DEPARTMENT 

of HEALTH

and HUMAN

SERVICES

Fiscal Year

2019

Substance Abuse and Mental Health 

Services Administration

Justification of Estimates for 

Appropriations Committees
ii

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Letter from the Assistant Secretary

I am pleased to present the Substance Abuse and Mental Health Services Administration (SAMHSA) 

fiscal year (FY) 2019 Budget Request. SAMHSA is requesting a total of $3.5 billion. In addition, the 

Budget provides $1.2 billion in additional opioids allocation resources to SAMHSA for a variety of new 

and expanded efforts to fight the opioid crisis. When accounting for these resources, the total for 

SAMHSA is $4.8 billion. As a primary federal agency responsible for addressing substance abuse and 

mental health services, SAMHSA proudly leads public health efforts to advance the behavioral health of 

the nation. Now, more than ever, we must ensure individuals living with substance use and mental 

disorders gain access to high quality prevention, treatment, and recovery services.

Consistent with the goals of the 21st Century Cures Act, SAMHSA’s budget demonstrates a commitment 

to addressing the nation’s pressing public health challenges, including the opioid crisis and serious mental 

illness (SMI). This budget aligns with the Administration’s priorities to address behavioral health for 

children, adults, families, and communities. Through a sustained focus on implementing evidence-based 

practices, SAMHSA’s budget aims to improve the lives of people across the nation.

SAMHSA’s FY 2019 budget request includes investments to:

• Expand access to care for opioid use disorders though the continued investment of in Medication 

- Assisted Treatment (MAT) and strategies to prevent opioid abuse through evidence-based 

prevention approaches, including the use of the life-saving drug, naloxone

• Prioritize ensuring individuals with SMI gain access to care over incarceration through increased 

investments in evidence-based programs, such as Assertive Community Treatment (ACT), jail 

diversion programs, including mental health courts, and a focus on addressing the needs of high 

utilizers of services through the Community Mental Health Services Block Grant

• Make critical data from national surveys and health surveillance available to support innovation 

and improve patient outcomes

SAMHSA provides strategic investments that foster flexibility and leverage change across the nation. In 

FY 2019, SAMHSA maintains a strong commitment to enhancing the delivery of clinically sound, 

evidence-based, effective services. SAMHSA continues to streamline its business operations, including 

the provision of technical assistance and training, to ensure an optimization of service provision across 

America’s communities.

The work SAMHSA does is vital to the health of this country. I am confident this budget supports 

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

communities.

/S/ Elinore F. McCance-Katz

Elinore F. McCance-Katz, M.D., Ph.D.

Assistant Secretary for Mental Health and Substance Use
iv

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v 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents 

Fiscal Year 2019 Budget Page 

Letter from Assistant Secretary..................................................................................................... iii 

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

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

A. Executive Summary 

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

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

3. Overview of Performance ..................................................................................................5 

4. All Purpose Table (APT)....................................................................................................7 

B. Budget Exhibits 

1. Appropriations Language .................................................................................................11 

2. Language Analysis ...........................................................................................................13 

3. Amounts Available for Obligation ...................................................................................17 

4. Summary of Changes .......................................................................................................18 

5. Budget Authority by Activity ...........................................................................................19 

6. Authorizing Legislation ....................................................................................................20 

7. Appropriations History.....................................................................................................21 

C. Mental Health

1. Mental Health Programs of Regional and National Significance ....................................26 

2. Children’s Mental Health Services ...................................................................................95 

3. Project for Assistance in Transition from Homelessness ...............................................101 

4. Protection and Advocacy for Individuals with Mental Illness .......................................107 

5. Community Mental Health Services Block Grant ..........................................................113 

D. Substance Abuse Prevention

1. Substance Abuse Prevention Programs of Regional and National Significance............128 

2. Drug Free Communities .................................................................................................157 

E. Substance Abuse Treatment

1. Substance Abuse Treatment Programs of Regional and National Significance ............168 

2. State Targeted Response to the Opioid Crisis Grants ....................................................217

3. Substance Abuse Prevention and Treatment Block Grant .............................................219
vi 

F. Health Surveillance and Program Support

1. Health Surveillance ........................................................................................................233 

2. Performance and Quality Information Systems .............................................................243

3. Program Support.............................................................................................................251

4. Public Awareness and Support .......................................................................................253

G. Additional Opioids Allocation............................................................................................259

H. Drug Control Budget.......................................................................................................... 261

I. Supplementary Tables 

1. Budget Authority by Object Class .................................................................................281 

2. Salaries and Expenses ......................................................................................................290 

3. Detail of Full-Time Equivalent Employee (FTE) ..............................................................292 

4. Detail of Positions ...........................................................................................................293 

5. Programs Proposed for Elimination ..................................................................................294 

6. Physician’s Comparability Allowance Worksheet ............................................................297 

J. Significant Items................................................................................................................. 298
(MA) OFFICE OF COMMUNICATIONS

Marla Hendriksson, M.P.M. 

Director

(MAB)

OFFICE OF BEHAVIORAL HEALTH EQUITY

Larke Huang Ph.D

Director

(MD-1) 

OFFICE OF FINANCIAL RESOURCES

Deepa Avula, M.P.H. 

Director

Vacant

 Deputy Director

(MG)

OFFICE OF MANAGEMENT, 

TECHNOLOGY AND OPERATIONS

Michael Etzinger 

Director 

CAPT Danny Nguyen 

Deputy Director 

(MB)

CENTER FOR SUBSTANCE ABUSE 

PREVENTION

Frances M. Harding 

Director 

CENTER FOR MENTAL HEALTH 

SERVICES

Paolo del Vecchio, M.S.W. 

Director

CENTER FOR SUBSTANCE ABUSE 

TREATMENT

Kimberly Johnson, Ph.D. 

Director

CENTER FOR BEHAVIORAL HEALTH 

STATISTICS AND QUALITY

Daryl Kade, M.A. 

Director

Gregory Goldstein, M.P.H. 

Deputy Director (MP)

Priscilla Clark, Ph.D. 

Deputy Director (MS)

Elizabeth Lopez, Ph.D. 

Deputy Director (MT)

Michael Corriere, Ph.D., PMP 

Deputy Director (MC)

Organizational Structure:

Substance Abuse and Mental Health Services Administration

(SAMHSA)

IMMEDIATE OFFICE OF THE ASSISTANT

SECRETARY

Elinore McCance-Katz, M.D., Ph.D.

Assistant Secretary

Vacant

Deputy Assistant Secretary
viii

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1 

Performance Budget Overview 

Introduction

The need to face mental health and substance abuse is critical to the nation’s future. Prevention, 

treatment, and support to help people recover from mental and/or substance use disorders are 

essential strategies for the health and prosperity of individuals, families, communities, and the 

country. Unfortunately, the majority of those who need treatment do not receive it. Only

43.1 percent of the 44.7 million adults with diagnosable mental health problemsreceived treatment

in the past year. The unmet treatment need for those who needed substance use treatment (19.9 

million adults) is even greater with only 1 in 9 individuals receiving specialty treatment in the past 

year. The nation can do better. SAMHSA has a unique responsibility to focus on these preventable 

and treatable problems, which, if unaddressed, lead to significant individual, societal, and 

economic consequences. 

Mission

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

communities. SAMHSA accomplishes this mission through providing leadership and devoting its 

resources, including programs, policies, information and data, contracts, and grants to help 

demonstrate that:

• Behavioral Health is essential to health

• Prevention works 

• Treatment is effective

• People recover from mental and substance use disorders 
2 

Overview of Budget Request 

The Fiscal Year (FY) 2019 President's Budget provides a program level of $3.5 billion for the 

Substance Abuse and Mental Health Services Administration (SAMHSA), which is a reduction of 

$688.4 million below the FY 2018 Continuing Resolution. In addition, the Budget provides $1.2 

billion to SAMHSA for a variety of new and expanded efforts to fight the opioid crisis. When 

accounting for these resources, the total for SAMHSA is $4.8 billion, which is an increase of 

$551.6 million above the FY 2018 Continuing Resolution. This budget request seeks to advance 

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

communities. The budget request aims to address critical national priorities including combating 

the nation’s opioid crisis, addressing serious mental illness, and developing and implementing 

strategies to prevent suicide.

Key Budget Highlights:

Additional Opioids Allocation

The FY 2019 President’s Budget Request includes $10.0 billion in new resources to combat the 

opioid epidemic and address serious mental illness. In FY 2019, an initial allocation provides $1.2 

billion in SAMHSA for a variety of new and expanded efforts to fight the opioid crisis. Of that 

amount, $1.0 billion is included to expand the State Targeted Response to the Opioid Crisis 

important program that addresses the opioid crisis by 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 addiction. The SAMHSA allocation also 

includes $150.0 million to reduce opioid-related injection drug use and related HIV/AIDS and 

Hepatitis C infection rates. In addition, also within SAMHSA, $90.0 million will be used to 

expand access to the overdose-reversing drug naloxone for first responders, expand the use of drug 

courts, and expand services to pregnant and postpartum women. 

Substance Abuse Prevention and Treatment Block Grant 

The FY 2019 President’s Budget Request is $1.9 billion. This funding serves as a safety net for 

substance abuse prevention and treatment services. The states and jurisdictions have the flexibility 

to plan, carry out, and evaluate substance abuse prevention, treatment, and recovery services that 

address the needs of individuals, families, and communities. Recognizing that prevention is an 

integral component to reduce the effects of substance abuse on America’s communities, the statute 

requires that twenty percent of the SABG state allocation must be spent on primary prevention 

services. 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT PDOA)

The FY 2019 President’s Budget Request is $56.0 million. MAT refers to the use of the Food and 

Drug Administration-approved pharmacotherapies (i.e., buprenorphine products, methadone, and 

naltrexone products) in combination with evidence-based psychosocial interventions for treatment 

of opioid addiction. MAT is a safe and effective strategy for decreasing the frequency and quantity 

of opioid abuse and reducing the risk of overdose and death. MAT PDOA addresses treatment 

needs of individuals who have an opioid addiction by expanding/enhancing treatment system 

capacity to provide accessible, effective, comprehensive, coordinated/integrated, and evidencebased MAT and recovery support services. Recovery support services include linking patients and 
3 

families to social, legal, housing, and other supports to improve the probability of positive 

outcomes. 

Grants to Prevent Prescription Drug and Opioid Overdose-related Deaths

The FY 2019 President’s Budget Request is $12.0 million. The Grants to Prevent Prescription 

Drug and Opioid Overdose-related Deaths program helps states identify communities of high need 

and provide education, training, and resources to meet their specific needs. The grant funds can 

be used for purchasing overdose-reversing drugs, equipping first responders with these 

medications, providing training on their use, disseminating other overdose-related death 

prevention strategies, and providing materials to assemble and disseminate overdose kits. 

First Responder Training 

The FY 2019 President’s Budget Request is $12.0 million. Under Section 202 of the 

Comprehensive Addiction and Recovery Act (CARA), SAMHSA is authorized to support 

additional efforts to prevent opioid overdose-related deaths by providing grants to states, local 

governments, and tribes to train first responders. The purpose of this program is to reduce the 

number of prescription drug/opioid overdose-related deaths and adverse events among individuals 

at risk for opioid abuse. Grantees will train first responders and members of other key community 

sectors at the local government and tribal levels to implement secondary prevention strategies, 

such as the administration of naloxone through FDA-approved delivery devices to reverse the 

respiratory depression associated with opioid overdose. 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

The FY 2019 President’s Budget Request is $10.0 million. SAMHSA implemented the Strategic 

Prevention Framework for Prescription Drugs 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 prevention activities and education to schools, communities, 

parents, prescribers, and their patients. 

Community Mental Health Services Block Grant

The FY 2019 President’s Budget Request is $562.6 million. This funding continues to serve as a 

safety net for mental health services for some of the nation’s most at-risk populations. By statute, 

MHBG funds must be used to address the needs of adults with serious mental illness (SMI) and 

children with serious emotional disturbances (SED). SAMHSA will maintain the ten percent 

set- aside for evidence-based programs that address the needs of individuals with early serious 

mental illness, including psychotic disorders. The set-aside funds help reduce costs to society, as 

intervening early helps prevent deterioration of functioning in individuals experiencing a first 

episode of serious mental illness.

Suicide Prevention Activities

The FY 2019 President’s Budget Request is $69.0 million. Suicide is a critical public health issue 

involving multiple psychological and social factors. It is one of the ten leading causes of death in 

the United States. SAMHSA supports a full complement of programs, which address the nation’s 

alarming rates of suicide. These include: the National Strategy for Suicide Prevention, which 

focuses on adult suicide prevention, the Garrett Lee Smith State and Campus Suicide Programs, 
4 

which address youth and young adult suicide, and the Tribal Training and Technical Assistance 

Center, which aims to provide needed training and TA to tribal communities to develop 

comprehensive suicide prevention strategies.

Assertive Community Treatment (ACT) for Adults with SMI 

The FY 2019 President’s Budget Request is $15.0 million. This program is authorized under the 

21st Century Cures Act. ACT is an evidence-based practice considered one of the most effective 

approaches to deliver services to people with SMI1 and has been disseminated by SAMHSA for 

widespread use through its Evidence-Based Toolkit series2 beginning in 2008. ACT was 

developed to reduce re-hospitalization and improve outcomes in community settings. ACT is 

designed as an integrated care approach to provide a comprehensive array of services, including 

medication management and other supportive services, directly rather than through an integrated 

team rather than referrals. The ACT team is composed of 10-12 multidisciplinary behavioral 

health staff, including psychiatrists, nurses, social workers, addition counselors, and peer 

specialists. These practitioners work together to deliver comprehensive, individualized, and 

recovery-oriented treatment and case management services to people with SMI in community 

settings. 

Criminal and Juvenile Justice Programs

The FY 2019 President’s Budget Request is $14.3 million. SAMHSA supports treatment and 

recovery efforts for people in criminal and juvenile justice systems with mental and/or substance 

use disorders. SAMHSA has created an array of programs, technical assistance centers, resources, 

and policy initiatives that take both public safety and behavioral health issues into consideration. 

Programs support judges and staff of specialty and other courts within a jurisdiction to work 

together to divert adults with mental illness or co-occurring mental and substance use disorders 

from the criminal justice system. The purpose of this grant program is to allow municipal courts 

more flexibility to collaborate with multiple criminal justice system components and local 

community treatment and recovery providers to address the behavioral health needs of adults who 

are involved with the criminal justice system. The program supports community behavioral health 

services as an integral alternative to incarceration.

 

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/

2 http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBPKIT/SMA08-4345
5 

Drug Free Communities 

The FY 2019 President’s Budget Request is $100.0 million. This activity was funded at $96.3 

million in the Office of National Drug Control Policy (ONDCP) under the FY 2018 Annualized 

CR. SAMHSA has administered this program for several years on behalf of ONDCP. The 

FY 2019 Budget proposes to directly appropriate these funds to SAMHSA to streamline program 

management and create administrative efficiencies. Funding will be used to continue both the 

DFC and DFC-Mentoring programs. The goal of the program is to establish and strengthen 

collaboration among communities, public and private non-profit agencies, as well as federal, state, 

local, and tribal governments to support the efforts of community coalitions working to prevent 

and reduce substance abuse among youth. In addition, the program aims to reduce substance abuse 

among youth and, over time, reduce substance abuse among adults by addressing the factors in a 

community that increase the risk of substance abuse and promoting the factors that minimize the 

risk of substance abuse. 
6 

Overview of Performance

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

Substance Abuse 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. SAMHSA seeks to identify the conditions that foster 

success, address barriers, enable collaboration across programs, and promote overall efficiency. 

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

programs include: abstinence from substance use, mental health functioning, overall physical 

health, criminal justice involvement, stable housing, social connectedness, and employment. 

Additionally, SAMHSA collects data on the numbers of people served, the numbers trained, and 

the number of training events held. 

SAMHSA also maintains its commitment to utilize these performance data to manage and monitor 

its portfolio of grants. In FY 2017, SAMHSA reconfigured its approach to uniform data collection 

with the successful launch and implementation of SAMHSA’s Performance Accountability and 

Reporting System (SPARS). This system provides a common data and reporting system for all 

SAMHSA discretionary grantees and allows for programmatic technical assistance on use of the 

data to enhance grantee performance monitoring and improve quality of service delivery. 

In FY 2018, SAMHSA built upon this effort to further streamline its data collection efforts and 

ensure critical data elements, such as client diagnosis, were accurately captured. Additionally, in 

FY 2018, SAMHSA closely examined data across its discretionary grant programs to ensure that 

only critical data elements were being reported in an effort to streamline data collection and 

reporting and reduce grantee burden. 

In FY 2019, SAMHSA will continue its efforts to improve upon data collection to better inform 

service delivery, needs, and program effectiveness. 
7 

All-Purpose Table

(Dollars in thousands)

Program

FY 2017

 Final

 FY 2018 

Annualized 

CR 

 FY 2019 

President's 

Budget 

 FY 2019

 President's 

Budget 

+/-

FY 2018

 Annualized CR 

Mental Health

Programs of Regional and National Significance

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

Children's Mental Health Services..................................................... 119,026 118,218 119,026 +808

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add). 11,903 11,822 11,903 +81

Projects for Assistance in Transition from Homelessness................. 64,635 64,196 64,635 +439

Protection and Advocacy for Individuals with Mental Illness............ 36,146 35,901 36,146 +245

Community Mental Health Services Block Grant.............................. 562,571 558,751 562,571 +3,821

Budget Authority (non-add).......................................................... 541,532 537,854 541,532 +3,678

PHS Evaluation Funds (non-add)................................................ 21,039 20,896 21,039 +143

Total, Mental Health .................................................................... 1,178,037 1,171,933 1,064,922 -107,011

Budget Authority (non-add).......................................................... 1,144,998 1,140,202 1,043,883 -96,319

Prevention and Public Health Fund (non-add)............................. 12,000 10,835 -- -10,835

PHS Evaluation Funds (non-add)................................................ 21,039 20,896 21,039 +143

Substance Abuse Prevention

Programs of Regional and National Significance............................... 221,869 221,703 120,885 -100,818 1 Drug Free Communities ............................................................ -- -- 100,000 100,000

Total, Substance Abuse Prevention.............................................

Substance Abuse Treatment

Programs of Regional and National Significance............................... 350,427 352,020 255,318 -96,702

PHS Evaluation Funds (non-add)............................................. 2,000 1,986 -- -1,986

State Targeted Response to the Opioid Crisis Grants ..................... 500,000 496,605 -- -496,605

Substance Abuse Prevention and Treatment Block Grant............... 1,858,079 1,845,461 1,858,079 +12,618

Budget Authority (non-add).......................................................... 1,778,879 1,766,799 1,778,879 +12,080

PHS Evaluation Funds (non-add)................................................ 79,200 78,662 79,200 +538

Total, Substance Abuse Treatment.............................................. 2,708,506 2,694,085 2,113,397 -580,688

SAT Budget Authority (non-add).................................................. 2,627,306 2,613,437 2,034,197 -579,240

SAT PHS Evaluation Funds (non-add)......................................... 81,200 80,648 79,200 -1,448

Health Surveillance and Program Support

 Health Surveillance and Program Support 124,258 123,414 121,885 -1,529

PHS Evaluation Funds (non-add)................................................ 30,428 30,221 19,428 -10,793

Public Awareness and Support........................................................... 13,000 12,912 11,572 -1,340

Performance and Quality Information Systems................................. 10,000 9,932 12,893 +2,961

Behavioral Health Workforce Data and Development...................... 1,000 993 998 +5

PHS Evaluation Funds (non-add)................................................ 1,000 993 998 +5

Data Request and Publications User Fees........................................... 1,500 1,490 1,500 +10

Total, Health Surveillance and Program Support..................... 149,758 148,741 148,848 +107

HSPS Budget Authority (non-add)................................................ 116,830 116,037 126,922 +10,885

HSPS PHS Evaluation Funds (non-add)...................................... 31,428 31,215 20,426 -10,789

Data Request and Publications User Fees (non-add).................... 1,500 1,490 1,500 +10

TO TAL, SAMHSA Program Level................................................ 4,258,170 4,236,462 3,548,052 -688,410

$395,659

12,000

$394,868

10,835

$282,544

--

 -$112,324 

-10,835

221,869 221,703 220,885 -818

Additional O pioids Allocation2

State Targeted Response to the Opioid Crisis ................................ --

Reducing Injection Drug Use, HIV/AIDS, and Hepatitis..................

Opioid Overdose Reversal Expansion ............................................ --

Drug Courts Expansion.................................................................. --

Treatment for Pregnant and Post-Partum Women ....................... --

Total, Additional O pioids Allocation.......................................... --

-- 1,000,000

150,000

-- 50,000

-- 20,000

-- 20,000

+1,000,000

+150,000

+50,000

+20,000

+20,000

-- 1,240,000 +1,240,000

TO TAL, SAMHSA with Additional O pioids Allocation............ 4,258,170 4,236,462 4,788,052 +551,590

Less Funds from Other Sources:

Additional Opioids Allocation (non-add)................................... -- -- -1,240,000 -1,240,000

Prevention and Public Health Fund (non-add).......................... -12,000 -10,835 -- +10,835

PHS Evaluation Funds.............................................................. -133,667 -132,759 -120,665 +12,094

Data Request and Publications User Fees.................................. -1,500 -1,490 -1,500 -10

TO TAL, SAMHSA Budget Authority........................................... $4,111,003 $4,091,378 $3,425,887 -$665,491

FTEs3 590 614 635 21

1

 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in FY 2017 and at $96.3 million 

under the FY 2018 Annualized CR.

3

 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act Mental Health and Substance 

Use Policy Laboratory. It also represents the staffing needed to administer the $1.2 billion in discretionary funding. It differs from 

the reported figure in MAX, which does not include these elements.

2

 This funding is part of the FY 2019 President's Budget for $10.0 billion in new resources to combat the opioid epidemic and address 

mental illness. The Additional Opioids Allocation funding request is displayed in its entirely on page 259. 
8 

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9 

SAMHSA

Budget Exhibits 

Table of Contents 

1. Appropriation Language ......................................................................................................... 11

2. Language Analysis.................................................................................................................. 13

3. Amounts Available for Obligation.......................................................................................... 17

4. Summary of Changes .............................................................................................................. 18

5. Budget Authority by Activity ................................................................................................. 18

6. Authorizing Legislation .......................................................................................................... 20

7. Appropriations History ........................................................................................................... 21
10 

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11 

Appropriations Language 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

MENTAL HEALTH

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

Protection and Advocacy for Individuals with Mental Illness Act, $1,043,883,000: Provided, That 

notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 

520A shall be available for carrying out section 1971 of the PHS Act: Provided further, That in 

addition to amounts provided herein, $21,039,000 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 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 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, $15,000,000 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). 

SUBSTANCE ABUSE TREATMENT

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

and title XIX of such Act with respect to substance abuse treatment and 

prevention, $2,034,197,000: Provided, That in addition to amounts provided 

herein, $79,200,000 shall be available under section 241 of the PHS Act to supplement funds 

otherwise available for substance abuse treatment activities and to carry out subpart II of part B 

of title XIX of the PHS Act to fund section 1935(b) technical assistance, national data, data 

collection and evaluation activities, and further that the total available under this Act for section 

1935(b) activities shall not exceed 5 percent of the amounts appropriated for subpart II of part B 

of title XIX: Provided further, That none of the funds provided for section 1921 of the PHS Act 

shall be subject to section 241 of such Act. 

SUBSTANCE ABUSE PREVENTION

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

prevention and for the Drug-Free Communities Support Program authorized by the Drug-Free 

Communities Act of 1997, as amended, $220,885,000, of which $2,000,000 shall be made 

available as directed by section 4 of Public Law 107–82, as amended by Public Law 109–469 (21 

U.S.C. 1521 note) and $3,000,000, to remain available until expended, shall be for activities 

authorized by section 103 of Public Law 114–198. 
12 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

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

the headings "Mental Health", "Substance Abuse Treatment", and "Substance Abuse Prevention" 

in carrying out titles III, V, and XIX of the PHS Act, the Drug-Free Communities Act of 1997, as 

amended, and the Protection and Advocacy for Individuals with Mental Illness Act in the 

Substance Abuse and Mental Health Services Administration 

("SAMHSA"), $126,922,000: Provided, That in addition to amounts provided 

herein, $20,426,000 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, 2020: Provided further, That funds made available under this heading may be used to 

supplement program support funding provided under the headings "Mental Health", "Substance 

Abuse Treatment", and "Substance Abuse Prevention": Provided further, That the Assistant 

Secretary for Mental Health and Substance Use may transfer discretionary funds (pursuant to the 

Balanced Budget and Emergency Deficit Control Act of 1985) which are appropriated for the 

current fiscal year for SAMHSA in this Act between any of the accounts of SAMHSA with 

notification to the Committees on Appropriations of both Houses of Congress at least 15 days in 

advance of any transfer, but no such account shall be decreased by more than 3 percent by any 

such transfer.

Note.—A full-year 2018 appropriation for this account was not enacted at the time the budget was 

prepared; therefore, the budget assumes this account is operating under the Continuing 

Appropriations Act, 2018 (Division D of P.L. 115–56, as amended). The amounts included for 

2018 reflect the annualized level provided by the continuing resolution.
13 

Language Analysis 

Language Provision Explanation

For carrying out titles III, V, and XIX of the PHS 

Act with respect to mental health, and the Protection 

and Advocacy for Individuals with Mental Illness 

Act, $1,043,883,000: Provided, That 

notwithstanding section 520A(f)(2) of the PHS Act, 

no funds appropriated for carrying out section 520A 

shall be available for carrying out section 1971 of 

the PHS Act:

Identifies the purpose for which funds 

can be used

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 and activities authorized under 

title XIX as well as under titles III and V.

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:

This provision permits SAMHSA to set 

aside up to 10 percent of CMHS for a 

demonstration with flexibility which 

would help address youth (which 

addresses 75 percent of first time 

psychotic episodes) instead of only 

children (which represent less than 50 

percent of first time psychotic episodes) 

in the prodrome phase, which evidence 

indicates may prevent the further 

development of serious emotional 

disturbances and ultimately serious 

mental illness. 
14 

Language Analysis (continued)

Language Provision Explanation

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, $15,000,000 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). 

Identifies the purpose for which funds 

can be used

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

respect to substance abuse treatment and title XIX of 

such Act with respect to substance abuse treatment 

and prevention, $2,034,197,000: 

Sets out the budget authority for the 

Substance Abuse Treatment 

appropriation. 

Provided, That in addition to amounts provided 

herein, $79,200,000 shall be available under section 

241 of the PHS Act to supplement funds otherwise 

available for substance abuse treatment activities 

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

the PHS Act to fund section 1935(b) technical 

assistance, national data, data collection and 

evaluation activities, and further that the total 

available under this Act for section 1935(b) 

activities shall not exceed 5 percent of the amounts 

appropriated for subpart II of part B of title 

XIX: Provided further, That none of the funds 

provided for section 1921 of the PHS Act shall be 

subject to section 241 of such Act.

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 as well as 

under titles III and V. These evaluation 

efforts will enable the gathering and 

dissemination of best practices. 

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

respect to substance abuse prevention and for the 

Drug-Free Communities Support Program 

authorized by the Drug-Free Communities Act of 

1997, as amended, $220,885,000, of 

which $2,000,000 shall be made available as 

directed by section 4 of Public Law 107–82, as 

amended by Public Law 109–469 (21 U.S.C. 1521 

note) and $3,000,000, to remain available until 

expended, shall be for activities authorized by 

section 103 of Public Law 114–198.

Identifies the purpose for which funds 

can be used. The FY 2019 Budget funds 

the Drug-Free Communities Support 

Program in SAMHSA. In previous years 

this activity was funded in the Office of 

National Drug Control Policy. 
15 

Language Analysis (continued)

Language Provision Explanation

For program support and cross-cutting activities that 

supplement activities funded under the headings 

"Mental Health", "Substance Abuse Treatment", and 

"Substance Abuse Prevention" in carrying out titles 

III, V, and XIX of the PHS Act, the Drug-Free 

Communities Act of 1997, as amended, and the 

Protection and Advocacy for Individuals with 

Mental Illness Act in the Substance Abuse and 

Mental Health Services Administration 

("SAMHSA"), $126,922,000:

Identifies the purpose for which funds 

can be used to supplement activities 

funded in the other three appropriations 

Provided, That in addition to amounts provided 

herein, $20,426,000 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:

Identifies the purpose for which funds 

can be used

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:

Provides authority to collect user fees

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, 2020: 

The 21st Century Cures Act authorizes 

funds for this program to be available for 

two years. However, recent 

appropriations acts have limited funds to 

annual periods of availability except as 

expressly provided within the 

appropriations acts themselves (which 

would not include the PHS Act). This 

proviso is that express authority.
16 

Language Analysis (continued)

Language Provision Explanation

Provided further, That funds made available under 

this heading may be used to supplement program 

support funding provided under the headings 

"Mental Health", "Substance Abuse Treatment", 

and "Substance Abuse Prevention": Provided 

further, That the Assistant Secretary for Mental 

Health and Substance Use may transfer 

discretionary funds (pursuant to the Balanced 

Budget and Emergency Deficit Control Act of 

1985) which are appropriated for the current fiscal 

year for SAMHSA in this Act between any of the 

accounts of SAMHSA with notification to the 

Committees on Appropriations of both Houses of 

Congress at least 15 days in advance of any 

transfer, but no such account shall be decreased by 

more than 3 percent by any such transfer. 

Establishes a permissive authority to 

transfer a small portion of funds between 

any of the SAMHSA accounts in order to 

ensure that multiple accounts are not a 

barrier to the efficient administration of the 

agency, or appropriate responsiveness to 

emerging issues with congressional 

notification. 
17 

Amounts Available for Obligation

(Whole dollars)

1 Source of funds displayed consistent with prior year presentations and the assumptions for the FY 2019 Budget.

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

General Fund Discretionary Appropriation:

Appropriation .......................................... $4,111,003,000 $4,119,353,000 $3,425,887,000 

Across-the-board reductions ................... --- 27,975,000 ---

Subtotal, Appropriation ....................... 4,111,003,000 4,091,378,000 3,425,887,000 

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

Subtotal, adjusted appropriation........... 4,111,003,000 4,091,378,000 3,425,887,000 

Prevention Fund Resource1..................

Additional Opioids Allocation.............. 

---

--- 

10,835,000

--- 1,240,000,000 

Total, Discretionary Appropriation 4,111,003,000 4,102,213,000 4,665,887,000 

Mandatory Appropriation:

Mandatory PPHF....................................... 12,000,000 --- ---

Subtotal, adjusted mandatory 

appropriation. 12,000,000 --- ---

Offsetting collections from:

Federal Source..................................... 133,667,000 132,759,000 120,665,000 

Data Request and Publications User Fees..... 1,500,000 1,490,000 1,500,000 

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

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

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

Total obligations..................................... $4,258,170,000 $4,236,462,000 $4,788,052,000 
18 

Summary of Changes 

(Whole dollars)

2018

2019

Increases:

A. Built-in:

1. Annualization of 2018 commissioned corps pay increase..

2. Annualization of 2018 civilian pay increase..........................

Subtotal, Built-in Increases.....................................................

A. Program:

1. Health Surveillance...................................................................

5. Performance and Quality Information Systems....................

Subtotal, Program Increases...................................................

Total Increases........................................................................

Decreases:

A. Built-in:

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

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

A. Program:

1. Mental Health ...........................................................................

2. Program Support........................................................................

3. Public Awareness and Support...............................................

2. Substance Abuse Prevention PRNS......................................

3. Substance Abuse Treatment ..................................................

Subtotal, Program Decreases.................................................

Total Decreases......................................................................

Net Change...........................................................................

FY 2019

PB FTE

FY 2019

PB BA

FY 2019

+/- 

FY 2018

FTE

FY 2019

+/- 

FY 2018

BA

 

$8,297,308 

87,383,119

+$206,320

+$413,108

 95,680,427

 

 

29,414,000

12,893,000

+619,428

+12,698,000

+2,962,000

 ---

 42,307,000

 --- ---

+15,660,000

+16,279,428

-619,428

 ---

 ---

 1,043,883,000

 73,043,000

 11,572,000

 220,885,000

 2,034,197,000

1,128,498,000

 ---

 $---

 ---

 $---

-619,428

-96,319,000

-3,434,000

-1,340,000

-818,000

-579,240,000

-681,151,000

-681,770,428

-$665,491,000

Total estimated budget authority........................................................................................................................... $4,091,378,000

(Obligations).............................................................................................................................................................. 4,091,378,000

Total estimated budget authority........................................................................................................................... 3,425,887,000

(Obligations).............................................................................................................................................................. 3,425,887,000

Net Change.............................................................................................................................................................. -$665,491,000
19 

Budget Authority by Activity 

(Dollars in thousands)

Program FY 2017 Final

 FY 2018 

Annualized CR 

 FY 2019 

President's 

Budget 

Mental Health 0.1901%

Programs of Regional and National Significance $395,659 $394,868 $282,544

Prevention and Public Health Fund (non-add).............................. 12,000 10,835 --

Children's Mental Health Services.............................................................. 119,026 118,218 119,026

Projects for Assistance in Transition from Homelessness..................... 64,635 64,196 64,635

Protection and Advocacy for Individuals with Mental Illness.............. 36,146 35,901 36,146

Community Mental Health Services Block Grant..................................... 562,571 558,751 562,571

Budget Authority (non-add)................................................................... 541,532 537,854 541,532

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

Total, Mental Health ....................................................................................

21,039 20,896 21,039

1,178,037 1,171,933 1,064,922

Substance Abuse Prevention

Programs of Regional and National Significance..................................... 221,869 1 Drug Free Communities ...........................................................

Total, Substance Abuse Prevention........................................................... 221,869

221,703

-- --

120,885

100,000

221,703 220,885

Substance Abuse Treatment

Programs of Regional and National Significance..................................... 350,427 352,020 255,318

PHS Evaluation Funds (non-add)...................................................... 2,000 1,986 --

State Targeted Response to the Opioid Crisis Grants /2...................... 500,000 496,605 --

Substance Abuse Prevention and Treatment Block Grant.................. 1,858,079 1,845,461 1,858,079

Budget Authority (non-add)................................................................... 1,778,879 1,766,799 1,778,879

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

Total, Substance Abuse Treatment...........................................................

79,200 78,662 79,200

2,708,506 2,694,085 2,113,397

Health Surveillance and Program Support

 Health Surveillance and Program Support 124,258 123,414 121,885

PHS Evaluation Funds (non-add)......................................................... 30,428 30,221 19,428

Public Awareness and Support................................................................... 13,000 12,912 11,572

Performance and Quality Information Systems........................................ 10,000 9,932 12,893

Data Request and Publications User Fees................................................ 1,500 1,490 1,500

Behavioral Health Workforce Data and Development............................ 1,000 993 998

PHS Evaluation Funds (non-add)......................................................... 1,000 993 998

Total, Health Surveillance and Program Support.................................. 149,758 148,741 148,848

TOTAL, SAMHSA Program Level........................................................... 4,258,170 4,236,462 3,548,052 2 Additional Opioids Allocation ................................................ -- -- 1,240,000

TOTAL, SAMHSA with Additional Opioids Allocation........................ 4,258,170 4,236,462 4,788,052

Less Funds from Other Sources:

Additional Opioids Allocation (non-add)........................................ -- -- -1,240,000 

Prevention and Public Health Fund (non-add).............................. -12,000 -10,835 --

PHS Evaluation Funds......................................................................... -133,667 -132,759 -120,665 

Data Request and Publications User Fees........................................ -1,500 -1,490 -1,500 

TOTAL, SAMHSA Budget Authority....................................................... $4,111,003 $4,091,378 $3,425,887

FTEs3 590 614 635

3

 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act Mental Health and Substance Use 

Policy Laboratory. It also represents the staffing needed to administer the $1.2 billion in discretionary funding. It differs from the reported 

figure in MAX, which does not include these elements.

1

 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in FY 2017 and at $96.3 million under 

the FY 2018 Annualized CR.

2

 This funding is part of the FY 2019 President's Budget for $10.0 billion in new resources to combat the opioid epidemic and address mental 

illness. The Additional Opioids Allocation funding request is displayed in its entirely on page 259. 
20 

Authorizing Legislation

(Whole dollars)

Program Name Location of Program Authorization 

Legal Citation 

(US Code)

Most Recent 

(Re)Authorizing 

Legislation FY 2019 Authorization

FY Auth. Expires or 

Expired Nature of Expiration

(i.e.: PHS Act, Section xx) (i.e.: Bill name or 

Public Law number)

(identify amounts 

authorized)

(Indicate the last 

year for which the 

program is 

authorized or has 

the appropriation. 

Response should 

indicate either a FY 

or "permanent.")

Program Authority

Grants for the Benefit of Homeless PHS Act, Section 506 (42 U.S.C. 290aa–5) Pub. L. 114–255 $ 41,304,000 FY 2022

Residential Treatment Programs for Pregnant and Postpartum Women PHS Act, Section 508 (42 U.S.C. 290bb–1) Pub. L. 114–198 $ 16,900,000 FY 2021

Priority Substance Abuse Treatment Needs of Regional and National Significance PHS Act, Section 509 (42 U.S.C. 290bb–2) Pub. L. 114–255 $ 333,806,000 FY 2022

Substance Abuse Treatment Services for Children and Adolescents PHS Act, Section 514 (42 U.S.C. 290bb–7) Pub. L. 114–255 $ 29,605,000 FY 2022

Priority Substance Abuse Prevention Needs of Regional and National Significance PHS Act, Section 516 (42 U.S.C. 290bb–22) Pub. L. 114–255 $ 211,148,000 FY 2022

Programs to Reduce Underage Drinking PHS Act, Section 519B (42 U.S.C. 290bb–25b) Pub. L. 114–255 $ 10,000,000 FY 2022

Priority Mental Health Needs of Regional and National Significance PHS Act, Section 520A (42 U.S.C. 290bb–32) Pub. L. 114–255 $ 394,550,000 FY 2022

Suicide Prevention Technical Assistance Center PHS Act, Section 520C (42 U.S.C. 290bb–34) Pub. L. 114–255 $ 5,988,000 FY 2022

Youth Suicide Early Intervention and Prevention Strategies PHS Act, Section 520E (42 U.S.C. 290bb–36) Pub. L. 114–255 $ 30,000,000 FY 2022

Mental Health and Substance Use Disorder Services on Campus PHS Act, Section 520E-2 (42 U.S.C. 290bb–36b) Pub. L. 114–255 $ 7,000,000 FY 2022

National Suicide Prevention Lifeline Program PHS Act, Section 520E-3 (42 U.S.C. 290bb–36c) Pub. L. 114–255 $ 7,198,000 FY2022

Grants for Jail Diversion Programs PHS Act, Section 520G (42 U.S.C. 290bb–38) Pub. L. 114–255 $ 4,269,000 FY 2022

Promoting Integration of Primary and Behavioral Health Care PHS Act, Section 520K (42 U.S.C. 290bb–42) Pub. L. 114–255 $ 51,878,000 FY 2022

Adult Suicide Prevention PHS Act, Section 520L (42 U.S.C. 290bb–43) Pub. L. 114–255 $ 30,000,000 FY 2022

Assertive Community Treatment Grant Program PHS Act, Section 520M (42 U.S.C. 290bb–44) Pub. L. 114–255 $ 5,000,000 FY 2022

Projects for Assistance in Transition From Homelessness PHS Act, Section 535(a) (42 U.S.C. 290cc–35(a)) Pub. L. 114–255 $ 64,635,000 FY 2022

First Responder Training PHS Act, Section 546 (42 U.S.C. 290ee-2) Pub. L. 114–198 $ 12,000,000 FY 2021

Building Communities of Recovery PHS Act, Section 547 (42 U.S.C. 290ee-2) Pub. L. 114–198 $ 1,000,000 FY 2021

Community Mental Health Services for Children with Serious Emotional Disturbances PHS Act, Section 565(f)(1) (42 U.S.C. 290ff-4) Pub. L. 114–255 $ 119,026,000 FY 2022

Children and Violence PHS Act, Section 581.29 (42 U.S.C. 290hh) Pub. L. 106–310 Such Sums as Necessary FY 2003 Appropriation in Authorizing Legislation

Grants for Persons who Experience Violence Related Stress PHS Act, Section 582 (42 U.S.C. 290hh–1) Pub. L. 114–255 $ 46,887,000 FY 2022

Community Mental Health Services Block Grants PHS Act, Section 1911 (42 U.S.C. 300x) Pub. L. 114–255 $ 532,571,000 FY 2022

Substance Abuse Prevention and Treatment Block Grants PHS Act, Section 1921 (42 U.S.C. 300x-21) Pub. L. 114–255 $ 1,858,079,000 FY 2022

Assisted Outpatient Treatment Grant Program for Individuals With Serious Mental Illness Section 224 of the Protecting Access 

to Medicare Act of 2014

(42 U.S.C. 290aa note) Pub. L. 114–255 $ 19,000,000 FY 2022

Protection and Advocacy for Individuals with Mental Illness Section 117 of the Proection and 

Advocacy of Mentally Ill Inidivduals Act 

of 1986

(42 U.S.C. 10827) Pub. L. 99-319 $ 19,500,000 FY 2003 Appropriation in Authorizing Legislation

Heath Surveillance PHS Act, Section 501, 505 (42 U.S.C. 290aa, 290aa–4) Pub. L. 114–255 Indefinite

Public Awareness and Support PHS Act, Section 501, 509, 516, 520A(42 U.S.C. 290aa, 290bb-2, 

290bb-22, 290bb-32)

Pub. L. 114–255 Indefinite 

Performance and Quality Improvement Systems PHS Act, Section 501, 509, 516, 520A(42 U.S.C. 290aa, 290bb-2, 

290bb-22, 290bb-32)

Pub. L. 114–255 Indefinite 
21 

Appropriations History

(Whole dollars)

Budget Estimate 

to Congress

House 

Allowance

Senate 

Allowance Appropriation

FY 2010

General Fund Appropriation:

Base...................................................................... $3,393,882,000 $3,429,782,000 $3,419,438,000 $3,431,116,000 1/

P.L. 111-117

Subtotal.................................................................. $3,393,882,000 $3,429,782,000 $3,419,438,000 $3,431,116,000

FY 2011

General Fund Appropriation:

Base...................................................................... $3,541,362,000 $3,565,360,000 $3,576,184,000 $3,386,311,000

P.L. 112-10

Subtotal.................................................................. $3,541,362,000 $3,565,360,000 $3,576,184,000 $3,386,311,000

FY 2012

General Fund Appropriation:

Base...................................................................... $3,386,903,000 $3,096,914,000 $3,354,637,000 $3,347,020,000 2/

P.L. 112-74

Subtotal.................................................................. $3,386,903,000 $3,096,914,000 $3,354,637,000 $3,347,020,000

FY 2013

General Fund Appropriation:

Base...................................................................... $3,151,508,000 --- $3,472,213,000 $3,172,154,778 3/

S.R. 112-176

Subtotal.................................................................. $3,151,508,000 --- $3,472,213,000 $3,172,154,778

FY 2014

General Fund Appropriation:

Base...................................................................... $3,347,951,097 --- $3,529,944,000 $3,434,935,000 4/

S.R. 113-071

Subtotal.................................................................. $3,347,951,097 --- $3,529,944,000 $3,434,935,000

1/ Reflects a $508 thousand transfer to HHS.

2/ Reflects a 0.189 percent across-the-board Rescission from the P.L. 112-74, and $953,809 Ryan White transfer.

3/ Reflects the annualized level provided by the continuing resolution.

4/ Reflects the whole year appropriation.
22 

Appropriations History (continued) 

(Whole dollars)

Budget Estimate 

to Congress

House 

Allowance

Senate 

Allowance Appropriation

FY 2015

General Fund Appropriation:

Base...................................................................... $3,297,669,000 --- $3,431,878,000 $3,474,045,000 5/

P.L. 113-235

Subtotal.................................................................. $3,297,669,000 --- $3,431,878,000 $3,474,045,000

FY 2016

General Fund Appropriation:

Base...................................................................... $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000 6/

P.L. 114-113

Subtotal.................................................................. $3,395,663,000 $3,642,710,000 $3,314,817,000 $3,634,269,000

FY 2017

General Fund Appropriation:

21st Century Cures Act........................................... $500,000,000 7/

Base...................................................................... $3,488,783,000 $4,211,603,000 $3,739,577,000 $4,111,003,000 8/

P.L. 115-31

Subtotal.................................................................. $3,488,783,000 $4,211,603,000 $3,739,577,000 $4,111,003,000

FY 2018

General Fund Appropriation:

21st Century Cures Act........................................... $496,605,000 7/

Base...................................................................... $3,770,668,000 $4,193,936,000 $4,131,925,000 $4,091,378,000 9/

Subtotal.................................................................. $3,770,668,000 $4,193,936,000 $4,131,925,000 $4,091,378,000

FY 2019

General Fund Appropriation:

Base...................................................................... $3,425,887,000

Subtotal.................................................................. $3,425,887,000 5/ Reflects the whole year appropriation.

6/ Reflects the whole year appropriation.

