7,811,200 

FY 2023 Enacted $7,828,000 

FY 2024 President's Budget $15,828,000 

Program Accomplishments

In FY 2022, SAMHSA funded the HBCU grant program, three SEP grants, and the Clinical 

Support Services TA Center. In FY 2022, SAMHSA funded a total of seven SEPs. These include 

four grant continuations from the Mental Health Systems Transformation and Health Reform funds 

and another three grants from PIT funds. 

In FY 2022, 59.9 percent of participants in the seven grant funded programs were competitively 

employed at six-month follow-up, compared to 18.4 percent at intake (baseline), representing a 

45.6 percent positive change. Additionally, 57.7 percent reported having a stable place to live at 

follow-up compared to 39.1% at intake, and 89.4 percent were retained in their community 

compared to 59.9 percent at intake (baseline).

In FY 2023, SAMHSA anticipates funding a new cohort of five SEP grants, awarding a new 

Clinical Support Services TA Center, and continuing to fund the HBCU grant program to support 

workforce development. 
92 

Consumer and Consumer-Supporter TA Centers

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Consumer and Consumer-Supporter Technical Assistance Centers......................... $1,901 $1,918 $1,918 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities.........................................................................................................States, political 

subdivisions of states, health facilities or programs operated in accordance with the Indian Health 

Service, or other domestic public or private non-profit entities

Program Description 

First funded in 1992, the Consumer and Consumer-Supporter Technical Assistance (TA) Centers 

provide technical assistance to facilitate quality improvement of the mental health system by the 

specific promotion of consumer-directed approaches for adults with serious mental illness (SMI). 

This program also improves collaboration among consumers, families, providers, and 

administrators and helps to transform community mental health services into a more consumer and 

family driven model. 

Consumer-centered services and supports, such as peer specialists, are key to improving the quality 

and outcomes of health and behavioral healthcare services for people with mental disorders 

including SMI. Such approaches maximize consumer self-determination, promote long-term 

recovery, and assist individuals with SMI to increase their community involvement through work, 

school, and social connectedness. 

Budget Request

The FY 2024 President’s Budget request is $1.9 million, level with the FY 2023 Enacted level. 

This funding request will support five continuation grants to provide technical assistance to 

facilitate the quality improvement of the mental health system by promoting consumer-directed 

approaches for adults with SMI and focus on coordination with the state-wide consumer network 

program and engaging people with lived experience of mental illness to improve mental health 

systems and supports and advance community inclusion, recovery, and resilience. In FY 2024, 

SAMHSA will continue to maintain the performance measure targets for this program.
93 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $1,918,000 

FY 2021 $1,901,492 

FY 2022 Final $1,901,200 

FY 2023 Enacted $1,918,000 

FY 2024 President's Budget $1,918,000 

Program Accomplishments

In FY 2022, SAMHSA awarded five grant continuations and provided training to 32,000 

individual and reached more than 330,313 people with mental health awareness activities. These 

trainings covered a range of topics, including peer support, peer-run crisis services, employment 

and education supports, mental health first aid, and improving care for people with mental illness 

and intellectual or developmental disabilities. 

In FY 2023, SAMHSA expects to support five grant continuations and provide technical assistance 

to facilitate the quality improvement of the mental health system by promoting consumer-directed 

approaches for adults with SMI. SAMHSA will continue to maintain its performance measure 

targets.
94 

Disaster Response

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Disaster Response................................................................................................... $1,936 $1,953 $1,953 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

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

Eligible Entities..............................................States, political sub-divisions of states, health 

...facilities or programs operated in accordance with the Indian Health Service, or other domestic 

.....................................................................public or private non-profit entities

Program Description 

Natural and human caused disasters and emergent events, such as the COVID-19 pandemic, 

wildfires; mass shootings; hurricanes and tropical storms along the coast; and floods and tornadoes

strike without warning and leave individuals, families, and whole communities struggling to 

rebuild. SAMHSA’s Disaster Behavioral Health Program aims to ensure that the nation is prepared 

to address, as well as respond to, the behavioral health needs that follow these disasters or events 

by funding three major programs: the Disaster Distress Helpline (DDH), the Crisis Counseling 

Assistance and Training Program (CCP), and the Disaster Technical Assistance Center (DTAC). 

These programs provide disaster behavioral health expertise around natural disasters, and 

emerging public health initiatives to develop and disseminate innovative consultation and 

technologies to communities, federal partners, and other stakeholders. 

SAMHSA’s DDH is the nation’s first permanent hotline dedicated to providing immediate disaster 

crisis counseling. SAMHSA launched the Oil Spill Distress Helpline in 2010 following the 

Deepwater Horizon Explosion/BP Oil Spill. The number then transitioned to the national Disaster 

Distress Helpline in February 2012. The DDH is a toll-free, multilingual crisis systems service 

available 24/7 via telephone (1-800-985-5990) and Short Message Service (SMS) (text 

‘TalkWithUs’ to 66746) to residents in the United States and its territories who are experiencing 

emotional distress resulting from disasters. 

SAMHSA operates the CCP through an interagency agreement with the Federal Emergency 

Management Agency (FEMA). The CCP was established in 1974 under the Stafford Act. Section 

416 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. § 5183, 

which authorizes FEMA to fund mental health assistance and training activities in areas that have 

been declared a major disaster by the President. This program assists individuals and communities 

to recover from presidentially declared disasters through the provision of community-based 

behavioral health outreach and psycho-educational services. 

The DTAC is funded by SAMHSA and FEMA that was founded in 2002. This program is designed 

to provide additional technical assistance, strategic planning, consultation, and logistical support. 

In addition, SAMHSA’s Disaster App (available on Apple and android platforms) provides 

evidence-informed and evidence-based resources in the Disaster Kit, along with additional partner 
95 

resources and information on local mental health and substance use treatment facilities. 

Budget Request

The FY 2024 President’s Budget Request is $2.0 million, level with the FY 2023 Enacted level. 

Funding will continue the support of a nationally available disaster distress crisis counseling 

telephone line and the DTAC. In FY 2024, SAMHSA will continue to maintain the same 

performance measure targets as FY 2023.

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $1,953,000 

FY 2021 $1,953,000 

FY 2022 Final $1,936,200 

FY 2023 Enacted $1,953,000 

FY 2024 President's Budget $1,953,000 

Program Accomplishments

In FY 2022, the SAMHSA DDH responded to over 27,746 calls and answered close to 3,389 text 

messages. While FY 2022 DDH volume was down 30 percent from its peak in FY 2020/2021 

during the height of the COVID-19 pandemic, overall volume is 150 percent higher compared to 

FY 2019. The majority of DDH callers and texters are experiencing acute, temporary stress related 

to a disaster. DDH crisis counselors utilize stabilization, psychological first aid, and other brief 

supportive counseling techniques regardless of presenting concern. COVID-19 continued to be the 

most common presenting concern of DDH callers and texters in FY 2022, followed by hurricanes 

and tropical storms (Ida, Fiona, Ian), incidents of mass violence (including mass shootings in 

Buffalo and Uvalde in May), floods, and wildfires. Following Hurricanes Fiona (9/18) and Ian 

(9/28) call volume to the DDH increased by 120 percent in the last two weeks of FY 2022, and 

Spanish-language call volume in September 2022 was almost 200 percent higher compared to 

September 2021. 

During FY 2022, the CCP Online Data Collection and Evaluation System (ODCES) showed the 

following contacts and encounters funded by 54 CCP grants: 

• 2,159,022 in-person brief educational supportive contacts. 

• 703,523 telephone/hotline contacts and 1,285,298 2 e-mail contacts. 

• 555,788 individual and family crisis counseling encounters (lasting 15 to 60 minutes or more) 

serving 651,059 individuals; and 

• 68,427 group encounters (public education and group counseling) serving 865,489 individuals. 
96 

Individual and family crisis counseling encounters were most often conducted with adults ages 40 

to 64 (281,637), followed by adults ages 18-39 (181,154), older adults (141,603), and children 

(46,665). Individual and family encounters occurred most often with female (58 percent) disaster 

survivors, compared to males (41.5 percent) and transgender (0.6 percent). A little less than half 

(43.8 percent) were conducted in Spanish due to three large CCP grants running in Puerto Rico. 

The three most common risk factors reported by counseling participants were past trauma (19.2 

percent), other financial loss (17.8 percent), prolonged separation from family or social network 

(14.5 percent) and preexisting physical disability (11.8 percent). Across the four major health 

concern categories (behavioral, emotional, physical, and cognitive), the highest number of reported 

disaster event reactions fell within the emotional category (716,421), followed by behavioral 

(691,690), physical (549,975), and cognitive (418,590). 

In FY 2023, SAMHSA anticipates continued funding for DDH and DTAC to support a nationally 

available disaster distress crisis counseling telephone line and the Disaster Technical Assistance 

Center and will continue to maintain its performance measures targets.
97 

Output and Outcomes

Mental Health - Science and Service Activities

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.4.06 Number of 

people trained by 

CMHS Science and 

Service Programs 

(Output) 

FY 2022: 884 

Target:

900 

(Target Not Met)

900 900 Maintain

1.4.14 Number of 

calls answered by the 

Disaster Distress 

Hotline (Output) 

FY 2022:28,746 

Target:

29,000 

(Target Not Met)

29,000 29,000 Maintain

1.4.15 Number of text 

messages answered 

by the Disaster 

Distress Hotline 

(Output) 

FY 2022: 3,889 

Target:

6,000 

(Target not met 

6,000 6,000 Maintain
98 

Seclusion and Restraint

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Seclusion and Restraint .......................................................................................... $1,130 $1,147 $1,147 $---

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

FY 2024 Authorization ................................................................................................$599,000,000 

Allocation Method ......................................................................... Grants/Cooperative Agreements

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description 

Because of the inappropriate use of seclusion and restraint practices, people die, countless others 

are injured, and many people are traumatized by coercive practices. Schoolchildren, with and 

without disabilities, have been restrained and secluded in the United States since at least the 

1950s.56 Children with emotional and behavioral issues are more frequently subjected to restraints 

in schools than students with other disabilities, often leading to serious physical injuries and 

emotional trauma for both students and staff. Even if children suffer no physical harm as the 

result of the use of seclusion and restraints, studies have shown they remain severely traumatized 

and may even experience post-traumatic stress disorder.57 As a result of their experiences, 

children who have been restrained have reported nightmares, anxiety, and mistrust of adults in 

authority.58 

In 2018, SAMHSA funded a regionally based technical assistance effort focused on providing 

supports and services for individuals living with mental disorders and/or serious mental illness 

(SMI), including the dissemination of trauma-informed practices across multiple service settings 

and promoting alternatives to restraint, seclusion, and other coercive practices. The purpose of the 

Mental Health Technology Transfer Center (MHTTC) Network is to disseminate and implement 

evidence-based practices for treating mental disorders into the field. In FY 2023, the MHTTC

Network includes 10 Regional Centers, and a Network Coordinating Office. The collaborative 

network supports resource development and dissemination, training and technical assistance, and 

workforce development for the mental health field. It works with systems, organizations, and 

treatment practitioners involved in the delivery of mental health services to strengthen their 

capacity to deliver effective evidence-based practices to individuals. 

56 Joseph B. Ryan & Reece L. Peterson, Physical Restraint in School, 29 J. COUNS. FOR CHILD. BEHAV. 

DISORDERS 154, 158 (2004).

57 CCBD, supra note 14; see also NDRN, supra note 3 (compiling research on harmful effects of seclusion and 

restraint).

58 David M. Day, Review of the Literature on Restraints and Seclusion with Children and Youth: Toward the 

Development of a Perspective in Practice (2000).
99 

Budget Request

The FY 2024 President’s Budget request is $1.1 million, level with the FY 2023 Enacted level

SAMHSA’s will support the MHTTC and maintain the same performance measure targets as FY 

2023. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $1,147,000 

FY 2021 $1,147,000 

FY 2022 Final $1,130,198 

FY 2023 Enacted $1,147,000 

FY 2024 President's Budget $1,147,000 

Program Accomplishments

In FY 2022, SAMHSA funded 13 MHTTC continuation grants. In FY 2022, the MHTTCs have 

conducted 986 trainings and technical assistance activities for 51,946 individuals. 

In FY 2023, SAMHSA expects to fund 11 MHTTC continuation grants and maintain the FY 2023 

performance measure targets. 
100 

Assertive Community Treatment for Individuals with Serious Mental Illness

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Assertive Community Treatment for Adults with SMI............................................. $8,983 $9,000 $9,000 $---

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

FY 2024 Authorization ....................................................................................................$9,000,000 

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

Eligible Entities..................States, Political Sub-divisions of states; community-based 

behavioral health non-profit organizations; Indian tribes or tribal organizations, mental health 

systems; health care facilities

Program Description 

Initiated in FY 2018, the Assertive Community Treatment (ACT) for Individuals with serious 

mental illness (SMI) program establishes or expands and maintains ACT programs for transitionaged youth and adults with a SMI or serious emotional disturbance (SED). Grantees are expected 

to implement an ACT program to fidelity and provide ACT services to the population of focus. 

With this program, SAMHSA aims to improve behavioral health outcomes for individuals by 

reducing rates of hospitalization, mortality, substance use, homelessness, and involvement with 

the criminal justice system. 

ACT is an evidence-based practice considered to be one of the most effective approaches to 

delivering services to individuals with the most severe impairments associated with SMI/SED.59

Individuals with severe functional impairments tend to need services from multiple providers (e.g., 

physicians, socials workers) and multiple systems (e.g., social services, housing services, health 

care). ACT was developed to deliver comprehensive effective services to those who live with the 

most serious psychiatric symptoms, the most significant social functioning challenges, and whose 

needs have not been well met by traditional approaches. 

ACT is a services-delivery model, not a case management program. The ACT team model is 

composed of 10-12 multi-disciplinary behavioral health care staff who work together to deliver a 

mix of individualized, recovery-oriented services to individuals living with SMI/SED to help them 

successfully reintegrate into the community. Team members themselves provide the 

comprehensive array of services directly rather than through referrals. Caseloads are 

approximately one staff for every 10 individuals served. Services are provided 24 hours – 7 days 

a week, as long as needed and wherever they are needed. Based on the ACT model, a multidisciplinary team is available around the clock to deliver a wide range of services in a person’s 

home or other community settings. The ACT Evidence-Based Practices toolkit is available in 

SAMHSA’s Evidenced-Based Resource Center.

59 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/
101 

Budget Request 

The FY 2024 President’s Budget Request is $9.0 million, level with the FY 2023 Enacted level. 

This funding will support the continuation of 13 grants to advance the ACT approach to address 

the needs of those living with SMI. 

ACT is considered one of the most effective evidence-based programs designed to support 

community living for individuals with the most severe functional impairments associated with 

SMI. As a result, the ACT model is implemented widely across the United States. The ACT 

program is focused on innovation and pairs grantees with a technical assistance center. This 

strategy supports grantees, captures lessons learned from grantee innovations, gives support to 

ACT providers outside the grant program, and supports state planning related to ACT and the 

continuum of care for people with serious mental illness. In FY 2024, SAMHSA will continue to 

maintain the same performance measure targets as FY 2023.

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $7,000,000 

FY 2021 $9,000,000 

FY 2022 Final $8,983,200 

FY 2023 Enacted $9,000,000 

FY 2024 President's Budget $9,000,000 

Program Accomplishments

In FY 2022 SAMHSA awarded 12 grant continuations. FY 2022 data indicate that 50.6 percent 

of individuals served by the ACT program report positive functioning in everyday life, compared 

to 41.8 percent reported at baseline. In addition, the percentage of individuals who experienced 

homelessness in the last 30 days decreased from 16.7 percent at baseline to 6.0 percent at the 6-

month reassessment; further, 26.2 percent of individuals served by the program reported that they 

had a stable place to live at baseline, compared to 59.5 percent at the 6-month reassessment. At 

baseline, 4.8 percent of the individuals served reported time spent in a correctional facility in the 

past 30 days, compared to 0 percent at 6-month assessment. Additionally, there was a decrease in 

hospitalization for mental health care in the past 30 days from 32.9 percent at baseline to 8.5 

percent at the 6-month reassessment, and an increase in retention in the community from 34.1 

percent to 84.1 at reassessment. There was also a decrease in emergency room usage for behavioral 

health issues in the past 30 days, from 22 percent at baseline to 3.7 percent at reassessment. Lastly, 

data showed that 465 individuals in the mental health workforce received training in mental health 

practices consistent with the goals of the program for FY 2022. 

In FY 2023 SAMHSA supported 5 continuation grants and awarded a new cohort of eight grants 
102 

to advance the ACT approach to address the needs of those living with SMI. SAMHSA will 

continue to maintain its performance measure targets for FY 2023.

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.4.13 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6-month follow-up. 

(Outcome)

FY 2022: 49.4

Target:

54.0 

(Target Not Met)

50.0 50.0 Maintain

3.4.14 Percentage of 

clients receiving 

services who are 

currently employed at 

6-month follow-up. 

(Outcome)

FY 2022: 19.8

Target:

17.0 

(Target Exceeded)

17.0 17.0 Maintain

3.4.15 Percentage of 

clients receiving 

services who have a 

permanent place to 

live in the community 

at 6-month follow-up. 

(Outcome)

FY 2022: 58.3

Target:

64.0 

(Target Not Met)

58.0 58.0 Maintain

3.4.36 Number of 

Clients Served

500 500 Maintain
103 

Tribal Behavioral Health Grants 

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Tribal Behavioral Health Grants............................................................................. $20,733 $22,750 $23,250 $500 

Authorizing Legislation...................... Section 520A (290bb-22) and 516 (290bb-22) of the 

Public Health Service Act, as amended.

FY 2024 Authorization ................................................................................................$599,000,000 

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

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

Program Description 

Starting in FY 2014, the Tribal Behavioral Health grant program supports tribal entities with the 

highest rates of suicide by providing effective and promising strategies that address substance use, 

trauma, and suicide and by promoting the mental health of American Indian/Alaska Native 

(AI/AN) young people. The purpose of this program is to prevent and reduce suicidal behavior 

and substance use, reduce the impact of trauma, and promote mental health among AI/AN youth, 

through age 24, by building a healthy network of systems, services, and partnerships that impact 

youth. 

In 2020, suicide was the leading cause of death among AI/AN youth and young adults ages ten to 

14 years. For AI/AN ages 10-19, the unadjusted suicide rate was nearly twice the rate for the nation 

as a whole.60 In 2019, AI/AN high school students reported higher rates of suicidal behaviors than 

the general population of U.S. high school students. These behaviors include serious thoughts of 

suicide (1.8 times as likely than the general population), suicide plans (1.5 times as likely as the 

general population), and suicide attempts (2.9 times as likely as the general population).61 

American Indian or Alaska Native (27.6%) are also more likely to have a substance use disorder 

(SUD) in the past year compared with Black or African American (17.2%), White (17.0%), 

Hispanic or Latino (15.7%), or Asian people (8.0%).62

In addition, SAMHSA’s Tribal Training and Technical Assistance Center 63 provides training 

and education to AI/AN grantees and organizations serving AI/AN populations to support their 

ability to achieve their goals. 

60 Centers for Disease Control and Prevention. Fatal injury data, 2020. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed January 25, 2023.

61 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). Available at 

http://www.cdc.gov/healthyyouth/yrbs/index.htm. Accessed May 27, 2014. 

62 Center for Behavioral Health Statistics and Quality. (2022). 2021 National Survey on Drug Use and Health: 

Methodological summary and definitions. https://www.samhsa.gov/data/report/2021-methodological-summary-anddefinitions

63 (http://www.samhsa.gov/tribal-ttac) 
104 

Budget Request

The FY 2024 President’s Budget Request is $23.25 million, an increase of $500,000 from the 

FY 2023 Enacted level. Combined with $23.7 million in the Substance Use Prevention Services 

appropriation, these funds will support technical assistance activities, 118 continuation grants and 

award a new cohort of 35 grants that promote mental health and prevent substance use activities 

for high-risk AI/AN youth and their families. In FY 2024, SAMHSA will continue the same

performance measures and it is expected that 500,000 youth with mental health or substance use 

disorders will be contacted through program outreach efforts targets. 

As a braided activity, SAMHSA is tracking separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensures that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $20,000,000 

FY 2021 $20,881,047 

FY 2022 Final $20,733,200 

FY 2023 Enacted $22,750,000 

FY 2024 President's Budget $23,250,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 133 grant continuations and a new cohort of 12 grants and 

technical assistance activities to expand youth suicide prevention and early intervention strategies 

for the tribal nations. In FY 2022, grantees screened 14,702 individuals for mental health and 

suicide concerns, 365,825 individuals were contacted through program outreach efforts, and 1,325 

organizations implemented specific mental health related practices and activities that aligned with 

program goals. 

In FY 2023, SAMHSA anticipates supporting 105 grant continuations and awarding a new cohort 

of 39 grants and technical assistance activities to expand youth suicide prevention and early 

intervention strategies for the tribal nations.
105 

Outcomes and Outputs

Measure Year and Most Recent 

Result /

Target for Recent Result 

/ 

(Summary of Result)

FY 2023 

Target

FY 2024 

Target

FY 2024 

Target

+/-FY 2023 

Target

2.4.12 Percentage of 

youth age 10 - 24 who 

received mental 

health or related 

services after 

screening, referral or 

attempt (Output)

FY 2022: 35.0 

Target:

33.0 

(Target Exceeded)

33.0 33.0 Maintain

2.4.17 Number of 

youths with mental 

health or substance 

use disorders who are 

contacted through 

program outreach 

efforts (Output) 

FY 2022: 470,790.0 

Target:

570,655.0 

(Target Not Met)

500,000 500,000 Maintain
106 

Minority Fellowship Program 

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Minority Fellowship Program................................................................................. $10,042 $11,059 $22,000 $10,941 

Authorizing Legislation ........................................................................ Section 597 of the PHS Act 

FY 2024 Authorization ..................................................................................................$25,000,000 

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

Eligible Entities................................................Organizations that represent individuals obtaining 

post-baccalaureate training (including for master’s and doctoral degrees) for mental and 

substance use disorder treatment professionals, including in the fields of psychiatry, nursing,

... social work, psychology, marriage and family therapy, mental health counseling, and substance 

use disorder and addiction counseling 

Program Description 

SAMHSA’s Minority Fellowship Program (MFP) is intended to increase behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; substance use/addiction counseling,

marriage and family therapists and professional counselors. This program is jointly administered 

by the Center for Substance Use Services (CSUS), the Center for Substance Use Prevention 

(CSUP), and the Center for Mental Health Services (CMHS) at SAMHSA. Combined, this 

program will support fellowships for hundreds of students as well as support additional training 

through webinars on culturally appropriate services to thousands of students. 

Budget Request

The FY 2024 President’s Budget Request is $22.0 million, an increase of $10.9 million from the 

FY 2023 Enacted level. Combined with $12.0 million in the Substance Use Services appropriation 

and $2.7 million in the Substance Use Prevention appropriation, funds will support eight 

continuation grants and a technical assistance contract. This funding will more than double the 

number of fellows from 428 to 1,182 and increase the number of trained behavioral health 

providers to 6,500. As a braided activity, this increase in fellows will directly address the 

significant treatment gap across the care continuum and the workforce shortage in disenfranchised 

and minority populations. In addition, SAMHSA will conduct a robust evaluation of the program 

for culturally appropriate approaches to further improve retention and increase recruitment of more 

diverse fellows into the workforce. 

Please note, SAMHSA is tracking separately any amounts spent, or awarded, under the Minority 
107 

Fellowship Program through the distinct appropriations to ensure that funds are used for purposes 

consistent with legislative direction and intent of these appropriations. 

The Budget also proposes to add a service requirement to ensure participants are supporting 

communities in need, as well as to add addiction medicine, and sexual and gender minority 

populations as participants in the Minority Fellowship Program. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $9,059,000 

FY 2021 $10,059,000 

FY 2022 Final $10,042,200 

FY 2023 Enacted $11,059,000 

FY 2024 President's Budget $22,000,000 

Program Accomplishments

In FY 2022, SAMHSA supported eight grant continuations, and the MFP technical assistance 

contract. In FY 2022, the MFP grant supported 428 fellows (see the table below for details). In 

addition, the MFP program provided over 135 trainings and workshops for the fellows and other 

interested participants. 

In FY 2023, SAMHSA anticipates funding one grant continuation and a new cohort of eight grants 

and a new MFP technical assistance contract. In FY 2022, the MFP grantees reported the following

program accomplishments: 

• The American Association for Marriage and Family Therapy had 57 master’s fellows 

representing their largest cohort since expanding to include master’s education in 2014, 

which is a 40% increase.

• The American Nurses Association used the Infusionsoft software to send weekly email 

blasts to prospective applicants, Historically Black Colleges, and Universities (HBCUs), 

tribal colleges, Hispanic Serving Institutions, and other major universities with a 

psychiatric nursing program. 

• The American Psychiatric Association fellows participated in the Presidential Taskforce 

on Social Determinants of Mental Health. Fellows joined a group discussion and 

provided their input and feedback based on their understanding of the social determinants 

of mental health based on their pre-clinical and clinical curriculum and training. 

• The American Psychological Association launched a leadership development program 

containing 10-modules with content, discussion, and implementation sections. Topics 

included mapping out your career, cultural competencies, professionalism, ethics, and 

others. 

• The Council on Social Work Education launched several new initiatives: 1) Monthly 
108 

Monday group mentoring sessions where MFP alum were invited to come and share their 

experiences, 2) Lunch and Learns on the last Wednesday of each month to discuss 

specific topics, and 3) Office hours twice a month on Fridays for fellows to ask questions. 

• The National Board of Certified Counselors hosted a virtual career fair, The Counseling 

Foundations: Your Path to Career Success virtual career fair, which aimed to connect 

employers, recent graduates from master’s and doctoral counseling programs, and 

seasoned counseling professionals nationwide in a virtual setting to explore current and 

future staffing opportunities. 

Outcomes and Outputs

Total Doctoral and Master’s Fellows FY 2022 

Total (428)

FY 2023 

Total (428) 

Grantee 

Organization 

Masters 

Fellows

Masters 

Fellows

Doctoral 

Fellows

Doctoral 

Fellows

National Board of Certified Counselors 70 70 20 20 

Council on Social Work Education 45 45 28 28 

Interdisciplinary Minority Fellowship 

Program 

18 18 37 37 

Amer. Psychological 

Association 

13 13 24 24 

Amer. Psychiatric 

Association 

0 0 51 51 

American Nurses 

Association 

16 16 24 24 

Amer. Association for Marriage and 

Family Therapy

57 57 25 25 

TOTAL: 219 219 209 209 
109 

Infant and Early Childhood Mental Health 

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Infant and Early Childhood Mental Health............................................................... $9,983 $15,000 $37,500 $22,500 

Authorization Legislation...................................Section 399Z-2 of the Public Health Service Act

FY 2024 Authorization.................................................................................................$50,000,000 

Eligible Entities.................................Human Services Agencies or Non-profit Institutions

Program Description 

Infant and Early Childhood Mental Health Funding supports two programs: The Infant and Early 

Childhood Mental Health (IECMH) grant program and the Center of Excellence for Infant and 

Early Childhood Mental Health Consultation (CoE-IECMHC)

Established in FY 2018, the IECMH programs are focused on improving the outcomes for 

children, from birth to 12 years of age, who are at risk for, show early signs of, or have been 

diagnosed with a mental illness, including a serious emotional disturbance. The purpose is to 

improve outcomes using a prevention-based approach that pairs a mental health consultant with 

adults who work with infants and young children in the different settings where they learn and 

grow, such as childcare, preschool, home visiting, early intervention, and their home. 

In FY 2019, the CoE-IECMCH was established to provide technical assistance to communities, 

states, territories, tribal communities, and IECMH grantees, as well as professional development 

to individual mental health consultants to increase access to high quality mental health consultation 

throughout the country. 

The IECMH program and the CoE-IECMHC have: (1) helped to increase access to a range of 

evidence-based and culturally appropriate infant and early childhood mental health services; (2) 

equipped caregivers to facilitate children’s mental health and social and emotional development, 

and (3) strengthened positive caregiving relationships, via multigenerational therapy approach and 

services. These IECMHC programs aid in addressing the national shortage of mental health 

professionals with infant and early childhood expertise. 

Budget Request

The FY 2024 President’s Budget Request is $37.5 million, an increase of $22.5 million from the 

FY 2023 Enacted level. The proposed funding will support the continuation of 28 grants and 

award a new cohort of 43 new grants, which will increase the number people in the mental health 

and related workforce who are trained to nearly 21,000; the number of young children screened 

for mental health disorders to nearly 52,000; and the number of children referred to nearly 18,000.
110

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount 

FY 2020 $7,000,000 

FY 2021 $8,096,291 

FY 2022 Final $9,983,200 

FY 2023 Enacted $15,000,000 

FY 2024 President's Budget $37,500,000 

Program Accomplishments 

In FY 2022, SAMHSA awarded 13 grant continuations, five new grants, and provided supplement 

to support COE-IECMHC technical assistance. In FY 2022, grantees trained 3,799 people in the 

mental health and related workforce in mental health-related practices/activities; screened 9,470 

children for mental health or related interventions; and referred 3,378 children for mental health 

services. 

In FY 2023, SAMHSA expects to support nine grant continuations and award a new cohort of 19 

grants. It is expected that the number of people trained in mental health-related practices/activities 

will near 7,000; the number of young children screened for mental health disorders will near 

14,000; and the number of children referred for mental health and related services will near 5,000. 

Outputs and Outcomes 

Measure Year and Most Recent 

Result / 

Target for Recent 

Result / 

(Summary of Result) 

FY 2023 

Target 

FY 2024 

Target 

FY 2024 

Target 

+/-FY 2023 

Target 

3.4.16 Number of 

children screened for 

mental health or 

related interventions 

(Output) 

FY 2022: 9,792.0 

Target: 

9,883.0 

(Target Not Met) 

14,000 52,000 +38,000
111

Measure Year and Most Recent 

Result / 

Target for Recent 

Result / 

(Summary of Result) 

FY 2023 

Target 

FY 2024 

Target 

FY 2024 

Target 

+/-FY 2023 

Target 

3.4.17 Number of 

children referred to 

mental health or 

related interventions 

(Output) 

FY 2022: 3,643.0 

Target: 

3,500.0 

(Target Exceeded) 

5,000 18,000.0 +13,000

3.4.18 Number of 

people in the mental 

health and related 

workforce trained in 

specific mental 

health-related 

practices/activities as 

a result of the 

program. (Output) 

FY 2022: 6,454.0 

Target: 

5,000.0 

(Target Exceeded) 

7,000 14,000.0 +7,000 
112 

Interagency Task Force on Trauma-Informed Care

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Interagency Task Force on Trauma-Informed Care.................................................. $1,000--- $2,000 $2,000 $---

Authorizing Legislation ........................................ ...................Section 7132 of the Support Act 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................................... Contract

Eligible Entities ....................................................... Domestic Public or Private Non-Profit Entities

Program Description 

Trauma-informed approaches are essential to ensure that children, youth, and their families receive 

the necessary behavioral health treatment and support services for substance use/misuse and 

mental health challenges to enhance their resilience, facilitate their recovery, and improve their 

well-being. Trauma-informed approaches are more critical now as we recognize the impact that 

COVID-19 and the resulting effects, i.e., social isolation, increased rates of anxiety and depression, 

have had on children, youth, and their families. Providing trauma-informed care is not limited to 

behavioral health interventions and can help increase the effectiveness of other kinds of 

interventions such as supportive employment services and health care. 

The creation of an Interagency Task Force on Trauma-Informed Care (Task Force) was mandated 

in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for 

Patients and Communities Act (SUPPORT Act).64 The SUPPORT for Patients and Communities 

Act is a bipartisan, comprehensive piece of legislation devoted to combatting substance use and 

the overdose epidemic and supporting children and families who experience trauma and adverse 

childhood experiences (ACEs), including trauma from substance misuse. 

The SUPPORT Act mandated SAMHSA lead an interagency task force comprised of twenty 

agencies in the development of a National Strategy for Trauma-informed Care and submit an 

operating plan outlines its implementation. In FY 2022, SAMHSA developed an operating plan 

to implement a National Strategy for Trauma-informed Care that establishes recommendations for 

children/families who have experienced trauma and federal agencies’ coordinated response, as 

well as publish best practices of trauma-informed care.

The Task Force submitted this plan to Congress detailing its implementation. The National 

Strategy is grounded in equity with four main pillars: best practices, research, data, and federal 

coordination. Implementation of the National Strategy is being implemented in a phased approach. 

Phase One is focused on planning and laying the groundwork (Year 1); Phase Two is focused on 

delivering value to stakeholders (Years 2 and 3); and Phase Three is focused on sustainability 

(Years 4 and 5). The Task Force has begun the implementation of Phase One.

SAMHSA anticipates the Interagency Task Force’s effort will result in the cataloguing of over 

64 (P.L. 115-271)
113 

1,200 different resources. These resources will provide much needed information to equip 

providers with trauma-informed evidenced based approaches and help to mitigate risks of further 

traumatizing the most vulnerable children and families. Based on SAMHSA’s experience with 

the National Child Traumatic Stress Network (NCTSN) website and prior stakeholder 

engagement, it is estimated that the website will have over 1 million visitors and that the resources 

provided will influence the care of over 2 million children and their families receive within the 

first three years. The Task Force will also develop a research agenda, create shared understanding 

of how to measure trauma-informed care, and enhance federal coordination. 

Budget Request

The FY 2024 President’s Budget Request is $2.0 million, level with the FY 2023 Enacted level. 

In FY 2024, SAMHSA expects to continue the implementation of the operating plan through a 

series of expert panel meetings, youth, family, and community stakeholder engagement; analysis 

of scientific reviews of the research and evidence based interventions; three environmental scans

to identify currently used measures and tools in the area of trauma and trauma-informed care data 

collection; identification of facilitators and barriers of coordinating across the government in the 

area of trauma-informed care; and development of an initial design for the best practices website.

Based on SAMHSA’s experience with the NCTSN website and prior stakeholder engagement, it 

is estimated that the website will have over 1 million visitors and that the resources provided will 

influence the care received of over 2 million children and their families. 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 $---

FY 2021 $---

FY 2022 Final $1,000,000 

FY 2023 Enacted $2,000,000 

FY 2024 President's Budget $2,000,000 
114 

National Child Traumatic Stress Network

(Dollars in thousands)

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

National Child Traumatic Stress Network............................................................... $81,887 $93,887 $150,000 $56,113 

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

FY 2024 Authorization ..................................................................................................................$0 

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

Eligible EntitiesStates, Local Governments, Tribes, Institutions of Higher Education, and 

Community Organizations 

Program Description 

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

thousands of children each year.65 Traumatic stress occurs when children and adolescents are 

exposed to events or situations that overwhelm their ability to cope and interfere with a wide range 

of childhood developmental capabilities, including social and educational functioning.66 Trauma 

experienced during childhood can have long-term mental, emotional, and physical consequences. 

Adverse childhood experiences (ACEs) study results using a sample size of 45,287 showed the 

most prevalent exposure experience by children was (22.5%) economic hardship.67 Additional 

study findings suggest a higher prevalence of childhood traumatic events among rural children.

68

At the same time, access to care in underserved/under-resourced communities is associated with 

inadequate trauma-responsive care.69 “Evidence-based treatments are available to address traumarelated symptoms, but their impact is hindered because access is limited and unequal. In the U.S., 

adverse experiences and mental disorders disproportionately affect socioeconomically 

disadvantaged groups that face treatment access barriers.”70 While the effects of trauma and 

exposure to violence are found in all child and adolescent populations and service sectors, it is 

particularly prominent among youth with mental illness and/or drug/alcohol addiction involved in 

the child welfare, and juvenile justice systems71.￼ 

Since the establishment in 2000, SAMHSA has funded a national network of grantees known as 

the National Child Traumatic Stress Network (NCTSN) to increase access to effective trauma- and 

grief-focused treatment and services systems for children, adolescents, and their families, who 

65 Crouch, E., Probst, J.C., Radcliff, E., Bennett, K.J., McKinney, S.H. (2019). Prevalence of adverse childhood 

experiences (ACEs) among US children. Child Abuse and Neglect, (92), 209-218. 66 Ibid 67 Ibid 68 Ibid 69 IbidCrouch, E., Probst, J.C., Radcliff, E., Bennett, K.J., McKinney, S.H. (2019). Prevalence of adverse childhood 

experiences (ACEs) among US children. Child Abuse and Neglect, (92), 209-218.

Mersky, J.P, Topitzes, J., Langlieb, J., Dodge, K.A. (2021). Increasing mental health treatment 

access and equity through trauma-responsive care. American Journal of Orthopsychiatry, (91), 6, 

703-731. 
115 

experience traumatic events. The NCTSN has grown from a collaborative network of 17 to 184 

centers and over 200 affiliate (formerly funded) centers and individuals located nationwide in 

universities, hospitals, and a range of diverse community-based organizations with thousands of 

national and local partners. A component of this work has been the development of resources and 

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

systems. Network members work together within and across diverse settings, including a wide 

variety of governmental and non-governmental organizations, and continue to be a principal source 

of child trauma information and training for the nation. With this program, SAMHSA aims to raise 

the standard of care and improve access to evidence-based services for children experiencing 

trauma across the nation. 

Budget Request

The FY 2024 President’s Budget Request is $150.0 million, an increase of $56.1 million from the 

FY 2023 Enacted level. SAMHSA will support 170 grant continuations and award a new cohort 

of 76 grants for the improvement of mental disorder treatment, services, and interventions for 

children and adolescents exposed to traumatic events and to provide trauma-informed services for 

children and adolescents as well as training for the child-serving workforce. SAMHSA estimates 

approximately 16,000 children and adolescents will be served and the approximately 500,000 

people in the mental health and related workforce will be trained. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount Supplemental Funding 

FY 2020 $68,887 

FY 2021 $71,671 $20,000 

FY 2022 Final $81,887 

FY 2023 Enacted1 $93,887 $10,000 

FY 2024 President's Budget1 $150,000 $10,000 

1

/Supplemental funding in 2023 and 2024 represents BSCA Advanced Appropriations.

Program Accomplishments

In FY 2022, SAMHSA supported 129 grant continuations (127 grants with base budget authority 

and two grants with American Rescue Plan Act) and awarded a new cohort of 28 grants. In FY 

2022, NCTSN grantee sites provided trauma-informed training to over 326,177 people. Since its 

inception, the NCTSN has provided training on best practices and other aspects of child trauma to 

over 2 million participants throughout the country. The NCTSI Learning Center now has over 

496,000 registered users accessing this evidence-based child trauma resource. Data collected in 

FY 2022 demonstrate that the current NCTSN grantees provided screening to over 84,767 

individuals and evidence-based treatment to 42,109 children, adolescents, and family members 
116 

which includes 7,500 children and adolescents. In addition, thousands more youth and families 

have benefited indirectly from the training and consultation provided by NCTSN grantees to 

organizations that deliver evidence-based trauma interventions to various communities throughout 

the country. 

In FY 2023, SAMHSA anticipates funding 144 grant continuations (142 grants with base budget 

authority and two grants with American Rescue Plan Act) and awarding a new cohort of 49 grants 

(28 new grants with base budget authority and 21 new grants with Bipartisan Safter Community 

Act). With the increase in funding, SAMHSA estimates that NCTSN grantees will provide 

screening to over 180,000 individuals and evidence-based treatment to 100,000 children, 

adolescents, and family members. 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024 

Target

+/-FY 2023 

Target

3.2.02a Percentage of 

children receiving 

trauma informed 

services who report 

positive functioning 

at 6-month follow-up 

(Outcome)

FY 2022: 65.6 %

Target:

70 %

(Target Not Met)

70 % 70 % Maintain

3.2.23 Unduplicated 

count of the number 

of children and 

adolescents receiving 

trauma-informed 

services (Outcome)

FY 2022: 7,500

Target:

50,000 

(Target Not Met)

12,000 16,000 +4,000 

3.2.39 Number of 

child-serving 

professionals trained 

in providing traumainformed services 

(Outcome)

FY 2022: 326,177 

Target:

550,000 

(Target Not Met)

326,000 500,0000 +224,000 
117 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness

(Dollars in thousands)

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

Assisted Outpatient Treatment for Individuals with Serious Mental Illness............ $21,420 $21,420 $21,420 $---

Authorizing Legislation ................ Section 224 of the Protecting Access to Medicare Act of 2014 

FY 2024 Authorization ..................................................................................................$22,000,000 

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

Eligible Entities.....................................................................States and communities

Program Description 

SAMHSA initiated the Assisted Outpatient Treatment (AOT) program in FY 2016. AOT is the 

practice of delivering outpatient treatment under a civil court order to adults with serious mental 

illness (SMI) who meet specific state civil commitment AOT criteria, such as a prior history of 

non-adherence to treatment, repeated hospitalizations, or arrest. AOT involves petitioning local 

courts through a civil process to order individuals to enter and remain in treatment within the 

community for a specified period of time. This program is intended reduce the incidence and 

duration of psychiatric hospitalization, homelessness, individual incarcerations, and interactions 

with the criminal justice system while improving the health and social outcomes of individuals 

with a SMI. The AOT program is designed to work with families and courts to allow individuals 

with SMI to obtain treatment while continuing to live in the community and their homes. 

In 2020, there were an estimated 14.2 million adults aged 18 or older in the United States with 

SMI, such as schizophrenia, bipolar disorder and major depression.

72 Approximately 4.2 million 

individuals remain untreated for serious mental illness, costing 28 billion dollars in hospitalization 

costs per year.73

To increase access to evidence-based mental health services for individuals with SMI, Congress 

passed the Protecting Access to Medicare Act of 2014 (PAMA), which authorized a four-year 

Assisted Outpatient Treatment (AOT) program for individuals with SMI. This authorization was 

extended in the 21st Century Cures Act. 

Budget Request

The FY 2024 President’s Budget Request is $21.4 million, level with the FY 2023 Enacted level. 

This funding will support six grant continuations and award a new cohort of 15 grants to improve 

the health and social outcomes for individuals with SMI and continuation of the technical 

assistance center. In FY 2024, SAMHSA will maintain the same performance targets as FY 2023.

72https://www.nimh.nih.gov/health/statistics/mentalillness#:~:text=Mental%20illnesses%20are%20common%20in,mild%20to%20moderate%20to%20severe./Updated 

January 2022. 73 Treatment Advocacy Center. (2017, May). Serious Mental Illness and Treatment Prevalence. Retrieved from 

Treatment Advocacy Center: https://www.treatmentadvocacycenter.org/
118 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $19,000,000 

FY 2021 $20,937,000 

FY 2022 Final $21,420,000 

FY 2023 Enacted $21,420,000 

FY 2024 President's Budget $21,420,000 

Program Accomplishments

In FY 2022, SAMHSA supported 20 grant continuations and awarded a new cohort of three grants.

In FY 2022, AOT data was used to capture outcomes in the four areas listed below: 

1. Cost savings and public health outcomes including hospitalization, and use of services 

• 6.5 percent of AOT program participants reported spending at least one day in the 

hospital for mental health care in the past 30 days at their most recent reassessment 

compared to 46.8 percent at intake. 

• 6.0 percent of AOT program participants reported spending at least one day in the 

emergency department for a psychiatric or emotional problem in the past 30 days at 

their most recent reassessment compared to 28.7 percent at intake.

2. Rates of Incarceration

• 2.8 percent of AOT program participants reported spending one or more nights in a 

correctional facility in the past 30 days at their most recent reassessment compared to 

7.9 percent at intake. 

3. Rates of Homelessness 

• 6.4 percent of AOT program participants reported spending one or more homeless 

nights in the past 30 days at their most recent reassessment compared to 10.1 percent 

at intake.

4. Patient and family satisfaction with program participation

• 87.0 percent of AOT program participants agreed or strongly agreed with the statement 

“I liked the services I received here” at their most recent reassessment. 

In FY 2023, SAMHSA supported 23 grant continuation that improve the health and social 

outcomes for individuals with SMI and continuation of the technical assistance center. SAMHSA 

will continue to maintain the performance measures targets as in FY 2022. 

Outputs and Outcomes 
119 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.4.06 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6 month follow-up. 

(Outcome)

FY 2022: 66.1

Target:

70.0 

(Target Not Met)

70% 70% Maintain

3.4.10 The number of 

organizations 

collaborating, 

coordinating, and/or 

sharing resources 

with other 

organizations as a 

result of the grant. 

(Output) 

FY 2022: 276.0 

Target:

373.0 

(Target Not Met)

Discontinued Discontinued N/A

3.4.31 Number of 

clients served

1,000 1,000 Maintain
120 

Children’s Mental Health Services

(Dollars in thousands)

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Children's Mental Health Services.......................................................................... $125,000 $130,000 $225,000 $95,000,000 

Authorizing Legislation ........................................... Sections 561 of the Public Health Service Act 

FY 2024 Authorization ................................................................................................$125,000,000 

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

Eligible Entities.....States and territories, governmental units within political sub-divisions of 

states, and federally recognized American Indian/Alaska Native tribes and tribal organizations 

Program Description 

It is estimated that 49.5 percent of adolescents in the United States have any mental illness, of 

which 22.2 percent had a severe impairment. Unfortunately, only 41 percent of those in need of 

mental health services receive treatment.74 Created in 1992, SAMHSA's Children's Mental Health 

Initiative (CMHI) addresses this gap by supporting "systems of care" (SOC) for children and youth 

with serious emotional disturbances (SED) and their families to increase their access to evidencebased treatment and supports. The 21st Century Cures Act reauthorized the CMHI through FY 

2022. CMHI provides grants to assist states, local governments, tribes, and territories in their 

efforts to deliver services and supports to meet the needs of children and youth with SED. 

CMHI funding supports two grant programs: Grants for Expansion and Sustainability of the 

Comprehensive Community Mental Health Services for Children with SED (CMHI); and Clinical 

High Risk for Psychosis (CHR-P) grants. CMHI supports the implementation, expansion, and 

integration of the SOC approach by creating sustainable infrastructure and services that are 

required as part of the Comprehensive Community Mental Health Services for Children and their 

Families Program (also known as the Children’s Mental Health Initiative or CMHI). With this 

program, SAMHSA aims to provide mental health services to children and youth, from birth 

through age 21, at risk for or with SED and their families. SAMHSA intends to prepare children 

and youth at risk for or with SED for successful transition to adulthood and assumption of adult 

roles and responsibilities. 

In FY 2018, SAMHSA implemented the CHR-P, often referred to as the prodrome phase, in which 

a disease process has begun but is not yet diagnosable or inevitable. The population of focus for 

CHR-P are youth and young adults (not more than 25 years of age) who are identified to be at 

clinical high risk for developing a first episode of psychosis. Award recipients are expected to use 

evidence-based intervention to: (1) improve symptomatic and behavioral functioning; (2) enable 

youth and young adults to resume age-appropriate social, academic, and/or vocational activities; 

(3) delay or prevent the onset of psychosis; and (4) minimize the duration of untreated psychosis 

for those who develop psychotic symptoms. 

74 https://www.nimh.nih.gov/health/statistics/mental-illness. 
121 

SAMHSA also funds the National Training & Technical Assistance Center for Children, Youth, 

& Family Mental Health (NTTAC) to provide resources that increase access to, effectiveness of, 

and dissemination of evidence-based mental health services for young people (birth to age 21) and 

their families, including young people experiencing serious mental illness (SMI) or SED. NTTAC 

supports CMHI grantees and provides an array of trainings, technical assistance, and resources to 

providers, organizations, and agencies from across the system of care. With these programs, 

SAMHSA aims to prevent the onset of psychosis or lessen the severity of psychotic disorders 

among youth and youth adults. 

Budget Request

The FY 2024 President’s Budget Request is $225.0 million, an increase of $95.0 million from the 

FY 2023 Enacted level. This funding will support the continuations of 31 CHR-P and award a new 

cohort of 23 grants under the 10 percent set-aside for CHR-P. In addition, funding will support 45 

CMHI continuation grants, a new cohort of 79 CMHI grants, and a technical assistance center. 

SAMHSA expects to serve 30,000 children and the train 80,000 in mental health activities and 

practices. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $125,000,000 

FY 2021 $125,000,000 

FY 2022 Final $125,000,000 

FY 2023 Enacted $130,000,000 

FY 2024 President's Budget $225,000,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 69 CMHI- SOC continuation grants and awarded a new cohort of 

six grants, and a technical assistance center. In FY 2022, CMHI SOC served 9,485 individuals 

with serious mental illness (SMI) or serious emotional disturbance (SED) diagnoses. Of those 

enrolled, 54.1 percent reported positive functioning in everyday life at 6-month follow-up, and 79 

percent were attending school regularly. In addition to direct service care, this grant program 

trained 24,067 individuals in the mental health and related workforce in specific mental healthrelated practices/activities.

In FY 2022, SAMHSA also awarded 19 CHR-P grants funded from a 10 percent set-aside of the 

base CMHI program. In FY 2022, CMHI CHR-P served 664 youth and young adults at clinical 

high risk for psychosis. Of those enrolled, 66.1 percent reported positive functioning in everyday 

life at 6-month follow-up, and 84.8 percent were attending school regularly and or currently 

employed. In addition to direct service care, CHR-P screened 8,560 individuals for mental health 

and related interventions. CHR-P provided outreach to 17,424 individuals and made 5,873 referrals 

to mental health or related services.
122 

In FY 2022, NTTAC provided trainings to 5,182 individuals in the mental health and related work 

force in specific mental-health related practices/ activities. In addition, during FY 2022, NTTAC 

exposed 212, 938 individuals to mental-health awareness messages. 

In FY 2023, SAMHSA anticipates funding 49 CMHI SOC continuation grants, funding one 

continuation award for the NTTAC, and awarding a new cohort of 26 grants. In FY 2023, 

SAMHSA also anticipates supporting 19 CHR-P continuation grants. In FY 2023, it is expected 

that CMHI-SOC grantees will train 25,000 individuals in mental and mental health-related services 

and activities and serve 9,600 youth; CHR-P grantees will provide services to screen 8,560 and 

refer to services 5,900 youth and provide outreach to 17,50 individuals; and the NTTAC will train 

5,400 individuals in the mental health and related workforce and expose 215,000 individuals to 

mental health-awareness messages. 
123 

Output and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023 

Target

FY 2024 

Target

FY 2024 

Target

+/-FY 2023 

Target

3.2.16 Number of 

children with severe 

emotional 

disturbance that are 

receiving services 

from the Children's 

Mental Health 

Initiative (Output)

FY 2022: 9,482 

Target:

9,000 

(Target Exceeded)

9,000 30,000 +21,000 

3.2.25 Percentage of 

children receiving 

services who report 

positive social 

support at 6 month 

follow-up (Outcome) 

FY 2022: 85.7 % 

Target:

77.0 % 

(Target Exceeded)

85.0 % 85.0 % Maintain

3.2.26 Percentage of 

children receiving 

Systems of Care 

mental health 

services who report 

positive functioning 

at 6 month follow-up 

(Outcome)

FY 2022: 58.4 % 

Target:

63.4 % 

(Target Not Met)

60.0 % 60.0 % Maintain

3.2.27 Number of 

people in the mental 

health and related 

workforce trained in 

specific mental 

health-related 

practices/activities as 

a result of the 

program (Output) 

FY 2022: 30,282 

Target:

52,000 

(Target Not Met)

52,000 80,000 +28,000 
124 

Mechanism Table 

Program Activity

FY 2022 

Final

FY 2023 

Enacted 

FY 2024 

President's Budget

Children's Mental Health Services 

Grants/Cooperative Agreements 

Continuations............................................................ 69 $86.62 69 $78.48 77 $85.46

New/Competing........................................................ 25 22.50 38 43.91 103 129.02

Supplements*............................................................ 13 3.94 --- --- --- 0.00

Subtotal................................................................. 107 113.07 107 122.39 180 214.49

Contracts 

Continuations............................................................ --- 11.93 --- 7.11 --- 10.51

New/Competing........................................................ --- --- --- 499 --- --- 

Subtotal................................................................. --- 11.93 --- 7.61 --- 10.51

Total, Children's Mental Health Services 107 $125.00 107 $130.00 180 $225.00

* Totals may not add due to rounding. 

Grant Awards Table 

 

FY 2022 

Final 

FY 2023

Enacted 

FY 2024

President's Budget 

FY 2024

Lower Level 

Number of Awards 107 107 179 

 

180 

Average Awards $1,056,702 $1,143,663 $1,188,659 $1,195,879

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,001
125 

Projects for Assistance in Transition from Homelessness

(Dollars in thousands)

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

PATH...................................................................................................................... $64,635 $66,635 $109,635 $43,000 

Authorizing Legislation ........................................ Section 535(a) of the Public Health Service Act

FY 2024 Authorization ............................................ Reauthorized at current level of $64,635,0000 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities..............................................................................................States and Territories

Program Description 

The Projects for Assistance in Transition from Homelessness (PATH) program was originally 

authorized by the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 and has 

been reauthorized most recently by the Consolidated Appropriations Act, 2023. The PATH 

program supports 56 grants to the 50 states, the District of Columbia, Puerto Rico, Guam, 

American Samoa, the United States Virgin Islands, and the Northern Mariana Islands, as well as 

centralized activities such as technical assistance and evaluation. 

On a single night in 2022, roughly 582,500 people were experiencing homelessness in the United 

States. Six in ten (60%) were staying in sheltered locations—emergency shelters, safe havens, or 

transitional housing programs—and four in ten (40%) were in unsheltered locations such as on the 

street, in abandoned buildings, or in other places not suitable for human habitation. Nearly onethird (30%) of all individuals experiencing homelessness in 2022 had chronic patterns of 

homelessness.75 Data also suggest that at least 20 percent of individuals experiencing 

homelessness have a serious mental illness (SMI).76 Mental illness affects individuals’ abilities to 

maintain stable relationships, perform daily living activities, and maintain stable employment. 

Symptoms of mental disorders also often cause individuals to become estranged from family 

members and caregivers, leaving them without a support system. As a result, individuals with a 

mental illness are more likely to experience homelessness than those without mental illness and 

experience homelessness longer than the rest of the homeless population. 

PATH funds community-based outreach, mental illness and substance use disorder treatment 

services, case management, assistance with accessing housing, and other supportive services for 

individuals with SMI or a co-occurring disorder (COD) who are experiencing homelessness in all 

fifty states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, 

Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. PATH 

The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. The 

2022 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available at: 

https://www.huduser.gov/portal/sites/default/files/pdf/2022-AHAR-Part-1.pdf 76 The U.S. Department of Housing 

and Urban Development, 2020 CoC Homeless Populations and Subpopulations Reports Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2020.pdf

76 The U.S. Department of Housing and Urban Development, 2020 CoC Homeless Populations and Subpopulations 

Reports Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2020.pdf
126 

outreach workers are specialized in engaging those who are most vulnerable in their communities 

and who are least likely to seek out services on their own. The primary goal of the PATH program 

is to link and connect homeless individuals into the mainstream treatment and service systems and 

supportive services that they need to access and stable housing, build social connections, and 

access treatment and services to support their recovery.

Budget Request

The FY 2024 President’s Budget Request is $109.6 million, an increase of $43.0 million from the 

FY 2023 Enacted level. The PATH program was flat funded from FY 2010 to FY 2022 and 

increased by $2 million in FY 2023, while costs associated with the program have steadily 

increased. The number of providers has decreased significantly over the past 10 years. In FY 

2022, 406 providers across the country provided PATH-related services, compared to 505 PATH 

providers in FY 2012. The PATH program pays for the street outreach and engagement not covered 

by most funding sources and helping to bring one of the most vulnerable groups, individuals with 

serious mental illness lacking housing, off the street. SAMHSA expects that the FY 2024 budget 

request will increase the local PATH providers to 505, resulting in 200,000 individuals being

contacted and 119,000 individuals enrolled in the PATH program. All of those contacted receive 

referrals to important local services and resources, and those eligible individuals who are enrolled 

receive extended engagement and supportive services to help them gain or maintain stable housing. 

In addition, the increase will expand the geographic reach of the program to a scope of 

communities consistent with earlier years of the program. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $64,635,000 

FY 2021 $64,635,000 

FY 2022 Final $64,635,000 

FY 2023 Enacted $66,635,001 

FY 2024 President's Budget $109,635,000 

Program Accomplishments

In FY 2021, PATH program staff contacted 103,933 persons experiencing homelessness; of those 

58,821 were actively enrolled in PATH at some point during the reporting period. Of the 58,821 

people who were actively enrolled in PATH in 2021, 24,815 were experiencing co-occurring 

drug/alcohol use disorders. Of those enrolled in PATH, 24,843 were receiving community mental 

health services, 4,813 received substance use disorder treatment and 6,447 received referrals to 

substance use disorder treatment services in the community. PATH provided housing/moving 

assistance to 1,974 individuals, housing eligibility determination services to 14,700 individuals, 

and one-time rent eviction support services for eviction prevention to 1,606 individuals. In 

addition, 16,365 PATH clients were referred to permanent housing and of those, 7,468 were able 

to attain permanent housing. Of the 12,966 PATH clients who were referred to temporary housing, 

6,381 attained the temporary housing. 
127 

In FY 2022, SAMHSA funded 50 states, the District of Columbia, the Commonwealth of Puerto 

Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern 

Mariana Islands to provide PATH services in over 400 communities. 

In FY 2023, SAMHSA anticipates funding all fifty states, the District of Columbia, the 

Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the 

Commonwealth of the Northern Mariana Islands and continuing to provide PATH services in over 

400 communities to support outreach workers and mental health specialists who engage with 

individuals living with SMI or those living with both SMI and drug/alcohol addiction and are 

homeless or at imminent risk of becoming homeless. 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.4.15 Percentage of 

enrolled homeless 

persons in the Projects 

for Assistance in 

Transition from 

Homelessness (PATH) 

program who receive 

community mental health 

services (Intermediate 

Outcome)

FY 2021: 44 %

Target:

64 %

(Target Not Met)

64 % 64 % Maintain

3.4.16 Number of 

homeless persons 

contacted (Outcome)

FY 2021: 103,933

Target:

125,000

(Target Not Met)

105,000 200,000 +95,000

3.4.17 Percentage of 

contacted homeless 

persons with serious 

mental illness who 

become enrolled in 

services (Outcome)

FY 2020: 57 %

Target:

57 %

(Target Met)

57 % 57 % Maintain

3.4.20 Number of 

Projects for Assistance in 

Transition from 

Homelessness (PATH) 

providers trained on 

SSI/SSDI Outreach, 

Access, Recovery 

(SOAR) to ensure 

eligible homeless clients 

are receiving benefits 

(Output)

FY 2021: 2,214

Target:

2,122

(Target Exceeded)

2,500 5,000 Maintain
128 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

 SAMHSA FY 2024 PATH Formula Grant Provisional Allotments 

Appropriation Amount $109,635,000, State-Territory Total $103,805,816 

CFDA # 93.150 

STATE/TERRITORY FY 2022 

Final

FY 2023 

Enacted

FY 2024 

President's 

Budget

FY2024+/- 

FY2023 

Alabama $613,296 $629,605 $1,064,255 $434,650 

Alaska $300,000 $300,000 $300,000 - 

Arizona $1,349,810 $1,385,704 $2,342,329 $956,625 

Arkansas $304,060 $312,145 $527,635 $215,490 

California $8,816,517 $9,050,968 $15,299,328 $6,248,360 

 

Colorado $1,019,514 $1,046,625 $1,769,165 $722,540 

Connecticut $799,681 $820,947 $1,387,689 $566,742 

Delaware $300,000 $300,000 $300,000 - 

District of Columbia $300,000 $300,000 $300,000 - 

Florida $4,336,015 $4,451,319 $7,524,300 $3,072,981 

 

Georgia $1,670,657 $1,715,084 $2,899,096 $1,184,012 

Hawaii $300,000 $300,000 $444,903 $144,903 

Idaho $300,000 $300,000 $362,414 $62,414 

Illinois $2,706,241 $2,778,206 $4,696,147 $1,917,941 

Indiana $1,011,895 $1,038,803 $1,755,944 $717,141 

 

Iowa $334,688 $343,588 $580,785 $237,197 

Kansas $377,537 $387,576 $655,140 $267,564 

Kentucky $469,085 $481,559 $814,004 $332,445 

Louisiana $733,329 $752,830 $1,272,548 $519,718 

Maine $300,000 $300,000 $300,000 - 

 

Maryland $1,272,026 $1,305,852 $2,207,351 $901,499 

Massachusetts $1,559,468 $1,600,938 $2,706,150 $1,105,212 

Michigan $1,730,236 $1,776,247 $3,002,483 $1,226,236 

Minnesota $811,300 $832,874 $1,407,851 $574,977 

Mississippi $300,000 $300,000 $375,082 $75,082 

 

Missouri $894,125 $917,902 $1,551,578 $633,676 

Montana $300,000 $300,000 $300,000 - 

Nebraska $300,000 $300,000 $449,536 $149,536 

Nevada $616,176 $632,561 $1,069,252 $436,691 

New Hampshire $300,000 $300,000 $300,000 - 
129 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

 SAMHSA FY 2024 PATH Formula Grant Provisional Allotments 

Appropriation Amount $109,635,000, State-Territory Total $103,805,816 

CFDA # 93.150 

STATE/TERRITORY FY 2022 

Final

FY 2023 

Enacted

FY 2024 

President's 

Budget

FY2024+/- 

FY2023 

New Jersey $2,138,979 $2,195,860 $3,711,777 $1,515,917 

New Mexico $300,000 $300,000 $506,529 $206,529 

New York $4,224,768 $4,337,114 $7,331,252 $2,994,138 

North Carolina $1,380,145 $1,416,846 $2,394,970 $978,124 

North Dakota $300,000 $300,000 $300,000 - 

 

Ohio $1,987,265 $2,040,111 $3,448,507 $1,408,396 

Oklahoma $453,008 $465,054 $786,106 $321,052 

Oregon $631,255 $648,041 $1,095,418 $447,377 

Pennsylvania $2,367,816 $2,430,781 $4,108,877 $1,678,096 

Rhode Island $300,000 $300,000 $435,762 $135,762 

 

South Carolina $680,484 $698,580 $1,180,846 $482,266 

South Dakota $300,000 $300,000 $300,000 - 

Tennessee $910,122 $934,324 $1,579,338 $645,014 

Texas $4,997,503 $5,130,398 $8,672,181 $3,541,783 

Utah $591,705 $607,440 $1,026,788 $419,348 

 

Vermont $300,000 $300,000 $300,000 - 

Virginia $1,472,784 $1,511,949 $2,555,727 $1,043,778 

Washington $1,329,684 $1,365,043 $2,307,404 $942,361 

West Virginia $300,000 $300,000 $300,000 - 

Wisconsin $836,976 $859,233 $1,452,407 $593,174 

Wyoming $300,000 $300,000 $300,000 - 

 State Subtotal $60,528,150 $62,002,107 $102,058,854 $40,056,747 

 

Puerto Rico $891,465 $915,171 $1,546,962 $631,791 

Guam $50,000 $50,000 $50,000 - 

Virgin Islands $50,000 $50,000 $50,000 - 

American Samoa $50,000 $50,000 $50,000 - 

Northern Mariana Islands $50,000 $50,000 $50,000 - 

 Territory Subtotal $1,091,465 $1,115,171 $1,746,962 $631,791 

Total Allotments $61,619,615 $63,117,278 $103,805,816 $40,688,538 

Total Administrative Costs $3,015,385 $3,517,722 $5,829,184 $2,311,462 

Total Appropriation Amount $64,635,000 $66,635,000 $109,635,000 $43,000,000 
130 

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

(Dollars in thousands)

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 

Enacted

PAIMI...................................................................................................................... $38,000 $40,000 $40,000 $---

Authorizing Legislation..................................................The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities..............................................................................................States and Territories 

Program Description 

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) Program ensures that 

the most vulnerable individuals with serious mental illness (SMI) and significant emotional 

impairment, especially those residing in public and private residential care and treatment facilities, 

are free from abuse, including inappropriate restraint and seclusion, neglect, and rights violations 

while receiving appropriate mental disorder treatment and discharge planning services.

The Protection and Advocacy for Individuals with Mental Illness Act of 1986, as amended by the 

Children’s Health Act of 2000, extended the protections of the Developmental Disabilities (DD) 

Assistance Act of 1975 to individuals with significant mental illness (adults) and significant 

emotional impairments (children/youth) at risk for abuse, neglect, and rights violations while 

residing in public or private care treatment facilities; or living in a community setting, including 

their own homes. The PAIMI Act authorized the same governor-designated state protection and 

advocacy (P&A) systems established under the DD Assistance Act of 1975 to receive PAIMI 

Program formula grant awards from SAMHSA. 

PAIMI supports legal-based advocacy services that are provided by the 57 governor-designated 

P&A systems, which include states, territories, and the District of Columbia. Each system is 

mandated to: (1) ensure that the rights of individuals with mental illness who are at risk of abuse, 

neglect, and rights violations while residing in public or private care or treatment facilities or living 

in a community setting are protected; (2) protect and advocate for the rights of these individuals 

through activities that ensure the enforcement of the Constitution and federal and state statutes; 

and (3) investigate incidents of abuse and/or neglect of individuals with mental illness. The 

priority for services is individuals who are an in-patient or residents of public or private care and 

treatment facilities for individuals with mental illness.

Budget Request

The FY 2024 President’s Budget Request is $40.0 million, level with the FY 2023 Enacted level. 

PAIMI programs will continue to focus on addressing abuse and neglect issues for vulnerable 

populations and advocate for the rights of individuals with mental illness as well as continue to 

assist individuals with SMI increase access to treatment. 
131

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount 

FY 2020 $36,146,000 

FY 2021 $36,146,000 

FY 2022 Final $38,000,000 

FY 2023 Enacted $40,000,000 

FY 2024 President's Budget $40,000,000 

Program Accomplishments 

In FY 2022, SAMHSA funded 57 annual grants to states, District of Columbia, and territories as 

well as the training and technical assistance activities for the grantees. It is expected that, when 

available in July 2023, PAIMI grantees will serve 8,800 individuals. 