9/ Reflects the Annualized Continuing Resolution.

7/ Reflects the additional amount provided to the Secretary of Health and Human Services to carry out the authorizations in the 21st Century Cures Act

8/ Reflects the whole year appropriation. 
23 

SAMHSA

Mental Health

Table of Contents 

1. Mental Health Appropriation ............................................................................................ 25 

2. Programs of Regional and National Significance (PRNS) ............................................... 26 

a) National Child Traumatic Stress Network ............................................................ 28 

b) Project AWARE.................................................................................................... 31 

c) Healthy Transitions ............................................................................................... 34 

d) Children and Family Programs ............................................................................. 37 

e) Consumer and Family Network Grants ................................................................ 39 

f) Project LAUNCH.................................................................................................. 41 

g) Mental Health System Transformation and Health Reform ................................. 45 

h) Primary and Behavioral Health Care Integration.................................................. 48 

i) Suicide Prevention Programs ................................................................................ 51 

i. National Strategy for Suicide Prevention ....................................................... 52 

ii. Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus...... 54 

iii. Garrett Lee Smith Suicide Prevention Resource Center ................................. 56 

iv. Suicide Lifeline ............................................................................................... 57 

v. American Indian/Alaska Native Suicide Prevention Initiative ....................... 59 

a. Homelessness Prevention Programs ..................................................................... 61 

b. Minority AIDS and HIV/AIDS Education ........................................................... 63 

c. Criminal and Juvenile Justice Programs ............................................................... 65 

d. Practice Improvement and Training...................................................................... 67 

e. Consumer and Consumer-Supporter TA Centers ................................................. 69 

f. Disaster Response ................................................................................................. 71 

g. Seclusion and Restraint ......................................................................................... 73 

h. Assisted Outpatient Treatment for Individuals with Serious Mental Illness ........ 75 

i. Tribal Behavioral Health Grants ........................................................................... 80 

j. Minority Fellowship Program ............................................................................... 83 

k. Assertive Community Treatment for Individuals with Serious Mental Illness .... 84 

3. PRNS Mechanism Table Summary .................................................................................. 86 

4. PRNS Mechanism Table by Program, Project, and Activity ............................................ 87 

5. Grant Awards Table .......................................................................................................... 94 

6. Children's Mental Health Services .................................................................................... 95 

7. Projects for Assistance in Transition from Homelessness (PATH) ................................ 101 

8. Protection and Advocacy for Individuals with Mental Illness (PAIMI) ......................... 107 

9. Community Mental Health Services Block Grant (MHBG)........................................... 113 
24 

Page intentionally left blank
25 

Mental Health Appropriation

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Programs of Regional and National Significance............... $395,659 $394,868 $282,544 -112,324

Prevention and Public Health Fund (non-add)............... 12,000 10,835 --- -10,835

Children's Mental Health Services...................................... 119,026 118,218 119,026 808

Projects for Assistance in Transition From Homelessness... 64,635 64,196 64,635 439

Protection and Advocacy For Individuals with Mental 

Illness............................................................... 36,146 35,901 36,146 245

Community Mental Health Services Block Grant................. 562,571 558,751 562,571 3,820

PHS Evaluation Funds (non-add)..................................... 21,039 20,896 21,039 143

Total, Mental Health......................................................... $1,178,037 $1,171,933 $1,064,922 -$107,011

The Mental Health FY 2019 President’s Budget request is $1.1 billion, a decrease of $107.0 million 

from the FY 2018 Annualized CR. The request includes $1.1 billion in Budget Authority and 

$21.0 million in Public Health Service (PHS) Evaluation funds. 
26 

Programs of Regional and National Significance (PRNS)

Mental Health Appropriation

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Capacity:

National Child Traumatic Stress Network......................... $48,887 $48,555 $48,887 $332

Project AWARE.................................................................. 68,964 71,475 --- -71,475

Project AWARE State Grants (non-add)......................... 54,001 56,614 --- -56,614

Mental Health First Aid (non-add).................................. 14,963 14,861 --- -14,861

Healthy Transitions.............................................................. 19,951 19,816 19,951 135

Children and Family Programs............................................ 7,229 7,180 7,229 49

Consumer and Family Network Grants............................... 4,954 4,920 4,954 34

Project LAUNCH .............................................................. 23,605 23,445 23,605 160

Mental Health System Transformation and Health Reform. 3,779 3,753 3,779 26

Primary and Behavioral Health Care Integration................ 49,877 49,538 --- -49,538

Suicide Prevention............................................................... 69,032 67,479 69,032 1,553

National Strategy for Suicide Prevention (non-add)....... 11,000 10,925 11,000 75

Zero Suicide (non-add)................................................ 9,000 8,939 9,000 61

Zero Suicide -AI/AN (non-add)............................ 2,000 1,986 2,000 14

Suicide Lifeline (non-add)............................................ 7,198 7,149 7,198 49

GLS - Youth Suicide Prevention - States (non-add)........ 35,427 34,103 35,427 1,324

Prevention & Public Health Fund (non-add).............. 12,000 10,835 --- -10,835

GLS - Youth Suicide Prevention - Campus (non-add)...... 6,488 6,444 6,488 44

GLS - Suicide Prevention Resource Center (non-add).... 5,988 5,947 5,988 41

AI/AN Suicide Prevention Initiative (non-add)............... 2,931 2,911 2,931 20

Homelessness Prevention Programs.................................... 30,696 30,488 30,696 208

Minority AIDS................................................................... 9,224 9,161 --- -9,161

Criminal and Juvenile Justice Programs.............................. 4,269 4,240 14,269 10,029

Seclusion and Restraint....................................................... 1,147 1,139 1,147 8

Assisted Outpatient Treatment for Individuals with SMI... 15,000 14,898 15,000 102

Assertive Community Treatment for Individuals with SMI. --- --- 15,000 15,000

Tribal Behavioral Health Grants.......................................... 15,000 14,898 15,000 102

Subtotal, Capacity 371,614 370,986 268,549 -102,438

Science and Service:

Primary and Behavioral Health Care Integration TTA....... 1,991 1,977 --- -1,977

Practice Improvement and Training................................. 7,828 7,775 7,828 53

Consumer and Consumer-Supporter TA Centers............... 1,918 1,905 1,918 13

Disaster Response............................................................... 1,953 1,940 1,953 13

Homelessness...................................................................... 2,296 2,280 2,296 16

Minority Fellowship Program............................................. 8,059 8,004 --- -8,004

HIV/AIDS Education......................................................... --- --- --- ---

Subtotal, Science and Service 24,045 23,882 13,995 -9,887

Total, PRNS $395,659 $394,868 $282,544 -$112,324
27 

Authorizing Legislation ....................................... Sections 520A of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities..............................................................States, Federally Recognized, 

American Indian/Alaska Native tribes or tribal organizations, 

Indian Health Service-operated and contracted health facilities 

and programs, other public and private nonprofit entities 
28 

National Child Traumatic Stress Network

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

National Child Traumatic Stress Network............... $48,887 $48,555 $48,887 $332

Authorizing Legislation ............................................. Section 582 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities ......................................................................... States, Local Governments, Tribes, 

Institutions of Higher Education, and Community Organizations 

Program Description and Accomplishments

Child traumatic stress is a pervasive and potentially life changing experience that affects tens of 

thousands of children each year. Child traumatic stress occurs when children and adolescents are 

exposed to traumatic events or traumatic situations that overwhelm their ability to cope with what 

they have experienced. Child traumatic stress can interfere with a wide range of childhood 

developmental capabilities, including social and educational functioning. There is strong evidence 

that the negative impact of child trauma progresses into adulthood and increases the likelihood of 

later adverse physical and behavioral health outcomes if not recognized and addressed early in 

life.3,4

 Studies show that 25 percent to 80 percent or more of children and adolescents are exposed 

to traumatic events, with many exposed to multiple traumatic events.5 While the effects of trauma 

and exposure to violence are found in all service sectors, it is particularly prominent among youth 

with mental illness and/or drug/alcohol addiction involved in the child welfare, and juvenile justice 

systems. Studies show that youth in foster care can have rates of Post-Traumatic Stress Disorder 

that are nearly double those of combat veterans.6

Established in 2000, the National Child Traumatic Stress Initiative (NCTSI) aims to improve 

behavioral health services and interventions for children and adolescents exposed to traumatic 

events. SAMHSA has provided funding for a national network of grantees known as the National 

Child Traumatic Stress Network (NCTSN) to develop and promote effective community practices 

for children and adolescents exposed to a wide array of traumatic events. The NCTSN has grown 

from a collaborative network of 17 sites to more than 225 funded and affiliate centers located 

 

3 Putnam, K.T., Harris, W.W., Putnam, F.W. (2013). Synergistic childhood adversities and complex adult 

psychopathology. Journal of Traumatic Stress, 26(4), 435-442. 4 Kerker, B.D., Zhang, J., Nadeem, E., Stein, R.E., Hurlburt, M.S., Heneghan, A., Landsverk, J., McCue Horwitz S

(2015). Adverse childhood experiences and mental health, chronic medical conditions, and development in young 

children. Academy of Pediatrics, 13(15), 00173-00174. 

5 Fairbank, J.A. (2008). The epidemiology of trauma, and trauma related disorders in children and youth. PTSD 

Research Quarterly, (19), 1050-1835. 6 Pecora, P.J., Kessler, R.C., Williams, J., O’Brien, K., Downs, A.C., English, E., Holmes, K. (2005). Improving 

family foster care: Findings from the northwest foster care alumni study. Casey Family Programs. Retrieved from 

http://www.casey.org/resources/publications/ImprovingFamilyFosterCare.htm
29 

nationwide in universities, hospitals, and other diverse community-based organizations with 

thousands of national and local partners. The NCTSN’s mission is to raise the standard of care 

and improve access to evidence-based services for children experiencing trauma, their families, 

and communities. 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.

Data collected in FY 2017 demonstrate that the current NCTSN grantees have provided 

evidence- based treatment to over 28,000 children, adolescents, and family members. 

Seventy- five percent reported positive functioning at six months, far exceeding the target of 

65 percent. In addition, thousands more youth and families have benefited indirectly from the 

training and consultation provided by NCTSN grantees to organizations not receiving direct 

NCTSN funding enabling these organizations to deliver evidence-based trauma interventions. 

The NCTSN continues to be a principal source of child-trauma information and training for the 

nation. In FY 2017, NCTSN grantee sites provided trauma-informed training to over 200,000 

individuals. Since its inception, the NCTSN has provided training on best practices and other 

aspects of child trauma to over one million participants throughout the country. The NCTSI’s 

newly created Helping Kids Recover and Thrive Campaign generated 100 online social media 

touches (e.g., Facebook, Twitter, etc.). This campaign informed the public about the efforts and 

resources available through the NCTSI. 

In FY 2016, SAMHSA awarded 82 new five-year NCTSI grants for the program. SAMHSA will 

continue to ensure that grantees disseminate information regarding evidence-based interventions 

for the prevention and treatment of childhood trauma so more children can benefit from proven 

practices. In FY 2017, SAMHSA awarded four new grants and supported 82 grant continuations. 

Under the FY 2018 Annualized CR level, SAMHSA would continue to support 86 grant 

continuations.

Funding History

Fiscal Year Amount

FY 2015 $45,887,000

FY 2016 $46,887,000

FY 2017 $48,887,000

FY 2018 $48,555,000

FY 2019 $48,887,000

Budget Request 

The FY 2019 President’s Budget request is $48.9 million, an increase of $332,000 from the 

FY 2018 Annualized CR. SAMHSA requests funding to continue support for 86 continuation 

grants for the improvement of mental disorder treatment, services, and interventions for children 

and adolescents exposed to traumatic events and plans to provide trauma-informed services for 

children and adolescents as well as provide training. 
30 

Outputs and Outcomes Table

Program: National Child Traumatic Stress Network

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.2.02a Increase the percentage of 

children receiving trauma informed 

services who report positive 

functioning at 6 month follow-up 

(Outcome)

FY 2017: 74.8 %

Target: 77 %

(Target Not Met)

74.8 % 74.8 % Maintain

3.2.23 Increase the unduplicated count 

of the number of children and 

adolescents receiving traumainformed services (Outcome)

FY 2017: 28,419

Target: 48,872 

(Target Not Met)

28,419 28,419 Maintain

3.2.24 Increase the number of childserving professionals trained in 

providing trauma-informed services 

(Outcome)

FY 2017: 215,289 

Target: 225,710 

(Target Not Met but Improved)

225,710 225,710 Maintain
31 

Project AWARE

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Project AWARE...................................................... $68,964 $71,475 $--- -$71,475

Project AWARE State Grants (non-add).............. 54,001 56,614 --- -56,614

Mental Health First Aid (non-add)........................ 14,963 14,861 --- -14,861

Authorizing Legislation ................ Sections 501, 520A, and 520J of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

Project AWARE is made up of three components: Project AWARE State Educational Agency 

(SEA) grants, Mental Health First Aid Grants, and Resilience in Communities After Stress and 

Trauma Grants. Project AWARE State Educational Agency grants are awarded to State Education 

Authorities (SEAs) to promote comprehensive, coordinated, and integrated state efforts to make 

schools safer and increase access to mental health services. Mental Health First Aid grants provide 

supports to teachers and other individuals who work with youth to help schools and communities 

understand, recognize, and respond to signs of mental illness or drug/alcohol addiction in children 

and youth. Resiliency in Communities After Stress and Trauma (ReCAST) program assists highrisk youth and families and promotes resilience in communities that have recently faced civil 

unrest through implementation of evidence-based violence prevention, and community youth 

engagement programs as well as linkages to trauma-informed behavioral health services.

Project AWARE supports several strategies for addressing mental health in schools: supports for 

mental wellness in education settings, building awareness of mental health issues, and early 

intervention with coordinated supports. In FY 2017, AWARE grantees trained nearly 60,000 

teachers, parents, first responders, school resource officers, and other adults who interact with 

youth to recognize and respond to the signs of mental health and substance use issues. To date, 

over 300,000 at-risk youth have been identified and referred.

In FY 2017, SAMHSA supported the continuation of 96 grants (19 AWARE SEA grants, 70 

MHFA Community grants, and 7 ReCAST grants), a new cohort of two ReCAST grants, and 

contracts for technical assistance and evaluation activities. 
32 

Under the FY 2018 Annualized CR level, SAMHSA would support the continuation of 16 grants 

(eight AWARE SEA grants and eight ReCAST grants), a new cohort of 102 grants (12 AWARE 

SEA grants and 90 MHFA grants), which will include program implementation and direct TA.

Funding History

Fiscal Year Amount

FY 2015 $54,865,000

FY 2016 $64,865,000

FY 2017 $68,964,000

FY 2018 $71,475,000

FY 2019 ---

Budget Request 

The FY 2019 President’s Budget request is $0.0, a decrease of $71.5 million from FY 2018

Annualized CR. SAMHSA is eliminating the program. SAMHSA has developed significant 

knowledge and evidence for states to begin implementing and bringing to scale these efforts. 

SAMHSA will continue to ensure this knowledge is disseminated. 
33 

Outputs and Outcomes Table

Program: Project AWARE

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.2.39 Increase the number of 

individuals who have received training 

in prevention or mental health 

promotion (Outcome)

FY 2017: 59,186

Target: 145,356

(Target Not Met)

59,186 59,186 Maintain
34 

Healthy Transitions

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Healthy Transitions................................................. $19,951 $19,816 $19,951 $136

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts 

Eligible Entities ...................................................................................................... States and Tribes

Program Description and Accomplishments

Youth and young adults with Serious Mental Illness (SMI), along with those with co-occurring 

mental illness and drug/alcohol addiction, face a more difficult transition to adulthood than do 

their peers. Nearly 20 percent of young adults aged 18 to 25 living in U.S. households had a 

diagnosable mental health condition in the past year. Of these, more than 1.3 million had a disorder 

so serious, such as schizophrenia, bipolar disorder, and major depression, that it compromised their 

ability to function. Compared to their peers, these young people were significantly more likely to 

experience homelessness,7 be arrested,8 drop out of school,9 and be unemployed.10 It is important 

to identify these young people, develop appropriate outreach and engagement processes, and 

facilitate access to effective clinical and supportive interventions. Outreach and engagement are 

essential to these youth and young adults, and their families, as many are disconnected from social 

and other community supports. 

FY 2016 data demonstrated positive outcomes for individuals in the program. For example, at sixmonth follow-up, 59 percent reported positive functioning, 38 percent reported having a permanent 

place to live in the community, and 66 percent reported being employed.

In FY 2016, SAMHSA supported 17 Healthy Transitions continuation grants and technical 

assistance and evaluation contracts. In FY 2017, SAMHSA continued to support 16 continuation 

grants, the technical assistance, and evaluation contracts. Under the FY 2018 Annualized CR 

 

7 Embry, L. E., Vander Stoep, A., Evens, C., Ryan, K. D., & Pollock, A. (2009). Risk factors for homelessness in 

adolescents released from psychiatric residential treatment. Journal of the American Academy of Child and 

Adolescent Psychiatry, 39(10), 1293-1299. 

8 Davis, M., Banks, S. M., Fisher, W. H., Gershenson, B.,& Grudzinskas, A. J. (2007). Arrests of adolescents clients 

of a public mental health system during adolescence and young adulthood. Psychiatric Services, 58(11), 1454-1460. 

9 Planty, M., Hussar, W., Snyder, T., Provasnik, S., Kena, G., Dinkes, R., Kemp, J. (2008). The condition of 

education 2008 (NCES 2008-031). 

10 Newman, L., Wagner, M., Cameto, R., & Knokey, A. M. (2009). The post-high school outcomes of youth with 

disability up to 4 years after high school: A report from the national longitudinal transition study-2 (NLTSC) 

(NCSER 2009-3017). Menlo Park, CA: SRI International.
35 

level, SAMHSA would continue support for 14 continuation grants, four new grants, and technical 

assistance and evaluation activities.

Funding History

Fiscal Year Amount

FY 2015 $19,951,000

FY 2016 $19,951,000

FY 2017 $19,951,000

FY 2018 $19,816,000

FY 2019 $19,951,000

Budget Request 

The FY 2019 President’s Budget request is $20.0 million, an increase of $135,500 from the 

FY 2018 Annualized CR 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. SAMHSA’s budget request will support four continuation grants and a 

new cohort of 14 grants and evaluation and technical assistance activities. 
36 

Outputs and Outcomes Table

Program: Healthy Transitions

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.2.34 Increase the percentage of 

clients receiving services who 

report positive functioning at sixmonth follow-up. (Outcome)

FY 2017: 66.1 %

Target: 64.0 % 

(Target Exceeded)

66.1 % 66.1 % Maintain

3.2.35 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at six-month follow-up. 

(Outcome)

FY 2017: 45.4 %

Target: 36.0 % 

(Target Exceeded)

45.4 % 45.4 % Maintain

3.2.36 Increase the percentage of 

clients receiving services who are 

currently employed at six-month 

follow-up. (Outcome)

FY 2017: 66.8 %

Target: 56.0 % 

(Target Exceeded)

66.8 % 66.8 % Maintain
37 

Children and Family Programs

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Children and Family Programs................................ $7,229 $7,180 $7,229 $49

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ................................... Competitive Grants/Contracts/ Interagency Agreements

Eligible Entities ....................................................................................................................... Tribes

Program Description and Accomplishments

Without early identification, intervention, treatment, and support, children with Serious Emotional 

Disturbance (SED) are likely to face challenges at home, in school, and in their psychosocial 

development. It is a public health priority that these children and their families have access to 

effective, evidence-based services, and support. 

SAMHSA’s Children and Family Programs provide funding for the Circles of Care grant program. 

Initially funded in 1998, the Circles of Care Program is a three-year infrastructure/planning grant 

which seeks to promote mental disorder treatment equity by providing American Indian/Alaska 

Native (AI/AN) communities with tools and resources to design and sustain their own culturally 

competent system of care approach for children. The Circles of Care program reflects the unique 

history and needs of individual AI/AN communities and promotes the idea of building on cultural 

strengths. The program increases capacity and community readiness to address the mental health 

issues of children and their families through the provision of evidence based treatment services 

and supports. This grant program is of critical importance as there are significant mental health 

needs in AI/AN communities. For example, suicide is the second leading cause of death for Indian 

youth ages 15 to 24. Through Circles of Care, SAMHSA has improved the availability, 

accessibility, and acceptability of behavioral health services for native youth. For example, data 

from the previous cohort of grantees show that over 3,000 consumer/family members were 

involved in ongoing mental health related planning activities and there were 4,300 peer-to-peer 

collaborations. 

Rehabilitation Research and Training Centers (RRTCs) seek to advance the current knowledge 

base by supporting research, training, technical assistance, and knowledge translation activities 

that help youth and young adults with serious mental health conditions, including youth and young 

adults from high-risk, disadvantaged backgrounds, achieve their life goals. SAMHSA’s Children 

and Family Program supports two RRTC programs that are co-funded with the National Institute 

on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The first program, 

RRTC on Transition to Employment for Youth and Young Adults with Serious Mental Health 

Conditions, will conduct research and evaluative studies that contribute to improved employment 

outcomes for youth and young adults with serious mental health conditions, including those from 
38 

high-risk, disadvantaged backgrounds. The second program, RRTC on Community Living and 

Participation for Youth and Young Adults with Serious Mental Health Conditions, will conduct 

research and evaluative studies that contribute to improved community participation for youth and 

young adults with serious mental health conditions. Unemployment rates for youth with mental 

disorders are significantly higher than those for youth with no disabilities. Unemployed young 

adults are three times more likely to suffer from depression, and youth without jobs are at higher 

risk to use alcohol and other drugs, and engage in risky behaviors that have negative health 

outcomes.11

In FY 2016, SAMHSA provided continuation support for 11 three-year Circles of Care grants to 

AI/AN communities and two RRTCs. 

In FY 2017, SAMHSA awarded 13 new Circles of Care grants and the continuation of two RRTCs. 

Under FY 2018 Annualized CR level, SAMHSA would support the continuations of the program.

Funding History

Fiscal Year Amount

FY 2015 $6,458,000 

FY 2016 $6,458,000 

FY 2017 $7,229,000 

FY 2018 $7,180,000 

FY 2019 $7,229,000 

Budget Request 

The FY 2019 President’s Budget request is $7.2 million, an increase of $49,000 from the FY 2018 

Annualized CR. SAMHSA requests funding to enhance and improve the quality of existing 

services and promote the use of culturally competent services and support for children and youth 

with, or at risk for, serious mental health conditions and their families. This funding will be used 

to support the continuation of 13 Circles of Care grants, and two RRTCs. 

The output and outcome measures for Children and Family Programs are part of the Mental Health 

- Other Capacity Activities Outputs and Outcomes table shown on page 78. 

 

11 McGee RE, Thompson NJ. Unemployment and Depression Among Emerging Adults in 12 States, Behavioral 

Risk Factor Surveillance System, 2010. Prev Chronic Dis 2015; 12:140451.
39 

Consumer and Family Network Grants

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Consumer and Family Network Grants................... $4,954 $4,920 $4,954 $34

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ....................................................................................... Community Organizations

Program Description and Accomplishments

Across the healthcare arena, there is growing recognition and evidence that patient-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. As with other health 

disciplines, people with 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 activities: the Statewide Consumer Network 

Program and the Statewide Family Network Program.

The Statewide Consumer Network Grant Program focuses on the needs of adults (18 years and 

older) with SMI by strengthening the capabilities of statewide consumer-run organizations. These 

entities serve an important role in engaging consumers of mental health services, caregivers, 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 coalition/partnership-building and economic 

empowerment as part of the recovery process for consumers. 

The Statewide Family Network 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 

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 Statewide Family Network Program focuses on families, parents, and the primary caregivers 

of children, youth, and young adults. 
40 

In FY 2017, SAMHSA supported 17 Statewide Consumer Network continuations, 26 Statewide 

Family Network continuations, one new Statewide Consumer Network grant, and one new 

Statewide Family Network grant, technical assistance activities, and a Statewide Peer Network 

Development activity demonstrating collaboration between the addiction recovery network and 

the consumer and family networks. 

Under the FY 2018 Annualized CR level, SAMHSA would support ten Statewide Consumer 

Network continuations and nine new grants, 21 Statewide Family Network continuations and five 

new grants which will support program implementation and direct TA. 

Funding History

Fiscal Year Amount

FY 2015 $4,954,000 

FY 2016 $4,954,000 

FY 2017 $4,954,000 

FY 2018 $4,920,000 

FY 2019 $4,954,000 

Budget Request 

The FY 2019 Presidents Budget request is $4.9 million, an increase of $34,000 from the FY 2018 

Annualized CR. SAMHSA requests funding to continue support for 16 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. SAMHSA 

will also fund a new cohort of 30 Family and Consumer Network grant programs. 

The output and outcome measures for Consumer and Family Network Programs are part of the 

Mental Health - Other Capacity Activities Outputs and Outcomes table shown on page 78. 
41 

Project LAUNCH

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Project LAUNCH ...................................................... $23,605 $23,445 $23,605 $160

Authorizing Legislation............................... Section 520A of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities ...................................................................................................... States and Tribes

Program Description and Accomplishments

Researchers estimate that between 9.5 percent and 14.2 percent of children from birth to age five 

experience an emotional or behavioral disturbance. Studies also show that half of all lifetime cases 

of mental illness begin before age 14.12 The preschool expulsion rate of these children is more 

than three times the expulsion rate of students in kindergarten through 12th grade. Boys are more 

than four times as likely to be expelled than girls. African American preschoolers are almost twice 

as likely to be expelled than Caucasian preschoolers.13 School suspensions and expulsions have 

shown to increase the likeliness of later life negative outcomes. Research has shown that 

prevention and early treatment of mental disorders is more beneficial and cost-effective than 

waiting to address these issues later in life. Integrating behavioral health into primary care and 

early childcare settings, increasing screening for developmental and social/emotional issues, and 

training people who interact with young children to help them feel safe and secure are all critical 

elements to ensure children start life with the tools and skills needed to succeed. 

Established in 2008, Project Linking Actions for Unmet Needs in Children’s Health (LAUNCH) 

is a national initiative that has funded 55 sites, including states, tribes, territories, communities, 

and the District of Columbia. The purpose of the Project LAUNCH initiative is to promote the 

wellness of young children from birth to eight years of age by addressing the physical, social, 

emotional, cognitive, and behavioral aspects of their development. Project LAUNCH pays 

particular attention to the social and emotional development of young children and works to ensure 

that the systems that serve them (including early childcare and education, home visiting, and 

primary care) are equipped to promote and monitor healthy social and emotional development. 

The program also ensures that the systems intervene to prevent mental, emotional, and behavioral 

disorders in early childhood and into the early elementary grades.

As of 2017, performance data for the program found that: 

• Approximately 197,000 children and parents have been screened or assessed for behavioral 

health concerns across a range of diverse settings (e.g., primary care, child care, and home 

visiting); 

• Approximately 126,000 families have been served through home visiting programs with 

an added focus on the social/emotional and behavioral health needs of children and parents; 
42 

• Approximately 79,000 community providers have been trained on social/emotional 

development and behavioral health for young children; 

• Nearly 159,000 individuals received evidence-based mental health-related services, and 

• Nearly 9,100 new organizations are collaborating, coordinating, and sharing resources to 

implement prevention/promotion strategies for young children and their families. 

The multi-site evaluation of Project LAUNCH is ongoing. Phase one of the evaluation used a 

meta-analytical approach to assess the implementation of the program. The findings indicate that 

grantees successfully achieved three goals: 1) improvements to the local child services system in 

the LAUNCH communities; 2) improvements to the state child services system; and 3) 

enhancements to the child and family services in the communities. In addition, Project LAUNCH 

grantees have reported improved social and academic functioning among the targeted population, 

and 78 percent have reported decreases in problem behaviors among the targeted population. As 

the program expands to new states and territories, the current phase of the multi-site evaluation 

has evolved to a quasi-experimental design to assess the impact of Project LAUNCH more 

effectively.

In FY 2016, SAMHSA supported 36 five-year continuation grants, a new cohort of grants, and a 

technical assistance and evaluation contract. The new grant cohort provides support to states and 

tribes that have successfully implemented Project LAUNCH with the goal of expanding the work 

beyond the pilot communities to additional communities across the states and tribes. Project 

LAUNCH Expansion grantees, funded in FY 2016, have been successfully implementing Project 

LAUNCH strategies in 15 additional communities across their five states. In FY 2017, SAMHSA 

awarded 25 continuation grants and a technical assistance and evaluation contract.

Under the FY 2018 Annualized CR level, SAMHSA would award a new cohort of eight grants. 

In addition, funding will be provided to support the continuation of 18 grants, and technical 

assistance activities. 

 

12 Brauner, Cheryl, and Cheryll Stephens. "Estimating the Prevalence of Early Childhood Serious 

Emotional/Behavioral Disorders: Challenges and Recommendations." Public Health Reports 121.3 (2006): 303-10. 

13 Gilliam, W. (2005). Pre-kindergarteners left behind: Expulsion rates in state prekindergarten systems. Foundation 

for Child Development. 
43 

Funding History

Fiscal Year Amount

FY 2015 $34,555,000 

FY 2016 $34,555,000 

FY 2017 $23,605,000 

FY 2018 $23,445,000 

FY 2019 $23,605,000 

Budget Request 

The FY 2019 President’s Budget request is $23.6 million, an increase of $160,000 from FY 2018 

Annualized CR. This funding will support eight continuation grants, 18 new grants, and contract 

activities that will improve health outcomes for young children and support children at high risk 

for mental illness and their families in order to prevent future disability. This funding request will 

provide services for over 14,421 individuals, training to 8,765 people, and screening for mental 

health or related intervention to 18,554 children up to eight years old.
44 

Outputs and Outcomes Table

Program: Mental Health-Project LAUNCH

Note: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.3.94 Increase the number of 

persons served. (Output) FY 2017: 14,421

Target: 38,594 

(Target Not Met)

14,421 14,421 Maintain 

2.3.95 Increase the number of 

persons trained in mental illness 

prevention or mental health 

promotion. (Outcome)

FY 2017: 8,765

Target: 13,102 

(Target Not Met)

8,765 8,765 Maintain 

2.4.00 Increase the number of 0-8 

year old children screened for 

mental health or related 

interventions. (Outcome)

FY 2017: 18,554

Target: 44,775 

(Target Not Met)

18,554 18,554 Maintain 

2.4.01 Increase the number of 0-8 

year old children referred to mental 

health or related interventions. 

(Outcome)

FY 2017: 3,652

Target: 9,114 

(Target Not Met)

3,652 3,652 Maintain 
45 

Mental Health System Transformation and Health Reform 

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Mental Health System Transformation and Health 

Reform $3,779 $3,753 $3,779 $26

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ...................................................................................................... States and Tribes

Program Description and Accomplishments

There is a significant gap between the number of people with SMI, such as schizophrenia, bipolar 

disorder, and major depression, who want to work (66 percent) and the number of people who are 

actually employed (less than 20 percent). The benefits of steady competitive employment 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.14 The 

Transforming Lives through Supported Employment Grant program is the remaining component 

of the Mental Health System Transformation program. This program was implemented 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. 

The program began in FY 2014 as a focused effort to enhance state and community capacity to 

provide evidence-based supported employment programs for adults and youth with SMI/SED. 

These grants help people with SMI build paths to self-sufficiency and recovery rather than 

disability and dependence. They also support treatment and service providers and employers to 

develop and maintain sustained competitive employment opportunities for people with SMI. The 

grant program helps states to identify and implement the structural and financing changes that are 

essential to make supported employment programs sustainable and statewide. FY 2017 program 

data show that 55 percent of individuals were employed at six-month follow-up; additionally, 74 

percent reported positive functioning and 66 percent had a permanent place to live. 

In FY 2017 and under the FY 2018 Annualized CR, SAMHSA would support the continuation of 

these grants and related technical assistance activities.

 

14 IPS Supported Employment: The Evidence-Based Practice for Employment. (n.d.). Retrieved August 4, 2015.
46 

Funding History

Fiscal Year Amount

FY 2015 $3,779,000 

FY 2016 $3,779,000 

FY 2017 $3,779,000

FY 2018 $3,753,000 

FY 2019 $3,779,000 

Budget Request 

The FY 2019 President’s Budget request is $3.8 million, an increase of $26,000 from the FY 2018 

Annualized CR. SAMHSA requests funding to support a new cohort of seven Transforming Lives 

Through Supported Employment grants to enhance state and community capacity to provide 

evidence-based supported employment programs for adults and youth with SMI/SED and technical 

assistance to the grantees.
47 

Outputs and Outcomes Table

Program: Mental Health System Transformation and Health Reform 

Note: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.2.11 Increase the number of 

persons in the mental health and 

related workforce trained in specific 

mental-health related practices/ 

activities as a result of the grant. 

(Outcome)

FY 2017: 5,262

Target: 4,303 

(Target Exceeded)

5,262 5,262 Maintain

1.2.21 Increase the percentage of 

clients receiving services who report 

positive functioning at six- month 

follow-up. (Outcome)

FY 2017: 74 %

Target: 57 %

(Target Exceeded)

74 % 74 % Maintain

1.2.22 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at six-month follow-up. 

(Outcome)

FY 2017: 66 %

Target: 77 %

(Target Not Met but Improved)

77 % 77 % Maintain

1.2.23 Increase the percentage of 

clients receiving services who are 

currently employed at six-month 

follow-up. (Outcome)

FY 2017: 55 %

Target: 32 %

(Target Exceeded)

55 % 55 % Maintain
48 

Primary and Behavioral Health Care Integration

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Primary and Behavioral Health Care Integration............ $49,877 $49,538 $--- -$49,538

Primary and Behavioral Health Care Integration TTA..... 1,991 1,977 --- -1,977

Total PBHCI $51,868 $51,516 $--- -$51,516

Authorizing Legislation................................Section 520K of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................................... Competitive Grants/Cooperative Agreements

Eligible Entities ............ Qualified Community Mental Health Programs (FY 2017 Authorization), 

States or State Agency

Program Description and Accomplishments

Adults with SMI, such as schizophrenia, bipolar disorder, and major depression, 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 in people 

with SMI.15 Physical health problems among people with SMI affect an individual’s quality of 

life and contribute to premature death. Empirical findings indicate the clear link between early 

mortality among people with SMI and the lack of access to primary care services.16

The Primary and Behavioral Health Care Integration (PBHCI) program began in FY 2009 to 

address specifically this intersection between primary care and treatment for mental illness and 

co- occurring drug/alcohol addiction. The program supports two activities: grants to community 

mental health centers and States and the PBHCI Training and Technical Assistance (TTA) Center, 

which is co-funded through a competitive cooperative agreement with the Health Resources and 

Services Administration (HRSA). These two activities collectively support the coordination and

integration of primary care services and publicly funded community behavioral health services for 

individuals with SMI or co-occurring mental illness and drug/alcohol addiction served by the 

public mental health system. PBHCI seeks to improve health outcomes for people with SMI and 

co-occurring mental illness and drug/alcohol addiction by encouraging grantees to engage in 

necessary collaboration, expand infrastructure, and increase the availability of primary healthcare 

and wellness services for individuals with SMI or co-occurring mental illness and drug/alcohol 

addiction. Through FY 2017, SAMHSA has awarded 214 PBHCI grants. 

PBHCI activities also include the braided Minority AIDS Initiative HIV Continuum of Care pilot 

program, which supports behavioral health screening, primary prevention, and treatment for 

 

15 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. 16 E. Chesney et al., Risks of all-cause and suicide mortality in mental disorders: a meta-review, World Psychiatry; 

2014: 13:1153-160.
49 

racial/ethnic minority populations with or at high risk for mental illness and drug/alcohol addiction 

and HIV/AIDS. This includes HIV/AIDS integrated programs that either co-locate or have fully 

integrated HIV/AIDS prevention and medical care services with behavioral health services.

In FY 2017, SAMHSA supported 61 continuation grants and awarded three new grants to states 

based on new requirements in the 21st Century Cures Act. These new awards to states reflect a 

change in the eligibility requirements and provide up to $2.0 million per grant per year. In line 

with the 21st Century Cures Act changes, the FY 2017 state grantees were allowed to expand the 

populations to be served to include children with SED, individuals with drug/alcohol addiction 

and adults with mental illness, as well as continue to support adults with SMI. 

Under the FY 2018 Annualized CR level, SAMHSA would continue to support 61 continuation 

grants and award a new cohort of 10 grants to states. Support will continue to all grantees through 

the training and technical assistance center.

Funding History

Fiscal Year Amount

FY 2015 $51,868,000

FY 2016 $51,868,000

FY 2017 $51,868,000

FY 2018 $51,516,000

FY 2019 ---

Budget Request 

The FY 2019 President’s Budget request is $0.0, a decrease of $51.5 million from the FY 2018 

Annualized CR. SAMHSA has eliminated this program due to other funding sources available for 

integrated care. SAMHSA will continue to disseminate the lessons learned from this program. 
50 

Outputs and Outcomes Table

Program: Primary & Behavioral Health Care Integration (PBHCI)

Note: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.2.41 Increase the percentage of clients 

receiving services who report positive 

functioning at 6 month follow-up. 

(Outcome)

FY 2017: 54.6 % 

Target: 55.9 %

(Target Not Met) 

54.6 % 54.6 % Maintain

3.2.42 Increase the percentage of clients 

receiving services who are currently 

employed at 6 month follow-up. 

(Outcome)

FY 2017: 24.1 % 

Target: 23.8 % 

(Target Exceeded)

24.1 % 24.1 % 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 2017: 71 % 

Target: 69.1 % 

(Target Exceeded)

71.0 % 71.0 % Maintain
51 

Suicide Prevention Programs

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Suicide Prevention........................................................ $69,032 $67,479 $69,032 $1,552

Suicide Lifeline (non-add)....................................... 7,198 7,149 7,198 49

GLS - Youth Suicide Prevention - States (non-add) 35,427 34,103 35,427 1,324

Budget Authority (non-add)................................. 23,427 23,268 35,427 12,159

Prevention & Public Health Fund (non-add)... 12,000 10,835 --- -10,835

GLS - Youth Suicide Prevention - Campus (non-add) 6,488 6,444 6,488 44

GLS - Suicide Prevention Resource Center (non-add) 5,988 5,947 5,988 41

AI/AN Suicide Prevention Initiative (non-add)... 2,931 2,911 2,931 20

National Strategy for Suicide Prevention (non-add) 11,000 10,925 11,000 75

Zero Suicide (non-add).......................................... 9,000 8,939 9,000 61

Zero Suicide -AI/AN (non-add)...................... 2,000 1,986 2,000 14

Program Description and Accomplishments

SAMHSA supports the goals and objectives of the National Strategy for Suicide Prevention 

(NSSP) through the Suicide Prevention Programs highlighted below. 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 as well as suicide 

attempts. The NSSP supports this type of comprehensive approach and is an important step toward 

reducing suicide. 

Approximately 44,193 Americans died by suicide in 2015. One American dies by suicide every 

11.9 minutes. In 2008, suicide became the 10th leading cause of death in the United States and has 

remained so through 2015, the most recent year for which there are available mortality data. The 

2015 National Survey on Drug Use and Health reported that approximately 1.4 million Americans 

age 18 and over attempted suicide, 9.7 million seriously considered suicide, and 2.7 million made 

a plan. While youth have the highest rate of suicide attempts, middle-aged adults have the highest 

number of deaths by suicide nationwide, and middle aged and older adult males have the highest 

rates of death by suicide. The nation’s suicide prevention efforts must address the issues of suicidal 

thoughts, plans, attempts, and deaths among adults and youth to reduce suicide in America. 
52 

National Strategy for Suicide Prevention

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

National Strategy for Suicide Prevention............... $11,000 $10,925 $11,000 $75

Zero Suicide (non-add)................................... 9,000 8,939 9,000 61

Zero Suicide -AI/AN (non-add)............... 2,000 1,986 2,000 14

Authorizing Legislation .......................................... Section 520L of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

Suicide has been increasing in the United States, particularly in adults and older adults. Suicide is 

the fifth leading cause of death among middle-aged adults (ages 35 to 64 years).17 In 2013, suicide 

among working-aged adults (25 to 64) accounted for almost 70 percent of all suicides, and from 

1999 to 2010, the suicide rate among individuals age 35 to 64 increased by nearly 30 percent.18 

Additionally, the highest rates of suicide are seen among men who are 80 or older. With the rising 

rates of suicide among adults, particularly middle-aged and older adults, focusing on preventing 

suicide among adults is urgently required in order to reduce suicide nationally. The baby boomer 

generation is the group that has had high rates of suicide throughout its lifecycle and is entering 

the stage of life that has historically had the highest rate of suicide. There is a risk that without 

significant targeted intervention toward adults, the number of suicides in the United States could 

continue to increase. 

The 2012 National Strategy for Suicide Prevention (NSSP) seeks to reduce the overall suicide rate 

and number of suicides in the U.S. nationally. The NSSP grant program supports states’ efforts to 

implement the NSSP. While the NSSP addresses all age groups and populations with specific 

needs, the goals and objectives of the NSSP grants are focused on preventing suicide and suicide 

attempts among adults over the age of 25 who comprised more than 38,000 of the more than 44,000 

suicides in the United States in 2015. In FY 2014, SAMHSA awarded four new grants to support 

states in implementing the NSSP goals and objectives. States use NSSP funding to support efforts 

such as raising suicide awareness, establishing emergency room referral processes, and improving 

clinical care practice standards. These grants focus on preventing suicide and suicide attempts 

 

17 Centers for Disease Control and Prevention (CDC) Vital Signs: Suicide among adults aged 35–64 years – United 

States, 1999–2010. MMWR Morbidity Mortality Weekly Report. 2013; 62 (17):321–325. 

18 Centers for Disease Control and Prevention (CDC) Vital Signs: Suicide among adults aged 35–64 years – United 

States, 1999–2010. MMWR Morbidity Mortality Weekly Report. 2013; 62 (17):321–325.
53 

among working-aged adults 25 to 64 years old. In FY 2015 and FY 2016, SAMHSA provided 

continuation funds for these four grants. 

In FY 2017, Congress appropriated $9.0 million, to implement Zero Suicide in health care systems 

including a $2.0 million tribal set aside. The Zero Suicide model is a comprehensive, multi-setting 

approach to suicide prevention in health systems. The purpose of this program is to implement 

suicide prevention and intervention programs for individuals who are 25 years of age or older by 

systematically applying evidence-based approaches to screening and risk assessment, developing 

care protocols, including collaborative safety planning, providing evidence-based treatments, 

maintaining continuity of care during high risk periods, and improving care and outcomes for such 

individuals who are at risk for suicide being seen in health care systems. In FY 2017, SAMHSA 

awarded three new Zero Suicide grants and five new NSSP grants. Under the FY 2018 Annualized 

CR level, SAMHSA would support the continuation of five NSSP grants and award a new cohort 

of three Zero Suicide grants. 

Funding History

Fiscal Year Amount

FY 2015 $2,000,000 

FY 2016 $2,000,000 

FY 2017 $11,000,000

FY 2018 $10,925,000

FY 2019 $11,000,000

Budget Request 

The FY 2019 President’s Budget request is $11.0 million, an increase of $75,000 from the FY 2018 

Annualized CR. Funding will support the continuation of five NSSP grants, three continuation

Zero Suicide grants, and evaluation and technical assistant activities. The grants support states in 

implementing the NSSP goal to prevent suicide. States use NSSP funding to support efforts such 

as raising suicide awareness, establishing emergency room referral processes, and improving 

clinical care practice standards. 
54 

Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus 

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's

Budget +/- 

FY 2018 

Annualized 

CR

GLS - Youth Suicide Prevention - States................ $35,427 $34,103 $35,427 $1,324

Prevention & Public Health Fund (non-add)...... 12,000 10,835 --- -10,835

GLS - Youth Suicide Prevention - Campus............ 6,488 6,444 6,488 44

Authorizing Legislation ..................... Sections 520E and 520E-2 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities ...................................................................................................... States and Tribes

Program Description and Accomplishments

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. Like most 

suicides, Garrett's came unexpectedly. As many families have tragically experienced, depression 

is not rare or peculiar, but can be deadly. It affects one in six Americans at some point. Hardly a 

family goes untouched.19

The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to manage two significant youth 

suicide prevention programs and one resource center. The GLS State/Tribal Youth Suicide 

Prevention and Early Intervention Grant Program has awarded 180 grants to 50 states and the 

District of Columbia, 47 tribes or tribal organizations, and one territory. These grants develop and 

implement youth suicide prevention and early intervention strategies involving public-private 

collaboration among youth-serving institutions. The GLS Campus Suicide Prevention program 

has awarded 190 grants to 175 institutions of higher education, including tribal colleges and 

universities, to prevent suicide and suicide attempts. 

Grantees use their funds to prevent suicide in their communities, often through providing trainings 

and events. By the end of FY 2017, 1,304,600 individuals had participated in 35,301 training 

events or educational seminars provided by grantees and over 86,000 youth had been screened for 

suicide risk. Grantees have identified almost 60,600 youth at risk for suicide and ensured that they 

receive appropriate services. Grantees’ efforts are reducing the likelihood of at-risk youth falling 

through the gaps in the system. 

Results from the congressionally mandated cross-site evaluation have shown that counties who 

implemented GLS supported activities had lower suicide rates than matched counties that did not 

in the first year following suicide prevention activities.

 

19 http://www.jaredstory.com/garrett_smith.html
55 

In FY 2016, SAMHSA provided continuation funds for 38 GLS State/Tribal grants, 37 GLS 

Campus grants, 4 new GLS State/Tribal grants and 18 new GLS Campus grants as well as the 

National Suicide Prevention Evaluation. 

In FY 2017, SAMHSA provided continuation funds for 42 GLS State/Tribal grants, three new 

GLS State/Tribal grants, 40 GLS Campus grants, 17 new GLS Campus grants, and the National 

Suicide Prevention evaluation. The 17 new GLS Campus grantees utilized funding in accordance 

with changes made in the 21st Century Cures Act. 

Under the FY 2018 Annualized CR level, SAMHSA would support the continuation for 45 GLS 

State/Tribal grants, 35 GLS Campus grants, 18 new GLS Campus grants, and continuation of the 

National Suicide Prevention evaluation.

Funding History

Fiscal Year Amount

FY 2015 $41,915,000 

FY 2016 $41,915,000 

FY 2017 $41,915,000 

FY 2018 $40,547,000 

FY 2019 $41,915,000 

Budget Request 

The FY 2019 President’s Budget request is $41.9 million, an increase of $1.4 million from the 

FY 2018 Annualized CR. SAMHSA requests funding for 19 State/tribal grant continuations, 53 

Campus continuations, and a new cohort of 26 State/tribal grants to continue developing and 

implementing youth suicide prevention and early intervention strategies involving public-private 

collaboration among youth serving institutions. In addition, the funding will support prevention 

of suicide and suicide attempts at institutions of higher education and the National Suicide 

Prevention Evaluation.
56 

Garrett Lee Smith Suicide Prevention Resource Center

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

GLS - Suicide Prevention Resource Center........... $5,988 $5,947 $5,988 $41

Authorizing Legislation .......................................... Section 520C of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ..................................................... Domestic Public and Private Nonprofit Entities, 

Tribal and Urban Indian Organizations, Community and Faith-Based Organizations 

Program Description and Accomplishments

In addition to the above programs that build suicide prevention capacity, SAMHSA also supports 

the Suicide Prevention Resource Center (SPRC). The purpose of this program 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 National Strategy for Suicide 

Prevention (NSSP), with the overall goal of reducing suicides and suicidal behaviors in the nation. 

This work includes support of the public-private National Action Alliance for Suicide Prevention, 

and working to advance high-impact objectives of the NSSP. 

In FY 2015, SAMHSA awarded a new five-year SPRC grant. In FY 2016 and FY 2017, SAMHSA 

supported the continuation of this grant and provided supplemental funding to support technical 

assistance to the new Zero Suicide Grantees. Under the FY 2018 Annualized CR level, SAMHSA 

would support the continuation of this grant. 

Funding History

Fiscal Year Amount

FY 2015 $5,988,000 

FY 2016 $5,988,000 

FY 2017 $5,988,000 

FY 2018 $5,947,000

FY 2019 $5,988,000 

Budget Request 

The FY 2019 President’s Budget request is $6.0 million, an increase of $41,000 from the FY 2018 

Annualized CR. Funding will support one grant continuation to promote the implementation of 
57 

the NSSP and enhance the nation’s mental health infrastructure. The Suicide Prevention Resource 

Center 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. 

Suicide Lifeline

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Suicide Lifeline.......................................................... $7,198 $7,149 $7,198 $49

Authorizing Legislation ....................................... Section 520E-3 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ............................................................... States, Tribes, Community Organizations

Program Description and Accomplishments

To prevent death and injury as the result of suicide attempts, individuals need rapid access to 

suicide prevention and crisis intervention services. In FY 2015, the National Suicide Prevention 

Lifeline answered calls from over 1.5 million Americans. This helped provide rapid access at any 

time of the day or night to crisis intervention, and when needed, emergency response. 

Launched in FY 2005, the National Suicide Prevention Lifeline (Lifeline), 1-800-273-TALK, 

coordinates a network of 164 crisis centers across the United States by providing suicide 

prevention and crisis intervention services for individuals seeking help at any time, day or 

night. The Lifeline routes calls from anywhere in the country to a network of certified local crisis 

centers that can then link callers to local emergency, mental health, and social services resources. 

The Lifeline averaged 156,418 calls per month for a total of 1,877,020 calls answered in FY 2017. 

SAMHSA evaluation studies have found that when a sample of suicidal callers to the Lifeline are 

asked, “...to what extent did calling the crisis hotline stop you from killing yourself?” 82 percent 

responded “a lot” (59 percent) or “a little” (22 percent). 

Since FY 2007, SAMHSA has collaborated with the Department of Veterans Affairs (VA) to 

ensure that veterans, service members, and their families who call the Lifeline and “press 1” have 

24/7 access to the VA’s Veterans Crisis Line. In FY 2017, year to date more than 54,000 callers 

per month pressed “1” and were connected to the Veterans Crisis Line.

The Lifeline Evaluation is a part of the National Suicide Prevention Evaluation (NSPE), which 

includes many of the programs in SAMHSA’s suicide prevention portfolio. The NSPE is an 
58 

evaluation that will assess the impact of SAMHSA’s suicide prevention initiatives on reducing 

suicidal behavior, attempts, and mortality. The NSPE also provides training and technical 

assistance to grantees related to evaluation, data collection, and surveillance.

Prior Lifeline evaluations have been the primary vehicle for collaborating with the crisis centers 

to adopt standards and guidelines based on evaluation results. These evaluation-driven standards 

and guidelines have, to date, focused on suicide risk assessment, imminent risk protocols, 

emergency intervention, and follow-up procedures and have advanced improvements in practice 

that are lifesaving. 

In FY 2016, SAMHSA awarded six new Crisis Center follow-up grants and the continuation of 

the Lifeline grant. In FY 2017, SAMHSA continued to support grant continuations of Crisis 

Center Follow-up grants and the Suicide Lifeline grant.

Under the FY 2018 Annualized CR level, SAMHSA would award a new Suicide Lifeline grant 

and support the continuation of six Crisis Center Follow-up grants.

Funding History

Fiscal Year Amount

FY 2015 $7,198,000 

FY 2016 $7,198,000 

FY 2017 $7,198,000 

FY 2018 $7,149,000 

FY 2019 $7,198,000 

Budget Request 

The FY 2019 President’s Budget Request is $7.2 million, an increase of $49,000 from the FY 2018 

Annualized CR. SAMHSA is requesting funding to the continuation of the National Suicide 

Prevention Lifeline, which routes calls from anywhere in the country to a network of certified local 

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

resources. In addition, the funding will support six new National Suicide Prevention Lifeline 

Crisis Center Follow-up grants to focus on providing follow-up to suicidal people discharged from 

emergency rooms and inpatient units, and will support a crisis chat system. 
59 

American Indian/Alaska Native Suicide Prevention Initiative

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

American Indian/Alaska Native Suicide Prevention 

Initiative................................................... $2,931 $2,911 $2,931 $20

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................................. Contracts 

Eligible Entities .......................................................................................................... Not applicable

Program Description and Accomplishments

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 abuse, and suicide among American Indian/Alaska Native (AI/AN) 

youth. These plans mobilize tribal communities’ existing social and educational resources to meet 

their goals. From 2015 to 2017, 126 tribal communities have received specialized technical 

assistance and support in suicide prevention and related areas. In addition, more than 10,860 

members of these communities received training in prevention and mental health promotion. 

In FY 2016, SAMHSA supported the continuation of this five-year contract. In FY 2017, 

SAMHSA continued support for this activity through the existing contract. Under the FY 2018

Annualized CR level, SAMHSA would award a new contract to support this activity.

Funding History

Fiscal Year Amount

FY 2015 $2,931,000 

FY 2016 $2,931,000 

FY 2017 $2,931,000

FY 2018 $2,911,000 

FY 2019 $2,931,000

Budget Request 

The FY 2019 President’s Budget Request is $2.9 million, an increase of $20,000 from the FY 2018 

Annualized CR. SAMHSA requests funding to support comprehensive, broad, focused, and 

intensive training and technical assistance to federally recognized tribes and other AI/AN 

communities in order to address and prevent mental illness and alcohol/other drug addiction, 

prevent suicide, and promote mental health through the contract continuation.
60 

Outputs and Outcomes Table

Program: Suicide Prevention

Note: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Enacted. The FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.3.59 Increase the total number of individuals 

trained in youth suicide prevention (Outcome)

FY 2017: 77,306

Target: 160,082

(Target Not Met)

77,306 77,306 Maintain

2.3.60 Increase the total number of youth 

screened (Output)

FY 2017: 62,542

Target: 3,337

(Target Exceeded)

62,542 62,542 Maintain

2.3.61 Increase the number of calls answered 

by the suicide hotline (Output)

FY 2017: 1,877,020

Target: 1,308,825

(Target Exceeded)

1,877,020 1,877,020 Maintain

3.1.01 Increase the number of individuals 

screened for mental health or related 

interventions (Intermediate Outcome)

FY 2017: Result Expected 

December 31, 2018

Target: Set Baseline

(Pending)

Maintain

3.1.02 Increase the number of individuals 

referred to mental health or related services 

(Intermediate Outcome)

FY 2017: Result Expected 

December 31, 2018

Target: Set Baseline

(Pending)

Maintain

3.1.03 Increase the number of organizations 

that establish management 

information/information technology system 

links across multiple agencies (Intermediate 

Outcome)

FY 2017: Result Expected 

December 31, 2018

Target: Set Baseline

(Pending)

Maintain

3.1.04 Increase the number of organizations or 

communities that demonstrate improved 

readiness to change their systems 

(Intermediate Outcome)

FY 2017: Result Expected

December 31, 2018

Target: Set Baseline

(Pending)

Maintain

3.2.37 Increase the number of youth referred 

to mental health or related services (Output)

FY 2017: 13,950

Target: 9,177

(Target Exceeded)

13,950 13,950 Maintain
61 

Homelessness Prevention Programs

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Homelessness Prevention Programs........................... $30,696 $30,488 $30,696 $208

Homelessness................................................................. 2,296 2,280 2,296 16

Authorizing Legislation .......................... Sections 520A and 506 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

While significant progress has been made over the last decade to reduce homelessness in specific 

communities and with specific populations, the number of people experiencing homelessness has 

remained high. Many factors contribute to homelessness, including lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, mental illness, and addiction. 

Services are needed to link individuals to permanent housing and coordinate benefits, treatment, 

and supportive services. According to the U.S. Department of Housing and Urban Development, 

549,928 individuals experienced homelessness on a given night in 2016 in the United States, about 

14 percent (77,486) of the homeless population is considered “chronically homeless,” and about 

seven percent (39,471) of individuals who are homeless are veterans.20 Almost 20 percent of 

individuals experiencing homelessness have an SMI and 17 percent struggle with chronic 

substance use and misuse.21

In FY 2011, SAMHSA initiated the Cooperative Agreements to Benefit Homeless Individuals

(CABHI) program, jointly funded by the Center for Mental Health Services (CMHS) and Center 

for Substance Abuse Treatment (CSAT) (Treatment for Homeless line) to support treatment 

services and the development and expansion of local systems that provide permanent housing and 

supportive services. This includes integration of treatment and other critical services for 

individuals with SMI or co-occurring mental illness and drug/alcohol addiction.

CABHI also supports coordination and planning at the local level with state or local Public 

Housing Authorities; local mental health, substance abuse treatment, and primary care provider 

organizations; the local Department of Housing and Urban Development-supported Continuum of 

 

20 The 2016 Annual Homeless Assessment Report (AHAR) to Congress . (November 2016.). Retrieved August 9, 

2017, from https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf 21 The U.S. Department of Housing and Urban Development, 2016 CoC Homeless Populations and Subpopulations 

Reports. Available at https://www.hudexchange.info/programs/coc/coc-homeless-populations-and-subpopulationsreports/ 
62 

Care (CoC) program; the state Medicaid Office; and the state Mental Health and Substance Abuse 

Authorities. This program expanded to include states as the eligible entity in 2013. 

In FY 2016, SAMHSA supported a national evaluation to compare the effectiveness of the CABHI 

program and various models of service delivery that are used across homeless service programs 

managed by states, local governments, and community-based organizations. Recent data show that 

at six-month follow-up, 73.4 percent of individuals reported positive functioning, 23.1 percent 

were employed, and 62.1 percent had a permanent place to live. SAMHSA also supported a 

technical assistance contract to provide training and support to its homeless service providers and 

grantees. 

In FY 2017, SAMHSA supported 39 continuation grants, and awarded 16 new grants to states, 

local governments, and community-based organizations, and a technical assistance and evaluation 

contract. 

Under the FY 2018 Annualized CR level, SAMHSA would support 46 continuation grants, a new 

cohort of 10 grants, technical assistance, and evaluation. 

Funding History

Fiscal Year Amount

FY 2015 $32,992,000

FY 2016 $32,992,000

FY 2017 $32,992,000

FY 2018 $32,768,000

FY 2019 $32,992,000

Budget Request 

The FY 2019 President’s Budget Request is $33.0 million, an increase of $224,000 from the 

FY 2018 Annualized CR. SAMHSA plans to support 26 CABHI continuation grants, award a new 

cohort of 30 grants, and support TA and evaluation activities. 
63 

Minority AIDS 

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Minority AIDS........................................................... $9,224 $9,161 $--- -$9,161

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

Minority AIDS

The Centers for Disease Control and Prevention (CDC) reports significantly higher rates of 

HIV/AIDS among racial/ethnic minorities compared with the general population.22 African 

Americans accounted for 45 percent and Hispanics accounted for 23 percent of all HIV/AIDS 

cases diagnosed in 2013.23 Psychiatric and psychosocial complications are frequently not 

diagnosed nor addressed at the time of HIV diagnosis or through the course of the disease process. 

When untreated, these complications are associated with increased morbidity and mortality,

impaired quality of life, and numerous medical issues such as non-adherence with the treatment 

regimen. 

The Minority AIDS program enhances and expands the provision of effective, culturally 

competent, HIV/AIDS-related mental health services in racial and ethnic minority communities 

for people living with or at high risk for HIV/AIDS. More than 4,600 individuals received services 

in FY 2017. 

In FY 2016 and FY 2017, SAMHSA supported the continuation of 34 HIV Continuum of Care 

grants, and evaluation and technical assistance contracts. Under the FY 2018 Annualized CR level, 

SAMHSA would award a new cohort of 34 grants focused on individuals with mental disorders 

and/or co-occurring disorders living with or at risk for HIV/AIDS. 

 

22 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance. 23 Centers for Disease Control and Prevention. HIV Surveillance Report. (2013); vol. 25. Published February 2015. 

Accessed May 8, 2015 from http://www.cdc.gov/hiv/library/reports/surveillance.
64 

Funding History

Fiscal Year Amount

FY 2015 $9,995,000 

FY 2016 $9,995,000 

FY 2017 $9,224,000

FY 2018 $9,161,000 

FY 2019 ---- 

Budget Request 

The FY 2019 President’s Budget request is $0.0 million, a decrease of $9.2 million from the 

FY 2018 Annualized CR. SAMHSA has discontinued this program because they overlap with 

other federal activities. 

States will be able to provide services to reduce injection drug use and related HIV/AIDS and 

Hepatitis C infection rates through $150 million in new funding proposed as part of the Additional 

Opioid Allocation described on page 259. 

The output and outcome measures for the Minority AIDS Initiative are part of the Mental Health 

- Other Capacity Activities Outputs and Outcomes table shown on page 78. 
65 

Criminal and Juvenile Justice Programs

(Dollars in thousands) 

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Criminal and Juvenile Justice Programs................. $4,269 $4,240 $14,269 $10,029

Authorizing Legislation..................Sections 520A and 520G of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities .................... Tribal Court Administrator, the Administrative Office of the Courts, 

the Single State Agency for Alcohol and Drug Abuse, the State Mental 

Health Agency, the Designated State Drug Court Coordinator, and 

Local Governmental Unit

Program Description and Accomplishments

Data indicate that a significant number of individuals that come in contact with law enforcement 

and the criminal justice system have a mental or substance use disorder. More than half of all 

prison and jail inmates (i.e., people in state and federal prisons and local jails) meet criteria for 

having a mental health problem; 6 in 10 meet criteria for a substance abuse problem; and more 

than one-third meet criteria for having both a substance abuse and mental health problem.24 

Approximately 250,000 individuals with serious mental illness (SMI) are incarcerated at any given 

time—about half arrested for non-violent offenses, such as trespassing or disorderly conduct. In 

addition, during street encounters, police officers are almost twice as likely to arrest someone who 

appears to have a mental illness. A Chicago study of thousands of police encounters found that 

47 percent of people with a mental illness were arrested, while only 28 percent of individuals 

without a mental illness were arrested for the same behavior.25 The costs associated with 

incarceration are high: state corrections budgets alone account for $39.0 billion in taxpayer 

costs.26,27 There is a clear and largely unmet need for effective behavioral health services and 

supports that are accessible before, during, and after incarceration and continue in the community 

as needed for this high-risk, population. 

In FY 2014, SAMHSA supported a second cohort of four-year Behavioral Health Treatment Court 

Collaborative grants (BHTCC) in the Mental Health and Substance Abuse Treatment 

 

24 U.S. Department of Justice, Office of Justice Programs. (2006) Mental health problems of prison and jail 

inmates. Retrieved, March 25, 2011, from http://bjs.ojp.usdoj.gov/content/pub/pdf/mhppji.pdf 25 The Role of Mental Health Courts in System Reform. The Bazelon Center for Mental Health Law. 

http://heinonline.org/HOL/LandingPage?handle=hein.journals/udclr7&div=10&id=&page= 26 Pew Center on the States. (2011). State of recidivism: The revolving door of America’s prisons. Washington, DC: 

The Pew Charitable Trusts. http://www.pewtrusts.org/en/research-and-analysis/reports/0001/01/01/state-ofrecidivism 27 Henrichson, C., & Delaney, R. (2012). The price of prisons: What incarceration costs taxpayers. New York: Vera 

Institute of Justice.
66 

appropriations. BHTCC supports judges and staff of specialty (e.g., drug court) and other courts 

within a jurisdiction to work together to divert adults with mental illness or co-occurring mental 

and substance use disorders from the criminal justice system. The purpose of this grant program 

is to allow municipal courts more flexibility to collaborate with multiple criminal justice system 

components and local community treatment and recovery providers to address the behavioral 

health needs of adults who are involved with the criminal justice system. The Court Collaborative 

focuses on the diversion of adults with mental illness and co-occurring mental illness and 

drug/alcohol addiction, from the criminal justice system and includes alternatives to incarceration. 

The program supports community behavioral health services and includes a focus on veterans 

involved with the criminal justice system. 

In FY 2017, SAMHSA provided continuation support for 17 grants, continued technical assistance, 

and awarded a new evaluation contract. The BHTCC evaluation focuses on examining the clinical 

and functional outcomes of program participants with behavioral health issues. The evaluations 

also build on the findings from the first cohort and more thoroughly examine both the features of 

successful collaborations between the courts and community services as well as the clinical and 

functional outcomes of program participants. 

Under the FY 2018 Annualized CR level, SAMHSA would award a new cohort of eight grants 

that divert adults with an SMI or a co-occurring disorder form the criminal justice system to 

community-based services prior to arrest and booking. In addition, SAMHSA will continue 

support for the technical assistance and evaluation contracts. 

Recent Evaluation Results

SAMHSA completed an evaluation of the first cohort of BHTCC grantees in September 2014. 

Findings of the evaluation demonstrate that grantees built multi-agency workgroups or 

collaboratives to oversee programs. Because of the grant funding, all grant recipients expanded 

access to specialty courts. Most grant recipients anticipated continuing new screening and 

assessment processes addressing a broader array of behavioral health needs after grant funding 

ended. Program innovations were divided into four main groups, including court and treatment 

provider collaboration, court and community case management, unified cross-court screening and 

referral, and meaningful peer involvement. BHTCC served over 2,997* individuals, with 77

percent of them identified as having co-occurring mental illness and drug/alcohol addiction and 

with nearly two thirds reporting violence or trauma exposure in their lives. Based on performance 

data reporting, alcohol and other drug use by program participants declined by 53 percent at six 

months**. Nearly 79 percent of participants either maintained good physical health or reported 

physical health improvements in the same time period***. In addition, employment rates 

increased from 29 percent to 45 percent over the first six months, with monthly mean income 

increasing by $217. 

*Cohort 2 data through November 15, 2017. 

**Calculated as the change in percentage of individuals reporting alcohol or drug use from 

baseline to six-month follow-up. 

***Calculated as the percentage of individuals who either maintained a health status of excellent 

to good, or who had an improvement in health status from baseline to six-month. 
67 

Funding History

Fiscal Year Amount

FY 2015 $4,296,000 

FY 2016 $4,269,000 

FY 2017 $4,269,000

FY 2018 $4,240,000

FY 2019 $14,269,000

Budget Request 

The FY 2019 President’s Budget Request is $14.3 million, an increase of $10.0 million from the 

FY 2018 Annualized CR. SAMHSA will award a new cohort of 27 grants that targets additional 

resources to address the needs of those with SMI. 

The output and outcome measures for Criminal and Juvenile Justice Programs are part of the 

Mental Health - Other Capacity Activities Outputs and Outcomes table shown on page 78. 

Practice Improvement and Training 

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Practice Improvement and Training........................ $7,828 $7,775 $7,828 $53

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ............. 105 Nationally Recognized Historically Black Colleges and Universities

Program Description and Accomplishments

SAMHSA facilitates health integration by engaging in activities that support mental health system 

transformation. The Practice Improvement and Training programs address the need for 

disseminating key information, such as evidence-based mental health practices, to the mental 

health delivery system.

The purpose of the HBCU-CFE program is to network the 105 HBCUs throughout the United 

States and promote behavioral health workforce development through 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 
68 

professions. The comprehensive focus of the HBCU-CFE program simultaneously expands 

service capacity on campuses and in other treatment venues. 

In FY 2017, SAMHSA awarded one new HBCU-Center for Excellence grant to a consortium of 

HBCUs with a lead university. 

Rehabilitation Research and Training Centers (RRTCs) seek to advance the current knowledge 

base by supporting research, training, technical assistance, and knowledge translation activities 

that help adults with serious mental health illness achieve their life goals. The RRTCs are funded 

in partnership with the Administration for Community Living’s National Institute on Disability, 

Independent Living, and Rehabilitation Research. Currently, there are two RRTCs funded for up 

to five years. The first program, RRTC on Improving Employment Outcomes for Persons with 

Mental Illness will conduct research activities and evaluation studies on improving employment 

outcomes of individuals with SMI. The second program, RRTC on Self-Directed Care to Promote 

Recovery, Health and Wellness for Individuals with SMI, will conduct research and evaluation 

studies to develop, adapt, and enhance self-directed models of medical, mental health, and 

nonmedical services designed to improve health, recovery and employment outcomes for 

individuals with SMI. 

In FY 2017, SAMHSA continued funding for two RRTCs and will continue this funding in 

FY 2018. 

Under the FY 2018 Annualized CR level, SAMHSA would award a new HBCU grant program. 

In addition, SAMHSA will award a Clinical Support Services TA Center dedicated to addressing 

issues for individuals living with SMI.

Funding History

Fiscal Year Amount

FY 2015 $7,828,000 

FY 2016 $7,828,000 

FY 2017 $7,828,000 

FY 2018 $7,775,000 

FY 2019 $7,828,000 

Budget Request 

The FY 2019 President’s Budget Request is $7.8 million, an increase of $53,000 from the FY 2018 

Annualized CR. Funding will support the continuation of the expanded HBCU program. It will 

also support the continuation of the Clinical Support Services TA Center for SMI. 

The output and outcome measures for Practice Improvement and Training are part of the Mental 

Health - Science and Service Activities Outputs and Outcomes table shown on page 79.
69 

Consumer and Consumer-Supporter TA Centers

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Consumer and Consumer-Supporter Technical 

Assistance Centers............................................ $1,918 $1,905 $1,918 $13

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................. Competitive Grants

Eligible Entities ....................................................................................... Community Organizations

Program Description and Accomplishments

Consumer-centered services and supports, such as peer specialists, are vital to improving the 

quality and outcomes of health and behavioral healthcare services for people with mental disorders 

including SMI. First funded in 1992, the purpose of Consumer and Consumer-Supporter Technical 

Assistance (TA) Centers is to provide technical assistance to facilitate quality improvement of the 

mental health system by specific promotion of consumer-directed approaches for adults with 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. This program also improves collaboration among consumers, families, providers, 

and administrators. It helps to transform community mental health services into a more consumer 

and family driven model. 

In the first six months of FY 2017, Consumer and Consumer-Supporter TA Centers provided 

training to nearly 8,500 people. These trainings covered a range of topics that including peer 

support, the Wellness Recovery Action Plan, financial literacy, and collaborative leadership. In 

addition, the Consumer and Consumer-Supporter TA Centers provided support and expertise to 

consumer organizations that led to these organizations obtaining over $700,000 in funding for 

consumer-directed activities and the program is responsible for nearly 400 consumers and family 

members holding positions within consumer or family organizations participated in mental healthrelated planning and systems improvement.

In FY 2017 and under the FY 2018 Annualized CR, SAMHSA supported the continuation of five 

grants. 
70 

Funding History

Fiscal Year Amount

FY 2015 $1,918,000 

FY 2016 $1,918,000 

FY 2017 $1,918,000

FY 2018 $1,905,000

FY 2019 $1,918,000

Budget Request 

The FY 2019 President’s Budget request is $1.9 million, an increase of $13,000 from the FY 2018 

Annualized CR. SAMHSA’s funding request will continue support of five grants to provide 

technical assistance to facilitate the quality improvement of the mental health system by promoting 

consumer-directed approaches for adults with SMI. 

The output and outcome measures for Consumer and Consumer-Supporter TA Centers are part of 

the Mental Health - Science and Service Activities Outputs and Outcomes table shown on page 

79. 
71 

Disaster Response

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Disaster Response.................................................... $1,953 $1,940 $1,953 $13

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ....................................................... Domestic Public or Private Non-Profit Entities

Program Description and Accomplishments

Disasters like Superstorm Sandy, Hurricanes Harvey, Irma, and Maria, the Oregon and 

Washington mudslides, the Iowa and Oklahoma tornados, and the Pulse nightclub shooting strike 

without warning. These unexpected disasters leave individuals, families, and whole communities 

struggling to rebuild. 

SAMHSA helps ensure that the nation is prepared to address the behavioral health needs that 

follow a natural or man-made disaster. SAMHSA focuses on three major programs: the Crisis 

Counseling Assistance and Training Program (CCP), the Disaster Distress Helpline (DDH), and 

Disaster Behavioral Health. These programs use appropriated funds to support survivors of natural 

and man-made disasters. 

SAMHSA, through an interagency agreement with the Federal Emergency Management Agency 

(FEMA), operates the CCP. This program assists individuals and communities in recovering from 

presidentially declared disasters through the provision of community-based behavioral health 

outreach and psycho-educational services. SAMHSA provides technical assistance, program 

guidance and monitoring, and oversight of the CCP. SAMHSA and FEMA jointly fund a Disaster 

Technical Assistance Center (DTAC) designed to provide additional technical assistance, strategic 

planning, consultation, and logistical support. SAMHSA provides Disaster Behavioral Health 

expertise around emerging public health initiatives to develop and disseminate innovative 

consultation and to technologies to communities, federal partners, and other stakeholders.

SAMHSA’s Disaster Distress Helpline 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. In FY 2017, SAMHSA responded to nearly 14,000 calls and received 

over 31,000 text messages through these services. In FY 2014, SAMHSA’s first Disaster app was 

created on Apple and Android platforms. The Disaster App provided evidence-informed and 

evidence-based resources in the Disaster Kit, along with additional partner resources and 

information on local mental health and substance use treatment facilities. It has the ability to share 

content anonymously and can function with limited Internet connectivity.
72 

In addition to these activities, SAMHSA funded a new cooperative agreement, Networking, 

Certifying and Training Suicide Prevention Hotlines and a National and a National Disaster 

Distress Helpline in FY 2015. This jointly funded cooperative agreement manages, enhances, and 

strengthens the National Suicide Prevention Lifeline and supports the Disaster Distress Helpline. 

SAMHSA continued to support for these activities in FY 2016 and FY 2017, and would maintain 

this support under the FY 2018 Annualized CR level. 

Funding History

Fiscal Year Amount

FY 2015 $1,953,000 

FY 2016 $1,953,000 

FY 2017 $1,953,000

FY 2018 $1,940,000

FY 2019 $1,953,000

Budget Request 

The FY 2019 President’s Budget request is $2.0 million, an increase of $13,000 from the FY 2018 

Annualized CR. SAMHSA is requesting funding to continue the support of a nationally available 

disaster distress crisis counseling telephone line and the Disaster Technical Assistance Center.

The output and outcome measures for Disaster Response are part of the Mental Health - Science 

and Service Activities Outputs and Outcomes table shown on page 79. 
73 

Seclusion and Restraint

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Seclusion and Restraint........................................... $1,147 $1,139 $1,147 $8

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................................. Contracts 

Eligible Entities ......................................................................................................... Not Applicable

Program Description and Accomplishments

People die because of the inappropriate use of seclusion and restraint practices; countless others 

are injured; and many are traumatized by coercive practices. 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. Coercive practices, such as seclusion and restraint, impede recovery and well-being. 

Through SAMHSA’s National Technical Assistance Center: Promoting Alternatives to Seclusion 

and Restraint Through Trauma-Informed Practices, evidence-based approaches to care have been 

developed, proven effective, and implemented to reduce or eliminate the use of traumatizing 

practices. This program provides technical assistance to states/tribes and communities in their 

efforts to implement best practices to reduce and ultimately eliminate the use of restraints and 

seclusion in institutional and community-based settings that provide services to individuals with 

mental illness and/or drug/alcohol addiction. This initiative focuses on the mental health delivery 

system and other service sectors, including criminal justice systems, schools, and child welfare 

organizations, that may use coercive practices with people who have mental illness and/or 

drug/alcohol addiction. 

SAMHSA awarded a five-year contract in FY 2013 to design, assess, and implement a technical 

assistance strategy to assist publicly funded systems, agencies, and organizations across the nation 

in addressing two high priority and interrelated objectives. The first objective is to promote 

alternatives to and the elimination of restraint, seclusion, and other coercive practices. The second 

objective is to develop and implement training and technical assistance on SAMHSA’s concept of 

trauma,28 key principles, and practice guidance for a trauma-informed approach,29 and enhance 

recognition that both organizational and cultural changes are necessary to sustain efforts to 

eliminate the use of seclusion and restraints. In addition, the contract facilitates dissemination of 

 

28 https://www.integration.samhsa.gov/clinical-practice/trauma 29 Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a 

Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental 

Health Services Administration, 2014.
74 

trauma-informed practices across multiple service settings. FY 2017, SAMHSA supported the 

continuation of this contract. 

Under the FY 2018 Annualized CR level, SAMHSA would utilize funding to contribute to a 

regionally-based TA effort focusing on issues related to the provision of services and supports for 

those living with mental disorders and/or SMI.

Funding History

Fiscal Year Amount

FY 2015 $1,147,000 

FY 2016 $1,147,000 

FY 2017 $1,147,000

FY 2018 $1,139,000

FY 2019 $1,147,000

Budget Request 

The FY 2019 President’s Budget request is $1.1 million, an increase of $8,000 from the FY 2018 

Annualized CR. SAMHSA’s funding request will provide support for the continuation of 

regionally-based TA activities.
75 

Assisted Outpatient Treatment for Individuals with Serious Mental Illness

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Assisted Outpatient Treatment for Individuals with 

Serious Mental Illness.................................. $15,000 $14,898 $15,000 $102

Authorizing Legislation ............... Section 224 of the Protecting Access to Medicare Act of 2014,

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ........................................................................................... States and Communities

Program Description and Accomplishments

Recent data show that one in 25 Americans live with a SMI, such as schizophrenia, bipolar disorder 

and major depression. Less than half of adults with diagnosable mental disorders receive the 

treatment they need. Without access to and receipt of evidence-based mental health services, 

mental health issues can negatively affect all areas of a person’s life.

In an effort to increase access to evidence-based mental health services for individuals with SMI, 

in April 2014, Congress passed the Protecting Access to Medicare Act of 2014 (PAMA), which 

authorized a four-year pilot program to award grants for Assisted Outpatient Treatment (AOT) 

programs for individuals with SMI. This authorization was extended in the 21st Century Cures 

Act. AOT is the practice of delivering outpatient treatment under court order to adults with SMI 

who meet specific criteria, such as a prior history of 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 will help to identify 

evidence-based AOT practices that support improved outcomes, including outreach and 

engagement, clinical treatment and supportive services, and due process protections. 

In FY 2016, SAMHSA implemented an AOT grant program and awarded 17 grants to eligible 

entities, such as a county, city, mental health system, mental health court, or any other entity with 

authority under the law of the state in which the grantee is located. This four-year pilot program 

is intended to implement and evaluate new AOT programs and identify evidence-based practices 

in order to reduce the incidence and duration of psychiatric hospitalization, homelessness, 

incarcerations, and interactions with the criminal justice system while improving the health and 

social outcomes of individuals with a SMI. This program is designed to work with families and 

courts to allow these individuals to obtain treatment while continuing to live in the community and 

their homes. Grants were awarded to applicants that have not previously implemented an AOT 

program. 

SAMHSA has partnered with the Assistant Secretary for Planning and Evaluation to implement a 

cross-site evaluation which will assess the effectiveness and impact of the AOT grant program. 

Additional program outcomes that will be evaluated will include, but are not be limited to, the 
76 

rates of incarceration, employment, healthcare utilization, mortality, suicide, substance use, 

hospitalization, homelessness, and use of services.

SAMHSA will continue to consult with the National Institute of Mental Health, the Attorney 

General, and the Administration for Community Living on this pilot program. In addition, 

SAMHSA will work with families and courts in the implementation of this program. 

In FY 2017 and under the FY 2018 Annualized CR, SAMHSA would provide funding for the 

continuation of 17 grants, technical assistance, and the evaluation of this program. 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 $15,000,000

FY 2017 $15,000,000

FY 2018 $14,898,000

FY 2019 $15,000,000

Budget Request 

The FY 2019 President’s Budget request is $15.0 million, an increase of $102,000 from the 

FY 2018 Annualized CR. This funding will support 17 grant continuations to improve the health 

and social outcomes for individuals with SMI by providing continuation funding for the AOT 

grants, and the evaluation, and technical assistance contracts.
77 

Outputs and Outcomes Table 

Program: Assisted Outpatient Treatment for Individuals with Serious Mental Illness

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.4.06 Increase the percentage of 

clients receiving services who report 

positive functioning at 6 month 

follow-up. (Outcome)

FY 2017: 74.6 %

Target: 55.7 %

(Target Exceeded)

74.6 % 74.6 % Maintain

3.4.07 Increase the percentage of 

clients receiving services who are 

maintained at six-month follow-up. 

(Outcome)

FY 2017: 81.8 %

Target: 70.5 %

(Target Exceeded)

81.8% 81.8% Maintain

3.4.08 Increase the number of people 

in the mental health and related 

workforce trained in mental healthrelated practices/activities.(Outcome)

FY 2017: 2,519 

Target: 756

(Target Exceeded)

2,519 2,519 Maintain

3.4.09 Increase the number of 

consumers/family members who 

provide mental health-related 

services.(Outcome)

FY 2017: 103

Target: 52

(Target Exceeded)

103 103 Maintain
78 

Outputs and Outcomes Table

Program: Mental Health – Other Capacity Activities 1

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.2.05 Increase the percentage of 

clients receiving services who 

report positive functioning at 6 

month follow-up. (Outcome)

FY 2017: 55.2 %

Target: 55.7 %

(Target Not Met)

55.2 % 55.2 % Maintain

1.2.82 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community at six-month follow-up. 

(Outcome)

FY 2017: 66.9 %

Target: 70.5 %

(Target Not Met but Improved)

70.5 % 70.5 % Maintain

1.2.83 Increase the percentage of 

clients receiving services who are 

currently employed at six-month 

follow-up. (Outcome)

FY 2017: 25.0 %

Target: 25.3 % 

(Target Not Met)

25.0 % 25.0 % Maintain

1.2.88 Increase the number of 

individuals screened for mental 

health or related interventions. 

(Outcome)

FY 2017: 77,818

Target: 29,813 

(Target Exceeded)

77,818 77,818 Maintain

1 includes the following: Children and Family, Consumer and Family Network, Minority AIDS Initiative, and Criminal 

and Juvenile Justice programs.
79 

Outputs and Outcomes Table

Program: Mental Health - Science and Service Activities

Note: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.4.06 Increase the number of 

people trained by CMHS Science 

and Service Programs. (Output)

FY 2017: 40,070

Target: 20,000 

(Target Exceeded)

40,070 40,070 Maintain

1.4.14 Increase the number of calls 

answered by the Disaster Distress 

Hotline. (Output)

FY 2017: 13,889

Target: 6,000 

(Target Exceeded)

13,889 13,889 Maintain

1.4.15 Increase the number of text 

messages answered by the Disaster 

Distress Hotline. (Output)

FY 2017: 31,644

Target: 10,000 

(Target Exceeded)

31,644 31,644 Maintain
80 

Tribal Behavioral Health Grants

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Tribal Behavioral Health Grants.............................. $15,000 $14,898 $15,000 $102

Authorizing Legislation .......................................... Section 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ....................................................................................................................... Tribes

Program Description and Accomplishments

Suicide is the second leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages eight to 24 years.30 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students.31 These behaviors include 

serious thoughts of suicide, suicide plans, suicide attempts, and medical attention for a suicide 

attempt. However, the risk of suicide is not the same in all AI/AN youth demographic groups. 

For instance, AI/AN youth raised in urban settings have a smaller risk of having thoughts of suicide 

than AI/AN youth raised on tribal reservations (21 percent and 33 percent, respectively).32

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG) 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 abuse, trauma, and 

suicide and by promoting the mental health of AI/AN young people. 

In FY 2014, SAMHSA’s Center for Mental Health Services awarded five-year TBHG grants of 

up to $0.2 million annually to 20 tribes or tribal organizations with high rates of suicide. These 

five-year grants help grantees develop and implement a plan that addresses suicide and substance 

abuse, thereby promoting mental health among tribal youth. In addition, SAMHSA’s Tribal 

Training and Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) provides training 

and education to AI/AN grantees and organizations serving AI/AN populations to support their 

ability to achieve their goals. An evaluation component allows grantees and SAMHSA to work 

collaboratively to monitor progress and learn from each other. 

 

30 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed May 27, 2014.

31 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. 

32 Freedenthal, S. & Stiffman, A. R. (2004). Suicidal Behavior in Urban American Indian Adolescents: A 

Comparison with Reservation Youth in a Southwestern State. Suicide and Life-Threatening Behavior, 34(2), 160-

171. 
81 

In FY 2016, SAMHSA expanded the TBHG program to include a Native youth initiative focused 

on removing possible barriers to success for Native youth. This initiative takes a comprehensive, 

culturally appropriate approach to help improve the lives of and opportunities for AI/AN youth. 

In addition to the Department of Health and Human Services, multiple agencies, including the 

Departments of Interior, Education, Housing and Urban Development, Agriculture, Labor, and 

Justice, are working collaboratively with tribes to address issues facing AI/AN youth. This 

funding allows SAMHSA to expand activities through the braided TBHG ($15.0 million in the 

Substance Abuse Prevention appropriation and $15.0 million in Mental Health appropriation) to 

allow tribes the flexibility to implement community-based strategies to address trauma, prevent 

substance abuse, and promote mental health and resiliency among youth in tribal communities. 

The additional FY 2016 funding expanded these activities to approximately 90 tribes and tribal 

entities. With the expansion of the TBHG program, SAMHSA’s goal is to reduce substance use 

and the incidence of suicide attempts among AI/AN youth and to address behavioral health 

conditions that affect learning in the Bureau of Indian Education-funded schools. The TBHG 

program will support mental health promotion, including trauma-informed strategies, and 

substance use prevention activities for high-risk AI/AN youth and their families, enhance early 

detection of mental illness and drug/alcohol addiction among AI/AN youth, and increase referral 

to treatment. In FY 2017, SAMHSA provided funding to support 81 grant continuations, 13 new 

grants, and the evaluation and technical assistance activities.

Under the FY 2018 Annualized CR level, SAMHSA would support 81 grant continuations, 36 new 

grants, evaluation, and technical assistance activities. 

Funding History

Fiscal Year Amount

FY 2015 $4,988,000 

FY 2016 $15,000,000 

FY 2017 $15,000,000

FY 2018 $14,898,000

FY 2019 $15,000,000

Budget Request 

The FY 2019 President’s Budget request is $15.0 million, an increase of $102,000 from the 

FY 2018 Annualized CR. This request, combined with $15.0 million in the Substance Abuse 

Prevention will award 18 new grants and continue support for 100 grants that promote mental 

health and prevent substance use activities for high-risk AI/AN youth and their families. 

As a braided activity, SAMHSA will track 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.
82 

Outputs and Outcomes Table

Program: Tribal Behavioral Health

Note: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.4.12 Increase the percentage of 

youth age 10 - 24 who received 

mental health or related services after 

screening, referral or attempt. 

(Output)

FY 2017: 56.0%

Target: 20.0%

(Target Exceeded)

56.0% 56.0% Maintain

2.4.13 Increase the number of 

programs/organizations that 

implemented specific mental-health 

related practices/activities as a result 

of the grant. (Outcome)

FY 2017: 5,670

Target: 296

(Target Exceeded)

5,670 5,670 Maintain
83 

Minority Fellowship Program

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Minority Fellowship Program.................................. $8,059 $8,004 $--- -$8,004

Authorizing Legislation ........................................................................ Section 597 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol 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, and 

psychology. In 2006, the program expanded to include marriage and family therapists and later 

added professional counselors. Professional guilds receive competitively awarded grants, and then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. The MFP program has had a variety of foci including youth and addiction counselors. 

Under the FY 2018 Annualized CR level, SAMHSA would award a new cohort of 11 MFP grants 

and a technical assistance and evaluation contract.

Funding History

Fiscal Year Amount

FY 2015 $8,059,000 

FY 2016 $8,059,000 

FY 2017 $8,059,000 

FY 2018 $8,004,000

FY 2019 ---
84 

Budget Request 

The FY 2019 President’s Budget request is $0.0 million, a decrease of $8.0 million from the 

FY 2018 Annualized CR. SAMHSA is eliminating this program because it overlaps with other 

federal activities. 

Assertive Community Treatment for Adults with SMI 

(Dollars in thousands) 

Programs of Regional and National Significance

FY 

2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Assertive Community Treatment for Adults with SMI.. $--- $--- $15,000 $15,000

Authorizing Legislation ........................................Sections 520M of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities. ............................ States, local governments, Indian tribes or tribal organizations, 

mental health systems, or health care facilities

Program Description and Accomplishments

The Assertive Community Treatment (ACT) for Adults with SMI program is authorized under the 

21st Century Cures Act. ACT is an evidence-based practice considered one of the most effective 

approaches to deliver services to people with SMI33 and has been disseminated by SAMHSA for 

widespread use through its Evidence Based Toolkit series34 beginning in 2008. ACT was 

developed to reduce re-hospitalization and improve outcomes in community settings. ACT is 

designed as an integrated care approach to provide a comprehensive array of services, including 

medication management and other supportive services, directly rather than through referrals. The 

ACT team is composed of 10-12 multidisciplinary behavioral health staff, including psychiatrists, 

nurses, social workers, addition counselors, and peer specialists. These practitioners work together 

to deliver comprehensive, individualized, and recovery-oriented treatment and case management 

services to approximately 100 people with SMI in community settings. Caseloads are 

approximately one staff member to every 10 individuals. The services are provided 24 hours, 7 

days a week and as long as needed, wherever they are needed. Teams often find they can anticipate 

and avoid crises. 