In FY 2023, SAMHSA anticipates supporting 57 annual grants to states, District of Columbia, and 

territories. In FY 2024, SAMHSA and maintaining the same performance targets as FY 2023.

Outputs and Outcomes 

Measure Year and Most 

Recent Result / 

Target for Recent 

Result / 

(Summary of Result) 

FY 2023

Target 

FY 2024 

Target 

FY 2024

Target 

+/-FY 2023 

Target 

3.4.12 Number of 

people served by the 

PAIMI program 

(Outcome) 

FY 2021: 8,876 

Target: 

9,821

(Target Not Met) 

9,821 9,821 Maintain 

3.4.19 Number 

attending public 

education/constituency 

training and public 

awareness activities 

(Output) 

FY 2021: 145,437 

Target: 

100,000

(Target Exceeded) 

120,000 120,000 Maintain 
132

Measure Year and Most 

Recent Result / 

Target for Recent 

Result / 

(Summary of Result) 

FY 2023

Target 

FY 2024 

Target 

FY 2024

Target 

+/-FY 2023 

Target 

3.4.21 Percentage of 

complaints of alleged 

abuse, neglect, and 

rights violations 

substantiated and not 

withdrawn by the client 

that resulted in positive 

change through the 

restoration of client 

rights, expansion or 

maintenance of 

personal decisionmaking, elimination of 

other barriers to 

personal decisionmaking, as a result of 

Protection and 

Advocacy for 

Individuals with 

Mental Illness (PAIMI) 

involvement 

(Outcome) 

FY 2021: 92 %

Target: 

89 % 

(Target Exceeded) 

92 % 92 % Maintain 
133 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

 SAMHSA FY 2024 PAIMI Formula Grant Provisional Allotments 

Appropriation $40,000,000, State-Territory Total $38,848,340 

CFDA # 93.150 

STATE/TERRITORY FY 2022 

Final

FY 2023 

Enacted

FY 2024 

President's 

Budget

FY2024+/- 

FY2023 

Alabama $480,022 $500,629 $510,653 $10,024 

Alaska $450,000 $473,700 $473,700 - 

Arizona $696,274 $728,342 $695,212 -$33,130 

Arkansas $450,000 $473,700 $473,700 - 

California $3,149,043 $3,258,367 $3,204,804 -$53,563 

 

Colorado $477,348 $502,394 $492,397 -$9,997 

Connecticut $450,000 $473,700 $473,700 - 

Delaware $450,000 $473,700 $473,700 - 

District of Columbia $450,000 $473,700 $473,700 - 

Florida $1,919,623 $2,009,341 $1,961,748 -$47,593 

 

Georgia $990,859 $1,027,926 $1,028,928 $1,002 

Hawaii $450,000 $473,700 $473,700 - 

Idaho $450,000 $473,700 $473,700 - 

Illinois $1,070,480 $1,095,797 $1,099,271 $3,474 

Indiana $625,258 $647,370 $644,156 -$3,214 

 

Iowa $450,000 $473,700 $473,700 - 

Kansas $450,000 $473,700 $473,700 - 

Kentucky $450,000 $473,700 $473,700 - 

Louisiana $450,000 $473,700 $473,700 - 

Maine $450,000 $473,700 $473,700 - 

 

Maryland $488,446 $512,647 $525,406 $12,759 

Massachusetts $524,180 $543,574 $549,080 $5,506 

Michigan $922,075 $942,630 $951,290 $8,660 

Minnesota $476,148 $495,993 $498,570 $2,577 

Mississippi $450,000 $473,700 $473,700 - 

 

Missouri $570,152 $590,911 $590,245 -$666 

Montana $450,000 $473,700 $473,700 - 

Nebraska $450,000 $473,700 $473,700 - 

Nevada $450,000 $473,700 $473,700 - 

New Hampshire $450,000 $473,700 $473,700 - 
134 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

 SAMHSA FY 2024 PAIMI Formula Grant Provisional Allotments 

Appropriation $40,000,000, State-Territory Total $38,848,340 

CFDA # 93.150 

STATE/TERRITORY FY 2022 

Final

FY 2023 

Enacted

FY 2024 

President's 

Budget

FY2024+/- 

FY2023 

New Jersey $690,534 $720,483 $755,144 $34,661 

New Mexico $450,000 $473,700 $473,700 - 

New York $1,500,968 $1,559,151 $1,618,029 $58,878 

North Carolina $983,884 $1,033,101 $1,001,626 -$31,475 

North Dakota $450,000 $473,700 $473,700 - 

 

Ohio $1,068,301 $1,101,859 $1,111,018 $9,159 

Oklahoma $450,000 $473,700 $473,700 - 

Oregon $450,000 $473,700 $473,700 - 

Pennsylvania $1,088,021 $1,123,397 $1,149,469 $26,072 

Rhode Island $450,000 $473,700 $473,700 - 

 

South Carolina $496,154 $521,389 $510,969 -$10,420 

South Dakota $450,000 $473,700 $473,700 - 

Tennessee $634,222 $665,972 $659,789 -$6,183 

Texas $2,581,922 $2,728,154 $2,712,634 -$15,520 

Utah $450,000 $473,700 $473,700 - 

 

Vermont $450,000 $473,700 $473,700 - 

Virginia $715,878 $753,430 $754,810 $1,380 

Washington $614,716 $649,831 $642,915 -$6,916 

West Virginia $450,000 $473,700 $473,700 - 

Wisconsin $516,413 $539,658 $542,739 $3,081 

Wyoming $450,000 $473,700 $473,700 - 

 State Subtotal $35,430,921 $37,042,246 $37,000,802 -$41,444 

 

Puerto Rico $521,784 $552,218 $578,538 $26,320 

American Samoa $241,100 $253,800 $253,800 - 

Guam $241,100 $253,800 $253,800 - 

American Indian Consortium $241,100 $253,800 $253,800 - 

Northern Mariana Islands $241,100 $253,800 $253,800 - 

Virgin Islands $241,100 $253,800 $253,800 - 

 Territory Subtotal $1,727,284 $1,821,218 $1,847,538 $26,320 

Total Allotments $37,158,205 $38,863,464 $38,848,340 -$15,124

Total Administrative Costs $812,898 $1,136,536 $1,151,660 $15,124

Total Appropriation Amount $37,971,103 $40,000,000 $40,000,000 - 
135 

Community Mental Health Centers (CMHC)

(Dollars in thousands)

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Community Mental Health Centers.......................................................................... $--- $--- $412,500 $412,500 

Authorizing Legislation Section 330 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method .................................................................................................................. Grants

Eligible Entities......Community Mental Health Centers, State and Local Government-Operated 

........................................................................Community Mental Health Centers 

Program Description 

SAMHSA proposes new mandatory funding for Community Mental Health Centers (CMHCs) to 

expand and improve the quality of services available to people with mental illness. The funding 

is provided through 50 states and 6 territories by utilizing the Mental Health Block Grant formula. 

CMHCs have informally existed in communities across America for decades but lack standards or 

consistency in the services available. This program is intended to offer an opportunity to increase 

the quality of mental health services in communities across the United States. 

The purpose of this program is to enable CMHCs to support and restore the delivery of clinical 

services that were impacted by the COVID-19 pandemic and effectively address the needs of 

individuals with serious emotional disturbance (SED), serious mental illness (SMI), and 

individuals with SMI or SED and substance use disorders, referred to as co-occurring disorder 

(COD). SAMHSA recognizes the needs of individuals with behavioral health conditions, including 

minority populations and economically disadvantaged communities, have not been met during the 

pandemic and that CMHC staff and other caregivers have been impacted.

Budget Request

The FY 2024 President’s Budget Request is $412.5 million, an increase of $412.5 million from 

the FY 2023 Enacted level. The funding increase will be used to further develop the quality and 

continuum of behavioral health services, expanding access to crisis care, integrated care, and other 

recovery support services. CMHC funding to states would require the providers to develop a 

continuum of behavioral health services plan, which incorporates a crisis care continuum (i.e., 

crisis residential, crisis stabilization, adverse event crisis coordination, and mobile crisis teams); 

screening (i.e., mental health, substance use disorder, and common medical conditions), treatment, 

and/or referral for substance use disorders and medical conditions; outpatient mental health 

services regardless of ability to pay; and recovery support services (i.e., case management; peer 

support, and family support approaches), including screening, treatment and recovery supports for 

children’s mental and co-occurring disorders. Funding would also support the development and 

implementation of the behavioral health services plan, including overhead costs (subject to all 

existing limitations on use of SAMHSA funds). Establishment of long-term support for CMHCs 

will directly increase the scope and quality of behavioral health services in CMHCs funded by the 

program, establish a higher standard as a target for all CMHCs and address the incomplete and 
136 

inconsistent service array in much of America.

SAMHSA is requesting that this be funded as a mandatory grant program. It is estimated that these 

services will directly benefit at least 20,000 individuals per year, providing an improved level of 

treatment and support to meet the increase behavioral health services needs in local communities. 

SAMHSA is requesting that this be funded as a mandatory grant program. 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 $---

FY 2021 $---

FY 2022 Final $---

FY 2023 Enacted $---

FY 2024 President's Budget $412,500 

Program Accomplishments

 

In FY 2021, SAMHSA awarded 230 CMHC grants for two years with COVID 19 Relief 

supplemental funding. 

In FY 2022, CMHC grantees trained 61,390 individuals in mental health and mental health-related 

practices, 161,755 individuals received evidence-based services, and 56.2 percent of all individuals 

served indicated that their functioning in everyday life improved from baseline to 6-month followup. 
137 

Certified Community Behavioral Health Clinics (CCBHC)

(Dollars in thousands)

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 +/- 

2023 Enacted

Certified Community Behavioral Health Clinic....................................................... $315,000 $385,000 $552,500 $167,500

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

FY 2024 Authorization ..............................................................................................$599,000,0000 

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

Eligible Entities .................................................... Certified Community Behavioral Health Clinics,

.................................................................................Community-Based Behavioral Health Clinics

Program Description 

In 2021, among adults aged 18 or older, 22.8 percent (or 57.8 million people) had a mental illness 

and 5.5 percent (or 14.1 million people) had a serious mental illness (SMI) in the past year. 46.3 

million people aged 12 or older (or 16.5 percent) had an SUD in 2021.77 While effective treatment 

and supportive services exist, many individuals with behavioral health conditions do not receive 

the help they need78. When they do try to access services, they often face significant delays and/or 

have limited access to services79. Too often, services are incomplete and uncoordinated. People 

who receive services, such as medication or psychotherapy, often do not get other supports they 

need, such as crisis management, supported employment, supportive housing, and care for cooccurring physical health problems80,

81,82. 

Congress created a new approach to addressing these issues by creating the Certified Community 

Behavioral Health Clinics (CCBHC) model as a part of the Protecting Access to Medicare Act of 

2014 (PAMA). The purpose of this program is to transform community behavioral health systems 

and provide comprehensive, coordinated behavioral health care by (a) enhancing and improving 

CCBHCs that meet the CCBHC Certification Criteria; (b) providing a comprehensive range of 

outreach, screening, assessment, treatment, care coordination, and recovery supports based on a 

needs assessment with fidelity to the CCBHC Certification Criteria; and (c) supporting recovery 

from mental illness and/or substance use disorders by providing access to high-quality mental 

health and substance use services, regardless of an individual’s ability to pay. 

CCBHC’s ensure access to coordinated care so that individuals receive timely diagnosis, 

77 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health 

indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. 

PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report 78 Ibid. 79 https://www.gao.gov/assets/gao-22-104597.pdf 80 https://www.samhsa.gov/data/sites/default/files/reports/rpt39371/Alabama.pdf 81 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health 

indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. 

PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality, Substance Abuse and 

Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report 82 https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf
138 

treatment, and recovery support services. As required in PAMA, HHS established criteria for 

clinics to be certified as CCBHCs in 2015. These criteria cover six areas that CCBHCs must 

address to be certified: (1) staffing; (2) availability and accessibility of services; (3) care 

coordination; (4) scope of services; (5) quality and other reporting; and (6) organizational 

authority. Crisis services are also required with the CCBHC model. 

CCBHCs serve all individuals across the lifespan in need of behavioral health services in the 

geographic catchment area served by the CCBHC. This includes individuals with SMI; SUD, 

including opioid use disorders; children and youth with SED; individuals with COD; and people 

experiencing a mental health or substance use related crisis. SAMHSA expects that applicants will 

include a focus on groups facing health disparities, as identified in the community needs 

assessment in the population of focus. 

In FY 2016, SAMHSA assisted 24 states through planning grants to be eligible for a CCBHC 

demonstration, and in FY 2017, CMS selected eight states to participate in a two-year CCBHC 

demonstration program. This demonstration program has been extended by Congress until 2023 

and expanded to include two additional states. The CMS funded demonstration program is 

separate from the SAMHSA-funded CCBHC-Expansion (CCBHC-E) program in terms of source 

of funding. Through the CMS Medicaid prospective payment system CCBHC demonstration 

clinics are reimbursed for the care and services provided to Medicaid beneficiaries. 

In 2018, SAMHSA established the (CCBHC-E) grant program. The CCBHC-E program is 

intended to improve the behavioral health of individuals across the nation by providing increased 

access to a comprehensive range of services. These include community-based mental, and 

substance use disorder services; treatment of co-occurring disorders; primary care screening and 

monitoring; and use of evidence-based practices chosen to meet community need. SAMHSA’s 

CCBHC-E program is separate from the Medicaid Demonstration program, though some clinics 

participate in both programs. 

Since 2020, applicants from all states can apply for SAMHSA’s CCBHC-E grants, grant funding 

for the CCBHC-E program is provided directly to the certified clinics. Grantees must use 

CCBHC-E funds to provide access to services for individuals with SMI or substance use disorders 

(SUD), including opioid disorders; children and adolescents with SED; and individuals with cooccurring mental and substance use disorders (COD). 

In FY 2022, SAMHSA also revamped the CCBHC-E funding announcement requirements and 

awarded two new cohorts of the program. One cohort is for clinics that are interested in newly 

becoming CCBHCs [the CCBHC Planning, Development, and Implementation (CCBHC-PDI) 

Grants], and the other cohort is for clinics that are already established CCBHCs seeking to expand, 

improve, and advance their services [the CCBHC Improvement and Advancement (CCBHC-IA) 

Grants]. 

SAMHSA expects that CCBHC-E grants will improve behavioral health care for individuals 

across the lifespan by supporting providers to operate in accordance with the Federal CCBHC 

criteria and:
139 

• Increase access to and availability of high-quality services that are responsive to the needs of 

the community; 

• Support recovery from mental health and substance use disorder challenges via comprehensive 

community-based mental and substance use disorder treatment and supports; 

• Use evidence-based practices that address the needs of the individuals the CCBHC serves;

• Continually work to measure and improve the quality of services; and 

• Meaningfully involve consumers and family members in their own care and the broader 

governance of the CCBHC. 

Budget Request

The FY 2024 President’s Budget Request is $552.5 million, an increase of $167.5 million from 

the FY 2023 Enacted level. The funding will support 360 continuation grants, award a new cohort 

of 158 grants, and a technical training assistance center grant to continue the improvement of 

mental disorder treatment, services, and interventions for children and adults. SAMHSA expects 

to serve approximately 400,000 individuals. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount COVID-19 

Supplemental Funding 

FY 2020 $200,000,000 

FY 2021 $249,249,440 $1,020,000,000 

FY 2022 Final $315,000,000 

FY 2023 Enacted $385,000,000 

FY 2024 President's Budget $552,500,000 

Program Accomplishments

In FY 2022, SAMHSA supported 31 continuation grants, awarded a new cohort of 301 grants (169 

new grants with base budget authority, and a Training and Technical Assistance Center. As of FY 

2022, CCBHC-E clinics have been funded in 42 states and Guam. Collected data on program 

recipients demonstrate favorable outcomes on critical domains. These outcomes include 

improvement in mental health functioning; reduction in substance use; reduction in homelessness 

and reduction in criminal justice system involvement. For example, 75 percent of assessed 

individuals reported no psychological distress at the six-month reassessment in comparison to 63.9

percent at baseline. Additionally, data from intake to most recent reassessment for individuals 

served in the CCBHC program demonstrate that as of July 2022, clients have a 72 percent 

reduction in hospitalization and a 69 percent reduction in Emergency Department visits. CCBHCE grantees have increased the availability of critical services, improved staffing and training, 

reduced wait times, enhanced the integration of physical and behavioral health care, expanded 
140 

addiction treatment capacity including Medication Assisted Treatment (MAT) for opioid use 

disorder. Together, these outcomes together comprise measurement for an improvement in overall 

quality of life. 

CCBHC-E grantees have increased the availability of critical services, improved staffing and 

training, reduced wait times, enhanced the integration of physical and behavioral health care, and 

expanded addiction treatment capacity while overcoming concerns related to behavioral health 

workforce challenges and COVID disruptions. CCBHC-E grantees provided services to 73,338 

individuals in FY 2020, 168,246 individuals in FY 2021, and 311,282 individuals in FY 2022. 

In FY 2023, SAMHSA anticipates funding 302 continuation grants (169 grants with base budget 

authority awarding a new cohort of 124 grants and continuing the technical training assistance 

center grant.) SAMHSA anticipates serving over 300,000 people in FY 2023. 
141 

Improvements in Functioning: Intake to Six Month Reassessment 58.9%63.9%67.9% 43.8% 69.3% 65.4%

98.7%

6.4%

65.3%

75.0%

71.9%

48.8%

72.7%

73.9%

99.4%

1.7%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0% Percentage of Clients

Intake 6-Month Reassessment
142 

Outputs and Outcomes

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.4.10 Percentage of 

clients receiving 

services who report 

positive functioning 

at 6 months followup. (Outcome) 

FY 2022: 55.0

Target:

56.0 

(Target Not Met)

56.0 56.0 Maintain

3.4.11 Percentage of 

clients receiving 

services who are 

currently employed 

at 6-month followup. (Outcome) 

FY 2022: 40.9

Target:

45.0 

(Target Not Met)

Discontinued Discontinued N/A

3.4.12 Percentage of 

clients receiving 

services who have a 

permanent place to 

live in the 

community at 6-

month follow-up. 

(Outcome)

FY 2022: 67.2

Target:

65.0 

(Target Exceeded)

Discontinued Discontinued N/A

3.5.10 Number of 

individuals served by 

the program (Output) 

FY 2022: 311,282.0

Target:

188,000.0 

(Target Exceeded)

311,000 400,000 Maintain
143 

Mechanism Table

Program Activity

FY 2022 

Final 

FY 2023 

Enacted 

FY 2024 President's 

Budget

Certified Community Behavioral Health Clinics 

Grants/Cooperative Agreements 

Continuations..................................................................... 31 $58.83 236 $235.13 360 $359.04

New/Competing................................................................. 278 240.31 124 123.78 158 158.30

Subtotal........................................................................... 309 299.14 360 358.91 518 517.34

Contracts 

Continuations..................................................................... --- 15.43 --- 20.84 2 35.16

New/Competing................................................................. --- 423 2 5,255 --- --- 

Subtotal........................................................................... --- 15.86 2 26.09 2 35.16

Total, Certified Community Behavioral Health Clinics 309 $315.00 362 $385.00 520 $552.50

Grant Awards Table 

 

FY 2022 

Final 

FY 2023

Enacted 

FY 2024

President's Budget 

Number of Awards 309 360 518

Average Awards $968,098 $996,961 $998,725

Range of Awards $1,000,000-$2,000,000 $1,000,000-$2,000,000 $1,000,000-$2,000,000
144 

Community Mental Health Services Block Grant (MHBG)

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024 

Final Enacted

 

President's 

Budget

FY2024 

+/- 2023 

Enacted

Community Mental Health Services Block Grant.................................................... $857,571 $1,007,571 $1,652,571 $645,000 

Budget Authority (non-add)................................................................................... 836,532 986,532 1,631,532 $645,000 

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

Authorizing Legislation..............................................................................Section 1911 of the PHS Act 

FY 2024 Authorization ............................................................................................... $857,571,000 

Allocation Method ..................................................................................................... Formula Grant 

Eligible Entities .................. States, Territories, Freely Associated States, and District of Columbia

Program Description

According to the 2021 National Survey on Drug Use and Health (NSDUH),83 5.5 percent of adults 

aged 18 and older had a serious mental illness (SMI) in 2021 (an estimated 14.1 million adults ) 

and only 65.4 percent adults with SMI received services in 2021 (an estimated 9.1 million adults). 

Studies and research indicate increased risk of COVID-19 mortality among individuals with 

mental illness,

84 The COVID-19 pandemic is also associated with high levels of psychological 

distress among general population85, and specifically among people with SMI and Serious 

Emotional Disturbance (SED).

86 

Since 1992, the Community Mental Health Services Block Grant (MHBG) has distributed funds 

to 59 eligible states and territories and freely associated states through a formula based upon 

specified economic and demographic factors.87 The MHBG distributes funds can be used for a 

83 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental 

health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health 

(HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Rockville, MD: Center for Behavioral 

Health Statistics and Quality, Substance use And Mental Health Services Administration. Retrieved from 

https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report

84 Bitan, D. T., Kridin, K., Cohen, A. D., & Weinstein, O. (2021). COVID-19 hospitalization, mortality, 

vaccination, and postvaccination trends among people with schizophrenia in Israel: a longitudinal cohort study. The 

Lancet Psychiatry.

85 Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M., Gill, H., Phan, L., ... & McIntyre, R. S. (2020). Impact of COVID19 pandemic on mental health in the general population: A systematic review. Journal of affective disorders. 86 Dickerson, F., Katsafanas, E., Newman, T., Origoni, A., Rowe, K., Squire, A., ... & Yolken, R. (2021). 

Experiences of Persons With Serious Mental Illness During the COVID-19 Pandemic. Psychiatric Services, appi-ps. 87 Territories include Guam, Puerto Rico, the Northern Mariana Islands, U.S. Virgin Islands and American Samoa. 

Freely Associated States, which have signed Compacts of Free Association with the United States, include the 

Republic of Palau, Federated States of Micronesia and Republic of the Marshall Islands. See 

http://www.doi.gov//oia/islands/index.cfm. Further information about the Block Grant program can be found on 

SAMHSA’s Web site at http://www.samhsa.gov/grants/block-grants
145 

variety of behavioral health services and for planning, administration, and educational activities. 

By statute, these services and activities must support community-based mental health services for 

children with SED and adults with SMI. MHBG services include: outpatient treatment for persons 

with SMI, such as schizophrenia and bipolar disorders; supported employment and supported 

housing; rehabilitation services; crisis stabilization and case management; peer specialist and 

consumer-directed services; wraparound services for children and families; jail diversion 

programs; and services for at-risk populations (e.g., individuals, who experience homelessness, 

those in rural and frontier areas, military families, and veterans). 

The MHBG continues to represent a significant “safety net” source of funding for mental health 

services for some of the most at-risk populations across the country. Together, SAMHSA’s block 

grants support the provision of services and related support activities to more than eight million 

individuals with mental and substance use conditions in any given year. The MHBG’s flexibility 

and stability have made it a vital support for public mental health systems. States rely on the 

MHBG for delivery of services and for an array of non-clinical coordination and support services 

that are not supported by Medicaid or other third-party insurance to strengthen their service. 

The MHBG statute provides for a five percent administrative set-aside that allows SAMHSA to 

assist the states and territories in the development of their mental health systems through the 

support of technical assistance, data collection, and evaluation activities. States also use block 

grant funds, with other funding sources, to support training for staff and implementation of 

evidence-based practices and other promising practices for the treatment of mental disorders, 

improved business practices, use of health information technology, and integration of physical and 

behavioral health services. 

SAMHSA’s MHBG and Substance Use Prevention, Treatment, and Recovery Services Block 

Grant (SUPTRS BG) applications align with changes in federal/state environments and statutes. 

SAMHSA offers states the opportunity to complete a combined application for mental health and 

substance abuse services, submit a biennial plan, and provide information regarding their efforts 

to respond to various changes in federal and state law.88,89 

There are many individuals, both adolescent and adult, with co-occurring mental illness and 

drug/alcohol addiction. In recognition of this, SAMHSA strongly encourages coordination 

between MHBG programs and those supported by the SUPTRS BG as well as other SAMHSAfunded efforts such as the systems of care for children and adolescents supported through the 

Children’s Mental Health Initiative. 

Crisis Services Set-Aside

States are required to set aside 5 percent of their total allocation for evidence-based crisis care 

programs that address the needs of individuals with SMIs and children with serious mental and 

emotional disturbances. The set-aside funds some or all of a set of core crisis care elements 

88 State Plan for Comprehensive Community Mental Health Services for Certain Individuals (Sec. 1912 of Title XIX, 

Part B, Subpart I of the Public Health Service (PHS) Act (42 USC § 300x-2). 89 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x32(b)).
146 

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

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

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

A fully developed crisis response system is responsive any time and any place. SAMHSA expects 

that states build on the emerging and growing body of evidence for effective community-based 

crisis-intervention and response systems. SAMHSA recognizes that the development of fully 

accessible and responsive crises services involves complex problem solving with multiple entities 

and systems including a partnership between mental health and law enforcement. SAMHSA 

anticipates that 988 will play a critical role in such fully developed crisis systems. SAMHSA also 

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

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

engagement, arrests, incarcerations, and 911 calls. SAMHSA views effective implementation of 

988 as a catalyst for this crisis service development and transformation. 

Now that the National Suicide Prevention Lifeline has transitioned to the 988 Suicide and Crisis 

Lifeline, SAMHSA has emphasized to states the importance of 988 implementation, and that the 

MHBG crisis set aside can be used to support local Lifeline call centers who provide regional or 

statewide coverage and coordinate in real time. SAMHSA continues to partner with states on the 

crisis set-aside through the provision of technical assistance on the use of funds, requests for 

information on specific allocations of funding across the crisis continuum of care, and 

recommended changes to the data reporting system. The Budget increases the crisis set-aside to 

10 percent. 

Set-aside for Evidence-based Programs that Address the Needs of Individuals with Early Serious 

Mental Illness

States are required to set aside ten percent of their MHBG funds to support “evidence-based 

programs that address the needs of individuals with early SMI, including psychotic disorders”90.

This totaled $81.5 million in FY 2022. SAMHSA is collaborating with the NIMH and states to 

implement this provision.

The majority of individuals with SMI experience their first symptoms during adolescence or early 

adulthood, and there are often long delays between the initial onset of symptoms and receiving 

treatment. The consequences of delayed treatment can include loss of family and social supports, 

reduced educational achievement, incarceration, disruption of employment, substance use, 

increased hospitalizations, and reduced prospects for long-term recovery.

Through this funding, 50 states, DC and Puerto Rico implemented fully operating first-episode 

treatment programs and SAMHSA continues to monitor and ensure that the set-aside program is 

solely used to address first-episode psychosis. 

Set-aside for Early Intervention and Prevention of Mental Disorders Among At-Risk Children 

and Adults 

90 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf
147 

The FY 2024 Budget includes a new set-aside that would require states to expend at least 10 

percent of their MHBG funding for evidence-based prevention and early intervention programs to 

improve outcomes for at-risk youth and adults who are at risk to develop SMI or SED through 

prevention, education, screening, and early identification. This investment expands funding to 

support earlier identification and prevention of mental health disorders and further support targeted 

services for youth and prevent more serious symptoms further on in a person’s life. 

Budget Request

The FY 2024 President’s Budget Request is $1.6 billion, an increase of $645.0 million from the 

FY 2023 Enacted level. With this funding, SAMHSA will continue to address the needs of 

individuals with SMI and SED and will continue to maintain the 10 percent set-aside for evidencebased programs that address the needs of individuals with early SMI, including psychotic 

disorders. The 10 percent crisis care set set-aside funds help reduce costs to society, as intervening 

early helps prevent deterioration of functioning in individuals experiencing a first episode of SMI. 

The Budget also includes a 10 percent set-aside for evidence-based programs for early intervention 

and prevention of mental disorders among at-risk children and adults. States will continue to use 

the Coronavirus Response and Relief Supplement and American Rescue Plan funding through FY 

2023 (or FY 2024 with No Cost Extension request approvals) and FY 2025, respectively, as states 

expand their MHBG infrastructure to address unmet service needs.

Funding History Table 

10 Year Funding Table

Fiscal Year Amount COVID-19 

Supplemental Funding 

FY 2015 $482,571,000 

FY 2016 $532,571,000 

FY 2016 $562,571,000 

FY 2018 $722,571,000 

FY 2019 $722,571,000 

FY 2020 $722,571,000 

FY 2021 $755,571,000 $3,150,000,000 

FY 2022 Final $857,571,000 

FY 2023 Enacted1 $1,007,571,000 $62,500,000 

FY 2024 President's Budget1 $1,652,571,000 $62,500,000 

1

/Funds are in advance of Appropriations in 2023 and 2024.
148 

Program Accomplishments

Most block grant recipients are currently reporting on National Outcome Measures (NOMS) for 

public mental health services within their state. State-level outcome data for mental health are 

currently reported by State Mental Health Authorities. According to the 2021 NOMS Report, the 

MHBG served 8,195,517 clients through the State Mental Health Systems. The table below 

provides 2021 demographics on the clients served. 

Mental Health Block Grant Demographics 

Adults 5,986,533 

Children 2,208,984 

Female 53.6% 

Male 46.4% 

Age

0-12 14.8% 

13-17 12.1% 

18-20 4.9% 

20-24 5.9% 

25-44 32.9% 

45-64 23.6% 

65-74 4.0% 

75+ 1.6% 

75+ 0.01% 

The following outcomes for all people served by the publicly funded mental health system during 

2021 show that:

For the 59 states and territories that reported data in the Employment Domain, 24.6 percent of the 

mental health consumers were in competitive employment;

For the 58 states and territories that reported data in the Housing Domain, 84.9 percent of the 

mental health consumers were living in private residences;

For the 59 states and territories that reported data in the Access/Capacity Domain, state mental 

health agencies provided mental health services for approximately 24.59 people per 1,000 

population; 

For the 43 states and territories that reported data in the Retention Domain, only 7.6 percent of the 

patients returned to a state psychiatric hospital within 30 days of state hospital discharge and 

For the 51 states and territories that reported data in the Perception of Care Domain, 77.2 percent 

of adult mental health consumers improved functioning as a direct result of the mental health 

services they received. 
149 

The table below identifies activities that states have implemented with the 10 percent set-aside for 

First Episode Psychosis (FEP)/Early Serious Mental Illness (ESMI).

State FY 2023 10% 

Set Aside 

Allotment

Program Description 

Alabama $1,405,119 

State uses the EASA and OnTrack USA. Services are delivered 

through a Coordinated Specialty Care Team that is reflective of 

the demographic mix of the community. 

Alaska $236,083 

Use the OnTrAK model. The staffing structure highlights the 

realities of the Mat-Su Borough in size, scope, and incidence rate 

leading to the development of a task-based team approach focused 

on outcome. 

American 

Samoa $18,003 

AS has adopted the Assertive Community Treatment (ACT) 

model for community mental health services for use with 

individuals with FEP. 

Arizona $2,420,760 State has CSC model at 3 sites with planned expansion. 

Arkansas $853,221 

State ESMI/FEP program is contractually assigned to the 

Community Mental Health Centers. Evidenced-based treatment 

models are utilized for each client newly diagnosed with 

psychosis. 

California $12,370,027 

State allocates MHBG funds to 57 local county subrecipients who 

administer their own Mental Health Plans that are unique to their 

particular geographic and population circumstances each year and 

utilize models, such as Portland Identification and Early Referral

(PIER).

Colorado $1,894,011 

Providers have implemented CSC models with high fidelity.

Connecticut $978,610 

State implemented four programs based on two distinct CSC 

models (Potential and STEP). 

Delaware $207,525 

A statewide program, Community Outreach, Referral and Early 

Intervention (CORE)) has been implemented. 

District of 

Columbia $237,982 

The District’s early intervention program (EIP), the Youth 

Blossom program at Community Connections, is utilizing CSC 

model offers early treatment to young adults (age 16-25) 

experiencing their first psychotic break. 

Florida $6,548,174 

The State of Florida currently has 7 Coordinated Specialty Care 

teams. Six of the seven utilize the NAVIGATE model and one 

utilizes the OnTrack model.

Georgia 

$2,944,305 

State has now implemented ten (10) Coordinated Specialty Care 

teams around the state. All programs are based on the LIGHTETP model. 
150 

State FY 2023 10% 

Set Aside 

Allotment

Program Description 

Guam

$64,005 

State has begun providing services in the I Fine'na program, which 

is based on OnTrackNY, and offers Early Serious Mental Illness 

(ESMI) services through the OASIS Empowerment Center. 

Hawaii $477,660 

State has implemented a program with three sites in Honolulu 

based on the OnTRACK model. 

Idaho $531,105 

Four CSC programs have been implemented Idaho is 

implementing the STAR (Strength Through Active Recovery) 

program to provide FEP treatment based on the On-Track CSC 

treatment model. 

Indiana $2,997,067 

State offers three programs based on the Prevention and Recovery 

Care (PARC) model and makes use of a "hub and spoke" design. 

Iowa $1,917,394 

State has three functioning CSC programs based on the 

NAVIGATE model. 

Kansas $773,941 

There are three teams in Kansas. The eligibility age was raised 

from 15 to 25-years-old to 15 to 36-years-old to increase access 

to women. 

Kentucky $700,572 

Eight EASA CSC program sites are available throughout the state, 

with one in the installation phase. State is also using the MHBG 

to support data infrastructure to track outcomes. 

Louisiana $1,258,208 

Six sites have been implemented. These programs are using the 

Navigate CSC model.

Maine $382,538 

State has implemented one program, Maine Medical 

Center/Portland Identification and Early Referral Program, based 

on the PIER Model in Portland. The state has also contracted with 

the PIER program to train staff at one other provider to provide 

FEP services.

Marshall 

Islands $29,532 

Use the set aside funding to develop first episode outreach 

practices and protocols for individuals experiencing FEP. 

Maryland $1,255,878 

The state has implemented four CSC programs, two in Baltimore, 

one in Gaithersburg and one in Catonsville.

Massachusetts $2,041,956 

Seven Community Clinics with comprehensive specialized FEP 

services are in operation, and 3 outpatient hospital sites. 

Michigan $2,796,893 

The State has implemented six CSC programs using the 

NAVIGATE CSC model. 

Federated 

States of 

Micronesia $38,869 

Funds are being used to train staff on the OnTrack CSC model in 

four locations. The state also has developed outreach and 

screening processes in schools and in the community in Majuro, 

Ebeye and Outer Islands. 
151 

State FY 2023 10% 

Set Aside 

Allotment

Program Description 

Minnesota $1,555,152 

State has implemented three CSC programs using the Navigate 

model. 

Mississippi $878,993 

State is fully implementing the NAVIGATE CSC programs to 

provide training and technical assistance to five CSC teams.

Missouri $1,642,217 

State has established ten sites spread throughout the state that 

provide Assertive Community Treatment for Transitional Age

Youth (ACT-TAY) for individuals experiencing an early SMI. 

Montana $350,987 

The state has implemented the NAVIGATE model in one site.

Northern 

Mariana 

Islands $19,697 

The Community Guidance Center implemented a 

psychoeducation group geared toward family education, which 

will help families and the community better identify FEP 

symptoms in their family or community leading to earlier 

treatment of the client.

Nebraska $448,906 

The state has implemented OnTrackUSA in two of the six 

behavioral health service regions of the state. 

Nevada $1,113,378 

The state has implemented three CSC programs: in the Reno area 

and Las Vegas area using the Recovery After Initial 

Schizophrenic Episode (RAISE) TEAM approach and a third 

CSC program in Carson City that follows the NAVIGATE model.

New 

Hampshire $324,777 

State currently has one FEP program at the Greater Nashua 

Mental Health Center (GNMHC), utilizing the NAVIGATE 

model. 

New Jersey $2,659,541 

State has implemented three CSC teams that provide CSC service 

in all 21 NJ counties. 

New Mexico $591,415 

State is expanding access to the NAVIGATE model for specialty 

coordinated care for individuals with FEP through the already 

implemented University of New Mexico EARLY program. 

New York $5,453,918 

State is spending set-aside funds to expand its existing 

OnTrackNY program to two new sites, for 22 CSC sites statewide.

North Carolina $2,872,609 

North Carolina supports four CSC for FEP programs. 

North Dakota $171,655 

State implemented CSC services in Fargo, which serves six 

counties in the state.
152 

State FY 2023 10% 

Set Aside 

Allotment

Program Description 

Ohio $3,019,256 

State has expanded to 17 teams serving 37 counties. 

Oklahoma $1,085,193 

State indicates they have expanded to 14 CSC and ESMI 

programs. 

Oregon $1,527,760 

Oregon is integrating Coordinated Specialty Care teams in all 

counties using a standard model of care supported by the EASA 

Center for Excellence at Oregon Health & Science University and 

Portland State University. 

Palau $8,179 

Supports one CSC team. 

Pennsylvania $3,238,835 

State has 14 Coordinated Specialty Care Programs for First 

Episode Psychosis, serving 20 counties. 

Puerto Rico $1,211,954 

Puerto Rico has implemented two Coordinated Specialty Care 

Programs using the OnTrack model. 

Rhode Island $338,106 

Rhode Island will continue to use the entire set-aside amount to 

serve individual ages 16-25 experience a first episode of 

psychosis in the two CSC community health care centers. 

South Carolina $1,482,932 

State is funding four programs for individuals with an early SMI, 

one of which uses the NAVIGATE model. 

South Dakota $211,838 

State has implemented two CSC programs in Sioux Falls and 

Rapid City. They have been trained by OnTrackNY. 

Tennessee $2,034,401 

State uses the MHBG funds to provide OnTrackTN in five sites 

across the state.

Texas $7,919,259 

State offers 24 CSC programs in rural and urban. These sites serve 

both indigent and Medicaid-eligible populations. 

Utah $1,084,863 

State has 5 programs in total, all funded by MHBG. Four are FEP 

programs that follow the RAISE model, and one is an ESMI 

program for Hispanic/Latino youth (14-25). 

Vermont $167,236 

State continues to partner with Vermont Corporative for Practice 

Improvement and Innovation to facilitate the initiative including 

targeted, research, implementation, workforce development, 

outreach, and education. 

Virgin Islands $40,377 

State reports site using the CSC model 

Virginia $2,453,857 

Eight (8) Virginia community services boards (CSBs) operate 

CSC programs. 

Washington 

$2,342,351 

State operates nine sites using the New Journeys model based on 

the NAVIGATE model.
153 

State FY 2023 10% 

Set Aside 

Allotment

Program Description 

West Virginia $515,627 

State has seven provider sites utilizing the FIRST CSC model 

ESMI services to fidelity.

Wisconsin $1,481,149 

State is continuing to fund the CSC model PROPS program 

operated by JMHC in Madison, which serves three rural counties 

north of Madison. In addition, the state is funding a CSC program 

in Milwaukee.

Wyoming $126,941 

The state has two providers providing CSC FEP programs: 

Southwest Counseling Service 

Yellowstone Behavioral Health Center.
154

Outputs and Outcomes 

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result) 

FY 2023

Target 

FY 2024

Target 

FY 2024

Target

+/-FY 2023

Target 

2.3.11 Number of 

evidence-based 

practices (EBPs) 

implemented (Output) 

FY 2021: 5.0 per 

State 

Target: 

5.0 per State 

(Target Met) 

5.0 per State 5.0 per State Maintain 

2.3.14 Number of 

people served by the 

public mental health 

system (Output) 

FY 2021: 8,195,517 

Target: 

7,808,416

(Target Exceeded) 

8,200,000 8,200,000 Maintain 

2.3.15 Rate of 

consumers (adults) 

reporting positively 

about outcomes 

(Outcome) 

FY 2021: 77.1 % 

Target: 

75.4 % 

(Target Exceeded) 

75.0 % 75.0 % Maintain 

2.3.16 Rate of family 

members 

(children/adolescents) 

reporting positively 

about outcomes 

(Outcome) 

FY 2021: 72.2 % 

Target: 

72 % 

(Target Exceeded) 

72.2 % 72.2 % Maintain 

2.3.19A: Supported 

Housing Supported 

Housing: Percentage of 

the population 

accessing selected 

evidence-based 

programs among 

people served by state 

mental health 

authorities (Outcome) 

FY 2021: 3.0 % 

Target: 

3.1 % 

(Target Not Met but 

Improved) 

3.1 % 3.1 % Maintain 
155

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result) 

FY 2023

Target 

FY 2024

Target 

FY 2024

Target

+/-FY 2023

Target 

2.3.19B Supported 

Employment: 

Percentage of the 

population accessing 

selected evidencebased programs among 

people served by state 

mental health 

authorities (Outcome) 

FY 2021: 1.9 % 

Target: 

2.0 % 

(Target Not Met) 

1.9 % 1.9 % Maintain 

2.3.19C Assertive 

Community Treatment: 

Percentage of the 

population accessing 

selected evidencebased programs among 

people served by state 

mental health 

authorities (Output) 

FY 2021: 2.0 % 

Target: 

1.9 % 

(Target Exceeded) 

1.9 % 1.9 % Maintain 

2.3.19D Family 

Psychoeducation: 

Percent of the 

population accessing 

selected evidencebased programs among 

people served by state 

mental health 

authorities (Outcome) 

FY 2021: 2.6 % 

Target: 

2.4 % 

(Target Exceeded) 

2.6 % 2.6 % Maintain 

2.3.19E Dual Diagnosis 

Treatment: Percent of 

the population 

accessing selected 

evidence-based 

programs among 

people served by state 

mental health 

authorities. (Outcome) 

(Outcome) 

FY 2021: 10.1 % 

Target: 

10.1 % 

(Target Not Met) 

10.1% 10.1 % Maintain 
156

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result) 

FY 2023

Target 

FY 2024

Target 

FY 2024

Target

+/-FY 2023

Target 

2.3.19F Illness SelfManagement: Percent 

of the population 

accessing selected 

evidence-based 

programs among 

people served by state 

mental health 

authorities. (Outcome) 

FY 2021: 18.7 % 

Target: 

18.0 % 

(Target Exceeded) 

18.7 % 18.7 % Maintain 

2.3.19G Medication 

Management: Percent 

of the population 

accessing selected 

evidence-based 

programs among 

people served by state 

mental health 

authorities. (Outcome) 

FY 2021: 30.5 

Target: 

31.0

(Target Not Met) 

30.5 30.5 Maintain 

2.3.19H Treatment 

Foster Care: Percent of 

the population 

accessing selected 

evidence-based 

programs among 

people served by state 

mental health 

authorities. (Outcome) 

FY 2021: 1.7 % 

Target: 

0.7 % 

(Target Exceeded) 

1.7 % 1.7 % Maintain 

2.3.19I Multi-Systemic 

Therapy: Percent of the 

population accessing 

selected evidencebased programs among 

people served by state 

mental health 

authorities. (Outcome) 

FY 2021: 3.7 % 

Target: 

4.2 % 

(Target Not Met) 

4.1 % 4.1 % Maintain 
157

Measure Year and Most 

Recent Result /

Target for Recent 

Result /

(Summary of Result) 

FY 2023

Target 

FY 2024

Target 

FY 2024

Target

+/-FY 2023

Target 

2.3.19J Functional 

Family Therapy: 

Percent of the 

population accessing 

selected evidencebased programs among 

people served by state 

mental health 

authorities. (Outcome) 

FY 2021: 5.1 % 

Target: 

5.9 % 

(Target Not Met) 

5.8 % 5.8 % Maintain 

2.3.81 Percentage of 

service population 

receiving any evidencebased practice 

(Outcome) 

FY 2021: 10.1 % 

Target: 

10.1 % 

(Target Met) 

10.1 % 10.1 % Maintain 
158 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA FY2024 Mental Health Block Grant Provisional Allotments 

Appropriation $1,652,571,000 State-Territory Total $1,563,677,000 

CFDA # 93.958 

 FY 2022 FY 2023 FY 2024 FY 2024 +/- 

State or Territory Final Enacted President's Budget FY 2023 

Alabama $11,970,063 $14,051,192 $23,419,507 $9,368,315 

Alaska $2,009,320 $2,360,826 $3,898,005 $1,537,179 

Arizona $20,309,036 $24,207,604 $37,896,751 $13,689,147 

Arkansas $7,226,436 $8,532,210 $13,831,996 $5,299,786 

California $107,016,379 $123,700,265 $201,400,930 $77,700,665 

 

Colorado $16,077,887 $18,940,105 $30,546,212 $11,606,107 

Connecticut $8,419,241 $9,786,104 $16,424,865 $6,638,761 

Delaware $1,726,567 $2,075,248 $3,476,177 $1,400,929 

District Of Columbia $1,989,524 $2,379,819 $3,446,134 $1,066,315 

Florida $55,973,788 $65,481,738 $105,019,695 $39,537,957 

 

Georgia $25,090,473 $29,443,052 $48,057,958 $18,614,906 

Hawaii $4,116,483 $4,776,600 $8,235,334 $3,458,734 

Idaho $4,449,061 $5,311,053 $9,037,812 $3,726,759 

Illinois $25,793,477 $29,970,671 $49,342,238 $19,371,567 

Indiana $16,334,378 $19,173,943 $31,435,272 $12,261,329 

 

Iowa $6,552,022 $7,739,414 $12,715,570 $4,976,156 

Kansas $6,039,700 $7,005,715 $11,477,520 $4,471,805 

Kentucky $10,720,222 $12,582,078 $20,553,587 $7,971,509 

Louisiana $10,714,229 $12,558,779 $20,423,192 $7,864,413 

Maine $3,247,773 $3,825,384 $6,292,248 $2,466,864 

 

Maryland $13,859,621 $16,215,620 $27,315,545 $11,099,925 

Massachusetts $17,523,932 $20,419,558 $33,912,367 $13,492,809 

Michigan $23,831,669 $27,968,934 $46,298,361 $18,329,427 

Minnesota $13,292,363 $15,551,519 $25,578,063 $10,026,544 

Mississippi $7,521,797 $8,789,930 $14,209,451 $5,419,521 

 

Missouri $14,008,429 $16,422,171 $26,664,883 $10,242,712 

Montana $2,977,265 $3,509,870 $5,872,471 $2,362,601 

Nebraska $3,833,345 $4,489,055 $7,316,430 $2,827,375 

Nevada $9,306,676 $11,133,777 $17,966,099 $6,832,322 

New Hampshire $2,743,172 $3,247,773 $5,405,074 $2,157,301 
159 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SAMHSA FY2024 Mental Health Block Grant Provisional Allotments 

Appropriation $1,652,571,000 State-Territory Total $1,563,677,000 

CFDA # 93.958 

 FY 2022 FY 2023 FY 2024 FY 2024 +/- 

State or Territory Final Enacted President's Budget FY 2023 

New Mexico $5,040,123 $5,914,148 $9,773,595 $3,859,447 

New York $47,652,165 $54,539,184 $91,873,507 $37,334,323 

North Carolina $24,326,475 $28,726,086 $46,006,456 $17,280,370 

North Dakota $1,470,335 $1,716,550 $2,803,728 $1,087,178 

 

Ohio $25,767,670 $30,192,557 $49,663,696 $19,471,139 

Oklahoma $9,163,723 $10,851,934 $17,685,057 $6,833,123 

Oregon $13,035,807 $15,277,597 $24,979,078 $9,701,481 

Pennsylvania $27,720,760 $32,388,348 $54,142,366 $21,754,018 

Rhode Island $2,878,060 $3,381,064 $5,807,574 $2,426,510 

 

South Carolina $12,537,402 $14,829,315 $23,786,115 $8,956,800 

South Dakota $1,794,733 $2,118,382 $3,440,133 $1,321,751 

Tennessee $17,223,030 $20,344,012 $33,405,886 $13,061,874 

Texas $67,041,162 $79,192,589 $129,251,007 $50,058,418 

Utah $9,206,794 $10,848,626 $17,971,486 $7,122,860 

 

Vermont $1,417,349 $1,672,361 $2,866,721 $1,194,360 

Virginia $20,856,032 $24,538,570 $40,021,818 $15,483,248 

Washington $20,053,058 $23,423,510 $38,053,909 $14,630,399 

West Virginia $4,444,613 $5,156,267 $8,346,031 $3,189,764 

Wisconsin $12,617,904 $14,811,489 $24,590,333 $9,778,844 

Wyoming $1,077,604 $1,269,406 $2,061,315 $791,909 

State Subtotal $779,999,127 $939,437,408 $1,540,221,845 $600,784,437 

 

American Samoa $160,472 $180,030 $292,534 $112,504 

Guam $538,205 $640,046 $1,065,004 $424,958 

Northern Marianas $165,539 $196,969 $325,929 $128,960 

Puerto Rico $10,371,421 $12,119,541 $19,828,515 $7,708,974 

Palau $69,137 $81,794 $136,361 $54,567 

Marshall Islands $245,856 $295,318 $497,363 $202,045 

Micronesia $329,865 $388,687 $641,491 $252,804 

Virgin Islands $341,304 $403,768 $667,958 $264,190 

Territory Subtotal $12,221,799 $14,306,153 $23,455,155 $9,149,002 

Total State-Territory $792,220,926 $953,743,561 $1,563,677,000 $609,933,439 

Total Administrative $42,784,370 $53,827,439 $88,894,000 $35,066,561 

Total Appropriation $835,005,296 $1,007,571,000 $1,652,571,000 $645,000,000 
160 

PRNS Mechanism Table

Summary 

(dollars in millions) 

MH PRNS

Program Activity

FY 2022 

Final

FY 2023 

Enacted 

FY 2024 

President's Budget

Programs of Regional & National Significance 

Grants/Cooperative Agreements 

Continuations..................................................................... 730 $384.20 638 $308.15 796 $514.85

New/Competing................................................................. 138 59.46 329 258.97 749 1,156.35

Supplements*..................................................................... 2 77.73 --- --- --- 0.00

Subtotal........................................................................... 868 521.39 967 567.12 1,545 1,671.20

Contracts 

Continuations..................................................................... 6 50.45 4 474.13 29 93.24

New/Competing................................................................. --- 5,774 1 2,779 119 3,827

Subtotal........................................................................... 6 56.22 5 476.91 148 97.07

Total, Mental Health PRNS 874 $577.62 972 $1,044.03 1,693 $1,768.27

* Excluding Supplements number count to avoid duplication. 
161 

PRNS Mechanism Table

Program, Project, and Activity 

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 

President's Budget

Capacity: 

Project AWARE 

Grants 

Continuations........................................................................................... 57 90.83 52 78.11 87 136.46

New/Competing....................................................................................... 13 18.16 33 54.31 52 94.33

Supplements*........................................................................................... --- 0.00 --- --- --- ---

Subtotal................................................................................................. 70 108.99 85 132.42 139 230.79

Contracts 

Continuations........................................................................................... --- 10.99 --- 7.58 --- 13.21

New/Competing....................................................................................... --- --- --- 0.00 --- ---

Subtotal................................................................................................. --- 10.99 --- 7.58 --- 13.21

Total, Project AWARE 70 119.98 85 140.00 139 244.00

MH Awareness Training 

Grants 

Continuations........................................................................................... 159 20.16 175 21.44 197 26.47

New/Competing....................................................................................... 30 3.66 22 5.01 277 34.06

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 189 23.83 197 26.45 474 60.54

Contracts 

Continuations........................................................................................... --- 1.12 --- 1.52 --- 3.46

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 1.12 --- 1.52 --- 3.46

Total, MH Awareness Training 189 24.95 197 27.96 474 64.00

Healthy Transitions 

Grants 

Continuations........................................................................................... 27 24.63 18 17.43 14 14.97

New/Competing....................................................................................... --- --- 11 11.37 44 43.11

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 27 24.63 29 28.80 58 58.08

Contracts 

Continuations........................................................................................... --- 4.80 --- 1.65 --- 3.32

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 4.80 --- 1.65 --- 3.32

Total, Healthy Transitions 27 29.43 29 30.45 58 61.40

Children and Family Programs 

Grants 

Continuations........................................................................................... 20 6.50 3 0.93 19 5.91

New/Competing....................................................................................... --- 0.00 19 5.91 3 0.93

Subtotal................................................................................................. 20 6.50 22 6.84 22 6.84

Contracts 

Continuations........................................................................................... --- 0.72 --- 0.39 --- 0.39

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.72 --- 0.39 --- 0.39

Total, Children and Family Programs 20 7.21 22 7.23 22 7.23

Consumer and Family Network Grants 

Grants 

Continuations........................................................................................... 24 2.26 43 4.54 20 2.42

New/Competing....................................................................................... 19 2.28 1 0.15 8 0.95

Subtotal................................................................................................. 43 4.54 44 4.69 28 3.38

Contracts 

Continuations........................................................................................... --- 0.40 --- 0.27 --- 0.27

New/Competing....................................................................................... --- --- --- --- 11 1,309

Subtotal................................................................................................. --- 0.40 --- 0.27 11 1.58

Total, Consumer and Family Network Grants 43 4.94 44 4.95 39 4.95
162 

PRNS Mechanism Table

Program, Project, and Activity

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 

President's Budget

Project LAUNCH 

Grants 

Continuations........................................................................................... 26 18.73 17 13.59 13 12.13

New/Competing....................................................................................... --- 2,352 13 10.63 17 21.36

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 26 21.08 30 24.22 30 33.49

Contracts 

Continuations........................................................................................... --- 2.51 --- 1.39 --- 1.92

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 2.51 --- 1.39 --- 1.92

Total, Project LAUNCH 26 23.59 30 25.61 30 35.41

Mental Health System Transformation and Health Reform 

Grants 

Continuations........................................................................................... 4 3.20 3 2.69 1 888

New/Competing....................................................................................... --- --- 1 0.89 3 2.69

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 4 3.20 4 3.57 4 3.57

Contracts 

Continuations........................................................................................... --- 0.56 --- 0.20 --- 0.20

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.56 --- 0.20 --- 0.20

Total, Mental Health System Transformation and Health Reform 4 3.76 4 3.78 4 3.78

Primary and Behavioral Health Care Integration 

Grants 

Continuations........................................................................................... 24 47.51 12 23.43 21 41.10

New/Competing....................................................................................... 1 1.68 15 29.42 29 56.21

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 25 49.19 27 52.85 50 97.31

Contracts 

Continuations........................................................................................... --- 3.67 --- 3.02 --- 5.57

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 3.67 --- 3.02 --- 5.57

Total, PBHCI 25 52.86 27 55.88 50 102.88

National Strategy for Suicide Prevention 

Grants 

Continuations........................................................................................... 45 21.64 25 11.64 47 25.67

New/Competing....................................................................................... --- --- 22 14.04 ---

 

0.49 

Supplements*........................................................................................... --- 0.00 --- --- --- ---

Subtotal................................................................................................. 45 21.64 47 25.67 47 25.67

Contracts 

Continuations........................................................................................... --- 1.54 --- 1.53 --- 2.53

New/Competing....................................................................................... --- --- --- 1,000 --- ---

Subtotal................................................................................................. --- 1.54 --- 2.53 --- 2.53

Total, National Strategy for Suicide Prevention 45 23.18 47 28.20 47 28.20

GLS - Youth Suicide Prevention - States 

Grants 

Continuations........................................................................................... 46 32.39 51 36.06 25 18.69

New/Competing....................................................................................... 6 3.22 5 35.74 30 21.15

Subtotal................................................................................................. 52 35.60 56 36.06 55 39.84

Contracts 

Continuations........................................................................................... --- 1.73 --- 4.17 --- 3.96

New/Competing....................................................................................... --- 1.46 --- --- --- ---

Subtotal................................................................................................. --- 3.18 --- 4.17 --- 3.96

Total, GLS - States 52 38.79 56 40.23 55 43.81
163 

PRNS Mechanism Table

Program, Project, and Activity 

(dollars in millions)

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 

Higher Level

GLS - Youth Suicide Prevention - Campus 

Grants 

Continuations........................................................................................... 41 4.03 46 4.66 44 4.50

New/Competing....................................................................................... 21 2.13 23 2.36 54 5.37

Subtotal................................................................................................. 62 6.15 69 7.03 98 9.87

Contracts 

Continuations........................................................................................... --- 0.32 --- 0.46 --- 1.62

New/Competing....................................................................................... --- --- --- 1,000 --- ---

Subtotal................................................................................................. --- 0.32 --- 1.46 --- 1.62

Total, GLS - Campus 62 6.47 69 8.49 98 11.49

GLS - Suicide Prevention Resource Center 

Grants 

Continuations........................................................................................... 1 7.59 1 7.59 2 10.40

New/Competing....................................................................................... --- 0.97 1 2.82 --- 0.00

Supplements*........................................................................................... --- 0.00

Subtotal................................................................................................. 1 8.56 2 10.40 2 10.40

Contracts 

Continuations........................................................................................... --- 0.43 --- 0.60 --- 0.60

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.43 --- 0.60 --- 0.60

Total, GLS - Suicide Prevention Resource Center 1 8.98 2 11.00 2 11.00

Suicide Lifeline 

Grants 

Continuations........................................................................................... 1 20.60 --- --- --- ---

New/Competing....................................................................................... --- 0.00 --- --- --- ---

Supplements*........................................................................................... 2 77.00 --- --- --- ---

Subtotal................................................................................................. 1 97.60 --- --- --- ---

Contracts 

Continuations........................................................................................... --- 4.02 --- --- --- ---

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 4.02 --- --- --- ---

Total, Suicide Lifeline 1 101.62 --- --- --- ---

AI/AN Suicide Prevention Initiative 

Grants 

Continuations........................................................................................... 1 0.50 --- --- 1 0.50

New/Competing....................................................................................... --- --- 1 0.50 --- ---

Subtotal................................................................................................. 1 0.50 1 0.50 1 0.50

Contracts 

Continuations........................................................................................... --- 2.43 1 3.43 1 3.43

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 2.43 1 3.43 1 3.43

Total, AI/AN 1 2.93 2 3.93 2 3.93

Homelessness Prevention Programs 

Grants 

Continuations........................................................................................... 48 27.07 24 13.77 37 19.34

New/Competing....................................................................................... --- --- 32 15.84 25 12.17

Supplements*........................................................................................... --- 0.00 --- --- --- ---

Subtotal................................................................................................. 48 27.07 56 29.62 62 31.51

Contracts 

Continuations........................................................................................... 1 3.61 1 4.08 --- 1.93

New/Competing....................................................................................... --- --- --- --- 1 2.25

Subtotal................................................................................................. 1 3.61 1 4.08 1 4.19

Total, Homelessness Prevention Programs 49 30.68 57 33.70 63 35.70
164 

PRNS Mechanism Table

Program, Project, and Activity

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted FY 2024 Higher Level

Minority AIDS 

Grants 

Continuations........................................................................................... --- --- 19 8.72 19 8.72

New/Competing....................................................................................... 19 9.21 --- --- --- ---

Subtotal................................................................................................. 19 9.21 19 8.72 19 8.72

Contracts 

Continuations........................................................................................... --- -0.01 --- 0.50 --- 0.50

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- -0.01 --- 0.50 --- 0.50

Total, Minority AIDS 19 9.21 19 9.22 19 9.22

Criminal and Juvenile Justice Programs 

Grants 

Continuations........................................................................................... 17 5.36 6 1.96 31 10.07

New/Competing....................................................................................... --- --- 25 8.09 --- 43.08

Subtotal................................................................................................. 17 5.36 31 10.06 31 53.15

Contracts 

Continuations........................................................................................... 1 0.89 1 1.21 1 3.24

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 1 0.89 1 1.21 1 3.24

Total, Criminal and Juvenile Justice Programs 18 6.25 32 11.27 32 56.39

Seclusion and Restraint 

Grants 

Continuations........................................................................................... 11 1.08 --- --- 11 1.08

New/Competing....................................................................................... --- --- 11 1.08 --- ---

Subtotal................................................................................................. 11 1.08 11 1.08 11 1.08

Contracts 

Continuations........................................................................................... --- 0.05 --- 0.06 --- 0.06

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.05 --- 0.06 --- 0.06

Total, Seclusion and Restraint 11 1.13 11 1.15 11 1.15

Interagency Task Force on Trauma-Informed Care 

Grants 

Continuations........................................................................................... 1 --- --- 0.00 --- 1.89

New/Competing....................................................................................... --- 0.99 --- 1,892 --- 0.00

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 1 0.99 --- 1.89 --- 1.89

Contracts 

Continuations........................................................................................... --- 0.01 --- 0.11 --- 0.11

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.01 --- 0.11 --- 0.11

Total, Interagency Task Force on Trauma-Informed Care 1 1.00 --- 2.00 --- 2.00
165 

PRNS Mechanism Table

Program, Project, and Activity 

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 

President's Budget

Behavioral Health Crisis Coordinating Office 

Grants 

Continuations........................................................................................... --- --- --- --- --- ---

New/Competing....................................................................................... --- 0.64 --- --- --- ---

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.64 --- --- --- ---

Contracts 

Continuations........................................................................................... --- 0.31 --- --- --- ---

New/Competing....................................................................................... --- 4.05 --- --- --- ---

Subtotal................................................................................................. --- 4.36 

Total, Behavioral Health Crisis Coordinating Office --- 5.00 --- --- --- ---

Mental Health Crisis Response Grants 

Grants 

Continuations........................................................................................... --- 0.00 11 8.23 26 19.61

New/Competing....................................................................................... 12 9.63 14 10.69 107 74.98

Supplements*........................................................................................... --- 0.00 --- 0.00 --- 0.00

Subtotal................................................................................................. 12 9.63 25 18.92 133 94.59

Contracts 

Continuations........................................................................................... --- 0.37 --- 1.08 0.00

New/Competing....................................................................................... --- 0.00 --- 0.00 0.00

Subtotal................................................................................................. --- 0.37 --- 1.08 133 0.00

Total, Mental Health Crisis Response Grants 12 10.00 25 20.00 266 94.59

988 and Behavioral Health Crisis Services 

Grants 

Continuations........................................................................................... --- --- 1 22.15 93 69.16

New/Competing....................................................................................... 92 46.70 --- 721.59

Supplements*........................................................................................... --- --- --- --- --- 0.00

Subtotal................................................................................................. --- --- 93 68.85 93 790.75

Contracts 

Continuations........................................................................................... --- 432.77 2 45.25

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- --- --- 432.77 2 45.25

Total, 988 and Behavioral Health Crisis Services --- --- 93 501.62 95 836.00
166 

PRNS Mechanism Table

Program, Project, and Activity 

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 

Higher Level

 

Assertive Community Treatment for Individuals with SMI 

Grants 

Continuations........................................................................................... 12 8.11 5 3.38 13 8.51

New/Competing....................................................................................... --- 0.00 8 5.14 --- ---

Subtotal................................................................................................. 12 8.11 13 8.51 13 8.51

Contracts 

Continuations........................................................................................... --- 0.60 --- 0.49 --- 0.49

New/Competing....................................................................................... --- 271 --- --- --- ---

Subtotal................................................................................................. --- 0.87 --- 0.49 --- 0.49

Total, Assertive Community Treatment for Individuals with Serious 

Mental Illness 12 8.98 13 9.00 13 9.00

Tribal Behavioral Health Grants 

Grants 

Continuations........................................................................................... 133 16.29 105 13.64 118 15.30

New/Competing....................................................................................... 12 1.22 39 5.88 35 5.07

Subtotal................................................................................................. 145 17.51 144 19.53 153 20.37

Contracts 

Continuations........................................................................................... 1 3.22 1 3.22 --- 2.88

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 1 3.22 1 3.22 --- 2.88

Total, Tribal Behavioral Health Grants 146 20.73 145 22.75 153 23.25

Infant and Early Childhood Mental Health 

Grants 

Continuations........................................................................................... 13 6.36 9 4.53 28 14.37

New/Competing....................................................................................... 5 3.31 19 9.65 43 21,099,190

Supplements*........................................................................................... --- 0.00 

Subtotal................................................................................................. 18 9.67 28 14.19 71 35.47

Contracts 

Continuations........................................................................................... --- 0.31 --- 0.81 --- 2.03

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.31 --- 0.81 --- 2.03

Total, Infant and Early Childhood Mental Health 18 9.98 28 15.00 71 37.50
167 

PRNS Mechanism Table

Program, Project, and Activity 

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 President's 

Budget

Science and Service: 

Primary and Behavioral Health Care Integration TA 

Grants 

Continuations........................................................................................... 1 1.89 1 1.88 --- ---

New/Competing....................................................................................... --- --- --- --- 1 1,883

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 1 1.89 1 1.88 1 1.88

Contracts 

Continuations........................................................................................... --- 0.08 --- 0.11 --- 0.11

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.08 --- 0.11 --- 0.11

Total, PBHCI TA 1 1.97 1 1.99 1 1.99

Practice Improvement & Training 

Grants 

Continuations........................................................................................... 4 4.48 4 2.96 6 5.81

New/Competing....................................................................................... --- --- 6 4.18 11 8.90

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 4 4.48 10 7.14 17 14.71

Contracts 

Continuations........................................................................................... 1 3.33 --- 0.69 --- 0.86

New/Competing....................................................................................... --- --- --- 0.00 --- 263

Subtotal................................................................................................. 1 3.33 --- 0.69 --- 1.12

Total, Practice Improvement & Training 5 7.81 10 7.83 17 15.83

Consumer and Consumer-Supporter TA Centers 

Grants 

Continuations........................................................................................... 5 1.81 5 1.81 5 1.81

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 5 1.81 5 1.81 5 1.81

Contracts 

Continuations........................................................................................... --- 0.10 --- 0.11 --- 0.11

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.10 --- 0.11 --- 0.11

Total, CCSTAC 5 1.90 5 1.92 5 1.92

Disaster Response 

Grants 

Continuations........................................................................................... --- 0.85 --- 0.85 --- 0.85

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 0.85 --- 0.85 --- 0.85

Contracts 

Continuations........................................................................................... 1 1.09 --- 1.10 --- 1.10

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 1 1.09 --- 1.10 --- 1.10

Total, Disaster Response 1 1.94 --- 1.95 --- 1.95
168 

PRNS Mechanism Table

Program, Project, and Activity 

(dollars in millions) 

Programs of Regional & National Significance

FY 2022 

Final

FY 2023

Enacted

FY 2024 

Higher Level

Science and Service: 

Homelessness 

Grants 

Continuations................................................................................ 1 2.14 1 0.77 1 2.19 

New/Competing............................................................................. --- --- --- 1.40 --- ---

Subtotal...................................................................................... 1 2.14 1 2.17 1 2.19 

Contracts 

Continuations................................................................................. --- 0.14 --- 0.12 --- 0.10 

New/Competing............................................................................. --- --- --- --- --- ---

Subtotal...................................................................................... --- 0.14 --- 0.12 --- 0.10 

Total, Homelessness 1 2.28 1 2.30 1 2.30

Minority Fellowship Program 

Grants 

Continuations................................................................................. 8 8.22 1 1.39 9 9.68

New/Competing............................................................................. --- --- 8 8.29 7 10.32 

Supplements*................................................................................. --- 728 --- --- --- ---

Subtotal...................................................................................... 8 8.95 9 9.68 16 20.01 

Contracts 

Continuations................................................................................. 1 1.10 --- 0.60 1 1.99 

New/Competing............................................................................. --- --- 1 0.78 --- 0.00

Subtotal...................................................................................... 1 1.10 1 1.38 1 1.99 

Total, Minority Fellowship Program 9 10.04 10 11.06 17 22.00

Subtotal, Science and Service 22 25.94 27 27.05 41 45.99

Total, Mental Health PRNS 874 $577.62 1,064

$1,040.4

6 1,693 $1,777.78

* Excluding Supplements number count to avoid duplication. 