 

33 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/

34 http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBPKIT/SMA08-4345
85 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 ---

FY 2017 ---

FY 2018 ---

FY 2019 $15,000,000 

Budget Request 

The FY 2019 President’s Budget request is $15.0 million, an increase of $15.0 million from the 

FY 2018 Annualized CR. Funding will support approximately 20 grants to advance the ACT 

approach to address the needs of those living with SMI and technical assistance and evaluation 

activities. 
86 

SAMHSA/Mental Health

PRNS Mechanism Table Summary

(Dollars in thousands) 

Program Activity

FY 2017 Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

No. Amount No. Amount No. Amount

Programs of Regional & National Significance

Grants/Cooperative Agreements

Continuations................................................ 624 $269,694 489 $214,054 368 $141,234

New/Competing..................................................... 83 54,983 259 117,232 198 93,492

Subtotal.............................................................. 707 324,676 748 331,285 566 234,725

Contracts

Continuations......................................................... 22 65,221 15 51,596 12 41,754

New/Competing.................................................... 2 5,762 6 11,987 6 6,065

Subtotal.............................................................. 24 70,983 21 63,583 18 47,819

Total, Mental Health PRNS 731 $395,659 769 $394,868 584 $282,544
87 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional and National Significance No. Amount No. Amount No. Amount

Capacity:

National Child Traumatic Stress Network

Grants

Continuations.......................................................................... 82 $43,280 86 $45,222 86 $45,215

New/Competing...................................................................... 4 1,901 --- --- --- ---

Subtotal................................................................................. 86 45,181 86 45,222 86 45,215

Contracts

Continuations.......................................................................... --- 2,959 --- 3,333 --- 3,673

New/Competing...................................................................... --- 748 --- --- --- ---

Subtotal................................................................................. --- 3,706 --- 3,333 --- 3,673

Total ,National Child Traumatic Stress Network 86 48,887 86 48,555 86 48,887

Project AWARE

Grants

Continuations.......................................................................... 96 56,420 16 24,755 --- ---

New/Competing...................................................................... 2 2,317 102 37,630 --- ---

Subtotal................................................................................. 98 58,737 118 62,385 --- ---

Contracts

Continuations.......................................................................... 3 10,227 2 8,333 --- ---

New/Competing...................................................................... --- --- 1 757 --- ---

Subtotal................................................................................. 3 13,227 3 9,090 --- ---

Total, Project AWARE 101 68,964 121 71,475 --- ---

Healthy Transitions

Grants

Continuations.......................................................................... 16 16,832 14 13,932 4 3,368

New/Competing...................................................................... --- --- 4 2,983 14 15,132

Subtotal................................................................................. 16 16,832 18 16,915 18 18,500

Contracts

Continuations.......................................................................... --- 3,119 --- 2,901 --- 1,451

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 3,119 --- 2,901 --- 1,451

Total, Healthy Transitions 16 19,951 18 19,816 18 19,951
88 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional and National Significance No. Amount No. Amount No. Amount

Children and Family Programs

Grants

Continuations.......................................................................... --- --- 13 5,028 13 5,093

New/Competing...................................................................... 13 5,115 --- --- --- ---

Subtotal................................................................................. 13 5,115 13 5,028 13 5,093

Contracts

Continuations.......................................................................... --- 2,114 --- 1,355 --- 2,136

New/Competing...................................................................... --- --- --- 796 --- ---

Subtotal................................................................................. --- 2,114 --- 2,151 --- 2,136

Total, Children and Family Programs 13 7,229 13 7,180 13 7,229

Consumer and Family Network Grants

Grants

Continuations.......................................................................... 43 4,169 32 3,026 16 1,500

New/Competing...................................................................... 2 190 14 1,473 30 2,950

Subtotal................................................................................. 45 4,359 46 4,499 46 4,451

Contracts

Continuations.......................................................................... --- 595 --- 421 --- 503

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 595 --- 421 --- 503

Total, Consumer and Family Network Grants 45 4,954 46 4,920 46 4,954

Project LAUNCH

Grants/Cooperative Agreements

Continuations.......................................................................... 25 19,289 18 12,851 8 4,457

New/Competing...................................................................... --- --- 8 4,457 18 14,170

Subtotal................................................................................. 25 19,289 26 17,309 26 18,627

Contracts

Continuations.......................................................................... 2 2,398 2 4,402 2 4,978

New/Competing...................................................................... 1 1,918 1 1,734 --- ---

Subtotal................................................................................. 3 4,316 3 6,136 2 4,978

Total, Project LAUNCH 28 23,605 29 23,445 28 23,605

Mental Health System Transformation and Health Reform

Grants

Continuations.......................................................................... 7 2,230 7 2,642 --- ---

New/Competing...................................................................... --- --- --- --- 7 2,687

Subtotal................................................................................. 7 2,230 7 2,642 7 2,687

Contracts

Continuations.......................................................................... --- 1,549 --- 1,111 --- 1,092

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 1,549 --- 1,111 --- 1,092

Total, Mental Health System Transformation and Health 

Reform 7 3,779 7 3,753 7 3,779
89 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2017 Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Primary and Behavioral Health Care Integration 

Grants 

Continuations............................................................................. 61 22,575 61 23,968 --- ---

New/Competing.......................................................................... 3 23,988 10 22,734 --- ---

Subtotal.................................................................................... 64 46,562 71 46,702 --- ---

Contracts 

Continuations............................................................................. --- 3,315 --- 2,836 --- ---

New/Competing.......................................................................... --- --- --- --- --- ---

Subtotal.................................................................................... --- 3,315 --- 2,836 --- ---

Total, PBHCI 64 49,877 71 49,538 --- ---

National Strategy for Suicide Prevention 

Grants 

Continuations............................................................................. --- --- 5 1,884 8 9,882

New/Competing.......................................................................... 8 10,447 3 7,948 --- ---

Subtotal.................................................................................... 8 10,447 8 9,832 8 9,882

Contracts 

Continuations............................................................................. --- --- --- 122 --- 1,118

New/Competing.......................................................................... --- 553 --- 972 --- ---

Subtotal.................................................................................... --- 553 --- 1,094 --- 1,118

Total, National Strategy for Suicide Prevention 8 11,000 8 10,925 8 11,000

GLS - Youth Suicide Prevention - States

Grants 

Continuations............................................................................. 42 28,479 45 29,665 19 12,205

New/Competing.......................................................................... 5 2,208 --- --- 26 18,145

Subtotal.................................................................................... 47 30,686 45 29,665 45 30,350

Contracts 

Continuations............................................................................. 1 4,741 1 4,438 --- 3,077

New/Competing.......................................................................... --- --- --- --- 1 2,000

Subtotal.................................................................................... 1 4,741 1 4,438 1 5,077

Total, GLS - States 48 35,427 46 34,103 46 35,427

GLS - Youth Suicide Prevention - Campus 

Grants 

Continuations............................................................................. 40 3,665 35 3,404 53 5,250

New/Competing.......................................................................... 17 1,656 18 1,847 --- ---

Subtotal.................................................................................... 57 5,320 53 5,251 53 5,250

Contracts 

Continuations............................................................................. --- 1,168 --- 1,193 --- 738

New/Competing.......................................................................... --- --- --- --- 1 500

Subtotal.................................................................................... --- 1,168 --- 1,193 1 1,238

Total, GLS - Campus 57 6,488 53 6,444 54 6,488
90 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

GLS - Suicide Prevention Resource Center

Grants

Continuations.......................................................................... 1 5,634 1 5,607 1 5,552

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 1 5,634 1 5,607 1 5,552

Contracts

Continuations.......................................................................... --- 354 --- 341 --- 436

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 354 --- 341 --- 436

Total, GLS - Suicide Prevention Resource Center 1 5,988 1 5,947 1 5,988

Suicide Lifeline

Grants

Continuations.......................................................................... 7 5,961 6 687 1 5,302

New/Competing...................................................................... --- --- 1 5,302 6 687

Subtotal................................................................................. 7 5,961 7 5,989 7 5,989

Contracts

Continuations.......................................................................... --- 1,237 --- 488 --- 1,209

New/Competing...................................................................... --- --- --- 672 --- ---

Subtotal................................................................................. --- 1,237 --- 1,161 --- 1,209

Total, Suicide Lifeline 7 7,198 7 7,149 7 7,198

AI/AN Suicide Prevention Initiative

Grants

Continuations.......................................................................... --- --- --- --- --- ---

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- --- --- --- --- ---

Contracts

Continuations.......................................................................... 1 2,931 --- --- 1 2,931

New/Competing...................................................................... --- --- 1 2,911 --- ---

Subtotal................................................................................. 1 2,931 1 2,911 1 2,931

Total, AI/AN 1 2,931 1 2,911 1 2,931

Homelessness Prevention Programs

Grants

Continuations.......................................................................... 39 19,068 46 14,605 26 15,585

New/Competing...................................................................... 16 4,928 10 10,393 30 9,678

Subtotal................................................................................. 55 23,996 56 24,998 56 25,263

Contracts

Continuations.......................................................................... 2 6,001 2 5,490 1 3,833

New/Competing...................................................................... --- 700 --- --- 1 1,600

Subtotal................................................................................. 2 6,700 2 5,490 2 5,433

Total, Homelessness Prevention Programs 57 30,696 58 30,488 58 30,696
91 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Minority AIDS

Grants

Continuations.......................................................................... 32 7,091 --- --- --- ---

New/Competing...................................................................... --- --- 32 7,622 --- ---

Subtotal................................................................................. 32 7,091 32 7,622 --- ---

Contracts

Continuations.......................................................................... --- 2,133 --- 1,136 --- ---

New/Competing...................................................................... --- --- --- 402 --- ---

Subtotal................................................................................. --- 2,133 --- 1,539 --- ---

Total, Minority AIDS 32 9,224 32 9,161 --- ---

Criminal and Juvenile Justice Programs

Grants

Continuations.......................................................................... 17 2,249 --- --- 8 2,950

New/Competing...................................................................... --- --- 8 2,698 27 9,148

Subtotal................................................................................. 17 2,249 8 2,698 35 12,098

Contracts

Continuations.......................................................................... 2 2,020 --- 1,542 --- 2,171

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 2 2,020 --- 1,542 --- 2,171

Total, Criminal and Juvenile Justice Programs 19 4,269 8 4,240 35 14,269

Seclusion and Restraint

Grants

Continuations.......................................................................... --- $--- --- $--- --- $---

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- --- --- --- --- ---

Contracts

Continuations.......................................................................... 1 1,147 --- 65 1 1,147

New/Competing...................................................................... --- --- 1 1,074 --- ---

Subtotal................................................................................. 1 1,147 1 1,139 1 1,147

Total, Seclusion and Restraint 1 1,147 1 1,139 1 1,147

Assertive Community Treatment for Individuals with Serious 

Mental Illness

Grants

Continuations.......................................................................... --- --- --- --- --- ---

New/Competing...................................................................... --- --- --- --- 20 13,720

Subtotal................................................................................. --- --- --- --- 20 13,720

Contracts

Continuations.......................................................................... --- --- --- --- --- ---

New/Competing...................................................................... --- --- --- --- 1 1,280

Subtotal................................................................................. --- --- --- --- 1 1,280

Total, Assertive Community Treatment for Individuals with 

Serious Mental Illness --- --- --- --- 21 15,000
92 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2017 Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Assisted Outpatient Treatment for Individuals with Serious 

Mental Illness

Grants

Continuations.......................................................................... 17 13,315 17 13,305 17 13,305

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal............................................................................... 17 13,315 17 13,305 17 13,305

Contracts

Continuations......................................................................... --- 1,685 1 1,593 1 1,595

New/Competing...................................................................... --- --- --- --- --- 100

Subtotal............................................................................... --- 1,685 1 1,593 1 1,695

Total, Assisted Outpatient Treatment for Individuals with 

Serious Mental Illness 17 15,000 18 14,898 18 15,000

Tribal Behavioral Health Grants

Grants

Continuations......................................................................... 81 7,737 81 8,519 100 7,855

New/Competing..................................................................... 13 2,733 36 2,871 20 3,624

Subtotal............................................................................... 94 10,470 117 11,390 120 11,479

Contracts

Continuations........................................................................ 1 4,235 1 3,508 1 3,521

New/Competing..................................................................... --- 295 --- --- --- ---

Subtotal.............................................................................. 1 4,530 1 3,508 1 3,521

Total, Tribal Behavioral Health Grants 95 15,000 118 14,898 121 15,000

Subtotal, Capacity 702 $371,614 742 $370,987 569 $268,549

Science and Service:

Primary and Behavioral Health Care Integration TA

Grants

Continuations........................................................................ --- --- --- --- --- ---

New/Competing..................................................................... --- --- --- --- --- ---

Subtotal............................................................................... --- --- --- --- --- ---

Contracts

Continuations......................................................................... 1 1,991 --- 113 --- ---

New/Competing..................................................................... --- --- 1 1,864 --- ---

Subtotal.............................................................................. 1 1,991 1 1,977 --- ---

Total, PBHCI TA 1 1,991 1 1,977 --- ---

Practice Improvement & Training

Grants

Continuations......................................................................... 2 2,042 1 3,158 3 1,935

New/Competing..................................................................... --- --- 2 1,721 --- 2,687

Subtotal.............................................................................. 7 2,042 10 4,879 10 4,623

Contracts

Continuations........................................................................ 6 5,267 4 2,896 3 2,620

New/Competing..................................................................... 1 519 --- --- 1 585

Subtotal............................................................................... 7 5,786 4 2,896 4 3,205

Total, Practice Improvement & Training 9 7,828 7 7,775 07 7,828
93 

SAMHSA/Mental Health

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Consumer and Consumer-Supporter TA Centers

Grants

Continuations.......................................................................... 5 1,749 5 1,796 5 1,779

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 5 1,749 5 1,796 5 1,779

Contracts

Continuations.......................................................................... --- 169 --- 109 --- 139

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- 169 --- 109 --- 139

Total, CCSTAC 5 1,918 5 1,905 5 1,918

Disaster Response

Grants

Continuations.......................................................................... --- 923 --- --- --- ---

New/Competing...................................................................... --- --- --- 810 --- 863

Subtotal................................................................................. --- 923 --- 810 --- 863

Contracts

Continuations.......................................................................... 1 --- 1 1,130 1 1,090

New/Competing...................................................................... --- 1,030 --- --- 1 ---

Subtotal................................................................................. 1 1,030 1 1,130 2 1,090

Total, Disaster Response 1 1,953 1 1,940 2 1,953

Homelessness

Grants

Continuations.......................................................................... --- --- --- --- --- ---

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. --- --- --- --- --- ---

Contracts

Continuations.......................................................................... 1 2,296 1 2,280 1 2,296

New/Competing...................................................................... --- --- --- --- --- ---

Subtotal................................................................................. 1 2,296 1 2,280 1 2,296

Total, Homelessness 1 2,296 1 2,280 1 2,296

Minority Fellowship Program

Grants

Continuations.......................................................................... 11 6,488 --- --- --- ---

New/Competing...................................................................... --- --- 11 6,742 --- ---

Subtotal................................................................................. 11 6,488 11 6,742 --- ---

Contracts

Continuations.......................................................................... 1 1,571 --- 458 --- ---

New/Competing...................................................................... --- --- 1 803 --- ---

Subtotal................................................................................. 1 1,571 1 1,262 --- ---

Total, Minority Fellowship Program 12 8,059 12 8,004 --- ---

Subtotal, Science and Service 29 24,045 27 23,882 15 13,995

Total, Mental Health PRNS 731 $395,659 769 $394,868 584 $282,544
94 

Grant Awards Table 

(Whole dollars) 

FY 2017

Final 

FY 2018 Annualized 

CR 

FY 2019 

President's Budget 

Number of Awards 707 748 566

Average Awards $459,231 $442,895 $414,709

Range of Awards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000
95 

Children’s Mental Health Services

(Dollars in thousands)

Programs of Regional and National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

Children's Mental Health Services............................. $119,026 $118,218 $119,026 $808

Authorizing Legislation ........................................... Sections 561 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities.................................................States, Tribes, Communities, Territories

Program Description and Accomplishments

It is estimated that over 7.4 million children and youth in the United States have a serious mental 

disorder. Unfortunately, only 41 percent of those in need of mental health services actually receive 

treatment.35 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 and their families to increase their access to evidence-based treatment and supports. 

The 21st Century Cures Act reauthorized the CMHI through FY 2022. Approximately 9-13 percent 

of America’s youth are estimated to have a serious emotional disturbance (SED), the term 

analogous to serious mental illness when applied to children. 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 supports the development, implementation, expansion, and sustainability of 

comprehensive, community-based services that use the SOC approach. SOC is a strategic 

approach to the delivery of services and supports that incorporates family-driven, youth-guided, 

strength-based, and culturally and linguistically competent care in order to meet the physical, 

intellectual, emotional, cultural, and social needs of children and youth throughout the U.S. The 

SOC approach helps prepare children and youth for successful transition to adulthood and 

assumption of adult roles and responsibilities. Services are delivered in the least restrictive 

environment with evidence-supported treatments and interventions. Individualized care 

management ensures that planned services and supports are delivered with an appropriate, 

effective, and youth-guided approach. This approach has demonstrated improved outcomes for 

children at home, at school, and in their communities. For example, CMHI grantee data show that 

suicide attempt rates decreased over 50 percent within 12 months after children and youth accessed 

CMHI-related SOC services. In addition, school suspensions/expulsions decreased over 50 

 

35 Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. 

(2014). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH 

Series H-48, HHS Publication No. (SMA) 144863. Rockville, MD: Substance Abuse and Mental Health Services 

Administration.
96 

percent and unlawful behavior decreased over 50 percent after 18 months of children and youth 

beginning SOC-related services and supports.36

In addition, the CMHI program seeks to address behavioral health disparities for children and 

youth with SED/Serious Mental Illness (SMI) from racial and ethnic minorities by promoting clear 

and culturally competent strategies to improve their access, use of services, and outcomes.

SAMHSA funding ensures that grantees will continue to expand and sustain CMHI SOC values, 

principles, infrastructure, and services throughout their states, tribes, and territories. A central 

focus of these efforts is ensuring collaboration between the CMHI SOC and other child-and 

youth- serving systems (e.g., Child Welfare, Juvenile Justice, and Education). SAMHSA also 

strongly encourages efforts by CMHI SOC grantees to coordinate with other SAMHSA programs, 

such as those supported by the Community Mental Health Services Block Grant (MHBG) and 

Substance Abuse Prevention and Treatment Block Grant (SABG). 

CMHI has an ongoing national evaluation, which is designed to provide information on: 1) the 

mental health outcomes of children and youth, and their families; 2) the implementation, process, 

and sustainability of SOC; and 3) critical and emerging issues in children’s and youth’s mental 

health. The evaluation includes an SOC assessment that describes the infrastructure and an 

assessment of outcomes derived from direct SOC services. A service experience study evaluates: 

1) change in service use patterns of children and their families; 2) differences in client satisfaction 

between groups of children (and their families) in the SOC communities who receive an

evidence- based treatment and those who do not; and 3) retention in services. 

National program evaluation data reported annually to Congress indicate that CMHI SOCs are 

successful, resulting in many favorable outcomes for children, youth, and their families, including: 

• sustained mental disorder improvements for participating children and youth in behavioral 

health outcomes after as little as six months of program participation; 

• improvements in school attendance and achievement; 

• reductions in suicide-related behaviors; 

• decreases in the use of inpatient care and reduced costs due to fewer days in residential 

settings; and 

• significant reductions in contacts with law enforcement. 

In FY 2016, SAMHSA supported 47 continuation grants, 53 new grants, and five contracts. In 

FY 2017, SAMHSA supported 63 continuation grants, 11 new grants, and four contracts. Under 

the FY 2018 Annualized CR level, SAMHSA would seek to develop and implement a services 

research demonstration effort based on the North American Prodrome Longitudinal Study funded 

by the National Institute of Mental Health. During the prodrome phase, a disease process has 

begun but is not yet diagnosable or inevitable. The demonstration will address whether 

community-based intervention during this phase can prevent the further development of serious 

 

36 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 

(2015). The Comprehensive Community Mental Health Services for Children with Serious Emotional 

Disturbances Program, Report to Congress. Retrieved from 

https://www.samhsa.gov/sites/default/files/programs_campaigns/nitt-ta/2015-report-to-congress.pdf. 
97 

emotional disturbances and ultimately serious mental illness. The project will examine the extent 

to which evidence-based early intervention for young people at clinical high risk for psychosis can 

be scaled up to mitigate or delay the progression of mental illness, reduce disability, and/or 

maximize recovery. The new effort will be funded from a 10 percent set-aside of the base program, 

and will focus on youth and young adults who are identified to be at clinical high risk for 

developing a first episode of psychosis. Funding of this new effort will not affect continuation 

funding of any CMHI-base funded program. The grantees will focus on this population in order 

to support the development and implementation of evidence-based programs providing community 

outreach and psychosocial interventions for youth and young adults in the prodrome phase of 

psychotic illness.

Funding History

Fiscal Year Amount

FY 2015 $117,026,000 

FY 2016 $119,026,000 

FY 2017 $119,026,000

FY 2018 $118,218,000

FY 2019 $119,026,000

Budget Request 

The FY 2019 President’s Budget request is $119.0 million, an increase of $808,000 from the 

FY 2018 Annualized CR. In FY 2019, the budget request will support continuation of the 10 

percent set-aside prodromal activity and will also support funding for 57 continuation grants and 

TA and evaluation activities. This funding will provide training to 5,100 people in the mental 

health and related workforce and serve 13,595 children with serious emotional disturbances. 
98 

SAMHSA/Mental Health

Mechanism Table 

(Dollars in thousands)

Program Activity

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

No. Amount No. Amount No. Amount

Children's Mental Health Services

Grants/Cooperative Agreements

Continuations.......................................................... 63 $76,628 62 $91,743 55 $81,914

New/Competing...................................................... 11 20,910 12 11,326 19 20,074

Subtotal................................................................. 74 97,538 74 103,069 74 101,989

Contracts

Continuations.......................................................... 2 11,435 1 9,824 1 11,712

New/Competing...................................................... --- 305 --- --- --- ---

Subtotal................................................................. 2 11,739 1 9,824 1 11,712

Technical Assistance................................................ 2 9,749 1 5,325 1 5,325

Total, Children's Mental Health Services 78 $119,026 76 $118,218 76 $119,026
99 

Outputs and Outcomes Table

Program: Children's Mental Health Initiative 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the

FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.2.16 Increase the number of 

children with severe emotional 

disturbance that are receiving 

services from the Children's Mental 

Health Initiative. (Output)

FY 2017: 10,187

Target: 7,830 

(Target Exceeded)

10,187 10,187 Maintain

3.2.25 Increase the percentage of 

children receiving services who 

report positive social support at sixmonth follow-up. (Outcome)

FY 2017: 84.2 %

Target: 87.6 %

(Target Not Met)

84.2 % 84.2 % Maintain

3.2.26 Increase the percentage of 

children receiving Systems of Care 

mental health services who report 

positive functioning at 6 month 

follow-up. (Outcome)

FY 2017: 57.8%

Target: 62.7 %

(Target Not Met)

57.8 % 57.8 % Maintain

3.2.27 Increase the 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 2017: 81,925

Target: 48,818 

(Target Exceeded)

81,925 81,925 Maintain
100 

Grant Awards Table 

(Whole dollars)

FY 2017 Final FY 2018 Annualized CR 

FY 2019 

President's Budget 

Number of Awards 74 74 74

Average Awards $1,318,079 $1,392,824 $1,378,225

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000
101 

Projects for Assistance in Transition from Homelessness

(Dollars in thousands) 

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualize

d CR

Projects for Assistant in the Transition from Homeless $64,635 $64,196 $64,635 $439

Authorizing Legislation ........................................ Section 535(a) of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ................................................................................................... Formula Grants

Eligible Entities ............................................................................................... States and Territories

Program Description and Accomplishments

On an average night, an estimate of 578,424 individuals experience homelessness.37 Data suggest 

that approximately 26 percent of individuals experiencing homelessness have a serious mental 

illness (SMI), and that 30 percent of the chronically homeless population (individuals or families 

with a disabling condition who have been experiencing homelessness for longer than one year or 

more than four times in the past three years) have a serious mental illness.38,39,40 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.41

Data show that the PATH program’s efforts to identify primary care, behavioral disorder treatment, 

and housing for individuals who are chronically homeless is two to three times more cost effective 

than having them in the criminal justice system or treating them via other costly healthcare settings 

(e.g., emergency rooms, critical care units).

In 1990, the Stewart B. McKinney Homeless Assistance Amendments Act authorized the PATH 

program to provide services to individuals who are experiencing homelessness and SMI. The 

 

37 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2014). The 2014 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.hudexchange.info/resources/documents/2014-AHAR-Part1.pdf 

38 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2010). The 2010 Annual Homeless Assessment Report (AHAR) to Congress. Available 

at: https://www.hudexchange.info/resources/documents/2010HomelessAssessmentReport.pdf 

39 National Alliance on Mental Illness. Mental Health by the Numbers. Available at: https://www.nami.org/LearnMore/Mental-Health-By-the-Numbers

40 Office of National Drug Control Policy. Integrate Treatment for Substance Use Disorders into Mainstream Health 

Care and Expand Support for Recovery. Available at: https://www.whitehouse.gov/ondcp/chapter-integratetreatment-for-substance-use-disorders 41 National Alliance on Mental Illness (2004). Homelessness. Available at: 

http://www2.nami.org/Content/ContentGroups/Policy/Fact_Sheets/homelessnessPFS.pdf
102 

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. PATH funds community-based 

outreach, mental illness and substance abuse treatment services, case management, assistance with 

accessing housing, and other supportive services. PATH helps to engage people with SMI into 

mental disorder treatment. PATH outreach workers specialize in engaging those who are most 

vulnerable in their communities and who are least likely to seek out services on their own. PATH’s 

primary goal is to bring the most vulnerable into the service system and to connect them with the 

mainstream resources and supportive services that they need in order to access and sustain stable 

housing, build social connections, and access treatment and services to support their recovery. 

In FY 2016, the PATH program outreached to 181,336 individuals experiencing homelessness and 

enrolled 60 percent of individuals with SMI into the PATH program (90,054 individuals). 

Additionally, 53 percent of enrolled individuals were experiencing a co-occurring drug/alcohol 

addiction. Of those enrolled in PATH, 56,405 individuals received community mental health 

services. In addition, 10,372 individuals received substance abuse treatment through PATH, while 

17,318 individuals were referred by PATH to substance abuse treatment services in the 

community. In addition, PATH assisted 17,232 individuals with addressing complex housing 

needs and referred 25,911 individuals to housing assistance agencies in their communities. The 

services provided by the PATH program fill gaps in existing community resources and play a 

crucial role in communities’ strategic plans to end homelessness. In FY 2017 and under the 

FY 2018 Annualized CR level, SAMHSA continued support for this program. 

Funding History

Fiscal Year Amount

FY 2015 $64,635,000 

FY 2016 $64,635,000 

FY 2017 $64,635,000

FY 2018 $64,196,000

FY 2019 $64,635,000

Budget Request 

The FY 2019 President’s Budget request is $64.6 million, an increase of $439,000 from the 

FY 2018 Annualized CR. This formula-based funding to all states will continue PATH services 

in over 500 communities that the states provide funding to in order to support outreach workers 

and mental health specialists that engage with individuals who are living with SMI or those living 

with both SMI and drug/alcohol addiction and are homeless or at imminent risk of becoming 

homeless. The services provided by the program help ensure that these individuals have an 

opportunity to access stable housing, improve their health and wellness, lead self-directed lives, 

and achieve their full potential. 
103 

Outputs and Outcomes Table

Program: Projects for Assistance in Transition from Homelessness

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.4.15 Increase the percentage of 

enrolled homeless persons in the 

Projects for Assistance in Transition 

from Homelessness (PATH) program 

who receive community mental 

health services. (Intermediate 

Outcome)

FY 2016: 54 %

Target: 66 %

(Target Not Met)

66 % 66 % Maintain

3.4.16 Increase the number of 

homeless persons contacted. 

(Outcome)

FY 2016: 174,978

Target: 191,926 

(Target Not Met)

174,978 174,978 Maintain

3.4.17 Increase the percentage of 

contacted homeless persons with 

serious mental illness who become 

enrolled in services. (Outcome)

FY 2016: 57 %

Target: 58 %

(Target Not Met)

57 % 57 % Maintain

3.4.20 Increase the 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 2016: 1,800

Target: 2,296

(Target Not Met but Improved)

2,296 2,296 Maintain
104 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150 

State/Territory

FY 2017 

Final

FY 2018

Annualized 

CR

FY 2019

President's 

Budget

FY 2019

+/- 

FY 2018

Alabama $612,850 $608,363 $610,179 $1,816

Alaska 300,000 300,000 300,000 ---

Arizona 1,348,828 1,338,952 1,342,948 3,996

Arkansas 303,838 301,614 302,514 900

California 8,810,100 8,745,597 8,771,696 26,099

Colorado 1,018,772 1,011,313 1,014,331 3,018

Connecticut 799,100 793,249 795,616 2,367

Delaware 300,000 300,000 300,000 ---

District of Columbia 300,000 300,000 300,000 ---

Florida 4,332,860 4,301,137 4,313,973 12,836

Georgia 1,669,441 1,657,218 1,662,164 4,946

Hawaii 300,000 300,000 300,000 ---

Idaho 300,000 300,000 300,000 ---

Illinois 2,704,272 2,684,472 2,692,483 8,011

Indiana 1,011,159 1,003,755 1,006,751 2,996

Iowa 334,444 331,996 332,986 990

Kansas 377,262 374,500 375,617 1,117

Kentucky 468,743 465,312 466,700 1,388

Louisiana 732,795 727,430 729,601 2,171

Maine 300,000 300,000 300,000 ---

Maryland 1,271,101 1,261,794 1,265,560 3,766

Massachusetts 1,558,333 1,546,924 1,551,541 4,617

Michigan 1,728,977 1,716,318 1,721,440 5,122

Minnesota 810,710 804,774 807,176 2,402

Mississippi 300,000 300,000 300,000 ---

Missouri 893,474 886,933 889,580 2,647

Montana 300,000 300,000 300,000 ---

Nebraska 300,000 300,000 300,000 ---

Nevada 615,728 611,220 613,044 1,824

New Hampshire 300,000 300,000 300,000 ---
105 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Projects for Assistance in Transition from Homelessness (PATH)

CFDA # 93.150 

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

New Jersey 2,137,423 2,121,774 2,128,106 6,332

New Mexico 300,000 300,000 300,000 ---

New York 4,221,694 4,190,784 4,203,291 12,507

North Carolina 1,379,141 1,369,043 1,373,129 4,086

North Dakota 300,000 300,000 300,000 ---

Ohio 1,985,819 1,971,280 1,977,163 5,883

Oklahoma 452,678 449,364 450,705 1,341

Oregon 630,795 626,177 628,046 1,869

Pennsylvania 2,366,093 2,348,769 2,355,779 7,010

Rhode Island 300,000 300,000 300,000 ---

South Carolina 679,989 675,010 677,025 2,015

South Dakota 300,000 300,000 300,000 ---

Tennessee 909,460 902,801 905,496 2,695

Texas 4,993,867 4,957,303 4,972,098 14,795

Utah 591,275 586,945 588,697 1,752

Vermont 300,000 300,000 300,000 ---

Virginia 1,471,713 1,460,937 1,465,297 4,360

Washington 1,328,716 1,318,988 1,322,924 3,936

West Virginia 300,000 300,000 300,000 ---

Wisconsin 836,367 830,243 832,721 2,478

Wyoming 300,000 300,000 300,000 ---

Puerto Rico 890,817 884,294 886,933 2,639

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 ---
106 

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107 

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR

PAIMI.................................................................... $36,146 $35,901 $36,146 $245

Authorizing Legislation ................................................... The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ................................................................................................... Formula Grants

Eligible Entities ............................................................................................... States and Territories

Program Description and Accomplishments

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) program ensures that 

the most vulnerable individuals with serious mental illness, especially those residing in public and 

private residential care and treatment facilities, are free from abuse, including inappropriate 

restraint and seclusion, neglect, and rights violations 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 and private care and treatment facilities. The PAIMI Act authorized the same 

governor-designated state protection and advocacy (P&A) systems established under the DD Act 

of 1975 to receive PAIMI Program formula grant awards from SAMHSA. The PAIMI Program 

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 for abuse, neglect, 

and rights violations while residing in public or private care or treatment facilities 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. 

In FY 2016, the 57 state PAIMI Programs: 

• Served 11,197 PAIMI-eligible individuals/clients: 2,520 children and youth (ages 0 to 18), 

7,987 adults (ages 19 to 64), and 690 older adults (age 65 and older). These individuals 

filed 9,344 complaints alleging abuse, neglect, and/or rights violations. 
108 

• Resolved 91 percent of abuse allegations, 89 percent of neglect allegations, and 92 percent 

of rights violations allegations, and attained outcomes that resulted in positive change for 

the clients served. These positive outcomes included receipt of appropriate medical and 

mental disorder treatment; safer, cleaner facility environment; discharge into an 

appropriate community-based setting; and discharge from a nursing facility. 

In FY 2016 and FY 2017, SAMHSA continued to fund 57 annual grants to states and territories as 

well as continued technical assistance activities and support for grantees. Under the FY 2018

Annualized CR level, SAMHSA would continue to support for this program. 

Funding History

Fiscal Year Amount

FY 2015 $36,146,000 

FY 2016 $36,146,000 

FY 2017 $36,146,000

FY 2018 $35,901,000

FY 2019 $36,146,000

Budget Request 

The FY 2019 President’s Budget Request is $36.1 million, an increase of $245,000 from the 

FY 2018 Annualized CR. Funding will support the continuation of the PAIMI grants in order to 

serve the same number of individuals, approximately 11,000-15,000, as in past years. This 

program will continue to assist individuals with serious mental illness increase access to treatment. 

These grantees protect and advocate for the rights of individuals with mental illness and investigate 

incidents of abuse and neglect of individuals with mental illness if the incidents are reported to the 

system or if there is probable cause to believe that the incidents occurred. 
109 

Outputs and Outcomes Table 

Program: Protection and Advocacy for Individuals with Mental Illness

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.4.12 Increase the number of 

people served by the PAIMI 

program. (Outcome)

FY 2016: 11,197 

Target: 15,925 

(Target Not Met)

11,197 11,197 Maintain

3.4.19 Increase the number 

attending public education/ 

constituency training and public 

awareness activities. (Output)

FY 2016: 98,441

Target: 139,427 

(Target Not Met but Improved)

139,427 139,247 Maintain

3.4.21 Increase percentage of 

complaints of alleged abuse, 

neglect, and rights violations 

substantiated and not withdrawn by 

the client that resulted in positive 

change through the restoration of 

client rights, expansion or 

maintenance of personal decisionmaking, elimination of other 

barriers to personal decisionmaking, as a result of Protection and 

Advocacy for Individuals with 

Mental Illness (PAIMI) 

involvement (Outcome)

FY 2016: 91 %

Target: 87 %

(Target Exceeded)

91 % 91 % Maintain
110 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

rotection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138 

P

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

Alabama $453,952 $455,298 $457,437 $2,139

Alaska 428,000 425,100 428,000 3

Arizona 626,682 629,701 638,466 8,765

Arkansas 428,000 425,100 428,000 3

California 3,140,635 3,079,038 3,062,888 -16,150

Colorado 438,159 440,297 448,981 8,684

Connecticut 428,000 425,100 428,000 3

Delaware 428,000 425,100 428,000 3

District of Columbia 428,000 425,100 428,000 3

Florida 1,738,714 1,749,217 1,775,184 25,967

Georgia 925,906 927,473 928,540 1,067

Hawaii 428,000 425,100 428,000 3

Idaho 428,000 425,100 428,000 3

Illinois 1,066,670 1,043,625 1,039,118 -4,507

Indiana 600,047 588,521 590,481 1,960

Iowa 428,000 425,100 428,000 3

Kansas 428,000 425,100 428,000 3

Kentucky 428,000 425,100 428,000 3

Louisiana 428,000 425,100 428,000 3

Maine 428,000 425,100 428,000 3

Maryland 466,105 463,731 463,294 -437

Massachusetts 507,663 499,407 501,833 2,426

Michigan 887,795 872,732 871,730 -1,002

Minnesota 445,887 443,077 447,152 4,075

Mississippi 428,000 425,100 428,000 3

Missouri 537,097 538,451 543,537 5,086

Montana 428,000 425,100 428,000 3

Nebraska 428,000 425,100 428,000 3

Nevada 428,000 425,100 428,000 3

New Hampshire 428,000 425,100 428,000 3
111 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Protection and Advocacy for Individuals with Mental Illness (PAIMI)

CFDA # 93.138 

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

New Jersey 678,311 670,834 671,532 698

New Mexico 428,000 425,100 428,000 3

New York 1,522,109 1,496,525 1,503,131 6,606

North Carolina 909,472 906,431 912,834 6,403

North Dakota 428,000 425,100 428,000 3

Ohio 1,019,483 1,012,261 1,015,748 3,487

Oklahoma 428,000 425,100 428,000 3

Oregon 428,000 425,100 428,000 3

Pennsylvania 1,058,552 1,044,467 1,048,220 3,753

Rhode Island 428,000 425,100 428,000 3

South Carolina 457,957 456,991 462,608 5,617

South Dakota 428,000 425,100 428,000 3

Tennessee 588,878 585,671 590,456 4,785

Texas 2,278,953 2,305,423 2,391,127 85,704

Utah 428,000 425,100 428,000 3

Vermont 428,000 425,100 428,000 3

Virginia 671,652 669,292 675,772 6,480

Washington 573,587 573,276 577,268 3,992

West Virginia 428,000 425,100 428,000 3

Wisconsin 494,807 489,789 493,300 3,511

Wyoming 428,000 425,100 428,000 3

Puerto Rico 528,202 525,206 510,845 -14,361

American Samoa 229,300 227,800 229,300 ---

Guam 229,300 227,800 229,300 ---

American Indian 

Consortium 229,300 227,800 229,300 ---

Northern Mariana Islands 229,300 227,800 229,300 ---

Virgin Islands 229,300 227,800 229,300 ---
112 

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113 

Community Mental Health Services Block Grant (MHBG)

(Dollars in thousands) 

FY 2017 

Final 

FY 2018 

Annualized 

CR 

FY 2019 

President's 

Budget 

FY 2019 

President's 

Budget +/- 

FY 2018 

Annualized 

CR 

Community Mental Health Services Block Grant......... $562,571 $558,751 $562,571 $3,820

PHS Evaluation Funds (non-add)........................... 21,039 20,896 21,039 143

Authorizing Legislation...............................Sections 1920 of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ..................................................................................................... Formula Grant

Eligible Entities .................. States, Territories, Freely Associated States, and District of Columbia

Program Description and Accomplishments

Serious mental illnesses are more common in the United States than is generally realized. 

According to the 2015 Behavioral Health Barometer: United States, approximately 4.1 percent of 

U.S. adults (an estimated 9.8 million individuals) reported having a serious mental illness (SMI) 

within the year prior to being surveyed.42,43 Nearly a third of these individuals did not receive any 

services in the year before being surveyed.44

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.45 The MHBG distributes funds for a variety of 

services and for planning, administration, and educational activities. By statute, these services and 

activities must support community-based mental health services for children with serious 

emotional disturbances and adults with serious mental illness. MHBG services include: outpatient 

treatment for serious mental illnesses, 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 are 

homeless, those in rural and frontier areas, military families, and veterans). Through the 

 

42 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-

4984, NSDUH Series H-51)

43 Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States, 2015. 

HHS Publication No. SMA–16–Baro–2015. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 

44 Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States, 2015. 

HHS Publication No. SMA–16–Baro–2015. Rockville, MD: Substance Abuse and Mental Health Services 

Administration, 2015. 

45 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
114 

administration of the MHBG, SAMHSA supports implementation of practices demonstrated and 

proven effective in the Mental Health Programs of Regional and National Significance (PRNS) 

portfolio. 

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 approximately 

seven million individuals with mental and substance use conditions in any given year. The Block 

Grant’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 systems. 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 Abuse Prevention and Treatment Block Grant (SABG) 

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 versus an annual plan, and provide information regarding their efforts 

to respond to various changes in federal and state law.46,47 Permitting MHBG recipients to submit 

the application/plan biennially reduces the burden on states.

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 Substance Abuse Prevention and Treatment 

Block Grant (SABG) as well as other SAMHSA-funded efforts such as the systems of care for 

children and adolescents supported through the Children’s Mental Health Initiative. 

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. The following outcomes for all people 

served by the publicly funded mental health system during 2016 show that: 

• For the 58 states and territories that reported data in the Employment Domain, 24.5 percent 

of the mental health consumers were in competitive employment;

 

46 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). 

47 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x32(b)).
115 

• For the 58 states and territories that reported data in the Housing Domain, 82.5 percent of 

the mental health consumers were living in private residences; 

• For the 58 states and territories that reported data in the Access/Capacity Domain, state 

mental health agencies provided mental health services for approximately 22.73 people per 

1,000 population; 

• For the 50 states and territories that reported data in the Retention Domain, only 8.8 percent 

of the patients returned to a state psychiatric hospital within 30 days of state hospital 

discharge; and

• For the 48 states and territories that reported data in the Perception of Care Domain, 

71.8 percent of adult mental health consumers improved functioning as a direct result of 

the mental health services they received. 

Set-aside for Evidence-based Programs That Address Needs of Individuals with Early Serious 

Mental Illness

Starting in FY 2014, states were required to set aside five percent of their MHBG funds to support 

“evidence-based programs that address the needs of individuals with early serious mental illness, 

including psychotic disorders.”48 SAMHSA is collaborating with the National Institute of Mental 

Health and states to implement this provision.

The majority of individuals with serious mental illness 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 abuse, increased hospitalizations, and reduced prospects for long-term 

recovery.

The five percent set-aside allocated to states totaling approximately $24.2 million per year in 

FY 2014 and FY 2015 supported implementation of evidenced-based models that seek to address 

treatment of serious mental illness at an early stage through reducing symptoms and relapse rates, 

and preventing deterioration of cognitive function in individuals living with psychotic illness. In 

FY 2016, Congress increased the set-aside to 10 percent; through this funding, the number of states 

with fully implemented operating first-episode treatment programs is 39 and SAMHSA continues 

to monitor and ensure that the set-aside program is solely used to address first-episode psychosis. 

Beginning in September 2016, SAMHSA, in partnership with NIMH, initiated a 3-year evaluation 

study of such programs funded through the MHBG set-aside to ensure that funds are only used for 

programs showing strong evidence of effectiveness and target first episode of psychosis. In 

FY 2017, SAMHSA continued support for the MHBG and maintained the ten percent set-aside. 

Under the FY 2018 Annualized CR level, SAMHSA would continue support for the MHBG and 

maintain the ten percent set-aside.

 

48 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf
116 

The table below identifies activities, which have been implemented with the 10 percent set-aside. 

State FY 2017

10% Set 

Aside 

Allotment

Program Description

Alabama $776,624 Statewide EASA (Early Assessment and Support Alliance) program 

model is being developed and implemented. 

Alaska $113,049 A CSC (Coordinated Specialty Care) Program model is in the 

process of being developed and implemented. 

American 

Samoa

$10,392 Training 2-4 peer support specialists to begin FEP outreach. 

Arizona $1,291,492 An EPICENTER FEP program is operational in Phoenix and in 

Tucson. 

Arkansas $481,445 Developing portions of CSC model in thirteen locations.

California $7,418,311 Forty-one CSC programs, from several different models, are in 

various states of development throughout CA. Thirty-seven are 

fully operational. 

Colorado $884,527 Implementing four CSC (OnTRACKUSA) programs, three in the 

Denver area and one in the rural northeastern portion of the state. 

Connecticut $559,824 State is implementing two programs based on two distinct CSC 

models (Potential and STEP).

District of 

Columbia 

$122,338 As part of the implementation of a CSC program. Training staff on 

Cognitive Behavioral Therapy for individuals experiencing 

psychosis. 

Delaware $161,013 A statewide program, CORE (Community Outreach, Referral and 

Early Intervention), has been implemented. 

Florida $3,671,016 State has implemented five CSC programs. All of these programs 

are based on the Navigate model.

Georgia $1,762,259 State has implemented six CSC programs. All programs are based 

on the LIGHT-ETP model. 

Guam $30,690 Staff have begun providing services in the I Fine'na program, which 

is based on OnTrackNY.

Hawaii $298,296 State has implemented a program in Honolulu based on the 

OnTRACK model.

Idaho $257,357 Three CSC programs have been implemented. 

Illinois $2,052,910 State has implemented CSC programs in 11 locations throughout 

the state.

Indiana $953,262 State is establishing four programs based on the PARC model and 

making use of a "hub and spoke" design. 

Iowa $427,942 State has two functioning CSC programs and is in the process of 

contracting for four additional locations/programs. 

Kansas $402,649 State has one fully functional CSC program in Kansas City and is 

operationalizing a second program in Topeka. 
117 

State FY 2017

10% Set 

Aside 

Allotment

Program Description

Kentucky $696,021 Six EASA CSC program sites are operational and two more are 

being developed. State is also developing data infrastructure to 

track outcomes. 

Louisiana $653,029 Three sites are in the process of being implemented. These 

programs are using the Navigate CSC model. 

Maine $214,240 State has implemented one program based on the PIER Model. 

The state has also contracted with the PIER program to train staff 

at two other providers to provide FEP services. 

Marshall Islands $13,531 Marshall Islands is using the set-aside block grant funding to 

develop first episode outreach practices and protocols for 

individuals experiencing FEP. 

Maryland $913,003 The state has implemented four CSC programs, two in Baltimore, 

one in Gaithersburg and one in Catonsville. They are continuing 

to develop staff expertise in the FEP approaches. 

Massachusetts $1,063,752 Massachusetts has developed two CSC programs, one in Boston 

and a second in western Mass. They are using the PREP model of 

CSC. 

Michigan $1,650,729 The State has implemented three CSC programs and are in the 

process of developing three additional locations. They are using 

the NAVIGATE CSC model. 

Federated States of 

Micronesia

$20,145 Funds are being used to train staff on the OnTrack CSC model in 

four locations. 

Minnesota $797,688 State has implemented three CSC teams (across two programs) in 

the Twin Cities area and has issued an RFP for a CSC program in 

a rural part of the state. 

Mississippi $488,430 State is fully implementing the NAVIGATE CSC programs to 

provide training and technical assistance to two CSC teams.

Missouri $895,085 State has established eight CSC sites spread throughout the state.

Montana $163,298 The state is implementing the NAVIGATE model in one site for 

the state. 

Nebraska $246,923 Nebraska has implemented OnTrackUSA in two of the six 

behavioral health service regions of the state.
118 

State FY 2017

10% Set 

Aside 

Allotment

Program Description

Nevada $569,929 Nevada has implemented one CSC program in the Reno area 

and a second program in the Las Vegas area using the 

RAISE TEAM approach. 

New Hampshire $191,588 The state is using a NAVIGATE training team to train 

Community Mental Health Centers to establish CSC teams 

that will continue to expand beyond the training period, 

using a staged approach. 

New Jersey $1,478,105 New Jersey has implemented three CSC teams adhering to 

the RAISE CSC model. 

New Mexico $325,382 New Mexico 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 $3,314,087 New York is spending set-aside funds to expand its existing 

OnTrackNY program to two new sites with a goal of having 

22 sites by the end of 2017. These sites will include rural and 

less-populated areas. 

North Carolina $1,515,525 North Carolina supports three CSC sites currently operated 

in the state, including one that started accepting clients in 

July 2017. The state will also fully implement a Quality 

Assurance Database developed by the UNC OASIS 

(Outreach and Support Intervention Services) technical 

assistance program, which will be utilized by all FEP sites 

funded through the MHBG (Mental Health Block Grant).

North Dakota $93,964 The state is using the set-aside funds to identify and contract 

with a vendor for the implementation of CSC services.

Northern Mariana 

Islands 

$9,814 The Community Guidance Center is implementing a 

psychoeducation group in FY 2016 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. 

Ohio $1,679,337 State has implemented 14 CSC programs and is currently 

installing three more.
119 

State FY 2017

10% Set 

Aside 

Allotment

Program Description

Oklahoma $579,240 Oklahoma has implemented two NAVIGATE CSC programs 

in Oklahoma City and Tulsa. The state has implemented the 

program Transition to Independence (TIP) in five to six 

CMHCs in Oklahoma, Okmulgee, and Washington Counties 

by funding training, outreach activities and an 

employment/education coach. 

Oregon $727,381 The state has implemented 31 CSC programs that currently 

serve all 36 counties.

Palau $5,000 One CSC team will be supported in a population area of 

roughly 20,000 with 1 percent need annually. 

Pennsylvania $1,876,252 Pennsylvania selected ten program sites for fiscal year 2017-

2018, including two new sites that are intended to serve rural 

populations. 

Puerto Rico $690,214 Puerto Rico has implemented two CSC programs, including the 

PORTI programs in San Juan and Mayagüez. 

Rhode Island $196,114 Rhode Island is using the entire set-aside amount to serve 

individuals ages 16-25 experiencing a first episode of psychosis 

by enhancing the two existing treatment teams so that they will 

be able to serve an additional ten clients.

South Carolina $791,804 South Carolina is funding two programs, the existing, or 

Traditional Program, will be evaluated against the CSC 

Program in terms of clinical and social outcomes. 

South Dakota $114,445 State has implemented two CSC programs in Sioux Falls and 

Rapid City. They have been trained by OnTrackNY. 

Tennessee $1,089,250 Tennessee used the additional funds to expand OnTrackTN to 

two additional sites (for a total of three), create a statewide FEP 

learning collaborative consisting of all three sites, improve 

outcomes, provide rapid access to services including services 

that are linguistically and culturally competent, increase 

awareness and early detection, provide statewide training for 

providers and the community, and increase statewide capacity 

to provide FEP services. In September 2017, the state held a 

conference for all providers in the state to learn about the CSC 

model and FEP in general.

Texas $4,347,182 Texas is in the process of expanding to eight additional 

locations in rural and urban areas across the state. These new 

sites will be able to serve both indigent and Medicaid eligible 

populations.
120 

State FY 2017

10% Set 

Aside 

Allotment

Program Description

Utah $419,638 State has implemented three CSC programs.

Vermont $95,607 Vermont is continuing to partner with the Vermont Cooperative 

for Practice Improvement and Innovation to facilitate the 

initiative including targeted research, implementation, 

workforce development, outreach and education.

Virgin Islands $19,857 Virgin Islands intends to establish a CSC program according to 

the NAVIGATE model.

Virginia $1,187,835 State has established eight CSC programs that are operated 

through the state’s community service boards (CSBs). The 

existing programs will continue to receive training and 

technical assistance to strengthen their clinical service delivery 

skills and to ensure fidelity to the model. 

Washington $1,257,951 Washington has established three CSC programs adhering to 

the NAVIGATE CSC Model. In addition, the state is currently 

establishing two more CSC programs. 

West Virginia $305,198 State has established one CSC program in the Wheeling area.

Wisconsin $873,289 Wisconsin is continuing to fund the CSC model PROPS 

program operated by JMHC in Madison and five rural counties 

north of Madison. In addition, the state is funding a CSC 

program in Milwaukee.

Wyoming $64,221 The state is piloting two CSC programs that are currently 

serving clients.
121 

Funding History

Fiscal Year Amount

FY 2009 420,774,000 

FY 2010 420,774,000 

FY 2011 419,933,000 

FY 2012 459,756,000 

FY 2013 436,809,376 

FY 2014 482,571,000 

FY 2015 482,571,000 

FY 2016 532,571,000 

FY 2017 562,571,000 

FY 2018 558,751,000 

FY 2019 562,571,000 

Budget Request 

The FY 2019 President’s Budget request is $562.6 million, an increase of $3.8 million from the 

FY 2018 Annualized CR. With this funding, SAMHSA will continue to address the needs of 

individuals with SMI and SED and will continue to maintain the ten percent set-aside for evidencebased programs that address the needs of individuals with early serious mental illness, including 

psychotic disorders. The set-aside funds help reduce costs to society, as intervening early helps 

prevent deterioration of functioning in individuals experiencing a first episode of serious mental 

illness. 
122 

Outputs and Outcomes Table

Program: Mental Health Block Grant

Note: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Enacted and the FY 2019 targets are based on the FY 2018 President’s Budget.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.3.11 Increase the number of 

evidence based practices (EBPs) 

implemented. (Output)

FY 2016: 4.6 per State

Target: 4.5 per State

(Target Exceeded)

4.6 per State 4.6 per State Maintain

2.3.14 Increase the number of 

people served by the public 

mental health system. (Output)

FY 2016: 7,399,821

Target: 7,620,000 

(Target Not Met)

7,339,821 7,339,821 Maintain

2.3.15 Increase the rate of 

consumers (adults) reporting 

positively about outcomes. 

(Outcome)

FY 2016: 75.7 %

Target: 71.8 %

(Target Exceeded)

75.7 % 75.7 % Maintain

2.3.16 Increase the rate of family 

members (children/adolescents) 

reporting positively about 

outcomes. (Outcome)

FY 2016: 73.5 %

Target: 66.1 %

(Target Exceeded)

73.5 % 73.5 % Maintain

2.3.81 Increase the percentage of 

service population receiving any 

evidence based practice. 

(Outcome)

FY 2016: 11.7 %

Target: 6.2 %

(Target Exceeded)

11.7 % 11.7 % Maintain
123 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Community Mental Health Services Block Grant Program

CFDA #93.958 

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

Alabama $7,766,238 $7,689,598 $7,751,758 $62,160

Alaska 1,130,485 1,108,020 1,094,747 -13,273

Arizona 12,914,921 12,990,602 14,302,111 1,311,509

Arkansas 4,814,450 4,785,464 4,668,655 -116,809

California 74,183,108 73,493,945 72,171,883 -1,322,062

Colorado 8,845,273 8,895,443 10,266,813 1,371,370

Connecticut 5,598,243 5,539,388 5,208,078 -331,310

Delaware 1,610,133 1,601,498 1,244,331 -357,167

District Of Columbia 1,223,382 1,242,006 1,249,876 7,870

Florida 36,710,162 36,929,628 35,028,428 -1,901,200

Georgia 17,622,593 17,618,691 17,166,833 -451,858

Hawaii 2,982,957 2,971,526 2,806,140 -165,386

Idaho 2,573,572 2,569,413 3,041,895 472,482

Illinois 20,529,098 20,161,517 19,323,751 -837,766

Indiana 9,532,616 9,402,339 9,491,586 89,247

Iowa 4,279,421 4,225,546 4,186,060 -39,486

Kansas 4,026,493 3,984,903 3,889,390 -95,513

Kentucky 6,960,209 6,873,537 6,945,506 71,969

Louisiana 6,530,287 6,612,667 7,642,645 1,029,978

Maine 2,142,401 2,124,838 2,116,680 -8,158

Maryland 9,130,026 9,098,670 10,541,659 1,442,989

Massachusetts 10,637,515 10,534,113 10,929,640 395,527

Michigan 16,507,285 16,226,414 15,851,241 -375,173

Minnesota 7,976,879 7,863,935 8,033,726 169,791

Mississippi 4,884,299 4,823,605 4,882,520 58,915

Missouri 8,950,847 8,845,118 8,976,420 131,302

Montana 1,632,975 1,621,121 1,596,734 -24,387

Nebraska 2,469,225 2,450,810 2,407,736 -43,074

Nevada 5,699,289 5,744,659 5,605,524 -139,135

New Hampshire 1,915,877 1,900,322 1,885,122 -15,200
124 

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

FY 2017 DISCRETIONARY STATE/FORMULA GRANTS

Community Mental Health Services Block Grant Program

CFDA #93.958 

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

New Jersey 14,781,050 14,661,166 15,015,386 354,220

New Mexico 3,253,819 3,190,825 3,142,979 -47,846

New York 33,140,871 32,543,235 31,623,473 -919,762

North Carolina 15,155,252 15,184,367 15,389,201 204,834

North Dakota 939,644 865,685 810,698 -54,987

Ohio 16,793,371 16,472,626 16,629,951 157,325

Oklahoma 5,792,397 5,656,138 5,623,520 -32,618

Oregon 7,273,805 7,454,720 8,220,871 766,151

Pennsylvania 18,762,518 18,377,069 17,675,837 -701,232

Rhode Island 1,961,141 1,936,810 2,018,420 81,610

South Carolina 7,918,037 7,925,945 8,022,467 96,522

South Dakota 1,144,445 1,137,677 1,127,968 -9,709

Tennessee 10,892,496 10,783,368 10,231,427 -551,941

Texas 43,471,820 43,597,726 45,054,899 1,457,173

Utah 4,196,380 4,224,023 4,710,898 486,875

Vermont 956,073 943,609 925,272 -18,337

Virginia 11,878,348 11,873,403 13,332,181 1,458,778

Washington 12,579,513 12,614,800 12,492,829 -121,971

West Virginia 3,051,982 2,969,962 2,919,126 -50,836

Wisconsin 8,732,888 8,600,323 9,260,142 659,819

Wyoming 642,205 634,739 616,825 -17,914

American Samoa 103,920 103,408 104,460 1,052

Guam 306,899 307,858 334,211 26,353

Northern Marianas 98,137 99,605 105,179 5,574

Puerto Rico 6,902,140 6,847,260 6,831,465 -15,795

Palau 50,000 50,000 50,000 ---

Marshall Islands 135,308 137,371 146,935 9,564

Micronesia 201,449 200,214 209,699 9,485

Virgin Islands 198,568 197,089 215,287 18,198
125 

SAMHSA

Substance Abuse Prevention

Table of Contents 

1. Substance Abuse Prevention Appropriation ......................................................................... 127 

2. Programs of Regional and National Significance (PRNS) ................................................... 128 

a) Strategic Prevention Framework..................................................................................... 129 

b) Federal Drug-Free Workplace ........................................................................................ 134 

c) Minority AIDS................................................................................................................ 137 

d) Sober Truth on Preventing Underage Drinking Act (Stop Act) ..................................... 140 

e) Center for the Application of Prevention Technologies................................................. 143 

f) Science and Service Program Coordination ................................................................... 146

g) Tribal Behavioral Health Grants..................................................................................... 148 

h) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ......................... 151 

i) First Responder Training for Opioid Overdose Reversal Drugs .................................... 153 

j) Minority Fellowship Program......................................................................................... 154 

3. Drug Free Communities........................................................................................................ 157 

4. PRNS Mechanism Table Summary ...................................................................................... 159 

5. PRNS Mechanism Table by Program, Project, and Activity................................................ 160 

6. Grant Awards Table.............................................................................................................. 163 
126 

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127 

Substance Abuse Prevention Appropriation

(Dollars in thousands)

Program Activities

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Programs of Regional and National Significance........... $221,869 $221,703 $120,885 -$100,818

Drug Free Communities1 --- --- $100,000 +$100,000

Total, Substance Abuse Prevention $221,869 $221,703 $220,885 -$818 1 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in FY 2017 and 

at $96.3 million under the FY 2018 Annualized CR. 

The Substance Abuse Prevention FY 2019 President’s Budget Request is $220.9 million, a 

decrease of $0.8 million from the FY 2018 Annualized CR. 
128 

Programs of Regional and National Significance (PRNS)

Substance Abuse Prevention Appropriation

(Dollars in Thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Capacity:

Strategic Prevention Framework.................................... $119,484 $118,673 $58,426 -$60,247

 Strategic Prevention Framework Rx (non-add)............. 10,000 9,932 10,000 68

Federal Drug-Free Workplace................................ 4,894 4,861 4,894 33

Comprehensive Addiction and Recovery Act............... 12,000 11,919 12,000 81

MinorityAIDS................................................................ 40,405 40,925 --- -40,925

Sober Truth on Preventing Underage Drinking Act 

(STOP Act)........................................................ 7,000 6,952 7,000 48

Grants to Prevent Prescription Drug/Opioid Overdose 

Related Deaths................................................ 12,000 11,919 12,000 81

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

Subtotal, Capacity

14,450

210,233 

14,898

210,146 

15,000

109,320 

102

-100,826 

Science and Service:

Center for the Application of Prevention Technologies 7,493 7,442 7,493 51

SAP Minority Fellowship Program............................... 71 71 --- -71

Science and Service Program Coordination........... 4,072 4,044 4,072 28

Subtotal, Science and Service 11,636 11,557 11,565 8

Total, PRNS $221,869 $221,703 $120,885 -$100,818

Authorizing Legislation ............................................................... ......Sections 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities............................................................States, political subdivisions of 

 States, Federally Recognized 

 American Indian/Alaska Native tribe or tribal organizations, 

 Indian Health Service-operated and contracted health facilities 

 and programs, public or private nonprofit entities 
129 

Strategic Prevention Framework

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Strategic Prevention Framework............................ $119,484 $118,673 $58,426 -$60,247

Strategic Prevention Framework Rx (non-add).. 10,000 9,932 10,000 68

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities .................................................................................. States, Tribes, and Territories

Program Description and Accomplishments

Strategic Prevention Framework (SPF) 

Drug and alcohol use are significant public health problems. Youth and adolescents who use 

alcohol and drugs face an increased risk of poor school performance, criminal justice involvement, 

the development of a drug/alcohol addiction, risky sexual behavior, illnesses such as HIV and 

hepatitis, depression and anxiety, and injury and death. The immediate and long-term risks and 

negative outcomes associated with adolescent drug and alcohol use underscore the need for 

effective prevention and treatment programs. 

Youth and adolescents use a variety of substances. In 2015, 27.1 million people aged 12 or older 

used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans (10 percent). 

The illicit drug use estimate for 2015 continues to be driven primarily by marijuana use and the 

misuse of prescription pain relievers, with 22.2 million individuals who currently use marijuana 

aged 12 or older (i.e., past 30 day use) and 3.8 million people aged 12 or older who reported current 

misuse of prescription pain relievers.49

The Strategic Prevention Framework – Partnerships for Success program addresses underage 

drinking among youth and young adults age 12 to 20 and allows states to prioritize State-identified 

top data driven substance abuse target areas. 

Data show that states and communities receiving Partnerships for Success funding have made 

improvements in reducing the impact of substance abuse. The 2015 National Survey on Drug Use 

and Health (NSDUH) shows that underage alcohol use (i.e., people aged 12 to 20) and binge and 

heavy drinking use among young adults aged 18 to 25, have declined over time but remain a 

concern. In 2015, 20.3 percent of underage people reported current use of alcohol, 13.4 percent 

 

49 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators

in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 

16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/
130 

reported binge drinking, and 3.3 percent reported heavy alcohol use. The binge-drinking rate 

declined from 14.2 percent to 13.4 percent, and the rate of heavy drinking declined from 3.7 

percent to 3.3 percent. In 2015, 7.0 percent of adolescents aged 12 to 17 were currently using 

marijuana. This means that approximately 1.8 million adolescents used marijuana in the past 

month. 50

In 2016, the program specifically addressed underage drinking and prescription drug misuse 

among youth and young adults and also encouraged grantees to address issues related to marijuana 

and heroin use. 

The cross-site evaluation for the Partnerships For Success program addresses the following 

questions: 

1) Was the implementation of Partnerships for Success program associated with a reduction 

in underage drinking and/or prescription drug misuse? 

2) Did variability in the total level of funding from all sources relate to outcomes? Did 

variability in the total level of Partnerships for Success funding relate to outcomes, above 

and beyond other funding available to communities? 

3) What intervention type, combinations of interventions, and dosages of interventions were 

related to outcomes at the grantee level? What intervention type, combinations of 

interventions, and dosages of interventions were related to outcomes at the community 

level? 

4) Were some types and combinations of interventions within communities more 

cost- effective than other interventions? 

5) How does variability in factors (strategy selection and implementation, infrastructure, 

geography, demography, sub-recipient selection, Training/Technical Assistance, barriers 

to implementation) relate to outcomes across funded communities? 

In FY 2017, SAMHSA funded 74 Strategic Prevention Framework grant continuations. Under the

FY 2018 Annualized CR, SAMHSA plans to support 48 Strategic Prevention Framework grant 

continuations and 18 new grants. SPF PFS addresses the Nation’s top substance abuse prevention 

priorities including underage drinking. Our nation is at a turning point in how it addresses 

substance-related issues. SAMHSA’s Talk. They Hear You.® media Campaign (TTHY®) 

recommends that messaging about underage drinking and substance use prevention begin by age 

9 in order to shape children’s attitudes and behaviors about substance use.

51 The SPF PFS program 

addresses underage drinking among persons aged 9 to 20. Additionally, states/tribes may use grant 

funds to target up to two additional, data-driven substance abuse prevention priorities targeting 

individuals ages 9 and above. Through expanded partnerships targeting populations in nontraditional settings, the SPF-PFS is designed to ensure that prevention strategies and messages 

reach the populations disproportionately impacted by the consequences of substance use. 

 

50 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators

in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 

16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data. 51 September 6, 2017 Substance Abuse and Mental Health Services Administration, expanded prevention messaging 

(moving beyond underage drinking) for the Talk. They Hear You. media campaign.
131 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

Drug overdose death rates have increased five-fold since 1980.52 Since 2000, the drug overdose 

death rates have more than doubled.53 In 2009, drug overdose deaths outnumbered deaths due to 

motor vehicle crashes for the first time. In the U.S., misuse of prescription drugs, including 

opioid-analgesic pain relievers, is responsible for much of the recent increase in drug-poisoning 

deaths.54

Funding for SAMHSA and the Centers for Disease Control and Prevention (CDC) in FY 2016 was 

part of a strategic effort to address non-medical use of prescription drugs as well as opioid 

overdoses. Leveraging the strengths and capabilities of each agency, SAMHSA and CDC 

partnered to ensure alignment with HHS’s policy and plan for prevention of opioid-related 

overdoses and deaths. CDC provided funding to states to address opioid prescribing on multiple 

fronts, and SAMHSA provided funding to states for the prevention of prescription drug misuse in 

high priority age groups (including young and middle-aged adults) and the public through the 

Strategic Prevention Framework – Partnerships for Success program. 

In FY 2016, SAMHSA implemented the Strategic Prevention Framework for Prescription Drugs 

to assist grantees in developing capacity and expertise in the use of data from state run prescription 

drug monitoring programs (PDMP). Grantees will also raise awareness about the dangers of 

sharing medications and 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 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. SAMHSA awarded 25 grants in FY2016 and FY 2017. SAMHSA

would support 25 grant continuations under the FY 2018 Annualized CR level. 

Funding History

Fiscal Year Amount

FY 2015 $109,484,000

FY 2016 $119,484,000

FY 2017 $119,484,000

FY 2018 $118,673,000

FY 2019 $58,426,000

 

52 Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980–

2008. NCHS data brief, no 81. Hyattsville, MD: National Center for Health Statistics. 2011.

53 Centers for Disease Control and Prevention. NCHS Data on Drug Poisoning Deaths. NCHS Fact Sheet. June 

2015. Hyattsville, MD: National Center for Health Statistics. 2015. Available at 

http://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.pdf. 

54 Paulozzi LJ. Prescription drug overdoses: A review. J. Safety Res 43(4):283–9. 2012.
132 

Budget Request 

The FY 2019 President’s Budget Request is $58.4 million, a decrease of $60.2 million from the 

FY 2018 Annualized CR. Funding for the SPF Rx program will be maintained in its entirety ($10.0

million). Funding will support 25 Strategic Prevention Framework continuation grants at a 

reduced rate, technical assistance, and evaluation to build capacity to address prescription drug 

misuse and overdose prevention efforts, in conjunction with other state and local partners. 
133 

Outputs and Outcomes Table

Program: Partnerships for Success

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/-FY 

2018 

Target

2.3.79 Increase the number of EBPs 

implemented by sub-recipient 

communities (Output)

FY 2016: 531

Target: 650 

(Target Not Met but Improved)

531 531 Maintain

2.3.80 Increase the number of subrecipient communities that 

improved on one or more targeted 

NOMs indicators. (Outcome)

FY 2016: 552

Target: 142 

(Target Exceeded)

552 552 Maintain

Program: Strategic Prevention Framework Rx

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 

targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.3.11 Increase the percent of 

funded states that incorporate 

PDMP data into their needs 

assessments in developing their 

strategic plans. (Outcome)

FY 2016: 72%

Target: 100 %

(Target Not Met))

85 % 85 % Maintain

3.3.12 Increase the percent of 

funded states reporting reductions in 

opioid overdoses. (Outcome)

FY 2016: 52%

Target: 55 % 

(Target Not Met)

55 % 55 % Maintain
134 

Federal Drug-Free Workplace

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Federal Drug-Free Workplace................................... $4,894 $4,861 $4,894 $33

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................................................. Inter-Agency Agreements/Contracts

Eligible Entities ...................................................................... Federal Agencies, Regulated Entities 

(e.g., Department of Transportation, Nuclear Regulatory Commission), 

HHS- Certified Laboratories

Program Descriptions and Accomplishments 

Alcohol and other drug misuse are widespread and have a variety of negative consequences, 

particularly in the workplace. Employers with successful drug-free workplace programs report 

decreases in absenteeism, accidents, downtime, turnover, and theft; increases in productivity; and

overall improved morale. They also report better health status among many employees and family 

members and decreased use of medical benefits. Some organizations with drug-free workplace 

programs qualify for incentives, for example, decreased premium costs for certain kinds of 

insurance, such as Workers’ Compensation. 

In 1986, the President signed an Executive Order mandating that all Federal agencies be drug-free. 

In 1988, Congress passed the Drug-Free Workplace Act.

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 drug testing are inspected and 

certified by HHS. Through this program, the federal government is able to avoid lost productivity 

and reduce absenteeism, injuries, and fatalities. 

SAMHSA implements the Federal Drug-Free Workplace Programs, which consist of two principal 

activities mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. These 

include: 1) oversight of the Federal Drug-Free Workplace Programs, aimed at the elimination of 

the use of illegal drugs and the misuse of prescription drugs 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 

and federally-regulated industries; the private sector also uses the HHS-Certified Laboratories. 

First signed on September 15, 1986, E.O. 12564 requires the head of each executive agency to 

establish a comprehensive Drug-Free Workplace Plan that includes supervisor/employee 

education, an employee assistance program, and a random testing component to test the use of 
135 

illegal substances and the misuse of prescription drugs by federal employees in safety-sensitive 

positions. 

The Supplemental Appropriations Act, 1987 (Public Law 100-71) included language which 

requires HHS to: 1) certify that each Executive Branch agency has developed a plan for achieving 

a drug-free workplace, and 2) publish mandatory guidelines that establish comprehensive 

standards for laboratory drug testing procedures, specify the drugs for which federal employees 

may be tested, and establish standards and procedures for periodic review and certification of 

laboratories to perform drug testing for federal agencies. 

Since FY 2014, SAMHSA has funded the Drug-Free Workplace drug testing activities. These 

activities will continue in FY 2018 under the NLCP contract. The NLCP oversees the certification 

of the labs that perform drug testing under the Drug-Free Workplace Programs. The Drug Testing 

Advisory Board (DTAB) provides recommendations to the Assistant Secretary for Mental Health 

and Substance Use based on an ongoing review of the direction, scope, balance, and emphasis of 

SAMHSA’s drug testing activities and the NLCP. 

On January 10, 2012, SAMHSA approved the DTAB’s recommendations to revise the mandatory 

guidelines to include oral fluid as an alternative specimen to urine as well as include additional 

Schedule II prescription drug medications (e.g., oxycodone, oxymorphone, hydrocodone and 

hydromorphone). On August 7, 2015, SAMHSA approved the DTAB’s recommendations to 

pursue hair as an alternative specimen in the Mandatory Guidelines for Federal Workplace Drug 

Testing Programs. 

CSAP’s Workplace Helpline supports the drug-free workplace program. The helpline is a toll- free 

telephone service (800-WORKPLACE) that answers questions from the public and private sectors 

about drug testing in the workplace. 

Continued funding for the Federal Drug-Free Workplace Programs has ensured the testing of 

federal employees in national security, public health, and public safety positions for the use of 

illegal drugs, the misuse of prescription drugs, and the inspection certification of HHS-certified 

laboratories for the past four years. 

Funding History

Fiscal Year Amount

FY 2015 $4,894,000

FY 2016 $4,894,000

FY 2017 $4,894,000

FY 2018 $4,861,000

FY 2019 $4,894,000
136 

Budget Request 

The FY 2019 President’s Budget Request is $4.9 million, an increase of $33,000 from the FY 2018 

Annualized CR. In FY 2019, SAMHSA will 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 designed testing positions of national security, public health, and public safety, 

and testing for illegal drug use and the misuse of prescription drugs. SAMHSA will continue its 

oversight role for the inspection and certification of the HHS-certified laboratories. 

SAMHSA will continue/add the below items to its drug testing portfolio: 

• DTAB continued evaluation of the scientific supportability of hair as an alternative 

specimen to urine and oral fluids in the Mandatory Guidelines for Federal Workplace Drug 

Testing Programs; 

• Continued use of subject matter experts and partnering with other federal agencies to 

establish the scientific standards set out in the mandatory guidelines; 

• Implementation of the final Urine Specimen Mandatory Guidelines and provide guidance 

on the implementation; 

• Research of alternative specimens for scientific supportability and inclusion in the 

Mandatory Guidelines; 

• Technical and scientific leadership for federal agencies on marijuana testing; and

• Updates to the DFWP website.
137 

Minority AIDS

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Minority AIDS............................................................. $40,405 $40,925 $--- -$40,925

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities ................................ Local Government Entities, Community-based Organization,

Minority Serving Institutions, 

and Institutions of Higher Education 

Program Description and Accomplishments 

The update to the 2010 National HIV/AIDS Strategy for the United States reports that there is still 

an HIV epidemic, which remains a major health issue for the United States. It also notes 

that people across the nation deserve access to tools and education to prevent HIV 

transmission. In 1995, 44 percent of the public indicated that HIV/AIDS was the most urgent 

health problem facing the U.S., compared to only six percent in 2009. Approximately 40,000 

people become infected with HIV each year.56 In addition, because HIV and viral hepatitis 

share common modes of transmission, one third of HIV infected individuals are also infected 

with hepatitis C.

57 Hepatitis C cases are also increasing because of the use of injection drugs. 

The Minority AIDS program supports activities that assist grantees in building a solid foundation 

for delivering and sustaining quality and accessible state-of-the-science substance misuse and HIV 

prevention services. The program aims to engage community-level domestic public and private 

non-profit entities, tribes, and tribal organizations in order to prevent and reduce the onset of 

substance misuse and transmission of HIV/AIDS among at-risk populations, including 

racial/ethnic minority youth and young adults, ages 13 to 24. SAMHSA works with college and 

university clinics/wellness centers and community-based providers that can provide 

comprehensive substance abuse and HIV prevention strategies. These strategies combine 

education and awareness programs, social marketing campaigns, and HIV and viral hepatitis 

testing services in non-traditional settings with substance misuse and HIV prevention 

programming for the population of focus. Because of the high rate of HIV/AIDS and hepatitis 

co- morbidity, this program includes viral hepatitis prevention and education training. 

56 Centers for Disease Control and Prevention. Trends in U.S. HIV Diagnoses, 2005-2014. February, 2016; 

https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-data-trends-fact-sheet-508.pdf. 57 Action Plan for the Prevention, Care and Treatment of Viral Hepatitis, 

http://www.hhs.gov/ash/initiatives/hepatitis/
138 

SAMHSA helps to prevent HIV and hepatitis infection acquired through substance misuse and 

other means. SAMHSA’s Minority AIDS programs address. SAMHSA HIV/AIDS prevention 

programs have included a focus on community-based organizations and minority serving 

institutions and a focus on the continuum of care. 

Funding History

Fiscal Year Amount

FY 2015 $41,205,000 

FY 2016 $41,205,000 

FY 2017 $40,405,000 

FY 2018 $40,925,000 

FY2019 ---

Budget Request 

The FY 2019 President’s Budget Request is $0.0 million, a decrease of $40.9 million from the 

FY 2018 Annualized CR. SAMHSA is eliminating this program because it overlaps with other 

federal activities. 

States will be able to provide services to reduce injection drug use and related HIV/AIDS and 

Hepatitis C infection rates through $150 million in new funding proposed as part of the Additional 

Opioid Allocation described on page 259. 
139 

Outputs and Outcomes Table

Program: Minority AIDS 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 

targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.3.56 Increase the number of 

program participants exposed to 

substance abuse prevention 

education services. (Output)

FY 2016: 3,332

Target: 2,580 

(Target Exceeded)

2,580 2,580 Maintain

2.3.83 Increase the percent of 

program participants who report no 

use of alcohol at pre-test who 

remain non-users at post-test (all 

ages). (Outcome)

FY 2016: 84%

Target: 91.2%

(Target Not Met)

85.7% 85.7% Maintain

2.3.85a Increase the number of 

persons tested for HIV through the 

Minority AIDS Initiative prevention 

activities. (Outcome)

FY 2016: 23,280

Target: 35,074 

(Target Not Met)

21,137 21,137 Maintain
140 

Sober Truth on Preventing Underage Drinking Act (STOP Act)

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Sober Truth on Preventing Underage Drinking Act 

(STOP Act).......................................... $7,000 $6,952 $7,000 $48

Authorizing Legislation ......................................................................Section 519B of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................. Competitive Grants/Contracts

Eligible Entities ............................................ Current and former Drug-Free Communities grantees

Program Description and Accomplishments

Underage drinking continues to be a national concern. It disrupts the lives of individuals and 

families and imposes great costs on communities. Alcohol-related consequences include 

impairments in cognitive abilities (e.g., decision-making and impulse control) and motor skills 

(e.g., balance and hand-eye coordination), death, injury, physical and sexual assault, unsafe sex, 

health problems, suicide attempts, memory loss, and more.58 Those who report being intoxicated 

at least once a week have a higher likelihood of becoming injured and needing medical treatment, 

causing injury in traffic crashes, and being taken advantage of sexually.59 Twenty-five percent of 

college students report academic consequences of their drinking, including missing class, falling 

behind in class, doing poorly on exams, and receiving lower grades overall.60

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 $50,000 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. 

Strong prevention efforts are necessary to continue to address underage drinking. These efforts 

have proven effective. Over the past decade, a large number of evaluation studies have 

demonstrated the far-reaching effects of prevention interventions in reducing alcohol, tobacco, and 

other drug abuse as well as delinquent behaviors; violence; and other mental, emotional, and 

behavioral health problems.61

 

58 Chaloupka, Grossman, & Saffer, 2002; O'Brien et al., 2013; White & Hingson, 2013. 59 White & Hingson, 2013. 60 White & Hingson, 2013. 61 e.g., Calear & Christensen, 2010; Lemstra et al., 2010; Ttofi & Farrington, 2011.
141 

In both FY 2011 and FY 2012, SAMHSA conducted program evaluations of the STOP Act grant 

program. The findings indicated that the program was accomplishing its intended goal of 

enhancing underage drinking prevention efforts in coalition communities around the country. 

In mid-2014, SAMHSA began conducting a retrospective national cross-site evaluation of the 

STOP Act grant program. 

In 2015, there were 138.3 million Americans aged 12 or older who reported current use of alcohol, 

including 66.7 million who reported binge alcohol use in the past month and 17.3 million who reported 

heavy alcohol use in the past month. Individuals with past month binge drinking and heavy alcohol 

use represented 24.9 and 6.5 percent of people aged 12 or older, respectively. 

FY 2016 data showed that 82 percent of coalitions report at least 5 percent improvement in the

 30-day use of alcohol in at least two grades. 

In FY 2017, SAMHSA provided funding for 81 STOP Act grant continuations and 17 new grants. 

Under the FY 2018 Annualized CR level, SAMHSA would continue these grants. 

Funding History

Fiscal Year Amount

FY 2015 $7,000,000

FY 2016 $7,000,000

FY 2017 $7,000,000

FY 2018 $6,952,000

FY2019 $7,000,000

Budget Request 

The FY 2019 President’s Budget Request is $7.0 million, an increase of $48,000 from the FY 2018 

Annualized CR. In FY 2019, SAMHSA will support 95 STOP Act grant continuations. This 

funding will continue to strengthen SAMHSA’s commitment to reduce and prevent underage 

drinking. 
142 

Outputs and Outcomes Table

Program: Sober Truth on Preventing Underage Drinking (STOP Act)

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 

Annualized CR. 

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.3.01 Increase the percent of 

coalitions that report at least 5 

percent improvement in the past 30-

day use of alcohol in at least two 

grades. (Outcome)

FY 2016: 63.6 %

Target: 62.0 %

(Target Exceeded)

62.0 % 62.0 % Maintain

3.3.02 Increase the percent of 

coalitions that report improvement 

in youth perception of risk from 

alcohol in at least two grades. 

(Outcome)

FY 2016: 72.7 %

Target: 68 %

(Target Exceeded)

70.0 % 70.0 % Maintain
143 

Center for the Application of Prevention Technologies

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Center for the Application of Prevention Technologies $7,493 $7,442 $7,493 $51

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................................. Contracts 

Eligible Entities ................................................................................... Domestic and Public Entities

Program Description and Accomplishments

SAMHSA’s Center for the Application of Prevention Technologies (CAPT) program provides 

state-of-the-art training and technical assistance to build the capacity of SAMHSA grantees and 

develop the skills, knowledge, and expertise of the prevention workforce. The program builds 

capacity and promotes the development of substance abuse prevention professionals in the 

behavioral health field through three core strategies: 1) establishing technical assistance networks 

using local experts; 2) developing and delivering targeted training and technical assistance 

activities; and 3) using communication media such as teleconference and video conferencing, 

online events, and web-based support. These activities help ensure the delivery of effective 

prevention programs and practices and the development of accountability systems for performance 

measurement and management. 

During FY 2013, the program completed a comprehensive revision and update of its flagship 

Substance Abuse Prevention Skills Training (SAPST), which offers participants 31 training hours 

toward certification as a Substance Abuse Prevention Specialist. The CAPT also developed a 

Pacific Islander and Native American adaptation of the training for six additional training hour 

credits. Through FY 2016, the CAPT continued to develop comprehensive training and technical 

assistance products. These products focus on shared risk and protective factors to promote 

collaboration across substance abuse and mental health disciplines within the behavioral health 

field. 

The program is increasing emphasis on virtual or distance forms of service delivery and relying 

more heavily on webinars and online training. The CAPT program developed a series of selfpaced courses to increase the capacity of community-level grantees to use epidemiological data to 

guide their prevention planning efforts, as well as webinars and coaching consultations to help 

grantees identify risk and protective factors and appropriate strategies to address emerging 

prevention needs such as prescription drug misuse and youth marijuana use. In FY 2015, the 

CAPT supported the organizational capacity of high-need communities to address health 

disparities and achieve benchmarks identified in SAMHSA’s Partnerships for Success program. 

CAPT continues to strengthen the prevention workforce, overall, by increasing the availability of 

interactive virtual trainings on using epidemiological data and risk and protective factors to guide 
144 

implementation of effective prevention strategies. Data show that over 8,400 participants were 

trained and 94 percent agreed or strongly agreed that the TA increased their capacity to do 

substance abuse prevention work. 

In FY 2016, CAPT expanded its scope of work by providing technical assistance to new SAMHSA 

grantees in the SPF Rx program as well as Grants to Prevent Prescription Drug/Opioid Overdose 

Related Deaths program. 

In FY 2017, funding continued to support the delivery of technical assistance and workforce 

development to the prevention field. 

Under the FY 2018 Annualized CR level, funding would continue to provide technical assistance 

through a robust approach to regional Centers for Applied Prevention TA delivery to the 

prevention field.

Funding History

Fiscal Year Amount

FY 2015 $7,493,000

FY 2016 $7,493,000

FY 2017 $7,493,000

FY 2018 $7,442,000

FY2019 $7,493,000

Budget Request 

The FY 2019 President’s Budget Request is $7.5 million, an increase of $51,000 from the 

FY 2018 Annualized CR. The program will continue to provide regionally based technical 

assistance and training to over 9,000 individuals in the prevention field. 
145 

Outputs and Outcomes Table

Program: Center for the Application of Prevention Technologies (CAPT)

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 

targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018 

Target

1.4.11 Prevention: increase the 

number of individuals trained by the 

CAPT. (Output)

FY 2016: 8,874

Target: 5,216

(Target Exceeded)

9,000 9,000 Maintain

1.4.12 Increase the percent of 

participants that agree or strongly 

agree that the training or TA 

provided increased their capacity to 

do substance abuse prevention 

work. (Outcome)

FY 2016: 94.0 %

Target: 90.0 %

(Target Exceeded)

90.0% 90.0% Maintain

1.4.13 Increase the percent of 

participants that agree or strongly 

agree that the training or TA 

provided increased their 

organization's capacity to do 

substance abuse prevention work. 

(Outcome)

FY 2016: 98

Target: 92 

(Target Exceeded) 

95 95 Maintain
146 

Science and Service Program Coordination

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Science and Service Program Coordination.......... $4,072 $4,044 $4,072 $28

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................................. Contracts 

Eligible Entities ................................................................................... Domestic and Public Entities

Program Description and Accomplishments

SAMHSA has made prevention of underage drinking a priority because of its potential impact on 

the health and well-being of young people and their communities. Over the past decade, there has 

been a steady decline in past month or current drinking by adolescents and young adults. Trend 

data report similar declines in underage binge and heavy drinking. In fact, among 8th to 12th grade 

students, rates of current, binge, and heavy drinking have declined to record lows.62 Yet, alcohol 

remains the drug of choice for individuals between the ages of 12 to 20 years, and risky and heavy

drinking among college-age youth students remains unacceptably high. 63

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around substance abuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance 

Center and the Underage Drinking Prevention Education Initiatives (UADPEI). 

The Tribal Training and Technical Assistance 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 abuse, and suicide among American Indian/Alaska Native (AI/AN) youth, in support of 

the HHS Tribal Health and Well-Being Coordination. These plans mobilize tribal communities’ 

existing social and educational resources to meet their goals. 

The Underage Drinking Prevention Education Initiatives engage parents and other caregivers, 

schools, communities, all levels of government, all social systems that interface with youth, and 

youth themselves in a coordinated national effort to prevent and reduce underage drinking and its 

consequences. Through this initiative, families, their children, and other youth-serving 

organizations have been reached through Town Hall Meetings, technical assistance, trainings, and 

 

62 Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2017). Monitoring the 

Future national survey results on drug use, 1975-2016: Overview, key findings on adolescent drug use. Ann Arbor: 

Institute for Social Research, the University of Michigan.

63 Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: 

Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
147 

a variety of tools and materials. Efficiencies have been achieved from the growing focus on trainthe-trainer models rather than training of individuals. 

In FY 2016, community-based organizations registered to host 1,500 events. These events were 

held in all 50 states, the District of Columbia, and three territories. Approximately 870 individuals 

attended live online training webinars and SAMHSA responded to 3,000 requests for technical 

assistance in planning, promoting, hosting, and evaluating events. SAMHSA will continue to fund 

two contracts to support these activities.

Funding History

Fiscal Year Amount

FY 2015 $4,072,000 

FY 2016 $4,072,000 

FY 2017 $4,072,000 

FY 2018 $4,044,000

FY 2019 $4,072,000

Budget Request 

The FY 2019 President’s Budget Request is $4.1 million, an increase of $28,000 from the 

FY 2018 Annualized CR. These funds will support SAMHSA’s substance abuse prevention 

efforts and include a focus on preventing underage drinking and providing technical assistance and 

training to American Indians/Alaska Native communities. 
148 

Tribal Behavioral Health Grants

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Tribal Behavioral Health Grants................................. $14,450 $14,898 $15,000 $102

Authorizing Legislation ........................................................................ Section 516 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities ....................................................................................................................... Tribes

Program Description and Accomplishments

Suicide is the second leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages eight to 24 years.64 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students.65 These behaviors include 

serious thoughts of suicide, suicide plans, suicide attempts, and medical attention for a suicide 

attempt. However, the risk of suicide is not the same in all AI/AN youth demographic groups. 

For instance, AI/AN youth raised in urban settings have a smaller risk of having thoughts of suicide 

than AI/AN youth raised on tribal reservations (21 percent and 33 percent, respectively).66

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health 

Grant (TBHG) 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 abuse, trauma, and 

suicide and by promoting the mental health of AI/AN young people. 

In FY 2014, SAMHSA’s Center for Mental Health Services awarded five-year TBHG grants of 

up to $0.2 million annually to 20 tribes or tribal organizations with high rates of suicide. These 

five-year grants help grantees develop and implement a plan that addresses suicide and substance 

abuse, thereby promoting mental health among tribal youth. In addition, SAMHSA’s Tribal 

Training and Technical Assistance Center (http://www.samhsa.gov/tribal-ttac) provides training 

and education to AI/AN grantees and organizations serving AI/AN populations to support their 

ability to achieve their goals. An evaluation component allows grantees and SAMHSA to work 

collaboratively to monitor progress and learn from each other. 

 

64 Centers for Disease Control and Prevention. Fatal injury data, 2010. Web-based Injury Statistics Query and 

Reporting System. Available at www.cdc.gov/injury/wisqars/fatal.html. Accessed May 27, 2014.

65 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. 

66 Freedenthal, S. & Stiffman, A. R. (2004). Suicidal Behavior in Urban American Indian Adolescents: A 

Comparison with Reservation Youth in a Southwestern State. Suicide and Life-Threatening Behavior, 34(2), 160-

171. 
149 

In FY 2016, SAMHSA expanded the TBHG program to include a Native youth initiative focused 

on removing possible barriers to success for Native youth. This initiative takes a comprehensive, 

culturally appropriate approach to help improve the lives of and opportunities for AI/AN youth. 

In addition to the Department of Health and Human Services, multiple agencies, including the 

Departments of Interior, Education, Housing and Urban Development, Agriculture, Labor, and 

Justice, are working collaboratively with tribes to address issues facing AI/AN youth. This 

funding allows SAMHSA to expand activities through the braided TBHG ($15.0 million in the 

Substance Abuse Prevention appropriation and $15.0 million in Mental Health appropriation) to 

allow tribes the flexibility to implement community-based strategies to address trauma, prevent 

substance abuse, and promote mental health and resiliency among youth in tribal communities. 

The additional FY 2016 funding expands these activities to approximately 90 tribes and tribal 

entities. With the expansion of the TBHG program, SAMHSA’s goal is to reduce substance use 

and the incidence of suicide attempts among AI/AN youth and to address behavioral health 

conditions that affect learning in the Bureau of Indian Education-funded schools. The TBHG

program will support mental health promotion, including trauma-informed strategies, and 

substance use prevention activities for high-risk AI/AN youth and their families, enhance early 

detection of mental illness and drug/alcohol addiction among AI/AN youth, and increase referral 

to treatment. 

In FY 2017, SAMHSA provided funding to support 61 grant continuations and 15 new grant 

awards. 

Under the FY 2018 Annualized CR level, SAMHSA would continue to support 76 grant 

continuations, evaluation, and technical assistance activities.