 
169 

Other Programs Mechanism Table

Program, Project, and Activity 

(dollars in millions) 

Other Programs

FY 2022 

Final

FY 2023

Enacted

FY 2024 

President's 

Budget

National Child Traumatic Stress Network 

Grants 

Continuations........................................................................................... 127 65.98 142 $72.05 170 $88.75

New/Competing....................................................................................... 28 12.08 28 16.76 76 54.57

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 155 78.06 170 88.81 246 143.33

Contracts 

Continuations........................................................................................... --- 3.83 --- 5.08 --- 6.68

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 3.83 --- 5.08 --- 6.68

Total, National Child Traumatic Stress Network 155 81.89 170 93.89 246 150.00

Assisted Outpatient Treatment for Individuals with SMI 

Grants 

Continuations........................................................................................... 20 17.67 23 20.30 6 5.04

New/Competing....................................................................................... 3 2.60 --- --- 15 15.38

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. 23 20.28 23 20.30 21 20.42

Contracts 

Continuations........................................................................................... --- 1.14 --- 1.12 --- 1.00

New/Competing....................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 1.14 --- 1.12 --- 1.00

Total, AOT for Individuals with SMI 23 21.42 23 21.42 21 21.42

Total, Other Programs 178 103.31 193 115.31 267 171.42
170 

Grant Awards Table 

(Whole dollars) 

 

FY 2022 

Final 

FY 2023

Enacted 

FY 2024

President's Budget 

FY 2024

Lower Level 

Number of Awards 868 1059 1635 1422

Average Awards $600,821 $532,731 $1,020,335 $1,164,306

Range of Awards $20,000 - $10,000,000 $20,000 - $10,000,000 $20,000 - $10,000,000 $20,000 - $10,000,000
171 

Substance Use Prevention Services

Table of Contents

Summary of the Request ................................................................................................. 172

Programs of Regional and National Significance (PRNS) ............................................. 173

Strategic Prevention Framework .......................................................................... 174

Federal Drug-Free Workplace .............................................................................. 180

Sober Truth on Preventing Underage Drinking Act (STOP Act) .......................... 183

Tribal Behavioral Health Grants .......................................................................... 187

Minority AIDS Initiative ........................................................................................ 190

Center for the Application of Prevention Technologies ........................................ 193

Minority Fellowship Program ............................................................................... 196

Science and Service Program Coordination ......................................................... 198

PRNS Mechanism Table ................................................................................................. 201

Grant Awards Table ........................................................................................................ 204
172 

Substance Use Prevention Services

Summary of the Request

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Total, Substance Use Prevention Services $218,219 $236,879 $250,738 $13,859

FTE 76 80 83 3 

SAMHSA’s substance use prevention programs reach across the lifespan and across the substance 

use continuum, with the goal of reaching people wherever they are to reduce the harmful impacts 

of substance misuse on their lives, on their families, and in their communities. The Center for 

Substance Use Prevention Services (CSUPS) leads SAMHSA’s substance use prevention 

programs, supporting providing resources to states, tribes, and communities to deliver a range of 

evidence-based, community public health programming, especially focusing on high-risk, 

underserved populations. 

CSUPS programs (1) protect and strengthen equitable access to high quality and affordable 

healthcare, (2) expand equitable access to comprehensive, community-based, innovative, and 

culturally competent healthcare services while addressing social determinants of health, (3) 

enhance youth-focused promotion of healthy behaviors to reduce occurrence and disparities in 

preventable injury, illness, and death, (4) strengthen social well-being, equity and economic 

resilience, and (5) increase safeguards to empower families and communities to prevent and 

respond to neglect, abuse, and violence, while supporting those who have experienced trauma or 

violence.

CSUPS programs largely reach young people early in life with primary prevention services. 

Primary prevention has the greatest return on investment in reducing the lifelong negative impacts 

of alcohol and substance misuse on individuals, families, and communities. Over 85 percent of 

the resources are dedicated to youth-focused primary prevention services, which aim to lay the 

foundation for lifelong healthy decisions for the approximately 74 million young people under 18 

in the U.S.91 In addition, these prevention programs make an important contribution to responding 

to the opioid and overdose crises. The spike in overdose deaths the country is experiencing 

demonstrates the need to focus on reaching vulnerable populations with intensive prevention 

programs that not only help people reduce harmful substance use but can also become a gateway 

to other behavioral health services. 

91 U.S. Census Bureau quickfacts: United States. (n.d.). Retrieved February 15, 2023, from 

https://www.census.gov/quickfacts/fact/table/US/PST045222 
173 

Substance Use Prevention Services

Programs of Regional and National Significance (PRNS)

(Dollars in Thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 

+/- FY 

2023

Capacity:

Strategic Prevention Framework $127,484 $135,484 $140,484 $5,000

Non-SPF Rx (non-add) 117,484 125,484 125,484 ---

Budget Authority (non-add) 117,484 125,484 125,484 ---

PHS Evaluation Funds (non-add) --- --- --- -- 

SPF-Prevention Workforce Initiative (non-add, new) --- --- --- -- 

Strategic Prevention Framework Rx (non-add) 10,000 10,000 15,000 5.000 

Budget Authority (non-add) 10,000 10,000 15,000 5.000 

PHS Evaluation Funds (non-add) --- --- --- -- 

Federal Drug-Free Workplace 4,894 5,139 5,139 -- 

Sober Truth on Preventing Underage Drinking Act (STOP Act) 12,000 14,500 14,500 -- 

Community-based Coalition Enhancement Grants (non-add) 9,000 7,000 11,000 4.000 

National Adult-Oriented Media Public Service Campaign (non-add) 2,000 2,000 2,500 0.500 

ICC on the Prevention of Underaged Drinking (non-add) 1,000 1,000 1,000 -- 

Tribal Behavioral Health Grants 20,750 23,665 23,665 -- 

Minority AIDS 41,205 43,205 43,205 -- 

Subtotal, Capacity 206,333 221,993 226,993 5,000

Science and Service:

Center for the Application of Prevention Technologies 7,493 9,493 11,993 2.500 

SAP Minority Fellowship Program 321 1,321 2,680 1.359 

Science and Service Program Coordination 4,072 4,072 4,072 -- 

Subtotal, Science and Service 11,886 14,886 18,745 3,859

Total, PRNS $218,219 $236,879 $245,738 $8,859
174 

Strategic Prevention Framework

(Dollars in thousands)

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Strategic Prevention Framework................................................... $127,484 $135,484 $140,484 $5,000

Non-SPF Rx (non-add)................................................................... 117,484 125,484 125,484 ---

 Budget Authority (non-add).......................................................... 117,484 125,484 125,484 ---

Strategic Prevention Framework Rx (non-add)................................... 10,000 10,000 15,000 5,000

 Budget Authority (non-add)........................................................... 10,000 10,000 15,000 5,000

Authorizing Legislation..............................................................................Section 516 of the PHS Act 

FY 2024 Authorization.....................................................................................................$218,219,000 

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

Eligible Entities............................................................................................States, Tribes, and Communities 

Program Description

The Strategic Prevention Framework (SPF) is a five-step data-driven community engagement 

model grounded in public health principles and focused on providing evidence-based prevention 

services to high-risk underserved communities. Under the Strategic Prevention Framework, 

SAMHSA funds the Strategic Prevention Framework Partnership for Success Program (SPF-PFS) 

and the Strategic Prevention Framework for Prescription Drugs (SPF Rx) grants. The SPF-PFS 

was developed to prevent the onset and reduce the progression of substance misuse and related 

problems while strengthening prevention capacity and infrastructure at the community and state 

level. The SPF Rx is intended to provide resources to help prevent and address prescription drug 

misuse within a state or locality.

Strategic Prevention Framework- Partnerships for Success Program (SPF-PFS) 

SPF-PFS is designed to help state, community, and tribal organizations reduce the onset and 

progression of substance misuse and its related problems by supporting the development and 

delivery of substance misuse prevention and mental health promotion services. The program

extends established cross-agency and community-level partnerships by connecting substance 

misuse prevention programming to departments of social services and their community service 

providers. This includes working with populations disproportionately impacted by the 

consequences of substance misuse (e.g., children entering the foster care system and transition age 

youth) and individuals who support persons with substance misuse issues (e.g., women, families, 

parents, caregivers, and young adults). Beginning in 2019, both states and communities were 

eligible for SPF-PFS funds. SPF-PFS helps states, tribes, and communities address locally 

identified prevention priorities through a data-driven process. Common priorities include underage 

drinking, as well as marijuana and other drug misuse among youth and young adults aged 12 to 

20. 
175 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

While illicit opioids, contributed to the spike in the opioid overdose crisis, prescription drugs 

continue to play a significant role, with prescription opioids contributing to over 16,000 overdose 

deaths in 2020.92 In addition to amplifying opioid overdose rates, opioid prescriptions can lead to 

dependence and opioid use disorder (OUD). An estimated 14.3 million individuals aged 12 or 

older in 2021 misused one or more prescription psychotherapeutic drugs in the past year including 

prescription pain killers (8.7 million), tranquilizers or sedatives (4.9 million), and stimulants (3.7 

million).93 In addition, 46.3 million people aged 12 or older in 2021 had a substance use disorder 

(SUD) in the past year.94 Among those aged 12 and older, 0.5 percent (or 1.5 million people) had 

a prescription stimulant use disorder, and 0.8 percent (or 2.2 million people) had a prescription 

tranquilizer use disorder or sedative use disorder in the past year.95

The purpose of the SPF Rx grant program is to provide resources to help prevent and address 

prescription drug misuse within a state or locality. The program was established in 2016 to raise 

awareness about the dangers of sharing medications as well as the risks of fake or counterfeit pills 

purchased over social media or other unknown sources, and to work with pharmaceutical and 

medical communities on the risks of overprescribing. Grant recipients are required to track 

reductions in opioid related overdoses and incorporate relevant prescription and overdose data into 

strategic planning and future programming. Recipients are expected to leverage knowledge gained 

through participation in the SPF process to address targeted community needs more effectively. 

Budget Request

The FY 2024 President Budget is $140.5 million an increase of $5.0 million from the FY 2023 

Enacted level. 

 

SPF-PFS

In FY 2024, the SPF-PFS program will award 57 new and 180 continuing grants. These grants will 

continue to support the development and delivery of state and community substance misuse 

prevention and mental health promotion services. CSUP intends to maintain outcome targets for 

92 National Institute on Drug Abuse (2022, January 22). Overdose death rates. https://nida.nih.gov/drug-topics/trendsstatistics/overdose-death-rates

93 Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health 

indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication 

No. PEP21-07-01-003, NSDUH Series H-56). Center for Behavioral Health Statistics and Quality, Substance Abuse 

and Mental Health Services Administration. https://www.samhsa.gov/data/

94 Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health 

indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication 

No. PEP21-07-01-003, NSDUH Series H-56). Center for Behavioral Health Statistics and Quality, Substance Abuse 

and Mental Health Services Administration. https://www.samhsa.gov/data/

95 Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health 

indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication 

No. PEP21-07-01-003, NSDUH Series H-56). Center for Behavioral Health Statistics and Quality, Substance Abuse 

and Mental Health Services Administration. https://www.samhsa.gov/data/
176 

the SPF-PFS program in FY 2024. 

SPF-Rx

In FY 2024, the SPF-Rx program will award a new cohort of 8 new grants and 37 grant 

continuations. The $5 million increase will be utilized to for a new cohort of grants. The increase 

of $5M for SPF-Rx will be used to allow more underserved populations to receive important 

technical support for the purposes of decreasing prescription drug misuse. Grantees seeking 

partnerships with agencies that manage state PDMPs will have more opportunities to engage in 

productive data-sharing agreements and activities. Access to and leveraging this data to reduce 

opioid dependency, and overdose incidence is at the very center of this program and SAMHSA’s 

intent for these funds. In FY 2024, the SPF-Rx program will also be evaluated and mined for 

“lessons learned,” because the grant program was opened to nonprofit agencies working with the 

single state agency (SSA) in FY 2022. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $119,484,000 

FY 2021 $119,484,000 

FY 2022 Final $127,484,000 

FY 2023 Enacted $135,484,000 

FY 2024 President's Budget $140,484,000 

Program Accomplishments

SPF-PFS

In FY 2022, SAMHSA awarded 12 new SPF-PFS grants (5 states and 9 communities) and 

supported the continuation of 234 existing SPF-PFS grants in FY 2022. States, territories, tribes, 

and other community-level organizations competed under the same notice of funding opportunity. 

The percent of SPF-PFS grantees that reported at least 5 percent improvement in past 30-day use 

of targeted substances among focal populations increased from 79.2 percent in FY 2021 to 84.6 

percent in FY 2022, which exceeded the FY 2022 target set at 79.2 percent. However, the percent 

of grantees that reported improvement in focal population perceptions of risk from use of targeted 

substances was 39.7 percent, which did not meet the FY 2022 target set at 50 percent. Grantees 

report a number of challenges that may have contributed to this decrease. These include difficulty 

sampling target populations, lack of available data to assess differences for racial/ethnic minorities, 

low survey response rates, and continued impact of COVID on states and communities. 

In FY 2023, the SPF-PFS program will award 74 new and 218 continuing grants to support state, 
177 

community, and tribal organizations. SAMHSA is committed to addressing substance misuse 

prevention with its state prevention partners through population health strategies and with its 

community and tribal organization partners through community health and evidenced-based 

prevention strategies. For 2023, PFS will implement two separate notices of funding opportunity 

(NOFOs) aimed at states and communities respectively to better address the specific needs of states 

and communities. While there will be two NOFOs, overall, PFS will continue to focus on the 

intersection of the needs, understanding and priorities for prevention and health, and the best 

methods for documenting the prevention and health evidence garnered from practice in the 

community and tribal organizations. 

SPF-Rx

In FY 2022, the SPF-Rx program supported 6 new grants and 21 continuations to address the 

nature and consequences of prescription drug misuse, raise awareness about the dangers of sharing 

medications, and work with the medical community on risk of over-prescribing that affects persons 

12 years and older. SPF-Rx grants active during FY 2022 received their new grant awards at the 

end of FY 2021 or FY 2022, so data reported provided baseline only. As a result, there were 

insufficient data to calculate the percent of funded states reporting reductions in opioid overdoses. 

However, most SPF-Rx funded states also participate in syndromic surveillance systems captured 

by CDC’s Drug Overdose Surveillance and Epidemiology (DOSE) system; 77.8 percent of those 

states experienced a decrease in suspected opioid overdose emergency department visits in FY 

2022.96 

In FY 2023, SPF-Rx will support 27 continuations to continue the work of addressing the nature 

and consequences of prescription drug misuse and bringing prescription drug abuse prevention 

activities and education to schools, communities, parents, prescribers, and patients. SAMHSA also 

plans to track reductions in opioid overdoses by incorporating Prescription Drug Monitoring 

Program (PDMP) data into needs assessments and strategic plans as indicators of the program's 

success.

96 Centers for Disease Control and Prevention. Drug Overdose Surveillance and Epidemiology (DOSE) System. 

Atlanta, GA: US Department of Health and Human Services, CDC. Accessed January 26, 2023. Available 

at: https://www.cdc.gov/drugoverdose/nonfatal/dashboard
178 

Outputs and Outcomes 

Program: Partnerships for Success

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.3.79A Number of 

individuals served by 

EBPPs implemented 

through the grant 

(Output)

Discontinued Discontinued N/A

2.3.81 Increase in the 

percent of grantees that 

report at least 5% 

improvement in the past 

30 day use of targeted 

substance in target 

population (Outcome)

FY2022: 84.6%

Target:

79.2 %

(Target Exceeded)

79.2 % 79.2 % Maintain

2.3.82 Increase in 

percent of grantees that 

report improvement of 

perception of risk from 

targeted substance use in 

target population. 

(Outcome)

FY 2022: 39.7%

Target:

50 %

(Target Not Met)

50 % 50 % Maintain
179 

Program: Strategic Prevention Framework Rx

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.3.12 Percent of 

funded states 

reporting reductions 

in opioid overdoses 

(Outcome)

FY 2021: 75 %97

Target:

62 %

(Target Exceeded)

TBD TBD Maintain

97SPF-Rx grants active during FY 2022 received their new grants awards at the end of FY 2021 or FY 2022. There were 

insufficient data to calculate the percent of funded states reporting reductions in opioid overdoses for FY2022.
180 

Federal Drug-Free Workplace

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President

's Budget

FY 2024 

+/- 

FY 2023

Federal Drug-Free Workplace................................................. $4,894 $5,139 $5,139 $--- 

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2024 Authorization ................................................................................................$218,219,000 

Allocation Method..............................................................................Inter-Agency Agreements/Contracts

Eligible Entities...................................................................................Federal Agencies, Regulated Entities

........................... (e.g., Department of Transportation, Nuclear Regulatory Commission), 

.................................................................................HHS- Certified Laboratories

Program Description

The Federal Drug-Free Workplace Programs (DFWP) ensure employees in national security, 

public health, and public safety positions are tested for the use of illegal drugs and the misuse of 

prescription drugs and ensure the laboratories that perform this regulated drug testing are inspected 

and certified by HHS. The DFWP helps individuals refrain from using illegal drugs and 

demonstrates that illegal drug use will not be tolerated in the federal workplace through policies 

and procedures including drug testing, which allows for the drug testing of all executive branch 

agency employees. Additionally, the DFWP helps reduce health insurance costs, improves 

attendance and employee productivity, provides a safer workplace with reduced accidents, and 

provides employee assistance programs (EAP) services to employees with substance use disorders.

In FY 2019, SAMHSA issued mandatory guidelines for oral fluid testing. In FY 2020, SAMHSA 

issued the proposed mandatory guidelines using hair in accordance with the Drug Testing Advisory 

Board (DTAB) recommendations to allow oral fluid and to pursue the use of hair as alternative 

specimens to urine. The final mandatory guidelines for hair testing are expected to be issued in FY 

2023. 

The Workplace Helpline supports the DFWP. The Helpline is a toll-free telephone service that 

answers questions from federal agencies, the public and private sectors about drug testing in the 

workplace. 

Budget Request

The FY 2024 President’s Budget is $5.1 million, level with the FY 2023 Enacted level. The 

funding supports the DFWP implementing and maintaining Mandatory Guidelines for oral fluid 

and the proposing hair in the federally regulated drug testing program. This includes costs 

associated with laboratory proficiency testing specimens, application fees, inspector training, HHS 

pre-inspections for applicant laboratories, and HHS laboratory certification for new oral fluid 

testing laboratories. Along with the implementation of the new oral fluid testing program, 

SAMHSA will continue to pursue the implementation of hair and oversight of the Executive 

Branch Agencies’ DFWP as well as continue its oversight role for the inspection and certification 
181 

of the HHS-certified laboratories.

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $4,894,000 

FY 2021 $4,894,000 

FY 2022 Final $4,894,000 

FY 2023 Enacted $5,139,000 

FY 2024 President's Budget $5,139,000 

Program Accomplishments

In FY 2022, the Federal Drug-Free program target was 26 HHS Certified Labs. In FY 2023 the 

target was updated due to several factors including final regulatory rules from other federal 

partners and financial decisions from laboratories on continuing to test federally regulated 

specimens. For FY 2022, there were 20 HHS Certified Labs, a decrease from 23 HHS Certified 

Labs in FY 2021. Due to financial reasons or consolidation, HHS certified labs decided to 

withdraw from the program. In FY 2022, the program implemented the Oral Fluid Mandatory 

Guidelines, with the goal that additional labs would become HHS Certified for Oral Fluid testing. 

Due to the delays from the Department of Transportation (DOT) not implementing 49 CRF Part 

40 to include Oral Fluid, labs had decided to wait for DOT’s final rule prior to applying for HHS 

Certification 

Accomplishments for FY 2022 included (1) creating and implementing an Online DFWP 

Supervisor Training program for federal agencies that have allowed them to meet the requirements 

of the DFWP (Executive Order 12564 and Public Law 100-71) saving over $2.1 million in training 

costs, (2) conducting 32 studies to support creating evidence based polices within the Mandatory 

Guidelines which are supported by science, reliable throughout the laboratory system, protect our 

stakeholders, are legally defensible, promote public safety, ensure consistency between our 

polices, and ensure that we account for the worst-case scenarios in drug use, and (3) proposing 

hair as an alternative specimen, subject to the legal and scientific supportability of this matrix for 

use in federal workplace drug testing programs. 

In FY 2023, plans for Drug Free Workplace include (1) certification of new laboratories across the 

nation to conduct federal and federally regulated drug tests that may include urine, oral fluid, and 

hair, (2) analysis of and guidance on new emerging issues (e.g., opioids/synthetic opiates; 

polysubstance use; young adults, high-risk workplaces), (3) analysis of and guidance on Employee 

Assistance Programs (EAPs), and (4) support the public and private drug testing industry through 

Helpline inquiry responses providing research and consultation on approaches to prevent the use 

and misuse of those substances in a workplace setting and include a revised and updated 

Workplace Toolkit. 
182 

Outputs and Outcomes 

Program: Federal Drug-Free Workplace

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

6.0 Number of HHS 

Certified Labs (Output)

FY 2022: 20.0 certified labs

Target:26.0 certified labs

(Target Not Met)

20.0 certified 

labs

20.0 certified 

labs

Maintain
183 

Sober Truth on Preventing Underage Drinking Act (STOP Act)

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Sober Truth on Preventing Underage Drinking Act..................................... $12,000 $14,500 $14,500 $---

Authorizing Legislation..................................................................................Section 519B of the PHS Act 

FY 2024 Authorization.....................................................................................................................$11,500,000 

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

Eligible Entities....................................................Current and former Drug Free Communities grantees 

Program Description

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 was the nation’s first 

comprehensive legislation on underage drinking and was reauthorized in 2022 as part of 

Consolidated Appropriations Act, 2023 (Public Law No. 117-328). The Act states, “a coordinated 

approach to prevention, intervention, treatment, enforcement, and research is key to making 

progress. This Act recognizes the need for a focused national effort and addresses particulars of 

the federal portion of that effort, as well as federal support for state activities.” 

In keeping with the STOP Act’s language calling for a multi-faceted, coordinated approach, the 

ICCPUD developed a Comprehensive Plan in 2022, with updates in 2023. The plan includes 

consensus recommendations from the federal agency members as well as for all interested parties 

identified in the STOP Act, and established the following overarching goals and objectives: 

1. Strengthen a national commitment to address the problem of underage drinking; 

2. Reduce demand for, the availability of, and access to alcohol by persons under the age of 

21; and 

3. Use research, evaluation, and scientific surveillance to improve the effectiveness of 

policies, programs, and practices designed to prevent and reduce underage drinking. 

The STOP Act requires the HHS Secretary, in collaboration with other federal officials enumerated 

in the Act, to “formally establish and enhance the efforts of the Interagency Coordinating 

Committee for the Prevention of Underage Drinking (ICCPUD) that began operating in 2004.” In 

2006, SAMHSA assumed leadership as the HHS Secretary’s designee. 

The STOP Act calls for data and information on individual state performance and the enforcement 

of drinking laws, steps to reduce alcohol’s availability to youth under the age of 21, research on 

underage drinking, and resources for local community efforts. The STOP Act also calls for four 

annual reports to Congress, which are developed under contract ($1 million/year): a report on the 

prevention and reduction of underage drinking, a report on state performance and best practices 

for the prevention and reduction of underage drinking, and a report series on state underage 

drinking prevention and enforcement activities. 

A report on the evaluation of the adult oriented national media campaign to prevent underage 
184 

drinking that includes the production, broadcasting, and effectiveness of the campaign – also 

known as “Talk They Hear You.” 

The national media campaign to prevent underage drinking, “Talk They Hear You.” (TTHY) 

responds to directives set forth in Section 2(d) of the STOP Act ($2.5 million/year), to produce 

and oversee an adult-oriented national media campaign to provide parents and caregivers of youth 

under the age of 21 with information and resources to discuss the issue of alcohol with their 

children. The ICCPUD will continue to guide the development process of the national media 

campaign, and subsequent evaluation, which is included as Chapter 5 of the Report to Congress 

annually. 

In meeting the requirements of the STOP Act, SAMHSA, under the leadership of Interagency 

Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), will continue to 

garner support for program efficacy over the next year and will implement evaluation plans for the 

upcoming 2023–2024 campaign evaluation cycle. These plans include 1) an evaluation of the 

usability, reach, and effectiveness of the TTHY mobile app and Screen4Success self-screening, a 

referral management system; 2) the initial development of a complementary youth campaign that 

includes message testing and audience segmentation analysis; and 3) beginning of a multi-year 

evaluation of the student assistance and school health and wellness-focused training with 

formative, outcome, and long-term impact evaluation methodologies that can be adopted by 

schools and districts. The formative measures will assess how well the campaign is being 

implemented, and the outcome and impact measures will look to examine impact on the target 

audiences, the students. Armed with data from this and future efforts, SAMHSA will persist in its 

work to estimate overall campaign impact as well as to ensure that the TTHY campaign evolves 

in ways that resonate with its primary target audiences and meets the needs of the U.S. population 

at large. The community-based coalition enhancement grant program provides up to $60,000 per 

year over four years to current or former grantees under the Drug-Free Communities Act of 1997 

to prevent and reduce alcohol use among youth under the age of 21. The STOP Act grant program 

enables organizations to strengthen collaboration and coordination among stakeholders to achieve 

a reduction in underage drinking in their communities. 

Budget Request 

The FY 2024 President’s Budget is $14.5 million, level with the FY 2023 Enacted level. 

SAMHSA plans to fund 93 new grants and 114 continuations and will continue to assess technical 

assistance needs to address areas identified as challenges in data collection and reporting 

processes, to prevent and reduce alcohol use among youth and young adults ages 12-20 in 

communities throughout the United States. The STOP Act Program aims to (1) address norms 

regarding alcohol use by youth, (2) reduce opportunities for underage drinking, (3) create changes 

in underage drinking enforcement efforts, (4) address penalties for underage use, and/or (5) reduce 

negative consequences associated with underage drinking. 
185 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $9,000,000 

FY 2021 $10,000,000 

FY 2022 Final $12,000,000 

FY 2023 Enacted $14,500,000 

FY 2024 President's Budget $14,500,000 

Program Accomplishments

In FY 2022, SAMHSA funded 40 new grants and 108 continuations. Funding supported plans to 

increase the number of communities that have the capacity to develop and implement interventions 

that identify, address, and reduce underage drinking within their jurisdictions among underage 

populations. Grantees stated 66.7 percent of coalitions reported significant reductions in past 30-

day alcohol use in at least two grades, but this fell short of the FY 2022 target set at 83 percent of 

coalitions. In addition, 33.3 percent of coalitions reported improvement in youth perceptions of 

risk from alcohol in at least two grades. However, this did not meet the FY 2022 target set at 75%. 

Grantees report a number of challenges that may have contributed to this decrease. These include 

difficulty sampling target populations, low survey response rates, and continued impact of COVID 

on states and communities. 

In FY 2023, SAMHSA anticipates funding 148 continuation grants for continued support to 

communities to implement interventions that identify, address, and reduce underage drinking 

among the underage population within their jurisdictions. The FY 2023 and FY 2024 targets were 

updated due to better reflect grantees abilities given identified challenges with data collection, 

access to target populations, and the ongoing impact of COVID. These targets will align with 

SAMHSA’s efforts to address identified challenges and the ongoing impact of COVID on program 

activities. 
186 

Outputs and Outcomes 

Program: Sober Truth on Preventing Underage Drinking (STOP Act)

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.3.01 Percent of 

coalitions that report at 

least 5% improvement 

in the past 30-day use 

of alcohol in at least 

two grades (Outcome)

FY2022: 66.7%

Target:

83%

(Target Not Met)

66.7 % 66.7 % Maintain

3.3.02 Percent of 

coalitions that report 

improvement in youth 

perception of risk from 

alcohol in at least two 

grades (Outcome)

FY2022: 33.3% 

Target:

75%

(Target Not Met)

75 % 75 % Maintain
187 

Tribal Behavioral Health Grants

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 

+/- 

FY 2023

Tribal Behavioral Health Grants......................................................... $20,750 $23,665 $23,665 $---

Authorizing Legislation..............................................Section 520A and 516 (290bb-22) of the PHS Act

FY 2023 Authorization ................................................................................................$218,219,000 

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

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

Program Description

Suicide is a leading cause of death among American Indian/Alaska Native (AI/AN) youth and 

young adults ages 10-24.98 For American Indian/Alaska Native Youth aged 10-24, the unadjusted 

suicide rate is nearly twice the rate for youth nationwide. Further, AI/AN high school students 

report higher rates of suicidal behaviors than the general population of U.S. high school students.99 

These behaviors include serious thoughts of suicide, suicide plans, suicide attempts, and medical 

attention for a suicide attempt. 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG/Native Connections (NC) program addresses the high incidence of substance use 

and suicide among AI/AN populations. Starting in FY 2014, this program supports tribal entities 

with the highest rates of suicide by providing effective and promising strategies that address 

substance use, trauma, and suicide and by promoting the mental health of AI/AN young people. 

These five-year grants help tribes or tribal organizations develop and implement a plan that 

addresses suicide and substance misuse, thereby promoting mental health among tribal youth. 

Grant recipients implement a variety of prevention strategies focused on suicide and substance 

use, but also on reducing the impact of trauma and promoting mental health. Grant recipients also 

focus on improving responses to young people who may have a history of suicidal behavior or are 

deemed at risk for suicide. 

In addition, SAMHSA’s Tribal Training and Technical Assistance Center (TTAC)100 provides 

training and education to AI/AN grantees and organizations serving AI/AN populations to support 

their ability to achieve their goals. 

98 Centers for Disease Control and Prevention. Fatal injury data, 2020. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed January 9, 2023. 99 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System (YRBSS). High School 

YRBS, United States 2019 Results. Available at http://www.cdc.gov/healthyyouth/yrbs/index.htm. Accessed 

January 15, 2023. 

100 (http://www.samhsa.gov/tribal-ttac) 
188 

Budget Request

The FY 2024 President’s Budget is $23.7 million, level with the FY 2023 Enacted level. 

Combined with $25 million in the Mental Health appropriation, these funds will support technical 

assistance activities, 118 continuation grants and award a new cohort of 10 grants that promote 

mental health and prevent substance use activities for high-risk AI/AN youth and their families. 

CSUP intends to maintain targets in FY 2024. 

As a braided activity, SAMHSA is tracking separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensure that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 $20,750,000 

FY 2021 $20,000,000 

FY 2022 Final $20,750,000 

FY 2023 Enacted $23,665,000 

FY 2024 President's Budget $23,665,000 

Program Accomplishments

In FY 2022, SAMHSA supported grant continuations, awarded a new cohort of 14 grants, and one 

technical assistance contract. As of July 2022, grantees have screened 9,995 individuals for mental 

health and suicide concerns, 176,229 individuals were contacted through program outreach efforts, 

and 771 organizations implemented specific mental health related practices and activities that 

aligned with program goals. Also, 38.10 percent of youth aged 10-24 received mental health or 

related services after screening, referral or attempt, which exceeded the FY 2022 target of 33 

percent. In addition. 470,790 youth with mental health or substance use disorders were contacted 

through program outreach efforts, which did not meet the FY 2022 target set at 570,655. CSUP 

will be conducting an analysis to identify factors associated with this decrease. In FY 2022, TTAC 

responded to 133 training and technical assistance (TTA) requests, including conducting 14 onsite TTA visits. TTAC provided 631 days of virtual TA to 139 tribes and conducted 26 webinars 

with 463 participants. 

In FY 2023, SAMHSA anticipates funding 108 continuation grants and a new cohort of 37 grants 

and technical assistance activities to expand youth suicide prevention and early intervention 

strategies for the tribal nations. SAMHSA intends to maintain the same target of 33 percentage of 

youth aged 10 - 24 who received mental health or related services after screening, referral or 

attempt in FY 2023 and FY 2024. In addition, SAMHSA intends to adjust the target to 470,790 

youths with mental health or substance use disorders who are contacted through program outreach 

efforts in FY 2023 and FY 2024 to reflect actual performance. 
189 

Outputs and Outcomes 

Program: Tribal Behavioral Health 

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.4.12 Percentage of 

youth age 10 - 24 who 

received mental health 

or related services after 

screening, referral or 

attempt (Output)

FY 2022: 38.10%

Target:

33%

(Target Exceeded)

33 33 Maintain

2.4.13 Number of 

programs/organizations 

that implemented 

specific mental-health 

related 

practices/activities as a 

result of the grant 

(Outcome)

FY 2020: 3,076

Target:

6,880

(Target Not Met)

Discontinued Discontinued N/A

2.4.17 Number of youth 

with mental health or 

substance use disorders 

who are contacted 

through program 

outreach efforts 

(Output)

FY 2022: 470,790

Target:

570,655.0

(Target No Met)

470,790 470,790 Maintain
190 

Minority AIDS Initiative

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 

+/- FY 

2023

Minority AIDS..................................................................... $41,205 $43,205 $43,205 $--- 

Authorizing Legislation ............................................. Section 516 of the Public Health Service Act

FY 2024 Authorization ................................................................................................$218,219,000 

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

Eligible EntitiesLocal Government Entities, Community-based Organization, Minority Serving 

Institutions, and Institutions of Higher Education 

Program Description

The Minority AIDS Initiative (MAI), established in 1998, provides funding designed to strengthen 

and expand organizational capacity of HIV-related services within minority communities. The 

purpose of the MAI is to provide services to those at highest risk for HIV and substance use 

disorders. CSUPS oversees two MAI programs: Prevention Navigator and HIV Capacity Building 

Initiative (HIV CBI). The programs use a navigation approach (community health workers, 

neighborhood navigators, and peer support specialists) to expedite services for these populations. 

The programs provide training and education around the risks of substance misuse, education on 

HIV/AIDS, and needed linkages to service provision for individuals with HIV. The HIV CBI 

program was established in 2017 to support an array of activities to assist grant recipients in 

building a solid foundation for delivering and sustaining quality and accessible state-of-the-science 

substance misuse and HIV prevention services. 

The MAI serves racial and ethnic minorities ages 13-24 at highest risk for HIV and substance use 

disorders. HIV CBI aims to engage community-level domestic public and private non-profit 

entities, as well as tribes and tribal organizations to prevent and reduce the onset of substance use 

disorders and transmission of HIV/AIDS among at-risk populations ages 13-24, including 

racial/ethnic minority youth and young adults, hereafter referred to as the “population of focus.” 

Applicants may elect to serve youth aged 13-17, young adults aged 18-24, or both youth and young 

adults. SAMHSA is particularly interested in eliciting the interest of college and university 

clinics/wellness centers and community-based providers who can provide comprehensive 

prevention strategies to reduce the impact of substance misuse, HIV, and viral hepatitis in highrisk communities. 

Budget Request 

The FY 2024 President’s Budget is $43.2 million, level with the FY 2023 Enacted level. This will 

fund 189 continuing and 5 new grants to support new activities in the Prevention Navigator 

Program. The activities include: outreach to men who have sex with men (MSM) ages 13-35 

including transgender individuals who are unaware of their HIV status and are not in stable 

housing; educating providers on the importance of screening for HIV and hepatitis; partnering with 

Ryan White and other HHS providers including various community sectors, such as healthcare, 
191 

schools, justice systems, social services, faith-based communities, and other relevant community 

sectors to implement comprehensive, community-based substance misuse, HIV, hepatitis, and 

other prevention strategies; and new messaging around mental health promotion, risk behaviors, 

and appropriate cautions associated with the risk of HIV and hepatitis transmission, as a strategy 

for behavior change to reduce stigma. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $41,205,000 

FY 2021 $41,205,000 

FY 2022 Final $41,205,000 

FY 2023 Enacted $43,205,000 

FY 2024 President's Budget $43,205,000 

Program Accomplishments

In FY 2022, SAMHSA funded 22 new grant awards and 161 continuations. MAI-funded programs 

tested 31,255 individuals for HIV. Although the number of individuals tested for HIV did not meet

the FY 2022 target set at 31,514, this was a marked improvement over FY 2021 where only half 

as many individuals (15,716) were tested for HIV. 8,936 individuals were also tested for viral 

hepatitis (VH). In addition to HIV/VH testing, MAI grants also supported other health care 

services (e.g., VH vaccination), individual services (e.g., risk reduction counseling and education), 

and group services (e.g., group counseling and opioid prevention education). 8,647 individuals 

were exposed to substance abuse prevention education services, which exceeds the target set at 

8,345. Although the percent of program participants who reported reduced binge drinking at 

follow-up (63.4%) did not meet the FY 2022 target set at 64 percent, this was a marked 

improvement over the 57 percent reported in FY 2021. 

Findings from baseline, exit and follow-up surveys completed by 13,429 MAI program 

participants indicate marked rate increases in knowledge and perceived risk of substance use, as 

well as decreases in the rate of substance use and risky sexual behavior in FY22. Examples include 

the following: 

• 49.43 percent increase in perceived risk of marijuana or hashish use, 

• 36.45 percent increase in perceived risk of having sex while under the influence of drugs 

or alcohol, 

• 36.93 percent decrease in binge drinking, 

• 40.74 percent decrease in use of nonprescription opioid drugs, and 

• 16.44 percent decrease in unprotected sex in the past 30 days.

In FY 2023, SAMHSA anticipates funding 41 new grants and 148 continuation grants. The MAI 

program plans to support 3,119 participating in baseline, exit and follow-up MAI surveys, 1,466 

in HIV testing, 507 viral hepatitistests, and 1,381 in risk reduction counselling. Over 2,176 persons 
192 

exposed to substance use and prevention education services as well as 1,623 referrals to support 

services are anticipated. SAMHSA intends to maintain the same targets in FY 2024. 

Outputs and Outcomes 

Program: Minority AIDS Initiative 

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.3.56 Number of 

program participants 

exposed to substance 

abuse prevention 

education services 

(Output)

FY 2022: 8,647

Target:

8,345

(Target Exceeded)

8,345 8,345 Maintain

2.3.85a Number of 

persons tested for HIV 

through the Minority 

AIDS Initiative 

prevention activities 

(Output)

FY 2022: 31,255

Target:

31,514

(Target Not Met but 

Improved)

31,514 31,514 Maintain

2.3.90 Percentage of 

program participants 

who reported reduced 

binge drinking at 

follow-up. (Outcome)

FY 2022: 63.40 %

Target:

64 %

(Target Not Met but 

Improved)

64 % 64 % Maintain
193 

Center for the Application of Prevention Technologies

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Center for the Application of Prevention Technologies ............................. $7,493 $9,493 $11,993 $2,500

Authorizing Legislation......................................................................................Section 516 of the PHS Act 

FY 2023 Authorization ................................................................................................$218,219,000 

Allocation Method................................................................................................................................. Contracts

Eligible Entities...................................................................................................Domestic and Public Entities

Program Description

The Prevention Technology Transfer Centers (PTTC) Network is comprised of 10 Domestic 

Regional Centers, and Network Coordinating Office. Together the Network serves the 50 U.S. 

states, District of Columbia, Puerto Rico, U.S. Virgin Islands, and the Pacific Islands of Guam, 

American Samoa, Republic of Palau, Republic of the Marshall Islands, Federated States of 

Micronesia, and the Commonwealth of Northern Mariana Islands. 

The purpose of the PTTC Network is to improve implementation and delivery of effective 

substance use prevention interventions and provide training and technical assistance services to 

the substance misuse prevention field. This is accomplished by developing and disseminating 

tools and strategies needed to improve the quality of substance use and misuse prevention efforts; 

providing intensive technical assistance and learning resources to prevention professionals to 

improve their understanding of prevention science, epidemiological data, and implementation of 

evidence-based and promising practices; and developing tools and resources to engage the next 

generation of prevention professionals. 

Since 2018, the PTTC has delivered over 3,747 events and provided training/technical assistance 

to over 140,530 participants and has developed many resources focusing on six priority areas: 

community coalitions and collaborators, building health equity and inclusion, data-informed 

decisions, implementation science, cannabis prevention, and workforce development. New 

products and resources addressing these specific areas have been developed and implemented. 

Budget Request 

The FY 2024 President’s Budget is $11.9 million, an increase of $2.5 million from the FY 2023 

Enacted level. The increase in funding will be used for the Prevention Fellowship program – 

approximately 20 fellows will be chosen for a new FY 2024 cohort, allowing them to spend one 

year in intensive training. This program is a key component to expanding and enhancing the 

prevention workforce. A pilot program was launched in FY 2022 (see accomplishments below) 

with a grant supplement. The funding increase will allow this important program to be an inherent 

part of the PTTC. The program funding includes support for a new grant cohort to continue the 

PTTC to ensure consistent high quality, easily accessible technical assistance resources are 

available to the prevention field. This funding also supports 11 PTTC continuation grants to 

continue support for the provision of state-of-the-art substance use prevention technical assistance 
194 

to states, communities, tribal communities, and territories. In FY 2024, CSUP intends to continue 

to advance key prevention knowledge transfer and workforce development through the PTTCS, 

including continued support of the prevention fellowship program and continued training of the 

prevention workforce. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $7,493,000 

FY 2021 $7,493,000 

FY 2022 Final $7,493,000 

FY 2023 Enacted $9,493,000 

FY 2024 President's Budget $11,993,000 

Program Accomplishments

In FY 2022, SAMHSA awarded 13 continuation grants. The PTTCs were successful in completing 

additional but related projects to support the prevention infrastructure. At the request of the Center 

for Substance Use Prevention Services (CSUPS), the PTTCs conducted a national inquiry of the 

2014 to 2020 SAMHSA Strategic Prevention Framework - Partnerships for Success (SPF-PFS) 

grantees (n=255) to identify factors of grantee success, barriers in meeting program requirements, 

and improvement recommendations. The PTTCs also conducted an environmental scan to 

organize substance use prevention resources to address social determinants of health, addressing 

the physical, mental, and psychosocial needs of communities to support substance use prevention, 

treatment, and recovery across every US state and territory. The PTTC Network was able to 

identify 59,460 resources across 12 priority categories and upload the data into Microsoft Power 

BI, allowing users to easily see contact information and services provided at each location. 

Additionally, reports were created using the resources, County Health Rankings and US census 

data allowing users to examine some of the social determinants of health variables impacting 

access to resources. The PTTC Network also launched a new interactive tool entitled “The 

Prevention Certification Matrix.” This is a user-friendly tool where the prevention workforce can 

easily find and explore state, territory, and US military prevention specialist certification 

requirements.

 

In FY 2022, the PTTC Network launched a new initiative that created a Coalition Business 

Administration (CBA) intensive training. The PTTC Network identified the need for a career path 

in prevention that supports leadership growth, professional advancement, and thusly retention. 

Additionally, they identified a need for those working in prevention to have more in depth 

knowledge of business administration to maintain consistent funding, staff and growth of the 

coalitions, and non-profits in which they work. In collaboration with Community Anti-Drug 

Coalitions of America (CADCA), they created the CBA intensive training to meet both these 

needs. 
195 

Additionally, in FY 2022, two new initiatives were funded with supplemental funds which 

included a Prevention Core Competencies curriculum and a Prevention Fellowship Program (PFP). 

The PTTC National Coordinating Center was tasked with developing a training curriculum for 

preventionists based on the Prevention Core Competencies to address the workforce needs of 

entry-level and mid-level preventionists that will build upon and complement existing workforce 

training curricula and resources. They will collaborate with interested stakeholders to develop the 

curriculum outline and training curriculum for entry-level and mid-level preventionists and 

develop a strategy to deploy this training with the aim of training 5,000 entry-level and mid-level 

preventionists by the end of FY 2023. The ten PTTC Regional Centers, the PTTC Hispanic and 

Latino Center, and the PTTC Tribal Affairs Center have been tasked with leading the charge for 

the development of the Prevention Fellowship Program. The PFP will support internships for 

fellows with hands-on experience working with state and community agencies while supported by 

state and community agency mentors with virtual and in-person training in professional 

development and prevention. In FY 2022, the number of people trained was 37,896, which did 

not meet the target set at 39,774. However, 91.0% of people trained stated that they expected to 

use information from training to change their practice, exceeding the 69.0% target. 

In FY 2023, SAMHSA anticipates funding 11 PTTCs as well as two Centers of Excellence

(COEs). SAMHSA intends to maintain a 90 percent target for people trained in FY 2023 and FY 

2024. 

Outputs and Outcomes 

Program: Center for the Application of Prevention Technologies 

Measure Year and Most Recent 

Result /

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.4.14 Number of people 

trained (Output) FY 2022: 37,896

Target:

39,774

(Target Not Met)

39,774.0 39,774.0 Maintain

1.4.15 Percentage 

expecting to use 

information from 

training to change their 

practice. (Outcome)

FY 2022: 91.0% 

Target:

69.0

(Target Exceeded)

90.0 90.0 Maintain
196 

Minority Fellowship Program 

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Minority Fellowship Program............................................................ $321 $1,321 $2,680 $1,359

Authorizing Legislation......................................................................................Section 597 of the PHS Act 

FY 2023 Authorization ..................................................................................................$25,000,000 

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

Eligible Entities......Organizations that represent individuals obtaining post baccalaureate training 

(including for master’s and doctoral degrees) for mental and substance use disorder treatment 

professionals in the fields of psychiatry, nursing, social work, psychology, marriage and family 

therapy, mental health counseling, and substance use disorder and addiction counseling. 

Program Description

SAMHSA’s Minority Fellowship Program (MFP) is intended to increase behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; substance use/addiction counseling,

marriage and family therapists and professional counselors. In FY 2023, SAMHSA added 

addiction medicine as a component of the MFP. This program is jointly administered by the Center 

for Substance Use Services (CSUS), the Center for Substance Use Prevention (CSUP), and the 

Center for Mental Health Services (CMHS) at SAMHSA. Combined, this program will support 

fellowships for hundreds of students as well as support additional training through webinars on 

culturally appropriate services to thousands of students. 

Budget Request

The FY 2024 President’s Budget is $2.7 million, an increase of $1.3 million from the FY 2023 

Enacted level. Combined with $22.0 million in the Mental Health appropriation and $12 million 

in the Substance Use Services appropriation, funds will support eight continuation grants and a 

technical assistance contract. This funding will more than double the number of fellows from 428 

to 1,182 and increase the number of trained behavioral health providers to 6,500. As a braided 

activity, this increase in fellows will directly address the significant treatment gap across the care 

continuum and the workforce shortage in disenfranchised and minority populations. In addition, 

SAMHSA will conduct a robust evaluation of the program for culturally appropriate approaches 

to further improve retention and increase recruitment of more diverse fellows into the workforce. 
197 

The Budget also proposes to add a service requirement to ensure participants are supporting 

communities in need, as well as to add addiction medicine, and sexual and gender minority 

populations as participants in the Minority Fellowship Program. 

Please note, SAMHSA is tracking separately any amounts spent, or awarded, under the Minority 

Fellowship Program through the distinct appropriations to ensure that funds are used for purposes 

consistent with legislative direction and intent of these appropriations. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $321,000 

FY 2021 $321,000 

FY 2022 Final $321,000 

FY 2023 Enacted $1,321,000 

FY 2024 President's Budget $2,680,000 

Program Accomplishments

In FY 2022, SAMHSA supported eight grant continuations, and the MFP technical assistance 

contract. In FY 2022, the MFP grant supported 428 fellows and provided over 135 trainings and 

workshops for the fellows and other interested participants. 

In FY 2023, SAMHSA anticipates funding one grant continuation, awarding a new cohort of 8 

grants, and a new MFP Coordinating Center, which will increase the number of trained behavioral 

health providers. 
198 

Science and Service Program Coordination

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Science and Service Program Coordination............................................ $4,072 $4,072 $4,072 $---

Authorizing Legislation......................................................................................Section 516 of the PHS Act 

FY 2023 Authorization ................................................................................................$218,219,000 

Allocation Method................................................................................................................................. Contracts

Eligible Entities...................................................................................................Domestic and Public Entities

Program Description

 

The Substance Use Disorder Prevention Engagement Initiatives (SUDPEI) contributes to 

SAMHSA’s efforts to collaborate across the agency to promote wider adoption and application of 

effective SUD prevention strategies across the continuum of care, with an emphasis on integrating 

prevention services into other systems through efforts such as partner engagement. The SUDPEI 

promotes the adoption of evidence-based policies, programs, and practices by developing

materials, resources, and other engagement tools to strengthen community-based prevention 

efforts to address substance use and misuse. The initiative supports the Interagency Coordinating 

Committee on the Prevention on Underage Drinking (ICCPUD) through operation and 

maintenance of the ICCPUD web portal, StopAlcoholAbuse.gov. As part of its work to support 

SAMHSA and the ICCPUD, the SUDPEI develops communications resources for prevention 

professionals and community coalitions that call out important trends from the NSDUH and 

promote evidence-based strategies to prevent substance use and misuse and related issues. Another 

key SUDPEI activity, Communities Talk to Prevent Substance Use Disorders, is designed to raise 

awareness of SUD prevention issues as well as mobilize and support community action. 

Communities Talk to Prevent Substance Use Disorders

Historically, every two years, the SUDPEI has distributed Communities Talk planning stipends to 

community-based organizations (CBOs), institutions of higher education (IHEs), and statewide or 

state-based organizations to plan activities that raise awareness and educate youth, families, and 

communities about the potentially harmful consequences of underage and problem drinking and 

other substance misuse among individuals 12 to 25 years old. Community events and activities 

have been conducted in every state and territory. 
199 

Budget Request

The FY 2024 President’s Budget is $4.0 million, level with the FY 2023 Enacted level. Funding 

will continue to maintain improvements in community readiness in identified tribal communities 

through tribally focused, and tribally specific technical assistance delivery. In FY 2024, CSUP 

intends to maintain a target of improving community readiness in six tribal organizations. 

In FY 2024, CSUP will also continue to elevate community success stories via its podcast series, 

webinars, and prominent placement of stories on the Communities Talk website. Additionally, 

CSUP will expand its use of mini campaigns, which promote and amplify substance use data, 

research, and prevention resources related to alcohol and substance misuse by youth and youth 

adults. Other focus areas for communications activities will include technical assistance in 

bridging prevention service delivery between substance misuse and mental health promotion as 

well as operationalizing diversity, equity, and inclusion in prevention service delivery. 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 $4,072,000 

FY 2021 $4,153,000 

FY 2022 Final $4,072,000 

FY 2023 Enacted $4,072,000 

FY 2024 President's Budget $4,072,000 

Program Accomplishments

In FY 2022, the number of organizations or communities that demonstrate improved readiness to 

change their systems was 5 organizations meeting the FY 2022 target. In FY 2022, key changes to 

the SUDPEI included availability of annual planning stipends to support community prevention 

efforts; expansion of public education initiatives using evidence-based mini-campaigns, webinars, 

and social media; development of audience focused materials and products; and expanded 

engagement with other federal agencies and national organizations to leverage communications 

resources to broaden resource sharing and dissemination to a wider range of audiences. 

In FY 2022, the Communities Talk activity worked with communities to implement prevention 

activities that promoted targeted messaging about underage drinking and substance use disorder 

(SUD) prevention. During and post-pandemic, the program deployed new strategies to share new 

resources and community prevention success stories through podcasts, webinars, and partner 

engagement.

Beginning in FY 2023, 500 Communities Talk planning stipends will be distributed every year to 
200 

CBOs and IHEs to conduct community-based prevention activities, with the focus broadening to 

address the potentially harmful consequences of underage and problem drinking and substance use 

and misuse. To support community-based planning, a new web-based planning app is now 

available. Using an OMB-approved survey, data regarding community activities will be captured 

in FY 2023. In addition, success stories are also developed and shared via 

https://www.stopalcoholabuse.gov/communitiestalk/. 

In FY 2024, CSUP will continue to elevate community success stories via its podcast series, 

webinars, and prominent placement of stories on the Communities Talk website. Additionally, 

CSUP will expand its use of mini campaigns, which promote and amplify substance use data, 

research, and prevention resources related to alcohol and substance misuse by youth and youth 

adults. Other focus areas for communications activities will include technical assistance in 

bridging prevention service delivery between substance misuse and mental health promotion as 

well as operationalizing diversity, equity, and inclusion in prevention service delivery. 

Outputs and Outcomes 

Program: Prevention - Science and Service Activities

Measure Year and Most Recent 

Result /

Target for Recent Result 

/

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.3.100 Number of 

organizations or 

communities that 

demonstrate improved 

readiness to change 

their systems (Output)

FY 2022: 5.0 

organizations

Target:

5.0 organizations

(Target Met)

5.0 

organizations

5.0 

organizations

Maintain
201 

PRNS Mechanism Table 

Summary

Programs of Regional & National Significance

FY 2022 

Final

FY 2023 

Enacted

FY 2024 

President's Budget

No. Amount No. Amount No. Amount

Grants 

Continuations................................................................................................. 709 170.57 661 133.45 659 168.68 

New/Competing............................................................................................. 93 22.29 232 75.46 196 48.33 

Supplements................................................................................................... --- -- --- -- --- -- 

Subtotal...................................................................................................... 802 192.86 893 208.91 855 217.01 

Contracts 

Continuations................................................................................................. 10 16.51 13 24.86 13 26.63 

New............................................................................................................... 6 8.85 1 3.11 1 2.09 

Subtotal...................................................................................................... 16 25.36 14 27.97 14 28.72 

Total, Substance Use Prevention PRNS 818 218.22 907 236.88 869 245.74 
202 

PRNS Mechanism Table

Program, Project, and Activity 

(Dollars in thousands) 

 

FY 2022

Final

FY 2023 

Enacted

FY 2024 

President's Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity: 

Strategic Prevention Framework 

Grants 

Continuations................................................................................................. 255 106.85 256 83.42 217 94.52 

New/Competing............................................................................................. 18 12.74 74 42.75 66 36.39 

Supplements................................................................................................... --- -- --- -- --- -- 

Subtotal 273 119.59 330 126.17 283 130.91 

Contracts 

Continuations................................................................................................. 2 7.61 2 7.64 2 8.74 

New............................................................................................................... 2 0.28 1 1.68 1 0.83 

Subtotal 4 7.90 3 9.31 3 9.58 

Total, Strategic Prevention Framework 277 127.48 333 135.48 286 140.48 

Federal Drug-Free Workplace 

Contracts 

Continuations................................................................................................. 2 1.50 3 4.55 3 4.57 

New............................................................................................................... 1 3.40 --- 0.59 --- 0.57 

Subtotal...................................................................................................... 3 4.89 3 5.14 3 5.14 

Total, Federal Drug-Free Workplace 3 4.89 3 5.14 3 5.14 

Minority AIDS 

Grants 

Continuations................................................................................................. 161 33.65 148 30.51 189 39.70 

New/Competing............................................................................................. 22 5.47 41 10.36 5 1.17 

Subtotal...................................................................................................... 183 39.12 189 40.87 194 40.87 

Contracts 

Continuations................................................................................................. --- 1.83 --- 2.13 --- 2.34 

New............................................................................................................... --- 0.25 --- 0.21 --- -- 

Subtotal...................................................................................................... --- 2.09 --- 2.34 --- 2.34 

Total, Minority AIDS 183 41.21 189 43.21 194 43.21 

Sober Truth on Preventing Underage Drinking Act 

Grants 

Continuations................................................................................................. 131 6.46 148 7.39 114 5.74 

New/Competing............................................................................................. 39 2.11 60 3.07 93 4.65 

Subtotal...................................................................................................... 170 8.57 208 10.46 207 10.39 

Contracts 

Continuations................................................................................................. --- 0.53 2 4.04 2 4.11 

New............................................................................................................... 2 2.89 --- -- --- -- 

Subtotal...................................................................................................... 2 3.43 2 4.04 2 4.11 

Total, Sober Truth on Preventing Underage Drinking Act 172 12.00 210 14.50 209 14.50 
203 

PRNS Mechanism Table

Program, Project, and Activity 

(Dollars in thousands) 

 

FY 2022 

Enacted

FY 2023 

President's 

Budget

FY 2024 President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Tribal Behavioral Health Grants 

Grants 

Continuations................................................................................................. 140 15.82 108 11.90 118 18.49 

New/Competing............................................................................................. 14 1.97 37 9.28 10 2.60 

Subtotal...................................................................................................... 154 17.79 145 21.18 128 21.09 

Contracts 

Continuations................................................................................................. 1 2.96 1 2.48 1 2.57 

New/Competing............................................................................................. --- -- --- -- --- -- 

Subtotal...................................................................................................... 1 2.96 1 2.48 1 2.57 

Total, Tribal Behavioral Health Grants 155 20.75 146 23.67 129 23.67 

Subtotal, Capacity 790 206.33 881 221.99 821 226.99 

Science and Service:

FY 2022 

Final

FY 2023 

Enacted

FY 2024 President's 

Budget

No. Amount No. Amount No. Amount

Center for the Application of Prevention Technologies 

Grants 

Continuations................................................................................................. 13 7.16 --- -- 13 8.98 

New/Competing............................................................................................. --- -- 13 8.98 5 2.36 

Subtotal...................................................................................................... 13 7.16 13 8.98 18 11.34 

Contracts 

Continuations................................................................................................. --- 0.33 --- 0.47 --- 0.65 

New/Competing............................................................................................. --- 0.00 --- 0.05 --- -- 

Subtotal...................................................................................................... --- 0.33 --- 0.51 --- 0.65 

Total, Center for the Application of Prevention Technol 13 7.49 13 9.49 18 11.99 

SAP Minority Fellowship Program 

Grants 

Continuations................................................................................................. 8 0.30 1 0.24 8 1.25 

New/Competing............................................................................................. --- -- 7 1.01 7 1.17 

Supplements*................................................................................................. --- -- --- -- --- -- 

Subtotal...................................................................................................... 8 0.30 8 1.25 15 2.42 

Contracts 

Continuations................................................................................................. --- 0.01 --- 0.07 --- 0.15 

New/Competing............................................................................................. --- 0.00 --- 0.01 --- 0.12 

Subtotal...................................................................................................... --- 0.02 --- 0.07 --- 0.26 

Total, SAP Minority Fellowship Program 8 0.32 8 1.32 15 2.68 

Science & Service Program Coordination 

Grants 

Continuations................................................................................................. 1 0.33 --- -- --- -- 

New/Competing............................................................................................. --- -- --- -- --- -- 

Subtotal...................................................................................................... 1 0.33 --- -- --- -- 

Contracts 

Continuations................................................................................................. 5 1.72 5 3.49 5 3.51 

New............................................................................................................... 1 2.02 --- 0.59 --- 0.57 

Subtotal...................................................................................................... 6 3.74 5 4.07 5 4.07 

Total, Science & Service Program Coordination 7 4.07 5 4.07 5 4.07 

Subtotal, Science and Service 28 11.89 26 14.89 38 18.75 

Total, Substance Use Prevention 818 $218.22 907 $236.88 859 $245.74
204 

Grant Awards Table 

 

FY 2022 Final FY 2023 Enacted FY 2024 President's 

Budget

Number of Awards 802 893 845

Average Award $240,473 $233,821 $256,820

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000
205 

Substance Use Services

Table of Contents

Substance Use Services ............................................................................................................. 205

Summary of the Request .............................................................................................. 206

Programs of Regional and National Significance (PRNS) ............................................. 208

Opioid Treatment Programs/Regulatory Activities ............................................... 209

Screening, Brief Intervention, and Referral to Treatment .................................... 213

Targeted Capacity Expansion-General ................................................................. 217

Pregnant and Postpartum Women ........................................................................ 224

Improving Access to Overdose Treatment ............................................................ 229

Building Communities of Recovery (BCOR) ......................................................... 232

Recovery Community Services Program ............................................................... 236

Children and Families ........................................................................................... 240

Treatment Systems for Homeless ........................................................................... 244

Criminal Justice Activities .................................................................................... 248

Minority AIDS Initiative ........................................................................................ 255

Minority Fellowship Program ............................................................................... 258

Addiction Technology Transfer Centers ............................................................... 260

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths .............. 263

Peer Support Technical Assistant Center .............................................................. 266

Treatment, Recovery, and Workforce Support ...................................................... 269

Emergency Department Alternatives to Opioids ................................................... 272

Comprehensive Opioid Recovery Centers ............................................................. 275

First Responder Training – Comprehensive Addiction and Recovery Act ........... 279

Community Harm Reduction and Engagement Initiative .................................. 283

Youth Prevention and Recovery Initiative ............................................................. 286

PRNS Mechanism Table ................................................................................................. 288

Grant Awards Table ........................................................................................................ 294

State Opioid Response Grants ........................................................................................ 295

Substance Use Prevention, Treatment, and Recovery Services Block Grant ................. 304
206 

Substance Use Services

Summary of the Request

 

(Dollars in thousands)

Programs of Regional & National Significance

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

FY 2024 

+/- FY 

2023

Programs of Regional and National Significance.......................................................................... $521,517 $574,219 $755,008 180,789 

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

State Opioid Response Grants...................................................................................................... 1,525,000 1,575,000 2,000,000 425,000

 Set-Aside for Tribes (non-add).................................................................................................. 55,000 55,000 75,000 20,000

Substance Use Presentation, Treatment, and Prevention Recovery Services Block Grant ........... 1,908,079 2,008,079 2,708,079 700,000

 Budget Authority (non-add)....................................................................................................... 1,828,879 1,928,879 2,628,879 700,000

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

Total, Substance Use Services................................................................................................... $3,954,596 $4,157,298 $5,463,087 $1,305,789

FTE 97 130 175 45

The FY 2024 President’s Budget request is $5.5 billion, an increase of $1.3 billion from The 

FY 2023 Enacted level. The Budget request includes $5.4 billion for Budget Authorities and 

$81.2 million for Public Health Services Evaluation fund. 

SAMHSA’s Center for Substance Use Services (CSUS) manages over 35 formula and 

discretionary grant programs with approximately 1,223 grantee entities throughout the nation. The 

Center’s programs fund interventions across the continuum of substance use care from prevention 

to harm reduction, treatment, and recovery services, with the broad goals of saving and improving 

lives, and recognizing the often-long-term nature of substance use disorders. The Budget 

proposes increasing access to quality evidence-based care and services for substance use disorders 

and addressing the overdose crisis for individuals, families, and communities —especially as it 

relates to opioid and stimulant use disorders. CSUS’s focus areas as outlined in this Budget align 

with ONDCP’s National Drug Control Strategy and the seven Biden-Harris Administration drug 

policy priorities through support for expansion of access to evidence-based harm reduction, 

prevention, treatment, specifically medication for opioid use disorder, recovery services, and the 

addiction workforce. 

The Budget for CSUS focuses on continuing investments not only in individuals and families 

impacted by substance use across the lifespan but also across diverse communities that are at 

especially high risk for overdose. This includes pregnant and post-partum women and their 

children, individuals with substance use disorders who encounter the criminal justice system or 

experience housing instability, and individuals specifically seeking treatment and recovery support 

services for addiction to heroin, fentanyl, and other opioids. SAMHSA’s substance use disorder 

budget request funds direct services, infrastructure development, system capacity building, and 

training and technical assistance efforts for service integration, quality improvement, and 

workforce development. Multiple touchpoints exist for people with substance use disorders and 

their families. CSUS’s programs involve multiple systems beyond the specialty behavioral health 
207

system, such as primary healthcare, school, child welfare, criminal and juvenile justice, and 

housing systems. 

Programs central to CSUS’s direct services and system capacity building and encompassing the 

majority of the Center’s current FY 2024 Budget Request, include the State Opioid Response 

(SOR) and Tribal Opioid Response (TOR) grants, as well as the Substance Use Prevention, 

Treatment, and Recovery Services Block Grants (SUPTRS BG). The $4.7 billion in proposed 

funds between these two formula grants provide a foundation for states, tribes, tribal nations, and 

territories to create a safety net of substance use disorder care across harm reduction, treatment, 

and recovery support services. Additional CSUS programs support direct funding to behavioral 

health workforce and community organizations to expand and enhance treatment and recovery 

support services in different settings and for a range of priority populations. This allows grant 

recipients to focus on meeting their community’s unique needs. Workforce shortages are one of 

the greater challenges facing many behavioral health providers today. CSUS grants provide 

significant training and technical assistance opportunities to connect health professional students 

and practitioners with the behavioral health and addiction medicine/addiction psychiatry field. 