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 $15,000,000 

FY 2017 $14,450,000 

FY 2018 $14,898,000 

FY 2019 $15,000,000

Budget Request 

The FY 2019 President’s Budget Request is $15.0 million, an increase of $102,000 from the 

FY 2018 Annualized CR. This request, combined with $15.0 million in the Center of Mental 

Health Services will continue support 93 grants that promote mental health and prevent substance 

use activities for high-risk AI/AN youth and their families.

As a braided activity, SAMHSA will track 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. 
150 

Outputs and Outcomes Table

Program: Tribal Behavioral Health

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

2.4.12 Increase the percentage of 

youth age 10 - 24 who received 

mental health or related services after 

screening, referral or attempt (Output)

FY 2017: 56 %

Target: 20 % 

(Target Exceeded)

56 % 56 % Maintain

2.4.13 Increase the number of 

programs/organizations that 

implemented specific mental-health 

related practices/activities as a result 

of the grant (Outcome)

FY 2017: 5,670

Target: 296

(Target Exceeded)

5670 5670 Maintain
151 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Grants to Prevent Prescription Drug/ Opioid 

Overdose Related Deaths.......................................... $12,000 $11,919 $12,000 $81

Authorizing Legislation ............................................. Section 516 and Section 546 of the PHS Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................ Competitive Grants, Contracts 

Eligible Entities ......................................... States, local government entities, Federally Recognized 

 American Indian/Alaska Native tribe or tribal organizations

Program Description and Accomplishments

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse illicit and prescription opioids (including synthetics such as fentanyl).67 Opioids include 

illegal drugs such as heroin, as well as prescription medications used to treat pain. These 

prescription medications include morphine, codeine, methadone, oxycodone (Oxycontin, 

Percodan, Percocet), hydrocodone (Vicodin, Lortab, Norco), fentanyl (Duragesic, Fentora), 

hydromorphone (Dilaudid, Exalgo), and buprenorphine (Subutex, Suboxone). Opioids bind to 

specific receptors in the brain, spinal cord, and gastrointestinal tract and reduce the body’s 

perception of pain. As opioids reduce pain, they induce a slight sense of euphoria, which can lead 

to overuse. 

In 2013, SAMHSA released the Opioid Overdose Prevention Toolkit to help reduce the number 

of opioid-related overdose deaths and adverse events. Developed by SAMHSA, the Association 

of State and Territorial Health Officials, the National Association of State Alcohol and Drug Abuse 

Directors, and the American Association for the Treatment of Opioid Dependence, the Toolkit was 

the first federal resource that includes safety and prevention information for individuals at risk for 

overdose. The toolkit provides information on how to recognize and respond appropriately to 

overdose, identifies specific drug-use behaviors to avoid, and describes the role of overdose 

reversing drugs in preventing death from an overdose. A growing evidence base suggests that 

overdose reversal drugs are a cost-effective method to reducing opioid overdose deaths. 

As the rates of prescription drug abuse, heroin abuse, illicit synthetic opioid abuse, overdoses, and 

opioid-related overdose deaths increase, communities are searching for ways to reduce the death 

rate from opioid-related overdoses. 

 

67 National Institute on Drug Use (NIDA). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. 

(2014) Available from URL: http://www.drugabuse.gov/about-nida/legislative-activities/testimony-tocongress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse#_ftnref4
152 

In FY 2016, SAMHSA awarded 12 grants to states for the Grants to Prevent Prescription Drug and 

Opioid Overdose-related Deaths program helps states identify communities of high need and 

provide education, training, and resources necessary to tailor the overdose kits to meet their 

specific needs. The grant funds can be used for purchasing overdose reversing drugs, equipping 

first responders with them, providing training on their use, and developing other overdose-related 

death prevention strategies, and providing materials to assemble and disseminate overdose kits. 

These grantees are also required to develop a dissemination plan and a training course tailored to 

meet the needs of first responders in the communities within their state. The course uses 

SAMHSA’s Opioid Overdose Prevention Toolkit as a guide and includes a comprehensive 

prevention program that will focus on prevention, treatment, and recovery services in order to 

decrease the likelihood of drug overdose recurrence. 

In FY 2017 and under the FY 2018 Annualized CR level, SAMHSA would provide funding to 

continue the 12 grants. 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 --- 

FY 2017 $12,000,000 

FY 2018 $11,919,000 

FY 2019 $12,000,000 

Budget Request 

The FY 2019 President’s Budget Request is $12.0 million, an increase of $81,000 from the 

FY 2018 Annualized CR. This funding will provide continuation grants to 12 states to reduce the 

number of opioid overdose-related deaths. 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. 
153 

First Responder Training for Opioid Overdose Reversal Drugs

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized CR

First Responder Training (CARA) ......................... $12,000 $11,919 $12,000 $81

Authorizing Legislation ........................................................................ Section 546 of the PHS Act

FY 2019 Authorization ................................................................................................... Permanent

Allocation Method............................................................................................Competitive Grants 

Eligible entities...............................States, local government entities, Federally Recognized 

 American Indian/Alaska Native tribe or tribal organizations

Program Description and Accomplishments

Under Section 202 of the Comprehensive Addiction and Recovery Act (CARA), SAMHSA is 

authorized to support additional efforts to prevent opioid overdose-related deaths by providing 

grants to train first responders. In FY 2017, SAMHSA funded 21 grants for the First Responder 

CARA grant program (FR-CARA). The purpose of this program is to allow 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 

overdose. Grantees will 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 overdose. Grantees will also establish 

processes, protocols, and mechanisms for referral to appropriate treatment and recovery 

communities. This program includes a broader eligibility than the previously referenced statebased Grants to Prevent Opioid Overdose-related Death program. The program allows for much 

needed services to reach local and tribal areas. Additionally, in FY 2017, the First Responder 

Training program also included a set-aside to address the critical needs of rural populations.

Training, technical assistance, and evaluation activities are also being supported to assist grantees, 

determine best practices, and assess program outcomes. Under the FY 2018 Annualized CR level, 

funding would support continuation grants to 21 grantees to address the opioid crisis in this 

country.
154 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 --- 

FY 2017 $12,000,000 

FY 2018 $11,919,000 

FY 2019 $12,000,000 

Budget Request 

The FY 2019 President’s Budget Request is $12.0 million, an increase of $81,000 from the 

FY 2018 Annualized CR. This funding will provide continuation grants to 20 grantees and support 

the continuation of training, technical assistance and evaluation activities to address the opioid 

crisis in this country. 

Minority Fellowship Program

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Minority Fellowship Program.................................. $71 $71 $--- -$71

Authorizing Legislation ........................................................................ Section 597 of the PHS Act

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol 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, and 

psychology. In 2006, the program expanded to include marriage and family therapists and later 
155 

added professional counselors. Professional guilds receive competitively awarded grants, and then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. In FY 2016 and FY 2017, SAMHSA funded six continuation grants. 

Funding History

Fiscal Year Amount

FY 2015 $71,000

FY 2016 $71,000

FY 2017 $71,000

FY 2018 $71,000

FY 2019 ---

Budget Request 

The FY 2019 President’s Budget Request is $0.0 million, a decrease of $71,000 from the FY 2018 

Annualized CR. The program is being discontinued because it overlaps with other federal 

activities. 
156 

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157 

Drug Free Communities

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President’s 

Budget

+/- 

FY 2018 

Annualized 

CR

Drug Free Communities1............................................ $--- $--- $100,000 $100,000 1 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in 2017 and at 

$96.3 million under the FY 2018 Annualized CR.

Authorizing Legislation ....................... Drug-Free Communities Act of 1997 (Public Law 105-20) 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities .................................................................................. States, Tribes, and Territories

Program Description and Accomplishments

The Drug-Free Communities (DFC) Act of 1997 created the DFC Support Program (Public Law 

105-20). By statute, the DFC Support Program has two goals: 

• Establish and strengthen collaboration among communities, public and private non-profit 

agencies, as well as federal, state, local, and tribal governments to support the efforts of 

community coalitions working to prevent and reduce substance abuse among youth. 

• Reduce substance abuse among youth and, over time, reduce substance abuse among adults 

by addressing the factors in a community that increase the risk of substance abuse and 

promoting the factors that minimize the risk of substance abuse.

The goal of the program is to establish and strengthen collaboration among communities, public 

and private non-profit agencies, as well as federal, state, local, and tribal governments to support 

the efforts of community coalitions working to prevent and reduce substance abuse among 

youth. In addition, the program aims to reduce substance abuse among youth and, over time, 

reduce substance abuse among adults by addressing the factors in a community that increase the 

risk of substance abuse and promoting the factors that minimize the risk of substance 

abuse. Five- year grants of up to $125,000 are awarded to new recipients each year. Recipients 

are eligible to apply for funding for a second five-year period, which is designated as a competing 

continuation grant. 

The program also includes the Drug Free Communities Mentoring (DFC-M) Program. The 

purpose of this program is to provide grant funds to existing DFC recipients so they may serve as 

mentors to newly-formed and/or developing coalitions that have never received a DFC grant. It is 

the intent of the DFC-M Program that, at the end of the Mentoring grant, each Mentee coalition 

will meet all of the statutory eligibility requirements of the DFC Support Program and be fully 

prepared to compete for a DFC grant on their own. DFC-M grants are awarded for two years for 

up to $75,000. Eligible applicants are coalitions that have been in existence for at least five years, 

have an active DFC grant at the time of the award, and are in good standing. 
158 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 ---

FY 2017 ---

FY 2018 ---

FY 2019 $100,000,000

Budget Request 

The FY 2019 President’s Budget Request is $100.0 million. This activity was funded at $96.3 

million in the Office of National Drug Control Policy (ONDCP) under the 2018 Annualized CR. 

SAMHSA has administered this program for several years on behalf of ONDCP. The FY 2019 

Budget proposes to directly appropriate these funds to SAMHSA to streamline program 

management and create administrative efficiencies. Funding will be used to continue both the 

DFC and DFC-Mentoring programs. 
159 

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table Summary

(Dollars in thousands)

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Grants

Continuations..................................................................... 385 $154,652 385 $119,446 291 $85,222

New/Competing................................................................. 85 $22,391 64 63,453 --- ---

Subtotal.......................................................................... 470 177,044 449 182,899 291 85,222

Contracts

Continuations..................................................................... 31 $32,604 20 34,105 24 35,663

New.................................................................................... 6 12,221 2 4,699 --- ---

Subtotal.......................................................................... 37 44,825 22 38,804 24 35,663

Total, Substance Abuse Prevention PRNS 507 $221,869 471 $221,703 315 $120,885
160 

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017

 Final

No. Amount

FY 2018 

Annualized CR

No. Amount

FY 2019 

President's 

Budget

No. Amount

Capacity:

Strategic Prevention Framework

Grants

Continuations.......................................................................

New/Competing....................................................................

Supplements.........................................................................

Subtotal

99

 ---

 ---

$104,032

---

---

73

18

 ---

$55,174

50,896

---

88

 ---

 ---

$48,022

---

---

99 104,032 91 106,070 88 48,022

Contracts

Continuations.......................................................................

New........................................................................................

14

 ---

15,452

---

6

 ---

12,603

---

7

 ---

10,404

---

Subtotal 14 15,452 6 12,603 7 10,404

Total, Strategic Prevention Framework

Federal Drug-Free Workplace 

Contracts

Continuations.......................................................................

New........................................................................................

113

4

 ---

119,484

4,894

---

97

3

1

118,673

769

4,092

95

4

 ---

58,426

4,894

---

Subtotal............................................................................. 4 4,894 4 4,861 4 4,894

Total, Federal Drug-Free Workplace 

Minority AIDS

Grants

Continuations.......................................................................

New/Competing....................................................................

Subtotal.............................................................................

4

131

32

4,894

29,147

6,290

4

105

45

4,861

25,488

12,490

4

 ---

 ---

4,894

---

---

163 35,437 150 37,979 --- ---

Contracts

Continuations.......................................................................

New........................................................................................

4

1

4,138

830

 ---

1

2,343

603

 ---

 ---

---

---

Subtotal............................................................................. 5 4,968 1 2,946 --- ---

Total, Minority AIDS

Sober Truth on Preventing Underage Drinking Act

Grants

Continuations.......................................................................

New/Competing....................................................................

Subtotal.............................................................................

168

81

17

40,405

3,791

766

151

98

 ---

40,925

4,567

---

 ---

95

 ---

---

4,504

---

98 4,557 98 4,567 95 4,504

Contracts

Continuations.......................................................................

New........................................................................................

1

1

1,384

1,060

2

 ---

2,385

---

2

 ---

2,496

---

Subtotal.............................................................................

Total, Sober Truth on Preventing Underage Drinking 

2 2,443 2 2,385 2 2,496

100 7,000 100 6,952 97 7,000
161 

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Grants to Prevent Prescription Drug/Opioid Overdose 

Grants

Continuations....................................................................... 12 10,650 12 10,687 12 10,254

New........................................................................................ --- --- --- --- --- ---

Subtotal............................................................................. 12 10,650 12 10,687 12 10,254

Contracts

Continuations....................................................................... 2 1,350 1 1,232 2 1,746

New........................................................................................ --- --- --- --- --- ---

Subtotal............................................................................. 2 1,350 1 1,232 2 1,746

Total, Grants to Prevent Prescription Drug/ Opioid 14 12,000 13 11,919 14 12,000

Tribal Behavioral Health Grants

Grants

Continuations....................................................................... 61 7,012 76 12,451 76 12,315

New/Competing.................................................................... 15 4,100 --- --- --- ---

Subtotal............................................................................. 76 11,111 76 12,451 76 12,315

Contracts

Continuations....................................................................... 3 3,339 3 2,447 3 2,685

New/Competing.................................................................... --- --- --- --- --- ---

Subtotal............................................................................. 3 3,339 3 2,447 3 2,685

 Total, Tribal Behavioral Health Grants 79 14,450 79 14,898 79 15,000

First Responder Training (CARA)

Grants

Continuations....................................................................... --- -45,333 21 11,079 20 10,127,232

New/Competing.................................................................... 21 $11,236 --- --- --- ---

Subtotal............................................................................. 21 $11,191 21 11,079 20 $10,127

Contracts

Continuations....................................................................... --- --- 1 839 2 1,873

New/Competing.................................................................... 1 809 --- --- --- ---

Subtotal............................................................................. 1 809 1 839 2 1,873

Total, First Responder Training (CARA) 22 12,000 22 11,919 22 12,000

Subtotal, Capacity 478 $198,233 444 $198,228 289 $97,320

FY 2019 

President's 

Budget

FY 2017

 Final

FY 2018 

Annualized CR
162 

SAMHSA/Center for Substance Abuse Prevention

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Science and Service:

Center for the Application of Prevention Technologies

Contracts

Continuations....................................................................... --- $429 1 $7,442 1 $7,493

New/Competing.................................................................... 1 7,064 --- --- --- ---

Subtotal............................................................................. 1 7,493 1 7,442 1 7,493

Technologies 1 7,493 1 7,442 1 7,493

SAP Minority Fellowship Program

Grants

Continuations....................................................................... 1 66 --- --- --- ---

New/Competing.................................................................... --- --- 1 66 --- ---

Subtotal............................................................................. 1 66 1 66 --- ---

Contracts

Continuations....................................................................... --- 5 --- --- --- ---

New/Competing.................................................................... --- --- --- 4 --- ---

Subtotal............................................................................. --- 5 --- 4 --- ---

Total, SAP Minority Fellowship Program 1 71 1 71 --- ---

Science & Service Program Coordination

Contracts

Continuations....................................................................... 3 1,614 3 4,044 3 4,072

New........................................................................................ 2 2,458 --- --- --- ---

Subtotal............................................................................. 5 4,072 3 4,044 3 4,072

Total, Science & Service Program Coordination 5 4,072 3 4,044 3 4,072

Subtotal, Science and Service 7 11,636 5 11,557 4 11,565

Total, Substance Abuse Prevention 507 $221,869 471 $221,703 315 $120,885

FY 2018 

Annualized CR

FY 2019 

President's 

Budget

FY 2017

 Final
163 

Grant Awards Table 

(Whole dollars)

FY 2017 Final

FY 2018 Annualized 

CR

FY 2019 President's 

Budget

Number of Awards 470 449 291

Average Award $376,689 $407,348 $292,858

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,000
164 

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165 

SAMHSA

Substance Abuse Treatment

Table of Contents 

1. Substance Abuse Treatment Appropriation.......................................................................... 167

2. Programs of Regional and National Significance (PRNS) ................................................... 168

a) Opioid Treatment Programs/Regulatory Activities....................................................... 169

b) Screening, Brief Intervention and Referral to Treatment.............................................. 172

c) Targeted Capacity Expansion-General.......................................................................... 176

d) Pregnant and Postpartum Women ................................................................................. 181

e) Recovery Community Services Program ...................................................................... 184

f) Children and Families ................................................................................................... 186

g) Treatment Systems for Homeless.................................................................................. 189

h) Minority AIDS .............................................................................................................. 193

i) Criminal Justice Activities............................................................................................ 195

j) Building Communities of Recovery .............................................................................. 203

k) Minority Fellowship Program ..............................................................................................204

l) Addiction Technology Transfer Centers ....................................................................... 205

m) Improving Access to Overdose Treatment.................................................................... 208

3. PRNS Mechanism Table Summary ...................................................................................... 210 

4. PRNS Mechanism Table by Program, Project, and Activity................................................ 211 

5. Grant Award Table ............................................................................................................... 215

6. State Targeted Response to the Opioid Crisis Grants........................................................... 217

7. Substance Abuse Prevention and Treatment Block Grant.................................................... 219 
166 

Page intentionally left blank
167 

Substance Abuse Treatment Appropriation

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Programs of Regional and National 

Significance.................. $350,427 $352,020 $255,318 -$96,702

PHS Evaluation Funds (non-add)................................ 2,000 1,986 --- -1,986 

State Targeted Response to the Opioid Crisis Grants...... 500,000 496,605 --- -496,605 

Substance Abuse Prevention and Treatment Block Grant 1,858,079 1,845,461 1,858,079 12,618 

 Budget Authority (non-add)........................................... 1,778,879 1,766,799 1,778,879 12,080 

PHS Evaluation Funds (non-add)................................ 79,200 78,662 79,200 538 

Total, Substance Abuse Treatment............................... $2,708,506 $2,694,085 $2,113,397 -$580,688 

The Substance Abuse Treatment FY 2019 President’s Budget Request is $2.1 billion, a decrease 

of $580.7 million from the FY 2018 Annualized CR. The request includes $2.0 billion in Budget 

Authority and $79.2 million in Public Health Service (PHS) Evaluation funds.
168 

Programs of Regional and National Significance (PRNS)

Substance Abuse Treatment Appropriation

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Capacity:

Opioid Treatment Programs/Regulatory Activities..................... $8,724 8,665 $8,724 $59

Screening, Brief Intervention and Referral to Treatment.......... 30,000 29,796 --- -29,796

Budget Authority (non-add)................................................... 28,000 27,810 --- -27,810

PHS Evaluation Funds (non-add).......................................... 2,000 1,986 --- -1,986

Targeted Capacity Expansion-General........................................ 67,192 66,736 67,192 456

Other Targeted Capacity Expansion....................................... 11,192 11,116 11,192 76

MAT for Prescription Drug and Opioid Addiction (non-add) 56,000 55,620 56,000 380

Pregnant and Postpartum Women................................... 19,931 19,796 19,931 135

Comprehensive Addiction and Recovery Act (non-add)...... 4,000 3,973 4,000 27

Recovery Community Services Program.................................. 2,434 2,417 2,434 17

Improving Access to Overdose Treatment (IATOT)................ 1,000 993 1,000 7

Building Communities of Recovery (BCOR)........................ 3,000 2,980 3,000 20

Children and Families............................................................ 29,605 29,404 29,605 201

Treatment Systems for Homeless....................................... 36,386 36,139 36,386 247

Minority AIDS.................................................................... 65,570 65,125 --- -65,125

Criminal Justice Activities.................................................... 74,000 77,470 78,000 530

Other Criminal Justice Activities (non-add).................... 18,000 17,878 18,000 122

Drug Court Activities (non-add)........................................... 56,000 59,593 60,000 407

Subtotal, Capacity 337,842 339,520 246,272 -93,248

Science and Service:

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

SAT Minority Fellowship Programs...............................

9,046 

3,539

8,985 

3,515

9,046 

---

61 

-3,515

Subtotal, Science and Service 12,585 12,500 9,046 -3,454

Total, PRNS $350,427 $352,020 $255,318 -$96,702

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Cooperative Agreements/Contracts

Eligible Entities.......................................... ...... .................States, local governments, 

 Communities, Federally Recognized

 American Indian/Alaska Native tribes or tribal organizations,

 Indian Health Service-operated and contracted health facilities

 and programs, public or private nonprofit entities
169 

Opioid Treatment Programs/Regulatory Activities

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Opioid Treatment Programs/Regulatory Activities......... $8,724 $8,665 $8,724 $59

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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

Program Description and Accomplishments

The misuse of prescription opioid pain relievers and illicit opioids, such as heroin, is causing 

suffering, sickness, overdose, and death in the United States at epidemic levels.68 Communities 

across the nation also face the risk that individuals who inject opioids will contract and spread 

Human Immunodeficiency Virus (HIV) and hepatitis C.69 The underlying cause of these problems 

is increasing rates of opioid abuse.70,71

With increasing incidence of opioid abuse, there is a corresponding increase in admissions for 

treatment of opioid abuse.72 Medication-assisted treatment (MAT) refers to the use of the Food 

and Drug Administration (FDA) approved pharmacotherapies (i.e., buprenorphine products, 

methadone, and naltrexone products) in combination with evidence-based psychosocial 

interventions for treatment of opioid use disorders. MAT is a safe and effective strategy for 

decreasing the frequency and quantity of opioid use and reducing the risk of overdose and death. 

 

68 U.S. Department of Health and Human Services. Addressing prescription drug abuse in the United States: 

current activities and future opportunities. 2013. Retrieved from 

www.cdc.gov/drugoverdose/pdf/hhs_prescription_drug_abuse_report_09.2013.pdf 

69 Substance Abuse and Mental Health Services Administration. Associations of nonmedical pain reliever use and 

initiation of heroin use in the United States. 2013. Retrieved from 

https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm 

70 Johnson EM, Lanier WA, Merrill RM, et al. Unintentional prescription opioid-related overdose deaths: 

description of decedents by next of kin or best contact, Utah, 2008-2009. J Gen Intern Med. 2013;28(4): 522-9. 

71 Bohnert AS, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioid overdoserelated deaths. JAMA. 2011;305(13):1315-1321. doi:10.1001/jama.2011.370.

72 Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital signs: overdoses of prescription opioid pain relievers – United 

States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2011;60(43): 1487-92.
170 

Approximately one million Americans need, but do not access, treatment for an opioid addiction.73

A search of SAMHSA’s behavioral health treatment locator reveals only 20 percent of surveyed 

facilities offer MAT for individuals with opioid addiction. The majority of the roughly 

1,500 opioid treatment programs (OTPs) which provide supervised dosing of methadone and 

buprenorphine are at or near capacity. 

OTPs are the only means of providing medication-assisted treatment (MAT) with methadone. 

Buprenorphine can be prescribed in an office setting by physicians who have received a waiver 

under the Drug Addiction Treatment Act of 2000 (DATA 2000) provision of the Controlled 

Substances Act. Most physicians with a waiver to prescribe buprenorphine do not treat the 

maximum allowable number of patients. On July 8, 2016, SAMHSA/HHS published a final rule, 

“Medication Assisted Treatment for Opioid Use Disorders,” which allows practitioners who have 

had a waiver to prescribe buprenorphine for up to 100 patients for a year or more, to now obtain a 

waiver to treat up to 275 patients.

SAMHSA is responsible for regulating and certifying approximately 1,500 OTPs to use opioid 

agonist treatment medications and processing waivers for physicians and mid-level practitioners, 

such as nurse practitioners and physician assistants, who wish to treat opioid abuse with 

buprenorphine. SAMHSA reviews new and renewal applications for OTPs and oversees their 

accreditation. OTPs are required to be accredited as a condition of certification. SAMHSA’s 

regulation of OTPs plays a critical role in expanding access and maintaining quality. Accrediting 

organizations must be approved by SAMHSA to fulfill this function and this approval must be 

renewed every five years. SAMHSA monitors the accrediting bodies for quality assurance and 

improvement by making 10 to 20 site visits to recently-accredited programs each year; 

additionally, SAMHSA conducts unannounced OTP site visits to investigate complaints. 

SAMHSA implements DATA 2000 in coordination with the Drug Enforcement Administration. 

This includes approving waivers for qualified practitioners to provide medication-assisted 

treatment in office-based settings. More than 37,000 practitioners have been granted waivers since 

2001. Waiver processing is conducted under a contract entitled DATA Waiver Processing and 

Support Project. From August 2016 through March 2017, SAMHSA processed over 7,365 waiver 

applications and certified 3,211 physicians to treat up to 30 patients, 1,107 to treat up to 100 

patients, and 3,047 to treat up to 275 patients. 

In November 2016, the implementation of Section 303 of the Comprehensive Addiction and 

Recovery Act (CARA) enabled the Department of Health and Human Services (HHS) to announce 

that nurse practitioners (NPs) and physician assistants (PAs) could immediately begin taking the 

24 hours of required training to prescribe buprenorphine for the treatment of opioid addiction. 

CARA expanded prescribing privileges to NPs and PAs for five years (until October 1, 2021). 

 

73 Jones, C. M. (2013). Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid 

pain relievers, United States, 2002-2004 and 2008-2010. Drug and Alcohol Dependence, 132(1-2):95-100. 
171 

NPs and PAs who complete the required training and seek to prescribe buprenorphine for up to 30 

patients were able to begin applying for a waiver in February 2017. As of November 2017, 

SAMHSA had approved 4,070 mid-level practitioners to begin prescribing buprenorphine. 

SAMHSA supports a cooperative agreement, the Providers Clinical Support Services for 

Medication-Assisted Treatment (PCSS-MAT), which provides education, training and mentors to 

behavioral healthcare providers. 

SAMHSA developed the MATx, a public domain app for healthcare practitioners to support 

medication-assisted treatment of opioid use disorder. This is a significant step forward in efforts

to improve access to MAT, making it easier for patients living with addiction to access effective, 

evidence-based treatment. This public domain app puts the most critical information to support 

the delivery of MAT in one place - the latest on treatment approaches, medications, and clinical 

support tools, plus helplines and access to SAMHSA’s Treatment Locators

(https://www.findtreatment.samhsa.gov/). 

Under the FY 2018 Annualized CR level, SAMHSA would support one continuation grant, one 

supplemental grant, and technical assistance efforts.

Funding History

Fiscal Year Amount

FY 2015 $8,724,000

FY 2016 $8,724,000

FY 2017 $8,724,000

FY 2018 $8,665,000

FY 2019 $8,724,000

Budget Request 

The FY 2019 President’s Budget Request is $8.7 million, an increase of $59,000 from the FY 2018 

Annualized CR. SAMHSA intends to continue to support the Secretary’s five-prong strategy to 

address the opioid crisis priorities through regulatory activities, ongoing training, certification, and 

technical assistance to provider groups and communities impacted by the opioid crisis.
172 

Screening, Brief Intervention, and Referral to Treatment

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Screening Brief Intervention and Referral to Treatment $30,000 $29,796 $--- -$29,796

 Budget Authority (non-add)................................. 28,000 27,810 --- -27,810

 PHS Evaluation Funds (non-add)......................... 2,000 1,986 --- -1,986

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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 Colleges

Program Description and Accomplishments 

Among individuals age 12 or older, 27.1 million (10.1 percent) use illicit drugs, 66.7 million (24.9 

percent) binge drink, and 17.3 million (6.5 percent) drink heavily.74 This imposes a great cost on 

society by compromising individual health and potentially causing injury to others. The National 

Institute on Drug Abuse found that misuse of illicit drugs and alcohol costs society $488.0 billion 

each year.75 Of the individuals who need treatment for substance abuse, only 10.8 percent receive 

treatment in a specialty treatment facility.76 The vast majority of those meeting criteria for having 

a drug/alcohol addiction have not been diagnosed. 

In 2003, SAMHSA started the Screening, Brief Intervention and Referral to Treatment (SBIRT) 

program, which is intended to help primary care physicians identify individuals who misuse 

substances and help them intervene early with education, brief treatment, or referral to specialty 

treatment. The program’s goal is to increase the number of individuals who receive treatment and 

reduce the rate of substance misuse. Studies have shown that this approach is effective in helping 

reduce harmful alcohol consumption.77,78,79

The SBIRT program seeks to increase the use of SBIRT in medical settings by promoting wide 

dissemination and adoption of the practice across the spectrum of primary care services. To 

achieve this, SAMHSA awards state implementation grants to encourage adoption of SBIRT by 

healthcare providers in each state. SAMHSA also supports the SBIRT Student Training grant 

programs. 
173 

The SBIRT program requires state 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 settings. Recipients may use funds to screen for substance use and co-occurring mental 

illness and drug/alcohol addiction. They can support evidence-based client-centered interventions, 

such as Motivational Interviewing, brief treatment, and referral to specialty care for individuals 

exhibiting addiction symptoms.

The SBIRT training program helps train a wide range of medical providers to incorporate SBIRT 

as part of their ongoing practice. This includes physicians, nurses, counselors, social workers, 

health promotion advocates, health educators, and others. A SAMHSA-funded cross-site 

evaluation found that allied health professionals, rather than the physicians themselves, were more 

likely to implement SBIRT with their patients.80 The SBIRT Student Training and Health 

Professionals Training grant programs support SBIRT training efforts for medical students, 

medical residents, nurses, social workers, psychologists, pharmacists, dentists, and physician 

assistants. These efforts aim to develop further the primary healthcare workforce in substance 

abuse treatment and services.

SAMHSA has demonstrated the effectiveness of SBIRT and continues to disseminate SBIRT 

practices. As of 2016, SAMHSA data show roughly 2.7 million individuals have received 

screening and/or intervention through the SBIRT initiative.81 Of those screened, roughly, 11.5 

percent were determined to be at risk, another 1.9 percent were referred for brief treatment, and an 

additional 2.2 percent were referred to specialty treatment.82

In FY 2017, SAMHSA funded three continuation state cooperative agreements and continued 

funding for eight state cooperative agreements and 69 training grant continuations. 

Under the FY 2018 Annualized CR level, SAMHSA would support seven new and eight 

continuation SBIRT state grants to support program implementation and direct TA, as needed, and 

12 SBIRT continuation training grants. 

 

74Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-

4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/ 75 National Institute on Drug Abuse (2016), Trends and Statistics, http://www.drugabuse.gov/related-topics/trendsstatistics.

76 Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the 

United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-

4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/ 77 Bertholet, N., Daeppen, J.-B., Wietlisbach, V., Fleming, M., & Burnand, B. (2005). Reduction of alcohol 

consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Archives of 

Internal Medicine 165, 986–995. 78 Kahan, M., Wilson, L., & Becker, L. (1995). Effectiveness of physician-based interventions with problem 

drinkers: A review. Canadian Medical Association Journal, 152, 851–859. 79 Wilk, A.I., Jensen, N.M., and Havighurst, T.C. (1997). Meta-analysis of randomized control trails addressing 

brief interventions in heavy alcohol drinkers. Journal of General Medicine, 12 (5), 274-283. 80 RTI International (2009). RTI International to Evaluate Comprehensive Substance Abuse Intervention Programs 

for SAMHSA. 

81 Services Accountability Improvement System, (2016). http://www.samhsa-gpra.samhsa.gov/ 82 Services Accountability Improvement System, (2016). http://www.samhsa-gpra.samhsa.gov/ 
174 

Funding History

Fiscal Year Amount

FY 2015 $46,889,000

FY 2016 $46,889,000

FY 2017 $30,000,000

FY 2018 $29,796,000

FY 2019 ---

Budget Request 

The FY 2019 President’s Budget Request is $0.0 million, a decrease of $29.8 million from the 

FY 2018 Annualized CR. The SBIRT program is being eliminated in FY 2019 as significant 

knowledge has been developed and disseminated for this program. SBIRT has been brought to 

scale in hundreds of communities across the nation. SAMHSA will continue to disseminate 

SBIRT program information through its national TA efforts. 
175 

Outputs and Outcomes Table

Program: Screening, Brief Intervention, and Referral to Treatment

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.2.40 Increase the number of clients 

served (Output)

FY 2017: 182,851

Target: 300,000 

(Target Not Met)

182,851 182,851 Maintain

1.2.41 Increase the percentage of 

clients receiving services who had no 

past month substance use (Outcome)

FY 2017: 34.8 %

Target: 36 %

(Target Not Met but Improved)

34.8 % 34.8 % Maintain
176 

Targeted Capacity Expansion-General

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Targeted Capacity Expansion General................................ $67,192 $66,736 $67,192 $456

 Other Targeted Capacity Expansion................................ 11,192 11,116 11,192 76

MAT for Prescription Drug and Opioid Addiction (non-add) 56,000 55,620 56,000 380

Authorizing Legislation ........................................... Sections 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities ........................................ Domestic Public and Private Non-Profit Entities, States,

Opioid Medication-Assisted SPF Rx Treatment Service Providers, Outpatient Substance Abuse 

Providers, Community Mental Health Centers, Federally Qualified Health Centers,

SAMHSA Certified Opioid Treatment Programs, and 

Licensed Outpatient Substance Abuse Treatment Programs 

Program Description and Accomplishments

Urgent, unmet, and emerging substance abuse treatment and recovery support service capacity 

needs remain a critical issue for the nation. In an effort to assist communities in overcoming these 

barriers, SAMHSA initiated the Targeted Capacity Expansion (TCE) program. The program 

provides rapid, strategic, comprehensive, and integrated community-based responses to gaps in 

and capacity for substance abuse treatment and recovery support services. Examples of such needs 

include limited or no access to medication-assisted treatment (MAT) for opioid use disorders; lack 

of resources needed to adopt and implement health information technology (HIT) in substance 

abuse treatment settings; and short supply of trained and qualified peer recovery coaches to assist 

individuals in the recovery process.

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction (MAT PDOA) 

MAT refers to the use of the Food and Drug Administration-approved pharmacotherapies 

(i.e., buprenorphine products, methadone, and naltrexone products) in combination with 

evidence- based psychosocial interventions for treatment of opioid addiction. MAT is a safe and 

effective strategy for decreasing the frequency and quantity of opioid abuse and reducing the risk 

of overdose and death. 

Drug overdose death continues to increase in the U.S., with 63,600 lethal drug overdoses in 2016, 

a record number of overdose deaths and an increase from 52,404 in 2015; among these deaths, 

42,249 (66 percent) involved an opioid, an increase from 33,091 (63 percent) in 2015. Opioid 

addiction is driving this alarming trend, with 19,413 overdose deaths related to synthetic opioids 
177 

other than methadone, and 15,469 overdose deaths related to heroin in 2016.

83 The rate of drug 

overdose deaths involving synthetic opioids other than methadone doubled between 2015 and 

2016. Heroin overdose death rates have more than tripled since 2010, from 1.0 per 100,000 in 

2010 to 4.9 per 100,000 in 2016. Despite these troubling statistics, significant gaps persist between 

treatment needs and capacity. In 2012, 48 states and the District of Columbia reported levels of 

opioid addiction that were higher than their rates of MAT capacity. Furthermore, 38 states reported 

that at least 75 percent of their opioid treatment programs (OTPs) were operating at 80 percent or 

greater capacity. 84

MAT PDOA addresses treatment needs of individuals who have an opioid addiction by 

expanding/enhancing treatment system capacity to provide accessible, effective, comprehensive, 

coordinated/integrated, and evidence-based MAT and recovery support services. Recovery 

support services include linking patients and families to social, legal, housing, and other supports 

to improve the probability of positive outcomes. 

In FY 2016, SAMHSA funded 11 continuation state grants, 11 new state grants, as well as one 

contract. The 22 grantees in FY 2016 represent all 10 HHS regions. As of August 2017, 

approximately 2,470 individuals with opioid addiction are being served through the grant program; 

at six-month follow-up, 61 percent of individuals served reported abstinence from illicit drug use, 

exceeding the 60 percent target. In FY 2017, SAMHSA multi-year funded five grants and 

annually funded one new grant, 23 continuations and one continuing technical assistance contract. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 20 new MAT PDOA and 

12 continuation MAT-PDOA grants, which will support program implementation and direct TA. 

Targeted Capacity Expansion-Technology Assisted Care (TCE-TAC)

Access to treatment remains inadequate for underserved populations living with drug/alcohol 

addiction and/or co-occurring mental illness and drug/alcohol addiction, such as those living in 

rural areas. A key component of this access challenge relates to a lack of dependable transportation 

and many organizations experience significant financial constraints in serving these rural 

populations. SAMHSA believes that behavioral healthcare providers who use health information 

technology (HIT) can help patients improve their access to necessary care and prevention services. 

For example, tele-health and tele-psychiatry can bring addiction medicine providers to clients in 

areas without local specialists. Web-based tools can improve communication and help deliver 

much-needed support and education. Health information technology approaches can also enable 

providers to document and coordinate better mental and substance abuse treatment services 

directly or via tele-psychiatry or telemedicine with families and other providers and specialists. 

SAMHSA established the TCE-TAC grant program to address the lack of resources in the field 

necessary to adopt and implement health information technologies, including electronic health 

records (EHRs), smart phones, tablets, web-based technologies and applications to support 

 

83 Hedegaard H, Warner M, Miniño AM. Drug overdose deaths in the United States, 1999–2016. NCHS Data Brief, 

no 294. Hyattsville, MD: National Center for Health Statistics. 2017. 84Jones, C. M., Campopiano, M., Baldwin, G., McCance-Katz, E. (2015). National and state treatment need and 

capacity for opioid agonist medication-assisted treatment. American Journal of Public Health, 105(8), e55-c63. 
178 

tele- psychiatry and telemedicine. The program also addresses the behavioral healthcare 

providers’ need to expand and/or enhance their ability to communicate effectively with individuals 

in treatment, as well as monitor their health to ensure treatment and prevention services are 

available when and where needed.

TCE-TAC and its predecessor program, Targeted Capacity Expansion-Health Information 

Technology (TCE-HIT), have improved care delivery in 48 behavioral healthcare organizations 

across 23 states. In FY 2017, the TCE-TAC program included 12 additional grantees bringing the 

total number of grantees since 2011 to 60 behavioral healthcare organizations. Grantees have 

deployed all of the above-mentioned technologies to provide substance abuse treatment services 

directly or via remote service delivery (i.e., tele-psychiatry and telemedicine). In FY 2017, the 

TCE-TAC and TCE- HIT programs served roughly 882 individuals. Health information 

technology clearly holds great potential for increasing access to treatment services and providing 

reliable exposure to meaningful health information for underserved individuals with mental illness 

and alcohol/drug addiction. Providing the means to sustain this technology is likely to be an 

ongoing challenge for these and similarly situated organizations. 

In FY 2016, SAMHSA funded 13 new TCE-TAC grants to enhance or expand the capacity of 

treatment providers to serve individuals who are traditionally underserved and to help achieve and 

maintain recovery and to improve the overall quality of life for those being served. In FY 2017, 

SAMHSA supported continued funding for the 13 TCE-TAC grant awards. These awards support 

the continuous development and deployment of unique advanced technology solutions to serve 

more clients with fewer resources. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 13 continuation TCETAC grants for implementation and direct TA. 

Targeted Capacity Expansion-Peer to Peer (TCE-PTP) 

Peer support is built on the premise that individuals in recovery from drug/alcohol addiction can 

be of great value through the sharing of their recovery experiences with those attempting to achieve 

and sustain recovery. Peer recovery support services, as an adjunct to clinical treatment, extend 

the reach of treatment beyond the clinical setting into the everyday environment of those seeking 

to achieve or sustain recovery from drug/alcohol addiction. Peer support and peer recovery support 

services have been shown to reduce healthcare costs. Additionally, the overall message from 

limited research studies conducted to date is that recovery support service adjuncts appear to be 

helpful over and above treatment alone. 

There is currently a short supply of adequately trained peer support providers to work both in 

treatment and in community-based settings. There is also a growing need to train and certify 

existing peer providers to address the increasing demand and diverse settings in which peer 

providers are employed. Since 2002, SAMHSA has awarded over 105 grants to community-based 

organizations to provide peer recovery support services to individuals in or seeking recovery from 

drug/alcohol addiction and their families. The primary objective of these services is to help 

individuals and families in search of recovery to obtain much needed support, sustain clinical 

treatment gains, engage in healthy community living, and improve overall quality of life. This 
179 

grant program incorporates a peer-to-peer model, which capitalizes on the expertise of those 

individuals with similar lived experience. 

The TCE-PTP program has reached over 5,800 individuals and their families. Significant strides 

have been made in increasing abstinence, work and educational opportunities, social 

connectedness, housing stability, housing support, and decreasing criminal justice involvement. 

In FY 2016, the percentage of people who were employed or currently attending school increased 

from 27.5 percent at intake to 47.1 percent at six-month follow-up and abstinence in the past 

30 days from alcohol and drug use improved from 63.6 percent at intake to 82.1 percent at sixmonth month follow-up. In addition, the percentage of individuals reporting stability in housing 

improved from 45.2 percent at intake to 55.6 percent at six-month follow-up. In FY 2017, 

SAMHSA funded 17 continuation TCE peer-to-peer grants and TA activities. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 17 continuation TCE PTP 

grants to support program implementation and direct TA.

The output and outcome measures for Targeted Capacity Expansion-General are part of the 

Treatment - Other Capacity Activities Outputs and Outcomes table shown on page 202. 

Funding History

Fiscal Year Amount

FY 2015 $23,223,000

FY 2016 $36,303,000

FY 2017 $67,192,000

FY 2018 $66,736,000

FY 2019 $67,192,000

Budget Request 

The FY 2019 President’s Budget Request is $67.2 million, an increase of $456,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund 32 continuation MAT PDOA grants, 13 new 

TCE-TAC grants, and 17 TCE-PTP new grants. 
180 

Outputs and Outcomes Tables

Program: Treatment Prescription Drug and Opioid Addiction

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the FY 2018 

targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.3.01 Increase the number of 

admissions for Medication Assisted 

Treatment (Output)

FY 2017: 2,230 

Target: 1,400 

(Target Exceeded)

2,230 2,230 Maintain

1.3.02 Increase number of clients 

receiving integrated care (Output)

FY 2017: 1,301 

Target: 1,100 

(Target Exceeded)

1,301 1,301 Maintain

1.3.03 Decrease illicit drug use at 6-

month follow-up (Outcome)

FY 2017: 62 % 

Target: 60 % 

(Target Exceeded) 

62 % 62 % Maintain
181 

Pregnant and Postpartum Women 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Pregnant and Postpartum Women..................................... $19,931 $19,796 $19,931 $135

 Comprehensive Addiction and Recovery Act (non-add). 4,000 3,973 4,000 27

Authorizing Legislation..................................Section 508 of the Public Health Service Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

From 1992 to 2012, a steady four percent of women admitted to treatment for drug/alcohol 

addiction were pregnant. From FY 2003 through FY 2015, 28.4 percent of pregnant and 

postpartum women who had custody of their children at intake reported illegal drug use in the past 

30 days.

85 Since many traditional substance abuse treatment programs do not allow for the 

inclusion of children, a woman may be torn between the need to care for her dependent children 

and her need for treatment.86 The nation’s opioid crisis has also added to this challenge for many 

pregnant and parenting women. The proportion of pregnant women entering treatment who 

reported any prescription opioid misuse increased substantially from two percent in 1992 to 28 

percent in 2012, an increase of 173 percent, from 351 to 6,087 women.87 The proportion of 

pregnant women who entered treatment and reported prescription opioids as their primary 

substance use increased from one percent in 1992 to 19 percent in 2012, an increase of 344 percent, 

from 124 to 4,268 women.88

Since 2003, SAMHSA has supported comprehensive residential substance abuse treatment, 

prevention, and recovery support services for pregnant and postpartum women, their minor 

children, and services for other family members (e.g., fathers of the children) through the Pregnant 

and Postpartum Women program (PPW). SAMHSA has successfully implemented a familycentered approach in the PPW program, which has evolved over time. This approach includes 

partnering with others to leverage diverse funding streams, encouraging the use of evidence-based 

practices, supporting innovation, and developing workforce capacity to meet the needs of these 

families. 

 

85 Internal SAMHSA performance data 86 Center for Substance Abuse Treatment. Substance Abuse Treatment: Addressing the Specific Needs of Women. 

Treatment Improvement Protocol (TIP) Series 51. HHS Publication No. (SMA) 09-4426. Rockville, MD: Substance

Abuse and Mental Health Services Administration, 2009. 87 Martin, C. E., Longinaker, N., & Terplan, M. (2015). Recent trends in treatment admissions for prescription 

opioid abuse during pregnancy. Journal of substance abuse treatment, 48(1), 37-42. 88 Ibid. 
182 

The PPW family-centered approach includes a variety of services and case management for 

women, children, and families. Services provided to women include: outreach; engagement; pretreatment; screening and assessment; detoxification; substance misuse education; treatment; 

relapse-prevention; healthcare services, including mental health services; postpartum health care, 

including attention to depression, anxiety, and medication needs; parenting education and 

interventions; home management and life skills training, education, testing, and counseling; and 

treatment of hepatitis, HIV/AIDS, and other sexually transmitted diseases. Services available to 

children include screening and developmental diagnostic assessments addressing social, 

emotional, cognitive, and physical well-being; and interventions related to mental, emotional, and 

behavioral wellness. Services for families include family-focused programs to support family 

strengthening, including, involvement with the child’s other parent. The PPW program also 

supports tobacco use counseling and interventions, screening and assessment for Fetal Alcohol 

Syndrome Disorders, and a trauma-informed approach. 

The PPW program provides services not covered under most public and private insurance. Based 

on an in-depth review of cross-site evaluation and performance data in FY 2014, SAMHSA built 

the current PPW program model on an evidence-based approach for serving pregnant and postpartum women in need of residential substance abuse treatment. 

In FY 2016, SAMHSA funded two new residential treatment grants, 25 residential treatment grant 

continuations, and one Addiction Technology Transfer Center (ATTC) supplement grant 

continuation. That same year SAMHSA convened a PPW Family-Centered Summit. The 

Summit’s purpose was to elicit recommendations from experts in the area of women’s substance 

abuse treatment services and family-centered care to inform the expansion of CSAT’s PPW 

program to incorporate a wider range of family-centered services for pregnant and postpartum 

women and their minor children. This includes the expansion of treatment modalities to go beyond 

residential treatment and include intensive outpatient and outpatient treatment with or without 

housing components. SAMHSA has reviewed the recommendations from the Summit and is 

taking them into consideration in determining the future direction of the PPW Program, including 

the development of service requirements for the PPW program expansion effort to support widescale adoption of the family-centered approach. 

In FY 2017, SAMHSA funded 18 new residential treatment grants, seven residential treatment 

grant continuations, and three contracts. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund five new PPW residential 

grants and 28 continuation PPW grants for program implementation and direct TA. 

Pregnant and Postpartum Women Pilot 

An aim of the Comprehensive Addiction and Recovery Act (CARA) is to address substance abuse 

and addiction across the country through the implementation of prevention, treatment, and 

recovery programs. In FY 2017, SAMHSA received funding to support three of these programs 

through its Substance Abuse Treatment Appropriation. 

Historically, the PPW program has only supported the provision of residential treatment services. 

In order to ensure increased accessibility and availability of services for pregnant women, CARA 
183 

authorizes the provision of outpatient and intensive outpatient services for pregnant women 

through the PPW Pilot program. 

In FY 2017, SAMHSA funded three new state PPW pilot grants to: 1) support family-based 

services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, 

including opioid disorders; 2) help state substance abuse agencies address the continuum of care, 

including services provided to women in nonresidential-based settings; and 3) promote a 

coordinated, effective and efficient state system managed by state substance abuse agencies by 

encouraging new approaches and models of service delivery. An evaluation of this program is 

underway to determine the effectiveness of the pilot.

Under the FY 2018 Annualized CR level, SAMHSA plans to fund three continuation state PPW 

pilot grants for program implementation and direct TA, and one continuation evaluation contract.

The output and outcome measures for Pregnant and Postpartum Women are part of the Treatment 

- Other Capacity Activities Outputs and Outcomes table shown on page 202. 

Funding History

Fiscal Year Amount

FY 2015 $15,931,000

FY 2016 $15,931,000

FY 2017 $19,931,000

FY 2018 $19,796,000

FY 2019 $19,931,000

Budget Request

The FY 2019 President’s Budget Request is $19.9 million, an increase of $135,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund two new residential treatment PPW grants 

and 26 continuation PPW grants. These funds also support the continuation of the three PPW Pilot 

grants ($4.0 million) to provide an array of services and supports to pregnant women and their 

children. 

The FY 2019 President’s Budget requests additional funds Pregnant and Postpartum Women 

through the Additional Opioids Allocation funding and is described on page 259. 
184 

Recovery Community Services Program

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Recovery Community Services Program............................. $2,434 $2,417 $2,434 $17

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities .......................................................... Family/Consumer Controlled Organizations, 

Domestic Public and Private Non-Profit Organizations in States, Territories, and Tribes, 

Recovery Community Organizations of Domestic Private Non-Profit Entities in States, 

Territories, and Tribal Organizations 

Program Description and Accomplishments

An estimated 23 million people in the United States are in recovery from addiction to alcohol and 

other drugs.89 As public education increases, there is broader acknowledgement of addiction as a 

treatable condition that needs to be managed over the course of a lifetime. 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. 

Since 1998, SAMHSA has recognized the value of supporting recovery through peers and other 

recovery supports, and has provided funding through the Recovery Community Services Program 

(RCSP). RCSP was designed to assist recovery communities strengthen their infrastructure and 

provide peer recovery support services to those in or seeking recovery from alcohol/other drug 

addiction across the nation. The delivery of recovery support services by people in recovery is 

known as peer recovery support services (PRSS). PRSS are a strong component in helping 

individuals and families address substance abuse in the context of chronic disease management, 

especially when delivered by a Peer (often known as a Recovery Coach, Peer Specialist, or Peer 

Mentor). SAMHSA initiated 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), that now number over one hundred in the 

U.S. alone. 

Though the RCSP was a services program from 2002-2010, it was evident that this approach 

needed to be taken system-wide to have a larger effect. Many states recognize the value of 

addiction peer recovery services; however, further efforts are required to realize the potential of 

these services and supports at a system-wide level. The infusion of these services into state 

 

89 Partnership for Drug Free Kids, March, 20152012. Retrieved from http://www.drugfree.org/newsroom/surveyten-percent-of-american-adults-report-being-in-recovery-from-substance-abuse-or-addiction 
185 

systems ensures the wide scale adoption of peer recovery support. By developing a workforce of 

trained and certified peers and engaging recovery community organizations in the full continuum 

of treatment and recovery services, states have the ability to enhance their systems to ensure 

holistic approaches to care. SAMHSA supports this state system development effort through the 

RCSP Statewide Network grant program. Since the inception of the RCSP, over 120 grants have 

been awarded to RCOs to expand PRSS locally and lay the groundwork for a national network of 

PRSS programs.

Recovery Community Services Program Statewide Network (RCSP-SN)

The RCSP-SN grant program supports a statewide approach to enhance the presence of people 

with lived experience in recovery from drug/alcohol addiction as key partners in state systems, as 

well as building a peer workforce. Activities include collaborating on local and state workforce 

development, developing linkages with other organizations that promote recovery throughout the 

state, and participating in policy, planning, and program development discussions at the state, 

community, and local level. Involving recovery community leaders and key stakeholders in 

decision-making helps states to design peer services and PRSS programs that are authentic to the 

recovery experience, complementary to clinical practice, demonstrate strong recovery outcomes, 

and are sustainable over time. Additionally, the statewide networks help to ensure the 

development of a trained, qualified, and effectively supervised peer workforce. 

Workforce outcomes for the program include the amount of training provided, the number of 

people trained, trainee satisfaction, and the usefulness of information presented. Other key 

outcomes include: the number of RCOs that have been linked across the state; the number of statesponsored events where participation of the statewide network occurred; the effects of linkages 

with behavioral health and other health systems; the outcomes of program activities on raising 

awareness about addiction peer recovery support; and the number of policy/program discussions 

which included addiction peer recovery support as a result of project efforts.

In FY 2017, SAMHSA funded a new cohort of 10 RCSP-SN grants, two contracts, as well as a 

statewide peer network development activity to foster collaboration between the addiction 

recovery and mental health consumer and family network communities. This effort is also 

supported by a contract designed to strengthen the development and expansion of the recovery 

support work of the RCSP-SN grantees and other related SAMHSA recovery support efforts. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 10 RCSP-SN continuation 

grants. 

The output and outcome measures for Recovery Community Services Program are part of the 

Treatment - Other Capacity Activities Outputs and Outcomes table shown on page 202.
186 

Funding History

Fiscal Year Amount

FY 2015 $2,434,000

FY 2016 $2,434,000

FY 2017 $2,434,000

FY 2018 $2,417,000

FY 2019 $2,434,000

Budget Request 

The FY 2019 President’s Budget Request is $2.4 million, an increase of $17,000 from the FY 2018 

Annualized CR. SAMHSA intends to fund the continuation of 10 RCSP Statewide Network grants 

and TA activities to continue the efforts of building addiction recovery networks throughout the 

nation and the collaboration among peer-run organizations. 

Children and Families

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Children and Families........................................................ $29,605 $29,404 $29,605 $201

Authorizing Legislation ............................. Sections 509 and 514 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities ............................................................................. Single States 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 and Accomplishments

Substance abuse plays a significant role in the lives of many children and youth (ages 12 to 25) 

throughout the nation. In 2015, approximately nine percent of adolescents between the ages of 12 

and 17 and 22 percent of youth between the ages of 18 and 25 reported current illicit drug use. 

Three percent of adolescents between the ages of 12 and 17, and 11 percent of youth between the 

ages of 18 and 25 met the criteria for an alcohol use disorder. Many of these youth have 

co- occurring mental and substance use disorders. In 2015, six percent of youth ages 18-15 had 
187 

co-occurring mental illness and substance use disorders.90 Most substance abuse begins during 

adolescence, making this developmental period a critical time for intervention. Approximately 

four percent of admissions to substance abuse treatment facilities were adolescents in 2015.91 

Sixty-one percent of infants and 41 percent of older children involved in the child welfare system 

have at least one parent who is using alcohol or other drugs.92 On average, 32 percent of children 

are removed from home care as a result of parental alcohol or other drug use.93

SAMHSA’s Children and Families program makes appropriate treatment available to youth and 

their families/caregivers to reduce the impact of substance abuse and/or co-occurring mental and 

substance abuse on communities in the U.S.

Substance Abuse Treatment for Youth 

In 2015, less than 7 percent of adolescents ages 12 to 17 and 8 percent of youth ages 18 to 25 who 

needed treatment received the needed treatment at a specialty facility. Youth have psychological, 

developmental, and emotional needs that are distinct from adults. The neurological and 

developmental differences between youth and adults require tailored treatment and recovery 

approaches for youth with alcohol/other drug addiction. 

SAMHSA’s programs to treat youth with addiction and/or co-occurring substance abuse and 

mental disorders address gaps in service delivery by providing services for youth and their families 

and primary caregivers using effective evidence-based, family-centered practices. SAMHSA 

supports a youth treatment grant initiative at the state, territorial, and tribal levels. The populations 

of focus for the initiatives are adolescents (ages 12 to 17), transition-aged youth (ages 18 to 25), 

and their families and caregivers. 

This initiative helps to further the use of, and access to, effective evidence-based family-centered 

treatment approaches for youth with alcohol/other drug addiction. It supports 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 and 

treatment interventions appropriate for adolescents and transition age youths. 

 

90 Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: 

Detailed Tables.

91 Substance Abuse 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.

92 Wulczyn, F., Ernst, M., & Fisher, P. (2011). Who are the infants in out-of-home care? An epidemiological

and developmental snapshot. Chicago: Chapin Hall at the University of Chicago. Retrieved from

http://www.chapinhall.org/sites/default/files/publications/06_08_11_Issue%20Brief_F_1.pdf

93 US Department of Health and Human Services. Administration for Children and Families, Administration on 

Children, Youth and Families, Children’s Bureau.(2016). The AFCARS report: Preliminary FY 2015 estimates as of 

June 2016 (No. 23). Washington, DC: Author. Research and Evaluation, Administration for Children and Families, 

US Department of Health and Human Services.
188 

In FY 2016, SAMHSA funded 32 grant continuations and five contracts. SAMHSA also funded 

two new youth treatment implementation grants to support treatment for youth with SUD. 

In FY 2017, SAMHSA funded 12 new youth treatment implementation grants and one new 

contract. SAMHSA also funded 14 grant continuations and two continuing contracts. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 18 new youth treatment 

grants and to provide funding for 13 continuation grants for program implementation and direct 

TA. New grant funding will include an emphasis on tribes.

Addressing Child Abuse and Neglect 

SAMHSA and the Administration for Children and Families collaborate to address child abuse 

and neglect by supporting a National Center on Substance Abuse and Child Welfare (NCSACW). 

NCSACW works across agencies to provide technical assistance and training to professionals in 

order to meet the needs of families affected by parental substance abuse. From September 2016 

through March 2017, NCSACW disseminated nearly 8000 informational materials, which include 

reports, guidance documents, presentations from conferences and webinars, research articles, 

toolkits, and grantee site-specific tools. NCSACW facilitated 30 events, attended by an estimated 

4,000 participants, with an average of 130 attendees per event. NCSACW monitored and provided 

support to trainees on web-based tutorials. Since 2007, 71,141 users have completed the 

NCSACW’s tutorials and the current completion rate is 97 percent. The content of the tutorials 

was updated in 2015 to infuse the latest research and evidence-based practices and to offer a more 

interactive and engaging user experience. NCSACW’s activities have assisted professionals 

throughout the nation in improving cross-system collaboration and being better prepared to meet 

child welfare mandates requirements for timely child permanency decisions. 

NCSACW continues to provide support and technical assistance and training to tribes, state 

agencies, and communities to develop collaborative approaches to the treatment of pregnant 

women with opioid addiction. Since August 2016, NCSACW has disseminated SAMHSA’s “A 

Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice 

and Policy Considerations for Child Welfare, Collaborating Medical, and Service Providers” to 

child welfare, substance abuse treatment, dependency court, and medical professionals. The 

publication has been downloaded 13,000 times from the NCSACW website. Since the passage of 

the Comprehensive Addiction and Recovery Act of 2016 (CARA), Section 503, Infant Plan of 

Safe Care Act, NCSACW has responded to 440 TA requests on Plans of Safe Care and the 

provisions on prenatal substance exposure in the Child Abuse and Prevention Treatment Act 

(CAPTA). Launched in September 2014, NCSACW provides the Substance Exposed Infant InDepth Technical Assistance Program (SEI-IDTA) to strengthen collaboration linkages across child 

welfare, substance abuse treatment, and the courts, as well as medical communities, early care and 

education systems, home visiting, and other key partners to improve outcomes for infants and their 

families. In FY 2017, SAMHSA funded a new NCSACW technical assistance contract. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to provide continuation support 

for the NCSACW technical assistance contract. 
189 

The output and outcome measures for Children and Families are part of the Treatment - Other 

Capacity Activities Outputs and Outcomes table shown on page 202.

Funding History

Fiscal Year Amount

FY 2015 $29,605,000

FY 2016 $29,605,000

FY 2017 $29,605,000

FY 2018 $29,404,000

FY 2019 $29,605,000

Budget Request 

The FY 2019 President’s Budget Request is $29.6 million, an increase of $201,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund eight new youth treatment grants and 27

youth treatment grants continuations. These funds will continue to address the gaps in substance 

abuse treatment by providing services for youth, their families, and caregivers. 

Treatment Systems for Homeless

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Treatment Systems for Homeless..................................... $36,386 $36,139 $36,386 $247

Authorizing Legislation ............................................. Section 506 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with 

alcohol/other drug addiction and who are experiencing homelessness, including veterans, and 

those experiencing chronic homelessness. 
190 

Between 2007 and 2014, homelessness in the United States declined by 11 percent, while chronic 

homelessness declined by 31 percent.95 Chronic homelessness is defined as individuals or families 

with a disabling condition who have been without housing for longer than one year or more than 

four times in the past three years. Despite this progress, the number of people experiencing 

homelessness remains at unacceptably high levels. On a given night in January 2015, 564,708 

individuals were experiencing homelessness. Of these individuals, 96,275 were experiencing 

chronic homelessness, 104,083 had severe mental illness, 103,888 were affected by chronic 

substance abuse, and 47,725 were veterans.96

Many factors contribute to the problem of homelessness, including lack of affordable housing, 

foreclosures, rising housing costs, job loss, underemployment, mental illness, and drug/alcohol 

addiction. The progress made to date in reducing homelessness points to improvement in services, 

as well as the effectiveness of collaboration across all levels, from the federal government to state 

governments and community systems. The U.S. Interagency Council on Homelessness, in which 

HHS participates, has set aggressive goals to prevent and end homelessness. These goals include: 

preventing and ending homelessness among veterans; preventing and ending chronic 

homelessness; preventing and ending homelessness for families, youth, and children; and setting 

a path to ending homelessness for all individuals. The services and support offered through 

SAMHSA’s Treatment Systems for Homeless programs are crucial to achieving these goals. 

SAMHSA manages the following Treatment Systems for Homelessness grant programs: 

Cooperative Agreements to Benefit Homeless Individuals for States (CABHI-States)

In FY 2013, SAMHSA initiated the CABHI-States program, funded jointly by CSAT and CMHS, 

which builds on the CABHI program by working with states to provide accessible, effective, 

comprehensive, coordinated/integrated, and evidence-based treatment services. CABHI-States 

supports services for individuals with serious mental illness and/or alcohol/other drug addiction 

who experience chronic homelessness and/or veterans who experience homelessness. It also 

provides peer supports and enhancement or development of a statewide plan to ensure sustained 

collaboration across public health and housing systems that will result in short-term and long-term 

strategies to support behavioral health services for individuals who experience chronic 

homelessness. The grantees work with state and local Public Housing Authorities and state 

Medicaid agencies to develop systematic, cost-effective, and integrated approaches to housing and 

behavioral disorder treatment and services for individuals with mental illness and/or alcohol/other 

drug addiction experiencing homelessness. This program was further enhanced in FY 2015 with 

the implementation of CABHI State Enhancement grants, which enabled CABHI-States grantees 

to build upon their programs. 

 

95 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2014). The 2014 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Retrieved 

from https://www.hudexchange.info/resources/documents/2015-AHAR-Part-1.pdf 96 U.S. Department of Housing and Urban Development (HUD) 2014 Continuum of Care (CoC) Homeless 

Assistance Programs-Homeless Populations and Subpopulations Report. Retrieved from 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2015.pdf
191 

Grants for the Benefit of Homeless Individuals (GBHI) 

In FY 2017, CSAT funded the GBHI program (last funded in FY 2010). The purpose of this 

program is to support the development and/or expansion of local implementation of a community 

infrastructure that integrates behavioral health treatment and services for alcohol/other drug 

addiction and co-occurring mental illness and alcohol/other drug addiction, permanent housing, 

and other critical services for individuals (including youth) and families experiencing 

homelessness.

Based on FY 2017 data for CSAT funded programs, 52.7 percent of clients in Treatment Systems 

for Homeless-supported programs report abstinence from substance use at a six-month follow- up, 

while approximately 20.7 percent of clients report being employed or engaged in productive 

activities and 64.4 percent of clients report having a permanent place to live in the community.97

In FY 2017, SAMHSA funded 16 new CABHI grants, 17 new GBHI grants, and 46 continuation 

grants (30 CABHI, seven GBHI-SSH, and nine CABHI-States) as well as two contracts for 

national evaluation and technical assistance. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 32 new homelessness 

treatment grants (nine CABHI and 23 GBHI) and 63 continuation grants (46 CABHI and 17 

GBHI). 

The output and outcome measures for Treatment Systems for Homeless are part of the 

Treatment- Other Capacity Activities Outputs and Outcomes table shown on page 202.

Funding History

Fiscal Year Amount

FY 2015 $41,386,000

FY 2016 $41,304,000

FY 2017 $36,386,000

FY 2018 $36,139,000

FY 2019 $36,386,000

Budget Request 

The FY 2019 President’s Budget Request is $36.4 million, an increase of $247,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund 65 continuation grants (17 CABHI and 48

GBHI). SAMHSA also plans to award 37 new CABHI grants. Additional funds will support two 

contracts including the continuation of cross-center contracts for national evaluation and technical 

assistance. 

 

97 SPARS. (2017). Retrieved from www.samhsa-gpra.samhsa.gov.
192 

Outputs and Outcomes Table

Program: Treatment System for Homelessness (GBHI)

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the 

FY 2018 targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

3.4.23 Increase the number of clients 

served (Output)

FY 2017: 6,544 

Target: 5,100 

(Target Exceed) 

6,544 6,544 Maintain

3.4.24 Increase the percentage of 

homeless clients receiving services who 

were currently employed or engaged in 

productive activities (Outcome)

FY 2017: 22 % 

Target: 30 % 

(Target Not Met) 

22 % 22 % Maintain

3.4.25 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community (Outcome)

FY 2017: 61.6% 

Target: 33% 

(Target Exceeded)

61.6 % 61.6 % Maintain
193 

Minority AIDS

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Minority AIDS.................................................................... $65,570 $65,125 $--- -$65,125

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

Three of SAMHSA’s Minority AIDS Initiative (MAI) programs address HIV and hepatitis 

infection by facilitating the development and expansion of culturally competent and effective 

community-based treatment systems for substance drug/alcohol addiction and co-occurring mental 

illness and substance abuse treatment within racial and ethnic minority communities. The goals 

of the MAI program are to reduce the impact of behavioral health issues, reduce the risk for and 

incidence of HIV and hepatitis, and increase access to HIV and hepatitis testing and treatment for 

these individuals in states with the highest HIV prevalence rates (at or above 299.5 per 100,000). 

By region, the prevalence rates were highest in the Northeast at 419.5 per 100,000 and the South 

at 352.5 per 100,000.98

SAMHSA has implemented a number of HIV programs with varying foci including minority 

women, at risk populations, and the continuum of care for individuals with both mental and 

substance use disorders. 

The output and outcome measures for Minority AIDS are part of the Treatment - Other Capacity 

Activities Outputs and Outcomes table shown on page 202. 

 

98 Centers for Disease Control and Prevention. (2016). HIV in the United States by Geographic Distribution. 

Retrieved fromhttps://www.cdc.gov/hiv/pdf/statistics/cdc-hiv-geographic-distribution.pdf
194 

Funding History

Fiscal Year Amount

FY 2014 $65,570,000

FY 2015 $65,570,000

FY 2016 $65,570,000

FY 2017 $65,125,000

FY 2018 ---

Budget Request 

The FY 2019 President’s Budget Request is $0.0 million, a decrease of $65.1 million from the 

FY 2018 Annualized CR. This program is being discontinued in FY 2019 because it overlaps with 

other federal activities. 

States will be able to provide services to reduce injection drug use and related HIV/AIDS and 

Hepatitis C infection rates through $150 million in new funding proposed as part of the Additional 

Opioid Allocation described on page 259. 
195 

Criminal Justice Activities

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Criminal Justice Activities................................................. $74,000 $77,470 $78,000 $530

 Other Criminal Justice Activities (non-add)................... 18,000 17,878 18,000 122

 Drug Court Activities (non-add)...................................... 56,000 59,593 60,000 407

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities ............................... Domestic Public and Private Non-Profit Entities, Operational

Individual Misdemeanor and Felony Adult Criminal Courts, 

Municipal Courts, Tribal, State, Local Government Proxies,

Government with Direct Involvement with Adult Criminal Courts,

Tribal Organizations and Individual Adult Tribal Healing to Wellness Courts, and

Individual Juvenile Treatment Drug Courts 

Program Description and Accomplishments

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 drug/alcohol addiction and/or co-occurring drug/alcohol addiction and mental illness.

Drug Courts 

According to a 2006 Bureau of Justice Statistics report, approximately 74 percent of state 

prisoners, 63 percent of federal prisoners, and 76 percent of jail inmates met the criteria for a 

mental disorder. An estimated 42 percent of state prisoners and 49 percent of jail inmates met the 

criteria for both a mental illness and drug/alcohol addiction.99 For youth in the juvenile justice 

system, 50 to 70 percent met criteria for a mental disorder and 60 percent met criteria for a 

substance use disorder. Of those youth with co-occurring mental illness ad drug/alcohol addiction, 

almost 30 percent experienced severe disorders that impaired their ability to function.100

 

99 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

100 Teplin, Linda et al, (2005) Major mental disorders, substance use disorders, comorbidity and HIV-AIDS risk 

behaviors in juvenile detainees. Psychiatric Services, 56,(7): pp 823-28.
196 

The criminal justice system was the major source of referrals to substance abuse treatment, with 

probation or parole referrals representing the largest proportion of criminal justice system referrals 

to treatment.101 Most probation or parole referrals to treatment were males between the ages of 18

and 44. The most common substances reported by these referrals were alcohol, marijuana, and 

methamphetamine.102

Drug courts are designed to combine the sanctioning power of courts with effective treatment 

services for a range of populations with circumstances, such as alcohol and/or other drug use, child 

abuse/neglect or criminal behavior, veterans or people with mental illness. Drug courts represent 

the coordinated efforts of the judiciary, prosecution, defense bar, probation, law enforcement, 

mental health, social service, and treatment communities to intervene and break the cycle of 

substance misuse, addiction, and crime. Stakeholders work together to give individual clients the 

opportunity to improve their lives, including recovery from substance drug/alcohol addiction, and 

develop the capacity and skills to become fully-functioning parents, employees, and citizens. 

Many drug courts lack sufficient funding or the ability to implement evidence-based practices for 

substance abuse treatment and recovery services.103 Through its Treatment Drug Court grant 

programs, SAMHSA seeks to reduce this gap in treatment services while also improving treatment 

services by requiring that evidence-based practices be used. SAMHSA’s interest is to support and 

shape treatment drug courts that serve clients with drug/alcohol addiction in the respective 

problem-solving court models as long as the court meets all the elements required for drug courts. 

The intent is to meet the treatment needs of clients using evidence-based practices consistent with 

the disease model and the problem-solving model, rather than with the traditional court caseprocessing model. A long-term goal of this program is to build sustainable systems of care for 

individuals needing treatment drug court services. 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound/recovery support services designed to improve 

access and retention, drug testing for illicit substances, education support, relapse prevention and 

long-term management, pharmacotherapy, and HIV testing conducted in accordance with state and 

local requirements. The program seeks to address behavioral health disparities among racial and 

ethnic minorities by encouraging the implementation of strategies to decrease the differences in 

access, service use, and outcomes among the racial and ethnic minority populations served. 

These grant programs use existing evidence from numerous studies to support current programs 

and new proposals. There have been more than 125 evaluation and research studies of the 

effectiveness of drug courts in addition to Government Accountability Office reports. SAMHSA 

requires evidence-based practices from federal inventories to be used. SAMHSA also has regular 

 

101 Substance Abuse 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.

102 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from http://www.samhsa.gov/criminal-juvenilejustice

103 SAMHSA's GAINS Center for Behavioral Health and Justice Transformation. (n.d.). Adult Mental Health 

Treatment Courts Database. Retrieved from http://gainscenter.samhsa.gov/judgescourts/courtsjudges.asp
197 

communications with the National Association of Drug Court Professionals to obtain and 

incorporate the latest findings and field expertise.

Performance data show that these grant programs are effective in improving the lives of drug court 

participants. In FY 2015, 5,497 clients received services through the Drug Court Programs. Of 

these, 85.1 percent had no past month substance use, 91.8 percent had no involvement with the 

criminal justice system thirty days prior to intake, 58.9 percent of adult clients were either 

employed or engaged in productive activities, and 43.8 percent had a permanent place to live in 

the community. 

In FY 2015, FY 2016 and FY 2017, SAMHSA’s Adult Drug Court grant programs were required 

to ensure that drug courts funded by SAMHSA could not deny the use of Food and Drug 

Administration (FDA)-approved medications for opioid addiction to drug court clients. Drug court 

judges, however, retained judicial discretion in cases where specified conditions for 

pharmacotherapy provisions were not met. 

In FY 2017, SAMHSA funded 51 new drug court grants, 122 drug court grant continuations, and 

four contracts. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 101 drug court grants 

continuation, 58 new drug court grants, and three contracts. 

Criminal Justice Other/Offender Reentry 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. Studies show that only about 10 percent of individuals involved with the criminal justice 

system who are in need of substance abuse treatment receive it as part of their justice system 

supervision. Approximately one-half of the institutional treatment provided is educational 

programming.104 During the past decade, awareness of the need for a continuum of care of services 

for adult offenders has grown as states and local communities have struggled with the increasing 

number of these individuals returning to the community after release from correctional 

confinement. ORP grants provide screening, assessment, comprehensive treatment, and recovery 

support services for individuals reentering the community from incarceration. ORP services 

include screening, comprehensive individual assessment for substance use and/or co-occurring 

mental disorders, case management, program management, alcohol and other drug treatment, 

wraparound services, drug testing, relapse prevention and long-term support. 

In FY 2017, SAMHSA funded 11 new ORP grants and 27 ORP grant continuations. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 16 new ORP grants, 11 

continuation OFR grants, and two contract activities. 

 

104 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. 
198 

Behavioral Health Treatment Court Collaborative Program 

In FY 2014, SAMHSA supported a second cohort of four-year Behavioral Health Treatment Court 

Collaborative grants (BHTCC) in the Mental Health and Substance Abuse Treatment 

appropriations. BHTCC supports judges and staff of specialty (e.g., drug court) and other courts 

within a jurisdiction to work together to divert adults with mental illness and/or alcohol/other drug 

addiction from the criminal justice system. The purpose of this grant program is to allow municipal 

courts more flexibility to collaborate with multiple criminal justice system components and local 

community treatment and recovery providers to address the behavioral health needs of adults who 

are involved with the criminal justice system. The court collaborative grant program focuses on 

adults with behavioral health problems, including serious mental illness, from the criminal justice 

system, including alternatives to incarceration. The program supports community behavioral 

health services for individuals with mental and/or substance disorders and includes a focus on 

veterans involved with the criminal justice system. 

SAMHSA completed an evaluation of the first cohort of BHTCC grantees in September 2014. 

Findings of the evaluation demonstrate that grantees built multi-agency workgroups or 

collaboratives to oversee programs. Because of the grant funding, all grant recipients expanded 

access to specialty courts. Most grant recipients anticipated continuing new screening and 

assessment processes addressing a broader array of behavioral health needs after grant funding 

ended. Program innovations were divided into four main groups, including court and treatment 

provider collaboration, court and community case management, unified cross-court screening and 

referral, and meaningful peer involvement. Roughly 1,400 individuals were served through the 

BHTCC., Two-thirds of the grantees reported that they provided co-occurring mental illness and 

substance abuse treatment services, trauma-specific treatment, and peer support. Based on 

performance data reporting, program participants experienced improvements in mental health and 

reductions in substance use. Alcohol and other drug use declined by 60 percent in the first six 

months while mental health symptoms declined by 20 percent over the same period and 74 percent 

of participants reported physical health improvements at six months. In addition, employment 

rates increased from 36 percent to 45 percent over the first six months, with monthly median 

income increasing by $298.105

In FY 2017, SAMHSA funded 17 continuation grants and the evaluation contract. 

Under the FY 2018 Annualized CR level, SAMHSA would plan to fund 16 new and 11 

continuation ORP grants continue support for the technical assistance and evaluation contracts. 

 

105 Advocates for Human Potential. (2014). Evaluation of the Adult Treatment Court Collaborative Program: Final 

evaluation report. Albany, NY: Author.
199 

Funding History

Fiscal Year Amount

FY 2015 $78,000,000

FY 2016 $78,000,000

FY 2017 $74,000,000

FY 2018 $77,470,000

FY 2019 $78,000,000

Budget Request 

The FY 2019 President’s Budget Request is $78.0 million ($60.0 million for Drug Courts 

Activities and $18.0 million for Other Criminal Justice Activities), an increase of $530,000 from 

the FY 2018 Annualized CR. SAMHSA intends to support 44 new drug court grants, 115 drug 

court continuation grants, and three contracts. SAMHSA intends to fund 27 ORP continuation 

grants. 

The FY 2019 President’s Budget requests additional funds Drug Courts through the Additional 

Opioids Allocation funding and is described on page 259. 
200 

Outputs and Outcomes Table

Program: Criminal Justice - Drug Courts 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore bases the 

FY 2018 targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result

(Summary of Result)

FY 2018 

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.2.72 Increase the percentage of adult 

clients receiving services who were 

currently employed or engaged in 

productive activities (Outcome)

FY 2017: 64.1 %

Target: 55 %

(Target Exceeded)

64.1 % 64.1 % Maintain

1.2.73 Increase the percentage of adult 

clients receiving services who had a 

permanent place to live in the 

community (Outcome)

FY 2017: 46 %

Target: 41 %

(Target Exceeded)

46 % 46 % Maintain

1.2.74 Increase the percentage of adult 

clients receiving services who had no 

involvement with the criminal justice 

system (Outcome)

FY 2017: 93.7 %

Target: 91 %

(Target Exceeded)

93.7 % 93.7 % Maintain

1.2.76 Increase the percentage of adult 

clients receiving services who had no 

past month substance use (Outcome)

FY 2017: 86.1 %

Target: 71 %

(Target Exceeded)

86.1 % 86.1 % Maintain

1.2.79 Increase the number of adult 

clients served (Output)

FY 2017: 8,597

Target: 5,500

(Target Exceeded)

8,597 8,597 Maintain
201 

Outputs and Outcomes Table

Program: Criminal Justice - Offender Re-Entry Program 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.2.80 Increase the number of clients 

served (Outcome)

FY 2017: 1,212

Target: 2,000106

(Target Not Met)

2,000 2,000 Maintain

1.2.81 Increase the percentage of 

clients who had no past month 

substance use (Outcome)

FY 2017: 69.1 %

Target: 74 %107

(Target Not Met)

74.0 % 74.0 % Maintain

GH: 1.2.84 Increase the percentage of 

clients receiving services who had no 

involvement with the criminal justice 

system (Outcome)

FY 2017: 93.3 %

Target: 94 %

(Target Not Met but Improved)

93.3 % 93.3 % Maintain

 

106Decrease in target from prior year level reflects a decrease in funding and changes in data trends. 

107Decrease in target from prior year level reflects a decrease in funding and changes in data trends.
202 

Outputs and Outcomes Table

Program: Treatment – Other Capacity

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final. The FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019 

Target

+/- 

FY 2018

Target

1.2.25 Increase the percentage of 

adults receiving services who had no 

past month substance use (Outcome)

FY 2017: 65.6 %

Target: 60 %

(Target Exceeded)

65.6 % 65.6 % Maintain

1.2.26 Increase the number of clients 

served (Output) 

FY 2017: 20,310

Target: 30,000

(Target Not Met)

20,310 20,310 Maintain

1.2.27 Increase the percentage of 

adults receiving services who were 

currently employed or engaged in 

productive activities (Outcome)

FY 2017: 45.6 %

Target: 43 %

(Target Exceeded)

45.6 % 45.6 % Maintain

1.2.28 Increase the percentage of 

adults receiving services who had a 

permanent place to live in the 

community (Outcome)

FY 2017: 46.6 %

Target: 47 %

(Target Not Met but Improved)

47 % 47 % Maintain

1.2.29 Increase the percentage of 

adults receiving services who had no 

involvement with the criminal justice 

system (Outcome)

FY 2017: 97.5 %

Target: 93 %

(Target Exceeded)

97.5 % 97.5 % Maintain
203 

Building Communities of Recovery

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Building Communities of Recovery.................................. $3,000 $2,980 $3,000 $20

Authorizing Legislation . Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2019 Authorization ....................................................................................................$3,000,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities ................................... Primary care, child welfare system, criminal justice system

Program Description and Accomplishments

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 funded a new cohort of grant through the Comprehensive 

Addiction Recovery Act (CARA) Building Communities of Recovery program. 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 addiction. 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 SUDs 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. Grantees will also work to reduce 

negative attitude, discrimination, and prejudice around addiction and addiction recovery. 

Under the FY 2018 Annualized CR level, SAMHSA will support five continuation grants for 

program implementation and direct TA. 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 ---

FY 2017 $3,000,000 

FY 2018 $2,980,000 

FY 2019 $3,000,000 
204 

Budget Request 

The FY 2019 President’s Budget Request is $3.0 million, an increase of $20,000 from the FY 2018 

Annualized CR. These funds will be used to support seven new grants and five continuation grants 

the Building Communities of Recovery Program to develop, expand, and enhance recovery 

support services. 

Minority Fellowship Program

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

SAT Minority Fellowship Program................................... $3,539 $3,515 $--- -$3,515

Authorizing Legislation ............................................. Section 597 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

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 and Accomplishments

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol 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, and 

psychology. In 2006, the program expanded to include marriage and family therapists and later 

added professional counselors. Professional guilds receive competitively awarded grants, and then 

competitively award the stipends to post-graduate students pursuing a degree in that professional 

field. In FY 2016 and FY 2017, SAMHSA funded six continuation grants. 

SAMHSA Minority Fellowship Programs have had a variety of foci including youth and addiction 

counselors. 

In FY 2017, SAMHSA provided continuation funding for this cohort of grants. 

Under the FY 2018 Annualized CR level, SAMHSA will award a new cohort of MFP grants. 
205 

Funding History

Fiscal Year Amount

FY 2015 $2,920,045 

FY 2016 $3,539,000 

FY 2017 $3,539,000 

FY 2018 $3,515,000 

FY 2019 ---

Budget Request

The FY 2019 President’s Budget Request is $0.0 million, a decrease of $3.5 million from the 

FY 2018 Annualized CR. This program is being discontinued in FY 2019 because it overlaps with 

other federal activities. 

Addiction Technology Transfer Centers

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Addiction Technology Transfer Centers........................... $9,046 $8,985 $9,046 $61

Authorizing Legislation ............................................. Section 509 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................... Competitive Grants/Contracts/Cooperative Agreements

Eligible Entities .................................................... Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

Misuse of, and addiction to alcohol, tobacco, and illicit drugs cost Americans more than 

$700 billion a year in increased healthcare costs, crime, and lost productivity. 108, 109 Recently, the 

nation’s attention has been on the increase misuse of opioids. The majority of drug overdose 

deaths (more than six out of ten) involved an opioid.110 Alcohol/other drug addiction is treatable 

and research has led to development of medications and evidence-based psychosocial interventions 

that help people achieve recovery and resume productive lives. One critical need is to help recruit, 

train, and support treatment providers in the use of evidence-based practices. 

 

108 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics 109 National Institute for Drugs and Alcohol. (2015). Trends and Statistics. Retrieved from NIH/NIDA: 

http://www.drugabuse.gov/related-topics/trends-statistics

110 Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 

2010–2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016
206 

The Addiction Technology Transfer Center Network (ATTC Network) is one of SAMHSA’s 

proven models for building behavioral health capacity in health systems and communities through 

the sharing and transfer of expertise. SAMHSA supports the ATTC Network to develop and 

provide low or no cost training opportunities using evidence-based teaching, technologies, 

implementation, coaching, and information dissemination to behavioral health professionals. 

During the last cycle of the ATTC program (FY 2011 - 2016), the ATTC network supported the 

completion of over 430 events (technical assistance, webinars, onsite training, presentations etc.) 

benefiting over 128,000 health professionals. Overall, over 94 percent of participants reported 

satisfaction with the quality of the training or technical assistance they received from the ATTC 

Network. There is a critical and rising need for practitioners to reflect the diversity of their client 

population in terms of characteristics, such as age, race/ethnicity, and sexual orientation. 

Existing diversity requires recruitment of new professionals from a variety of backgrounds.111 

Treating persons with drug/alcohol addiction is difficult and challenging. Pay and benefits often 

do not fully reflect the difficulty of this work. Burnout and turnover are significant challenges for 

providers and their employing organizations and may impede patient recovery.

Faced with an average annual staff turnover rate of 18.5 percent, substance use disorder treatment 

programs deal with significant challenges to fill open positions.112 Common hurdles for many 

abuse treatment facilities include difficulty retaining and recruiting qualified individuals, the need 

for a diverse workforce capable of working in integrated settings, and the perception that 

drug/alcohol addiction is not a valid health issue (i.e., that addiction is a ‘choice’).113

To address the gaps in workforce, the ATTC Network supports national and regional activities 

focused on improving the skills of substance abuse treatment and other healthcare professionals. 

The ATTC Network decreases the gap in time between the release of new scientific findings and 

the adoption of these interventions by front-line substance abuse treatment clinicians. ATTC 

grantees develop evidence-based and promising practices for addiction treatment/recovery 

professionals, public health/mental health personnel, institutional and community corrections 

professionals, nurses, and other health professions. The ATTC Network dissemination models 

include technical assistance, training and an extensive array of web-based resources created to 

translate the latest science for adoption into practice by the substance abuse treatment workforce. 

Using a systems change approach, the goal is to improve organizations and systems of care, 

enhancing access, engagement, and outcomes in a continuous quality improvement framework.

 

111 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence 

at the University of Missouri-Kansas City. Retrieved from 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf 

112 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence 

at the University of Missouri-Kansas City. Retrieved from 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf 113 Ryan, O., Murphy, D., Krom, L. (2012). Vital Signs: Taking the Pulse of the Addiction Treatment Workforce, A 

National Report, Version 1. Kansas City, MO: Addiction Technology Transfer Center National Office in residence 

at the University of Missouri-Kansas City. Retrieved from 

http://www.attcnetwork.org/documents/VitalSignsReport.pdf
207 

In FY 2016, the ATTC Network included 10 Regional Centers, four National Focus Area Centers, 

and a Network Coordinating Office. In FY 2017, a new cohort of grants was awarded to 10 

Regional Centers and one Coordinating Center. 

Under the FY 2018 Annualized CR level, SAMHSA plans to fund one new AI/AN and eleven

continuation grants in the ATTC program. Together, the members of the ATTC Network will 

continue to provide technical assistance, workforce training, support meetings, and the 

collaboration with other HHS agencies, the SAMHSA Regional Administrators, and other 

partners. 

Funding History

Fiscal Year Amount

FY 2015 $9,046,000

FY 2016 $9,046,000

FY 2017 $9,046,000

FY 2018 $8,985000

FY 2019 $9,046,000

Budget Request 

The FY 2019 President’s Budget Request is $9.0 million, an increase of $61,000 from the FY 2018 

Annualized CR. SAMHSA plans to fund twelve continuation grants. Funding will allow the 

ATTC grantees to disseminate evidence-based, promising practices to addiction treatment and 

recovery professionals, public health and mental health personnel, institutional and community 

corrections professionals, and other related disciplines. 
208 

Improving Access to Overdose Treatment

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Improving Access to Overdose Treatment..................... $1,000 $993 $1,000 $7

Authorizing Legislation . Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2019 Authorization ....................................................................................................$1,000,000 

Allocation Method ................................................................................................. Grants/Contracts 

Eligible Entities ................................... Primary care, child welfare system, criminal justice system

Program Description and Accomplishments

Drug overdose deaths and opioid-involved deaths continue to increase in the United States. In 

2016, there were more than 63,600 drug overdose deaths in the United States. Opioids—

prescription and illicit—are the main driver of drug overdose deaths. 116 Americans die every day 

from an opioid overdose. Opioid overdose deaths were five times higher in 2016 than 1999.114 In 

2013, SAMHSA released the Opioid Overdose Prevention Toolkit to help reduce the number of 

opioid-related overdose deaths and adverse events. The Improving Access to Overdose Treatment 

(CARA) grant program utilizes this toolkit and other resources to help grantees train and provide 

resources to health care providers and pharmacists on the prescribing of drugs or devices approved 

or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or 

suspected opioid overdose. 

Further, the Improving Access to Overdose Treatment (CARA) grant program addressesthe opioid 

crisis by 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 (including prescription opioids as well as illicit drugs such as heroin). 

SAMHSA awarded one (1) Improving Access to Overdose Treatment (CARA) grant in FY 2017. 

The grantee partners with other prescribers at the community level to develop best practices for 

prescribing and co-prescribing FDA-approved overdose reversal drugs. After developing best 

practices, the grantee will train other prescribers in key community sectors as well as individuals 

who support persons at high risk for overdose. This grant program also ensures the grantee 

establishes protocols to connect patients who have experienced a drug overdose with appropriate 

treatment, including medication-assisted treatment and appropriate counseling and behavioral 

therapies.