Funding also supports innovative delivery of pharmacologic therapies for opioid use disorder 

under CSUS’s regulatory framework. 

CSUS’s programs prevent overdose; promote children and youth behavioral health; integrate 

primary and substance use disorder health care; and use performance measures, data, and 

evaluation to guide decision-making. CSUS’s strategies aim to improve access and reduce barriers 

to quality care and reduce the stigma of substance use disorders, which often prevents individuals 

from receiving needed services to promote recovery. 

CSUS’s programs support the framework of a coordinated, integrated continuous care model of 

substance use disorder services. To achieve this, the programs work to: 1) drive the integration of 

behavioral health into the healthcare system to strengthen and expand access to mental and 

substance use disorder treatment and recovery services for individuals and families; 2) bolster the 

health workforce to ensure delivery of quality services and care; 3) enhance the promotion of 

healthy behaviors to reduce occurrence and disparities in preventable injury, illness, and death; 

and 4) improve the design, delivery, and outcomes of HHS programs by prioritizing science, 

evidence, and inclusion. 
208 

Substance Use Services

Programs of Regional and National Significance (PRNS) 

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2022 FY 2023 FY 2024

Final Enacted President's 

Budget

FY2024 +/- 

FY 2023

Capacity:

Opioid Treatment Programs/Regulatory Activities........................... $8,724 $10,724 $13,086 $2,362

Screening, Brief Intervention and Referral to Treatment..................... 31,840 33,840 33,840 --- 

Budget Authority (non-add)...................................................... 29,840 31,840 31,840 --- 

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

Targeted Capacity Expansion-General 112,192 122,416 157,916 $35,500

Other Targeted Capacity Expansion 11,192 11,416 11,416 --- 

MAT for Prescription Drug and Opioid Addiction (non-add) 101,000 111,000 136,500 $25,500

 MAT for Prescription Drug and Opioid Addiction Tribes(non-add) 12,000 14,500 16,500 $2,000

Low-Threshold Housing First Pilot Project (non-add, new) --- --- 10,000 $10,000

Pregnant and Postpartum Women 34,931 38,931 49,397 $10,466

Recovery Community Services Program 2,434 4,434 5,151 $717

Improving Access to Overdose Treatment 1,000 1,500 1,500 --- 

Building Communities of Recovery 13,000 16,000 28,000 $12,000

Children and Families 29,605 30,197 30,197 --- 

Treatment Systems for Homeless 36,386 37,114 37,114 --- 

Minority AIDS 65,570 66,881 66,881 --- 

Criminal Justice Activities 89,000 94,000 124,380 $30,380

Other Criminal Justice Activities (non-add) 19,000 20,000 19,380 -$620

Drug Court Activities(non-add) 70,000 74,000 105,000 $31,000

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths 14,000 16,000 28,000 $12,000

Peer Support TA Center 1,000 2,000 2,000 --- 

Treatment, Recovery, and Workforce Support 10,000 12,000 12,000 --- 

Emergency Department Alternatives to Opioids 6,000 8,000 9,000 $1,000

Comprehensive Opioid Recovery Centers 5,000 6,000 6,000 --- 

Community Harm Reduction and Engagement Initiative (new) --- --- 50,000 $50,000

First Responder Training (CARA) 46,000 56,000 77,500 $21,500

First Responder Training (non-add) 20,000 25,000 46,500 $21,500

Rural Set-Aside (non-add) 26,000 31,000 31,000 --- 

Youth Prevention and Recovery Initiative --- 2,000 2,000 --- 

Subtotal, Capacity 506,682 558,037 733,962 $175,925

Science and Service: --- 

SAT Minority Fellowship Programs 5,789 7,136 12,000 $4,864

Addiction Technology Transfer Centers 9,046 9,046 9,046 --- 

Subtotal, Science and Service 14,835 16,182 21,046 $4,864

Total, PRNS $521,517 $574,219 $755,008 $180,789
209 

Opioid Treatment Programs/Regulatory Activities

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Opioid Treatment Programs/Regulatory Activities................................................. $8,724 $10,724 $13,086 $2,362

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2024 Authorization ...............................................................................................$ 521,517,000 

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

Eligible Entities ............................................................. American Society of Addiction Medicine,

American Academy of Addiction Psychiatry, American Medical Association, American

Osteopathic Association, American Psychiatric Association, American Dental Association

Domestic Medical Schools, Physician Assistant Schools, and Schools of Nursing 

Program Description 

SAMHSA seeks to close the gap between the number of people needing treatment for Opioid Use 

Disorder (OUD) and the capacity to treat them with Food and Drug Administration (FDA)-

approved Medications for Opioid Use Disorder (MOUD) (buprenorphine, methadone, and 

naltrexone products). These medications are often used in combination with additional evidencebased treatment and recovery support services. SAMHSA expands access to MOUD through 

Opioid Treatment Programs (OTPs), provider support for those who provide MOUD with 

buprenorphine in office-based settings and education and training of healthcare students and 

practitioners for treatment of OUD, including MOUD, via universities and professional 

organizations. These activities apply to multiple other CSUS programs and form a cornerstone of 

efforts related to the HHS Overdose Prevention Strategy. 

MOUD in Opioid Treatment Programs 

SAMHSA is responsible for regulating and certifying the country's OTPs; providing direct support 

to OTPs, healthcare systems, states, and other federal agencies regarding certification, 

accreditation, and evidence-based MOUD treatment; and overseeing accreditation of these 

programs. SAMHSA approves all organizations that accredit OTPs (accreditation bodies), reviews 

the standards they apply in their accreditation of OTPs, and monitors them for quality assurance 

and improvement. SAMHSA meets regularly with the State Opioid Treatment Authorities 

(SOTAs). SOTAs provide oversight of OTPs in their respective state; provide state-level technical 

assistance, guidance, and support for issues related to MOUD, such as assisting state officials in 

evaluating state requirements and adherence to the federal regulations for OTPs; and promote 

evidence-based substance use disorder (SUD) treatment and related care. These responsibilities 

and interactions enable SAMHSA to address barriers to treatment and promote means of 

expanding access to services. 

A key population of focus are individuals with OUD who are involved in the criminal justice 

system. To address access to MOUD for this high-risk population, CSUS has partnered with the 

federal Bureau of Prisons (BOP), states’ Departments of Corrections (DOC), the Drug 

Enforcement Administration (DEA), and other stakeholders to establish OTP services throughout 

federal and state correctional systems. For example, by the end of FY 2022, all 97 BOP facilities 
210

were certified to provide MOUD for its residents with OUD. The next step is to assist states in 

implementing MOUD in their DOC facilities.

 

CSUS’ certification and accreditation oversight activities continue in FY 2023. This includes 

continuing to assist the BOP with service implementation, arranging training and providing 

technical support as the sites prepare for accreditation, and working with at least five additional 

states to improve the capacity of their criminal justice systems to provide MOUD and training 

resources to support this expansion. In addition, during FY 2023, CSUS is identifying and 

addressing gaps in access to MOUD across the country and improving consistency of state-based 

approaches and federal guidance.

MOUD Education and Training of Providers 

The Consolidated Appropriations Act, 2023, PL 117-238 removed the former requirement that 

practitioners hold a waiver that certifies their qualification to prescribe buprenorphine in an officebased setting, as established in the Drug Addiction Treatment Act of 2000 (DATA 2000). It also 

expanded the requirement of SUD training for all providers qualified to prescribe any controlled 

medications designated by the DEA as Schedule II-V substances. Together, these expand the range 

of providers available to treat OUD and the numbers of practitioners requiring training and other 

practice support. 

Healthcare providers play a pivotal role in educating their patients and colleagues about substance 

use and SUD; screening, diagnosing, and treating patients; and modeling positive attitudes to 

reduce the stigma attached to SUD. Early career physicians have identified lack of preparedness 

to treat SUD as a barrier to prescribing MOUD101; further research shows that lack of appropriate 

education fosters an unwillingness to prescribe MOUD102. Comprehensive and uniform training 

on SUDs and treatment and recovery modalities can overcome these deficits. SAMHSA promotes 

provider education through its grants and contracted programs, including the Provider’s Clinical 

Support System-University (PCSS-U) and Provider’s Clinical Support System-Medications for 

Opioid Use Disorder (PCSS-MOUD.) PCSS-U promotes SUD education in professional 

healthcare schools and aims to engage students in treating SUD upon graduation. PCSS-MOUD 

expands the number of licensed providers completing training requirements for prescribing 

MOUD and provides mentoring and other supports for practitioners treating OUD and other SUDs. 

There remains a significant need to increase the number of healthcare providers prepared to 

provide treatment for OUD and other SUDs. SAMHSA will continue to provide up-to-date and 

evidence-based information to support the training of health professionals and to address the 

complex issues of SUD. 

101 DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA, Jr. Analysis of barriers to adoption of buprenorphine 

maintenance therapy by family physicians. Rural & Remote Health. 201515:3019.

102 Mackey K, Veazie S, Anderson J, Bourne D, and Peterson K. Evidence Brief: Barriers and Facilitators to Use of 

Medications for Opioid Use Disorder. Washington, DC: Evidence Synthesis Program, Health Services Research 

and Development Service, Office of Research and Development, Department of Veterans Affairs. 2019
211 

Budget Request

The FY 2024 President’s Budget request is $13.1 million, an increase of $2.4 million from the 

FY 2023 Enacted level. SAMHSA plans to award 16 new and 9 continuation PCSS-U grants, plus 

three continuation cooperative agreements, each for PCSS-MOUD, PCSS-MAUD, and PCSS-CM 

and two contracts. 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $8,724,000 

FY 2021 $8,724,000 

FY 2022 Final $8,724,000 

FY 2023 Enacted $10,724,000 

FY 2024 President's Budget $13,086,000 

Program Accomplishments

MOUD in Opioid Treatment Programs 

In 2022, SAMHSA certified 151 new opioid treatment programs, new brick and mortar medication 

units, as well as new mobile units to expand treatment across the nation. As of December 2022, 

there were 1,994 active opioid treatment programs (OTPs) with 80 having affiliated brick and 

mortar medication units, and 24 with mobile locations. Additionally, SAMHSA assisted the 

Federal Bureau of Prisons (BOP) with establishing 97 OTPs for its hub and spoke model for 

providing methadone for treatment of OUD throughout their system. During FY 2023, SAMHSA 

will assist states and local jails in implementing MOUD in their criminal justice settings. 

MOUD in Other Health Care Settings

As of the end of FY 2022, the number of practitioners certified to provide MOUD exceeded 

137,000. With the removal of the DATA-waiver certification process and the addition of training 

requirements for all providers prescribing controlled substances, during FY 2023, CSUS expects 

to expand the support it provides for these and additional practitioners. It will also expand its 

support activities to assure MOUD providers and other systems of care have access to CSUSfunded technical assistance and training resources. 
212

MOUD Education and Training of Providers 

The number of students trained to prescribe MOUD by PCSS-U program in 2022 was 3,168 and 

PCSS-MOUD program was 22,361. 

In FY 2023, SAMHSA initiated funding of a new PCSS that focuses on identification and 

treatment of alcohol use disorder (AUD). The purpose of this program is to provide training, 

guidance, and mentoring on the use of Medications for Alcohol Use Disorders (MAUD). It is 

intended to enhance the capacity of healthcare and counseling professionals to identify and treat 

AUD. Award recipients will be expected to develop discipline-specific and multidisciplinary 

curricula for practitioners, provide training on use of MAUD, and provide ongoing mentoring, 

consultation, and technical assistance to foster knowledge, adoption, and treatment with MAUD. 

SAMHSA is also supporting a PCSS to provide training, mentoring, and ongoing support for 

organizations seeking to implement Contingency Management (CM) to foster knowledge adoption 

and best practices. 

In FY 2022, SAMHSA funded six new and 27 PCSS-U continuation grants and two contracts. 

In FY 2023, SAMHSA anticipates funding three new PCSS-U grants, one new PCSS-MOUD, one 

new PCSS-MAUD, and one new PCSS-CM cooperative agreement, 18 PCSS-U continuation 

grants and two contracts. 
213 

Screening, Brief Intervention, and Referral to Treatment

(Dollars in thousands)

Programs of Regional & National Significance

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

FY 2024 

+/- 

FY 2023

Screening, Brief Intervention and Referral to Treatment................................. $31,840 $33,840 $33,840 ---

Budget Authority (non-add)...................................................................... 29,840 31,840 $31,840 ---

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

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2024 Authorization ..................................................................................................$521,517,00 

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

Eligible Entities Single State Authority and Health Departments in States, Territories, the District 

of Columbia, Federally Recognized American Indian/Alaska Native 

Tribes or Tribal Organizations, Domestic Public and Private Non-Profit Entities, 

and Public and Private Universities and Colleges 

Program Description 

In 2021, 46.3 million people aged 12 or older (or 16.5 percent) had a substance use disorder (SUD) 

in the past year, including 29.5 million who had an alcohol use disorder, 24.0 million who had a 

drug use disorder, and 7.3 million people who had both an alcohol use disorder and a drug use 

disorder. Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million 

people (or 45.1 percent) were past month binge drinkers. Among past month binge drinkers, 16.3 

million people were past month heavy drinkers (SAMHSA, 2022).

103 The National Institute on 

Drug Abuse estimates that the misuse of illicit drugs, tobacco, and alcohol costs society $740 

billion each year.104 Unfortunately, of the individuals who need treatment for substance use 

disorder, only 6.8 percent received specialty treatment for their condition105. 

The Screening, Brief Intervention and Referral to Treatment (SBIRT) program, including state 

implementation grants intended to help primary care physicians, identifies individuals who misuse 

substances and intervenes with education, brief interventions, or referral to specialty treatment if 

necessary. The program’s goals are to reduce the rate of substance misuse, intervene early to 

prevent progression to more severe illness, and increase the number of individuals who receive 

treatment for their substance use disorder (SUD). Studies have long shown that this approach is 

effective in helping reduce harmful alcohol consumption.

The SBIRT program is designed to expand/enhance the continuum of care for SUD services and 

reduce alcohol and other drug (AOD) consumption and its negative health impact, increase 

abstinence, reduce costly health care utilization, and promote sustainability and the integration of 

behavioral health and primary care services through policy changes that increase treatment access 

in generalist and specialist practice. These grants support clinically appropriate services for 

persons at risk for SUD, as well as those diagnosed with SUD. The SBIRT program requires state 

103https://www.hhs.gov/about/news/2023/01/04/samhsa-announces-national-survey-drug-use-health-resultsdetailing-mental-illness-substance-use-levels-2021.html 104 https://nida.nih.gov/research-topics/trends-statistics 105 Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health 

indicators in the United States: Results from the 2021 National Survey on Drug Use and Health 

https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
214 

grant recipients to implement the model in all primary care settings, as well as hospitals, trauma 

centers, federally qualified health centers, and other relevant health care and community settings. 

Recipients may use funds to screen for substance use and co-occurring mental illness and 

substance use disorders. They can support evidence-based person-centered interventions, such as 

reinforcement of less risky alcohol use, motivational interviewing, brief interventions, and referral 

to specialty care for individuals exhibiting symptoms of substance use disorder. The population 

of focus is adults and adolescents seeking medical attention and intervention in primary care and 

other health care settings.

The SBIRT program, like the majority of CSUS’ discretionary grant programs, gathers grantee 

data on six National Outcome Measures (NOMS). SAMHSA’s NOMS are built into GPRA-based 

survey instruments for all SAMHSA discretionary grant programs. This data helps SAMHSA 

create a national picture of substance misuse to build evidence to support program outcomes 

associated with SAMHSA grants.

Budget Request

The FY 2024 President’s Budget request is $33.8 million, level with the FY 2023 Enacted level. 

SAMHSA plans to award 11 new grants and 20 continuations with these funds with a target of 

serving 146,366 people. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $30,000,000 

FY 2021 $30,000,000 

FY 2022 Final $31,840,000 

FY 2023 Enacted $33,840,000 

FY 2024 President's Budget $33,840,000 

Program Accomplishments

In FY 2022, SAMHSA funded 2 new and 27 continuation SBIRT grants. During this year, across 

27 grants, 141,685 clients were served in the SBIRT program. Based on 141,685 client intakes 

assessments, and 1,366 client six-month follow-up reassessments, the recipients of SBIRT services 

saw improvements in key National Outcome Measures, specifically reductions in substance use 

and substance use-related consequences which are the targets for SBIRT programs. These data are 

displayed below. 
215 

In FY 2023, SAMHSA anticipates funding seven new and 24 continuation SBIRT grants. This 

year, the program has set a target of serving 144,917 people. 

. 

Screening, Brief Intervention and 

Referral to Treatment (SBIRT)

At Intake At 6-months percent +/-change 

between intake and 6-

months follow-up (n=141,685) (n=1,366) 

No past 30-day use alcohol/illegal drugs 6.3% 42.4% 569.7% 

No past 30-day arrest 95.4% 98.9% 3.7% 

Past 30-day employment or school 

attendance 

 44.1% 50.4% 14.3% 

No past 30-day experience with alcohol 

or drug related health, behavioral, or 

social consequences

 24.1% 53.0% 119.7% 

Past 30-day socially connectedness 63.5% 68.3% 7.6% 

Past 30-day permanent place to live in 

the community

 42.2% 40.8% (-)3.3% 
216 

Outputs and Outcomes

Program: Screening, Brief Intervention and Referral to Treatment

1. Measure Year and Most Recent 

Result

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.2.40 The number of 

clients served (Output)

FY 2022: 141,685

Target: 

143,482

(Target Not Met)

144,917 146,366 +1,449 

1.2.41 Percentage of 

clients receiving services 

who had no past month 

substance use (Outcome)

FY 2022: 53.0%

Target: 

45.7%

(Target Not Met)

46.7 % 47.7 % +1% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not 

limited to) incomplete data, self-report, and selection bias. 
217 

Targeted Capacity Expansion-General 

 

(Dollars in thousands) 

 

FY 2022 FY 2023 FY 2024

Final Enacted

Presiden

t's 

Budget

FY 2024

+/- 

FY 2023

Targeted Capacity Expansion-General.......................................................................... $112,192 $122,416 $157,916 $35,500

MAT for Prescription Drug and Opioid Addiction (non add)................................ 101,000 111,000 136,500 25,500 

 Set-Aside for Indian Tribes, Tribal Organizations, or Consortia (non-add)...... 12,000 14,500 16,500 2,000 

Low-Threshold Housing First Pilot Project.............................................................. --- --- 10,000 10,000 

Other Targeted Capacity 

Expansion.......................................................................... 11,192 11,416 11,416 ---

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2024 Authorization ..................................................................................................................$0 

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

Eligible Entities........ States, local governments, communities, other public and non-profit private 

entities, Indian tribes and tribal organizations, health facilities 

Program Description 

 

Urgent, unmet, and emerging substance use disorder treatment and recovery support service 

capacity needs remain a critical issue for the nation. To assist communities in addressing these 

needs, SAMHSA initiated the Targeted Capacity Expansion (TCE) program. Projects within this 

program provide rapid, strategic, comprehensive, and integrated community-based responses to 

gaps and capacity for substance use disorder treatment and recovery support services. Examples 

of the gaps addressed by these projects include: limited or no access to medications for opioid use 

disorders (MOUD); lack of resources needed to adopt and implement health information 

technology (HIT) in substance use disorder treatment settings; and short supply of trained and 

qualified peer recovery coaches to assist individuals in the recovery process. This program 

supports the MAT-PDOA and TCE-Special Projects.

 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT-PDOA) 

The MAT-PDOA program addresses unique local treatment needs of individuals who have an 

opioid use disorder (OUD) by expanding/enhancing local treatment system capacity to provide 

accessible, effective, comprehensive, coordinated, integrated, and evidence-based MOUD and 

recovery support services. MOUD refers to the use of the Food and Drug Administration-approved 

pharmacotherapies (i.e., buprenorphine products, methadone, and naltrexone products) for the

treatment of OUD. Medications are often combined with evidence-based psychosocial 

interventions tailored to an individual’s needs. This approach is a safe and effective strategy for 

decreasing the frequency and quantity of opioid misuse and reducing the risk of overdose and 

death. Recovery support services include linking patients and families to social, legal, housing, 

and other supports to improve retention in care and increase the probability of positive outcomes. 

 

Among people aged 12 or older in 2021, 3.3 percent (or 9.2 million people) misused opioids in the 

past year.106 CDC provisional data indicate there were 107,477 predicted drug overdose deaths 

106 Highlights for the 2021 National Survey on Drug Use and Health (samhsa.gov) 
218

in the United States during the 12-month period ending in August 2022, an increase of 3.3 percent 

from the 104,038 predicted deaths during the same period the year before.

107 In addition, there 

were an estimated 77,842 drug overdose deaths involving opioids for the 12-month period ending 

in August 2022, an increase of .01 percent from the 77,060 opioid-involved drug overdose deaths 

reported during the same period the year before.

108 Opioid overdose deaths increased in 2021 by 

26 percent underscoring the risks of potent illicit synthetic opioids and need to continue to engage 

people in a continuum of public health-focused harm reduction, treatment, and recovery services.109 

 

Targeted Capacity Expansion – Special Projects 

The Targeted Capacity Expansion-Special Projects (TCE-SP) program develops and implements 

targeted strategies for the provision of substance use disorder (SUD) treatment services to 

underserved populations and address unmet need identified by the community. The purpose of the 

program is to implement targeted strategies for the provision of SUD or co-occurring disorder 

(COD) public health-focused harm reduction, treatment, and/or recovery support services to 

support under-resourced populations or community-identified unmet needs. Diversity, equity, 

access, and inclusion are integrated in the provision of services and activities throughout the 

project including for example, when conducting eligibility assessments, outreach, and engagement 

or developing policies. 

 

TCE-SP also supports the Historically Black Colleges and Universities (HBCU) Center for 

Excellence (COE) in Behavioral Health. This five-year discretionary grant program established 

in 2017 is jointly administered by the Center for Mental Health Services (CMHS) and the Center 

for Substance Use Services (CSUS). The purpose of this program is to recruit college-level 

students for careers in the behavioral health field addressing mental and substance use disorders, 

provide training that can lead to careers in behavioral health, and/or prepare students to obtain 

advanced degrees in behavioral health. Grant recipient’s activities should emphasize education, 

awareness, and preparation for careers in mental and substance use disorder treatment. 

 

Budget Request 

 

The FY 2024 President’s Budget request is $157.9 million, an increase of $35.5 million from the 

FY 2023 Enacted level. Of this, the request for MAT-PDOA is $136.5 million, an increase of $25.5 

million from Enacted level, and $10 million to expand TCE to add a new program: the TCE - LowThreshold Housing First Pilot Project, which will address service needs and housing instability for 

people with SUDs and/or CODs. 

 

With this proposed funding, SAMHSA will award one new and 26 continuation TCE-SP grants, 

along with 10 new Low-Threshold Housing First Pilot Project cooperative agreements. 

Collectively, these grants are projected to serve over 5,000 individuals annually, an increase of 

107 Centers for Disease Control and Prevention, National Center for Health Statistics. Vital Statistics Rapid Release: 

Provisional Drug Overdose Death Counts. Available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdosedata.htm

108 Ibid 109 https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm
219 

about 2,000 individuals served from FY 2023. SAMHSA plans to fund 183 continuation and 29 

new MAT-PDOA grants and expects to serve between 12,000 and 14,000 people with substance 

use disorders. 

 

TCE - Low-Threshold Housing First Pilot Project ($10 million) 

The TCE - Low-Threshold Housing First Pilot program will address service needs and housing 

instability for people with substance use disorders (SUDs) and/or co-occurring substance use and 

mental disorders (CODs), regardless of where they are on the continuum of readiness to change. 

This program will combine services that span the continuum of public health-focused harm 

reduction, treatment, and recovery supports with housing and intensive case management, 

delivered based on individualized needs assessments, at home and in the community. With an 

expectation and requirement for supporting people taking a medication for opioid use disorder, 

including upon reentry from incarceration, this program aligns with ONDCP’s National Drug 

Control Strategy objective of engaging people through “low barrier to entry settings” engagement 

and supporting at-risk populations. 

 

The primary client-level outcomes for this program are housing attainment; reduced overdoses; 

increased access to and participation in public health activities, treatment, recovery support 

services; and education and employment activities. In addition, grantees will enhance coordinated 

efforts across health, housing, education, labor, criminal justice, and transportation. Based on 

other grant programs, SAMHSA anticipates a 95 percent increase in the number of clients served 

that are employed or attending school between intake and 6-month follow up, a 380 percent 

increase in the number of clients served that report having stable housing between intake and 6-

month follow up, and that awardees will screen 78 percent of clients for co-occurring mental health 

and substance use disorders, of which 81 percent will screen positive. 

 

Funding Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $100,192,000 

FY 2021 $100,192,000 

FY 2022 Final $112,192,000 

FY 2023 Enacted $122,416,000 

FY 2024 President's Budget $157,916,000 

 

Program Accomplishments 

 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT-PDOA) 

In FY 2022, SAMHSA funded 35 new and 122 continuation MAT-PDOA grants. During this 

year, 10,784 clients were served in the MAT-PDOA program. Based on 10,784 client intakes 
220 

assessments, and 3,797 client six-month follow-up reassessments, the recipients of MAT-PDOA 

services saw improvements across all National Outcome Measures (NOM). In FY 2023, the 

program has a target of serving 12,586 people. The NOMS are reported: 

 

 

Medication-Assisted Treatment for 

Prescription Drug and Opioid Addiction 

(MAT-PDOA) 

At Intake At 6-months percent change between 

intake and 6-months 

follow-up (n=10,784) (n=3,797) 

No past 30-day use alcohol/illegal drugs 38.0% 58.6% 54.3% 

No past 30-day arrest 94.1% 97.8% 4.0% 

Past 30-day employment or school 

attendance 

32.3% 47.9% 48.3% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

56.0% 75.0% 34.0% 

Past 30-day socially connectedness 86.5% 90.0% 4.1% 

Past 30-day permanent place to live in the 

community 

42.7% 50.4% 18.1% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias

 

In FY 2023, SAMHSA anticipates funding 24 new and 154 continuation MAT-PDOA grants. This 

year, SAMHSA has set a target of 12,586 clients served. 

 

Targeted Capacity Expansion – Special Projects 

In FY 2022, SAMHSA funded 22 new and 4 continuation TCE-SP grants along with the braided 

HBCU COE continuation grant. In FY 2022, the program achieved positive client outcomes for 

NOMs, improved mental health outcomes, reduced drug use and reduced risky behavior outcomes. 

Strategies utilized by the program included the following: 1) screening and assessing clients for 

the presence of SUD and/or COD and using the information obtained to develop appropriate harm 

reduction, treatment and/or recovery approaches; 2) providing evidence-based and populationappropriate harm reduction, treatment, and/or recovery approaches to meet the unique needs of 

diverse populations; 3) providing recovery support services designed to improve access and 

retention in services; 4) developing and implementing strategies that are inclusive and used to 

recruit and engage diverse people in care, ensuring those with the greatest need are being served 

by the program; 5) collaborating with trained community partners that can serve diverse 

populations to provide comprehensive services. 

 
221 

Based on 1,960 client intakes assessments, and 961 client six-month follow-up reassessments, the 

recipients of TCE-SP services saw improvements across all NOMS. The NOMS are reported:

 

TCE-SP At Intake At 6-months percent change between 

intake and 6-months 

follow-up (n=1,960) (n=961) 

No past 30-day use alcohol/illegal drugs 45.7% 63.3% 38.4% 

No past 30-day arrest 97.6% 98.7% 1.2% 

Past 30-day employment or school 

attendance 

43.0% 60.6% 40.9% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences 

69.1% 88.4% 28.0% 

Past 30-day socially connectedness 72.7% 73.1% 0.6% 

Past 30-day permanent place to live in the 

community 

36.5% 42.0% 15.2% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

 

In FY 2023, SAMHSA anticipates funding 3 new and 25 continuation TCE-SP grants along with 

the new braided HBCU COE grant. This year, SAMHSA has set a target of 2,844 client served. 
222 

Outcomes and Outputs 

 

Program: Medication-Assisted Treatment for Prescription Drug and Opioid Addiction 

 

Measure Year and Most 

Recent Result 

 

Target for Recent 

Result /

 

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

 

+/-FY 2023

Target

1.3.01 Number of 

admissions for 

Medication Assisted 

Treatment (Output) 

FY 2022: 10,784 

 

Target: 

12,461 

 

(Target Not Met) 

12,586 13,844 +1,258

1.3.03 Illicit drug use 

at 6-month follow-up 

(Outcome) 

FY 2022: 58.6 % 

 

Target: 

61% 

 

(Target Not Met) 

62 % 67 % +5 percentage 

point(s)

 
223 

Program: Treatment-Targeted Capacity Expansion: Special Projects 

 

Measure Year and Most Recent 

Result /1

 

Target for Recent Result 

/

 

(Summary of Result)

FY 2023

Target

FY 2024

Target/2

FY 2024

Target

 

+/-FY 2023

Target

1.2.25 Percentage of 

adults receiving 

services who had no 

past month substance 

use (Outcome) 

FY 2022: 69.6 % 

 

Target: 

62 % 

 

(Target Exceeded) 

63 % 64 % +1 percentage 

point(s) 

1.2.26 Number of 

clients served (Output) 

FY 2022: 2,856 

 

Target: 

2,815 

 

(Target Exceeded) 

2,844 5,000 +2,156 

22 a1.2.27 Percentage 

of adults receiving 

services who were 

currently employed or 

engaged in productive 

activities (Outcome) 

FY 2022: 58.7 % 

 

Target: 

59.1% 

(Target Not Met) 

60.1 % 61.1 % +1 percentage 

point(s) 

1.2.28 Percentage of 

adults receiving 

services who had a 

permanent place to live 

in the community 

(Outcome) 

FY 2022: 44.3 % 

 

Target: 

53.3 % 

 

(Target Not Met) 

54.3 % 55.3 % +1 percentage 

point(s) 

1.2.29 The percentage 

of adults receiving 

services who had no 

involvement with the 

criminal justice system 

(Outcome) 

FY 2022: 98.5 % 

 

Target: 

98.7 % 

 

(Target Not Met) 

99.7 % 99.7 % Maintain 

1/Target includes both TCE-SP and RCSP data

 
224 

Pregnant and Postpartum Women 

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 

+/- 

FY 2023

Pregnant and Postpartum Women............................................................................ $34,931 $38,931 $49,397 $10,466

Authorizing Legislation..................................Section 508 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................$29,931,000 

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

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description

The Pregnant and Postpartum Women (PPW) program uses a family-centered approach to provide

comprehensive residential substance use disorder treatment, prevention, and recovery support 

services for pregnant and postpartum women, their minor children, and other family members 

(e.g., fathers of the children). Section 501 of the Comprehensive Addiction and Recovery Act 

(CARA) increased accessibility and availability of services for pregnant women by expanding the 

authorized purposes of the PPW program to include the provision of outpatient and intensive 

outpatient services for pregnant women. CARA requires that twenty-five percent of all PPW funds 

support these ambulatory services. The PPW program provides services not covered under most 

public and private insurance and includes the Pregnant and Postpartum Women – Residential 

Treatment (PPW-R) program and Pregnant and Postpartum Women – Pilot (PPW-PLT) programs. 

Pregnant and Postpartum Women – Residential Treatment (PPW-R)

The PPW-R program provides services for pregnant and postpartum women for treatment of 

substance use disorders through programs in which: 1) the women reside in funded facilities; 2) 

the minor children of the women reside with the women in such facilities, at the request of the 

women; 3) the family members as designated by the women receive services; and 4) facilities 

providing these services are in locations accessible to low-income women. The PPW-R familycentered approach includes a variety of services and case management for women, children, and 

families. Interventions include outreach, substance use disorder assessment, public health harm 

reduction services, tobacco cessation therapies, FDA-approved medication for OUD, and recovery 

support services. Services available to children through the PPW-R program include screening and 

developmental diagnostic assessments addressing social, emotional, cognitive, and physical wellbeing; and interventions related to mental, emotional, and behavioral wellness. The PPW-R 

program also includes assessment for Fetal Alcohol Syndrome Disorders. 

Pregnant and Postpartum Women – Pilot (PPW-PLT)

PPW-PLT program enhances the flexibility in the use of funds to support family-based services 

for pregnant and postpartum women with primary substance use disorders, emphasizing the 
225 

treatment of opioid use disorders; helping state substance use agencies address the continuum of 

care, including services provided to pregnant and postpartum women in nonresidential-based 

settings; and promoting a coordinated, effective and efficient state system managed by state 

substance use agencies by encouraging new approaches and models of service delivery.

 

Budget Request

The FY 2024 President’s Budget request is $49.4 million, an increase of $10.5 million from the 

FY 2023 Enacted level. SAMHSA plans to award seven new and six continuation PPW-pilot 

grants, as well as 17 new and 50 continuation residential treatment grants to provide an array of 

services and supports to pregnant women and their families. 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $31,931,000 

FY 2021 $32,766,850 

FY 2022 Final $34,931,000 

FY 2023 Enacted $38,931,000 

FY 2024 President's Budget $49,397,000 

Program Accomplishments

Pregnant and Postpartum Women – Residential Treatment (PPW-R)

The PPW-R has demonstrated benefits in the following areas: increasing access to medications 

for substance use disorders, mental disorders, and primary health conditions; integrates peer 

recovery approaches to engage and retain women in care; incorporating home visiting as part of 

the continuum of care, and as a key strategy to extending services to support recovery; and 

providing opportunities to increase access to care for diverse populations of women, particularly 

for those living in rural and remote locations in southern states. 

In FY 2022, SAMHSA funded 23 new and 24 continuation PPW residential treatment grants. In 

FY 2022, the program served 1,288 women. Of the women served:

• 34.6 percent used methamphetamine 

• 31.7 percent used marijuana 

• 20.8 percent use any alcohol

• 18.8 percent used heroin 

• 15.4 percent used cocaine 

Program accomplishments were achieved despite challenges PPW grantees have experienced 
226 

coming out of the COVID-19 pandemic and workforce shortages. To overcome some of these 

challenges, SAMHSA has held quarterly learning communities during which external experts and 

grantees share successful strategies and best practices for mutual problem solving Based on 1,288 

client intakes assessments, and 451 client six-month follow-up reassessments, the recipients of 

PPW-R services saw improvements across all National Outcome Measures (NOMS) data are 

displayed below. 

Pregnant and Postpartum Women - 

Residential

At Intake At 6-months percent change between 

intake and 6-months 

follow-up (n = 1,288) (n = 451)

No past 30-day use alcohol/illegal drugs 28.6% 85% 197.7%

No past 30-day arrest 89.0% 98.4% 10.6%

Past 30-day employment or school 

attendance 

8.4% 40.4% 378.9%

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

37.1% 83.9% 125.9%

Past 30-day socially connectedness 87.9% 96.7% 9.9% 

Past 30-day permanent place to live in the 

community

20.7% 31.8% 53.8%

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

In FY 2023, SAMHSA anticipates funding 23 new and 30 continuation PPW residential treatment 

grants to provide an array of services and supports to pregnant women and their families. This 

year, the PPW Residential program has a target of serving 12,586 people, of which, 1,929 are 

women. 

￼

Pregnant and Postpartum Women – Pilot (PPW-PLT)

In FY 2022, SAMHSA funded nine PPW-PLT continuation grants. During this year, the PPW - 

Pilot program severed 935 women. Of the women served:

• 37.9 percent used marijuana 

• 10.1 percent used methamphetamine 

• 9.2 percent use any alcohol 

• 4.1 percent used heroin 

• 3.3 percent used cocaine 
227 

Based on 935 client intakes assessments, and 188 client six-month follow-up reassessments, the 

following National Outcome Measures are reported: 

Pregnant and Postpartum Women - Pilot At Intake At 6-months +/_percent change 

between intake and 6-

months follow-up

(n = 935) (n = 188)

No past 30-day use alcohol/illegal drugs 53.6% 72.6% 35.4%

No past 30-day arrest 95.8% 96.4% 0.6%

Past 30-day employment or school 

attendance 

47.5% 61.3% 29.1%

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

88.3% 89.6% 1.5%

Past 30-day socially connectedness 85.4% 84.8% (-) 0.8% 

Past 30-day permanent place to live in the 

community

55.6% 56.7% 2.0%

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

SAMHSA’s CSUS Children and Families Team hosted quarterly learning communities where 

staff, grantees and guest Subject Matter Experts shared learning from successful and unsuccessful 

project implementation and data collection experiences to deepen the collective knowledge and 

share best practices to overcome barriers. 

In FY 2023, SAMHSA anticipates funding six new PPW-PLT grants and four PPW-PLT 

continuation grants. 
228 

Outputs and Outcomes

Program: Pregnant and Postpartum Women Program 

Measure Year and Most Recent 

Result /1

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target/2

FY 2024

Target

+/-FY 2023

Target

1.2.84 Number of 

admissions of women who 

are currently pregnant or 

have a child to substance 

abuse treatment programs 

(Output)

FY 2022: 1,288

Target:

1,312

(Target Not Met)

1,929.0 2,122 +193 

1.2.85 Percentage of PPW 

clients reporting no drug use 

in the past month at six 

month follow-up (Outcome)

FY 2022: 85.0%

Target: 86.8%

(Target Not Met)

87.0 92.0 +5 

1.2.86 Percentage of PPWPLT clients who reported 

substance misuse at intake, 

percent who report reduction 

in substance misuse at six 

month follow-up (Outcome)

FY 2022: 72.6%

Target: 78.9%

(Target Not Met)

79.6 84.6 +5 

1.2.87 Percentage of PPW 

clients who reported 

child/children not living 

with client at intake, percent 

who report child/children is 

living with client at six 

month follow-up (Outcome)

FY 2022: 56.4% 

Target: 50.0%

Target Exceeded

51.0 56.0 +5 

1.2.88 Number of PPW-PLT 

women who are currently 

pregnant or have a child 

who receive SUD and 

related treatment services 

(Outcome) (Outcome)

FY 2022: 935

Target: 394

576.0 634.0 + 58 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias. 
229 

Improving Access to Overdose Treatment

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final

President's 

Budget/1 

President's 

Budget

FY 2024 

+/- 

FY 2023

Improving Access to Overdose Treatment ............................................................ $1,000 $1,500 $1,500 ---

Authorizing Legislation..................................Section 544 of the Public Health Service Act 

FY 2024 Authorization ....................................................................................................$5,000,000 

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

Eligible Entities ...... Federally qualified health center (as defined in section 1861(aa) of the Social 

Security Act), an opioid treatment program under part 8 of title 42, Code of Federal Regulations, 

any practitioner dispensing narcotic drugs pursuant to section 303(h) of the Controlled 

Substances Act, or any other entity that the Secretary deems appropriate

Program Description

The Improving Access to Overdose Treatment (ODTA) program supports awards to Federally 

Qualified Health Centers (FQHCs), Opioid Treatment Programs, and practitioners who prescribe 

buprenorphine to expand access to Food and Drug Administration (FDA)-approved drugs or 

devices for emergency treatment of known or suspected opioid overdose. Grant recipients serve 

individuals at high risk for opioid overdose by partnering with other prescribers at the community 

level to develop best practices for prescribing and co-prescribing FDA-approved overdose reversal 

drugs. The ODTA program is a key component of the public health response to the overdose 

epidemic. It uses a combination of community-based public health prevention and harm reduction 

strategies across the prevention continuum to mitigate the impact of the overdose epidemic within 

communities. These community-based public health prevention efforts serve the high-risk 

population outside of substance use treatment facilities and can serve as an important engagement 

point to treatment for people with substance use disorders. 

CDC provisional data indicate there were 107,477 predicted drug overdose deaths in the United 

States during the 12-month period ending in August 2022, an increase of 3.3 percent from the 

104,038 predicted deaths during the same period the year before.110 In addition, there were an 

estimated 76,683 drug overdose deaths involving opioids for the 12-month period ending in 

August 2022, a decrease of 0.49 percent from the 77,060 opioid-involved drug overdose deaths 

reported during the same period the year before.111

110 Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health 

Statistics. 2023. Accessed January 25, 2023. Available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

111 Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health 

Statistics. 2023. Accessed January 25, 2023. Available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
230 

Budget Request

The FY 2024 President’s Budget request is $1.5 million, level with the FY 2023 Enacted level. 

SAMHSA will support seven continuation grants to continue increasing access to treatment, 

reducing unmet treatment need, and reducing opioid overdose related deaths through the provision 

of prevention, harm reduction, treatment, and recovery activities for opioid use disorder. 

Funding History Table

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $1,000,000 

FY 2021 $1,000,000 

FY 2022 Final $1,000,000 

FY 2023 Enacted $1,500,000 

FY 2024 President's Budget $1,500,000 

Program Accomplishments

In FY 2022, SAMHSA funded five ODTA continuation grants to continue increasing access to 

treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through 

the provision of prevention, treatment, and recovery activities for opioid use disorder. Grantees 

reported 1,864 physicians, pharmacists, and other healthcare professionals were trained in FY 2022 

on prescribing FDA- approved opioid-overdose reversal drugs or devices for emergency treatment 

of known or suspected opioid overdose. Although this did not meet the target set at 2,141, this was 

a marked improvement over the 595 individuals trained in FY 2021. 

In FY 2023, SAMHSA anticipates funding seven new grants to continue increasing access to 

treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through 

the provision of prevention, treatment, and recovery activities for opioid use disorder. This year, 

the ODTA program will focus its efforts on Trainer of Trainer Models (ToT) that will expand its 

scope to secondary and higher educational settings to reach future prescribers and train them in 

best practices on prescribing opioids. This approach will focus on demographic populations in 

rural and urban areas with the highest incidence of opioid overdose rates and substance use 

disorders to address the increasing overdose deaths in the U.S. The training curriculums will focus 

on reducing stigma using a culturally informed approach and scale up ToT models in person, 

virtually or hybrid settings to reach health care providers and pharmacists who will also train future 

providers in their regions. This program is moving from a grant to a cooperative agreement to 

enhance technical assistance opportunities and to develop resources for states and communities. 

The proposed number of grants to be funded is seven awards at $200,000 per year for up to five 

years. Eligibility is limited to FQHCs (as defined in section 1861(aa) of the Social Security Act), 

opioid treatment programs as defined under part 8 of title 42, Code of Federal Regulations, and 

practitioners dispensing narcotic drugs pursuant to section 303(g) of the Controlled Substances 

Act (including secondary and higher education settings). 
231 

Outputs and Outcomes 

Program: Improving Access to Overdose Treatment (ODTA)

Measure 2022 Result 

Target for 2022 Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

5.2.1 Number trained on 

prescribing FDAapproved opioid-overdose 

reversal drugs or devices 

for emergency treatment 

of known or suspected 

opioid overdose. (Output)

FY 2022: 1,864

Target:

2,141.0

(Target Not Met, but 

Improved)

2,141.0 2,141.0 Maintain
232 

Building Communities of Recovery (BCOR)

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 

+/- 

FY 2023

Building Communities of Recovery........................................................................ $13,000 $16,000 $28,000 $12,000

Authorizing Legislation ............................................. Section 547 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................$5,000,0000 

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

Eligible Entities . .....................Recovery Community Organizations (RCOs) that are domestic 

private nonprofit communities in states, territories, or tribes that are led and governed by 

representatives of local communities of recovery. Only organizations wholly or principally 

governed by people in recovery for substance use disorders who reflect the community served 

are eligible. 

Program Description 

Peer services play a vital role in assisting individuals in achieving recovery from substance use 

disorders. Recovery Community Organizations (RCOs) are central to the delivery of those 

services. In FY 2017, SAMHSA launched the Building Communities of Recovery (BCOR) grant 

program. This program mobilizes resources within, and outside of the recovery community to 

increase the prevalence and quality of long-term recovery support from substance use disorder. 

These grants are intended to support the development, enhancement, expansion, and delivery of 

recovery support services (RSS) as well as the promotion of and education about recovery. They 

are administered and implemented by individuals with lived experience who are in recovery from 

SUD and COD and reflect the needs and population of the community being served. 

. 

￼Budget Request

The FY 2024 President’s Budget Request is $28 million, an increase of $12 million from the 

FY 2023 Enacted level. SAMHSA plans to support 58 new grants and 32 continuation grants for 

the BCOR program serving 3,566 clients. The funding increase will further enhance coverage and 

integration of recovery support services in order to promote access to and use of these services. 

The BCOR program relies heavily on the peer support of others in recovery. Investing in peer 

recovery services bolsters a strong community of shared life experiences and a wealth of practical 

knowledge among program participants. With increased investment, SAMHSA is responding 

directly to concerns from the recovery community that more funding is needed to provide the full 

range of recovery services. This proposed increase also supports ONDCP’s priority of increasing 

the number of peer-led recovery community organizations and certified recovery residences by 25 

percent in 2025.112

112 https://www.whitehouse.gov/wp-content/uploads/2022/04/2022Performance-Reporting-System.pdf
233 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $12,000,000 

FY 2021 $12,000,000 

FY 2022 Final $13,000,000 

FY 2023 Enacted $16,000,000 

FY 2024 President's Budget $28,000,000 

Program Accomplishments

In FY 2022, SAMHSA funded 13 new and 44 continuation BCOR grants. During this year, 

several grantees identified goals of public education and outreach. One grantee in Colorado 

Springs produced and disseminated awareness videos as part of a campaign to reduce the stigma 

surrounding addiction and encourage hope for recovery. Another grantee in Tennessee hosted a 

successful Town Hall meeting with 70 individuals including school personnel, church or faith 

community members, civic leaders and state and local government officials, and law enforcement, 

courts, and detention facility staff. From the post-event feedback form, more than 70 percent of 

respondents ‘strongly agreed’ that the event offered insights into how to support individuals 

through the recovery process and 43 percent ‘strongly agreed’ that the event increased their 

knowledge and understanding of the recovery process. 

In FY 2022, one grantee in Massachusetts established and expanded a 24/7 Recovery Support 

Hotline that now has 15 Recovery Coaches, two of whom are bilingual in English and Spanish. In 

the second half of FY 2022 the Hotline received 307 unduplicated calls and texts with callers 

requesting assistance from a Recovery Coach, and treatment referrals, including 288 unduplicated 

calls. 

In FY 2022, 4,254 clients were served through SAMHSA’s BCOR Program. Based on 4,254 

client intakes assessments, and 1,987 client six-month follow-up reassessments, the following 

National Outcome Measures are reported:

Comprehensive Addiction and Recovery 

Act: Building Community

At Intake At 6-months Percent +/- change 

between intake and 6-

months follow-up (n=4,254) (n=1,987)

No past 30-day use alcohol/illegal drugs 60.2% 76.3% 26.7%

No past 30-day arrest 94.6% 98.3% 3.9%

Past 30-day employment or school attendance 40.8% 63.8.8% 56.4%

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

64.6% 78.2% 21.1%
234 

Past 30-day socially connectedness 83.3% 88.9% 6.7%

Past 30-day permanent place to live in the 

community

34.9% 44.6% 27.8%

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

In FY 2023, SAMHSA anticipates funding 18 new and 43 continuation BCOR grants to develop, 

expand, and enhance recovery support services. This year, the program has a target to serve 2,972 

clients. 

BCOR grantees conduct ongoing outreach to build relationships and expand their referral and 

engagement network for clients. Grantees prioritized many sectors and populations including: 

mental health, LGBTQI+, veterans, justice involved, Blacks/African Americans, Indigent, 

Hispanic and Spanish-speaking. 

Other BCOR grant recipients have prioritized expanding Recovery Oriented Systems of Care 

(ROSC), including adding Tribal members, LGBTQI+ community centers, non-profits fighting 

human trafficking, and peer recovery support programs. 

As a requirement of the BCOR grant, grantees prioritize lived experience first and foremost, 

allowing coaches to draw upon their insights, challenges and lessons learned when working with 

members. One grantee developed their own internal assessments used to determine the depth of 

lived experience, which helps the organization understand how well prospective coaches will relate 

to members in coaching sessions. 

Additionally, grantees have also helped families by providing family coaching and various efforts

including but not limited to food and clothing assistance as well as job placement. They hold 

Family Recovery meetings/groups to give the families their own time and their own meeting to 

discuss their obstacles. Aside from family events, they also provide weekly events, daily 

education, and nightly meetings at Resource Centers. Furthermore, they have spent a lot of time 

and resources doing community outreach to educate the community. BCOR grantees have longterm good standing relationships within the community and disseminate resources not only to 

individuals struggling with SUD but to their support systems as well. 
235 

Outputs and Outcomes 

Program: Building Communities for Recovery 

Measure Year and Most Recent 

Result /1

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target/2

FY 2024

Target

+/-FY 2023

Target

1.2.80 Number of clients 

receiving recovery 

services (Output)

FY 2022: 4,254

Target:

2,942

(Target Exceeded

2,972.0 4,254 +594 

1.2.81 Percent of clients 

who report not having 

stable housing at baseline 

who report having stable 

housing at six-month 

follow-up (Outcome)

FY 2022: 44.6%

Target:

35.4%

(Target Exceeded) 

36.4% 41.4% +5 

1.2.82 Percent of clients 

who report not being 

employed (full-time or 

part-time) or in school at 

baseline who report 

having employment or 

being in school at followup (Outcome)

FY 2022: 63.8%

Target:

65.6% 

(Target Not Met)

66.6% 71.6% +5 
236 

Recovery Community Services Program

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Recovery Community Services Program................................................................ $2,434 $4,434 $5,151 $717

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2024 Authorization ................................................................................................$521,517,000 

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

Eligible Entities .. Family/Consumer Controlled Organizations, Domestic Public and Private NonProfit Organizations in States, Territories, and Tribes, Recovery Community Organizations of 

Domestic Private Non-Profit Entities in States, Territories, and Tribal Organizations 

Program Description

In 2021, 46.3 million people aged 12 or older (or 16.5 percent) had a substance use disorder (SUD) 

in the past year, including 29.5 million who had an alcohol use disorder, 24.0 million who had a 

drug use disorder, and 7.3 million people who had both an alcohol use disorder and a drug use 

disorder.113 As public education increases, there is broader acknowledgement of substance use 

disorder as a treatable condition that can be successfully managed over the course of a lifetime 

with the appropriate resources. More people in recovery are now willing to be open about their 

own recovery and to share their experience to help others attempting to achieve recovery. Through 

the use of their lived experience, individuals in recovery can provide support and hope to those 

newly seeking recovery. 

The Recovery Community Services Program (RCSP) is designed to assist recovery communities 

with strengthening their infrastructure and provide direct peer recovery support services to those 

in or seeking recovery from substance use disorders or co-occurring substance use and mental 

disorders across the nation. The delivery of recovery support services (RSS) by people in recovery 

is known as peer recovery support services (PRSS). SAMHSA initiated the RCSP to help build an 

infrastructure for PRSS programs to support the development and expansion of peer recovery 

services. These peer services are most frequently offered by Recovery Community Organizations 

(RCOs). 

RCSP – Statewide Network (RCSP-SN) program

The RCSP – Statewide Network (RCSP-SN) program was established to further strengthen 

Recovery Community Organizations (RCOs), similar organizations, and their statewide network 

of recovery stakeholders as key partners in the delivery of state and local recovery support services 

(RSS). Other key partners include the specialty and general health care systems, state and local 

public health departments, payers, and other systems that collaborate with RCOs and the statewide 

recovery network to foster systems improvement, public health messaging, and training conducted 

with, and for, key recovery stakeholder organizations. By partnering with traditional SUD 

113 https://www.samhsa.gov/data/release/2021-national-survey-drug-use-and-health-nsduh-releases
237 

providers and other purchasers of RSS, RCSP-SN grantees strengthen and embed critical RSS 

service elements as part of the Recovery Oriented Systems of Care (ROSC) landscape.

Budget Request

The FY 2024 President’s Budget Request is $5.2 million, an increase of $0.7 million from the 

FY 2023 Enacted level. SAMHSA plans to award two new and 12 continuation RCSP grants

serving 915 clients, as well as two continuation RCSP-SN grants. 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $2,434,000 

FY 2021 $2,512,107 

FY 2022 Final $2,434,000 

FY 2023 Enacted $4,434,000 

FY 2024 President's Budget $5,151,000 

Program Accomplishments

In FY 2022, SAMHSA funded eight RCSP continuation grants. This year, the clients served target 

was 806 individuals. SAMHSA exceeded this target, reaching a total of 896 individuals. 
238 

During FY 2022, 896 clients were served in the RCSP. Based on 896 client intakes assessments, 

and 562 client six-month follow-up reassessments, the following National Outcome Measures are 

reported: 

Recovery Community Services Program 

(RCSP) - Services

At Intake At 6-months percent change between 

intake and 6-months 

follow-up

(n=896) (n=562)

No past 30-day use alcohol/illegal drugs 68.3% 80.4% 17.6% 

No past 30-day arrest 96.4% 98.2% 1.9% 

Past 30-day employment or school attendance 33.3% 55.4% 66.3% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

81.1% 87.4% 7.8% 

Past 30-day socially connectedness 89.8% 93.6% 4.2% 

Past 30-day permanent place to live in the 

community

32.2% 48.1% 49.4% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

In FY 2022, grant recipients expanded trainings to include mental health first aid, de-escalation, 

trauma informed care, and increasing awareness of community resources through direct contact 

and exchange of information. In addition, grantees, recognizing the role of social support in 

enhancing the recovery experience, connected clients to ancillary services such as recreational 

activities, financial literacy, wellness and yoga sessions, intensive outpatient groups for alcohol 

and opioid use disorders to address community need. One grantee was successful in expanding 

their network and partnering with additional human services agencies and workforce development 

agencies resulting in 243 participants enrolled in their services. 

One RCSP grantee established a recovery café serving women and families and included. 

transportation for people to get to and from this recovery community. The program trained nine 

peer recovery coaches, completed 22 naloxone trainings and established 35 community 

partnerships. Through intentional targeted outreach and recruitment, another grant recipient was 

able to broaden the demographics within their coaching pool, adding more women, a transgender 

individual, and people who identify as Black, Indigenous, People of Color (BIPOC). By April 

2022, the pool of active coaches had grown to 27. 

One grantee established an ongoing partnership with their Fire Department (FD) to integrate 

Recovery Centers into FD Safe Stations expanding outreach and engagement in response to 

crises/high risk episodes. Since January 2022, the FD Safe Stations Project has responded to 13 

requests from local fire stations within the city. Their trained recovery coaches respond within one 

hour and 90 percent of people they encounter leave with overdose prevention, and other 

educational materials. The program also extends to working with FD first responders to offer 

support and promote engagement for individuals encountered when emergency medical 

technicians are dispatched to respond to potential overdoses or other substance use-related crises.
239

Grantees report ongoing challenges with recruiting participants from Treatment Centers, 

Emergency rooms, senior centers, veteran facilities, and healthcare clinics as community partners 

are still reluctant to allow outside providers in their facilities to minimize the spread of illness, 

including COVID 19, within their facilities. Despite those barriers, grantees continue to increase 

their network of partners and successfully enroll individuals into their recovery support services. 

In FY 2023, SAMHSA anticipates funding four new and eight continuation RCSP grants and two 

new RCSP-SN grants. SAMHSA started supporting the RCSP-SN program again in FY 2023. 
240 

Children and Families

(Dollars in thousands) 

Authorizing Legislation ............................................. Section 514 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................$29,605,000 

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

Eligible Entities ............................................................................... Single State Agencies in States,

Territories, District of Columbia, public and private non-profit entities,

Federally Recognized American Indian/Alaska Native Tribes Tribal Organizations, 

and health facilities or programs operated by or in accordance with a contract or 

grant with the Indian Health Service 

Program Description

SAMHSA’s Children and Families programs support youth-friendly treatment initiatives to further 

the use of, and access to, evidence-based family-focused models for youth with alcohol and/or 

other substance use disorders. In addition, programs support training across participating states 

and collaboration between local community-based providers and their state, tribal, or territorial 

infrastructure. The services provided include evidence-based assessment, treatment, prevention,

recovery supports, public health-focused harm reduction interventions, and medication for opioid 

use appropriate for adolescents and young adults. This program supports the Enhancement and 

Expansion of Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and 

their Families (YFTREE) grant and National Center on Substance Abuse and Child Welfare 

(NCSACW) contract. 

Enhancement and Expansion of Treatment and Recovery Services for Adolescents, Transitional 

Aged Youth, and their Families (YFTREE) 

The YFTREE program enhances and expands comprehensive outpatient-based treatment, early 

intervention, and recovery support services for adolescents (ages 12-18) and transitional aged 

youth (ages 16-25) with substance use disorders (SUD) and/or co-occurring substance use and 

mental disorders (COD), and their families/primary caregivers. The services include screening, 

assessment, treatment, and wraparound services in ambulatory settings. 

National Center on Substance Abuse and Child Welfare (NCSACW) 

SAMHSA and the Administration for Children and Families (ACF) collaborate to support the 

NCSACW contract. NCSACW provides training and technical assistance to improve collaborative 

practices among agencies and organizations that serve families affected by substance use disorders 

and have involvement with child welfare services. 

Budget Request

The FY 2024 President’s Budget Request is $30.2 million, level with the FY 2023 Enacted level. 

 FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Children and Families............................................................................................ $29,605 $30,197 $30,197 ---
241 

SAMHSA plans to award one new and 52 continuation YFTREE grants, estimated to serve 1,740 

people. 

Funding History Table 

Program Accomplishments

In FY 2022, SAMHSA funded 51 Youth and Family Tree (YFTREE) continuation grants. 

During FY 2022, 2,924 clients were served through the YFTREE Program. Based on 2,924 

client intakes assessments, and 1,338 client six-month follow-up reassessments, the following 

National Outcome Measures are reported:

Youth and Family TREE (YFTREE)

At Intake At 6-months percent change between 

intake and 6-months 

follow-up (n=2,924) (n=1,338) 

No past 30-day use alcohol/illegal drugs 44.3% 66.3% 49.5% 

No past 30-day arrest 96.0% 98.0% 2.0% 

Past 30-day employment or school attendance 83.5% 85.5% 2.4% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

81.9% 87.6% 7.0% 

Past 30-day socially connectedness 63.0% 68.7% 9.0% 

Past 30-day permanent place to live in the 

community

66.9% 69.4% 3.8% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, , 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

In FY 2023, SAMHSA anticipates funding 34 new and 18 continuation Youth and Family Tree 

(YFTREE) grants. This year, the Children and Families program has a target to serve 1,723 people.

Consistent with local and national behavioral health workforce trends, YFTREE programs 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $29,605,000 

FY 2021 $29,605,000 

FY 2022 Final $29,605,000 

FY 2023 Enacted $30,197,000 

FY 2024 President's Budget $30,197,000 
242

experienced staff hiring and retention challenges. Barriers to engaging adolescents and young 

adults over an extended period is a transition that comes with this population and affects program 

performance. Retaining parents/families is a recurring challenge. The prevalence and state 

legalization of cannabis use pose challenges among the YFTREE population. 

The SAMHSA Children and Families Team emphasized prioritization of outreach efforts, 

continuous and frequent outreach activities coupled with the implementation of the evidence-based 

practice contingency management and public health-focused harm reduction intervention to 

counter barriers to engagement and retention of adolescents, youth adults, and families in 

treatment.
243 

Outputs and Outcomes 

Program: Enhancement and Expansion of Treatment and Recovery for Adolescents, 

Transitional Aged Youth, and their Families

Measure Year and Most Recent 

Result

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.00.2 Percentage of 

adults receiving services 

who had no past 

substance use (Outcome)

FY 2022: 66.3

Target: 

62.0

(Target Exceeded)

63.0 64.0 +1 

2.00.3 Number of clients 

served (Output)

FY 2022: 2,924 

Target:

1,706.0

(Target Exceeded) 

1,723.0 2,924 +1,201 

2.00.4 Percentage of 

adults receiving services 

who were currently 

employed or engaged in 

productive activities 

(Outcome)

FY 2022: 85.5

Target:

79.0

(Target Exceeded) 

80.0 81.0 +1 

2.00.5 Percentage of 

adults receiving services 

who had a permanent 

place to live in the 

community (Outcome)

FY 2022: 85.5

Target:

64.0

(Target Exceeded)

65.0 66.0 +1 

2.00.6 Percentage of 

adults receiving services 

who had no involvement 

with the criminal justice 

system (Outcome)

FY 2022: 98.0

Target:

99.0

(Target Exceeded) 

100.0 100.0 Maintain
244 

Treatment Systems for Homeless

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Treatment Systems for Homeless............................................................................ $36,386 $37,114 $37,114 ---

Authorizing Legislation ............................................. Section 506 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................$41,304,000 

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

Eligible Entities .................................................... Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description

On a single night in January 2022, 582,462 people were experiencing homelessness in the United 

States. Of these, 138,361 were experiencing chronic homelessness, 122,888 had severe mental 

illness, 95,001 were affected by chronic substance use, and 33,129 were veterans.114 Many factors 

contribute to the problem of homelessness, including lack of affordable housing, foreclosures, 

rising housing costs, job loss, underemployment, mental illness, and alcohol and other drug misuse 

and use disorders. The U.S. Interagency Council on Homelessness, in which HHS participates, 

has set aggressive goals to prevent and end homelessness. These goals include ending 

homelessness among veterans, people with disabilities, families with children, families, youth, and 

all other individuals. 

SAMHSA’s Treatment Systems for Homeless portfolio, that includes programs from across the 

agency, supports services for those with substance use disorders, mental illness, or co-occurring 

mental and substance use disorders who are experiencing homelessness, including youth, veterans, 

and families. The services and support offered through SAMHSA’s Treatment Systems for 

Homeless programs are crucial to achieving U.S. Interagency Council on Homelessness’s goals. 

The Grants for the Benefit of Homeless Individuals (GBHI) program managed in CSUS supports 

the development and/or expansion of local implementation of a community infrastructure that 

integrates treatment and recovery support services for substance use disorders or co-occurring 

mental and substance use disorders, permanent housing, and other critical services for individuals 

(including youth) and families experiencing homelessness. 

Budget Request

The FY 2024 President’s Budget Request is $37.1 million, level with the FY 2023 Enacted level. 

SAMHSA intends to fund 15 new and 62 continuation GBHI grants with a target to serve 

4,237people. 

114 U.S. Department of Housing and Urban Development (HUD) 2022 Continuum of Care (CoC) Homeless 

Assistance Programs Homeless Populations and Subpopulations Report – Retrieve from 

https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2022.pdf 
245 

Funding History Table

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $36,386,000 

FY 2021 $36,386,000 

FY 2022 Final $36,386,000 

FY 2023 Enacted $37,114,000 

FY 2024 President's Budget $37,114,000 

Program Accomplishments

In FY 2022, SAMHSA funded 18 new grants and 69 continuation GBHI grants. During this year, 

the program achieved positive client outcomes for National Outcome Measures (NOMs), 

improved mental health outcomes, and reduced drug use outcomes. Strategies utilized by the 

program included the following: (1) Engaging and connecting the population of focus to 

behavioral health treatment, public health-focused harm reduction services, case management, and 

recovery support services; (2) Assisting with identifying sustainable permanent housing by 

collaborating with homeless services organizations and housing providers, including public 

housing agencies; and (3) Providing case management that includes care coordination/service 

delivery planning and other strategies that support stability across services and housing transitions. 

Challenges, though, continue as potential clients live in congregate settings (e.g., shelters) that 

periodically may be closed to external organizations. For enrolled clients, the program utilizes a 

combination of in-person and virtual service provision to maintain contact with clients and provide 

services.

In FY 2022, the program served 4,237 clients during the year. Based on 4,237 client intake 

assessments and 2,131 client six-month follow-up reassessments, the following National 

Outcome Measures are reported:

Grants for the Benefit of Homeless 

Individuals (GBHI)

At Intake At 6-months Percent +/-change 

between intake and 6-

months follow-up

(n=4,237) (n=2,131)

No past 30-day use alcohol/illegal drugs 44.0% 58.1% 32.1%

No past 30-day arrest 95.4% 97.9 2.5%

Past 30-day employment or school attendance 26.2% 42.8% 62.9%

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

63.1% 75.6% 19.7%

Past 30-day socially connectedness 70.6% 77.6% 10.0%

Past 30-day permanent place to live in the 

community

9.1% 29.4% 224.1%

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 
246

http://spars.samhsa.gov Based on 4,237 client intakes assessments, and 2,131 client six-month follow-up reassessments. 

Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and 

selection bias.

In FY 2023, SAMHSA anticipates funding 31 new grants and 51 continuation GBHI grants. The 

program anticipates serving 4,237 clients during this year. 

.. 
247 

Outputs and Outcomes 

Program: Treatment System for Homelessness (GBHI)

Measure Year and Most Recent 

Result 

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

3.4.23 The number of 

clients served (Output)

FY 2022: 4,237

Target:

4,003

 (Target Exceeded)

4,043 4,237 +194 

3.4.24 Percentage of 

homeless clients 

receiving services who 

were currently employed 

or engaged in productive 

activities (Outcome)

FY2022: 42.8%

Target:

35.9%

 

(Target Exceeded) 

36.9 % 37.9 % +1 percentage 

point(s)

3.4.25 Percentage of 

clients receiving services 

who had a permanent 

place to live in the 

community (Outcome)

FY2022: 29.4%

Target:

30.9%

(Target Not Met)

41.9 % 42.9 % +1 percentage 

point(s)
248 

Criminal Justice Activities

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Criminal Justice Activities....................................................................................... $89,000 $94,000 $124,380 $30,380

Other Criminal Justice Activities (non-add).................................................... 19,000 20,000 19,380 -620 

Drug Court Activities (non-add).......................................................................... 70,000 74,000 105,000 31,000 

Authorizing Legislation ................................................... Section 509 of the Public Health Service 

FY 2024 Authorization ................................................................................................$521,517,000 

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

Eligible Entities ........ States; local, Tribal, and territorial governments; Tribal organizations; nonprofit community-based organizations; and primary and behavioral health organizations 

Program Description

SAMHSA’s Criminal Justice Activities portfolio includes several grant programs that focus on 

diversion, alternatives to incarceration, drug courts, and re-entry from incarceration for adolescents 

and adults with alcohol and other drug use disorders and/or co-occurring alcohol and other drug 

use disorders and mental illness. This program supports the Adult Treatment Drug Court (ATDC), 

Family Treatment Drug Court (FTDC), and the Adult Reentry (AR) programs.

Referral Source for Substance Use Disorder Treatment

The criminal justice system is a major source of referrals to substance use disorder treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.115 Most probation or parole referrals to treatment are men between the ages of 18 and 

44. The most commonly used substances reported by these individuals are alcohol, marijuana, and 

methamphetamine.116 

Drug Courts 

Estimates of substance use disorders among prison and jail populations range from 53 to 68 

percent, in stark contrast to approximately 14.5 of those 12 years and older in the general public117. 

Similar trends exist among those with co-occurring mental and substance use disorders – 33 to 60 

115 Substance use And Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 

Treatment Episode Data Set (TEDS): 2005-2015. National Admissions to Substance Abuse Treatment Services. 

BHSIS Series S-91, HHS Publication No. (SMA) 17-5037. Rockville, MD: Substance Abuse and Mental Health 

Services Administration, 2017.

116 SAMHSA. (2022). Criminal and Juvenile Justice. Retrieved from http://www.samhsa.gov/criminal-juvenilejustice

117 https://store.samhsa.gov/product/Guidelines-for-Successful-Transition-of-People-with-Mental-or-Substance-UseDisorders-from-Jail-and-Prison-Implementation-Guide/SMA16-4998
249

percent of those in prison and jail have co-occurring disorders compared to 14 to 25 percent of 

those not incarcerated. 118 Individuals with an opioid use disorder are at significantly increased 

risk for recurrence, overdose, and death upon leaving incarceration compared with their 

community-dwelling peers and the general population.119

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations with circumstances that have put them in contact with the 

criminal justice system. This could be circumstances related to alcohol and/or other drug use 

and/or mental illness. Drug courts represent the coordinated efforts of the judiciary, prosecution, 

defense bar, probation, law enforcement, mental health, social service, and substance use disorder 

treatment communities to intervene and break the cycle of substance use disorder and crime. 

SAMHSA’s Adult Treatment Drug Court (ATDC) programs support a variety of services 

including direct treatment services for diverse populations, wraparound, and recovery support 

services such as recovery housing and peer recovery support services designed to improve access 

to and retention in care, drug test monitoring for illicit substances, educational support, relapse 

prevention and long-term disease management skills development, and HIV and viral hepatitis B 

and C testing and/or referral, conducted in accordance with state and local requirements. 

The Family Treatment Drug Court (FTDC) program expands substance use disorder (SUD) 

treatment services in existing family treatment drug courts, which use the family treatment drug 

court model in order to provide alcohol and drug treatment (including recovery support services, 

screening, assessment, case management, and program coordination) to parents with a SUD and/or 

co-occurring SUD and mental disorders, who have had a dependency petition filed against them 

or are at risk of such filing. 

SAMHSA’s grant programs are encouraged to use part of their annual award to support the 

provision of Medications for Opioid Use Disorder (MOUD) and are required to ensure that drug 

courts funded by SAMHSA not deny the use of Food and Drug Administration (FDA)-approved 

medications for opioid use disorder by drug court clients. SAMHSA requires the use of evidencebased practices from federal resource access points. SAMHSA also has regular communications 

with the National Association of Drug Court Professionals to obtain and incorporate the latest 

findings and field expertise. 

Adult Reentry Program

Over 10,000 ex-prisoners are released from America’s state and federal prisons every week and 

arrive on the doorsteps of our nation's communities. More than 650,000 ex-offenders are released 

from prison every year, and studies show that approximately two-thirds will likely be rearrested 

within three years of release.120 The high volume of returnees is a reflection on the tremendous 

growth in the U.S. prison population during the past 30 years. For the communities to which most 

118 https://store.samhsa.gov/product/Guidelines-for-Successful-Transition-of-People-with-Mental-or-Substance-UseDisorders-from-Jail-and-Prison-Implementation-Guide/SMA16-4998 119 James, D. J., & Glaze, L. E. (2006). Highlights mental health problems of prison and jail inmates. Retrieved from 

https://www.bjs.gov/index.cfm?ty=pbdetail&iid=789

120 Prisons and Prisoners Re-Entry (n.d.). Retrieved September 6, 2022, from USDOJ: E Interact website: USDOJ: 

FBCI: Prisoners and Prisoner Re-Entry (justice.gov)
250

former prisoners return (communities which are often impoverished and disenfranchised 

neighborhoods with few social supports and persistently high crime rates), the release of exoffenders represents a variety of challenges. Often, when individuals are released, they face 

several critical barriers to successful reentry that they will need to overcome. Some have substance 

use issues, others have no place to live, and a criminal record makes it difficult for many to find a 

job.121 For many, it is only a matter of time before they return to prison. According to the Bureau 

of Justice Statistics, 68 percent of state prisoners are rearrested within three years of their release.122

Studies show that only about 10 percent of individuals involved with the criminal justice system 

who are in need of substance use disorder treatment receive it as part of their justice system 

supervision. Approximately one-half of the institutional treatment provided is educational 

programming.123 The Adult Reentry Program (AR) grants provide screening, assessment, 

comprehensive treatment, and recovery support services for diverse populations reentering the 

community from incarceration. Other supported services include wraparound and recovery 

support services, such as recovery housing and peer recovery support, designed to improve access 

to and retention in care, drug test monitoring for illicit substances, educational support, relapse 

prevention and long-term disease management skills development, and HIV and viral hepatitis B 

and C testing and/or referral, conducted in accordance with state and local requirements. 

SAMHSA’s AR grants are encouraged to use part of their annual award to provide MOUD 

treatment with FDA-approved medications. Performance data show that these grant programs are 

effective in improving the lives of Adult Reentry Program (AR) court participants. 

Budget Request

The FY 2024 President’s Budget Request is $124.4 million, an increase of $30.4 million from the 

FY 2023 Enacted level. SAMHSA plans to support 144 new and 105 drug court continuation 

grants, 43 continuation AR grants, and one contract. At least 20 awards will be made to 

tribes/tribal organizations, and at least 20 awards will be made to FTDCs, pending sufficient 

application volume from these groups. Collectively, these programs are expected to serve over 

9,900 people, with the drug court program serving 7,787 people and the Adult Reentry Program 

serving 2,151 people. 

121 Blair Ames, “NIJ-Funded Research Examines What Works for Successful Reentry,” NIJ Journal 281, November 

2019, https:// nij.ojp.gov/topics/articles/nij-funded-researchexamines-what-works-successful-reentry. 122 Mariel Alper, Matthew R. Durose, and Joshua Markman, 2018 Update on Prisoner Recidivism: A 9-Year Followup Period (2005-2014), Special Report, Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, 

May 2018, NCJ 250975, https://www.bjs.gov/content/pub/ pdf/18upr9yfup0514.pdf. 123 Taxman FS, Perdoni ML, Harrison LD. (2007). Drug treatment services for adult offenders: The state of the state. 

Journal of Substance Abuse Treatment 32(3), 239-254. 
251 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $65,570,000 

FY 2021 $65,570,000 

FY 2022 Final $89,000,000 

FY 2023 Enacted $94,000,000 

FY 2024 President's Budget $124,380,000 

Program Accomplishments

The Criminal Justice Activities portfolio has seen significant improvements across a variety of 

outcome measures, including alcohol/drug use, criminal justice involvement, employment/school 

attendance, and housing stability. 

In FY 2022, SAMHSA funded 20 new and 166 continuation ATDC and FTDC grants and one 

contract. In FY 2022, the ATDC and FTDC programs served 6,584 clients, which include 5,444 

in the ATDC program and 1,140 in the FTDC program. 

In FY 2023, SAMHSA anticipates funding 81 new and 97 continuation ATDC and FTDC grants

and one contract. 

For the ATDC program, based on 5,444 client intake assessments, and 2,860 client six-month 

follow-up reassessments, the following National Outcome Measures were reported: 

Adult Treatment Drug Courts

At Intake At 6-months percent change between 

intake and 6-months 

follow-up 

(n=5,444) (n=2,860)

No past 30-day use alcohol/illegal drugs 61.2% 83.7% 36.7% 

No past 30-day arrest 88.8% 94.7% 6.7% 

Past 30-day employment or school attendance 48.2% 66.0% 37.0% 

No past 30-day experience with alcohol or drug 

related health, behavioral, or social 

consequences

80.4% 91.7% 14.0% 

Past 30-day socially connectedness 90.1% 95.0% 5.5% 

Past 30-day permanent place to live in the 

community 38.9% 47.1% 21.2%

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Based on 5,444 client intakes assessments, and 2,860 client six-month follow-up reassessments. 

Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and 

selection bias
252 

For the FTDC program, based on 1,140 client intake assessments, and 587 client six-month followup reassessments, the following National Outcome Measures were reported: 

Family Treatment Drug Courts

At Intake At 6-months percent change 

between intake and 6-

months follow-up

(n=1,140) (n=587)

No past 30-day use alcohol/illegal drugs 55.5% 79.7% 43.7% 

No past 30-day arrest 95.5% 98.6% 3.2% 

Past 30-day employment or school attendance 45.3% 58.3% 28.8% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

76.9% 85.8% 11.5% 

Past 30-day socially connectedness 92.4% 93.6% 1.3% 

Past 30-day permanent place to live in the 

community 44.4% 55.1% 24.0% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Based on 1,140 client intakes assessments, and 587 client six-month follow-up reassessments. Limitations: 

There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and selection 

bias.

In FY 2022, SAMHSA funded 33 AR continuation grants and one contract. 

In FY 2022, the AR program served 2,473 clients. Based on 2,473 intake assessments, and 1,106 

client six-month follow-up reassessments, the following National Outcome Measures are 

reported: 

Adult Reentry Program

At Intake At 6-months percent change 

between intake and 6-

months follow-up 

(n=2,473) (n=1,106)

No past 30-day use alcohol/illegal drugs 38.5% 73.6% 91.0% 

No past 30-day arrest 77.4% 94.7% 22.5% 

Past 30-day employment or school attendance 17.1% 44.4% 159.8% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

68.0% 83.7% 23.1% 

Past 30-day socially connectedness 86.0% 88.8% 3.3%

Past 30-day permanent place to live in the 

community

10.5% 21.5% 105.2% 

In FY 2023, SAMHSA anticipates funding 33 new and 11 continuation AR grants and one 

contract.
253 

Outputs and Outcomes

Program: Criminal Justice – Drug Courts

Measure Year and Most Recent 

Result 

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.2.72 Percentage of 

adult clients receiving 

services who were 

currently employed or 

engaged in productive 

activities (Outcome)

FY 2022: 64.7 % 

Target:

61.4 % 

(Target Exceeded)

62.4 % 67.4 % +5 percentage 

point(s)

1.2.73 Percentage of 

adult clients receiving 

services who had a 

permanent place to live in 

the community 

(Outcome)

FY 2022: 48.5 % 

Target:

48 % 

(Target Exceeded)

49 % 54 % +5 percentage 

point(s)

1.2.74 Percentage of 

adult clients receiving 

services who had no 

involvement with the 

criminal justice system 

(Outcome)

FY 2022: 95.4 % 

Target:

95.5 % 

(Target Not Met)

96.5 % 98.5 % +2 percentage 

point(s)

1.2.76 Percentage of 

adult clients receiving 

services who had no past 

month substance use 

(Outcome)

FY 2022: 83.0 % 

Target:

83.9 % 

(Target Not Met)

84.9 % 86.9 % +1 percentage 

point(s)

1.2.79 Number of adult 

clients served (Output)

FY 2022: 6,584

Target:

6,425

(Target Exceeded) 

6,489 7,787 +1,298 
254 

Program: Criminal Justice – Adult Reentry Program 

Measure Year and Most Recent 

Result 

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.2.80 Number of clients 

served (Outcome)

FY 2022: 2,473

Target:

2,109

(Target Exceeded)

2,130 2,151 +21 

1.2.81 Percentage of 

clients who had no past 

month substance use 

(Outcome)

FY 2022: 73.6 % 

Target:

79.2 % 

(Target Not Met) 

80.2 % 81.2 % +1 percentage 

point(s)

1.2.84 Percentage of 

clients receiving services 

who had no involvement 

with the criminal justice 

system (Outcome)

FY 2022: 94.7 % 

Target:

96.1 % 

(Target Not Met) 

97.1 % 98.1 % +1 percentage 

point(s)
255 

Minority AIDS Initiative

(Dollars in Thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Minority AIDS....................................................................................................... $65,570 $66,881 $66,881 ---

Authorizing Legislation....................................... Section 509 of the Public Health Service 

Act

FY 2024 Authorization ................................................................................................$521,517,000 

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

Eligible Entities ...... States, political subdivisions of States, Indian Tribes or Tribal organizations, 

health facilities, programs operated by or in accordance with a contract or grant with the Indian 

Health Service, public and nonprofit private entities. 

Program Description

The purpose of the Minority AIDS Initiative – High Risk Population (MAI-HRP) program is to 

increase engagement in care for racial and ethnic underrepresented individuals with substance use 

disorders (SUD) and/or co-occurring substance use and mental disorders (COD) who are at risk 

for or living with HIV/AIDS. In FY 2019, the MAI-HRP grant program replaced the Targeted 

Capacity Expansion for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV) grant 

program. The final cohort of the TCE-HIV grant program will conclude grant activities in FY

2023. Eligible grant recipients are domestic public and private nonprofit entities. 

Budget Request

The FY 2024 President’s Budget request is $66.9 million, level with the FY 2023 Enacted level. 

SAMHSA plans to award 25 new grants and 103 MAI-HRP continuation grants with a target to 

serve 10,185 clients. 

Funding History Table

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $65,570,000 

FY 2021 $65,570,000 

FY 2022 Final $65,570,000 

FY 2023 Enacted $66,881,000 

FY 2024 President's Budget $66,881,000 
256 

Program Accomplishments

Although the COVID-19 pandemic necessitated office closures for some grantee organizations, 

MAI-HRP and TCE-HIV grant recipients have continued to serve the public by implementing 

evidence-based practices (EBP) while offering clients increased flexibilities, including the use of 

telehealth and the ability to receive HIV and hepatitis C self-test kits that could be mailed to them 

which was supported by grant funds. Grant recipients have generally been able to continue 

providing comprehensive whole-person care through creative social media marketing, strong 

partnerships, continuous community outreach and updated internal processes to engage clients. . 

In FY 2022, SAMHSA funded 61 new MAI-HRP as well as 36 TCE-HIV and 26 MAI-HRP 

continuations grants and 2 COE grants. In FY 2022, the program served 9,923 clients. Based on 

9,923 client intake assessments, and 4,293 client six-month follow-up reassessments, the following 

National Outcome Measures are reported: 

Minority AIDS

At Intake At 6-months

% Increase in the 

number of clients 

reporting percent 

change between intake 

and 6-months followup 

(n=9,923) (n=4,293) 

No past 30-day use alcohol/illegal drugs 33.1% 54.0% 63.1% 

No past 30-day arrest 97.2% 99.0% 1.9%

Past 30-day employment or school attendance 44.90% 56.6% 26.0% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

67.6% 89.3% 20.4% 

Past 30-day socially connectedness 61.7% 65.3% 5.9% 

Past 30-day permanent place to live in the 

community 50.0% 53.3% 6.6% 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from Based on 

2,072 client intakes assessments, and 1,019client six-month follow-up reassessments. Limitations: There are several limitations to 

the program evaluation including (but not limited to) incomplete data, self-report, and selection bias. Limitations: There are several 

limitations to the program evaluation including (but not limited to) incomplete data, self-report, and selection bias.

In FY 2023, SAMHSA anticipates funding 42 new and 86 continuation MAI-HRP grants
257 

Outputs and Outcomes 

Program: Treatment: Minority AIDS Initiative- Targeted Capacity Expansion-HIV

Measure Year and Most Recent 

Result 

Target for Recent 

Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.1.11 Percentage of adults 

receiving services who had no 

past month substance use at 6-

month follow-up (Outcome)

FY 2022: 54.0

Target:

50.1

(Target Exceeded)

51.1 52.1 +1 

2.1.12 Number of clients 

served (Output)

FY 2022: 9,923

Target:

9,984.0

(Target Not Met) 

10,084.0 10,185.0 +101 

2.1.13 Percentage of adults 

receiving services who were 

currently employed or engaged 

in productive activities at 6-

month follow-up (Outcome)

FY 2022: 56.6

Target:

55.4(Target Exceeded)

56.4 57.4 +1 

2.1.14 Percentage of adults 

receiving services who had a 

permanent place to live in the 

community at 6-month followup (Outcome)

FY 2022: 53.3

Target:

55.6

(Target Not Met) 

56.6 57.6 +1 

2.1.15 Percentage of adults 

receiving services who had no 

involvement with the criminal 

justice system at 6-month 

follow-up (Outcome)

FY 2022: 99.09 

Target:

98.7

(Target Exceeded) 

99.7 99.7 Maintain

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Based on 2,072 client intakes assessments, and 1,019client six-month follow-up reassessments. 

Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and 

selection bias. Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete data, 

self-report, and selection bias.
258 

Minority Fellowship Program 

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Minority Fellowship Program ................................................................................. $5,789 $7,136 $12,000 $4,864

Authorizing Legislation ............................................. Section 597 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................$25,000,000 

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

Eligible Entities ..... Organizations that represent individuals obtaining post-baccalaureate training

(including for master’s and doctoral degrees) for mental and substance use disorder treatment 

professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage 

and family therapy, mental health counseling, and substance use disorder and addiction 

counseling 

Program Description

SAMHSA’s Minority Fellowship Program (MFP) is intended to increase behavioral health 

practitioners’ knowledge of issues related to prevention, treatment, and recovery support for 

mental illness and addiction among racial and ethnic minority populations. The program provides 

stipends to increase the number of culturally competent behavioral health professionals who teach, 

administer, conduct services research, and provide direct mental illness or substance use disorder 

treatment services for minority populations that are underserved. Since its start in 1973, the 

program has helped to enhance services for racial and ethnic minority communities through 

specialized training of mental health professionals in psychiatry, nursing, social work, marriage 

and family therapy, mental health counseling, psychology; substance use/addiction counseling, 

marriage and family therapists and professional counselors. In FY 2023, SAMHSA added 

addiction medicine as a component of the MFP. This program is jointly administered by the Center 

for Substance Use Services (CSUS), the Center for Substance Use Prevention (CSUP), and the 

Center for Mental Health Services (CMHS) at SAMHSA. Combined, this program will support 

fellowships for hundreds of students as well as support additional training through webinars on 

culturally appropriate services to thousands of students. 

 

Budget Request

The FY 2024 President’s Budget request is $12.0 million, an increase of $4.9 million from the 

FY 2023 Enacted level. Combined with $22.0 million in the Mental Health appropriation and 

$2.7 million in the Substance Use Prevention appropriation, funds will support eight continuation 

grants and a technical assistance contract. This funding will more than double the number of 

fellows from 428 to 1,182 and increase the number of trained behavioral health providers to 6,500.

As a braided activity, this increase in fellows will directly address the significant treatment gap 

across the care continuum and the workforce shortage in disenfranchised and minority populations. 

In addition, SAMHSA will conduct a robust evaluation of the program for culturally appropriate 

approaches to further improve retention and increase recruitment of more diverse fellows into the 

workforce. 
259 

The Budget also proposes to add a service requirement to ensure participants are supporting 

communities in need, as well as to add addiction medicine, and sexual and gender minority 

populations as participants in the Minority Fellowship Program. 

Please note, SAMHSA is tracking separately any amounts spent, or awarded, under the Minority 

Fellowship Program through the distinct appropriations and to ensure that funds are used for 

purposes consistent with legislative direction and intent of these appropriations. 

Funding History Table

Program Accomplishments

In FY 2022, SAMHSA supported eight braided MFP grant continuations, one CSAT grant 

continuation and the MFP technical assistance contract. In FY 2022, the program supported 428 

fellows and provided over 135 trainings and workshops for the fellows and other interested 

participants. In addition, 1,200 health professionals in the field of mental health and/or 

substance use disorder and related workforce were trained in specific mental health and/or 

substance use-related practices/activities. Using SAMHSA’s Performance Accountability and 

Reporting System (SPARS) https://spars.samhsa.gov/, 29 events were completed, and 542 

participants were targeted.

In FY 2023, SAMHSA will fund one continuation and eight new MFP, along with the MFP 

technical assistance contract. The program will continue to increase the number of trained 

behavioral health providers. 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $5,789,000 

FY 2021 $5,789,000 

FY 2022 Final $5,789,000 

FY 2023 Enacted $7,136,000 

FY 2024 President's Budget $12,000,000 
260 

Addiction Technology Transfer Centers

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Addiction Technology Transfer Centers................................................................. $9,046 $9,046 $9,046 ---

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2024 Authorization ................................................................................................$521,517,000 

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

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description

The estimated cost of substance use in the United States - including illegal drugs, alcohol, and 

tobacco - is more than $740 billion a year and growing.[1] Substance misuse in the U.S. costs society 

in increased healthcare expenses, crime, and lost productivity. In recent years, the nation’s 

attention has been on the increased misuse and lethal consequences of opioids. According to the 

Centers for Disease Control and Prevention (CDC), CDC provisional data indicate there were 

107,477 predicted drug overdose deaths in the United States during the 12-month period ending in 

August 2022, an increase of 3.3 percent from the 104,038 predicted deaths during the same period 

the year before.2 In addition, there were an estimated 76,683 drug overdose deaths involving 

opioids for the 12-month period ending in August 2022, a decrease of .49 percent from the 77,060 

opioid-involved drug overdose deaths reported during the same period the year before.

[2] Illicitly 

manufactured fentanyl continues to drive the majority of deaths but mortality rates due to cocaine 

and psychostimulants such as methamphetamine are also on the rise, both with and without the 

presence of fentanyl. The misuse of opioids and opioid use disorder - including prescription pain 

relievers, heroin, and synthetic opioids such as fentanyl - is a serious national crisis that affects 

public health as well as social and economic welfare, and that was exacerbated by the COVID-19 

pandemic. The country will be dealing with the repercussions of the pandemic’s effect on 

substance use disorder for years to come. In the midst of these ongoing challenges, there is a 

critical need to recruit, train, and support treatment providers in the use of evidence-based 

practices. 

The purpose of the Technology Transfer Centers (TTCs) is to develop and strengthen the 

specialized behavioral healthcare and broad primary healthcare workforce who provides the 

continuum of prevention, public health harm reduction, treatment, and recovery support services 

for substance use disorder (SUD) and mental illness. The program’s mission is to help people and 

organizations to incorporate effective evidence-based practices into the aforementioned services. 

The TTCs are comprised of three networks, which include the Addiction Technology Transfer 

Centers (ATTC) network. 

In 1993, SAMHSA established the ATTC network, which has undergone several maturations to 

evolve over time. The most recent iteration of the ATTC network from FYs 2017 to 2023 includes 

ten regional ATTCs, a National American Indian and Alaska Native ATTC, a National Hispanic 

and Latino ATTC and a ATTC National Coordinating Office. Together, the ATTC network serves 

the 50 United States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific 

Islands of Guam, American Samoa, Palau, the Marshall Islands, Micronesia, and the Mariana 
261 

Islands. The target audience of the ATTC network includes medical and behavioral health 

professionals, recovery specialists, addictions counselors, criminal justice professionals, 

administrators, and educators. 

Specific activities that the ATTC network carries out include: providing custom technical 

assistance, building capacity to address regional, local and/or population-specific needs on a 

variety of topics; promoting and facilitating relationship building among stakeholders in 

behavioral health policy, research, and practice; serving as a continuous feedback loop for 

innovation and practice; focusing on consultation and implementation to achieve systems change; 

and continually adapting and growing to improve, advance, and expand treatment and recovery 

services.

[1] https://nida.nih.gov/research-topics/trends-statistics. [2] https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

Budget Request

The FY 2024 President’s Budget Request is $9 million, level with the FY 2023 Enacted level. At 

this level, SAMHSA will fund 11 continuations and 3 cooperative agreement continuations and

maintain the same performance target as FY 2023. 

Funding History Table 

Program Accomplishments

The ATTCs have been improving and updating their programs to offer novel training and technical 

assistance options that include multiple learning components in new delivery formats focused on 

changing practices. In response to the COVID-19 pandemic, the ATTC network developed and 

implemented many alternative ways to deliver training and technical assistance. The network 

developed a robust virtual platform that has proven successful in supporting healthcare 

professionals with telehealth strategies and many adaptations of evidence-based interventions for 

virtual settings. Using this platform and other training modalities, the ATTC network will continue 

to respond to the differential impact of the evolving overdose crisis by addressing the needs of 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $9,046,000 

FY 2021 $9,046,000 

FY 2022 Final $9,046,000 

FY 2023 Enacted $9,046,000 

FY 2024 President's Budget $9,046,000 
262

providers and continuing to develop resources to help to address the needs of all communities. 

In FY 2022, SAMHSA funded a 12-month extension for 11 of the 12 ATTCs, which included ten 

regional ATTCs and one ATTC National Coordinating Office. During this time, the 12 ATTCs 

continued to focus on delivering training and technical assistance for providers who are serving 

patients with substance use disorders by improving their capacity and understanding of evidence -

based practices, especially practices that are effective in combating the opioid crisis.

FY 2022 data shows that participant satisfaction rates were consistently high, with over 89.2 

percent of participants reporting that they were satisfied with the quality of training or technical 

assistance events; over 90 percent of participants reporting that they expected benefits to 

themselves, clients, professional development, practice, or community from the events they 

attended; and close to 83 percent of participants reporting that they expect the events will improve 

their ability to work effectively.

In FY 2023, SAMHSA funded a nine-month extension for the National American Indian and 

Alaska Native ATTC, as part of an evolution of the specialty ATTC entities. Additionally, in FY 

2023, SAMHSA anticipates funding 11 ATTC cooperative agreements (ten regional ATTCs and 

one ATTC National Coordinating Office) to disseminate evidence-based promising practices that 

are effective in combating substance misuse, including the opioid crisis. Using braided funding, 

SAMHSA will also fund two new Centers of Excellence (CoE), the American Indian Alaska 

Native Behavioral Health CoE and Hispanic Latino Behavioral Health CoE, to strengthen the 

behavioral health workforce who serves American Indian, Alaska Native, Hispanic, and Latino 

populations and communities. 
263 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final

President's 

Budget

President's 

Budget

FY 2024 +/- 

FY 2023

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths.............. $14,000 16,000 $28,000 $12,000

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................ Competitive Grants, Contracts

Eligible Entities .............................................................................States, local government entities,

federally recognized American Indian/Alaska Native tribe or tribal organizations 

Program Description

The purpose of the Prevent Prescription Drug/Opioid Overdose-Related Deaths (PDO) grant 

program is to reduce the number of prescription drug/opioid overdose-related deaths and adverse 

events among individuals by training first responders and other key community sectors on the 

prevention of prescription drug/opioid overdose-related deaths and implementing secondary 

prevention and harm reduction strategies, including the purchase and distribution of naloxone to 

first responders. Examples of the long-term and short-term outcomes for education and 

distribution of naloxone include: (1) the rate of intentional, unintentional, and undetermined 

intentional opioid overdose (using hospitalization, emergency department, police, or other 

accessible data); (2) the number of opioid overdose-related deaths; (3) the number of opioid 

overdose reversals; (4) the number of referrals to substance use disorder treatment services; and 

(5) the number of naloxone kits that reached communities of high need. 

The Grants to Prevent Prescription Drug and Opioid Overdose-related Deaths program is a key 

component of the public health response to the overdose epidemic. It uses a combination of 

community-based public health prevention and harm reduction strategies across the continuum to 

mitigate the impact of the overdose epidemic within communities. These community-based public 

health prevention efforts serve the high-risk population outside of substance use treatment facilities 

and offer an engagement opportunity and linkage to care for people with a substance use disorder. 

Budget Request

The FY 2024 President’s Budget Request is $28 million, an increase of $12 million from the 

FY 2023 Enacted level. SAMHSA will fund 15 new and 17 continuation grants. This funding will 

help states purchase overdose reversing drugs, equip first responders in high-risk communities, 

support education on the use of naloxone and other overdose-related death prevention strategies, 

provide the necessary materials to assemble overdose kits, and cover expenses incurred from 

dissemination efforts. SAMHSA anticipates an additional 13,281 naloxone kits will be distributed 

and 6,793 more lay people will be trained with this additional funding. 

While the PDO and First Responder Training -Comprehensive Addictions and Recovery Act (FRCARA) programs are very similar, PDO places greater emphasis upon getting lifesaving opioid 

reversal kits into the hands of community organizations and individuals that are in close to 

proximity to those vulnerable to opioid overdose. Helping to support those organizations and 
264 

individuals to leverage digital information sharing mechanisms that will improve naloxone 

administration outcome measures will be critical as we enter FY 2024. 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $14,000,000 

FY 2021 $14,000,000 

FY 2022 Final $14,000,000 

FY 2023 Enacted $16,000,000 

FY 2024 President's Budget $28,000,000 

Program Accomplishments

In FY 2022, SAMHSA funded two new and 13 continuation PDO grants. Grantees distributed 

36,719 Naloxone or other FDA-approved kits in FY 2022, which did not meet the target set at 

73,104. Nevertheless, grantees reported 4,907 administration events and 3,547 overdose reversals. 

In addition, 8,207 lay persons were trained how to administer Naloxone or other FDA approved 

drug or device in FY 2022, which did not meet the target set at 27,266. However, 8,207 first 

responders and 2,640 other individuals were also trained in FY 2022 for a combined total of 22,216 

individuals trained in how to administer Naloxone or other FDA approved drug or device.

Inconsistencies in grantee reporting and inaccuracies with how targets were calculated contributed 

to the program not meeting targets. 

In FY 2023, SAMHSA will fund two new and 15 continuation grants. The program has set a FY

2023 target to distribute 36,719 Naloxone or other FDA-approved kits and to train 8,207 people. 

SAMHSA has adjusted its targets for FY 2023 and FY2024 as a "correction to former targets" to 

better reflect real life circumstances within the communities in which our grantees conduct 

business. The FY 2023 targets are more pragmatic, as a result, and yet remain aspirational. These 

targets align with SAMHSA’s efforts to reduce opioid overdose by saturating communities with 

high rates of opioid overdose with opioid overdose reversal medication, trained first responders 

and concerned public citizens, who have been trained to administer naloxone to those experiencing 

an overdose, and an increased emphasis to refer these individuals into buprenorphine and other 

related MAT and other forms of treatment and recovery supports, wherever appropriate. The 

program aims to distribute 50,000 Naloxone or other FDA-approved kits and train 15,000 lay 

persons how to administer them with the increased funding in FY 2024. 
265 

Outputs and Outcomes Table Program: 

PDO/Naloxone 

Measure Year and Most Recent 

Result 

Target for Recent Result

/

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

5.0 Number of 

Naloxone (or other 

FDA-approved) kits 

distributed (Output)

FY 2022: 36,719

Target: 

73,104

(Target Not Met) 

36,719 50,000 +13,281

5.1 Number of lay 

personstrained how to 

administer Naloxone 

(or other FDA 

approved drug or

device). (Output)

FY 2022: 8,207

Target: 

27,266

(Target Not Met) 

8,207 15,000 +6,793
266 

Peer Support Technical Assistant Center

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Peer Support TA Center................................................................................... $1,000 $2,000 $2,000 ---

Authorizing Legislation ...........................................................................Sec. 547A of the PHS Act 

FY 2024 Authorization ....................................................................................................$5,000,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities . Recovery Community Organizations (RCOs) and Recovery Community Centers 

..................(RCCs) that are domestic private nonprofit entities in states, territories, or tribes.

Program Description

The Recovery Support Services – CoE program builds off the existing Peer Recovery Center of 

Excellence. The Peer Recovery Center of Excellence provides peer recovery support services 

through training and technical assistance for RCOs as well as peer support networks. The current 

Center reinforces recovery as a guiding principle in SAMHSA’s policies, programs, and services. 

The RSS – CoE program will continue these efforts while also increasing the number of individuals 

served and expanding the topic areas for technical assistance, specifically recovery housing. For 

this reason, SAMHSA is proposing the new name of Recovery Support Services Center of 

Excellence (CoE) for this program. 

RSS – CoE aligns with one of the seven ONDCP drug policy priorities, “Expanding access to 

recovery support services,” as well as the four dimensions of 2022 National Drug Control Strategy 

of building a “recovery-ready nation” of “home, health, purpose, and community,” which aims to 

(1) expand RSS and PRSS capacity and foster the adoption of more consistent standards for the 

peer workforce, RCCs, RCOs, and similar peer-led organizations and (2) foster the adoption of 

more consistent recovery housing standards.

Budget Request

The FY 2024 President’s Budget Request is $2 million, level with the FY 2023 Enacted level. The 

RSS Center of Excellence will provide a regionally focused approach to technical assistance and 

provide higher quality guidance and tailored efforts in each region for the Peer Recovery Center 

being restructured. SAMHSA will award one new cooperative agreement at $2 million, providing 

training for 2,500 new individuals per year in peer support services and will support the National 

Drug Control Strategy goal of increasing the number of certified recovery residences by 25 percent 

by 2025.124

124 https://www.whitehouse.gov/wp-content/uploads/2022/04/2022Performance-Reporting-System.pdf
267 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $1,000,000 

FY 2021 $1,000,000 

FY 2022 Final $1,000,000 

FY 2023 Enacted $2,000,000 

FY 2024 President's Budget $2,000,000 

Program Accomplishments

In FY 2022, SAMHSA will fund one continuation grant. During this year, 1,925 individuals were 

trained for the support of the recovery community organizations and peer support networks. There 

were also changes in leadership and competing priorities including high-priority deliverables such 

as the Optimizing Recovery Funding Reports and Comparative Analysis in FY 2022. Additionally, 

the CoE received supplemental funding, and had additional requirements as a result. 

In FY 2023, SAMHSA will fund one continuation grant. The Peer CoE will continue to address 

four major service gaps: (1) discrimination in traditionally “non-peer” systems, (2) minimal 

workforce development for peer support workers, (3) deficiency of scalable approaches to build 

RCOs, and (4) shortage of mechanisms to spread existing and future peer recovery support 

evidence-based practices. Four goals for addressing these gaps are (1) increase the number of 

clinical and other settings that integrate peer support workers into care delivery (specifically those 

that have not traditionally used peers), (2) enhance professionalization of the peer support 

workforce, (3) increase the number of RCOs with strong organizational capacity to provide 

sustainable services to the communities in which they are located, and (4) improve the 

dissemination of peer recovery support evidenced base practices and practice-based evidence. Key 

activities will include conducting capacity assessments, develop and maintain a web-based 

resource library, provide TA to requesters, create toolkits/curriculum, webinars/podcasts, online 

courses, and educational and RCO leadership development events. In FY 2024, the program 

anticipates training 2,500 people with the increase in funding. 
268 

Outputs and Outcomes 

Program: Peer Support Technical Assistance Center

Measure Year and Most Recent 

Result

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.1.0 Number of people 

train for the support of 

the recovery community 

organizations and peer 

support networks 

(Output)

FY 2022: 1,925

Target:

5,000

(Target Not Met)

2,100.0 2,500.0 +400

1.2.0 Number trained on 

technical assistance, 

translation and 

interpretation services, 

data collection, capacity 

building, and evaluation 

and improvement of the 

effectiveness of such 

services provided by 

recovery community 

organizations (Output)

FY 2021: 174.0

Target:

100.0

(Target Exceeded)

174 174 N/A
269 

Treatment, Recovery, and Workforce Support

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Treatment, Recovery, and Workforce Support....................................................... $10,000 $12,000 $12,000 ---

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act 

FY 2024 Authorization ................................................................................................$521,517,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ....... States, political subdivisions of States, Indian Tribes or Tribal organizations, 

health facilities, programs operated by or in accordance with a contract or grant with the Indian 

Health Service, public and nonprofit private entities 

Program Description 

The Treatment, Recovery and Workforce Support (TRWS) program aims to implement evidencebased programming to support individuals in SUD treatment and recovery to live independently 

and participate in the workforce. Eligible entities are those that provide treatment or recovery 

services for individuals with substance use disorders and partner with one or more local or state 

stakeholders, which may include local employers, community organizations, the local workforce 

development board, local and state governments, and Indian tribes or tribal organizations, to 

support recovery, independent living, and participation in the workforce. Grant recipients conduct 

outreach activities informing employers of substance use resources that are available to employees. 

Grant funds have been used to hire Case Managers, Care Coordinators, Peer Recovery Specialists 

and other professionals to provide services that support treatment and recovery for clients. As a 

result of innovative implementation strategies, the TRWS grant has assisted clients with sustaining 

recovery while attaining viable employment. 

Budget Request

The FY 2024 President’s Budget Request is $12 million, level with the FY 2023 Enacted level.

This level will continue to provide access to career services for people in recovery from substance 

use disorder through partnerships with local organizations. SAMHSA plans to fund 23 

continuation grants. The investment will further strengthen and develop America’s workforce and 

allow for greater support to those in recovery. SAMHSA will maintain the same performance 

targets as in FY 2023. 
270 

Funding History Table

Program Accomplishments

In FY 2022, SAMHSA funded eight new and 12 continuation TRWS grants. The TRWS 

program has demonstrated significant process in several National Outcome Measures, including 

alcohol and other substance use, criminal justice involvement, and employment and/or school 

attendance. In FY 2022, the program served 1,623 clients. Based on 1,623 client intake 

assessments and 546 client six-month follow-up reassessments, the following National Outcome 

Measures are reported:

Treatment Recovery and Workforce 

Services

At Intake At 6-months percent change 

between intake and 6-

months follow-up 

(n=1,623) (n=546)

No past 30-day use alcohol/illegal drugs 83.4% 86.5% 3.8% 

No past 30-day arrest 96.3% 99.3% 3.1% 

Past 30-day employment or school attendance 20.6% 70.0% 240.5%

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

86.3% 89.6% 3.9% 

Past 30-day socially connectedness 92.6% 90.0% -2.8% 

Past 30-day permanent place to live in the 

community

25.1% 35.7% 41.9% 

Grant recipients provide various career and workforce needs including but not limited to GED 

preparation classes, trainings and bootcamps, mock interviews and record expungement. Grant 

recipients also foster connections with other organizations such as the Department of Labor and 

have multiple partnerships to offer their clients job positions in areas they are interested in. 

Grant recipients have continued to utilize telemedicine and virtual mediums to engage clients, 

provide entrepreneurial training and support programs, and work to improve linkages between 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $10,000,000 

FY 2021 $10,000,000 

FY 2022 Final $10,000,000 

FY 2023 Enacted $12,000,000 

FY 2024 President's Budget $12,000,000 
271 

one-stop delivery systems and employers in their state. 

In FY 2023, SAMHSA anticipates funding three new and 20 continuation TRWS grants. Grant 

recipients provide various career and workforce needs including but not limited to GED 

preparation classes, trainings and bootcamps, mock interviews and record expungement. Grant 

recipients also foster connections with other organizations such as the Department of Labor and 

have multiple partnerships to offer their clients job positions in areas they are interested in. Grant 

recipients have continued to utilize telemedicine and virtual mediums to engage clients, provide 

entrepreneurial training and support programs, and work to improve linkages between one-stop 

delivery systems and employers in their state. 

Outputs and Outcomes 

Program: Treatment, Recovery, and Workforce Support 

Measure Year and Most Recent 

Result 

Target for Recent Result 

/ 

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.21.1 Number of 

people participating in 

the workforce (Output)

FY 2022: 1,623.0

Target:

820.0

(Target Exceeded) 

828.0 836.0 +8 

1.21.2 Number of 

clients who report 

having stable housing 

at six-month follow-up 

(Outcome)

FY 2022: 546.0 

Target:

229.0

(Target Exceeded) 

231.0 233.0 +2 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited 

to) incomplete data, self-report, and selection bias.
272 

Emergency Department Alternatives to Opioids 

(Dollars in thousands) 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

Higher 

Level

+/- FY 2023 

PB

Emergency Department Alternatives to Opioids..................................................... $6,000 $8,000 $9,000 $1,000

Authorizing Legislation ............................... Section 1221 of the Consolidated Appropriations Act 

FY 2024 Authorization ..................................................................................................$10,000,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities .................................................. Nonprofit Hospitals and Emergency Departments

Program Description

The Emergency Department Alternative to Opioids (EDAO) program provides funding to 

hospitals and emergency departments, including freestanding emergency departments, to develop, 

implement, enhance, or study alternative pain management protocols and treatments that limit the 

use and prescribing of opioids in emergency departments. These funds are used to target common 

painful conditions, train providers and other hospital personnel to recognize the presence of an 

opioid use disorder, initiate treatment as appropriate, and provide alternatives to opioids for 

patients with painful conditions. 

Budget Request

The FY 2024 President’s Budget Request is $9 million, an increase of $1 million from the 

FY 2023 Enacted level. SAMHSA plans to award two new and 15 continuation grants with a 

target of training 2,520 providers on using non-opioid therapies and providing non-opioid 

therapies to 115,850 patients.

Funding History Table

Program Accomplishments

In FY 2022, SAMHSA funded 12 continuation EDAO grants. During this year, EDAO trained

2,468 providers on using non-opioid therapies and providing non-opioid therapies to 113,563 

patients. 

In FY 2023, SAMHSA anticipates funding 15 new and two continuation EDAO grants. In FY

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $6,000,000 

FY 2021 $6,000,000 

FY 2022 Final $6,000,000 

FY 2023 Enacted $8,000,000 

FY 2024 President's Budget $9,000,000 
273

2023, EDAO anticipates training 2,493 providers on using non-opioid therapies and providing 

non-opioid therapies to 114,698 patients.
274 

Outputs and Outcomes 

Program: Emergency Department Alternative to Opioids

Measure Year and Most Recent 

Result

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.60.1 Number of 

providers trained on 

non-opioids 

therapies. (Output)

FY 2021: 2,468

Target:

1,020

(Target Exceeded)

2,493 2,520 +27 

1.60.2 Number of 

patients who 

received non-opioid 

therapies. (Output)

FY 2021: 113,563

Target:

8,364

(Target Exceeded)

114,698 115,850 +1,152 
275 

Comprehensive Opioid Recovery Centers

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Comprehensive Opioid Recovery Center................................................................ $5,000 $6,000 $6,000 ---

Authorizing Legislation ........................................................ ...Section 7121 of the SUPPORT Act 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ... Public and private nonprofit entities (that provide treatment and other services 

for individuals with a substance use disorder). 

Program Description

Comprehensive Opioid Recovery Centers (CORC) provide grants to nonprofit substance use 

disorder treatment organizations to operate comprehensive centers which provide a full spectrum 

of treatment and recovery support services for opioid use disorders. Grantees are required to

provide outreach and the full continuum of treatment services, including medication for opioid use 

disorder (MOUD); counseling; treatment for mental disorders; testing for infectious diseases, 

residential treatment, and intensive outpatient services; recovery housing; peer recovery support 

services; job training, job placement assistance, and continuing education; and family support 

services such as childcare, family counseling, and parenting interventions. Grantees must utilize 

third party and other revenue to the extent possible. Grantees are required to report client-level 

data, including demographic characteristics, substance use, assessment, services received, types of 

MOUD received, length of stay in treatment, employment status, criminal justice involvement, 

and housing. 

Budget Request

The FY 2024 President’s Budget Request is $6 million, level with the FY 2023 Enacted level. 

SAMHSA plans to fund two new and five continuation grants. SAMHSA is targeting to serve a 

baseline of 264 clients in FY 2024. These funds will provide critical comprehensive care services, 

including long-term care and support services utilizing the full range of FDA-approved 

medications and evidence-based services and will cover the costs of critical linkage and system 

development not currently covered by other sources of funding. These funds will extend the reach 

of MOUD treatment and recovery support services to address the overdose epidemic across 

systems and regional locations, reducing scattered, uncoordinated treatment efforts, and expanding 

access to care for people with special needs and/or in rural areas. SAMHSA will maintain the same 

performance targets as in FY 2023. 
276 

Funding History Table

Program Accomplishments

In FY 2022, SAMHSA funded one new and four continuation CORC grants. The CORC Grantees 

have been utilizing funding to expand access to comprehensive services in a variety of ways, 

including improving the system of comprehensive MOUD care at the county level; improving 

access to overdose reversal medications and providing follow up with clients who have 

experienced overdose reversals; removing barriers to accessing MOUD in residential treatment; 

engaging special populations, such as homeless persons, tribal members, LGBTQI+, people in 

correctional settings and those on probation; and increasing access to services for those in 

underserved areas. Grantees have also ensured access to recovery-based services, including 

recovery housing and support. 

The CORC program has demonstrated significant process in several National Outcome 

Measures, including alcohol and other substance use, criminal justice involvement, and 

employment and/or school attendance. In FY 2022, the program served 301 clients. Based on 

301 client intake assessments and 137 client six-month follow-up reassessments, the following 

National Outcome Measures are reported:

Comprehensive Opioid Recovery Centers

At Intake At 6-months Percent +/- change 

between intake and 6-

months follow-up

(n=301) (n=137)

No past 30-day use alcohol/illegal drugs 38.0% 76.6% 101.9%

No past 30-day arrest 94.1% 98.5% 4.7%

Past 30-day employment or school attendance 20.4% 50.4% 146.4%

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

54.7% 89.8% 64,0%

Past 30-day socially connectedness 91.2% 89.1% 2.4%

Past 30-day permanent place to live in the 

community

19.3% 19.3% 0.0%

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Based on 301 client intakes assessments, and 137 client six-month follow-up reassessments. Limitations: 

There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and selection 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $5,000,000 

FY 2021 $5,000,000 

FY 2022 Final $5,000,000 

FY 2023 Enacted $6,000,000 

FY 2024 President's Budget $6,000,000 
277

bias.

In FY 2023, SAMHSA anticipates funding two new and five continuation CORC grants. In 

addition to directly providing services and supports grantees are also required to conduct outreach 

activities. Grantees have provided outreach on the effectiveness of MOUD and strategies for 

overdose reversals to a variety of stakeholders, including criminal justice staff, college campuses, 

state health department representatives, Tribes, first responders, public transportation employees, 

and veterans' services organizations. Grantees will continue to raise awareness of MOUD services 

and overdose reversal medications in 2024. 
278 

Outputs and Outcomes

Program: Comprehensive Opioid Recovery Centers

Measure Year and Most Recent 

Result 

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.1.1 Number of clients 

served with MOUD 

(Output)

FY 2022: 301

Target:

258.0

(Target Exceeded) 

261.0 264.0 +3 

1.2.1 Percentage of adults 

receiving services who 

had no past month 

substance use at 6-month 

follow-up (Output)

FY 2022: 89.8

Target:

89.2

(Target Exceeded) 

90.2 91.2 +1 

1.3.1 Percentage of adults 

receiving services who 

were currently employed 

or engaged in productive 

activities at 6-month 

follow-up (Outcome)

FY 2022: 50.4

Target:

64.9

(Target Not Met)

65.9 66.9 +1 

1.4.1 Number of adults 

receiving recovery 

housing and community 

based and peer recovery 

support services at 6-

month follow-up 

(Output)

FY 2022: 89.1

Target:

24.3

(Target Exceed) 

25.3 26.3 +1 

Source: SAMHSA’s Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Based on 301 client intakes assessments, and 137 client six-month follow-up reassessments. Limitations: 

There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and selection 

bias.
279 

First Responder Training – Comprehensive Addiction and Recovery Act

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final

President's 

Budget

President's 

Budget

FY 2024 +/- 

FY 2023

First Responder Training (CARA).......................................................................... $46,000 $56,000 $77,500 $21,500

First Responder Training (non-add).............................................................. 20,000 25,000 46,500 21,500 

Rural Set-Aside (non-add)................................................................................. 26,000 31,000 31,000 ---

Authorizing Legislation ........................................................................ Section 546 of the PHS Act 

FY 2024 Authorization........................................................................................................................................$0 

Allocation Method............................................................................................Competitive Grants 

Eligible Entities .............................................................................States, local government entities,

federally recognized American Indian/Alaska Native tribe or tribal organizations

Program Description 

SAMHSA’s First Responder Training – Comprehensive Addiction and Recovery Act (FR-CARA) 

program is an important part of the US government’s response to the opioid crisis. The program 

provides resources to first responders and members of other key community sectors at the state, 

tribal, and other government levels to train, carry, and administer Federal Food, Drug, and 

Cosmetic Act approved drugs and devices for emergency reversal of known or suspected opioid 

overdose. FR-CARA is a key component of the public health response to the overdose epidemic. 

It uses a combination of community-based public health prevention and harm reduction strategies 

across the continuum to mitigate the impact of the overdose epidemic within communities. These 

community-based public health prevention efforts serve the high-risk population outside of 

substance use treatment facilities, and provide a linkage and engagement point to treatment for 

individuals with a substance use disorder. The program serves populations disproportionately 

impacted (relative to national averages) by opioid use as evidenced by high rates of opioid and 

other drug-related overdose 

Rural Emergency Medical Services Training Grant 

The Rural Emergency Medical Services Training Grant (EMS Training) program is a one-year 

program to recruit and train EMS personnel in rural areas with a particular focus on addressing 

mental and substance use disorders. This program also provides activities to develop new ways to 

educate emergency health care providers using technology-enhanced educational methods. 

SAMHSA recognizes the great need for emergency services in rural areas and the critical role 

EMS personnel serve across the country. SAMHSA funded the first EMS Training cohort in FY 

2020. 

Budget Request

The FY 2024 President’s Budget Request is $77.5 million, an increase of $21.5 million from the 

FY 2023 Enacted level. SAMHSA anticipates funding 118 new and 75 continuation grants. First 

Responder Training for Opioid Overdose Reversal Drugs (FR-CARA) is a key component of the 

public health response to the overdose epidemic. It uses a combination of community-based public 

health prevention and harm reduction strategies across the continuum to mitigate the impact of the 
280 

overdose epidemic within communities. These community-based public health prevention efforts 

serve the high-risk population outside of substance use treatment facilities, and provide a linkage 

and engagement point to treatment for individuals with a substance use disorder. This funding 

increase will allow SAMHSA to provide much needed support to combat the nation’s opioid 

overdose epidemic and enhance linkage to care for people at risk for opioid overdose and 

implementing innovative strategies. 

SAMHSA will utilize multiple sources of data (including, but not limited to, previous program, 

morbidity, and mortality data) to identify priority communities and populations in greatest need of 

funding. 

FR-CARA will continue to prevent overdoses with increasing access to overdose prevention that 

includes purchasing, training, and equipping first responders and community members with 

naloxone and other FDA-approved overdose reversal devices. SAMHSA anticipates an additional 

71,975 overdose reversal devices will be distributed and an additional 14,310 First Responders 

will be trained. Additionally, an important goal will be facilitating referral and linkage where the 

first responder is directly connecting the person in need of services with a provider of substance 

use services. This program will increase access for individuals treated with naloxone for overdose 

to obtain services such as low threshold buprenorphine with psychosocial support services to 

address the multifaceted challenges a person experiences after an overdose.

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $46,000,000 

FY 2021 $46,000,000 

FY 2022 Final $46,000,000 

FY 2023 Enacted $56,000,000 

FY 2024 President's Budget $77,500,000 

Program Accomplishments

In FY 2022, SAMHSA funded 40 new and 42 continuation grants to ensure that EMS personnel 

are trained on mental and substance use disorders and care for people with such disorders in 

emergency situations. During this year, 58,025 FDA-approved overdose reversing medication kits 

were distributed, but this did not meet the target set at 171,831. In addition, 10,540 first responders 

were trained on how to administer FDA-approved overdose reversing medication kits. The target 

set for FY 2022 was based on the total number of individuals trained rather than the number of 

first responders trained, which in part explains why the program did not meet the FY 2022 target 

set at 44,155. However, the program also trained 20,620 lay persons and 2,657 community 

organization staff for a total of 33,817 individuals trained on how to administer FDA-approved 
281

overdose reversing medication kits. 

In FY 2023, the program will fund 86 new and 47 continuation grants that expand organizational 

and workforce capacity that enhances linkage to care for people at risk for opioid overdose and 

implementing innovative prevention activities. In FY 2024, the program has a target of 130,000 

FDA-approved overdose reversing medication kits distributed and 25,000 first responders trained. 
282 

Output and Outcome 

Program: First Responder Training-CARA

Measure Year and Most Recent 

Result

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

5.0.1 Number of FDAapproved overdose 

reversing medication kits 

distributed. (Output)

FY 2022: 58,025

Target:

171,831

(Target Not Met) 

58,025 130,000 +71,975

5.1.1 Number of first 

responders trained how to 

administer FDAapproved overdose 

reversing medication kits 

(Output)

FY 2022: 10,690

Target:

44,155

(Target Not Met)

10,690 25,000 +14,310
283 

Community Harm Reduction and Engagement Initiative

(Dollars in thousands) FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Community Harm Reduction and Engagement Initiative (new).......................... --- --- $50,000 $50,000

Authorizing Legislation...............................Section 509 of the Public Health Service Act 

FY 2024 Authorization ................................................................................................$521,517,000 

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

Eligible Entity ...............................States; local, Tribal, and territorial governments; Tribal 

organizations; non-profit community-based organizations; and primary and behavioral health 

organizations

Program Description 

Among people aged 12 or older in 2021, 61.2 million people (or 21.9 percent of the population) 

used illicit drugs in the past year.125 Harm reduction is a proactive and evidence-based public 

health approach to reduce the negative individual and public health impacts of alcohol and other 

substance use/use disorder. With millions of Americans meeting diagnostic criteria for a substance 

use disorder and not receiving treatment, harm reduction approaches engage individuals in 

lifesaving care that meets people where they are. This program will address the gap in care by 

supporting broad-based community harm reduction activities and linkages to services. 

Specifically, harm reduction services can:

• Connect individuals to overdose education, counseling, and referral to treatment for 

infectious diseases and substance use disorders.

• Distribute opioid overdose reversal medications (e.g., naloxone) to individuals at risk of 

overdose, or to those who might respond to an overdose.

• Lessen harms associated with drug use and related behaviors that increase the risk of 

infectious diseases, including HIV, viral hepatitis, and bacterial and fungal infections.

• Reduce infectious disease transmission among people who use drugs, including those 

who inject drugs by equipping them with accurate information and facilitating referral to 

resources.

• Reduce overdose deaths, promote linkages to care, facilitate co-location of services as 

part of a comprehensive, integrated approach.

• Reduce stigma associated with substance use and co-occurring disorders

• Promote a philosophy of hope and healing by utilizing those with lived experience of 

recovery in the management of harm reduction services, and connecting those who have 

expressed interest to treatment, peer support workers and other recovery support services.

The 2024 Budget proposes to remove the ban on federal funds to purchase syringes. Should this 

policy change be enacted, this program would also allow grantees to purchase syringes using 

125 SAMHSA Announces National Survey on Drug Use and Health (NSDUH) Results Detailing Mental Illness and 

Substance Use Levels in 2021 | HHS.gov
284

federal funds and builds on the foundations established by the initial American Rescue Plan Act’s 

investment. 

SAMHSA’s harm reduction proposal builds upon the following three components in support of 

the American Rescue Plan: 

1) Support for smaller community-based harm reduction service organizations focused on 

high-risk populations such as those experiencing homelessness; 

2) Expansion grants to existing programs such as SAMHSA’s dedicated harm reduction 

program, Targeted Capacity Expansion-Special Projects program, and Medication 

Assisted Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) program, 

with the inclusion of low-threshold buprenorphine initiation for opioid use disorder and 

linkages to harm-reduction oriented SUD treatment services; and 

3) Technical assistance to support communities and organizations seeking to establish or 

improve existing harm reduction services. 

In addition to the above, this new harm reduction program proposal will facilitate the distribution 

of naloxone to help prevent overdose deaths, increase testing for HIV and viral hepatitis and 

improve access to infectious disease care, and provide peer support services.

Budget Request

The FY 2024 President’s Budget request is $50 million to establish this new harm reduction 

program. The SAMHSA harm reduction and engagement initiative aims to reach 330,000 

individuals with harm reduction and low threshold treatment services through three approaches:

1) Harm Reduction Resources for Community-Based Organizations ($17 million): 

Develop a Notice of Funding Opportunity that is targeted to small, community-based 

organizations. This funding amount would reach at least 100 organizations already 

serving populations needing these services but without other federal resources to 

support harm reduction services. These organizations will receive technical assistance 

and capacity-building support, as well as resources to expand their services. These 

efforts will enable organizations to expand their reach to an additional 50,000 

individuals. 

2) Community Harm Reduction and Engagement Expansion Grants ($30 million): 

Develop a Notice of Funding Opportunity that is targeted to harm reduction 

organizations and harm reduction-oriented substance use disorder treatment programs. 

This funding level would support approximately 50 harm organizations, that 

collectively have the capacity to expand their services to an additional 100,000 

individuals. 

3) Harm Reduction Technical Assistance (TA) Center ($3 million): SAMHSA will 

support a TA center to provide TA to States, Tribes, and communities interested in 

establishing or strengthening their harm reduction services. SAMHSA will continue 

funding one in partnership with CDC. It is estimated this TA will reach a minimum of 

120 organizations. 
285 

Funding History Table

5 Year Funding Table 

Fiscal Year Amount

FY 2020 ---

FY 2021 ---

FY 2022 Final ---

FY 2023 Enacted ---

FY 2024 President's Budget $50,000,000 
286 

Youth Prevention and Recovery Initiative 

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY2024 +/

FY 2023

Youth Prevention and Recovery Initiative................................................ --- $2,000 $2,000 ---

Authorizing Legislation ............................................. Section 514 of the Public Health Service Act

FY 2024 Authorization ..................................................................................................$29,605,000 

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ............................. A local education agency that is seeking to establish or expend 

substance use prevention or recovery support services at one or more high schools; (ii) a State 

educational agency; (iii) an institution of higher education (or consortia of such institutions), 

which may include a recovery program at an institution of higher education; (iv) a local board or 

one-stop operator; (v) a nonprofit organization with appropriate expertise in providing services 

or programs for children, adolescents, or young adults, excluding a school; (vi) a State, political 

subdivision of a State, Indian tribe, or tribal organization; or (vii) a high school or dormitory 

serving high school students that receives funding from the Bureau of Indian Education. 

Program Description

Access to treatment for individuals experiencing SUD is critical and the use of Medications for 

Opioid Use Disorder (MOUD) has been shown to be a safe and effective treatment. However, 

access to MOUD for adolescents and young adults remains low. In order to provide MOUD to 

those who need it, adolescent health care providers must have the ability to prescribe these 

medications and must also have access to the latest resources and training to be able to prescribe 

MOUD safely and effectively126,

127. 

The Preventing Youth Overdose: Treatment, Recovery, Education Awareness and Training (PYOTREAT) is a new grant program in FY 2023 for health care providers and other entities. The 

purpose of this program is to increase access to medication for opioid use disorder (MOUD) for 

adolescents and young adults and to train healthcare providers on the safe prescribing of MOUD. 

The prevalence of documented OUD was higher with increasing age from 0.16% among 16–17 

year-olds, to 0.67% among 18–21 year-olds, and 1.02% among 22–25 year-olds.128 The program 

aims for healthcare providers and other entities to create SUD treatment and prevention programs 

that include the appropriate use of MOUD for adolescents and young adults (Society for 

126 Andrew Terranella, Gery P. Guy, Christina Mikosz; Buprenorphine Dispensing Among Youth Aged ≤19 Years in 

the United States: 2015–2020. Pediatrics February 2023; 151 (2): e2022058755. 10.1542/peds.2022-058755 

https://publications.aap.org/pediatrics/article-abstract/151/2/e2022058755/190503/Buprenorphine-DispensingAmong-Youth-Aged-19-Years?redirectedFrom=fulltext

127 COMMITTEE ON SUBSTANCE USE AND PREVENTION; Medication-Assisted Treatment of Adolescents

With Opioid Use Disorders. Pediatrics September 2016; 138 (3): e20161893. 10.1542/peds.2016-1893 

https://publications.aap.org/pediatrics/article/138/3/e20161893/52715/Medication-Assisted-Treatment-ofAdolescents-With

128 Bagley, S.M., Chavez, L., Braciszewski, J.M. et al. Receipt of medications for opioid use disorder among youth 

engaged in primary care: data from 6 health systems. Addict Sci Clin Pract 16, 46 (2021). 

https://doi.org/10.1186/s13722-021-00249-3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8262000/
287 

Adolescent Health and Medicine).129 

SAMHSA intends to advance the goal of increasing integrated behavioral health access to children, 

youth, and families by allocating funding for fiscal year (FY) 2023 to support the Youth Prevention 

and Recovery Initiative for Adolescents and Young Adults Program. The PYO TREAT new 

awards will address the overdose crisis that continues to adversely affect adolescents and young 

adults and has led to numerous preventable deaths. 

Budget Request

The FY 2024 President’s Budget Request is $2 million, level with the FY 2023 Enacted level. 

SAMHSA anticipates funding four continuation grants.

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 ---

FY 2021 ---

FY 2022 Final ---

FY 2023 Enacted $2,000,000 

FY 2024 President's Budget $2,000,000 

Program Accomplishment

In FY 2023, SAMHSA anticipates funding four new PYO-TREAT grants.

129 Society for Adolescent Health and Medicine. Medication for Adolescents and Young Adults With Opioid Use 

Disorder. J Adolesc Health. 2021 Mar;68(3):632-636. doi: 10.1016/j.jadohealth.2020.12.129. Epub 2021 Jan 21. 

PMID: 33485735; PMCID: PMC7902443. https://www.jahonline.org/article/S1054-139X(20)30848-X/fulltext
288 

PRNS Mechanism Table 

Summary

(Dollars in millions)

 

FY 2022

Final

FY 2023

Enacted

FY 2024 President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity: 

Opioid Treatment Programs/Regulatory Activities 

 Grants 

Continuations.................................................................................................... 27 6.18 18 3.20 12 7.20 

New/Competing............................................................................................... 6 1.47 6 5.74 16 3.92 

Supplements*................................................................................................... --- -- --- -- --- -- 

Subtotal......................................................................................................... 33 7.64 24 8.93 28 11.12 

 Contracts 

Continuations.................................................................................................... 2 1.23 2 1.02 3 1.88 

New/Competing............................................................................................... 1 -0.15 1 0.78 --- 0.08 

Subtotal......................................................................................................... 3 1.08 3 1.79 3 1.96 

Total, Opioid Treatment Programs/Regulatory Activities 36 8.72 27 10.72 31 13.09 

Screening, Brief Intervention and Referral to Treatment 

 Grants 

Continuations.................................................................................................... 27 26.17 24 25.06 20 21.65 

New/Competing............................................................................................... 2 3.84 7 6.97 11 10.95 

Supplements*................................................................................................... --- -- --- -- --- -- 

Subtotal......................................................................................................... 29 30.01 31 32.02 31 32.59 

 Contracts 

Continuations.................................................................................................... --- 1.41 --- 1.78 --- 1.55 

New/Competing............................................................................................... --- 0.42 --- 0.03 --- -0.30 

Subtotal......................................................................................................... --- 1.83 --- 1.82 --- 1.25 

Total, Screening, Brief Intervention and Referral to Treatment 29 31.84 31 33.84 31 33.84 

Targeted Capacity Expansion 

 Grants 

Continuations.................................................................................................... 127 65.31 179 96.13 208.83601 118.32 

New/Competing............................................................................................... 57 40.83 28 19.46 40 32.13 

Supplements*................................................................................................... --- -- --- -- --- -- 

Subtotal......................................................................................................... 184 106.14 207 115.59 249 150.45 

 Contracts 

Continuations.................................................................................................... --- 5.63 --- 6.63 --- 7.29 

New/Competing............................................................................................... --- 0.43 --- 0.20 --- 0.18 

Supplements*................................................................................................... --- -- --- -- --- -- 

Subtotal......................................................................................................... --- 6.05 --- 6.82 --- 7.47 

Total, Targeted Capacity Expansion 184 112.19 207 122.42 249 157.92 
289 

PRNS Mechanism Table

Program, Project, and Activity 

 

FY 2022

Final

FY 2023

Enacted

FY 2024 

President's Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Pregnant and Postpartum Women 

 Grants 

Continuations.................................................................................................... 34 20.13 34 19.10 56 31.91 

New/Competing............................................................................................... 23 12.07 29 17.48 24 15.01 

Supplements*................................................................................................... --- 0.48 --- -- --- -- 

Subtotal......................................................................................................... 57 32.68 63 36.58 80 46.91 

 Contracts 

Continuations.................................................................................................... --- 2.04 --- 2.11 --- 2.23 

New/Competing............................................................................................... --- 0.22 --- 0.24 --- 0.25 

Supplements*................................................................................................... --- -- --- -- --- -- 

Subtotal......................................................................................................... --- 2.26 --- 2.35 --- 2.48 

Total, Pregnant and Postpartum Women 57 34.93 63 38.93 80 49.40 

Recovery Community Services Program 

 Grants 

Continuations.................................................................................................... 8 2.39 8 2.40 14 4.20 

New/Competing............................................................................................... --- -0.07 6 1.80 2 0.60 

Supplements **................................................................................................. --- -- --- -- --- -- 

Subtotal......................................................................................................... 8 2.33 14 4.20 16 4.80 

 Contracts 

Continuations.................................................................................................... --- 0.11 --- 0.24 --- 0.23 

New/Competing............................................................................................... --- -- --- --- --- 0.12 

Subtotal......................................................................................................... --- 0.11 --- 0.24 --- 0.35 

Total, Recovery Community Services Program 8 2.43 14 4.44 16 5.15 

Children and Families 

 Grants 

Continuations.................................................................................................... 51 28.46 18 9.79 52 28.24 

New/Competing............................................................................................... --- -- 34 18.53 1 0.55 

Supplements *.................................................................................................. --- -- --- -- --- -- 

Subtotal......................................................................................................... 51 28.46 52 28.32 53 28.79 

 Contracts 

Continuations.................................................................................................... --- 1.32 --- 1.63 --- 1.35 

New/Competing............................................................................................... --- -0.18 --- 0.24 --- 0.06 

Subtotal......................................................................................................... --- 1.14 --- 1.87 --- 1.41 

Total, Children and Families 51 29.61 52 30.20 53 30.20 
290 

PRNS Mechanism Table

Program, Project, and Activity 

 

FY 2022

Final

FY 2023

Enacted

FY 2024 President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Treatment Systems for Homeless 

 Grants 

Continuations.................................................................................................... 69 26.57 51 19.42 62 28.17 

New/Competing............................................................................................... 18 7.04 31 15.67 15 7.50 

Supplements *.................................................................................................. --- 0.53 --- -- --- -- 

Subtotal......................................................................................................... 87 34.14 82 35.09 77 35.67 

 Contracts 

Continuations.................................................................................................... --- 1.62 --- 2.01 --- 1.66 

New/Competing............................................................................................... --- 0.63 --- 0.01 --- -0.22 

Subtotal......................................................................................................... --- 2.25 --- 2.02 --- 1.44 

Total, Treatment Systems for Homeless 87 36.39 82 37.11 77 37.11 

Minority AIDS 

 Grants 

Continuations.................................................................................................... 63 31.09 85 42.30 103 51.34 

New/Competing............................................................................................... 62 30.55 42 20.94 25 12.50 

Supplements *.................................................................................................. --- 0.88 --- -- --- -- 

Subtotal......................................................................................................... 125 62.51 127 63.24 128 63.84 

 Contracts 

Continuations.................................................................................................... --- 2.92 --- 3.62 --- 3.00 

New/Competing............................................................................................... --- 0.14 --- 0.02 --- 0.04 

Subtotal......................................................................................................... --- 3.06 --- 3.64 --- 3.04 

Total, Minority AIDS 125 65.57 127 66.88 128 66.88 

Criminal Justice Activities 

 Grants 

Continuations.................................................................................................... 199 76.38 108 41.56 148 59.12 

New/Competing............................................................................................... 20 7.13 114 45.42 144 57.60 

Supplements *.................................................................................................. --- -- --- -- --- -- 

Subtotal......................................................................................................... 219 83.51 222 86.98 292 116.72 

 Contracts 

Continuations.................................................................................................... --- 3.46 1 7.00 1 7.47 

New/Competing............................................................................................... 1 2.03 --- 0.02 --- 0.19 

Subtotal......................................................................................................... 1 5.49 1 7.02 1 7.66 

Total, Criminal Justice Activities 220 89.00 223 94.00 293 124.38 

Improving Access to Overdose Treatment 

 Grants 

Continuations.................................................................................................... 5 0.91 --- -- 7 1.40 

New/Competing............................................................................................... --- -- 7 1.40 --- -- 

Supplements *.................................................................................................. --- 0.10 --- -- --- -- 

Subtotal......................................................................................................... 5 1.02 7 1.40 7 1.40 

 Contracts 

Continuations.................................................................................................... --- 0.04 --- 0.08 --- 0.07 

New/Competing............................................................................................... --- -0.06 --- 0.02 --- 0.03 

Subtotal......................................................................................................... --- -0.02 --- 0.10 --- 0.10 

Total, Improving Access to Overdose Treatment 5 1.00 7 1.50 7 1.50 
291 

PRNS Mechanism Table

Program, Project, and Activity 

 

FY 2022

Final

FY 2023

Enacted

FY 2024 President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Building Communities of Recovery 

 Grants 

Continuations.................................................................................................... 44 8.53 42 9.60 31 9.36 

New/Competing............................................................................................... 13 3.82 18 5.53 58 17.39 

Supplements *.................................................................................................. --- -- --- -- --- -- 

Subtotal......................................................................................................... 57 12.35 60 15.13 89 26.75 

 Contracts 

Continuations.................................................................................................... --- 0.58 --- 0.87 --- 1.25 

New/Competing............................................................................................... --- 0.08 --- 0.00 --- -- 

Subtotal......................................................................................................... --- 0.65 --- 0.87 --- 1.25 

Total,Building Communities of Recovery 57 13.00 60 16.00 89 28.00 

Grants to Prevent Prescription Drug/Opioid Overdoes-Related Deaths 

 Grants 

Continuations.................................................................................................... 13 11.04 15 12.74 17 14.44 

New/Competing............................................................................................... 2 1.70 --- -- 15 12.75 

Supplements *.................................................................................................. --- -- --- -- --- -- 

Subtotal......................................................................................................... 15 12.74 15 12.74 32 27.19 

 Contracts 

Continuations.................................................................................................... --- 1.12 --- 0.87 --- 0.80 

New/Competing............................................................................................... --- 0.13 --- 0.69 --- 0.01 

Subtotal......................................................................................................... --- 1.26 --- 1.56 --- 0.81 

Total, Grants to Prevent Prescription Drug/Opioid Overdoes-Related 

Deaths 15 14.00 15 14.30 32 28.00 

First Responder Training (CARA) 

 Grants 

Continuations.................................................................................................... 42 21.87 47 25.29 75 39.72 

New/Competing............................................................................................... 66 21.58 86 27.68 118.1594 34.78 

Subtotal......................................................................................................... 108 43.45 133 52.97 193 74.50 

 Contracts 

Continuations.................................................................................................... --- 2.53 --- 3.03 --- 3.00 

New/Competing............................................................................................... --- 0.03 --- -- --- -- 

Subtotal......................................................................................................... --- 2.55 --- 3.03 --- 3.00 

Total, First Responder Training (CARA) 108 46.00 133 56.00 193 77.50 
292 

PRNS Mechanism Table

Program, Project, and Activity 

 

FY 2022

Final

FY 2023

Enacted

FY 2024 President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Peer Support TA Center 

 Grants 

Continuations.................................................................................................... 1 0.95 1 0.95 --- ---

New/Competing............................................................................................... --- -- --- -- 4.1168421 3.91 

Subtotal......................................................................................................... 1 0.95 1 0.95 4 3.91 

 Contracts 

Continuations.................................................................................................... --- 0.04 --- 0.11 --- 0.09 

New/Competing............................................................................................... --- 0.01 --- -- --- -- 

Subtotal......................................................................................................... --- 0.05 --- 0.11 --- 0.09 

Total, Peer Support TA Centers 1 1.00 1 1.06 4 4.00 

Treatment, Recovery, and Workforce Support 

 Grants 

Continuations.................................................................................................... 12 5.91 20 9.79 23 11.37 

New/Competing............................................................................................... 8 3.88 3 1.50 --- -- 

Subtotal......................................................................................................... 20 9.79 23 11.29 23 11.37 

 Contracts 

Continuations.................................................................................................... --- 0.20 --- 0.36 --- 0.28 

New/Competing............................................................................................... --- 0.01 --- 0.35 --- 0.35 

Subtotal......................................................................................................... --- 0.21 --- 0.71 --- 0.63 

Total, Treatment, Recovery, and Workforce Support 20 10.00 23 12.00 23 12.00 

Emergency Department Alternatives to Opioids 

 Grants 

Continuations.................................................................................................... 12 5.49 2 0.22 15.079254 7.54 

New/Competing............................................................................................... --- -- 15 7.54 2 1.00 

Subtotal......................................................................................................... 12 5.49 17 7.76 17 8.54 

 Contracts 

Continuations.................................................................................................... --- 0.12 --- 0.24 --- 0.20 

New/Competing............................................................................................... --- 0.39 --- --- --- 257.97

Subtotal......................................................................................................... --- 0.51 --- 0.24 --- 0.46 

Total, Emergency Department Alternatives to Opioids 12 6.00 17 8.00 17 9.00 
293 

PRNS Mechanism Table

Program, Project, and Activity 

 

FY 2022

Final

FY 2023

Enacted

FY 2024 

President's Budget

Science and Service No. Amount No. Amount No. Amount

Addiction Technology Transfer Centers 

 Grants 

Continuations.................................................................................................... 1 0.50 --- -- 2 0.88 

New/Competing............................................................................................... --- -- 2 0.88 9.5399394 7.39 

Supplements *.................................................................................................. 11 8.14 --- -- --- -- 

Subtotal......................................................................................................... 1 8.64 2 0.88 11.539939 8.27 

 Contracts 

Continuations.................................................................................................... --- 0.40 --- 0.49 1 0.78 

New/Competing............................................................................................... --- 15 1 0.38 --- -- 

Subtotal......................................................................................................... --- 0.40 1 0.87 1 0.78 

Total, Addiction Technology Transfer Centers 1 9.05 3 1.74 12.539939 9.05 

SAT Minority Fellowship Program 

 Grants 

Continuations.................................................................................................... 9 4.34 0.30 9 6.58 

New/Competing............................................................................................... --- -- 8 6.28 6 4.62 

Supplements *.................................................................................................. --- 1.07 --- -- --- -- 

Subtotal......................................................................................................... 9 5.41 9 6.58 15 11.19 

 Contracts 

Continuations.................................................................................................... 1 0.41 --- 0.39 --- 0.64 

New/Competing............................................................................................... --- -0.03 1 0.17 1 0.17 

Subtotal......................................................................................................... 1 0.38 1 0.56 1 0.81 

Total, Minority Fellowship Program (MF) 10 5.79 10 7.14 16 12.00 

Subtotal, Science and Service: 11 14.84 13 8.88 29 21.05 

Total, Substance Use Services PRNS 1,031 $521.52 1,102 $556.28 1,454 $755.01
294 

Grant Awards Table 

(Whole Dollars)

 

FY 2022

Final

FY 2023

Enacted

FY 2024 

President's Budget

Number of Awards 1,026 1,096 1,448

Average Award $479,048 $480,300 $495,634

Range of Awards $300,000-$600,000 $300,000-$600,000 $300,000-$600,000
295 

State Opioid Response Grants

(Dollars in thousands)

FY 2022 FY 2023 FY 2024

Programs of Regional & National Significance Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

State Opioid Response Grants......................................................... $1,525,000 $1,575,000 $2,000,000 $425,000

Set-Aside for Tribes (non-add)......................................................... 55,000 55,000 75,000 20,000 

Authorizing Legislation ............................................... Section 1003 of the 21st Century Cures Act 

FY 2024 Authorization .............................................................................................$1,750,000,000 

Allocation Method ................................................................................................... Formula Grants

Eligible Entities ............................ Limited to Single State Agencies (SSAs), and U.S. Territories,

Tribes and Tribal organizations are eligible to apply to set-aside funds described below 

Program Description

The State Opioid Response Grants (SOR) program was established by Congress in 2018 to address 

the public health crisis caused by escalating opioid misuse and substance use disorder across the 

nation. CDC provisional data indicate there were 107,477 predicted drug overdose deaths in the 

United States during the 12-month period ending in August 2022, an increase of 3.3 percent from 

the 104,038 predicted deaths during the same period the year before. In addition, there were an 

estimated 76,683 drug overdose deaths involving opioids for the 12-month period ending in 

August 2022, a decrease of 0.49 percent from the 77,060 opioid-involved drug overdose deaths 

reported during the same period the year before.

130 Illicitly manufactured fentanyl continues to 

drive the majority of deaths, but mortality rates due to cocaine and psychostimulants such as 

methamphetamine have also increased, both with and without the presence of fentanyl. As in other 

areas, the COVID-19 years saw an exacerbation of health disparities in overdoses. 

The SOR program provides resources to states and territories to continue and enhance the 

development of comprehensive strategies focused upon preventing, intervening, and promoting 

recovery from issues related to opioid use and misuse and stimulant use. This program aims to 

address the overdose crisis by increasing access to the three FDA-approved medications for the 

treatment of opioid use disorder (MOUD), reducing unmet treatment need, and reducing opioidrelated overdose deaths through the provision of prevention, public health harm reduction 

interventions, treatment, and recovery activities for opioid use disorder (OUD) and other 

concurrent substance use disorders. The SOR program also supports the continuum of care for 

stimulant misuse and use disorders, including for cocaine and methamphetamine. In FY 2022, 

SAMHSA awarded base grants to 58 states and territories via a formula. 

The SOR program requires grantees to use evidence-based treatments, practices, and interventions 

for OUD and stimulant use disorders. The program requires that MOUD is available to those 

diagnosed with OUD. MOUD includes methadone, buprenorphine products, including singleentity buprenorphine products, buprenorphine/naloxone tablets, films, long-acting injectable 

buprenorphine products and injectable extended-release naltrexone. The program supplements 

130 Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health 

Statistics. 2023. Accessed January 25, 2023. Available at https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
296

activities pertaining to opioids currently undertaken by the state agency that also manages the 

Substance Use Prevention, Treatment, and Recovery Services Block Grant, and supports a 

comprehensive response to the overdose epidemic. The program identifies gaps and resources, 

while building upon existing substance use primary prevention, public health harm reduction 

interventions including naloxone and fentanyl test strip purchase and distribution, and treatment 

activities as well as community-based recovery support services. A primary strategy to reduce 

overdose deaths in the SOR program, that will continue in FY 2024, is education on, and purchase 

and distribution of, naloxone, a proven medication that reverses opioid-related overdoses to save 

lives. 

In addition to the grant program, SAMHSA supports a robust technical assistance and training 

effort to enhance education across the country to address the overdose crisis. This effort is 

available not only to SOR and Tribal Opioid Response grantees but to all their sub-recipients and 

affiliated entities. A key component of this technical assistance is local teams of multi-disciplinary 

experts, including clinicians, preventionists, and recovery specialists, in every state. These teams 

and the technical expertise and educational resources provide training not only to individual 

practitioners but also to individuals and families, healthcare practices, and law enforcement, 

criminal justice groups, and other community-based organizations. Providing this training ensures 

that local response to the opioid and overdose crisis is tailored to local needs.

Tribal Opioid Response Grants 

The Tribal Opioid Response Grants (TOR) is a key component of the SOR program and seeks to 

address the public health crisis of escalating opioid misuse and overdose in Tribal communities. 

The purpose of the TOR program is to assist in addressing the overdose crisis in Tribal 

communities by increasing access to FDA-approved medications for the treatment of opioid use 

disorder (MOUD), and supporting the continuum of prevention, public health harm reduction 

interventions, treatment, and recovery support services for opioid use disorder (OUD) and cooccurring substance use disorders. The TOR program also supports the full continuum of 

prevention, public health harm reduction, treatment and recovery support services for stimulant 

misuse and use disorders, including for cocaine and methamphetamine. According to the Centers 

for Disease Control and Prevention, American Indians and Alaska Natives (AI/AN) had the highest 

drug overdose death rates in both 2020 and 2021. 

American Indian and Alaska Native communities experience high rates of physical, emotional, 

and historical trauma and significant socioeconomic disparities, all of which may contribute to 

higher rates of drug misuse in the Tribal communities.131 The TOR program addresses the gaps 

in prevention, public health harm reduction, treatment, and recovery identified by Tribes and 

supports strategies to purchase and disseminate naloxone and provide training on its use to first 

responders and other Tribal members. 

Rural Opioids Technical Assistance- Regional Centers (ROTA-R) Cooperative Agreements The 

Rural Opioids Technical Assistance- Regional Centers (ROTA-R) is a key component of the SOR 

131

https://www.cdc.gov/injury/tribal/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Finjury%2Ffu

ndedprograms%2Ftribal.html
297

program. The purpose of this program is to develop and disseminate training and technical 

assistance on addressing opioid and other stimulant issues affecting rural communities. Recipients 

are expected to facilitate the identification of model programs, develop and update materials 

related to the prevention, public health harm reduction, treatment, and recovery activities for OUD 

and/or Stimulant Use Disorder, and ensure that high-quality training is provided. 

 

According to CDC National Center for Health Statistics Data Brief, from 1999 through 2019, the 

rate of drug overdose deaths increased from 4.0 to 19.6 in rural counties. They also reported that 

the in 2019, the rate of drug overdose deaths involving psychostimulants with abuse potential 

(drugs such as methamphetamine) was 1.4 times higher in rural counties (6.7 per 100,000) than in 

urban counties (4.8).132

The literature recognizes the need to develop creative and nuanced solutions that work with 

impacted communities.133 The need for an innovative opioid response is particularly clear in rural 

areas, which face unique social, economic, and infrastructural challenges.134 Some solutions 

offered by the evidence base include providing public overdose education, improving access to 

naloxone135 and efforts to reduce OUD-related stigma.136 

Budget Request

The FY 2024 President’s Budget Request is $2.0 billion, an increase of $425.0 million from the 

FY 2023 Enacted level. The funding includes $75.0 million set-aside for the Tribal Opioid 

Response program. SAMHSA plans to fund 59 new SOR grants to continue to support states and 

territories. SAMHSA aims to admit 140,569 people for OUD treatment through SOR. The 

allowable uses of this program will continue to include state efforts to address stimulants, including 

methamphetamine, and cocaine. Stimulants are an increasing source of concern and are involved 

in a significant proportion of deaths in a number of states.137 

Based on an assessment of a state’s naloxone purchasing and distribution conducted in FY 2022 

and further refined through technical assistance and early implementation in FY 2023, states will 

utilize SOR grant dollars as a key source of funds to target naloxone to underserved areas and 

organizations in FY 2024. SAMHSA will assist states in the identification of underserved 

communities and agencies and continue in FY 2024 to work with states on implementation and 

further refinement of naloxone distribution and saturation. 

132 https://www.cdc.gov/nchs/data/databriefs/db403-H.pdf 133 Nabila El-Bassel, Rebecca D Jackson, Jeffrey Samet, and Sharon L Walsh, “Introduction to the Special Issue on 

the HEALing Communities Study.” Drug and Alcohol Dependence, (December 1, 2020): 1, 

https://doi.org/10.1016/j.drugalcdep.2020.108327

134 Shannon Monnat and Khary Rigg, “The Opioid Crisis in Rural and Small Town America,” University of New 

Hampshire Carsey School of Public Policy, (2018): 3, doi:10.34051/p/2020.332 135 Joan Stephenson, “Commission Outlines New Strategies to Combat Opioid Crisis,” JAMA Health Forum 3, no. 2 

(2022): e220382, doi:10.1001/jamahealthforum.2022.0382

136 Bernard Showers, Danielle Dicken, Jennifer S. Smith, and Aaron Hemlepp, “Medication for Opioid Use Disorder 

in Rural America: A Review of the Literature,” Journal of Rural Mental Health 45, no. 3 (2021): 184, 

doi:10.1037/rmh0000187

137 https://www.cdc.gov/nchs/data/databriefs/db457.pdf
298 

Funding History Table 

5 Year Funding Table 

Fiscal Year Amount

FY 2020 $1,525,000,000 

FY 2021 $1,525,000,000 

FY 2022 Final $1,525,000,000 

FY 2023 Enacted $1,575,000,000 

FY 2024 President's Budget $2,000,000,000 

Program Accomplishments

In FY 2022, SAMHSA awarded base grants to 58 states and territories via a formula. In addition, 

the program includes a 15 percent set-aside for states with the highest mortality rate related to drug 

overdose deaths. Since the SOR program began, states report that approximately 1,148,915 

patients have received treatment services, including 553,347 who have received an FDA-approved 

medication for opioid use disorder (MOUD). Of that number, 212,542 received methadone, 

310,428 received buprenorphine, and 30,377 received naltrexone.138 Through the SOR program, 

97,768 patients received treatment services for stimulant use disorder 139 and 1,171,670 patients 

received recovery support services.140

During FY 2022, 117,358 clients had an intake assessment in the SOR program. Based on these 

117,358 client intakes assessments, and 34,476 client six-month follow-up reassessments, the 

following National Outcome Measures are reported: 

 

State Opioid Response At Intake At 6-months percent change 

between the intake and 

6-months follow-up 

(n=117,358) (n=34,476)

No past 30-day use alcohol/illegal drugs 52.2% 70.9% 35.7% 

No past 30-day arrest 94.6% 97.8% 3.4% 

Past 30-day employment or school 

attendance 

31.4% 50.3% 60.5% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

68.4% 86.1% 25.8% 

138 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018-September 29, 2021); and the FY 2020 SOR cohort Performance Progress Reports (September 30, 2020, to 

September 29, 2022); this is the most current data available. 139 Data is from the FY 2020 SOR cohort Performance Progress Reports (September 30, 2020, to September 29, 2022); 

this is the most current data available.

140 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018-September 29, 2021); and the FY 2020 SOR cohort Performance Progress Reports (September 30, 2020, to 

September 29, 2022); this is the most current data available.
299 

State Opioid Response At Intake At 6-months percent change 

between the intake and 

6-months follow-up 

(n=117,358) (n=34,476)

Past 30-day socially connectedness 89.0% 90.7% 1.9% 

Past 30-day permanent place to live in the 

community

36.9% 45.9% 24.2%

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Limitations: There are several limitations to the program evaluation including (but not limited to) 

incomplete data, self-report, and selection bias.

In FY 2022, SAMSHA funded 102 new TOR grants. Since 2018, Tribes and Tribal organizations 

have provided TOR-funded treatment and recovery support services to 7,700 clients. Tribes have 

also purchased and distributed 16,955 naloxone kits and 7,045 fentanyl testing strips and trained 

3,357 community members on the use of lifesaving naloxone. Tribes and Tribal organizations 

funded through TOR also educated over 25,000 individuals on the consequences of opioid misuse 

and overdose through prevention activities. 

During FY 2022, 2,468 clients had an intake assessment in the TOR program. Based on these 

2,468 client intakes assessments, and 421 client six-month follow-up reassessments, the 

following National Outcome Measures are reported: 

Tribal Opioid Response

At Intake At 6-months % I=/- in the number 

of clients reporting 

(n=2,468) (n=421) 

No past 30-day use alcohol/illegal drugs 42.1% 66.4% 57.8% 

No past 30-day arrest 96.8% 95.4% -1.5 

Past 30-day employment or school attendance 44.8% 54.0% 20.7% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

61.9% 77.8% 25.7% 

Past 30-day socially connectedness 84.7% 84.7% 0.0% 

Past 30-day permanent place to live in the 

community

56.9% 58.8% 3.3% 

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from 

http://spars.samhsa.gov. Based on 2,468 client intakes assessments, and 420 client six-month follow-up reassessments. Based on 

2,468client intakes assessments, and 421 client six-month follow-up reassessments.

Limitations: There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, 

and selection bias. 

In FY 2022, SAMHSA funded 10 new ROTA grants. From the beginning of FY 2022 through 

January 2023, the ROTA grantees have implemented 2,359 events serving over 52,300 providers 

and community members, disseminating training and technical assistance for rural communities 

addressing opioid and stimulant issues affecting their communities. 

In FY23, SAMHSA aims to admit 133,875 people for OUD treatment through SOR.
300 

During FY 2022, 117,358 clients had an intake assessment in the SOR program. Based on these 

117,358 client intakes assessments, and 34,476 client six-month follow-up reassessments, the 

following National Outcome Measures are reported:

State Opioid Response At Intake At 6-months percent change 

between the intake and 

6-months follow-up 

(n=117,358) (n=34,476)

No past 30-day use alcohol/illegal drugs 52.2% 70.9% 35.7% 

No past 30-day arrest 94.6% 97.8% 3.4% 

Past 30-day employment or school 

attendance 

31.4% 50.3% 60.5% 

No past 30-day experience with alcohol or 

drug related health, behavioral, or social 

consequences

68.4% 86.1% 25.8% 

Past 30-day socially connectedness 89.0% 90.7% 1.9% 

Past 30-day permanent place to live in the 

community

36.9% 45.9% 24.2%

Source: SAMHSA’ Performance Accountability and Reporting System (SPARS). Retrieved January 30, 2023, from . Limitations: 

There are several limitations to the program evaluation including (but not limited to) incomplete data, self-report, and selection 

bias.

In FY 2023, SAMHSA will fund 59 SOR grants with a target to admit 133,875 people for OUD 

treatment through SOR. The program also continues to support technical assistance and training 

grants that enhance states’ ability to address stimulants, as well as other issues related to the 

evolving overdose epidemic As of January 20, 2023, grantees reported in the SAMHSA 

Performance Accountability and Reporting System (SPARs), 6,084,849 naloxone kits were 

distributed.141 Grantees also reported using naloxone to reverse approximately 446,458 

overdoses.142

In FY 2023, SAMHSA will fund 10 continuation ROTA grants. 

In FY 2023, SAMHSA will fund 89 continuation TOR grants. 

141 Data reported is based on GPRA data generated in SPARs on January 20, 2023 for the number of naloxone kits 

distributed.

142 Data is from the FY 2018 SOR cohort, including no-cost extensions, Performance Progress Reports (September 

30, 2018-September 29, 2021); and the FY 2020 SOR cohort Performance Progress Reports (September 30, 2020, to 

September 29, 2022); this is the most current data available.
301 

Outputs and Outcomes 

Program: State Opioid Response Grants

Measure Year and Most Recent 

Result 

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.2.70 Number of 

admissions for OUD 

treatment (Output)

FY 2022: 117,358.0

Target:

127,500.0

(Target Not Met)

133,875.0 140,569.0 +6,694 

1.2.71 number of clients 

receiving recovery 

services (Output)

FY 2022: 60,648

Target:

38,147.0

(Target Exceeded)

51,639.0 54,221.0 +2,582 

1.2.73 Illicit drug use at 6 

months follow-up 

(Output)

FY 2022: 70.9

Target:

70.0

(Target Exceeded) 

73.3 75.3 +2 

1.2.74 Number of people 

educated on the 

consequences of opioid 

and/or stimulant misuse 

through prevention 

activities (Output)

FY 2022: 3,939,191

Target:

Set Baseline

(Not Applicable)

TBD TBD Maintain
302 

Substance Abuse and Mental Health Services Administration

FY 2024 State Opioid Response 

Budget Request $2,000,000,000, State - Territory Total $1,885,000,000

STATE/TERRITORY FY 2022

Actual

FY 2023

Enacted

FY 2024

Request

FY 2024 +/- 

FY 2023 

Alabama $16,267,833 $16,836,973 $21,409,214 $4,572,241

Alaska $4,000,000 $4,000,000 $4,000,000 $0

Arizona $31,963,651 $33,081,919 $42,065,631 $8,983,712

Arkansas $10,882,752 $11,263,492 $14,322,201 $3,058,709

California $107,060,968 $110,806,562 $140,897,143 $30,090,581

 Colorado $21,078,320 $21,815,758 $27,740,036 $5,924,278

Connecticut $14,375,862 $14,878,810 $18,919,294 $4,040,484

Delaware $37,284,006 $38,558,404 $48,866,126 $10,307,722

District Of Columbia $24,139,141 $24,964,374 $31,638,786 $6,674,412

Florida $101,302,478 $104,846,607 $133,318,707 $28,472,100

 Georgia $29,607,100 $30,642,922 $38,964,301 $8,321,379

Hawaii $4,000,000 $4,000,000 $5,173,262 $1,173,262

Idaho $7,937,724 $8,215,430 $10,446,409 $2,230,979

Illinois $37,195,746 $38,497,062 $48,951,308 $10,454,246

Indiana $29,147,743 $30,167,495 $38,359,767 $8,192,272

 Iowa $9,083,075 $9,400,852 $11,953,743 $2,552,891

Kansas $8,370,570 $8,663,419 $11,016,053 $2,352,634

Kentucky $35,916,929 $37,160,645 $47,182,039 $10,021,394

Louisiana $17,457,546 $18,068,309 $22,974,932 $4,906,623

Maine $6,326,670 $6,548,012 $8,326,187 $1,778,175

 Maryland $51,384,298 $53,158,433 $67,465,901 $14,307,468

Massachusetts $57,647,564 $59,648,324 $75,758,979 $16,110,655

Michigan $36,852,749 $38,142,065 $48,499,908 $10,357,843

Minnesota $11,357,382 $11,754,726 $14,946,835 $3,192,109

Mississippi $7,242,937 $7,496,336 $9,532,037 $2,035,701

 Missouri $25,300,398 $26,185,548 $33,296,484 $7,110,936

Montana $4,000,000 $4,000,000 $4,685,231 $685,231

Nebraska $4,492,812 $4,649,996 $5,912,746 $1,262,750

Nevada $16,723,421 $17,308,500 $22,008,789 $4,700,289

New Hampshire $28,507,046 $29,482,949 $37,372,768 $7,889,819

New Jersey $66,756,027 $69,075,453 $87,746,134 $18,670,681
303 

Substance Abuse and Mental Health Services Administration

FY 2024 State Opioid Response 

Budget Request $2,000,000,000, State - Territory Total $1,885,000,000 

STATE/TERRITORY FY 2022

Actual

FY 2023

Enacted

FY 2024

Request

FY 2024 +/- 

FY 2023 

New Mexico $7,618,859 $7,885,409 $10,026,768 $2,141,359

New York $56,870,542 $58,860,193 $74,844,241 $15,984,048

North Carolina $35,546,609 $36,790,229 $46,780,968 $9,990,739

North Dakota $4,000,000 $4,000,000 $4,000,000 $0

Ohio $97,370,121 $100,755,241 $127,999,733 $27,244,492

 Oklahoma $16,153,919 $16,719,074 $21,259,298 $4,540,224

Oregon $15,474,271 $16,015,648 $20,364,851 $4,349,203

Pennsylvania $80,784,879 $83,589,755 $106,172,794 $22,583,039

Rhode Island $7,443,492 $7,598,950 $8,847,839 $1,248,889

South Carolina $18,142,218 $18,776,935 $23,875,991 $5,099,056

 South Dakota $4,000,000 $4,000,000 $4,000,000 $0

Tennessee $30,457,651 $31,523,231 $40,083,666 $8,560,435

Texas $52,783,865 $54,630,540 $69,465,986 $14,835,446

Utah $10,842,291 $11,221,615 $14,268,952 $3,047,337

Vermont $4,000,000 $4,000,000 $4,473,714 $473,714

 Virginia $27,953,005 $28,930,958 $36,787,437 $7,856,479

Washington $27,480,888 $28,442,323 $36,166,109 $7,723,786

West Virginia $44,337,509 $45,856,535 $58,134,478 $12,277,943

Wisconsin $16,917,133 $17,508,989 $22,263,724 $4,754,735

Wyoming $4,000,000 $4,000,000 $4,000,000 $0

State Subtotal $1,425,840,000 $1,474,425,000 $1,867,567,500 $393,142,500

 American Samoa $250,000 $250,000 $250,000 $0

Guam $250,000 $250,000 $250,000 $0

Northern Marianas $250,000 $250,000 $250,000 $0

Puerto Rico $12,160,000 $12,575,000 $15,932,500 $3,357,500

Palau $250,000 $250,000 $250,000 $0

Marshall Islands $0 $0 $0 $0

Micronesia $250,000 $250,000 $250,000 $0

Virgin Islands $250,000 $250,000 $250,000 $0

Territory Subtotal $13,660,000 $14,075,000 $17,432,500 $3,357,500

Total State - Territory $1,439,500,000 $1,488,500,000 $1,885,000,000 $396,500,000

TOR $54,976,150 $55,000,000 $75,000,000 $20,000,000

Total Administrative $30,523,850 $31,500,000 $40,000,000 $8,500,000

Total Appropriation $1,525,000,000 $1,575,000,000 $2,000,000,000 $425,000,000
304 

Substance Use Prevention, Treatment, and Recovery Services Block Grant

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2022 FY 2023 FY 2024

Final Enacted

Higher 

Level

+/- FY 

2023 PB

Substance Use Prevention, Treatment, and Recovery Services Block Grant $1,908,079 $2,008,079 $2,708,079 $700,000

Budget Authority (non-add)....................................................................... 1,828,879 1,928,879 2,628,879 700,000 

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

Authorizing Legislation ........................................... Section 1935 of the Public Health Service Act 

FY 2024 Authorization .............................................................................................$1,908,079,000 

Allocation Method ................................................................................................... Formula Grants 

Eligible Entities .... States, Territories, Freely Associated States, District of Columbia, and the Red 

Lake Band of Chippewa Indians 

Program Description

The Substance Use Prevention, Treatment, and Recovery Services Block Grant program (SUPTRS 

BG) is a formula grant which funds 60 eligible states, territories and freely associated states, the 

District of Columbia, and the Red Lake Band of Chippewa Indians (referred to collectively as 

states). SUPTRS BG grantees plan, implement, and evaluate substance use disorder (SUD) 

prevention, treatment, and recovery support services based on the specific needs of their state 

systems and populations. Ninety-five percent of SUPTRS BG funding is distributed to states 

through a formula that allocates funds based on specified economic and demographic factors and 

provisions that limit fluctuations in allotments as the total SUPTRS BG appropriation changes 

from year to year. 

The goal of the SUPTRS BG program is to ensure that individuals, their families, and communities 

have access to the range of substance use-related prevention, treatment, public health interventions 

and recovery support services necessary to improve individual outcomes and reduce the impact of 

substance use on America’s communities. 

Priority Services and Populations 

The SUPTRS BG program’s authorizing statute and regulations afford states flexibility to identify 

and deliver substance use-related services to meet their state-specific needs while also ensuring 

attention to critical prevention-focused public health issues. However, certain service areas and 

populations are statutorily required to be addressed to receive SUPTRS BG funds. The following 

services and populations of focus must be addressed using program funds: 

1. Primary prevention services; 

2. Tuberculosis (TB) services involving TB screening, counseling, and referral for medical 

evaluation and treatment for individuals in SUD treatment services; 

3. Early intervention services for HIV/AIDS for individuals in SUD treatment services in 

designated states; 

4. Services for substance using pregnant women and women with dependent children; and 

5. Services for persons who inject drugs. 

States must also comply with the Synar Amendment to receive their full SUPTRS BG 
305

funding. The Synar Amendment requires states to enact and enforce laws prohibiting the sale or 

distribution of tobacco products to individuals under the federal legal age of sale. 

Maintenance of Effort (MOE) 

The SUPTRS BG statute requires that a state maintain its state expenditures for certain SUD 

prevention, treatment, and recovery support activities at a level that is no less than the state’s 

average expenditures for the previous two state fiscal years. Additionally, the statute requires 

states to maintain no less than an amount equal to the FFY 1994 level of expenditures for SUD 

treatment services for pregnant women and women with dependent children. The statute and 

regulation provide states with the flexibility to expend a combination of SUPTRS BG and state 

SUD treatment funds focused on women to satisfy the MOE for women’s services. 

Funding Set-Asides

The authorizing legislation and implementing regulations for the SUPTRS BG include two 

maintenance of effort requirements and two specific funding set-asides, including a 20 percent setaside for primary prevention and a five percent set-aside for early intervention services for HIV 

for designated states. The President’s Budget includes a 10 percent set-aside within the SABG for 

recovery support services to significantly expand the upstream and downstream continuum of care. 

The Budget Request also uses HIV cases as opposed to AIDS cases to calculate the HIV-set aside.

Primary Prevention Set-Aside

The 20 percent primary prevention set-aside requires SUPTRS BG grantees to spend at least 20 

percent of their SUPTRS BG funds to develop and implement a comprehensive substance use/ 

misuse primary prevention program, which includes a broad array of prevention strategies directed 

at individuals not identified to need SUD treatment. The primary prevention program set-aside is 

one of SAMHSA’s main vehicles aimed at preventing substance use/misuse and allows states to 

develop prevention infrastructure and capacity. A thriving prevention infrastructure will achieve 

and maintain long-term outcomes by ensuring that states have the necessary infrastructure in place 

to conduct needs assessments, develop strategic plans, provide culturally appropriate services, 

capture data to make data driven decisions on how prevention resources should be allocated 

throughout communities in their state, and evaluate process and outcome data. Some states rely 

solely on the 20 percent set-aside to fund their primary prevention systems while others use the 

funds to target gaps and enhance existing program efforts. SAMHSA regularly works with states 

to improve their accountability systems for prevention and to establish necessary reporting 

capacities. 

Recovery Support Services Set-Aside 

The Budget Request includes a 10 percent set-aside within the SUPTRS BG for recovery support 

services. 

The SUPTRS BG strongly encourages states to expend funds to support a robust array of recovery 

support services. This includes recovery community organizations, peer recovery support services, 

and recovery housing which meets national certification standards, among others.
306

The FY 2024 budget includes a 10 percent set-aside for non-clinical recovery support services. 

The set-aside requires that at least 10 percent of grantees’ SUPTRS BG expenditures be used for 

recovery community organizations, peer recovery support services, and other recovery support 

services. Recovery support systems partner people in recovery from mental and substance use 

disorders, as well as their family members, with recovery services. These services may include

recovery housing, recovery community centers, recovery schools, recovery industries, and 

recovery ministries. These programs utilize individual, community, and system-level approaches 

to increase the four dimensions of recovery as defined by SAMHSA: 

 

 1. Health (access to quality health and SUD treatment); 

 2. Home (housing with needed supports); 

 3. Purpose (education, employment, and other pursuits); and 

 4. Community (peer, family, and other social supports) 

 

 States can use these funds to develop local recovery community support institutions, provide 

 system navigation resources and supports, and collaborate and coordinate with local private, 

 public, non-profit, and faith community response efforts. SAMHSA anticipates that this setaside will help increase access to recovery support services across the country and complement 

the existing efforts to respond to the ongoing overdose crisis that has accelerated during the 

COVID-19 pandemic. 

Section 1242 of the Consolidated Appropriations Act, 2023 (P.L. 117-328) included language 

that requires states to describe the State’s comprehensive statewide recovery support services 

activities, including the number of individuals being served, target populations, workforce 

capacity, and priority needs; and the amount of funds received expended on recovery support 

services, disaggregated by the amount expended for type of service activity. Further, the Joint 

Explanatory Statement accompanying the Consolidated Appropriations Act, 2023 noted that the 

agreement does not include a new set-aside within the SUPTRS BG for recovery services but 

urges SAMHSA to strongly encourage States to use a portion of their SUPTRS BG funding for 

recovery support services. The Budget includes a 10 percent set-aside for recovery support 

services to ensure the more than 20 million Americans recovering from substance use disorder 

substance use disorder receive the services and supports to help them thrive. 

Budget Request

The FY 2024 President’s Budget request is $2.7 billion, an increase of $700 million from the 

FY 2023 Enacted level. Coming out of the COVID-19 pandemic, and with an evolving overdose 

crisis, the need and demand for prevention, treatment and recovery support services for SUDs 

continues to grow. The Substance Use Prevention, Treatment, and Recovery Services Block Grant

(SUPTRS BG) will continue to serve as a source of safety-net funding for vulnerable populations 

that rely on public funding to pay for substance use disorder prevention, treatment, public health 

interventions, and recovery support services. SAMHSA will provide assistance to states in

addressing and evaluating activities to prevent, reduce harm, treat, and provide recovery support 

services for individuals, families, and communities that are adversely impacted by substance use 

disorders (SUDs) and related conditions SAMHSA will also assist states and jurisdictions in 
307 

planning for, expanding, enhancing, and building capacity in their service systems to address these 

evolving needs. States will continue to use the Coronavirus Response and Relief Supplement and 

American Rescue Plan funding through FY 2023 (or FY 2024 with No Cost Extension request 

approvals) and FY 2025, respectively, as states expand their SUD infrastructure to address unmet 

service needs.

10 Year Funding Table 

10 Year Funding Table 

Fiscal Year Amount COVID-19 

Supplemental 

Funding 

FY 2014 $1,815,443,000 

FY 2015 $1,819,856,000 

FY 2016 $1,858,079,000 

FY 2017 $1,857,079,000 

FY 2018 $1,858,079,000 

FY 2019 $1,858,079,000 

FY 2020 $1,858,079,000 

FY 2021 $1,858,079,000 $3,150,000,000 

FY 2022 Final $1,908,079,000 

FY 2023 Enacted $2,008,079,000 

FY 2024 President's Budget $2,708,079,000 

Program Accomplishments 

States and their sub-recipients have learned a tremendous amount from the COVID 19 experience 

and the evolution of the overdose crisis. This includes the need for, and ability to provide, support 

for targeted housing and funding of recovery support services. Both service areas have been 

integral to undergirding the substance use disorder treatment services that have been provided to 

clients at all levels of care at a time when the need for the continuum of care is at an all-time high. 

There has been extensive adoption of telehealth services to provide continuous accessibility of 

services to clients and communities. Grantees have also been encouraged to use SUPTRS BG 

funds to strengthen the crisis continuum of care, and to expand mobile substance use disorder 

services, including mobile medication services to reach persons with Opioid Use Disorder. Plans 

for FY 2024 are to continue strengthening service accessibility and quality, while expanding 

services to under-served populations, including the expansion of recovery support services. 

Importantly, SUPTRS BG funds are also directed towards the collection of performance and 

outcome data to determine the ongoing effectiveness of supported activities and provide states and 

the federal government the grounding to plan the implementation of new evidence-based services. 

At this critical moment in our country’s substance use crisis, it is imperative that our response truly 

evolve from an acute, short-term response to a broader and longer-term community recovery 
308

response. Substance use disorder is a chronic illness, and recovery often is a life-long process 

where the healthcare system, external community, and social determinants of health play vital roles 

in its sustainability. Modernizing the data component for the SUPTRS BG will be a significant 

focus for FY 2024. 

Performance and Evaluation

The SUPTRS BG enables the development of comprehensive statewide systems of care that 

provide a broad continuum of SUD services and recovery supports encompassing prevention, 

treatment, and recovery support services for individuals in need. By statute, SAMHSA collects 

performance metric data from the states to monitor performance outcomes across the program. 

The data is used to measure and monitor state program goals and client outcomes. The data is used 

by the states for future strategic planning to enhance the state’s SUD systems of care. In addition, 

the data is used by SAMHSA in policymaking and recommendations for innovative programs to 

address gaps in the SUD systems of care.

In FY 2023-2024, as part of SAMHSA’s ongoing data modernization strategy, SAMHSA is 

developing a common performance, evaluation, and quality dataset, and clarifying reporting 

instructions for states. This new dataset and clearer instructions will increase SAMHSA’s ability 

to assess and monitor SAMHSA’s BG programs. 

SUPTRS BG SUD Treatment Outcomes

States reported nearly two million143 SUD treatment admissions for state fiscal year SFY 2022, 

suggesting ongoing critical support of SUD treatment by public funding, including BG funds. The 

outcome data from the Behavioral Health Services Information System/Treatment Episode Data 

Set (TEDS), administered by SAMHSA’s Center for Behavioral Health Statistics and Quality 

(CBHSQ) provides more detailed information for SFY 2022. 

 

In SFY 2022, states expended Block Grant funds as follows: 

• $139,970,636 for SUD Treatment for Pregnant Women and Women with 

Dependent Children 

• $1,115,687,387 for All Other SUD Treatment and Prevention Services

• $356,542,698 for SUD Primary Prevention Program Services 

• $299,148 for Tuberculosis Services 

• $12,127,486 for HIV Early Intervention Services 

• $83,509,694 for SSA Administration 

Source: WebBGAS Report Title “SABG State Agency Reported Expenditures by Target 

Activity within Source of Funds” Report Year: 2023, Table 2a (for SFY 2022) 

In total, all states and jurisdiction admitted 1,761,772 clients in SFY 2022, specifically: 

143 Web Block Grant Application System (WebBGAS) FY 2015 - 2021 SABG Treatment Utilization Matrix 

Admissions & Persons Served, State/Jurisdiction Selection: All States/Jurisdictions. 
309

• 205,059 persons admitted to withdrawal management services; 

• 329,034 persons admitted to residential treatment levels of care; 

• 883,782 persons admitted to ambulatory services; and 

• 343,897 persons received outpatient treatment that included medications for 

opioid use disorder 

Source: WebBGAS Report Title “SABG Treatment Utilization Matrix - Summary of 

Admissions by Level of Care” Report Year: 2023, Table 10 (for SFY 2022). 

Note: this number does not represent unduplicated individuals as persons may have been 

admitted more than once to a particular service. 
310 

SFY 2022 SUPTRS BG Demographics144,145

Total Unduplicated Persons Served (Adults 

and Children) 1,508,202 

Female 40.52% 

Male 59.48% 

Race

White 62.11% 

Blacks or African Americans 16.35% 

American Indian/Alaska Natives 4.11% 

Asians 0.76% 

Native Hawaiian/Other Pacific Islanders 0.42% 

Unknown 13.54% 

Multi-Racial 2.69% 

Ethnicity

Not Hispanic or Latino 85.7% 

Hispanic or Latino 14.3% 

Age

17 and Under 3.93% 

18 – 24 9.17% 

25 – 44 56.63% 

45 – 64 27.40% 

65 and Over 2.88% 

Source: WebBGAS Report Titles “SABG Percentage of Unduplicated Persons Served by 

Age Group-Race” Report Year: 2023, Table 11A (for SFY 2022), and “SABG 

Unduplicated Count of Persons Served by Age Group with Gender and Ethnicity 

Breakout” Report Year: 2023, Table 11a (for SFY 2022). 

Synar Program Outcomes 

The Synar Program was established to monitor and enforce the federal prohibition on the sale or 

distribution of tobacco products to individuals under the age of 18, recently updated to 21, by 

conducting unannounced and random inspections of retailers selling such products. While the 

national weighted retailer violation rate declined steadily from 40.1 percent in the program’s 

baseline year in FY 1997 through FY 2011, the rate increased from an all-time low of 8.5 percent 

in FY 2011 to 9.6 percent in FY 2018. In FY 2019 and FY 2020, the national weighted retailer 

144 Source: FY 2020 SABG Report – Table 10 - Treatment Utilization Matrix has been used to reflect official total 

number of persons served. Kentucky did not supply data. Historically, Table 10 has been used to reflect official 

numbers of persons served. Furthermore, the table does not break out persons served by age or gender. The total 

reflects adults and children served.

145 Source: FY 2020 SABG Report - Table 11 – Unduplicated Count of Persons Served for Alcohol and Other Drug 

Use. Kentucky did not supply data. Table 11 is the only table that collects gender and age data. Hence, gender and 

age percentages are calculated based on data from Table 11.
311

violation rate was 7.6 and 8.4, respectively.146 These figures represent the latest data as there are 

currently no withhold amounts under subsection (b) for the 3-year period immediately following 

the date of enactment of the Consolidated Appropriations Act, 2020. 

Tobacco 21 legislation was included in a larger fiscal year 2020 appropriations package (P.L. 116-

94) that was enacted in December 2019. Tobacco 21 legislation, signed into law in 2019, does not 

require that states pass laws to raise their sales age to 21, but, in line with Synar requirements, it 

does require states to demonstrate that their retailers are complying with the federal law not to sell 

tobacco products to individuals under the age of 21. Synar inspections are conducted on a federal 

fiscal year timeline. The next federal fiscal year that would subject states to penalty would be 

October 1, 2023-September 30, 2024. 

Technical Assistance

In addition to the states and jurisdictions’ plans and reports, authorizing legislation provides 

SAMHSA with resources to support technical assistance to the SUPTRS BG grantees and their 

sub-recipients to ensure that they can effectively provide prevention, substance use disorder 

treatment, and recovery support services. SAMHSA’s Knowledge Application Program (KAP) 

(https://www.samhsa.gov/kap) produces the Technical Assistance Publication Series that provide 

practical guidance and information related to the delivery of SUD treatment services and related 

public health services to individuals and families. The KAP also produces the Treatment 

Improvement Protocol Series, a growing library of best practice guidelines, which are produced 

by a consensus-development process based on the experience and knowledge of clinical, research, 

and administrative experts. SAMHSA is also re-developing a two-pronged quality assurance and 

individualized, state-specific technical assistance program to provide additional support to states 

in their implementation of the SUPTRS BG program. 

Program Accomplishments 

States and their sub-recipients have learned a tremendous amount from the COVID 19 experience 

and the evolution of the overdose crisis. This includes the need for, and ability to provide, support 

for targeted housing and funding of recovery support services. Both service areas have been 

integral to undergirding the substance use disorder treatment services that have been provided to 

clients at all levels of care at a time when the need for the continuum of care is at an all-time high. 

There has been extensive adoption of telehealth services to provide continuous accessibility of 

services to clients and communities. Grantees have also been encouraged to use SUPTRS BG 

funds to strengthen the crisis continuum of care, and to expand mobile substance use disorder 

services, including mobile medication services to reach persons with Opioid Use Disorder. Plans 

for FY 2024 are to continue strengthening service accessibility and quality, while expanding 

services to under-served populations, including the expansion of recovery support services. 

Importantly, SUPTRS BG funds are also directed towards the collection of performance and 

outcome data to determine the ongoing effectiveness of supported activities and provide states and 

the federal government the grounding to plan the implementation of new evidence-based services. 

146 https://www.samhsa.gov/sites/default/files/synar_program_rvr_table_1997-2018_dec_11_2018.pdf. 
312

At this critical moment in our country’s substance use crisis, it is imperative that our response truly 

evolve from an acute, short-term response to a broader and longer-term community recovery 

response. Substance use disorder is a chronic illness, and recovery often is a life-long process 

where the healthcare system, external community, and social determinants of health play vital roles 

in its sustainability. Modernizing the data component for the SUPTRS BG will be a significant 

focus for FY 2024. 
313 

Output and Outcomes

Program: Treatment Activities

Measure Year and Most Recent 

Result ‘

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

1.2.43 Number of 

admissions to substance 

abuse treatment programs 

receiving public funding 

(Output)

FY 2022: 1,501,647

Target:

1,419,631

(Target Exceeded)

1,448,024 1,476,984 +28,960 

1.2.48 Percentage of clients 

reporting no drug use in the 

past month at discharge 

(Outcome)

FY 2022: 51.14%

Target:

50.4%

Target Exceeded

52.4 % 54.4 % +2 % 

1.2.49 Percentage of clients 

reporting no alcohol use in 

the past month at discharge 

(Outcome)

FY 2022: 77.12%

Target:

76.6%

Target Exceeded

78.6 % 80.6 % +2% 

1.2.50 Percentage of clients 

reporting being employed/in 

school at discharge 

(Outcome)

FY 2022: 30.11%

Target:

34.4%

(Target Not Met)

36.4 % 38.4 % +2% 

1.2.51 Percentage of clients 

reporting no involvement 

with the Criminal Justice 

System (Outcome)

FY 2022: 97.47%

Target:

93.8%

(Target Exceeded)

95.8 % 97.8 % +2% 

1.2.85 Percentage of clients 

receiving services who had a 

permanent place to live in 

the community (Outcome)

FY 2022: 87.87%

Target:

90.9%

(Target Not Met)

92.9 % 94.9 % +2% 
314 

Program: Prevention Set-Aside

Measure Year and Most Recent 

Result 

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

2.3.65 Percent of states 

showing a decrease in state 

level estimates of percent of 

survey respondents who 

report 30 day use of alcohol 

(age 12-17) (Outcome)

FY 2022: 62.5 %

Target:

73.9 %

(Target Not Met) 

73.9 % 73.9 % Maintain

2.3.67 Percent of states 

showing a decrease in state 

level estimates of percent of 

survey respondents who 

report 30 day use of any 

illicit drugs other than 

marijuana (age 12-17) 

(Outcome)

FY 2022: 69.6 %

Target:

63 %

(Target Exceed) 

63 % 63 % Maintain

2.3.68 Percent of states 

showing a decrease in state 

level estimates of percent of 

survey respondents who 

report 30 day use of any 

illicit drugs other than 

marijuana (age 18+) 

(Outcome)

FY 2022: 39.3 %

Target:

48 %

(Target Not Met) 

48 % 48 % Maintain
315 

Substance Abuse and Mental Health Services Administration

FY 2024 Substance Use Prevention, Treatment, and Recovery Services Block Grant Final Allotment

Budget Request $2,708,079, State - Territory Total $2,523,049,352

 

State/Territory FY 2022 

Final

FY2023

Enacted FY2024 Request FY 2024 +/- 

FY 2023 

Alabama $23,284,640 $24,686,455 $34,990,474 $10,304,019

Alaska $6,365,096 $7,365,856 $10,155,296 $2,789,440

Arizona $43,466,912 $47,835,777 $63,713,344 $15,877,567

Arkansas $13,638,808 $14,433,529 $19,939,737 $5,506,208

California $256,565,098 $260,569,705 $346,108,411 $85,538,706

 

Colorado $33,296,290 $36,229,697 $49,656,123 $13,426,426

Connecticut $19,103,524 $20,463,616 $29,045,529 $8,581,913

Delaware $7,155,296 $7,530,296 $10,155,296 $2,625,000

District Of Columbia $7,155,296 $7,530,296 $10,155,296 $2,625,000

Florida $112,320,687 $116,814,207 $158,767,581 $41,953,374

 

Georgia $57,635,273 $58,534,875 $78,755,502 $20,220,627

Hawaii $8,654,757 $8,789,845 $12,115,686 $3,325,841

Idaho $8,607,984 $9,195,796 $13,283,266 $4,087,470

Illinois $68,217,527 $69,282,302 $81,952,056 $12,669,754

Indiana $34,062,891 $36,957,352 $51,519,199 $14,561,847

 

Iowa $13,204,014 $14,119,045 $19,750,194 $5,631,149

Kansas $12,104,947 $12,976,950 $18,104,575 $5,127,625

Kentucky $20,550,614 $21,294,912 $29,615,125 $8,320,213

Louisiana $25,237,957 $25,631,884 $31,435,864 $5,803,980

Maine $7,155,296 $7,530,296 $10,155,296 $2,625,000

 

Maryland $34,368,033 $34,904,467 $44,791,940 $9,887,473

Massachusetts $40,958,540 $44,048,382 $61,801,836 $17,753,454

Michigan $56,526,618 $57,408,915 $73,908,249 $16,499,334

Minnesota $24,806,407 $26,746,812 $37,423,306 $10,676,494

Mississippi $13,920,231 $14,137,505 $19,436,489 $5,298,984

 

Missouri $26,772,865 $29,032,034 $40,069,498 $11,037,464

Montana $7,155,296 $7,530,296 $10,155,296 $2,625,000

Nebraska $7,802,372 $8,476,196 $11,798,767 $3,322,571

Nevada $18,578,267 $20,537,145 $28,086,137 $7,548,992

New Hampshire $7,155,296 $7,530,296 $10,155,296 $2,625,000
316 

Substance Abuse and Mental Health Services Administration

FY 2024 Substance Use Prevention, Treatment, and Recovery Services Block Grant Final Allotment

Budget Request $2,708,079, State - Territory Total $2,523,049,352

 

State/Territory FY 2022 

Final

FY2023

Enacted FY2024 Request FY 2024 +/- FY 2023 

New Jersey $48,470,437 $52,033,413 $76,692,382 $24,658,969

New Mexico $9,645,959 $10,381,561 $14,590,776 $4,209,215

New York $112,775,260 $114,535,516 $148,379,060 $33,843,544

North Carolina $47,867,180 $52,356,446 $71,357,798 $19,001,352

 

North Dakota $7,061,663 $7,530,296 $10,155,296 $2,625,000

Ohio $65,081,199 $66,097,021 $76,088,428 $9,991,407

Oklahoma $17,402,859 $19,133,801 $26,640,940 $7,507,139

Oregon $24,280,524 $26,191,379 $36,302,994 $10,111,615

Pennsylvania $59,599,723 $60,529,987 $83,524,980 $22,994,993

 

Rhode Island $7,662,698 $7,782,301 $10,608,117 $2,825,816

South Carolina $23,934,835 $26,137,986 $35,622,838 $9,484,852

South Dakota $6,530,070 $7,530,296 $10,155,296 $2,625,000

Tennessee $32,860,513 $35,879,258 $50,067,126 $14,187,868

Texas $148,608,271 $163,031,546 $226,630,442 $63,598,896

Utah $23,254,669 $25,514,492 $36,202,490 $10,687,998

 

Vermont $6,982,034 $7,530,296 $10,155,296 $2,625,000

Virginia $43,608,532 $47,578,842 $65,860,547 $18,281,705

Washington $39,029,910 $41,988,215 $57,458,398 $15,470,183

West Virginia $8,503,953 $8,636,687 $11,138,226 $2,501,539

Wisconsin $27,427,864 $27,855,973 $38,261,962 $10,405,989

Wyoming $4,536,852 $5,250,164 $10,155,296 $4,905,132

Subtotal $1,780,951,837 $1,871,630,215 $2,523,049,352 $651,419,137

 

Red Lake Indians $611,387 $659,211 $922,347 $263,136

American Samoa $356,222 $358,798 $479,377 $120,579

Guam $1,194,727 $1,275,605 $1,745,230 $469,625

Northern Marianas $367,469 $392,556 $534,101 $141,545

Puerto Rico $23,022,866 $24,154,125 $32,493,119 $8,338,994

 

Palau $153,473 $163,016 $223,456 $60,440

Marshall Islands $545,761 $588,566 $815,032 $226,466

Micronesia $732,246 $774,650 $1,051,215 $276,565

Virgin Islands $757,640 $804,706 $1,094,587 $289,881

Subtotal Territory $27,741,791 $29,171,233 $39,358,464 $10,187,231

Adjustments $99,385,372 $107,277,552 $145,671,184 $38,393,632

Total Resources $1,908,079,000 $2,008,079,000 $2,708,079,000 $700,000,000
317 

Health Surveillance and Program Support

Table of Contents 

Health Surveillance and Program Support ............................................................................ 317

Summary of the Request ................................................................................................. 318

Health Surveillance ............................................................................................... 319

Performance and Quality Information Systems (PQIS) ........................................ 324

Drug Abuse Warning Network (DAWN) ............................................................... 328

Program Support ................................................................................................... 330

Public Awareness and Support ............................................................................. 331

PRNS Mechanism Table ................................................................................................. 335
318 

Health Surveillance and Program Support

Summary of the Request

(Dollars in Thousands)

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted President's 

Budget

FY 2024 +/- 

FY 2023

Health Surveillance and Program Support $130,123 $135,123 $137,795 $2,672

Program Support (non-add) 81,500 84,500 84,500 

Health Surveillance (non-add) 48,623 50,623 53,295 2,672

Budget Authority (non-add) 18,195 20,195 22,867 2,672

PHS Evaluation Funds (non-add).................................................. 30,428 30,428 30,428 --- 

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

Public Awareness and Support........................................................... 13,000 13,260 13,260 --- 

Performance and Quality Information Systems.................................. 10,000 10,200 10,200 --- 

Behavioral Health Workforce Data and Development....................... 1,000 1,000 1,000 --- 

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

Drug Abuse Warning Network........................................................... 10,000 13,000 20,000 7,000

Community Project Funding.............................................................. 127,535 160,777 --- -160,777

Total, Health Surveillance and Program Support ........................ $293,158 $334,860 $183,755 -151,105

FTE 354 378 423 45

Overview

The Health Surveillance and Program Support (HSPS) FY 2024 President’s Budget Request is 

$184 million, a decrease of $151 million from FY 2023 Enacted. 

SAMHSA’s maintains multiple U.S. behavioral health data collection systems and surveys, 

supports public awareness, and funds a range of business operations and processes within HSPS. 
319 

Health Surveillance

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

+/- FY 2023 

Budget

Health Surveillance........................................................................ $48,623 $50,623 $53,295 $2,672

Budget Authority (non-add)............................................................... 18,195 20,195 22,867 2,672

PHS Evaluation Funds (non-add)..................................................... 30,428 30,428 30,428 ---

Authorizing Legislation......................Sections 501 and 505 of the Public Health Service Act 

FY 2024 Authorization .................................................................................................... Permanent

Allocation Method ..................................................... Federal/Intramural, Contracts, Grants, Other 

Eligible Entities ......................................................................................................... Not Applicable 

Program Description 

The Center for Behavioral Health Statistics and Quality (CBHSQ) within SAMHSA is the lead 

Federal government agency for behavioral health data collection, evaluation, and research. 

CBHSQ promotes basic and applied research in behavioral health data systems and statistical 

methodology, designs and carries out special data collection and analytic projects to examine 

issues for SAMHSA and other federal agencies and participates with other federal agencies in 

developing national health statistics policy. CBHSQ’s focus is to leverage data and evidence to 

strengthen SAMHSA data collection activities to prevent overdose; enhance access to suicide 

prevention and crisis care; promote resilience and emotional health for children, youth, and 

families; integrate behavioral and physical healthcare; and strengthen the behavioral health 

workforce. 

CBHSQ performs activities that: (1) coordinate and implement SAMHSA’s integrated data 

strategy, including annual data collection; (2) provide statistical and analytical support for 

SAMHSA’s activities; (3) develop and manage a core set of performance metrics to evaluate high 

priority activities supported by SAMHSA; (4) coordinate with the Assistant Secretary, the 

Assistant Secretary for Planning and Evaluation, as well as SAMHSA’s National Mental Health 

and Substance Use Policy Lab, Chief Medical Officer, and the Office of Behavioral Health Equity, 

as appropriate, to improve the quality of data collection services and evaluations of SAMHSA 

activities. 

Health Surveillance supports the following activities: (1) Population Data Collection, Analysis, 

and Dissemination; (2) Treatment Services Data Collection, Analysis, and Dissemination; (3) 

Behavioral Health Data Dissemination; (4) Performance Measurement/Systems and; (5) Drug 

Abuse Warning Network (DAWN). 
320 

Resources by Activity/Program 

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

FY 2024 +/- 

FY 2023

Health Surveillance

Population Data Collection, Analyis, and Dissemination $15,035 $8,805 $10,937 $2,132

National Survey on Drug Use and Health (NSDUH).......... 15,035 8,805 10,937 2,132

Treatment Services Data Collection, Analysis, and 

Dissemination 11,653 12,855 12,165 -690

Behavioral Health Services Information System (BHSIS).... 11,653 12,855 12,165 -690

Behavioral Health Data Dissemination 3,015 4,349 4,349 ---

SAMHDA/Data Webpage.............................................. 3,015 4,349 4,349 ---

Performance Measurement/Systems 1,488 2,487 487 -2,000

WebBGAS.................................................................. 1,488 2,487 487 -2,000

Drug Abuse Warning Network 6,232 1,738 --- -1,738

PHS Evaluation (non add)..................................... 6,232 1,738 --- -1,738

Support 11,200 20,388 25,357 4,968

Operations................................................................ 11,200 20,388 25,357 4,968

Total Health Surveillance $48,623 $50,623 $53,295 $2,672

Population Data Collection, Analysis, and Dissemination 

CBHSQ leads SAMHSA’s annual requirement to collect prevalence data on substance use and 

mental illness through the National Survey of Drug Use and Health (NSDUH). NSDUH is an 

annual collection of behavioral health data on persons aged 12 or older of the U.S. civilian, noninstitutionalized population. It is used as the nation’s primary source of statistical information on 

the use of illicit drugs, alcohol, tobacco, certain mental health issues, co-occurring drug/alcohol 

addiction and mental illness, and treatment for mental and substance use disorders. NSDUH data 

provide estimates at the national, state, and sub-state level and among demographic, 

socioeconomic, or geographic subgroups, as well as trend estimates over time. The public can 

readily access NSDUH data via SAMHSA’s interactive online tools, specifically designed for 

customized analyses of substance use and mental health indicators, without needing to download 

any data. In addition, SAMHSA disseminates data-based products in the form of annual reports, 

data visualizations, slide decks, data tables and other types of reports. 

In a united effort to support broader use of restricted-use NSDUH data, researchers can apply for, 

and obtain access to, restricted-use NSDUH data using a process that has been streamlined and 

expanded to facilitate easier and broader access to the data. SAMHSA promotes data use by aiding 

researchers in navigating resources, accessing relevant substance use and mental health indicators, 

and completing important public health investigations, while also protecting privacy and 

minimizing disclosure risk. Findings from the research analytic activities have been helpful in 

influencing program implementation of evidence-based interventions and strategies. 
321 

To ensure NSDUH is collecting the highest quality data to address emerging and critical data needs 

related to mental health and substance use behaviors, SAMHSA continues to revise the 

questionnaire. In 2021, questions were expanded to include vaping marijuana and other flavorings 

and non-prescription fentanyl use. In 2022, a number of changes were made including updating 

and renaming the Nicotine module (formerly Tobacco module) and the Alcohol and Drug 

Treatment module (formerly the Drug Treatment module). The Marijuana module was also 

updated through an extensive literature review, SME input, and three rounds of cognitive testing. 

This revised module includes updated terminology, updated modes of administration for 

marijuana, and items on CBD use. 

Treatment Services Data Collection, Analysis, and Dissemination 

CBHSQ collects data on mental health and substance use disorder treatment services through the 

Behavioral Health Services Informational System (BHSIS). Data collected through BHSIS 

provides information to the public on treatment services through the Behavioral Health Treatment 

Services Locator at FindTreatment.gov, which is part of the National Treatment Referral Service. 

BHSIS includes multiple data collection programs and information resources. The data collections 

comprise: 

1) The National Substance Use and Mental Health Services Survey (N-SUMHSS), which 

provides information on all public and private specialty mental health and substance use 

disorder treatment facilities in the United States; 

2) The Treatment Episode Data Set (TEDS), which provides demographic, clinical, and 

substance use characteristics on publicly funded admissions and discharges from substance 

use disorder treatment facilities; 

3) The Mental Health Treatment Episode Data Set (MH-TEDS) and the Mental Health Client 

Level Data (MH-CLD), which provide demographic characteristics and outcomes of 

individuals served by state mental health agencies (SMHAs) for mental health treatment; and 

4) The Uniform Reporting System (URS), which provides a set of standardized data tables 

submitted annually by states and territories as part of their Mental Health Block Grant annual 

implementation reports. 

Behavioral Health Data Dissemination

The Substance Abuse and Mental Health Data Archive (SAMHDA) makes public-use data files 

available in a variety of downloadable formats through SAMHDA, CBHSQ provides access to a 

data visualization tool and to public- and restricted-use data through a web-based analytic tool. 

This site currently resides at https://datafiles.samhsa.gov/. The Data webpage, which currently 

resides at https://www.samhsa.gov/data/, makes reports, survey information, and supporting 

documentation available for various public audiences. In FY 2022 CBHSQ updated the SAMHDA 

site, and the Data webpage. These updates have allowed easier access to a wider audience and 

promoted increased use and access to behavioral health data. 
322 

Drug Abuse Warning Network (DAWN)

DAWN provides necessary information, such as patient demographic details and substances used, 

to respond effectively to the opioid and addiction crises in the United States. DAWN data is used 

to better inform public health, clinicians, policymakers, and other stakeholders when responding 

to emerging substance use trends. By using data abstracted directly from emergency department 

(ED) records, DAWN captures detailed information about the substances involved in ED visits 

and serves as an early warning system for the emergence of new and novel psychoactive 

substances. It monitors the geographic, temporal, and demographic characteristics of drug-related 

ED visits. DAWN captures both ED visits that are directly caused by drugs, such as overdoses, 

and those in which drugs are a contributing factor but not the direct cause of the ED visit, such as 

a motor vehicle crash involving a driver who had combined medications with alcohol. These 

criteria encompass all types of drug-related events, from substance use and misuse to substancerelated suicide attempts. 

Budget Request

The FY 2024 Budget Request for SAMHSA’s Health Surveillance programs is $53.3 million, an 

increase of $2.7 million from the FY 2023 Enacted level. CBHSQ plans to use the additional $2.7 

million for N-SUMHSS to increase the scope of eligible substance use and mental health treatment 

facilities. The proposed increase in funding would: (1) increase N-SUMHSS’ operational capacity 

in order to double the number of facility respondents (currently about 31,000), (2) provide 

resources for the first comprehensive needs assessment since the mid-1990s for determining and 

addressing "gaps" for facilities not currently eligible for the survey, and (3) expand the data 

dissemination to include state and region-specific reports and evaluations for the provision of 

treatment services and underserved populations. CBHSQ will begin designing the Spanish version 

of the FindTreatment.gov to expand treatment services to the racial and ethnic minorities. CBHSQ 

completed modernization of the FindTreatment.gov and further plans to implement features such 

as appointments, wait times for services reduce barriers for individuals and families to access 

treatment. Also, within BHSIS, CBHSQ is planning to implement a National Substance Use and 

Mental Health Services Summary (N-SUMHSS) supplement to gather additional information on 

racial and ethnic minority-based treatment facilities. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $47,258,000 

FY 2021 $47,154,285 

FY 2022 Final $48,623,000 

FY 2023 Enacted $50,623,000 

FY 2024 President's Budget $53,295,000 
323 

Program Accomplishments

In FY 2022, the SAMHSA Data webpage (Data webpage) and Substance Abuse and Mental Health 

Data Archive (SAMHDA) received over 2 million page views overall, with around 64% of the 

traffic consisting of new visitors to the website. There were over 367,000 total files downloaded 

from SAMHSA and SAMHDA in FY 2022. NSDUH webpages within SAMHSA and SAMHDA 

received over 1 million page views and around 240,000 downloads in FY 2022. 

In FY 2022, the Behavioral Treatment Locator homepage received more than 1.16 million page 

views, while the locator map had over 1.25 million-page views from individuals, families, 

community groups, and organizations, to identify appropriate treatment services. The Data 

webpage received over 1.8 million page views, with the public downloading more than 39,897 

BHSIS publications, including 8,041 downloads of TEDS publications, 3,417 of MH-CLD 

publications, 3,211 downloads of DAWN publications, and 5,832 URS tables. 

In FY 2022, the CBHSQ data webpage had over 457,000 users and almost 1.7 million page views

and SAMHDA had around 145,000 users with 331,000 page views and around 64,000 files 

downloaded. 
324 

Performance and Quality Information Systems (PQIS) 

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

+/- FY 2023 

Budget

Performance and Quality Information Systems............................... $10,000 $10,200 $10,200 $---

Authorizing Legislation .................. Sections 501, 505, 509, 516, 520A, and 543A of the PHS Act 

FY 2024 Authorization ...................................................................................................... Indefinite

Allocation Method ............................................................................................................. Contracts

Eligible Entities ......................................................................................................... Not Applicable 

Program Description

SAMHSA’s maintains Performance Measurement and Performance Systems, Evidenced-Based 

Programs and Practices and CBHSQ’s Operations with PQIS funds. 

Resources by Activity/Program 

(Dollars in thousands) 

Performance Measurement and Performance Systems

SAMHSA Performance Accountability and Reporting System (SPARS) 

SAMHSA collects data on key client demographics, output, and outcome measures to monitor and 

manage discretionary grant performance to improve the quality of treatment, prevention and 

mental health services through SPARS. Data collected and analyzed through SPARS enable 

SAMHSA to monitor the progress of discretionary grants, support data-informed decision-making 

for funding, and provide an understanding of the services delivered through the programs. The 

Office of Evaluation Center Evaluation Advisors (CEAs) work closely with SAMHSA 

Program Name

FY 

2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

FY 2024 

+/- FY 

2023

Performance and Quality Information Systems

Performance Measurement and Performance Systems............ $7,295 $6,118 $6,011 $6,011

SAMHSA Performance Accountability Reports System (SPARS) 7,295 6,118 6,011 6,011

Evidence-Based Programs/Practices................................. 1,839 2,150 2,110 2,110

Evidence Based Resource Center................................................. 1,839 2,150 2,110 2,110

Behavioral Health Data Dissemination.............................. 271 --- --- ---

Support Operations...................................................... 595 1,932 2,079 2,079

Operations...................................................................................... 595 1,932 2,079 2,079

Total Performance and Quality Information Systems $10,000 $10,200 $10,200 $10,200
325 

programmatic Centers and Program Officers to routinely enhance SPARS to be more user friendly 

with greater data visualization strategies. In FY 2022, the Office of Evaluation (OE) worked with 

programmatic Centers to develop a comprehensive list of proposed enhancements to SPARS.

These enhancements will not only improve data visualization options for examination of 

demographic and outcomes data, SPARS enhancement will provide a better user experience 

offering more efficient data entry and access to resources. Also, in FY 2022, SPARS was updated 

to include new versions of more than 40 of SAMHSA’s Government Performance Results Act 

(GPRA) tools for discretionary grant programs. These updated tools required CBHSQ to make 

significant changes to the SPARS system and required updates to GPRA documentation and 

resources including recorded videos and live, interactive training sessions. SPARS infrastructure 

and security were upgraded to ensure operational stability and protection. 

 

Evidenced-Based Programs and Practices

Evidence-Based Practice Resource Center (EBPRC) 

Section 7002 of the 21st Century Cures Act directs SAMHSA to promote access to reliable and 

valid information on evidence-based programs and practices and share information on the strength 

of evidence associated with such programs and practices related to mental illness and drug/alcohol 

addiction. To fulfill this charge, SAMHSA has developed the Evidence-Based Practices Resource 

Center (EBPRC), which is managed by the National Mental Health and Substance Use Policy 

Laboratory (NMHSUPL). The EBPRC enables SAMHSA to collaborate with experts in the field 

and to rapidly translate science into action. It provides states, local communities, clinicians, 

policymakers, and others in the field with the latest information and tools that they need to 

incorporate evidence-based practices in their communities or clinical settings. As part of this 

effort, SAMHSA develops, curates, and disseminates resources, such as new or updated 

guidebooks, advisories, treatment improvement protocols, practical guides, toolkits, systematic 

reviews, data reports, and other actionable materials from across the Department of Health and 

Human Services. In particular, SAMHSA disseminates the evidence-based practices listed in the 

EBPRC through various avenues including through regional and locally based training and 

technical assistance efforts, SAMHSA e-blasts and other tools to ensure that communities and 

practitioners are equipped to bring about the improvements in mental health and substance use 

prevention, treatment, and recovery that our Nation requires. 

 

Support

Operations 

The CBHSQ/OE is responsible for providing centralized planning and management of program 

evaluation and performance management activity across SAMHSA. In this role, OE provides 

support to SAMHSA’s three programmatic centers, CMHS, CSUS, CSUPS, the Office of Tribal 

Affairs and Policy (OTAP), and the Office of Intergovernmental and Public Affairs grantees and 

project officers, by supporting evaluation proposals, performance management and monitoring and 

quality improvement activities. OE provides oversight and management of agency quality 

improvement and performance management activities and advances agency goals and objectives 

relating to performance measurements and quality improvement. In FY 2022, OE led the creation 
326 

of a SAMHSA Evidence and Evaluation Board (SEEB) with the purpose of serving as the agency’s 

principal evaluation and evidence forum and decision-making body for managing SAMHSA’s 

evaluation portfolio, evaluation and evidence data, and as a strategic asset to support SAMHSA in 

meeting its mission and agency priorities, including implementation of the Evidence Act. The 

SEEB meets regularly and includes members for all SAMHSA Centers and Offices. In FY 2022, 

OE also created an Evaluation Policy and Procedures (P & P) document to formalize a systematic 

approach to planning, managing and overseeing programmatic and policy evaluation activities 

within SAMHSA.

The OE provides oversight of the agency’s quality improvement efforts, including the 

identification of gaps in behavioral health quality measurement and the adoption and 

implementation of behavioral health quality measures. This work includes partnerships with the 

Center for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Planning and 

Evaluation (ASPE), among other federal partners, in quality measures work. 

Budget Request

The FY 2024 President’s Budget Request is $10.2 million, level with the FY 2023 Enacted level. 

CBHSQ will focus on modernization efforts and continuation of the SPARS and EBPRC contracts. 

SAMHSA plans to improve the SPARS system to handle the substantial increase in the number of 

discretionary grants reporting into SPARS in the past two years (more than 7,400 grants in FY

2022). This has led to an increase in the number of internal and external stakeholders who use the 

SPARS system requiring targeted training, resources both digital and printable, and technical 

support for use of the SPARS online system. 

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $10,000,000 

FY 2021 $9,969,596 

FY 2022 Final $10,000,000 

FY 2023 Enacted $10,200,000 

FY 2024 President's Budget $10,200,000 

Program Accomplishments

In FY 2022, CBHSQ/OE introduced “Data Parties’ designed to bring together diverse stakeholders 

from across SAMHSA to collectively analyze data that have been collected and to support 

interpretation of what the data mean and implications for action. The first event included over 70 

SAMHSA staff and leadership. 

In FY 2022, OE conducted an internal evaluation of the quality measures currently used by 

SAMHSA grantees with recommendations approved by SAMHSA leadership in FY 2022. These 

new quality measures will be implemented in FY 2023 and beyond. In addition, CBHSQ/OE 
327 

serves as the SAMHSA lead to the National Quality Forum (NQF), as well as participates as a 

federal advisor for other agencies conducting measure development work, including CMS and 

ASPE. 
328 

Drug Abuse Warning Network (DAWN) 

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

+/- FY 

2023 

Budget

Drug Abuse Warning Network....................................................... $10,000 $13,000 $20,000 $7,000

Authorizing Legislation..................................Section 505 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method ............................................................................................................. Contracts

Eligible Entities ......................................................................................................... Not Applicable 

Program Description 

DAWN provides necessary information, such as patient demographic details and substances used, 

to respond effectively to the opioid and addiction crises in the United States. DAWN data is used 

to better inform public health, clinicians, policymakers, and other stakeholders when responding 

to emerging substance use trends. By using data abstracted directly from emergency department 

(ED) records, DAWN captures detailed information about the substances involved in ED visits 

and serves as an early warning system for the emergence of new and novel psychoactive 

substances. It monitors the geographic, temporal, and demographic characteristics of drug-related 

ED visits. DAWN captures both ED visits that are directly caused by drugs, such as overdoses, 

and those in which drugs are a contributing factor but not the direct cause of the ED visit, such as 

a motor vehicle crash involving a driver who had combined medications with alcohol. These 

criteria encompass all types of drug-related events, from substance use and misuse to substancerelated suicide attempts. 

Budget Request

The FY 2024 President’s Budget Request is $20.0 million, an increase of $7 million from the 

FY 2023 Enacted level. CBHSQ plans to increase the number of participating hospitals to report 

robust national estimates, as well as early warning system. SAMHSA began natural language 

processing for data abstraction as a pilot in selected hospitals in 2023. SAMHSA/CBHSQ also 

published two Drug Abuse Warning Network (DAWN) reports in 2022. SAMHSA/CBHSQ plans 

to disseminate multiple reports which includes annual estimates, non-fatal overdose report, 

methamphetamine report, methodology report, array of infographics, as well as trend report in 

2023. SAMHSA/CBHSQ is planning to further expand machine learning based early warning 

system to identify patterns of drug-related emergency department (ED) visits to be made available 

to inform SAMHSA and policy makers. SAMHSA/CBHSQ implemented a technical expert panel 

that will involve engaging local public health officials and policy makers to assess their need for 

opioid related data to address local opioid crisis. SAMHSA further plans to expand substance use 

related public health surveillance of hospital ED visits and provide a more comprehensive 

campaign on drug overdose based on the data abstracted from the DAWN system in FY 2024. 
329 

Funding History Table

5 Year Funding Table

Fiscal Year Amount

FY 2020 $10,000,000 

FY 2021 $10,000,000 

FY 2022 Final $10,000,000 

FY 2023 Enacted $13,000,000 

FY 2024 President's Budget $20,000,000 

Program Accomplishments 

In FY 2022, the DAWN surveillance system has reviewed more than 5,285,028 ED records from 

53 participating hospitals (26 urban, 11 suburban, and 16 rural) and abstracted over 410,133 

DAWN cases (7.8 percent of total ED records reviewed). Preliminary analysis demonstrates that 

the most common substances associated with DAWN cases are alcohol (191,800 cases, 38.8 

percent), illicit substances (146,426 cases, 29.6 percent) and Central Nervous System (CNS) 

agents (71,951 cases, 14.6 percent); among illicit drugs, stimulants were the most commonly 

associated with DAWN cases, with the majority involving methamphetamine.
330 

Program Support 

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

+/- FY 

2023 

Budget

Program Support............................................................................ $81,500 $84,500 $84,500 --- 

FTE 354 378 423 45

Authorizing Legislation ............................................. Section 501 of the Public Health Service Act 

FY 2024 Authorization ..................................................................................................................$0 

Allocation Method .......................................... Direct Federal/Intramural, Contracts, Grants, Other 

Eligible Entities ......................................................................................................... Not Applicable 

Program Description 

The Program Support budget supports SAMHSA staff who plan, direct, and administer 

SAMHSA’s programs, as well as business operations and processes, information technology, and 

overhead expenses, such as rent and utilities. In addition, this budget supports the Unified 

Financial Management System (UFMS), which covers administrative activities such as human 

resources, information technology, financial integrity, and the centralized services provided by 

HHS and the Program Support Center. SAMHSA’s FTE increase in FY 2023 and FY 2024 

supports programmatic growth described throughout the budget. SAMHSA also applies an 

estimated internal administrative charge for overhead expenses to all programs, projects, and 

activities.

Budget Request 

The FY 2024 Budget Request is $84.5 million, level with FY 2023 Enacted level. SAMHSA will 

continue to support staff to administer and manage SAMHSA’s diverse array of programs. At this 

funding level, SAMHSA will also ensure the agency can efficiently and effectively respond to the 

evolving and growing opioid crisis, as well as provide the significant resources, technical 

assistance, and leadership within the mental health and behavioral health public health sphere. 

This level of funding will also continue to cover overhead costs associated with 5600 Fishers Lane, 

including rent, the Federal Acquisition Service loan repayment program, and security charges 

activities.

Funding History Table 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $79,000,000 

FY 2021 $78,762,000 

FY 2022 Final $81,500,000 

FY 2023 Enacted $84,500,000 

FY 2024 President's Budget $84,500,000 
331 

Public Awareness and Support 

(Dollars in thousands) 

Program Name

FY 2022 FY 2023 FY 2024

Final Enacted

President's 

Budget

+/- FY 

2023 

Budget

Public Awareness and Support...................................................... $13,000 $13,260 $13,260 --- 

Authorizing Legislation.... Sections 501, 509, 516, and 520A of the Public Health Service Act 

FY 2024 Authorization ............................................................................ Indefinite 

Allocation Method................................................................................. Contracts 

Eligible Entities ......................................................................................................... Not Applicable 

 

Program Description 

 

SAMHSA’s mission is to lead public health and service delivery efforts that promote mental 

health, prevent substance misuse, and provide treatments and supports to foster recovery while 

ensuring equitable access and better outcomes. To support the mission, SAMHSA’s Office of 

Communications (OC) staff ensure that the vital information, publications, and training materials 

produced through SAMHSA’s centers and offices are available to the healthcare workforce, people 

in treatment and recovery, people in crisis or in areas affected by disasters, SAMHSA grantees, 

and the public. Several channels are used to communicate this information, including online, print, 

radio, and television media; social media platforms; the SAMHSA.gov website; the SAMHSA 

Store, the subscription-based e-blast system; and inquiries received through the National 

Helpline. In addition, the OC staff manage SAMHSA events to interact with stakeholders, media 

organizations, and the public and assist in the development and execution of materials, products, 

and campaigns. 

The OC media team evaluate and act upon media inquiries; develop rollout plans; issue press 

releases, news bulletins, and media advisories; and provide in-house media support to SAMHSA 

centers and offices. The team build relationships with representatives of the media; identify and 

seek corrections to inaccuracies about SAMHSA in media products, when necessary; work to add 

SAMHSA’s life-saving resources to journalistic and entertainment products; support broad HHS 

and administration communications priorities; and collaborate with departmental operating 

divisions. The media team also collaborate with SAMHSA staff when a disaster occurs to quickly 

disseminate press releases and social media featuring SAMHSA’s Disaster Distress Helpline and 

links to relevant SAMHSA resources. 

The OC digital team manage SAMHSA’s social media presence on Facebook, Twitter, LinkedIn, 

Instagram, and YouTube. Social media messaging is incorporated in all communications plans

and is employed daily to communicate messages about SAMHSA news and resources. The staff 

monitor social media conversations, create content, participate in Twitter chats and Facebook Live 

sessions, and post blogs on SAMHSA.gov. The digital team also manage the SAMHSA.gov 

website, which provides enterprise-wide content and related public-facing websites, and support 

Section 508 activities. 

 
332 

The following contract services are managed within the OC and provide various levels of support 

to enable the sharing of vital information to the public. Examples of this work include content 

development and amplification of critical resources like the 988 Suicide and Crisis Lifeline, 

Disaster Distress Helpline, and findtreatment.gov; materials development and dissemination for 

national observances like Mental Health Awareness and Recovery Month, Prevention Week, and 

others; support for messaging around the Administration’s behavioral health strategies and 

program funding; building and maintaining the new findsupport.gov resource and continuous 

revitalizing SAMHSA.gov webpages; and developing educational campaigns and resources to 

support people in recovery from mental health conditions and substance use disorder. 

Public Awareness and Support Activities: Enables the agency to develop and disseminate a 

variety of national informational campaigns, public service announcements (PSAs), and other 

materials for a broad range of platforms. Topics, audiences, and formats range but all phases from 

creative concepts to storyboards as well as focus group testing are included. As an example, the 

OC has issued, with the assistance of this contract, information, graphics and resources for 

National Mental Health Awareness and National Recovery Month as well as the continued 

promotion of the 988 Suicide and Crisis Lifeline. 

Materials Development and Editorial Services: Provides communication support services for 

media outreach, publications, digital products, speechwriting, graphics, copyediting, and 

meeting/event logistics. As an example, through this contract OC is supporting the Office of 

Recovery in developing reports and outreach materials for their programs and events. 

Web Management and Support: Supports SAMHSA’s website, list serve and subscriber 

database system, and mobile applications. For its online publication library (aka SAMHSA Store), 

the OC has entered into an interagency agreement with the U.S. Government Publishing Office 

(GPO) to manage a customer-oriented fulfillment and distribution center, including a warehouse 

to store SAMHSA publications. This contract also keeps the website current in terms of U.S. web 

standards, improved search engines, new dashboards, and a modernized homepage. 

Contact Center: Supports the National Helpline (1-800-662-HELP) and the 1-877-SAMHSA-7 

information line. The National Helpline provides free, confidential treatment referral and 

information services in English and Spanish for individuals and families facing mental illness 

and/or substance use disorders via phone or text (HELP4U). It is operational 365 days-a-year, 

24/7. The 1-877-SAMHSA-7 line is the single point of entry for SAMHSA’s information services 

and is operated Monday through Friday, 8:00 am to 8:00 pm (except for federal holidays). 

Budget Request 

 

The FY 2024 President’s Budget request is $13.3 million, level with FY 2023 Enacted level. 

SAMHSA intends to fund four contracts and one interagency agreement that will allow SAMHSA 

to manage media relationships, maintain its web and social media presence, manage critical 

helplines, deliver publications and resources, produce, and deliver PSAs, and conduct national 

campaigns. 
333 

Funding History Table 

 

5 Year Funding Table

Fiscal Year Amount

FY 2020 $13,000,000 

FY 2021 $12,961,000 

FY 2022 Final $13,000,000 

FY 2023 Enacted $13,260,000 

FY 2024 President's Budget $13,260,000 

Accomplishments 

In FY 2022, OC increased content development and amplification of the 988 Suicide and Crisis 

Lifeline, Disaster Distress Helpline, and findtreatment.gov; materials development and 

dissemination for Mental Health Awareness and Recovery Month, Prevention Week, and others; 

support for messaging around the Administration’s behavioral health strategies and program 

funding; building and maintaining the new findsupport.gov resource and continuous revitalizing 

SAMHSA.gov webpages; and developing educational campaigns and resources to support people 

in recovery from mental health conditions and substance use disorders. A significant 

accomplishment was the interagency agreement with the U.S. Government Publishing Office to 

manage a customer-oriented fulfillment and distribution center, including a warehouse to store 

SAMHSA publications. 

In FY 2022, the number of individuals referred for behavioral health treatment resources exceeded 

the target by 92,404 referrals. In addition, the total number of interactions through phone inquiries, 

e-blasts, dissemination of SAMHSA publications, and website hits exceeded the target by over 16 

million interactions. 
334 

Outputs and Outcomes 

Program:  Public Awareness and Support 

 

Measure Year and Most Recent 

Result /

Target for Recent Result /

(Summary of Result)

FY 2023

Target

FY 2024

Target

FY 2024

Target

+/-FY 2023

Target

4.4.12 The number of 

individuals referred for 

behavioral health 

treatment resources. 

(Output)

FY 2022: 1,115,900

Target:

1,023,496

(Target Exceeded)

1,054,200 1,085,800 +31,600 

4.4.13 The total number 

of interactions through 

phone inquiries, e-blasts, 

dissemination of 

SAMHSA publications, 

and total website hits 

(Output)

FY 2022: 75,883,440

Target:

59,441,622

(Target Exceeded)

61,224,900 63,061,650 +1,836,750 
335 

PRNS Mechanism Table

Program, Project, and Activity 

(Dollars in millions)

Program Activity

FY 2022

Final

FY 2023

Enacted

FY 2024 

President's Budget

No. Amount No. Amount No. Amount

Health Surveillance 

Contracts 

Continuations.......................................................................... --- 48.62 --- 47.62 --- 50.62 

New/Competing...................................................................... --- --- 1 3.00 1 2.67 

Subtotal............................................................................... --- 48.62 1 50.62 1 53.30 

Total, Health Surveillance --- 48.62 1 50.62 1 53.30 

Program Support 

Grants 

Continuations.......................................................................... 1 0.80 --- --- --- ---

New/Competing...................................................................... 8 1.99 --- --- --- ---

Subtotal............................................................................... 9 2.79 --- --- --- ---

Contracts 

Continuations.......................................................................... --- 78.71 --- 84.50 --- 84.50 

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- 78.71 --- 84.50 --- 84.50 

Total, Program Support 9 81.50 --- 84.50 --- 84.50 

Public Awareness and Support 

Contracts 

Continuations.......................................................................... 5 7.95 5 10.21 6 13.26 

New/Competing...................................................................... 2 5.05 2 3.05 --- -- 

Subtotal............................................................................... 7 13.00 7 13.26 6 13.26 

Total, Public Awareness and Support 7 13.00 7 13.26 6 13.26 

Performance and Quality Information Systems 

Contracts 

Continuations.......................................................................... 2 10.00 2 10.20 2 10.20 

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal............................................................................... 2 10.00 2 10.20 2 10.20 

Total, Performance and Quality Information Systems 2 10.00 2 10.20 2 10.20 

Drug Abuse Warning Network 

Contracts 

Continuations.......................................................................... 1 10.00 1 13.00 1 20.00 

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal............................................................................... 1 10.00 1 13.00 1 20.00 

Total, Drug Abuse Warning Network 1 10.00 1 13.00 1 20.00 

Behavioral Health Workforce Data and Development 

Grants 

Continuations.......................................................................... 1 0.98 1 0.98 1 0.98 

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal............................................................................... 1 0.98 1 0.98 1 0.98 

Contracts 

Continuations.......................................................................... --- 0.02 --- 0.02 --- 0.02 

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- 0.02 --- 0.02 --- 0.02 

Total, Behavioral Health Workforce Data and Development 1 1.00 1 1.00 1 1.00 

Total, HSPS 20 164.12 12 172.58 11 182.26 1

/ The table excludes Data Request and Publications User Fee of $1.5M and Congressional Earmarks of $127.5M in FY 22 and $160.7M in 

FY 23.
336 

Supplementary Tables

Table of Contents

Budget Authority by Object Class .................................................................................. 337

Salaries and Expenses ..................................................................................................... 346

Details of Full-Time Equivalent Employment ................................................................ 348

Detail of Positions ........................................................................................................... 349

Physicians’ Comparability Allowance Worksheet ......................................................... 350

Resources for Cyber Activities ....................................................................................... 351

 
337 

Budget Authority by Object Class

Summary Direct Budget Authority

(Dollars in thousands) 

Object Class - Direct Budget Authority1,2,3

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 

+/- FY 

2023

Personnel compensation:

Full-time permanent (11.1) $53,316 $66,801 $86,346 +$19,545 

Other than full-time permanent (11.3) 1,535 2,341 2,838 +496 

Other personnel compensation (11.5) 2,271 2,457 3,578 +1,121 

Military personnel (11.7) 4,645 5,172 7,645 +2,474 

Special personnel services payments (11.8) 16 16 28 +12 

Subtotal personnel compensation: 61,785 76,786 100,435 +23,648 

Civilian benefits (12.1) 21,575 26,943 32,933 +5,991 

Military benefits (12.2) 618 673 886 +213 

Subtotal Pay Costs: 83,977 104,402 134,254 +29,852 

Travel and transportation of persons (21.0) 661 709 653 -56 

Transportation of things (22.0) 11 16 -16 

Rental payments to GSA (23.1) 6,830 6,953 7,078 +125 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) 414 195 241 +46 

Printing and reproduction (24.0) 584 618 915 +298 

Other Contractual Services:

Advisory and assistance services (25.1) 52,177 28,433 28,484 +51 

Other services (25.2) 135,459 101,020 175,750 +74,730 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 34,297 25,308 34,627 +9,319 

Operation and maintenance of facilities (25.4) 212 125 132 +7 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 1,696 959 1,032 +73 

Subtotal Other Contractual Services: 223,841 155,845 240,025 +84,180 

Supplies and materials (26.0) 160 138 124 -14 

Equipment (31.0) 414 240 250 +10 

Grants, subsidies, and contributions (41.0) 6,073,628 7,100,934 9,890,918 +2,789,983 

Insurance claims and indemnities (42.0) 341 366 350 -16 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 6,306,886 7,266,014 10,140,554 +2,874,540 

Total Direct Obligations $6,390,863 $7,370,416 $10,274,808 +2,904,392 1 Does not include PHS Evaluation Funds.

2 Does not include Prevention and Public Health Funds.

3 Does not include Mandatory funds
338 

Budget Authority by Object Class

Mental Health

(Dollars in thousands) 

Object Class - Direct Budget Authority1,2,3

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1) $9,901 $8,257 $14,067 +$5,809 

Other than full-time permanent (11.3) 201 167 285 +118 

Other personnel compensation (11.5) 577 482 820 +339 

Military personnel (11.7) 1,285 1,139 1,940 +801 

Special personnel services payments (11.8) 8 7 12 +5 

Subtotal personnel compensation: 11,972 10,052 17,124 +7,072 

Civilian benefits (12.1) 3,856 3,216 5,478 +2,262 

Military benefits (12.2) 174 154 262 +108 

Subtotal Pay Costs: 16,002 13,422 22,864 +9,442 

Travel and transportation of persons (21.0) --- --- --- --- 

Transportation of things (22.0) + 

Rental payments to GSA (23.1) 1,854 1,887 1,921 +34 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) 294 113 133 +20 

Printing and reproduction (24.0) 5 2 3 +1 

Other Contractual Services:

Advisory and assistance services (25.1) 29,081 11,128 8,196 -2,933 

Other services (25.2) 46,967 17,972 13,236 -4,736 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 16,883 6,460 4,757 -1,703 

Operation and maintenance of facilities (25.4) 45 17 24 +7 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 851 326 447 +121 

Subtotal Other Contractual Services: 93,827 35,903 26,660 -9,243 

Supplies and materials (26.0) 37 14 11 -3 

Equipment (31.0) 216 83 98 +15 

Grants, subsidies, and contributions (41.0) 1,933,546 2,704,082 4,444,666 +1,740,583 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 2,029,780 2,742,085 4,473,493 +1,731,408 

Total Direct Obligations $2,045,781 $2,755,507 $4,496,356 +$1,740,850 1 Does not include PHS Evaluation Funds.

2 Does not include ACA or PPHF

3 Does not include Mandatory funds of $412.5M
339 

Budget Authority by Object Class

Substance Use Prevention Services

(Dollars in thousands) 

Object Class - Direct Budget Authority1

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 

+/- FY 

2023

Personnel compensation:

Full-time permanent (11.1) $617 $9,712 $10,585 +$873 

Other than full-time permanent (11.3) 49 777 846 +70 

Other personnel compensation (11.5) 2 28 31 +3 

Military personnel (11.7) --- --- --- --- 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 668 10,517 11,462 +945 

Civilian benefits (12.1) 249 3,911 4,262 +352 

Military benefits (12.2) --- --- --- --- 

Subtotal Pay Costs: 917 14,427 15,724 +1,297 

Travel and transportation of persons (21.0) --- --- --- --- 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) 1,100 1,120 1,140 +20 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) 2 2 1 -1 

Other Contractual Services:

Advisory and assistance services (25.1) 5,455 3,556 4,127 +571 

Other services (25.2) 15,723 10,249 11,786 +1,537 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 2,257 1,471 3,121 +1,650 

Operation and maintenance of facilities (25.4) 167 108 108 - 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) --- --- --- --- 

Subtotal Other Contractual Services: 23,602 15,385 19,142 +3,757 

Supplies and materials (26.0) --- --- + 

Equipment (31.0) --- --- --- --- 

Grants, subsidies, and contributions (41.0) 192,296 205,945 209,731 +3,786 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 217,000 222,452 230,014 +7,562 

Total Direct Obligations $217,917 $236,879 $245,738 +$8,859 1 Does not include PHS Evaluation Funds.
340 

Budget Authority by Object Class

Substance Use Services

(Dollars in thousands) 

Object Class - Direct Budget Authority1

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1) $8,085 $11,431 $17,118 +$5,687 

Other than full-time permanent (11.3) 37 52 78 +26 

Other personnel compensation (11.5) 370 524 784 +261 

Military personnel (11.7) 517 776 1,163 +386 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 9,009 12,784 19,144 +6,360 

Civilian benefits (12.1) 2,952 4,173 6,249 +2,076 

Military benefits (12.2) 29 44 65 +22 

Subtotal Pay Costs: 11,990 17,000 25,459 +8,458 

Travel and transportation of persons (21.0) 3 3 3 + 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) 2,776 2,826 2,877 +51 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges 

(23.3) 120 82 108 +27 

Printing and reproduction (24.0) 13 9 911 +902 

Other Contractual Services:

Advisory and assistance services (25.1) 15,594 10,555 12,798 +2,243 

Other services (25.2) 19,361 13,105 90,842 +77,736 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 4,703 3,184 12,345 +9,161 

Operation and maintenance of facilities (25.4) --- --- --- --- 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 687 464 422 -42 

Subtotal Other Contractual Services: 40,345 27,308 116,407 +89,098 

Supplies and materials (26.0) 23 15 10 -6 

Equipment (31.0) 139 94 92 -2 

Grants, subsidies, and contributions (41.0) 3,817,084 4,028,761 5,236,021 +1,207,260 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 3,860,502 4,059,098 5,356,428 +1,297,331 

Total Direct Obligations $3,872,493 $4,076,098 $5,381,887 

+$1,305,78

9 1 Does not include PHS Evaluation Funds.
341 

Budget Authority by Object Class

Health Surveillance and Program Support

(Dollars in thousands)

Object Class - Direct Budget Authority1

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1) $34,713 $37,400 $44,576 +$7,176 

Other than full-time permanent (11.3) 1,248 1,345 1,628 +283 

Other personnel compensation (11.5) 1,321 1,424 1,943 +519 

Military personnel (11.7) 2,844 3,256 4,542 +1,286 

Special personnel services payments (11.8) 8 9 16 +7 

Subtotal personnel compensation: 40,134 43,434 52,706 +9,271 

Civilian benefits (12.1) 14,519 15,643 16,944 +1,301 

Military benefits (12.2) 415 475 558 +83 

Subtotal Pay Costs: 55,068 59,553 70,208 +10,655 

Travel and transportation of persons (21.0) 658 706 650 -56 

Transportation of things (22.0) 11 16 -16 

Rental payments to GSA (23.1) 1,100 1,120 1,140 +20 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) 564 605 1 -604 

Other Contractual Services:

Advisory and assistance services (25.1) 2,047 3,194 3,364 +170 

Other services (25.2) 53,408 59,693 59,886 +193 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 10,454 14,193 14,403 +210 

Operation and maintenance of facilities (25.4) --- --- --- --- 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) 158 169 163 -6 

Subtotal Other Contractual Services: 66,067 77,249 77,816 +567 

Supplies and materials (26.0) 101 108 103 -5 

Equipment (31.0) 59 63 60 -3 

Grants, subsidies, and contributions (41.0) 130,702 162,146 500 -161,646 

Insurance claims and indemnities (42.0) 341 366 350 

Interest and dividends (43.0) --- --- --- --- 

Subtotal Non-Pay Costs 199,604 242,379 80,620 -161,760 

Total Direct Obligations $254,672 $301,932 $150,827 -$151,105 1 Does not include PHS Evaluation Funds.
342 

Budget Authority by Object Class

Summary PHS Evaluation Funds

(Dollars in thousands) 

Object Class - PHS Evaluation Funds

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 

+/- FY 

2023

Personnel Compensation:

 Full Time Permanent (11.1) $10,575 $18,143 $20,526 +$2,383 

 Other than Full-Time Permanent (11.3) 30 62 62 +1 

 Other Personnel Compensation (11.5) 248 437 482 +45 

 Military Personnel Compensation (11.7) 729 1,283 1,398 +116 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal Personnel Compensation: 11,582 19,924 22,469 +2,545 

 Civilian Personnel Benefits (12.1) 3,911 6,711 7,593 +882 

 Military Personnel Benefits (12.2) 78 140 152 +12 

Subtotal Pay Costs: 15,571 26,774 30,214 +3,439 

Travel (21.0) 4 10 10 --- 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communications, Utilities and Misc. Charges 

(23.3) --- --- --- --- 

Printing and Reproduction (24.0) 950 1,000 1,001 +1 

Other Contractual Services:

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 109,692 100,109 97,015 -3,093 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 774 828 848 +20 

Operation and maintenance of equipment (25.7) --- --- --- --- 

Subtotal Other Contractual Services: 110,466 100,937 97,863 -3,073 

Supplies and Materials (26.0) --- --- --- --- 

Equipment (31.0) --- --- --- --- 

Grants, Subsidies, and Contributions 

(41.0).......................................................................... 5,218 4,946 4,580 -366 

Subtotal Non-Pay Costs 116,638 106,893 103,454 -3,438 

Total PHS Evaluation Funds $132,209 $133,667 $133,667 -$ 
343 

Budget Authority by Object Class

Mental Health

(Dollars in thousands) 

Object Class - PHS Evaluation 

FY 

2022

Final

FY 

2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- FY 

2023

Personnel compensation:

Full-time permanent (11.1) $3,529 $7,328 $7,820 +$492 

Other than full-time permanent (11.3) 5 20 22 +1 

Other personnel compensation (11.5) 91 196 210 +13 

Military personnel (11.7) 542 1,055 1,126 +71 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 4,166 8,600 9,177 +578 

Civilian benefits (12.1) 1,299 2,713 2,895 +182 

Military benefits (12.2) 61 119 126 +8 

Subtotal Pay Costs: 5,526 11,431 12,199 +768 

Travel and transportation of persons (21.0) --- --- --- --- 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communication, utilities, and misc. charges 

(23.3) --- --- --- --- 

Printing and reproduction (24.0) --- --- --- --- 

Other Contractual Services:

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 12,494 6,871 6,477 -394 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 46 47 47 --- 

Operation and maintenance of equipment 

(25.7) --- --- --- --- 

Subtotal Other Contractual Services: 12,540 6,918 6,524 -394 

Supplies and materials (26.0) --- --- --- --- 

Equipment (31.0) --- --- --- --- 

Grants, subsidies, and contributions (41.0) 2,968 2,690 2,316 -374 

Subtotal Non-Pay Costs 15,508 9,608 8,840 -768 

Total PHS Evaluation Funds $21,035 $21,039 $21,039 -$ 
344 

Budget Authority by Object Class

Substance Use Services

(Dollars in thousands) 

Object Class - PHS Evaluation 

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 

2024 

+/- FY 

2023

Personnel compensation:

Full-time permanent (11.1) $3,903 $4,473 $5,351 +$878 

Other than full-time permanent (11.3) 10 12 14 +2 

Other personnel compensation (11.5) 88 101 121 +20 

Military personnel (11.7) 187 228 272 +45 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 4,189 4,813 5,758 +945 

Civilian benefits (12.1) 1,460 1,673 2,001 +329 

Military benefits (12.2) 17 21 25 +4 

Subtotal Pay Costs: 5,666 6,507 7,785 +1,278 

Travel and transportation of persons (21.0) --- --- --- --- 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) 200 200 201 +1 

Other Contractual Services: --- --- 

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 72,618 72,156 70,870 -1,286 

 Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 80 81 81 + 

Operation and maintenance of equipment (25.7) --- --- --- --- 

Subtotal Other Contractual Services: 72,698 72,237 70,951 -1,286 

Supplies and materials (26.0) --- --- --- --- 

Equipment (31.0) --- --- --- --- 

Grants, subsidies, and contributions (41.0) 2,250 2,256 2,263 +7 

Subtotal Non-Pay Costs 75,148 74,693 73,415 -1,278 

Total PHS Evaluation Funds $80,814 $81,200 $81,200 +$ 
345 

Budget Authority by Object Class

Health Surveillance and Program Support

(Dollars in thousands)

Object Class - PHS Evaluation 

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1) $3,143 $6,343 $7,356 +$1,013 

Other than full-time permanent (11.3) 15 29 27 -3 

Other personnel compensation (11.5) 69 139 152 +12 

Military personnel (11.7) --- --- --- --- 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation: 3,227 6,512 7,534 +1,022 

Civilian benefits (12.1) 1,152 2,325 2,696 +372 

Military benefits (12.2) --- --- --- --- 

Subtotal Pay Costs: 4,379 8,837 10,230 +1,393 

Travel and transportation of persons (21.0) 4 10 10 --- 

Transportation of things (22.0) --- --- --- --- 

Rental payments to GSA (23.1) --- --- --- --- 

Communication, utilities, and misc. charges (23.3) --- --- --- --- 

Printing and reproduction (24.0) 750 800 800 --- 

Other Contractual Services:

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 24,581 21,081 19,668 -1,413 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) 648 700 720 +20 

Operation and maintenance of equipment (25.7) --- --- --- --- 

Subtotal Other Contractual Services: 25,228 21,781 20,388 -1,393 

Supplies and materials (26.0) --- --- --- --- 

Equipment (31.0) --- --- --- --- 

Grants, subsidies, and contributions (41.0) --- --- --- --- 

Subtotal Non-Pay Costs 25,982 22,591 21,198 -1,393 

Total Reimbursable Obligations $30,361 $31,428 $31,428 +$ 
346 

Salaries and Expenses

(Dollars in thousands)

Object Class - Direct Budget Authority1,2,3

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Personnel compensation:

Full-time permanent (11.1) $53,316 $66,801 $86,346 +$19,545 

Other than full-time permanent (11.3) 1,535 2,341 2,838 +496

Other personnel compensation (11.5) 2,271 2,457 3,578 +1,121

Military personnel (11.7) 4,645 5,172 7,645 +2,474

Special personnel services payments (11.8) 16 16 28 +12

Subtotal personnel compensation 61,785 76,786 100,435 +23,648

Civilian benefits (12.1) 21,575 26,943 32,933 +5,991

Military benefits (12.2) 618 673 886 +213

Subtotal Pay Costs: 83,977 104,402 134,254 +29,852

Travel (21.0) 661 709 653 -56

Transportation of things (22.0) 11 16 -16

Rental payments to Others (23.2) --- --- --- ---

Communication, utilities, and misc. charges (23.3) 414 195 241 +46

Printing and reproduction (24.0) 584 618 915 +298

Other Contractual Services:

Advisory and assistance services (25.1) 52,177 28,433 28,484 +51

Other services (25.2) 135,459 101,020 175,750 +74,730

Purchase of Goods & Svcs. from Govt. Accts 

(25.3) 34,297 25,308 34,627 +9,319

Operation and maintenance of facilities (25.4) 212 125 132 +7

Research and Development Contracts (25.5) --- --- --- ---

Operation and maintenance of equipment (25.7) 1,696 959 1,032 +73

Subtotal Other Contractual Services: 223,841 155,845 240,025 +84,180

Supplies and materials (26.0) 160 138 124 -14

Subtotal Non-Pay Costs 225,672 157,520 241,958 +84,438

Total Salary and Expenses 309,649 261,922 376,213 +114,291

Rental Payments to GSA (23.1) 6,830 6,953 7,078 +125

Grand Total, Salaries & Expenses and Rent $316,479 $268,875 $383,291 +$114,416 

Direct 

FTE....................................................... 487 577 706 +129 1 Does not include PHS Evaluation Funds.

2 Does not include Prevention and Public Health Funds.

3 Does not include Mandatory Funds.
347 

Salaries and Expenses

PHS Salaries and Expenses Table

(Dollars in thousands) 

Object Class - PHS Evaluation 

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 

+/- FY 

2023

Personnel compensation:

Full-time permanent (11.1) $10,575 $18,143 $20,526 +$2,383 

Other than full-time permanent (11.3) 30 62 62 +1 

Other personnel compensation (11.5) 248 437 482 +45 

Military personnel (11.7) 729 1,283 1,398 +116 

Special personnel services payments (11.8) --- --- --- --- 

Subtotal personnel compensation 11,582 19,924 22,469 +2,545 

Civilian benefits (12.1) 3,911 6,711 7,593 +882 

Military benefits (12.2) 78 140 152 +12 

Subtotal Pay Costs: 15,571 26,774 30,214 +3,439 

Travel (21.0) 4 10 10 --- 

Transportation of things (22.0) --- --- --- --- 

Rental payments to Others (23.2) --- --- --- --- 

Communication, utilities, and misc. charges 

(23.3) --- --- --- --- 

Printing and reproduction (24.0) 950 1,000 1,001 +1 

Other Contractual Services:

Advisory and assistance services (25.1) --- --- --- --- 

Other services (25.2) 109,692 100,109 97,015 -3,093 

Purch. Goods & Svcs. Govt. Accts (25.3) 774 828 848 +20 

Operation and maintenance of facilities (25.4) --- --- --- --- 

Research and Development Contracts (25.5) --- --- --- --- 

Operation and maintenance of equipment (25.7) --- --- --- --- 

Subtotal Other Contractual Services: 110,466 100,937 97,863 -3,073 

Supplies and materials (26.0) --- --- --- --- 

Subtotal Non-Pay Costs 111,420 101,947 98,874 -3,072 

Total Salary and Expenses 126,991 128,721 129,088 +367 

Rental Payments to GSA (23.1) --- --- --- --- 

Grand Total, Salaries & Expenses and Rent $126,991 $128,721 $129,088 +367 

Reimbursable 

FTE...................................... 90 148 159 +11 
348 

Substance use And Mental Health Services Administration

Details of Full-Time Equivalent Employment

FY 2022 

Est. 

Civilian

FY 2022 

Est. 

Military

FY 

2022 

Est. 

Total

FY 2023 

Est. 

Civilian

FY 2023 

Est. 

Military

FY 

2023 

Est. 

Total

FY 2024 

Est. 

Civilian

FY 2024 

Est. 

Military

FY 

2024 

Est. 

Total

Mental Health Services

 Direct: 79 8 87 74 -- 74 120 -- 120

 Reimbursable: 31 3 34 59 4 63 60 4 64

 Total: 110 11 121 133 4 137 180 4 184

Substance Use Prevention

 Direct: 5 -- 5 72 8 80 75 8 83 

 Reimbursable: -- -- -- -- -- -- -- -- -- 

 Total: 5 -- 5 72 8 80 75 8 83 

Substance Use Services

 Direct: 62 3 65 90 4 94 130 4 134

 Reimbursable: 31 1 32 35 1 36 40 1 41

 Total: 93 4 97 125 5 130 170 5 175

Health Surveillance and Program Support1 

 Direct: 311 19 330 310 19 329 350 19 369

 Reimbursable: 24 0 24 45 4 49 50 4 54

 Total: 335 19 354 355 23 378 400 23 423

SAMHSA FTE Total........................ 543 34 577 685 40 725 825 40 865

1

/ HSPS includes SAMHSA’s Offices and CBHSQ staff. 
349 

Substance use And Mental Health Services Administration

Detail of Positions 

FY 2022

Final

FY 2023

Enacted

FY 2024

President's Budget

Executive Level IV 1 1 1 

Subtotal 1 1 1 

Total - Exec Level Salaries $221,142 $231,889 $243,947

SES 3 7 7 

Subtotal 3 7 7 

Total, SES salaries $854,075 $2,089,695 $2,198,359

GM/GS-15/EE 72 64 100

GM/GS-14 125 134 175

GM/GS-13 193 217 265

GS-12 55 65 75

GS-11 49 27 60

GS-10 2 1 5 

GS-09 12 27 35

GS-08 13 18 20

GS-07 15 22 25

GS-06 1 11 10

GS-05 2 3 2 

GS-04 -- -- -- 

GS-03 -- -- -- 

GS-02 -- -- -- 

GS-01 -- -- -- 

Subtotal 539 677 772

Total, GS salaries $93,075,890 $121,497,066 $143,058,716

CC-08/09 -- 1 1 

CC-07 -- -- -- 

CC-06 14 18 18

CC-05 8 9 9 

CC-04 10 10 10

CC-03 2 2 2 

CC-02 -- -- -- 

CC-01 -- -- -- 

Subtotal 34 40 40

Total, CC salaries $6,069,971 $7,357,814 $9,457,951

Total Positions 577 725 820

Average EX level ES ES ES

Average EX salary $221,142 $221,142 $221,142

Average SES level SES SES SES

Average SES salary $284,692 $298,528 $314,051

Average GS grade 13.5 13.4 13.4

Average GS salary $172,683 $179,464 $185,309

Average CC level 5 5 5 

Average CC salaries $178,529 $183,945 $236,449
350 

Physicians’ Comparability Allowance Worksheet 

1. Department and component: 

 HHS/Substance Abuse and Mental Health Services Administration 

2. Explain the recruitment and retention problem(s) justifying the need for the PCA pay 

authority. 

(Please include any staffing data to support your explanation, such as number and duration of 

unfilled positions and number of accessions and separations per fiscal year.)

We have to offer PCAs because our salaries are not competitive with the private sector.

 

3-4) Please complete the table below with details of the PCA agreement for the following 

years:

 

 

PY 2022 

(Final) 

CY 2023 

(Enacted)/

1 

BY 2024 

(President’s 

Budget)

3a) Number of Physicians Receiving PCAs 1 1 1 

3b) Number of Physicians with One-Year PCA Agreements -- -- --

3c) Number of Physicians with Multi-Year PCA Agreements 1 1 1 

4a) Average Annual PCA Physician Pay (without PCA payment) 164,102 172,075 172,075

4b) Average Annual PCA Payment 16,000 16,000 16,000

 1/ FY 2023 data will be approved during the FY 2024 Budget cycle 

5) Explain the degree to which recruitment and retention problems were alleviated in 

your agency through the use of PCAs in the prior fiscal year. 

(Please include any staffing data to support your explanation, such as number and duration of 

unfilled positions and number of accessions and separations per fiscal year.) 

We have to offer PCAs because our salaries are not competitive with the private sector (e.g., we 

might offer 75% of a physician's salary on the outside). In addition, physicians of interest to 

SAMHSA often have income from consulting as well. The PCA is the only way to raise the 

government income to make the offer acceptable.

6) Provide any additional information that may be useful in planning PCA staffing levels 

and amounts in your agency. 

N/A

 
351 

Resources for Cyber Activities

(Dollars in millions) 

Cyber Category FY 2022 Final FY 2023 

Enacted

FY 2024 

President's 

Budget

FY 2024 

+/- FY 

2023

1 Cyber Human Capital.................... 

2.325 

 

2.925 

 

3.725 

 

+0.800 

2 Sector Risk Management Agency (SRMA).... 

-- 

 

-- 

 

-- 

 

-- 

3 Securing Infrastructure Investments.............. 

-- 

 

0.650 

 

1.450 

 

+0.800 

4 Technology Ecosystems................................ 

-- 

 

-- 

 

-- 

 

-- 

5 Zero Trust Implementation............................. 

-- 

 

0.600 

 

1.400 

 

+0.800 

Other NIST CSF Capabilities...........................

 

5.754 

 

6.274 

 

6.439 

 

+0.165 

 Detect............................................................. 

1.041 

 

1.107 

 

1.174 

 

+0.067 

 Identity............................................................ 

1.168 

 

1.240 

 

1.315 

 

+0.075 

 Protect............................................................ 

2.105 

 

2.396 

 

2.480 

 

+0.084 

 Recover.......................................................... 

1.212 

 

1.287 

 

1.212 

 -

0.075 

 Respond......................................................... ________ 

0.228 

 

0.244 

 

0.258 

 

+0.014 

Total Cyber 

Request........................................................... 

 

8.079 

 

10.449 

 

13.014 

 

+2.565 

Footnotes

1Based on fifteen GS-2210 FTE's

2SAMHSA does not have any critical systems

3Nothing to report for FY22. In FY23 and FY24, SAMHSA plans to move all CoCo servers on prem. FY23 and 

FY24 figures include AWS hosting fees, one additional Engineer, and procurement of SaaS software.

4Not Applicable to SAMSHA.

5FY22 = cost is included in 'NIST CSF Capabilities'; FY23 and FY24 = estimated based on emerging requirements.
352 

Drug Control Programs 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance use And Mental Health Services Administration 

(Dollars in millions)

Resource Summary

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- FY 

2023 

Drug Resources by Decision Unit and Function

Programs of Regional and National Significance

Substance Use Prevention $218.219 $236.879 $245.738 $8.859 

 Harm Reduction...................................................................................................................... 91.840 105.840 199.340 93.500 

Substance Use Treatment 403.243 431.945 506.517 74.572 

 Recovery ............................................................................................................................... 26.434 34.434 47.151 12.717 

Total Programs of Regional and National Significance 739.736 809.098 998.746 189.648 

State Opioid Response Grant1 ......................................................................................... 1,509.750 1,559.250 1,980.000 420.750 

 Harm Reduction........................................................................................ 15.250 15.750 20.000 4.250 

Total, State Opioid Response Grant 1,525.000 1,575.000 2,000.000 425.000 

Substance Use Prevention, Treatment, and Recovery Services Block Grant2

Prevention 362.535 381.535 514.535 133.000 

 Harm Reduction........................................................................................ 19.081 20.081 27.081 7.000 

Treatment 1,526.463 1,405.655 1,895.655 490.000 

Recovery......................................................................................... -- 200.808 270.808 70.000 

Total, Substance Use Prevention, Treatment, and Recovery Services Block Grant 1,908.079 2,008.079 2,708.079 700.000 

Health Surveillance and Program Support3

Prevention 22.069 21.732 21.116 -.616 

 Harm Reduction........................................................................................ 3.31 3.26 3.167 -.092 

Treatment 79.449 78.236 76.017 -2.219 

Recovery......................................................................................... 5.517 5.433 5.279 -.154 

Total, Health Surveillance and Program Support 110.345 108.661 105.579 -3.082 

Total Funding $4,283.160 $4,500.838 $5,812.404 $1,311.566 

Drug Resources Personnel Summary

Total FTEs4 299 327 362 35 

Drug Resources as a Percent of Budget

Total Agency Budget $6,547.102 $7,517.583 $10,834.475 $3,316.892 

Drug Resources Percentage 65.4% 59.9% 53.6% -6.2% 

1

/The State Opioid Response Grant is split 99% to the Treatment function and 1% to the Harm Reduction function.

2/

The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the Harm 

Reduction function, and 10% to the Recovery function.

3/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug control by 

determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion covering Drug Controlrelated services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total appropriated 

funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is assessed at 

3% toward Harm Reduction and 5% toward Recovery, consistent with the drug control methodology

4

/Only Direct FTEs included in total.
353 

Drug Budget Split between Prevention, Harm Reduction, Treatment, and Recovery

FY 2022-2024

(Dollars in millions)

Prevention:

Substance Use Prevention Services

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Programs of Regional and National Significance (PRNS)

Strategic Prevention Framework $127.484 $135.484 $140.484 $5.000

Strategic Prevention Framework Rx (non-add) 10.000 10.000 15.000 5.000

Budget Authority (non-add) 10.000 10.000 15.000 5.000

Federal Drug-Free Workplace 4.894 5.139 5.139 --

Sober Truth on Preventing Underage Drinking 12.000 14.500 14.500 --

Tribal Behavioral Health Grants 20.750 23.665 23.665 --

Minority AIDS 41.205 43.205 43.205 --

SAP Minority Fellowship Program .321 1.321 2.680 1.359

Center for the Application of Prevention Technologies 7.493 9.493 11.993 2.500

Science and Service Program Coordination 4.072 4.072 4.072 --

Total, Substance Use Prevention Services PRNS 218.219 236.879 245.738 8.859

Substance Use Prevention, Treatment, and Recovery Services Block Grant1 362.535 381.535 514.535 133.000

PHS Evaluation Funds (non-add) 15.048 15.048 15.048 --

Total, Substance Use Prevention, Treatment, and Recovery Services Block Grant 362.535 381.535 514.535 133.000

Health Surveillance and Program Support2

Health Surveillance and Program Support $17.197 $16.324 $14.469 -$1.855

Health Surveillance 6.426 6.116 5.596 -.520

Budget Authority (non-add) 2.405 2.440 2.401 -.039

PHS Evaluation Funds (non-add) 4.021 3.676 3.195 -.481

Program Support 10.771 10.208 8.873 -1.336

Public Awareness and Support 1.300 1.326 1.326 --

Performance and Quality Information Systems 1.322 1.232 1.071 -.161

Behavorial Helath Workforce Data and Development .100 .100 .100 --

PHS Evaluation Funds (non-add) .100 .100 .100 --

Drug Abuse Warning Network 2.000 2.600 4.000 1.400 

Data Request/Publication User Fees .150 .150 .150 --

Total, Health Surveillance and Program Support 22.069 21.732 21.116 -.616

Total, Substance Use Prevention Services 602.823 640.146 781.389 141.243

1/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% to the 

Harm Reduction function, and 10% to the Recovery function. 2/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under drug 

control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the proportion 

covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS is 

assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology
354 

Drug Budget Split between Prevention, Harm Reduction, Treatment, and Recovery

FY 2022-2024

(Dollars in millions)

Harm Reduction

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- 

FY 2023

Community Harm Reduction and Engagement 

Initiative1

........................................... -- -- $50.000 $50.000

Screening, Brief Intervention and Referral to Treatment 31.840 33.840 33.840 --

Budget Authority (non-add) 29.840 31.840 31.840 --

PHS Evaluation Funds (non-add) 2.000 2.000 2.000 --

Target Capacity Expansion2 -- -- 10.000 10.000

TCE - Low-Threshold Housing First Pilot Project (nonadd) -- -- 10.000 10.000

First Responder Training 

(CARA)........................................................................... 46.000 56.000 77.500 21.500

Grants to Prevent Prescription Drug/Opioid Overdose Related 

Deaths ............. 14.000 16.000 28.000 12.000

Total, Harm Reduction PRNS 91.840 105.840 199.340 93.500

State Opioid Response Grants3

................................................................................. 15.250 15.750 20.000 4.250

Substance Use Prevention, Treatment, and Recovery Services 

Block Grant4 19.081 20.081 27.081 7.000

PHS Evaluation Funds (non-add) .792 .792 .792 --

Total, Substance Use Prevention, Treatment, and Recovery 

Services Block Grant 19.081 20.081 27.081 7.000

Health Surveillance and Program Support5

Health Surveillance and Program Support $2.580 $2.449 $2.170 -$.278

Health Surveillance .964 .917 .839 -.078

Budget Authority (non-add) .361 .366 .360 -.006

PHS Evaluation Funds (non-add) .603 .551 .479 -.072

Program Support 1.616 1.531 1.331 -.200

Public Awareness and Support .195 .199 .199 --

Performance and Quality Information Systems .198 .185 .161 -.024

Behavorial Helath Workforce Data and Development .015 .015 .015 --

PHS Evaluation Funds (non-add) .015 .015 .015 --

Drug Abuse Warning Network .300 .390 .600 .210

Data Request/Publication User Fees .023 .023 .023 --

Total, Health Surveillance and Program Support 3.31 3.26 3.167 -.092

Total, Harm Reduction 129.481 144.931 249.588 104.658

1

/New program proposed in SAMHSA's FY 2024 Performance Budget. 

2

/New program proposed in SAMHSA's FY 2024 Performance Budget.

3/ The State Opioid Response Grant is split 99% to the Treatment function and 1% to the Harm Reduction function.

4/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the 

Treatment function, 1% to the Harm Reduction function, and 10% to the Recovery function.

5/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally 

assessed under drug control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for 

Mental Health Services) and the proportion covering Drug Control-related services (the Center for Substance Use Services and the Center for 

Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are

assessed at 50% of total appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for 

Treatment, HSPS is assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology
355 

Drug Budget Split between Prevention, Harm Reduction, Treatment, and Recovery

FY 2022-2024

(Dollars in millions)

Treatment:

Substance Use Services

FY 2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 2024 +/- FY 

2023 

Programs of Regional and National Significance (PRNS)

Opioid Treatment Programs/Regulatory Activities $8.724 $10.724 $13.086 $2.362 

Target Capacity Expansion 112.192 122.416 147.916 25.500 

Other Targeted Capacity Expansion 11.192 11.416 11.416 --

MAT for Prescription Drug and Opioid Addiction (non-add) 101.000 111.000 136.500 25.500 

Pregnant & Postpartum Women 34.931 38.931 49.397 10.466 

Improving Access to Overdose Treatment.................................................................. 1.000 1.500 1.500 --

Children and Family Programs 29.605 30.197 30.197 --

Treatment Systems for Homeless 36.386 37.114 37.114 --

Minority AIDS 65.570 66.881 66.881 --

Minority Fellowship Program 5.789 7.136 12.000 4.864 

Criminal Justice Activities 89.000 94.000 124.380 30.380 

Addiction Technology Transfer Centers 9.046 9.046 9.046 --

Emergency Department Alternatives to Opioids 6.000 8.000 9.000 1.000 

Comprehensive Opioid Recovery Centers 5.000 6.000 6.000 --

Total, Substance Use Services PRNS 403.243 431.945 506.517 74.572 

State Opioid Response Grants1 ................................................................................. 1,509.750 1,559.250 1,980.000 420.750 

Substance Use Prevention, Treatment, and Recovery Services Block Grant2 1,526.463 1,405.655 1,895.655 490.000 

PHS Evaluation Funds (non-add) 63.360 55.440 55.440 .000 

Total, Substance Use Prevention, Treatment, and Recovery Services Block Grant 1,526.463 1,405.655 1,895.655 490.000 

Health Surveillance and Program Support3

Health Surveillance and Program Support $61.911 $58.766 $52.088 -$6.678 

Health Surveillance 23.134 22.016 20.146 -1.870 

Budget Authority (non-add) 8.657 8.783 8.644 -.139 

PHS Evaluation Funds (non-add) 14.477 13.233 11.502 -1.731 

Program Support 38.777 36.750 31.942 -4.808 

Public Awareness and Support 4.680 4.774 4.774 --

Performance and Quality Information Systems 4.758 4.436 3.856 -.580 

Behavorial Helath Workforce Data and Development .360 .360 .360 --

PHS Evaluation Funds (non-add) .360 .360 .360 --

Drug Abuse Warning Network 7.200 9.360 14.400 5.040 

Data Request/Publication User Fees .540 .540 .540 --

Total, Health Surveillance and Program Support 79.449 78.236 76.017 -2.219 

Total, Substance Use Services 3,518.905 3,475.086 4,458.189 983.103 

1/ The State Opioid Response Grant is split 99% to the Treatment function and 1% to the Harm Reduction function. 2/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the Treatment function, 1% 

to the Harm Reduction function, and 10% to the Recovery function. 3/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally assessed under 

drug control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for Mental Health Services) and the 

proportion covering Drug Control-related services (the Center for Substance Use Services and the Center for Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are assessed at 50% of 

total appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for Treatment, HSPS 

is assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology
356 

Drug Budget Split between Prevention, Harm Reduction, Treatment, and Recovery

FY 2022-2024

(Dollars in millions)

Recovery

FY 

2022

Final

FY 2023

Enacted

FY 2024

President's 

Budget

FY 

2024 

+/- FY 

2023

Programs of Regional and National Significance (PRNS)

Recovery Community Services Program $2.434 $4.434 $5.151 $.717

Building Communities of Recovery 13.000 16.000 28.000 12.000

Peer Support TA Center 1.000 2.000 2.000 --

Treatment, Recovery, and Workforce Support 10.000 12.000 12.000 --

Total, Recovery PRNS 26.434 34.434 47.151 12.717

Substance Use Prevention, Treatment, and Recovery Services Block Grant1 -- 200.808 270.808 70.000

PHS Evaluation Funds (non-add) -- 7.920 7.920 --

Total, Substance Use Prevention, Treatment, and Recovery Services Block Grant .000 200.808 270.808 70.000

Health Surveillance and Program Support2

Health Surveillance and Program Support $4.299 $4.081 $3.617 -$.464

Health Surveillance 1.607 1.529 1.399 -.130

Budget Authority (non-add) .601 .610 .600 -.010

PHS Evaluation Funds (non-add) 1.005 .919 .799 -.120

Program Support 2.693 2.552 2.218 -.334

Public Awareness and Support .325 .332 .332 --

Performance and Quality Information Systems .330 .308 .268 -.040

Behavorial Helath Workforce Data and Development .025 .025 .025 --

PHS Evaluation Funds (non-add) .025 .025 .025 --

Drug Abuse Warning Network .500 .650 1.000 .350

Data Request/Publication User Fees .038 .038 .038 --

Total, Health Surveillance and Program Support 5.517 5.433 5.279 -.154

Total, Recovery 31.951 240.675 323.238 82.563

1/ The Substance Use Prevention, Treatment, and Recovery Services Block Grant is split 19% to the Prevention function, 70% to the 

Treatment function, 1% to the Harm Reduction function, and 10% to the Recovery function.

2/ The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Drug Control as follows:

- The Drug Abuse Warning Network is allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally 

assessed under drug control by determining the proportion of SAMHSA's total budget that covers Mental Health services (the Center for 

Mental Health Services) and the proportion covering Drug Control-related services (the Center for Substance Use Services and the Center for 

Substance Use Prevention).

- Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request and Publication User Fees are 

assessed at 50% of total appropriated funds are directed toward drug control activities. 

- The drug control total for HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within the total for 

Treatment, HSPS is assessed at 3% toward harm reduction and 5% toward recovery, consistent with the drug control methodology
357 

Methodology 

SAMHSA distributes drug control funding into four functions: Prevention, Harm Reduction, 

Treatment, and Recovery. 

Prevention includes all the Substance Use Prevention Services appropriation (i.e., 100 percent of 

PRNS programs), 19 percent of the Substance Use Prevention, Treatment, and Recovery Services 

Block Grant (SUPTRS BG) funds which is specifically appropriated for prevention activities from 

the Substance Use Prevention Services appropriation, and 20 percent is of the Health Surveillance 

and Program Support (HSPS) funding. 

Harm Reduction includes 100 percent of the Community Based Funding for Local Substance use 

Disorder Services from the American Rescue Plan Act of 2021; 100 percent of the Community 

Harm Reduction and Engagement Initiative; 100 percent of First Responders- Comprehensive 

Addiction and Recovery Act (FR-CARA) Training; 100 percent of Grants to Prevent Prescription 

Drug/Opioid Overdose Related Deaths; 100% of Screening, Brief Intervention, and Referral to 

Treatment; 100% of the funds allocated to the new Low-Threshold Housing First Pilot Project 

funded under Targeted Capacity Expansion-General; 1 percent of SOR grants; 1 percent of the 

SUPTRS BG funds; and a proportionate share of HSPS funding. 

Treatment includes 100 percent of the Substance Use Services PRNS, 99 percent of SOR grants, 

70 percent of the SUPTRS BG funds, and a proportionate share of HSPS funding. 

Recovery includes 100 percent of the Recovery Community Services Program; 100 percent 

Building Communities of Recovery; 100 percent of Treatment, Recovery and Workforce Support; 

100 percent of Recovery Support Services- Center of Excellence (COE); 10 percent of the 

SUPTRS BG funds (i.e., 10 percent is a proposed set-aside for recovery support services in 

SUPTRS BG for FY 2023); and a proportionate share of HSPS funding. 

HSPS is proportionately attributed to the Prevention, Harm Reduction, Treatment, and Recovery. 

First, the HSPS base for the Drug Control budget is calculated using the following three rules: (1) 

100% of the Drug Abuse Warning Network funding; (2) 50% of the Public Awareness and 

Support, Behavioral Health Workforce Data and Development and Data Request and Publication 

user fees funding; and (3) The combined Program Support, Health Surveillance, and PQIS funding 

multiplied by SAMHSA’s total Substance Use budgets divided by SAMHSA’s total Substance 

Use budgets plus SAMHSA’s Mental Health budget. Second, the calculated HSPS base is 

allocated to the four drug control areas base on the proportionately: 20% Prevention, 3% Harm 

Reduction, 72% Treatment and 5% Recovery. 

Equity

The Office of Behavioral Health Equity (OBHE) coordinates SAMHSA’s efforts to reduce mental 

and/or substance use disorders across a spectrum of under resourced populations. The SAMHSA 

Office of Behavioral Health Equity (OBHE) was established in accordance with Section 10334(b) 

of the Patient Protection and Affordable Care Act (ACA) of 2010. OBHE advances behavioral 

health equity by reducing disparities in racial, ethnic, LGBTQI+, and other under-resourced 

communities across the country by improving access to quality services and supports that enables 
358 

all to thrive, participate, and contribute to healthier communities. OBHE is organized around 5 

key public-facing strategic domains on policy, data, quality practice and workforce development, 

communication, and technical assistance. 

OBHE also has one internal facing strategy area focused on infrastructure. For the next three 

years, OBHE’s efforts are focused on the promotion of behavioral health equity for populations of 

focus: under resourced racial and ethnic minority, LGBTQI+, mixed race, and poor rural white 

residents.

OBHE currently funds two sperate contracts from The National Network to Eliminate Disparities 

in Behavioral Health (NNED) and NNED Learn. OBHE Flagship Initiatives include the Disparity 

Impact Statement (DIS), Elevate Community Based Organizations (CBOs), The NNED, and 

LGBTQI+-CoE. Additionally, OBHE conducts a monthly SAMHSA-wide Equity CrossCollaborative workgroup that addresses topics like Diversity Equity and Inclusion (DEI) that also 

includes SAMHSA’s key Offices and Centers. OBHE also works closely with the Agency for 

Healthcare Research and Quality's (AHRQ) to co-produce racial/ethnic/LGBTQI+ small reports 

data snap shots. OBHE representatives also serve on President Biden’s Equity driven Executive 

Order (EO) workgroups (EO 13985, 13995, 14021, and others) and other trans-HHS workgroups 

such as NIH’s SDoH as well as on the NASEM Forum on Mental Health and Substance Use 

Disorders. 

Disparity Impact Statement 2.0 Initiative 

SAMHSA’s Disparity Impact Statement (DIS) 2.0 Initiative seeks to reach all Americans in need 

of behavioral health services- no matter their race, ethnicity, social-economic status, or sexual 

orientation. This Initiative will involve analyzing how the current DIS is implemented across the 

agency, the capacity of SAMHSA to expand the DIS across a greater segment of its investments 

and programs, and the necessary changes needed to update the current DIS components and 

framework. This Initiative will also provide guidance to SAMHSA to facilitate the development 

of clear direction for grantees on the purpose and expectations for focusing on and addressing 

behavioral health disparities in their communities, provide clear instruction on how to submit an 

appropriate DIS to SAMHSA, and determine the most effective method to report, monitor and 

evaluate DIS impact to ensure effectiveness. The DIS will also identify racial, ethnic, 

LGBTQI+, mixed-race, and poor rural white residents’ behavioral health gaps that could be filled 

by SAMHSA’s future Notice of Funding Opportunities (NOFO). 

Elevate CBOs Initiative   

Elevate CBOs is an overarching policy-driven initiative at SAMHSA's Office of Behavioral Health 

Equity to build capacity, increase the visibility, and highlight the unique role of CBOs serving 

under-resourced communities in behavioral health. Community-based organizations (CBOs) play 

an important role when serving their respective communities. CBOs work at the local level to 

maintain community morale and cohesion, build connection between officials at various levels of 

government with community and provide critical services to the community. 
359 

The National Network to Eliminate Disparities in Behavioral Health (NNED)

NNED is a virtual network of community-based organizations across the U.S. focused on the 

mental health and substance use issues of diverse racial, ethnic, cultural, and sexual minority 

communities. Using data informed approaches, the NNED supports information sharing, training, 

and technical assistance towards the goal of promoting behavioral health equity. It is currently 

funded by SAMHSA and managed by SAMHSA’s Office of Behavioral Health Equity 

(OBHE). NNED opportunities include NNEDLearn, Partner Central, and 

NNEDshare. NNEDLehe section break? This is an annual intensive training for NNED members 

from community-based organizations to develop their skills in evidence-supported and culturally 

appropriate practices for mental illness and substance use. Partner Central is a private space for 

NNED members to search for community-based organizations in the network to build partnerships 

to achieve a shared goal. NNED share is a collaborative online space for NNED members and the 

public to share resources and intervention efforts to improve the delivery of behavioral health care 

interventions in diverse populations. 

Asian American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence 

The Center of Excellence on Asian American, Native Hawaiian, and Pacific Islander (AANHPICoE) Behavioral Health Center of Excellence will promote culturally and linguistically 

appropriate behavioral health information and practices; establish a steering committee to identify 

emerging issues; and provide training, technical assistance, and consultation to practitioners, 

educators, and community organizations. Training topics include addressing mental health impacts 

caused by unconscious bias and hate against AANHPI communities. The AANHPI-CoE will also 

develop accessible, public-facing infographics and other materials that address behavioral health, 

including those that provide data disaggregated by race and ethnicity, as well as best practices for 

improving engagement and retention of AANHPI behavioral health professionals. 

African American Behavioral Health Center of Excellence

Responding to the urgent need for greater equity and effectiveness in behavioral health services 

for African Americans, the U.S. Department of Health and Human Services, Substance Abuse and 

Mental Health Services Administration (SAMHSA) has established a new National Center, the 

African American Behavioral Health Center of Excellence (AABH-COE). From its administrative 

and academic home in the National Center for Primary Care at Morehouse School of Medicine 

(MSM) in Atlanta, the new Center of Excellence will develop and disseminate training, technical 

assistance (TA), and resources to help healthcare practitioners eliminate behavioral health 

disparities within this large and diverse population. 

The new Center of Excellence will take a highly collaborative public health approach toward 

cultural and practical transformation of: 

• Behavioral health systems; 

• Intervention, treatment, and recovery support practices; 

• The professional and non-professional workforce; and 

• The systems of education, training, and TA that prepare the field for its work. 
360 

The Center of Excellence on LGBTQI+ Behavioral Health Equity 

The Center of Excellence on LGBTQI+ Behavioral Health Equity provides behavioral health 

practitioners with vital information on supporting the population of people identifying as lesbian, 

gay, bisexual, transgender, queer, questioning, intersex, two-spirit, and other diverse sexual 

orientations, gender identities, and expressions. Through training, coaching, and technical 

assistance we are implementing change strategies within mental health and substance use disorder 

treatment systems to address disparities affecting LGBTQI+ people across all stages of life.

This Center for Excellence is led by  SAMHSA’s OBHE, the National SOGIE

Center at Innovations Institute, University of Connecticut School of Social Work and is a 

partnership with Affirmative Research, Judge Baker Children’s Center, Harvard Medical School, 

and The Institute for Innovation and Implementation, University of Maryland School of Social 

Work. The work of this Center relies on: 

• an expert pool that includes individuals with lived experience 

• leaders from provider organizations that are implementing best practices to 

address behavioral health disparities among the LBGTQ+ community 

• and researchers and clinical experts skilled in translating research into practice in 

mental health and substance use practice settings. 
361 

Budget Request

The FY 2024 President’s Budget Request is $5.8 billion, an increase of $1.3 billion from the

FY 2023 Enacted level. 

The budget directs resources to activities that have demonstrated improved health outcomes and 

that increase service capacity. SAMHSA has five major drug-related portfolios, and attendant 

decision units: Substance Use Prevention Services, Substance Use Services, Health Surveillance 

and Program Support, Harm Reduction, and Recovery. 

Each decision unit is discussed below: 
362 

Prevention

Substance Use Prevention Services

Programs of Regional and National Significance

Strategic Prevention Framework

The FY 2024 Budget Request: $140.4 million, an increase of $5 million from the FY 2023 

Enacted level. 

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help 

grantees build a solid foundation for delivering and sustaining effective Substance Use Prevention 

Services and reducing substance use problems. 

Strategic Prevention Framework – Partnerships for Success (SPF-PFS) 

The Strategic Prevention Framework – Partnerships for Success (SPF-PFS) program addresses 

underage drinking among youth and young adults age 12 to 20 and allows states to prioritize stateidentified top data driven substance use target areas. The budget increase in FY 2024 will be used 

to award 57 new and 180 continuing grants. These grants will continue to support the development 

and delivery of state and community substance misuse prevention and mental health promotion 

services. 

Strategic Prevention Framework for Prescription Drugs

SAMHSA implemented the Strategic Prevention Framework for Prescription Drugs (SPF-Rx) to 

raise awareness about the dangers of sharing medications and to work with pharmaceutical and 

medical communities on the risks of overprescribing to young adults. SAMHSA’s program 

focuses on raising community awareness and bringing prescription drug use and misuse prevention 

activities and education to schools, communities, parents, prescribers, and their 

patients. SAMHSA tracks reductions in opioid overdoses and the incorporation of prescription 

drug monitoring data into needs assessments and strategic plans as indicators of program 

success. The SPF-Rx programs are currently being implemented in 18 states and three Tribes. In 

FY 2024, the SPF-Rx program will award 8 new grants and 37 continuations. The SPF-Rx 

program plans to provide additional technical support to grantee’s who seek partnerships with 

those agencies that manage state PDMPs and work on data sharing agreements. Access to and 

leveraging this data to reduce opioid dependency, and overdose incidence is at the very center of 

this program and SAMHSA’s intent for these funds. In FY 2024, the SPR-Rx program will be 

evaluated and mined for “lessons learned,” because the grant program was opened to nonprofit 

agencies working with the single state agency (SSA) in FY 2022. 

Federal Drug-Free Workplace

The FY 2024 Budget Request: $5.1 million, level with the FY 2023 Enacted level.

SAMHSA’s activities related to the Federal Drug-Free Workplace support two principal activities 

mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 10071. This includes: 1) 
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oversight of the Federal Drug-Free Workplace, aimed at the elimination of illicit drug use within 

Executive Branch agencies and the federally regulated industries; and 2) oversight of the National 

Laboratory Certification Program (NLCP), which certifies laboratories to conduct forensic drug 

testing for federal agencies, federally regulated industries; the private sector also uses the HHSCertified Laboratories. SAMHSA will continue to implement the new mandatory guidelines for 

oral fluid and hair in the federally regulated drug testing program and continue oversight of the 

Executive Branch Agencies’ Federal Drug-Free Workplace programs to operationalize the newly 

authorized specimen and new drug testing program for oral fluid, a first in over 30 years. 

The budget request will allow SAMHSA to continue oversight of the Executive Branch Agencies’ 

Federal Drug-Free Workplace Programs. This includes review of Federal Drug-Free Workplace 

plans from those federal agencies that perform federal employee testing, random testing of those 

designated testing positions of national security, public health, and public safety, and testing for 

illicit drug use and the misuse of prescription medications. SAMHSA will continue its oversight 

role for the inspection and certification of the HHS-certified laboratories and HHS laboratory 

certification for new oral fluid and hair testing laboratories. 

Sober Truth on Preventing Underage Drinking

The FY 2024 Budget Request: $14.5 million, level with the FY 2023 Enacted level. 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109 - 

422) was the nation’s first comprehensive legislation on underage drinking. One of the primary 

components of the STOP Act is the community-based coalition enhancement grant program, which 

provides up to $60,000 per year over four years to current or former grantees under the Drug Free 

Communities Act of 1997 to prevent and reduce alcohol use among youth under the age of 21. The 

STOP Act grant program enables organizations to strengthen collaboration and coordination 

among stakeholders to achieve a reduction in underage drinking in their communities. The STOP 

Act was reauthorized in the 21st Century Cures Act. In FY 2024, SAMHSA will continue to 

support the 2023–2024 campaign evaluation cycle, which includes an evaluation of the usability, 

reach, and effectiveness of the TTHY mobile app and Screen4Success self-screening and referral 

management system; the initial development of a complementary youth campaign that includes 

message testing and audience segmentation analysis; and the beginning of a multi-year evaluation 

of the student assistance- and school health and wellness-focused training with formative, 

outcome, and long-term impact evaluation methodologies that can be adopted by schools and 

districts. SAMHSA will also continue to assess technical assistance needs to address areas 

identified as challenges in data collection and reporting processes, to prevent and reduce alcohol 

use among youth and young adults ages 12-20 in communities throughout the United 

States. SAMHSA will support 93 new and 114 continuation grants. 

Tribal Behavioral Health Grants

The FY 2024 Budget Request: $24 million, level with the FY 2023 Enacted level.

SAMHSA’s Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of 

substance use, misuse, and suicide among AI/AN populations. Starting in FY 2014, this program 

supports tribal entities with the highest rates of suicide by providing effective and promising 

strategies that address substance use, misuse, trauma, and suicide and by promoting the mental 
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health of AI/AN young people. In FY 2016, SAMHSA expanded activities through the braided 

TBHG funding to allow tribes the flexibility to implement community-based strategies to address 

trauma, prevent substance misuse, and promote mental health and resiliency among youth in tribal 

communities. The budget will continue to support grants that expand efforts to address the high 

incidence of substance misuse and suicide among AI/AN populations. SAMHSA will support 

technical assistance activities, 118 continuation grants and award a new cohort of 10 grants. 

Centers for the Application of Prevention Technologies

The FY 2024 Budget Request: $12 million, an increase of $3 million from the FY 2023 

Enacted level.

In 2019, Center for the Application of Prevention Technologies (CAPT) changed how it delivered 

services and began providing science-based training and technical assistance through Prevention 

Technology Transfer Centers (PTTC) cooperative agreements. SAMHSA leadership established 

the PTTC the previous year to expand and improve implementation and delivery of effective 

Substance Use Prevention Services interventions and provide training and technical assistance 

services to the Substance Use Prevention Services field. The PTTC does this by developing and 

disseminating tools and strategies needed to improve the quality of Substance Use Prevention 

Services efforts; providing intensive technical assistance and learning resources to prevention 

professionals to improve their understanding of prevention science, epidemiological data, and

implementation of evidence-based and promising practices; and developing tools and resources to 

engage the next generation of prevention professionals. The budget increase will be used for the 

Prevention Fellowship program – approximately 20 fellows will be chosen for a new FY 2024 

cohort, allowing them to spend one year in intensive training. This program is a key component to 

expanding and enhancing the prevention workforce. A pilot program was launched in FY 2022 

with a grant supplement. The funding increase will allow this important program to be an inherent 

part of the PTTC. The funding will also support 11 PTTC continuation grants to continue support 

for the provision of state-of-the-art substance use prevention technical assistance to states, 

communities, tribal communities, and territories. This funding will support the HHS priority of 

advancing the goal of ending the opioid crisis and the ONDCP Drug Policy Priority of supporting 

evidence-based prevention efforts to reduce youth substance use. 

Science and Service Program Coordination

FY 2024 Budget Request is: $4.1 million, level with the FY 2023 Enacted level.

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around Substance Use 

Prevention Services. Specifically, the program supports the Tribal Training and Technical 

Assistance Center and the Underage Drinking Prevention Education Initiatives (UADPEI). The 

budget request will continue to maintain improvements in community readiness in identified tribal 

communities through tribally focused, and tribally specific technical assistance 

delivery. SAMHSA will also continue to elevate community success stories via its podcast series,

webinars, and prominent placement of stories on the Communities Talk website. Additionally, 

SAMHSA will expand its use of mini campaigns, which promote and amplify substance use data, 

research, and prevention resources related to alcohol and substance misuse by youth and youth 

adults. Other focus areas for communications activities will include technical assistance in 
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bridging prevention service delivery between substance misuse and mental health promotion as 

well as operationalizing diversity, equity, and inclusion in prevention service delivery. 

Other PRNS Prevention Programs

The FY 2024 Budget Request: $46 million, an increase of $1.4 million from the FY 2023 

Enacted level.

The budget request includes resources for Minority AIDS and Minority Fellowship Program. The 

funding will support activities that build a strong foundation for delivering and sustaining highquality and accessible substance misuse and HIV prevention services among at-risk populations, 

including racial/ethnic minority youth and young adults, ages 13 to 24. The funding will also 

support new activities in the Prevention Navigator Program which provides training and education 

around the risks of substance misuse, education on HIV/AIDS, and needed linkages to service 

provision for individuals with HIV. Finally, the increase will double the number of fellows from 

428 to 1,182 and increase the number of trained behavioral health providers to 6,500. As a braided 

activity, this increase in fellows will directly address the significant treatment gap across the care 

continuum and the workforce shortage in disenfranchised and minority populations. In addition, 

SAMHSA will conduct a robust evaluation of the program for culturally appropriate approaches 

to further improve retention and increase recruitment of more diverse fellows into the 

workforce. 
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Harm Reduction

Community Harm Reduction and Engagement Initiative 

The FY 2024 Budget Request: $50 million, an increase of $50 million above FY 2023 

Enacted level. 

In FY 2024, SAMHSA is establishing a new Community Harm Reduction and Engagement 

Initiative program which builds off the $30 million from Community Based Funding for Local 

Substance use Disorder Services funded with the American Rescue Plan Act in FY 2021. The 

Community Harm Reduction and Engagement Initiative program builds upon the lessons learned 

from the ARP funds with three components: 1) support for smaller community-based harm 

reduction service organizations focused on high-risk populations such as those experiencing 

homelessness; 2) expansion grants to existing programs such as SAMHSA’s dedicated harm 

reduction program, Targeted Capacity Expansion-Special Projects program, and Medication 

Assisted Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) program, with the 

inclusion of low-threshold buprenorphine initiation for opioid use disorder and linkages to harmreduction oriented SUD treatment services and 3) technical assistance to support communities and 

organizations seeking to establish or improve existing harm reduction services. In addition to the 

above, the program will facilitate the distribution of naloxone to help prevent overdose deaths, 

increase testing for HIV and viral hepatitis and improve access to infectious disease care, and 

provide peer support services. The Harm Reduction and Engagement Initiative aims to reach 

330,000 individuals with harm reduction services through three approaches: 

1. Harm Reduction Resources for Community-Based Organizations ($17 million): Develop a 

Notice of Funding Opportunity that will target small community-based organizations that are 

already serving populations needing these services but without other federal resources to 

support harm reduction services. This funding amount would support approximately 100 

organizations. These organizations will receive technical assistance and capacity-building 

support, as well as resources to expand their services. These efforts will enable organizations 

to expand their reach to an additional 50,000 individuals. 

2. Community Harm Reduction and Engagement Expansion Grants ($30 million): Develop a 

Notice of Funding Opportunity that will target harm reduction and harm-reduction oriented 

substance use disorder treatment programs. This funding level would support approximately 

50 harm organizations that collectively have the capacity to expand their services to an 

additional 100,000 individuals. 

3. Harm Reduction TA Center ($3 million): Technical assistance (TA) will be made available 

to States, Tribes and communities interested in establishing or strengthening their harm 

reduction services. SAMHSA will continue funding one in partnership with CDC. It is 

estimated this TA will reach a minimum of 120 organizations. 

 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

The FY 2024 Budget Request: $28 million, an increase of $12 million from the FY 2023 

Enacted level.
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Opioid overdose is a significant contributor to accidental deaths among those who use illicit and 

prescription opioids (including synthetics), such as fentanyl. SAMHSA’s Grants to Prevent 

Prescription Drug/Opioid Overdose Related Deaths program seeks to help states identify 

communities of high need, and provide education, training, and resources necessary to tailor 

overdose response kits to meet their specific needs. Grantees can use the funds to purchase 

naloxone, equip first responders with naloxone and other overdose death prevention strategies, 

support education on these strategies, provide materials to assemble and disseminate overdose 

response kits. The funding request will fund 15 new and 17 continuation grants to help states 

purchase overdose reversing drugs, equip first responders in high-risk communities, support 

education on the use of naloxone and other overdose-related death prevention strategies, provide 

the necessary materials to assemble overdose response kits, and cover expenses incurred from 

dissemination efforts. 

First Responders- Comprehensive Addiction and Recovery Act (FR-CARA) Training

The FY 2024 Budget Request: $77.5 million, an increase of $21.5 million from the FY 2023

Enacted level. 

FR-CARA Training supports efforts to help first responders and members of other key community 

sectors to administer a drug or device approved or cleared under the Federal Food, Drug, and 

Cosmetic Act for emergency treatment of known or suspected opioid-related overdose. Grantees 

train and provide resources to first responders and members of other key community sectors at the 

state, tribal, and local governmental levels on carrying and administering a drug or device approved 

or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or 

suspected opioid-related overdose. Grantees also establish processes, protocols, and mechanisms 

for referral to appropriate treatment and recovery communities. Training, technical assistance, and 

evaluation activities are also being supported to assist grantees, determine best practices, and 

assess program outcomes. The FR-CARA program provides funding to state, Tribal and local 

governments to train and equip first responders to administer naloxone. The budget request will 

continue to fund about 118 new and 75 continuation grants to provide much needed support to 

combat the nation’s opioid overdose epidemic and enhance linkage to care for people at risk for 

opioid overdose and implementing innovative strategies. The program will also increase access 

for individuals treated with naloxone for overdose to obtain services such as low threshold 

buprenorphine with psychosocial support services to address the multifaceted challenges a person 

experiences after an overdose.

Screening, Brief Intervention and Referral to Treatment

The FY 2024 Budget Request: $34 million, level with the FY 2023 Enacted level.

The Screening, Brief Intervention and Referral to Treatment (SBIRT) program, including state 

implementation grants intended to help primary care physicians, identifies individuals who misuse 

substances and intervenes with education, brief interventions, or referral to specialty treatment if 

necessary. The program’s goals are to reduce the rate of substance misuse, intervene early to 

prevent progression to more severe illness, and increase the number of individuals who receive 

treatment for their substance use disorder. Studies have long shown that this approach is effective 

in helping reduce harmful alcohol consumption. The SBIRT program requires state grant 

recipients to implement the model in all primary care settings, as well as hospitals, trauma centers, 
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federally qualified health centers, and other relevant health care and community 

settings. Recipients may use funds to screen for substance use and co-occurring mental illness and 

substance use disorders. They can support evidence-based person-centered interventions, such as 

reinforcement of less risky alcohol use, motivational interviewing, brief interventions, and referral 

to specialty care for individuals exhibiting symptoms of substance use disorder. The population 

of focus is adults and adolescents seeking medical attention and intervention in primary care and 

other health care settings. The budget request will support 11 new and 20 continuation grants and 

will serve approximately 146,366 people. 

Targeted Capacity Expansion- Low-Threshold Housing First Pilot Project

The FY 2024 Budget Request: $10 million, an increase of $10 million from the FY 2023 

Enacted level. 

The new Targeted Capacity Expansion- Low-Threshold Housing First Pilot Project addresses 

service needs and housing instability for people with substance use disorders (SUDs) and/or cooccurring substance use and mental disorders (CODs), regardless of where they are on the 

continuum of readiness to change. This program will combine services that span the continuum 

of public health-focused harm reduction, treatment, and recovery supports with housing and 

intensive case management, delivered based on individualized needs assessments, at home and in 

the community. The primary client-level outcomes for this program are housing attainment; 

reduced overdoses; increased access to and participation in public health activities, treatment, 

recovery support services; and education and employment activities. In addition, grantees will 

enhance coordinated efforts across health, housing, education, labor, criminal justice, and 

transportation. Based on other grant programs, SAMHSA anticipates a 95 percent increase in the 

number of clients served that are employed or attending school between intake and 6-month follow 

up, a 380 percent increase in the number of clients served that report having stable housing between 

intake and 6-month follow up, and that awardees will screen 78 percent of clients for co-occurring 

mental health and substance use disorders, of which 81 percent will screen positive. The budget 

request will fund 10 new Low-Threshold Housing First Pilot Project cooperative agreements. 
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Treatment

Substance Use Services

Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS BG):

The FY 2024 Budget Request: $2.7 billion, an increase of $700 million from the FY 2023 

Enacted level.

The goal of the SUPTRS BG program is to ensure that individuals, their families, and communities 

have access to the range of substance use-related prevention, treatment, harm reduction, and 

recovery support services necessary to improve individual outcomes and reduce the impact of 

substance misuse and substance use disorders (SUDs) on America’s communities. SUPTRS BG 

grantees plan, implement, and evaluate SUD prevention, treatment, and recovery support services 

based on the specific needs of their state systems and populations. 

The SUPTRS BG program enables the development of comprehensive statewide systems of care 

that provide a broad continuum of SUD services and supports encompassing prevention, treatment, 

and recovery support services for all individuals who need them. Funding will aid in having a 

positive effect on the health and quality of life of individuals with SUD as demonstrated by positive 

client outcomes in the treatment domains of the National Outcomes Measures (NOMs); improve 

state prevention and treatment systems’ infrastructure and capacity resulting in an increase in 

services, development and implementation of evidence-based practices, development and 

collection of specific outcome measures, and development and maintenance of state data 

management systems; aid states in leveraging requirements, resources, and federal guidance to 

sustain and improve state systems further emphasizing the importance of the SUPTRS BG in the 

development of the same; and contribute to the development and maintenance of successful state 

collaborations with other agencies and stakeholders concerned with preventing and treating 

SUD. 

It is imperative that our addiction crisis response evolves from an acute short-term -treatment 

response to a broader long-term individual and community recovery response. Addiction is a 

chronic illness, and recovery often is a life-long process where external community and social 

determinants of health play vital roles in its sustainability. The FY 2023 President’s Budget 

proposed a new 10 percent set aside within the SUPTRS BG to enhance non-clinical recovery 

support services. The set-aside would require that least 10 percent of grantees’ SUPTRS BG 

expenditures be used for recovery community organizations, peer recovery support services, and 

other recovery support activities. Services and activities may include funding recovery housing, 

recovery community centers, recovery schools, recovery industries, and recovery ministries; 

developing strategies and educational campaigns, trainings, and events to reduce 

addiction/recovery-related stigma and discrimination at the local level; providing integrated 

addiction treatment and recovery resources and support system navigation; making accessible peer 

recovery support services that support diverse populations and are inclusive of all pathways to 

recovery; and collaborating and coordinating with local private and non-profit clinical health care 

providers, the faith community, city, county, state, and federal public health agencies, and criminal 

justice response efforts that support, promote, and enhance recovery. 
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SAMHSA anticipates that this set-aside will help increase access to recovery support services 

across the country and complement the existing efforts to respond to the ongoing overdose crisis 

that has accelerated during the COVID-19 pandemic. In FY 2024, SAMHSA plans to continue 

serving as a source of safety-net funding, including providing assistance to states in addressing 

and evaluating activities to prevent, reduce harm, treat, and provide recovery support services for 

individuals, families, and communities that are adversely impacted by substance use disorders 

(SUDs) and related conditions. 

State Opioid Response

The FY 2024 Budget Request: $2.0 billion, an increase of $425 million from the FY 2023 

Enacted level.

The Substance use And Mental Health Services Administration established the State Opioid 

Response Grants (SOR) program in FY 2018. This program aims to address the opioid crisis by 

increasing access to treatment that includes the three FDA-approved medications for the treatment 

of opioid use disorder, reducing unmet treatment needs, and reducing opioid overdose related 

deaths through the provision of prevention, treatment, and recovery activities for opioid use 

disorder (OUD) (including prescription opioids, heroin and illicit fentanyl and fentanyl 

analogs). Funding is awarded through grants to states and territories via formula. The program 

includes a $75 million set-aside for tribes. Given the varying nature of substance misuse across 

the United States, the budget continues to allow the use of State Opioid Response grants to include 

methamphetamine and other stimulants, giving states and tribes flexibility to address their unique 

community needs. The budget request will continue to enhance states’ ability to address 

stimulants, as well as other issues related to the overdose epidemic that have been compounded 

due to COVID-19. A primary strategy to reduce overdose deaths in the SOR program, that will 

also continue in FY 2024, is education on, and purchase and distribution of naloxone, a proven 

medication that reverses opioid-related overdoses to save lives. SAMHSA will assist states in the 

identification of underserved communities and agencies and continue in FY 2024 to work with 

states on implementation and further refinement of naloxone distribution and saturation. 

Programs of Regional and National Significance

Opioid Treatment Programs/Regulatory Activities

The FY 2024 Budget Request: $13.1 million, an increase of $2.4 million from the FY 2023 

Enacted level. 

As part of its regulatory responsibility, SAMHSA certifies Opioid Treatment Programs that 

provide methadone, buprenorphine, or buprenorphine/naloxone to treat patients with opioid use 

disorder (OUD). SAMHSA carries out this responsibility by enforcing regulations established by 

an accreditation-based system. This is accomplished in coordination with the Drug Enforcement 

Administration, states, territories, and the District of Columbia. Additionally, SAMHSA funds 

grants and contracts that support the regulatory oversight and monitoring activities of Opioid 

Treatment Programs, prescribers eligible to prescribe buprenorphine for the treatment of OUD, 

and workforce development and training activities, such as the Provider Clinical Support SystemUniversity (PCSS-U) and Provider’s Clinical Support System-Medications for Opioid Use 

Disorder (PCSS-MOUD), to expand access to medications for OUD (MOUD) and related 
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substance use disorder and other health conditions. In FY 2023, SAMHSA initiated funding of a 

new Provider Clinical Support System that focuses on identification and treatment of alcohol use 

disorder- PCSS MAUD. The purpose of this program is to provide training, guidance, and 

mentoring on the use of Medications for Alcohol Use Disorders. In FY 2023, SAMHSA is also 

supporting a new Provider Clinical Support System aimed at providing training, mentoring, and 

ongoing support for organizations seeking to implement Contingency Management- PCSS CM to 

foster knowledge adoption and best practices. The budget request will allow SAMHSA to fund 

16 new and 9 continuation PCSS-U grants, plus three continuation cooperative agreements, each 

for PCSS-MOUD, (PCSS-MAUD), (PCSS-CM) and two contracts. 

Targeted Capacity Expansion

The FY 2024 Budget Request: $148 million, an increase of $26 million from the FY 2023 

Enacted level. 

The Targeted Capacity Expansion (TCE) program provides rapid, strategic, comprehensive, and 

integrated community-based responses to gaps in and capacity for SUD treatment and recovery 

support services. Examples of such needs include limited or no access to medications for opioid 

use disorder (MOUD) and related therapies; lack of resources needed to adopt and implement 

health information technologies (HIT) in SUD treatment settings; and short supply of trained and 

qualified peer recovery coaches to assist individuals in the recovery process. The budget request 

would support one new grant and 26 continuation TCE-Special Projects and fund 183 continuation 

and 29 new MAT PDOA grants, that collectively will serve between 12,000 and 14,000 000 people 

with substance use disorders. 

Treatment Systems for Homeless

The FY 2024 Budget Request: $37 million, level with the FY 2023 Enacted level.

On a single night in January 2022, 582,462 people were experiencing homelessness in the United 

States. Of these, 138,361 were experiencing chronic homelessness, 122,888 had severe mental 

illness, 95,001 were affected by chronic substance use, and 33,129 were veterans.1 SAMHSA’s 

Treatment Systems for Homeless portfolio supports services for those with substance use disorders 

or co-occurring mental and substance use disorders who are experiencing homelessness, including 

youth, veterans, and families. SAMHSA’s Treatment Systems for Homeless programs are crucial 

to achieving the goal of reducing homelessness for nearly 4,000 people. In FY 2022, 4,237 clients 

were served through SAMHSA’s Grants for the Benefit of Homeless Individuals (GBHI) 

program. The budget request will fund 15 new and 62 continuation GBHI grants with a target to 

serve 4,083 people. 

Pregnant and Postpartum Women

The FY 2024 Budget Request: $49 million, an increase of $10 million from the FY 2023 

Enacted level.

The Pregnant and Postpartum Women supports grants for residential treatment and the Pregnant 

and Postpartum Women Pilot, authorized in the Comprehensive Addiction and Recovery Act 

(CARA). This pilot program helps state substance use agencies address the continuum of care, 

including services provided to women in nonresidential-based settings and promotes a 
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coordinated, effective, and efficient state system managed by state substance use agencies by 

encouraging new approaches and models of service delivery. The overall PPW program provides 

services not covered under most public and private insurance. In FY 2020, SAMHSA funded new 

state PPW pilot grants and continuation state PPW pilot grants for program implementation, 

supplement for direct technical assistance, and a continuation evaluation contract to provide an 

array of services and supports to pregnant individuals and their children. During FY 2022, 935 

women were served in the PPW-PLT program and 1,288 women in the PPW residential treatment 

program. The budget request will allow SAMHSA to continue to fund seven new and six 

continuation PPW pilot grants, and 17 new and 50 continuation residential treatment grants. 

Criminal Justice Activities

The FY 2024 Budget Request: $124 million, an increase of $30 million from the FY 2023 

Enacted level.

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

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

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

includes Treatment Drug Courts and the Offender Re-Entry Programs. 

Drug Court Activities

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound, and recovery support services such as recovery 

housing and peer recovery support services designed to improve access and retention, drug testing 

for illicit substances, educational support, relapse prevention and long-term management, and HIV 

and viral hepatitis B and C testing conducted in accordance with state and local requirements. The 

program seeks to address behavioral health disparities among racial and ethnic populations by 

encouraging the implementation of strategies to decrease the differences in access, service use, 

and outcomes among the racial and ethnic populations served. 

Ex-Offender Re-Entry Program 

In addition to the drug court portfolio, SAMHSA supports Offender Reentry Program (ORP) 

grants, as well as other criminal justice activities, such as evaluation and behavioral health 

contracts. The grants will provide screening, assessment, comprehensive treatment, and recovery 

support services for diverse populations reentering the community from incarceration. Other 

supported services include wraparound and recovery support services such as recovery housing 

and peer recovery support designed to improve access and retention, drug testing for illicit 

substances, educational support, relapse prevention and long-term management, and HIV and viral 

hepatitis B and C testing conducted in accordance with state and local requirements. SAMHSA’s 

ORP grants are encouraged to use part of their annual award to provide medications for opioid use 

disorder (MOUD) with FDA-approved medications for individuals with no other means of 

obtaining them. 

 

The budget request will support 144 new and 105 drug court continuation grants, 43 continuation 

AR grants, and one contract. At least 20 awards will be made to tribes/tribal organizations, and at 
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least 20 awards will be made to FTDCs, pending sufficient application volume from these 

groups. Collectively, these programs are expected to serve over 8,500 people, with the drug court 

program serving 6,554 people and the Adult Reentry Program serving 2,151 people. 

Emergency Department Alternatives to Opioids

The FY 2024 Budget Request: $9 million, an increase of $1 million from the FY 2023 

Enacted level.

The Emergency Department Alternative to Opioids (EDAO) program provides funding to 

hospitals and emergency departments, including freestanding emergency departments, to develop, 

implement, enhance, or study alternative pain management protocols and treatments that limit the 

use and prescribing of opioids in emergency departments. In addition, the program seeks to, train 

providers and other hospital personnel in the provision of alternatives to opioids for patients with 

painful conditions, including conducting screening for opioid use disorder and initiation of 

treatment, if warranted. The funding request will continue to fund two new and 15 continuing 

grants with a target of training 2,520 providers on using non-opioid therapies and providing nonopioid therapies to 115,850 patients. 

Improving Access to Overdose Treatment

The FY 2024 Budget Request: $1.5 million, level with the FY 2023 Enacted level. 

SAMHSA’s Improving Access to Overdose Treatment (ODTA) grant program supports awards to 

Federally Qualified Health Centers (FQHCs), Opioid Treatment Programs, and practitioners who 

prescribe buprenorphine to expand access to Food and Drug Administration (FDA)-approved 

drugs or devices for emergency treatment of known or suspected opioid overdose. Grant recipients 

serve individuals at high risk for opioid overdose by partnering with other prescribers at the 

community level to develop best practices for prescribing and co-prescribing FDA-approved 

overdose reversal drugs. The ODTA program is a key component of the public health response to 

the overdose epidemic. It uses a combination of community-based public health prevention and 

harm reduction strategies across the prevention continuum to mitigate the impact of the overdose 

epidemic within communities. These community-based public health prevention efforts serve the 

high-risk population outside of substance use treatment facilities and can serve as an important 

engagement point to treatment for people with substance use disorders. The budget request will 

fund seven continuation grants to continue increasing access to treatment, reducing unmet 

treatment need, and reducing opioid overdose related deaths through the provision of prevention, 

treatment, and recovery activities for opioid use disorder. 

Other PRNS Treatment Programs

The FY 2024 Budget Request is $124 million, an increase of $5 million from the FY 2023 

Enacted level. 

The budget request includes resources for several Treatment Capacity programs including 

Children and Families; Addiction Technology Transfer Centers; Comprehensive Opioid Recovery 

Centers; Minority AIDS; and Minority Fellowship Program. The budget request in FY 2024 will 

continue to enhance overall drug treatment quality by incentivizing treatment and service providers 

to achieve specific performance targets. The budget will fund one new and 52 continuation grants 
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under the Children and Families program with a target to serve 1,740 people. The Addiction 

Technology Transfer Center will fund 11 continuations and 3 cooperative agreement 

continuations. The budget increase for the Minority Fellowship Program will support eight 

continuation grants and a technical assistance contract. This funding will more than double the 

number of fellows from 428 to 1,182 and increase the number of trained behavioral health 

providers to 6,500. The Comprehensive Opioid Recovery Centers will fund two new and five 

continuation grants to provide critical comprehensive care services, including long-term care and 

support services utilizing the full range of FDA-approved medications and evidence-based services 

and will cover the costs of critical linkage and system development not currently covered by other 

sources of funding. The Minority AIDS will fund 25 new grants and 103 continuation grants with 

a target to serve 10,185 clients. 
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Recovery

Programs of Regional and National Significance

Recovery Community Services Program

The FY 2024 Budget Request: $5.2 million, an increase of 717,000 from the FY 2023 Enacted 

level.

As public education increases, there is broader acknowledgement of substance use disorder as a 

treatable condition that can be successfully managed over the course of a lifetime with the 

appropriate resources. The Recovery Community Services Program (RCSP) was designed to assist 

recovery communities to strengthen their infrastructure and provide peer recovery support services 

to those in or seeking recovery from substance use disorders across the nation. The delivery of 

recovery support services (RSS) by people in recovery is known as peer recovery support services 

(PRSS). SAMHSA initiated the RCSP to help build an infrastructure for PRSS programs to support 

the development and expansion of peer recovery services. These peer services are most frequently 

offered by Recovery Community Organizations (RCOs). 

The RCSP – Statewide Network (RCSP-SN) program was established to further strengthen 

Recovery Community Organizations (RCOs), similar organizations, and their statewide network 

of recovery stakeholders as key partners in the delivery of state and local recovery support services 

(RSS). Other key partners include the specialty and general health care systems, state and local 

public health departments, payers, and other systems that collaborate with RCOs and the statewide 

recovery network to foster systems improvement, public health messaging, and training conducted 

with, and for, key recovery stakeholder organizations. By partnering with traditional SUD 

providers and other purchasers of RSS, RCSP-SN grantees strengthen and embed critical RSS 

service elements as part of the Recovery Oriented Systems of Care (ROSC) landscape.

The budget request will fund two new and 12 continuation RCSP grants, as well as two 

continuation RCSP-Statewide Network (SN) grants. Under the RSCP program, SAMHSA will 

aim to serve 915 clients. 

Building Communities of Recovery

The FY 2024 Budget Request: $28 million, an increase of $12 million from the FY 2023 

Enacted level.

The purpose of this program is to mobilize resources within and outside of the recovery community 

to increase the prevalence and quality of long-term recovery support from drug/alcohol 

misuse. Programs are designed to be overseen by individuals in recovery from SUDs who reflect 

the community served. These grants are intended to support the development, enhancement, 

expansion, and delivery of Recovery Support Services (RSS) as well as promotion of, and 

education about recovery. Programs are designed to be overseen by people in recovery from 

substance use disorders who reflect the community served. Grants support linkages between 

recovery networks and a variety of other organizations, systems, and communities, including 

primary care, other recovery networks, child welfare system, criminal justice system, housing 

services and employment systems. The budget request will support 58 new and 32 continuation 
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grants to develop, expand, and enhance recovery support services with a target of serving 3,002 

clients. The increase will also support ONDCP’s priority to expand recovery services by increasing 

the number of peer-led recovery community organizations and certified recovery residences by 

25% in 2025. 

Recovery Support Services - Center of Excellence (based on the Peer Support Technical 

Assistance Center program)

The FY 2024 Budget Request: $2 million, level with the FY 2023 Enacted level.

The Peer Support Technical Assistance Center has provided training and technical assistance and 

support to recovery community organizations (RCOs), and peer support networks. The technical 

assistance is related to training, translation and interpretation services, data collection, capacity 

building, and evaluation and improvement of the effectiveness of such services provided by 

recovery community organizations and peer support networks. The budget request in FY 2024 

will create a new Center of Excellence (CoE) that builds from the Peer Support Technical 

Assistance Center. The new Recovery Support Services – Center of Excellence (RSS-CoE) 

program will incorporate the peer support technical assistance provided by the Peer Support 

Technical Assistance Center and expand to include training and technical assistance for recovery 

housing. This will result in an increase in the number of individuals served and expand the topic 

areas for technical assistance as well as the structure through which technical assistance is 

provided. Specifically, a regional approach allows the RSS-CoE to tailor the training needs and 

recovery system development activities to the needs of each distinct geographic region. SAMHSA 

plans to award four new cooperative agreements at $1 million each, providing training for 20,000 

new individuals per year in peer support services and increasing the number of certified recovery 

residences by 25% by 2025, a goal from the National Drug Control Strategy. 

RSS-CoE aligns with one of the seven Biden-Harris Administration drug policy priorities of, 

“Expanding access to recovery support services” as well as the four dimensions of 2022 National 

Drug Control Strategy of building a “recovery-ready nation” of “home, health, purpose, and 

community” which aims to (1) expand RSS and PRSS capacity and foster the adoption of more 

consistent standards for the peer workforce, RCCs, RCOs, and similar peer-led organizations and

(2) foster the adoption of more consistent recovery housing standards. 

Treatment, Recovery, and Workforce Support

The FY 2024 Budget Request: $12 million, level with the FY 2023 Enacted level.

Authorized by section 7081 of the SUPPORT for Patients and Communities Act, The Treatment, 

the Recovery, and Workforce Support (TRWS) program aims to implement evidence-based 

programs to support individuals in substance use disorder treatment and recovery to live 

independently and participate in the workforce. Grant recipients conduct outreach activities 

informing employers of substance use resources that are available to employees. Grant funds have 

been used to hire Case Managers, Care Coordinators, Peer Recovery Specialists and other 

professionals to provide services that support treatment and recovery for clients. As a result of 

innovative implementation strategies, the TRWS grant has assisted clients with 

sustaining recovery while attaining viable employment. The budget request will be used to 
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provide career services for people in recovery from substance use disorder through partnerships 

with local organizations. SAMHSA plans to fund 23 continuation grants. 
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Health Surveillance and Program Support

The budget request represents the Substance Use portion of the Health Surveillance and Program 

Support appropriation and supports staffing and activities to administer SAMHSA programs as 

described below.

Health Surveillance and Program Support

FY 2024 Budget Request: $106 million, a decrease of $3 million from the FY 2023 Enacted 

level. 

Health Surveillance and Program Support (HSPS) provides funding for personnel costs, building 

and facilities, equipment, supplies, administrative costs, and associated overhead to support 

SAMHSA programmatic activities, as well as provide funding for SAMHSA national data 

collection and survey systems, funding to support the Center for Disease Control and Prevention’s 

National Health Information Survey, and the data archive. HSPS funded activities are split 

between Mental Health and Drug Control as follows: (1) The Drug Abuse Warning Network is 

allocated fully to Drug Control. Program Support, Health Surveillance and PQIS are proportionally 

assessed under drug control by determining the proportion of SAMHSA's total budget that covers 

Mental Health services (the Center for Mental Health Services) and the proportion covering Drug 

Control-related services (the Center for Substance Use Services and the Center for Substance Use 

Prevention); (2) Public Awareness and Support, Behavioral Health Workforce Data and 

Development and Data Request and Publication User Fees are assessed at 50% of total 

appropriated funds are directed toward drug control activities; and (3) The drug control total for 

HSPS after these calculations is allocated between Prevention (20%) and Treatment (80%). Within 

the total for Treatment, HSPS is assessed at 3% toward harm reduction and 5% toward recovery, 

consistent with the drug control methodology. 

Program Support 

The FY 2024 budget request is $44 million, a decrease of $7 million from the FY 2023 Enacted 

level. The budget request represents the Program Support portion that is attributable to the drug 

control budget only, and not SAMHSA’s total funding for this program. At this funding level, 

SAMHSA will continue to support staff to administer and manage SAMHSA’s diverse array of 

programs. SAMHSA will also ensure the agency can efficiently and effectively respond to the 

evolving and growing opioid crisis, as well as provide the significant resources, technical 

assistance, and leadership within the mental health and overall behavioral health (inclusive of 

mental health and substance use) public health sphere. This level of funding will also continue to 

cover overhead costs associated with 5600 Fishers Lane, including rent, the Federal Acquisition 

Service loan repayment program, and security charges. 

Health Surveillance

The FY 2024 budget request is $28 million, a decrease of $3 million from the FY 2023 Enacted 

level. The budget request represents the Health Surveillance portion that is attributable to the drug 

control budget only, and not SAMHSA’s total funding for this program. The budget request will 

fund the modernization of the Behavioral Health Treatment Locator to feature appointment 
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capability to reduce barriers for individuals and families to access treatment. CBHSQ will also 

begin designing the Spanish version of the Locator to expand treatment services to the racial and 

ethnic minorities. Also, within BHSIS, CBHSQ is planning to implement a National Substance 

Use and Mental Health Services Survey (N-SUMHSS) supplement to gather additional 

information on racial and ethnic minority-based treatment facilities. 

Public Awareness and Support

FY 2024 Budget Request: $7.0 million, level with the FY 2023 Enacted level.

Public Awareness and Support provides funding to support the unified communications approach 

to increase awareness of behavioral health, inclusive of mental disorders and substance use 

issues. SAMHSA’s Office of Communications (OC) staff ensure that the vital information, 

publications, and training materials produced through SAMHSA’s centers and offices are available 

to the healthcare workforce, people in treatment and recovery, people in crisis or in areas affected 

by disasters, SAMHSA grantees, and the public. Several channels are used to communicate this 

information, including online, print, radio, and television media; social media platforms; the 

SAMHSA.gov website; the SAMHSA Store, the subscription-based e-blast system; and inquiries 

received through the National Helpline. Recently the OC provided information, graphics and 

resources for the transition of the National Suicide Prevention Lifeline to the 988 Suicide and 

Crisis Lifeline. In FY 2022, SAMHSA had over 59 million interactions through phone inquiries, 

e-blasts, dissemination of SAMHSA publications, and total website hits. 

A proportionate share of the Health Surveillance and Program Support (HSPS) appropriation is 

allocated to SAMHSA’s Drug Control budget. The budget request represents the Health 

Surveillance portion that is attributable to the drug control budget only, and not SAMHSA’s total 

funding for this program. The funding for Public Awareness and Support will support four 

contracts and one interagency agreement that will allow SAMHSA to manage media relationships, 

maintain its web and social media presence, manage critical helplines, and deliver publications 

and resources. 

Performance and Quality Information Systems

FY 2024 Budget Request: $5.4 million, a decrease of $810,000 from the FY 2023 Enacted 

level.

Performance and Quality Information Systems provides funding to support SAMHSA’s 

Performance Accountability and Reporting System (SPARs) related activities, as well as provide 

support for the National Registry of Evidence-based Programs and Practices. SPARS provides a 

common data and reporting system for all SAMHSA discretionary grantees and allows 

programmatic technical assistance (TA) on use of the data to enhance grantee performance 

monitoring and improve quality of service delivery. Between FY 2020 and FY 2021, the Office 

of Evaluation (OE) has completed over 60 office hour and 64 learning lab events. In FY 2022,

CBHSQ/OE introduced “Data Parties’ designed to bring together diverse stakeholders from across 

SAMHSA to collectively analyze data that have been collected and to support interpretation of 

what the data mean and implications for action. The first event included over 70 SAMHSA staff 

and leadership. 
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A proportionate share of the Health Surveillance and Program Support (HSPS) appropriation is 

allocated to SAMHSA’s Drug Control budget. The budget request represents the Health 

Surveillance portion that is attributable to the drug control budget only, and not SAMHSA’s total 

funding for this program. The budget request will fund modernization efforts and continuation of 

the SPARS and Evidence-Based Practices Resource Center contracts. SAMHSA plans to improve 

the SPARS system to handle the substantial increase in the number of discretionary grants awarded 

in the past two years (over 7,400 grants in FY22). This has led to an increase in the number of 

internal and external stakeholders who use the SPARS system requiring targeted training, 

resources both digital and printable, and technical support for use of the SPARS online system. 

Behavioral Health Workforce Data and Development

FY 2024 Budget Request: $500,000, level with the FY 2023 Enacted level. 

The purpose of this program is to provide comprehensive data and analysis on individuals who 

comprise the prevention and treatment fields to address mental and substance use disorders. The 

goal of the program is to provide valid data on the existing practitioners and usable information to 

SAMHSA on which to make policy and planning decisions. 

Drug Abuse Warning Network (DAWN)

FY 2024 Budget Request: $20 million an increase of $7 million from the FY 2023 Enacted 

level.

Authorized by the 21st Century Cures Act, DAWN provides necessary information such as patient 

demographic details and substances used to respond effectively to the overdose and addiction 

crises in the United States and to better inform public health, clinicians, policymakers, and other 

stakeholders to respond to emerging substance use trends. In 2021, DAWN surveillance of 

emergency department (ED) visits was expanded to include those visits to due to alcohol use by 

individuals 21 years and older. In FY 2022, the DAWN surveillance system has reviewed more 

than 5,285,028 ED records from 53 participating hospitals (26 urban, 11 suburban, and 16 rural) 

and abstracted over 410,133 DAWN cases (7.8 percent of total ED records 

reviewed). Preliminary analysis demonstrates that the most common substances associated with 

DAWN cases are alcohol (191,800 cases, 38.8 percent), illicit substances (146,426 cases, 29.6 

percent) and Central Nervous System (CNS) agents (71,951 cases, 14.6 percent); among illicit 

drugs, stimulants were the most commonly associated with DAWN cases, with the majority 

involving methamphetamine. 

DAWN is allocated fully to substance use. The budget request will increase the number of 

participating hospitals to move closely align with legacy DAWN to report robust national 

estimates, as well as an early warning network. SAMHSA/CBHSQ is planning to further expand 

machine learning based early warning system to identify patterns of drug-related emergency 

department (ED) visits to be made available to inform SAMHSA and policy makers. SAMHSA 

further plans to expand substance use related public health surveillance of hospital ED visits and 

provide a more comprehensive campaign on drug overdose based on the data abstracted from the 

DAWN system in FY 2024. 
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Data Request and Publication User Fees

FY 2024 Budget Request: $750,000, level with the FY 2023 Enacted level.

SAMHSA will collect and retain fees for extraordinary data and publications requests. 
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Significant Items

House Appropriations Committee, Labor/HHS/Education Subcommittee (H. Rept. 117-403) 

1. Data Collection for SUD Grants to States: The Committee is aware that in November 2020, 

the GAO issued a report (GAO–21– 96) recommending that school-based drug prevention 

programs under SUBG and SOR better report how their activities contribute to the National Drug 

Control Strategy’s prevention education goals. A GAO report issued in December 2021 (GAO–

22–104520) recommends further analysis and clarification of data collected through the SOR 

program. The Committee encourages SAMHSA to fully adopt the recommendations in these 

reports and requests an update in the fiscal year 2024 Congressional Budget Justification on the 

implementation of these recommendations. 

Actions Taken or to be taken

SAMHSA provides implementation updates to GAO six months after the report is published and 

every subsequent six months until the recommendations are considered implemented/closed. 

These specific reports were published in 2022 and 2020. The GAO report below contains 

SAMHSA’s most recent implementation updates on the recommendations, and GAO's response 

to the updates. 

Opioid Use Disorder: Opportunities to Improve Assessments of State Opioid Response Grant 

Program GAO-22-104520 (published January 10, 2022) 

Recommendation #1: 

The Assistant Secretary for Mental Health and Substance Use should ensure that SAMHSA's 

SOR grant program assessment reports, such as its annual SOR program profile and report to 

Congress, identify potential limitations in their findings, and describe how any such limitations 

may affect the conclusions that can and cannot be drawn about the effectiveness of the program.

SAMHSA’s December 2022 Implementation Update

SAMHSA conducted additional robust analyses of current programmatic data for the SOR 

Report to Congress. These analyses include using disaggregated data by client characteristics, 

which provided a more comprehensive, and in-depth assessment of the SOR program 

performance. A limitation section was included in the report, which describes limitations in data 

collected and report findings, and how these limitations affected the conclusions drawn about the 

effectiveness of the SOR program. The SOR Report is on track to be delivered to Congress 

during the third quarter of FY 2023. Once the report has been released, SAMHSA will provide 

GAO a copy of the report.

Recommendation #2: 

The Assistant Secretary for Mental Health and Substance Use should further analyze existing 

SOR grant program information, such as by disaggregating data by client groups, to provide a 
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more comprehensive, in-depth assessment of program performance and use such information to 

identify opportunities for program improvement.

SAMHSA’s December 2022 Implementation Update 

SAMHSA has conducted more robust analysis of its current programmatic data. New analysis 

includes using disaggregated data by client characteristics to provide a more comprehensive, indepth assessment of program performance. Findings from this analysis was included in the SOR 

Report to Congress. The SOR Report is on track to be delivered to Congress during the third 

quarter of FY 2023. SAMHSA has also modified its two Government Performance and Results 

Act (GPRA) tools that SOR grantees must use to report performance measures. First, SAMHSA 

revised the State Opioid Response (SOR)/Tribal Opioid Response (TOR) - Program Instrument 

to better assess the program’s performance on required education and prevention activities The 

Program Instrument has been in use since April 1, 2022. SOR grantees and GPOs have access to 

multiple resources such as the training recordings, slides, transcripts, Question-by-Question 

instruction guide (available in both English and Spanish), Codebook, and a Frequently Asked 

Questions (FAQ) document on SAMHSA’s Performance Accountability and Reporting System 

(SPARS) training page for future use.

Second, SAMHSA’s Center for Substance Abuse Treatment (CSAT) GPRA Client Outcome 

Measures for Discretionary Programs tool implementation was revised to reduce administrative 

burden and improve data quality. Implementation of the new tool was delayed to January 4, 

2023, in response to questions and feedback received during the public comment period. The 

postponement gives grantees additional time with reference and training materials as well as 

additional time to update data collection processes and systems and prepare staff. Resources, 

including the final GPRA Tool in both English and Spanish, a crosswalk from the existing tool to 

the new tool, Question-by-Question Guides, a transition Quick Reference Guide, and Frequently 

Asked Questions (FAQs), will be made available on SAMHSA’s Performance Accountability 

and Reporting System (SPARS). Training sessions focused on the changes and updates to the 

CSAT GPRA Client Outcome Measures Discretionary Programs Tool were conducted for GPOs 

and grantees in October. 

GAO Response: 

Awaiting the SOR report that will be delivered to Congress during the third quarter on FY 2023.

Drug Misuse: Agencies Have Not Fully Identified How Grants That Can Support Drug 

Prevention Education Programs Contribute to National Goals GAO-21-96 (published November 

18, 2020) 

Recommendation #2: 

The Secretary of Health and Human Services should clarify how the Substance Abuse 

Prevention and Treatment Block Grant (SABG) prevention set-aside contributes to the goals of 

the National Drug Control Strategy, including considering how the performance measures relate 

to the prevention education goal 
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SAMHSA’S December 2022 Implementation Update

The Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS BG) 

program’s objectives are to help plan, implement, and evaluate activities that prevent and treat all 

substance misuse. The SUPTRS BG Prevention Set-Aside Program addresses the ONDCP 

National Drug Control Strategy through prevention education, which includes the delivery of 

evidence-based prevention programming, captures evaluation data/National Outcome Measures 

(NOM), and requires data reporting from grantees related to evidence-based activities. The 2019-

2020 NOM data shows a direct correlation between an increase in evidence-based program 

delivery and a reduction in illicit drug use, which supports the overall goals and objectives of 

National Drug Control Strategy. SAMHSA considers this recommendation closed as 

implemented.

Recommendation #3: 

The Secretary of Health and Human Services should determine how the State Opioid Response 

program contributes to the prevention goals of the National Drug Control Strategy and develop 

performance measures that relate to achieving those goals including the prevention education 

goal.

SAMHSA’S December 2022 Implementation Update

The Substance Abuse and Mental Health Service Administration (SAMHSA) modified the 

SOR/TOR Program Instrument based on the prevention goals of the National Drug Control 

Strategy. The revised OMB-approved SOR/TOR Program Instrument was approved in 

November 2021 and has been in use since April 1, 2022. SOR grantees and GPOs have access to 

multiple resources such as the training recordings, slides, transcripts, Question-by-Question 

instruction guide (available in both English and Spanish), Codebook, and a Frequently Asked 

Questions (FAQs) document on SAMHSA’s Performance Accountability and Reporting System 

(SPARS) training page for future use. SAMHSA’s revised SOR instrument includes questions 

which allow for the development of performance measures related to achieving the ONDCP 

prevention goals at the time the GAO-21-96 report was published. Specifically, 

Goal 2: Educate the public, especially adolescents, about drug use, specifically opioids.

• Objective 1: Reduce the rate of past year use of any illicit drug among youth each 

year, and by 15 percent by 2022. 

• Objective 2: Reduce the rate of past year use of opioids among youth each year, 

and by 15 percent by 2022. 

SAMHSA developed the following measures to address this ONDCP goal: 

• Number of school-based aged children that received prevention and education on 

the consequences of opioid and/or stimulant misuse. 

• Number of people trained to provide school-based prevention and education 

activities to school aged children. 
385

However, as highlighted in ONDCP’s 2022 Preliminary National Drug Control Assessment, 

ONDCP modified their goals. These modifications included focusing the prevention goal on 

alcohol and vaping among youth. This modification meant that the prevention goal was no 

longer applicable to the SOR program. 

Goal 2: Prevention efforts are increased in the United States. 

• Objective 1: Past 30-day alcohol use among young people aged 12-17 is reduced 

by 10 percent by 2025. 

• Objective 2: Past 30-day use of any vaping among youth aged 12-17 is reduced by 

15 percent by 2025. 

The new ONDCP goals also include a new harm reduction goal. 

Goal 3: Harm Reduction efforts are increased in the United States. 

• Objective 1: The number of counties with high overdose death rates which have 

at least one Syringe Service Program (SSP) is increased by 85 percent by 2025. 

• Objective 2: The percentage of SSPs that offer some type of drug safety checking 

support service, including, but not limited to Fentanyl Test Strips (FTS), is 

increased by 25 percent by 2025. 

Due to these changes, SAMHSA moved the SOR program from prevention to the ONDCP harm 

reduction goals. We developed new measures from the SOR Program to address the harm 

reduction objectives. Going forward metrics from SAMHSA’s Youth and Family Tree Program 

will be reported as part of the prevention goals, while the SOR program metrics will be reported 

as part of the harm reduction goal. 

Given that ONDCP has changed the Prevention Goal addressed in the GAO study and SAMHSA 

took the necessary steps to implement the recommendation as originally intended, SAMHSA 

considers this recommendation closed as implemented. 

GAO Response: 

Waiting for ONDCP to issue the National Drug Control Assessment in February of 2023, at that 

time they will review it and revisit the status of the recommendation closure. 
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Proposed Law 

Renames Substance Abuse and Mental Health Services Administration, Center for 

Substance Abuse Treatment, and Center for Substance Abuse Prevention. 

SEC.__. (a) The Public Health Service Act (42 U.S.C. 201 et seq.) is amended— 

(1) by striking “Substance Abuse and Mental Health Services Administration” each place 

it appears and inserting “Substance use And Mental Health Services Administration”; 

(2) by striking “Center for Substance Abuse Treatment” each place it appears and inserting 

“Center for Substance Use Services”; and 

(3) by striking “Center for Substance Abuse Prevention” each place it appears and inserting 

“Center for Substance Use Prevention Services”. 

(b) Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended— 

(1) in the title heading, by striking “SUBSTANCE ABUSE AND MENTAL HEALTH 

SERVICES ADMINISTRATION” and inserting “SUBSTANCE USE AND MENTAL HEALTH 

SERVICES ADMINISTRATION”; 

(2) in section 501— 

 

(A) in the section heading, by striking “SUBSTANCE ABUSE AND MENTAL 

HEALTH SERVICES ADMINISTRATION” and inserting “SUBSTANCE USE AND 

MENTAL HEALTH SERVICES ADMINISTRATION”; and 

(B) in subsection (a), by striking “(hereafter referred to in this title as the 

‘Administration’)” and inserting “(hereafter referred to in this title as ‘SAMHSA’ or the 

‘Administration’)”; 

(3) in section 507, in the section heading, by striking “CENTER FOR SUBSTANCE 

ABUSE TREATMENT” and inserting “CENTER FOR SUBSTANCE USE SERVICES”; 

(4) in section 513(a), in the subsection heading, by striking “CENTER FOR SUBSTANCE 

ABUSE TREATMENT” and inserting “CENTER FOR SUBSTANCE USE SERVICES”; and 

(5) in section 515, in the section heading, by striking “CENTER FOR SUBSTANCE 

ABUSE PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION 

SERVICES”. 

(c) Section 1932(b)(3) of the Public Health Service Act (42 U.S.C. 300x-32(b)(3)) is 

amended in the paragraph heading by striking “CENTER FOR SUBSTANCE ABUSE 

PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION SERVICES”. 
387 

(d) Section 1935(b)(2) of the Public Health Service Act (42 U.S.C. 300x-35(b)(2)) is 

amended in the paragraph heading by striking “CENTER FOR SUBSTANCE ABUSE 

PREVENTION” and inserting “CENTER FOR SUBSTANCE USE PREVENTION SERVICES”. 

(e) The Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (25 U.S.C. 

2401 et seq.) is amended by striking “Substance Abuse and Mental Health Services 

Administration” each place it appears and inserting “Substance use And Mental Health Services 

Administration”. 

(f) The Social Security Act is amended in sections 1861, 1866F, and 1945 (42 U.S.C. 

1395x, 1395cc-6, 1396w-4) by striking “Substance Abuse and Mental Health Services 

Administration” each place it appears and inserting “Substance use And Mental Health Services 

Administration”. 

(g) Section 105(a)(7)(C)(i)(III) of the Child Abuse Prevention and Treatment Act (42 

U.S.C. 5106(a)(7)(C)(i)(III)) is amended by striking “Substance Abuse and Mental Health 

Services Administration” and inserting “Substance use And Mental Health Services 

Administration”. 

(h)(1) Except as provided in paragraph (2), any reference in any law, regulation, map, 

document, paper, or other record of the United States— 

(A) to the Substance Abuse and Mental Health Services Administration shall be considered 

to be a reference to the Substance use And Mental Health Services Administration; 

(B) to the Center for Substance Abuse Treatment of such Administration shall be treated 

as a reference to the Center for Substance Use Services of such Administration; and 

(C) to the Center for Substance Abuse Prevention of such Administration shall be treated 

as a reference to the Center for Substance Use Prevention Services of such Administration. 

(2) Paragraph (1) shall not be construed to alter or affect section 6001(d) of the 21st Century 

Cures Act (42 U.S.C. 290aa note), providing that a reference to the Administrator of the Substance 

Abuse and Mental Health Services Administration shall be construed to be a reference to the 

Assistant Secretary for Mental Health and Substance Use.
388 

Minority Fellowship Program Proposal 

The Minority Fellowship Program (MFP) currently aims to reduce health disparities and improve 

behavioral health care outcomes for racial and ethnic populations. SAMHSA is seeking to improve 

the MFP in three ways. SAMHSA is proposing to require that graduating professionals who have 

received a fellowship from one of the MFP grantees serve in low-income, underserved 

communities including racial, ethnic, sexual and gender minority populations for a minimum of 2 

years. Additionally, SAMHSA proposes that professionals in the addiction medicine field be an 

eligible profession under the Minority Fellowship Program. Lastly, the agency proposes inclusion 

of sexual and gender minority populations as populations served by this program. All of the 

proposed changes have a positive impact on equity for individuals from racial, ethnic, sexual and 

gender minority populations and socioeconomically diverse backgrounds. 

 

Certified Community Behavioral Health Clinic Proposal 

Certified Community Behavioral Health Clinics (CCBHCs) provide comprehensive, coordinated 

treatment and recovery support services to anyone who requests care for mental health or substance 

use, regardless of their ability to pay. This includes crisis services that are available 24 hours a 

day, 7 days a week. This proposal supports CCBHCs by proposing an accreditation process similar 

to the process for which many health facilities are accredited. This new process would support 

consistent implementation of the CCBHC model and adherence to the CCBHC certification 

criteria. A CCBHC accreditation process will allow for improved accountability for CCBHCs 

across the country s and will ensure that CCBHCs are consistently providing access to quality 

behavioral health care.