 

114 (Hedegaard H, Warner M, Miniño AM. Drug overdose deaths in the United States, 1999–2016. NCHS Data Brief, 

no 294. Hyattsville, MD: National Center for Health Statistics. 2017/ CDC. Wide-ranging online data for 

epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at 

http://wonder.cdc.gov. 
209 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 ---

FY 2017 $1,000,000 

FY 2018 993,000 

FY 2019 $1,000,000 

Budget Request

The FY 2019 President’s Budget Request is $1.0 million, an increase of $7,000 from the FY 2018 

Annualized CR. In FY 2019, SAMHSA will support three 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.
210 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table Summary

(Dollars in thousands)

Programs of Regional & National Significance 

FY 2017 

Final

FY 2018 

Annualized CR

FY 2019 

President's 

Budget

No. Amount No. Amount No. Amount

Grants/Cooperative Agreements:

 Continuations............................................................ 420 $155,345 384 $176,300 320 $173,677

 New/Competing......................................................... 241 142,641 206 125,681 131 39,248 

 Subtotal.................................................................... 661 297,986 590 301,981 451 212,925

Contracts:

 Continuations............................................................ 21 36,947 29 41,318 49 36,581 

 New/Competing......................................................... 17 19,494 6 8,721 2 5,811 

 Subtotal.................................................................... 38 56,441 35 50,039 51 42,393

Total, Substance Abuse Treatment 699 $350,427 625 $352,020 502 $255,318
211 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

Opioid Treatment Programs/Regulatory Activities

 Grants

Continuations............................................................................... 1 $1,000 1 $1,393 --- $394

New/Competing........................................................................... 1 1,400 1 1,000 1 1,999

Subtotal...................................................................................... 2 2,400 2 2,393 1 2,393

 Contracts

Continuations............................................................................... 4 4,645 3 4,078 4 4,840

New/Competing........................................................................... 3 1,679 2 2,194 1 1,492

Subtotal...................................................................................... 7 6,324 5 6,272 5 6,331

Total, Opioid Treatment Programs/Regulatory Activities 9 8,724 7 8,665 6 8,724

Screening, Brief Intervention and Referral to Treatment 

 Grants

Continuations............................................................................... 80 25,298 20 16,607 --- ---

New/Competing........................................................................... --- --- 7 6,853 --- ---

Subtotal...................................................................................... 80 25,298 27 23,461 --- ---

 Contracts

Continuations............................................................................... 2 4,588 2 5,979 --- ---

New/Competing........................................................................... --- 114 --- 357 --- ---

Subtotal...................................................................................... 2 4,702 2 6,336 --- ---

Total, Screening, Brief Intervention and Referral to 

Treatment 82 30,000 29 29,796 --- ---

Targeted Capacity Expansion

 Grants

Continuations............................................................................... 52 28,006 44 21,209 33 52,151

New/Competing........................................................................... 8 31,899 21 41,030 32 8,409

Subtotal...................................................................................... 60 59,905 65 62,239 65 60,561

 Contracts

Continuations............................................................................... 2 5,094 1 4,000 1 6,352

New/Competing........................................................................... 1 2,193 1 497 --- 279

Subtotal...................................................................................... 3 7,287 2 4,497 1 6,631

Total, Targeted Capacity Expansion 63 67,192 67 66,736 66 67,192

Subtotal, Capacity 154 105,916 103 105,197 72 75,916
212 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

Pregnant and Postpartum Women 

 Grants

Continuations............................................................................... 7 3,413 23 13,537 26 14,603

New/Competing........................................................................... 22 13,086 5 2,377 2 1,035

Subtotal...................................................................................... 29 16,499 28 15,914 28 15,638

 Contracts

Continuations............................................................................... 2 2,326 5 3,541 5 3,866

New/Competing........................................................................... 2 1,106 --- 340 --- 427

Subtotal...................................................................................... 4 3,432 5 3,881 5 4,293

Total, Pregnant and Postpartum Women 33 19,931 33 19,796 33 19,931

Recovery Community Services Program

 Grants

Continuations............................................................................... --- --- 10 1,496 10 1,499

New/Competing........................................................................... 10 1,499 --- --- --- ---

Subtotal...................................................................................... 10 1,499 10 1,496 10 1,499

 Contracts

Continuations............................................................................... --- 132 2 789 2 831

New/Competing........................................................................... 2 803 --- 133 --- 104

Subtotal...................................................................................... 2 935 2 922 2 935

Total, Recovery Community Services Program 12 2,434 12 2,417 12 2,434

Children and Families

 Grants

Continuations............................................................................... 14 $9,684 13 $12,329 27 $18,884

New/Competing........................................................................... 12 11,741 18 12,017 8 4,529

Subtotal...................................................................................... 26 21,425 31 24,346 35 23,413

 Contracts

Continuations............................................................................... 2 4,012 3 5,058 28 5,629

New/Competing........................................................................... 1 4,168 --- --- --- 563

Subtotal...................................................................................... 3 8,180 3 5,058 28 6,192

Total, Children and Families 29 29,605 34 29,404 63 29,605

Subtotal, Capacity 228 157,886 182 156,814 180 127,886
213 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Capacity:

Treatment Systems for Homeless 

 Grants

Continuations............................................................................... 46 20,910 63 21,312 65 22,815

New/Competing........................................................................... 33 11,638 32 11,177 37 8,586

Subtotal...................................................................................... 79 32,548 95 32,489 102 31,401

 Contracts

Continuations............................................................................... 2 3,701 2 3,650 2 4,227

New/Competing........................................................................... --- 137 --- --- --- 758

Subtotal...................................................................................... 2 3,838 2 3,650 2 4,985

Total, Treatment Systems for Homeless 81 36,386 97 36,139 104 36,386

Minority AIDS 

 Grants

Continuations............................................................................... 82 29,090 82 40,598 --- ---

New/Competing........................................................................... 59 29,181 36 17,678 --- ---

Subtotal...................................................................................... 141 58,271 118 58,276 --- ---

 Contracts

Continuations............................................................................... 2 5,083 2 4,874 --- ---

New/Competing........................................................................... 1 2,217 2 1,975 --- ---

Subtotal...................................................................................... 3 7,299 4 6,849 --- ---

Total, Minority AIDS 144 65,570 122 65,125 --- ---

Criminal Justice Activities

 Grants

Continuations............................................................................... 130 35,837 112 36,816 142 54,118

New/Competing........................................................................... 75 26,354 74 30,500 44 13,238

Subtotal...................................................................................... 205 62,191 186 67,316 186 67,355

 Contracts

Continuations............................................................................... 3 6,424 4 7,219 4 8,456

New/Competing........................................................................... 4 5,386 1 2,935 1 2,189

Subtotal...................................................................................... 7 11,809 5 10,154 5 10,645

Total, Criminal Justice Activities 212 74,000 191 77,470 191 78,000

Subtotal, Capacity 665 333,842 592 $335,548 475 242,272
214 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands)

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Improving Access to Overdose Treatment (IATOT)

 Grants

Continuations............................................................................... --- --- --- --- --- ---

New/Competing........................................................................... --- --- --- --- --- ---

Subtotal...................................................................................... --- --- --- --- --- ---

 Contracts

Continuations............................................................................... --- --- 3 993 3 1,000

New/Competing........................................................................... 3 1,000 --- --- --- ---

Subtotal...................................................................................... 3 1,000 3 993 3 1,000

Total, Improving Access to Overdose Treatment (IATOT) 3 1,000 3 993 3 1,000

Building Communities of Recovery (BCOR)

 Grants

Continuations............................................................................... --- --- 5 2,533 5 $825

New/Competing........................................................................... 8 2,533 --- --- 7 1,453

Subtotal...................................................................................... 8 2,533 5 2,533 12 2,278

 Contracts

Continuations............................................................................... --- --- --- 171 --- 722

New/Competing........................................................................... --- 467 --- 276 --- ---

Subtotal...................................................................................... --- 467 --- 447 --- 722

Total, Building Communities of Recovery (BCOR) 8 3,000 5 2,980 12 3,000

Science and Service:

Addiction Technology Transfer Centers

 Grants

Continuations............................................................................... --- --- 11 8,470 12 8,388

New/Competing........................................................................... 11 8,515 1 --- --- ---

Subtotal...................................................................................... 11 8,515 12 8,470 12 8,388

 Contracts

Continuations............................................................................... --- 492 --- 514 --- 658

New/Competing........................................................................... --- 39 --- --- --- ---

Subtotal...................................................................................... --- 531 --- 514 --- 658

Total, Addiction Technology Transfer Centers 11 9,046 12 8,985 12 9,046

Subtotal, Science and Service 11 9,046 12 8,985 12 9,046

Minority Fellowship Program (MFP)

 Grants

Continuations............................................................................... 8 2,107 --- --- --- ---

New/Competing........................................................................... 2 796 11 3,048 --- ---

Subtotal...................................................................................... 10 2,903 11 3,048 --- ---

 Contracts

Continuations............................................................................... 2 450 2 452 --- ---

New/Competing........................................................................... --- 186 --- 14 --- ---

Subtotal...................................................................................... 2 636 2 467 --- ---

Total, Minority Fellowship Program (MF) 12 3,539 13 3,515 --- ---

Subtotal, Science and Service: 23 12,585 25 12,500 12 9,046

Total, Substance Abuse Treatment PRNS 699 350,427 625 352,020 502 255,318
215 

Grant Awards Table 

(Whole Dollars) 

FY 2017 

Final

FY 2018 

Annualized CR

FY 2019 

President's Budget

Number of Awards 661 590 451

Average Award $450,811 $511,832 $472,118

Range of Awards $300,000-$600,000 $300,000-$600,000 $300,000-$600,000
216 

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217 

State Targeted Response to the Opioid Crisis

(Dollars in thousands)

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

State Targeted Response to the Opioid Crisis Grants. $500,000 $496,605 $---* -$496,605

Authorizing Legislation ...............................................Section 1003 of the 21st Century, Cures Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................................................................................................. Grants 

Eligible Entities ...................................................................................................... States/Territories

*Additional funding is proposed for this program as part of the Additional Opioids Allocation 

funding request. That funding request is displayed in its entirety on page 259. 

Program Description and Accomplishments

Opioid abuse continues to cause a significant crisis across the nation. According to the CDC, 

opioid-overdose related deaths numbered approximately 64,000 in 2016. As misuse and abuse 

continues to rise, Americans are dealing with the devastating consequences that accompany this 

use including: loss of employment, social connectedness, increased criminal justice involvement, 

injury, and death. 

The State Targeted Response to the Opioid Crisis Grant Program (Opioid STR) was authorized

under Section 1003 of the 21st Century Cures Act. The program aims to address the opioid crisis 

by 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 

addiction. 

Grantees are required to: use epidemiological data to demonstrate the critical gaps in availability 

of treatment for opioid addiction in geographic, demographic, and service level terms; utilize 

evidence-based implementation strategies to identify which system design models will most 

rapidly address the gaps in their systems of care; implement prevention strategies; deliver evidence 

based treatment interventions including medication and psychosocial interventions; deliver 

recovery support services; and report progress toward increasing availability of treatment for 

opioid addiction and reducing opioid-related overdose deaths.

The Opioid STR grants have helped states target these resources to address the particular problems 

they are facing with respect to opioids. States have applied learn lessons from the first year of this 

program and are already identifying ways to maximize impact and efficiency. States have quickly 

implemented a wide range of evidence-based prevention, treatment, and recovery interventions 

that respond to the unique needs in their communities
218 

In FY 2017, Opioid STR grants were awarded via formula to all 50 states, the District of Columbia, 

Puerto Rico, the Virgin Islands, Northern Marianas, Micronesia, Palau, and American Samoa. 

Funds are also being used to support a cross-site evaluation to demonstrate program effectiveness 

and technical assistance activities. 

Funding History

Fiscal Year Amount

FY 2015 ---

FY 2016 ---

FY 2017 $500,000,000

FY 2018 $496,605,000 

FY 2019 ---

Budget Request 

Section 1003 of the 21st Century Cures Act authorized $500.0 million to be appropriated to the 

HHS Secretary for use as grants to support state responses to opioid abuse in FY 2017 and 

FY 2018. There is no funding authorized under current law in FY 2019. The FY 2019 President’s 

Budget request is $1.0 billion in the Additional Opioids Allocation funding and is described on 

page 259. 
219 

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget 

+/- 

FY 2018 

Annualized 

CR

Substance Abuse Prevention and Treatment Block Grant $1,858,079 $1,845,461 $1,858,079 $12,618

 Budget Authority (non-add)....................................... 1,778,879 1,766,799 1,778,879 12,080 

PHS Evaluation Funds (non-add).......................... 79,200 78,662 79,200 538 

Authorizing Legislation ........................................... Section 1935 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ................................................................................................... Formula Grants

Eligible Entities ........................ States, Territories, Freely Associated States, District of Columbia, 

and the Red Lake Band of Chippewa Indians of Minnesota 

Program Description and Accomplishments

The authorizing legislation and implementing regulation governing the Substance Abuse 

Prevention and Treatment Block Grant (SABG) includes a number of prescriptive performance 

and expenditure requirements as well as explicit expenditure prohibitions. The states and 

jurisdictions have the flexibility to plan, carry out, and evaluate substance abuse treatment and 

recovery services that reflect comments received from individuals, families and communities 

during the development of their respective biennial plans and the results of such plans are reflected 

in their respective annual reports. The legislation and regulation prioritizes two populations to be 

served with SABG funds: (1) substance using pregnant women and women with dependent 

children; and (2) persons who inject drugs. Although the legislation and regulation prioritizes such 

individuals, the states and jurisdictions have the flexibility to prioritize other underserved 

populations as determined by anecdotal and empirical data. For example, most states and 

jurisdictions prioritize substance abuse treatment and recovery services for adolescents and 

transitional age youth. Some states and jurisdictions are also developing peer-to-peer recovery 

services to facilitate individuals’ entry to substance abuse treatment services and to promote and 

support individuals in early recovery. States and jurisdictions frequently partner with other 

executive branch departments, e.g., education, human services, justice and public health, to 

coordinate services for individuals and families impacted by substance abuse.

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds 

to 60 eligible states, territories and freely associated states115, the District of Columbia, and the Red 

Lake Band of Chippewa Indians of Minnesota (referred to collectively as states) to plan, carry out, 

and evaluate substance abuse prevention, treatment, and recovery support services for individuals, 

 

115 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. Retrieved from 

http://www.doi.gov//oia/islands/index.cfm
220 

families, and communities impacted by substance abuse. The SABG’s overall goal is to support 

and expand substance abuse prevention and treatment services while providing maximum 

flexibility to grantees. 

The SABG is critically important because it provides the states and their respective SABG subrecipients, including, but not limited to, administrative service organizations, county and municipal 

governments, and prevention and treatment providers, the flexibility to respond to local and/or 

regional emergent issues impacting health, public health, and public safety through a consistent 

federal funding stream. SABG accounts for approximately 32 percent of total state substance 

abuse agency funding and 23 percent of total state substance abuse prevention and public health 

funding.116 Individuals and families without health coverage or whose health insurance benefit 

will not cover certain services (e.g., recovery support) rely on services funded by the SABG. Block 

grant funds are being leveraged by states, along with other funding sources, to support training for 

staff and implementation of evidence-based practices for the prevention of substance misuse and 

the treatment of drug/alcohol addiction, improved business practices such as facilitating 

enrollment in appropriate health coverage and use of health information technology and integration 

of physical and behavioral health.117 SAMHSA encourages states to use block grant resources to 

support and not supplant services that are covered through commercial and public insurer plans. 

SAMHSA Block Grant funds are directed toward four purposes: to fund priority treatment and 

support services for individuals without insurance or for whom coverage is terminated for short 

periods of time; to fund those priority treatment and support services not covered by Medicaid, 

Medicare, or private insurance for low-income individuals and that demonstrate success in 

improving outcomes and/or supporting recovery; to fund primary prevention for individuals not 

identified as needing treatment (universal programs that reach everyone in a group being served 

regardless of risk, selective interventions that serve people at elevated risk of substance misuse or 

a drug/alcohol addiction, and indicated prevention interventions that serve people who exhibit 

some symptoms of a clinical substance use disorder, but do not yet meet criteria for a diagnosis); 

and to collect performance and outcome data to determine the ongoing effectiveness of behavioral 

disorder treatment, and recovery support services and to plan the implementation of new services 

on a nationwide basis. SAMHSA also encourages the states to use their Block Grants to: allow 

recovery to be pursued through personal choice and many pathways; encourage providers to assess 

performance based on outcomes that demonstrate client successes; and expand capacity by 

increasing the number and types of providers who deliver clinical treatment and/or recovery 

support services. 

In addition to the states’ and jurisdictions’ plans and reports, the authorizing legislation provides 

SAMHSA with significant resources to support targeted technical assistance to the SABG grantees 

and their respective sub-recipients, i.e., community- and faith-based organizations approved by the 

states and jurisdictions to provide substance abuse treatment and recovery services. SAMHSA’s

Knowledge Application Program (KAP) (http://www.samhsa.gov/kap) produces the Technical 

 

116 SABG State Agency Reported Expenditures by Target Activity Within Source of Funds, State/Jurisdiction 

Selection: All States/Jurisdictions (2015)

117 Case Studies of Three Policy Areas and Early State Innovators: 2014 State Profiles of Mental Health and 

Substance Use Disorder Agencies. HHS Publication in Press. Rockville, MD: Substance Abuse and Mental Health 

Services Administration. (2015). 
221 

Assistance Public Series that provide practical guidance and information related to the delivery of 

substance abuse 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.

Funding Allocations and Requirements

SABG funds are distributed118 through a formula grant that provides funding based on specified 

economic and demographic factors and is administered by SAMHSA’s Centers for Substance 

Abuse Treatment (CSAT) and Center for Substance Abuse Prevention (CSAP). Of the amounts 

appropriated for the SABG program, 95 percent are distributed to states through a formula 

included in the authorizing legislation. Factors used to calculate the allotments include total 

personal income, state population data by age groups (total population data for territories), total 

taxable resources, and a cost of services index factor. The SABG also includes “hold harmless” 

provisions that limit fluctuations in allotments as the total block grant appropriation changes from 

year to year. 

Maintenance of Effort: The SABG requires states to maintain its expenditures for certain substance 

abuse prevention and treatment activities at a level that is no less than the state’s average 

expenditures for the previous two-years. 

Funding Set-Asides and Other Requirements: The authorizing legislation and implementation 

regulation for the SABG includes specific funding set-asides, including 20 percent for primary 

prevention (see below), and five percent for early intervention service for HIV for designated 

states.119 The statute also includes performance requirements for the treatment of substance-using 

pregnant women and women with dependent children, and provides states with the flexibility to 

expend a combination of federal and non-federal funds. There are also requirements and potential 

penalty reduction of the Block Grant allotment if the recipient fails to prohibit and enforce sale of 

tobacco products to individuals under the age of 18. 

Coordination of Efforts: SAMHSA emphasizes that Block Grant recipients should coordinate and 

partner with government agencies, nonprofit organizations, consumers and families and providers 

to support integrated and coordinated services and programs. SAMHSA provides targeted 

technical assistance for SABG grantees through a technical assistance contract. 

Performance and Evaluation

SAMHSA is undertaking a series of agency-wide efforts designed to develop a set of common 

performance, quality, and cost measures to demonstrate the impact of SAMHSA’s programs. 

Ultimately, SAMHSA and its state partners will collaborate to develop a streamlined behavioral 

health data system that complements other existing systems (e.g., Medicaid administrative and 

 

118 Block Grants and Formula Grants: A Guide for Allocation Calculations; 2007 Department of Health and Human 

Services, SAMHSA. 119 Substance Abuse and Mental Health Services Administration. (2015). Block Grant Laws and Regulations.

Retrieved from http://www.samhsa.gov/grants/block-grants/laws-regulations.
222 

billing data systems, and state mental health and substance abuse treatment data systems), ensures 

consistency in the use of measures, and provides a more complete perspective of the delivery of 

mental illness and substance abuse treatment services.

An independent evaluation of the SABG demonstrated how states have leveraged the statutory 

requirements of this Block Grant program to expand existing or establish new treatment capacity 

in underserved areas of states and territories and to improve coordination of services with other 

state systems.120 SAMHSA data show that the SABG has been successful in expanding treatment 

capacity by supporting approximately two million121 admissions to treatment programs receiving 

public funding. Outcome data for the Block Grant program show positive results as reported 

through Behavioral Health Services Information System/Treatment Episode Data Set (TEDS) 

administered by SAMHSA’s Center for Behavioral Health Statistics and Quality. In FY 2015, at 

discharge, clients demonstrated high abstinence rates from both illegal drug (70 percent) and 

alcohol (83 percent) use. State substance abuse authorities reported the following outcomes for 

services provided during FY 2015, the most recent year for which data is available: 

State substance abuse authorities reported the following outcomes for services provided during 

FY 2016, the most recent year for which data is available: 

• For the 50[3] states and the District of Columbia that reported data concerning abstinence 

from alcohol use, all 51 identified improvements in client abstinence;

• Similarly, for the 50 states and D.C. that reported data concerning the abstinence from drug 

use, 50 of 51 identified improvements in client abstinence;

• For the 50 states and D.C. that reported employments data, 45 of 50 identified 

improvements in client employment;

• For the 50 states and D.C. that reported criminal justice data, 47 of 51 reported an increase 

in clients with no arrests based on data reported to TEDS; 

• For the 50 states and D.C. that reported housing data, 48 of 51 identified improvements in 

stable housing for clients based on data reported to TEDS; and 

• For the 50 states and D.C that reported recovery support data, 51 states out of 51 

identified improvements in client engagement in recovery support programs. At intake 

clients who were engaged in recovery support programs increased from 29 percent to 

44.8 percent at discharge.

20 Percent Prevention Set-Aside

SAMHSA is responsible for managing the 20 percent prevention set-aside of the SABG. The 

20 percent set-aside requires SABG grantees to spend at least 20 percent of their SABG award to 

develop and implement a comprehensive prevention program, which includes a broad array of 

 

120 Substance Abuse and Mental health Administration. Retrieved from

http://tie.samhsa.gov/SAPT2010.html#Evaluation. 121 Substance Abuse and Mental Health Services Administration (2015). Clients Level Data / TEDS. Retrieved from 

http://www.samhsa.gov/data/client-level-data-teds

[3] Source: West Virginia numbers have been included in the text, but they appear lower than expected.
223 

prevention strategies directed at individuals not identified to be in need of treatment.122 The 

prevention set-aside is one of SAMHSA’s main vehicles for supporting SAMHSA’s Strategic 

Initiative for the Prevention of Substance Abuse and Mental Illness. The 20 percent set-aside is 

focused only on substance use prevention. States use these funds to develop infrastructure and 

capacity and to fund programs specific to primary substance abuse prevention. Some states rely 

solely on the 20 percent set-aside to fund their prevention systems while others use the funds to 

target gaps and enhance existing program efforts. 

States are encouraged to make prevention a top priority, taking advantage of recent science, best 

practices in community coordination, proven planning processes, and the findings articulated by 

the Institute of Medicine report, Preventing Mental, Emotional, and Behavioral Disorders Among 

Young People.123 SAMHSA regularly works with states to improve their accountability systems 

for prevention and to establish necessary reporting capacities. 

Synar

The Synar program is the set of actions put in place by states, with the support of the federal 

government, to implement the requirements of the Synar Amendment. The Synar Amendment 

requires states to ensure tobacco is not sold to individuals under age 18.124 The Amendment was 

developed in the context of a growing body of evidence about the health problems related to 

tobacco use by youth, as well as evidence about the ease with which youth could purchase tobacco 

products through retail sources. The Synar program is a critical component of the success of youth 

tobacco use prevention efforts. SAMHSA is charged with overseeing states’ implementation of 

the Synar requirements and provides technical assistance to states on both the Synar requirements 

and youth tobacco access issues in general. 

While the national weighted retailer violation rate declined steadily from the program’s baseline 

year in FY 1997 through FY 2011, the rate has increased slightly since FY 2012. One of the 

greatest predictors of a state's retailer violation rate is the amount and reach of their enforcement 

efforts. As states have faced budget shortfalls, some have scaled back on their enforcement 

programs and this may be contributing to the increase in the rate of tobacco sales to youth. Also,

under the Synar program, SAMHSA encourages states to include in their inspections the types of 

tobacco products most often used by youth in their states. As states have expanded the types of 

tobacco products included in their Synar inspections, some states are reporting that retailers are 

sometimes more likely to sell non-cigarette tobacco products, including smokeless tobacco, to 

youth. These factors are likely contributing to the overall increase in the national weighted retailer 

violation rate. SAMHSA is addressing this increase by providing technical assistance to states, as 

well as examining Synar data in order to provide states with guidance on best practices including 

enforcement, merchant education, and community mobilization. 

 

122 Substance Abuse and Mental Health Services Administration (2015). Substance Abuse Prevention and Treatment 

Block Grant. Retrieved from http://www.samhsa.gov/grants/block-grants/sabg 123 "Front Matter." Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and 

Possibilities. Washington, DC: The National Academies Press, 2009. Retrieved from 

http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-Young-PeopleProgress-and-Possibilities.aspx. 124 Substance Abuse and Mental Health Services Administration (2015). Synar Program. Retrieved from 

http://www.samhsa.gov/synar 
224 

Funding History

Fiscal Year Amount

FY 2010 1,454,713,000 

FY 2011 1,782,528,000 

FY 2012 1,800,332,000 

FY 2013 1,710,306,376 

FY 2014 1,815,443,000 

FY 2015 1,819,856,000 

FY 2016 1,858,079,000 

FY 2017 1,858,079,000 

FY 2018 1,845,460,786

FY 2019 1,858,079,000 

Budget Request 

The FY 2019 President’s Budget request is $1.9 billion, an increase of $12.6 million from the

FY 2018 Annualized CR. SABG funds will continue to serve as a source of safety net funding, 

including assistance to states in addressing the opioid epidemic, and will continue to support 

certain services (e.g., recovery support services) not covered by commercial insurance and nonclinical activities and services that address the critical needs of state substance abuse prevention 

and treatment service systems.
225 

Substance Abuse and Mental Health Services Administration

FY 2019 DISCRETIONARY STATE/FORMULA GRANTS

Substance Abuse Prevention and Treatment Block Grant (SABG)

CFDA #93.959 

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

Alabama $23,089,756 $22,935,346 $22,983,552 $48,206

Alaska 5,889,143 5,849,760 5,969,752 119,992

Arizona 40,188,203 39,919,450 43,347,842 3,428,392

Arkansas 13,524,655 13,434,211 13,462,447 28,236

California 254,417,734 252,716,349 253,247,522 531,173

Colorado 28,777,682 28,585,235 31,004,115 2,418,880

Connecticut 18,212,438 18,090,645 18,128,669 38,024

Delaware 6,967,878 6,921,281 6,967,796 46,515

District Of Columbia 6,967,878 6,921,281 6,967,796 46,515

Florida 111,380,602 110,635,759 110,868,297 232,538

Georgia 57,152,886 56,770,684 56,890,007 119,323

Hawaii 8,515,901 8,458,952 8,476,731 17,779

Idaho 8,535,938 8,478,855 8,496,676 17,821

Illinois 67,646,569 67,194,191 67,335,422 141,231

Indiana 32,246,464 32,030,820 32,098,144 67,324

Iowa 13,093,501 13,005,940 13,033,276 27,336

Kansas 11,899,802 11,820,224 11,845,068 24,844

Kentucky 20,378,612 20,242,333 20,284,879 42,546

Louisiana 25,026,724 24,859,361 24,911,611 52,250

Maine 6,967,878 6,921,281 6,967,796 46,515

Maryland 34,080,384 33,852,476 33,923,628 71,152

Massachusetts 39,845,551 39,579,089 39,662,278 83,189

Michigan 56,053,510 55,678,660 55,795,687 117,027

Minnesota 24,102,321 23,941,140 23,991,460 50,320

Mississippi 13,803,724 13,711,413 13,740,232 28,819

Missouri 26,548,786 26,371,244 26,426,672 55,428

Montana 6,967,878 6,921,281 6,967,796 46,515

Nebraska 7,641,330 7,590,230 7,606,183 15,953

Nevada 16,890,245 16,777,294 16,812,557 35,263
226 

Substance Abuse and Mental Health Services Administration

FY 2019 DISCRETIONARY STATE/FORMULA GRANTS

Substance Abuse Prevention and Treatment Block Grant (SABG) CFDA #93.959 

State/Territory

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

+/- 

FY 2018

New Hampshire 6,967,878 6,921,281 6,967,796 $46,515

New Jersey 48,064,756 47,743,329 47,843,678 100,349

New Mexico 9,565,226 9,501,260 9,521,230 19,970

New York 111,831,371 111,083,513 111,316,992 233,479

North Carolina 44,992,436 44,691,555 44,785,489 93,934

North Dakota 6,533,624 6,489,931 6,623,054 133,123

Ohio 64,536,492 64,104,913 64,239,651 134,738

Oklahoma 17,149,542 17,034,857 17,070,661 35,804

Oregon 20,578,587 20,440,970 22,030,242 1,589,272

Pennsylvania 59,100,893 58,705,664 58,829,054 123,390

Rhode Island 7,598,565 7,547,751 7,563,615 15,864

South Carolina 23,718,051 23,559,440 23,608,958 49,518

South Dakota 6,041,781 6,001,377 6,124,479 123,102

Tennessee 31,978,622 31,764,769 31,831,533 66,764

Texas 144,710,369 143,742,637 144,044,760 302,123

Utah 16,588,775 16,477,840 16,758,971 281,131

Vermont 6,459,950 6,416,750 6,548,372 131,622

Virginia 41,980,395 41,699,657 41,787,303 87,646

Washington 37,785,106 37,532,423 37,611,310 78,887

West Virginia 8,432,779 8,376,386 8,393,992 17,606

Wisconsin 27,198,302 27,016,417 27,073,201 56,784

Wyoming 4,197,608 4,169,537 4,255,064 85,527

Red Lake Indians 594,034 590,061 591,301 1,240

American Samoa 343,467 341,781 345,156 3,375

Guam 1,014,336 1,017,520 1,104,302 86,782

Northern Marianas 324,352 329,209 347,532 18,323

Puerto Rico 22,812,308 22,631,279 22,572,549 -58,730

Palau 133,476 133,743 141,245 7,502

Marshall Islands 447,206 454,034 485,502 31,468

Micronesia 665,810 661,739 692,887 31,148

Virgin Islands 656,290 651,412 711,354 59,942
227 

Outputs and Outcomes Tables

Program: Synar Amendment

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/-

FY 2018

Target

2.3.49 Increase the number of States 

(including Puerto Rico) whose retail sales 

violations is at or below 20% (Outcome)

FY 2016: 52

Target: 52

(Target Met)

52 52 Maintain

2.3.62 Increase the number of States 

(excluding Puerto Rico) reporting retail 

tobacco sales violation rates below 10% 

(Outcome)

FY 2016: 30

Target: 33

(Target Not Met but Improved)

33 33 Maintain
228 

Outputs and Outcomes Tables

Program: Prevention Set-Aside

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the 

FY 2018 targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 

Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018 

Target

2.3.63 Increase the percent of states 

showing an increase in state level 

estimates of survey respondents 

who rate the risk of substance abuse 

as moderate or great (age 12-17). 

(Outcome)

FY 2014: 35.3%

(Historical Actual)

22.0% 22.0% Maintain

2.3.65 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use 

of alcohol (age 12-20). (Outcome)

FY 2015: 73.0%

Target: 67.5 %125

(Target Exceeded)

67.5% 67.5% Maintain

2.3.67 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use 

of other illicit drugs (age 12-17). 

(Outcome)

FY 2014: 49.0%

Target: 59.0%

(Target Not Met)

63.0% 63.0% Maintain

2.3.68 Increase the percent of states 

showing a decrease in state level 

estimates of percent of survey 

respondents who report 30 day use 

of other illicit drugs (age 18+). 

(Outcome)

FY 2014: 24.0%

Target: 37.3%

(Target Not Met)

43.0% 43.0% Maintain

 

125Data not available for FY 15 and FY 16 for most measures because of the NSDUH redesign prevented data 

collection during these fiscal years.
229 

Outputs and Outcomes Tables

Program: Treatment Activities

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 

targets on the FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

1.2.43 Increase the number of 

admissions to substance abuse 

treatment programs receiving public 

funding. (Output)

FY 2015: 1,806,941

Target: 1,937,960

(Target Not Met)

1,880,000 1,880,000 Maintain

1.2.48 Percentage of clients 

reporting no drug use in the past 

month at discharge. (Outcome)

FY 2016: 69.6 %

Target: 74.0%

(Target Not Met)

74.0% 74.0% Maintain

1.2.49 Increase the percentage of 

clients reporting no alcohol use in 

the past month at discharge. 

(Outcome)

FY 2016: 83.1 %

Target: 78.0%

(Target Exceeded)

78.0% 78.0% Maintain

1.2.50 Increase the percentage of 

clients reporting being employed/in 

school at discharge. (Outcome)

FY 2015: 35.7 %

Target: 43.0%

(Target Not Met)

40.0% 40.0% Maintain

1.2.51 Increase the percentage of 

clients reporting no involvement 

with the Criminal Justice System. 

(Outcome)

FY 2015: 93.2 %

Target: 92.0%

(Target Exceeded)

92.0% 92.0% Maintain

1.2.85 Increase the percentage of 

clients receiving services who had a 

permanent place to live in the 

community. (Outcome)

FY 2015: 88.9 %

Target: 92.0%

(Target Not Met)

92.0% 92.0% Maintain
230 

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231 

SAMHSA 

Health Surveillance and Program Support

Table of Contents 

1. Health Surveillance ........................................................................................................ 233 

2. Performance and Quality Information Systems ............................................................ 243 

3. Program Support ............................................................................................................. 251 

4. Public Awareness Support .............................................................................................. 253 
232 

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233 

Health Surveillance

(Dollars in thousands) 

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

Program Activity CR

Health Surveillance....................................................... $47,258 $46,937 $48,842 $1,905

Budget Authority (non-add).................................. 16,830 16,716 29,414 12,698

PHS Evaluation Funds (non-add)........................ 30,428 30,221 19,428 -10,793

Data Request and Publication User Fees................... $1,500 $1,490 $1,500 $---

Authorizing Legislation ............................. Sections 501 and 505 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method .................................................................. Federal/Intramural, Contracts, Other

Eligible Entities ......................................................................................................... Not Applicable

Program Description and Accomplishments

The Health Surveillance funding primarily supports the activities of the Center for Behavioral 

Health Statistics and Quality (CBHSQ). The detailed funding for each activity along with a 

detailed narrative description of each project follows. 
234 

Resources by Activity/Program

(Dollars in thousands)

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019

President's 

Budget

FY 2019

President's 

Budget

+/- 

FY 2018

Annualized 

CR

Health Surveillance and Program Support Appropriation

Health Surveillance

Population Data Collection, Analysis, and Dissemination $14,718 $11,890 $12,992 $1,102

National Survey on Drug Use and Health (NSDUH)............................. 5,326 2,939 640 -2,300

Community Behavioral Health Surveillance 3,000 3,000 --- -3,000

Community Early Warning and Monitoring System (CEM-S)............. 3,000 1,000 --- -1,000

Evidence-Based Programs/Practices 2,258 1,191 --- -1,191

Emergency Department Data Collection, Analysis, and Dissemination 125 4,000 15,000 11,000

SAMHSA’s Emergency Department Surveillance System (SEDSS)..... 125 4,000 15,000 11,000

Treatment Services Data Collection, Analysis, and Dissemination 11,013 13,696 11,512 -2,184

Behavioral Health Services Information System (BHSIS)..................... 11,013 13,696 11,512 -2,184

Behavioral Health Research and Dissemination 3,903 3,142 929 -2,214

Substance Abuse and Mental Health Data Archive (SAMHDA).......... 425 177 177 ---

Analytic Support Center (ASC).................................................................. 2,790 2,965 751 -2,214

Center for Financing Reform & Innovations (CFRI)............................. 688 --- --- ---

Performance Measurement/Systems 1,756 441 --- -441

SAMHSA Performance Accountability Reports System (SPARS)........ --- --- --- ---

Program Evaluations 1,346 1,350 --- -1,350

Primary and Behavioral Health Care Integration (PBHCI)................ 1,346 1,350 --- -1,350

Content Management --- --- --- ---

Innovation and Logistical Services Support --- --- --- ---

Support 9,140 8,227 8,409 182

Operations.................................................................................................... 2,358 2,433 2,503 70

Payroll...................................................................................................... 5,350 5,794 5,906 112

Total Health Surveillance $47,258 $46,937 $48,842 $1,905

Overview

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) is the government’s 

lead agency for behavioral health statistics. As authorized by Section 6004 of the 21st Century 

Cures Act, which amends Section 505 of the Public Health Service Act, CBHSQ performs 

activities that: (1) coordinate SAMHSA’s integrated data strategy, including by collecting data 

each year; (2) provide statistical and analytical support for SAMHSA’s activities; (3) recommend 

a core set of performance metrics to evaluate activities supported by SAMHSA; (4) coordinate 

with the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, and SAMHSA’s 

Chief Medical Officer, as appropriate, to improve the quality of services and evaluations. CBHSQ 

activities are integrated and cross over multiple funding lines. 

CBHSQ receives funding for Health Surveillance (HS) and Performance and Quality Information 

Systems (PQIS) within the Health Surveillance and Program Support appropriation (HSPS) 
235 

funding sources and the Substance Abuse Treatment appropriation from Block Grant Set Aside 

(BGSA) funding sources. Programs are often funded from several sources. (A table detailing All 

Funding Sources follows the PQIS section). Under Health Surveillance, CBHSQ work includes 

Population Data Collection, Analysis, and Dissemination; Treatment Services Data Collection, 

Analysis, and Dissemination; Emergency Services Data Collection, Analysis, and Dissemination; 

Behavioral Health Surveillance; and Behavioral Health Research and Dissemination. Under PQIS, 

CBHSQ activities include Performance Measurement/Systems, Program Evaluations, and 

Evidence-Based Programs/Practices.

The total funding amount for CBHSQ (from all sources) in FY 2018 Annualized CR is $113.1 

million, including $57.9 million from Health Surveillance and Program Support (HSPS) 

Appropriation and $55.2 million from the Substance Abuse Treatment (SAT) Appropriation. 

Population Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42 USC 290aa-4) requires SAMHSA, on an annual 

basis, to collect data on the prevalence of substance use and mental illness. To accomplish this, 

SAMHSA administers the National Survey on Drug Use and Health (NSDUH). NSDUH is an 

annual collection of behavioral health data on approximately 67,500 persons aged 12 or older of 

the U.S. civilian, non-institutionalized population. NSDUH is the nation’s primary source of 

statistical information on the use of illegal drugs, alcohol, and tobacco, certain mental disorders, 

co-occurring drug/alcohol addiction and mental illness, and treatment for substance abuse and 

mental health problems. NSDUH data provide estimates at the national, state, and sub-state level. 

NSDUH can be used to determine the prevalence of substance abuse and mental illness among 

demographic or geographic subgroups and provides trend estimates over time. NSDUH data 

provide states the opportunity to focus on their leading public health challenges through the release 

of state-specific data. Each year, three simultaneous NSDUH activities are ongoing: planning for 

future surveys, collecting data on over 67,500 persons in the current year survey, and analysis and 

dissemination of data from previous collections. 

The prevalence of substance use from the FY 2015 NSDUH estimates that 27.1 million Americans 

aged 12 or older, or 10.1 percent were current (past month) illicit drug users.126 From the FY 2015 

NSDUH, 17.9 percent of adults ages 18 and older had any mental illness in the past year (43.4 

million) and 4 percent (9.8 million) of adults had serious mental illness.127

 

126 Substance Abuse and Mental Health Services Administration, Behavioral Health Trends in the United States: 

Results from the 2014 National Survey on Drug Use and Health, NSDUH Series H-50, HHS Publication No. (SMA) 

15-4927. Rockville, MD: Substance Abuse and Mental Health Services

Administration, 2015. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1- 2014.pdf.

127 Substance Abuse and Mental Health Services Administration, Behavioral Health Trends in the United States: 

Results from the 2015 National Survey on Drug Use and Health, NSDUH Series H-50, HHS

Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services

Administration, 2016. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1- 2014.pdf.
236 

The FY 2015 NSDUH included changes to the data collection equipment, respondent contact 

materials, and survey questions. The changes made to the survey questions were intended to 

improve the quality of the data collected and address changing substance use (e.g., misuse of 

prescription drugs) and mental health policy and research needs. All of the FY 2015 NSDUH 

changes were evaluated in field tests during FY 2012 and FY 2013, with appropriate adjustments 

made to the FY 2015 NSDUH based on field test findings.128 A contract was awarded in early 

FY 2017 for survey years FY 2018 through FY 2021. 

CBHSQ has partnered with the Office of the Assistant Secretary for Planning and Evaluation 

(ASPE) and the National Research Council (NRC) for guidance on how to collect data on other 

behavioral health issues (including trauma, recovery, and serious emotional disturbance among 

children) through extramural data collection initiatives. In FY 2018, SAMHSA will begin a 

NSDUH redesign to ensure the survey is clinically up-to-date through alignment of questions to 

the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Other

potential areas for the next possible redesign include, but are not limited to, electronic cigarettes, 

synthetic marijuana, and alignment of treatment questions for substance abuse and mental health. 

NSDUH data are disseminated through public-use files made available online on the Substance 

Abuse and Mental Health Data Archive (SAMHDA). Data are also disseminated through annual 

reports.129,130,131 Collectively, in FY 2015 and FY 2016, approximately 200 reports and articles were 

written by external researchers using NSDUH, TEDS, N-SSATS, and DAWN data. In FY 2017, 

30,000 NSDUH downloaded events are anticipated. CBHSQ staff also responded to over 600 

requests for NSDUH data in FY 2016. 

Treatment Services Data Collection, Analysis, and Dissemination

Section 505 of the Public Health Service Act (42.U.S.C. 290aa-4) requires SAMHSA to collect 

data on mental illness and substance abuse treatment services. For this purpose, SAMHSA’s 

CBHSQ developed the Behavioral Health Services Information System (BHSIS). Data collected 

through the BHSIS provides information to the public on treatment services through the Behavioral 

Health Treatment Services Locator, a portion of the National Treatment Referral Service. The 

 

128 The following report provides a summary of the changes made to the 2014 NSDUH sample design and 2015 

NSDUH redesign, including data collection equipment, respondent contact materials, and the survey questionnaire. 

http://www.samhsa.gov/data/sites/default/files/NSDUH-RedesignChanges-2015.pdf

129 Substance Abuse and Mental Health Services Administration, Behavioral Health Trends in the United States: 

Results from the 2014 National Survey on Drug Use and Health, NSDUH Series H-50, HHS

Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services

Administration, 2015. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1- 2014.pdf.

130 Substance Abuse and Mental Health Services Administration. Suicidal Thoughts and Behavior among Adults: 

Results from the 2014 National Survey on Drug Use and Health

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. See 

http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR2-2014/NSDUH-FRR2-2014.pdf 131 Substance Abuse and Mental Health Services Administration. Risk and Protective Factors and Initiation of 

Substance Use: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse 

and Mental Health Services Administration, 2015. See: 

http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR4-2014v1/NSDUH-DR-FRR4-2014.pdf 
237 

Locator provides accurate, timely, and regularly updated information on mental and substance 

abuse treatment facilities across the country. BHSIS includes multiple data collection programs 

and information resources to support the Locator. BHSIS data collections comprise: (1) the 

National Mental Health Services Survey (N-MHSS) which provides information on all specialty 

mental disorder treatment facilities in the United States; in FY 2016, the overall response rate was 

92.1 percent; (2) the National Survey of Substance Abuse Treatment Services (N-SSATS) which 

provides information on all public and private substance abuse treatment facilities in the United 

States; in FY 2016, the overall response rate was 92.4 percent; (3) the Treatment Episode Data Set 

(TEDS) which provides demographic and services information on publicly funded admissions and 

discharges from substance abuse treatment; (4) the Mental Health Treatment Episode Data Set 

(MH-TEDS) and the Mental Health Client Level Data (MH-CLD) which provide demographic 

and services information on publicly funded admissions and discharges of clients in mental 

disorder treatment; and (5) 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 (MHBG) annual implementation reports. 

One important element of the BHSIS is the Inventory of Behavioral Health Services (I-BHS) 

which provides a listing of all known mental disorder and substance abuse treatment facilities. As 

of March 2017, I-BHS had identified 19,529 active substance abuse treatment facilities and 14,263 

active mental disorder treatment facilities in the United States and its territories.

In FY 2015, the Behavioral Health Treatment Services Locator was accessed more than 2.8 million 

times by individuals, families, community groups, and organizations to identify appropriate 

treatment services. Also in FY 2016, for the months of May through October that SAMHDA was 

operational, researchers downloaded over 2,000 BHSIS public-use datasets, and it is projected, 

based on increasing downloads and an expanding repository of datasets available, that in FY 2017, 

researchers will download over 10,000 BHSIS public use datasets. CBHSQ staff responded to 

over 100 requests for BHSIS data. In February 2017, data users accessed over 380 web pages for 

URS tables. 

In FY 2016, SAMHSA awarded a new BHSIS contract for four cycles of the annual N-SSATS 

and N-MHSS. The Behavioral Health Treatment Services Locator is part of the National 

Treatment Referral Routing Service, which is required through Section 9006 of the 21st Century 

Cures Act. In FY 2017, SAMHSA continued each of the BHSIS data programs and is coordinating 

with states to develop Mental Health-Treatment Episode Data Set/Mental Heath-Client Level Data 

(MH-TEDS/MH-CLD) further. 

Emergency Department Data Collection, Analysis, and Dissemination

Section 505 of the Public Health Service Act (42.U.S.C. 290aa-4) requires SAMHSA to collect 

and publish data on Emergency departments (ED) visits related to the use of alcohol and drugs. 

Emergency departments (EDs) are a robust source of information about substance abuse and 

mental disorder-related morbidity; an ongoing collection of data allows monitoring of patterns, 

trends, and the identification of emergent drugs of use. 
238 

In late FY 2011, SAMHSA began collaborating with the National Center for Health Statistics 

(NCHS) to obtain data from the National Hospital Care Survey (NHCS) on ED visits related to 

substance abuse and mental illness for the SAMHSA Emergency Department Surveillance System 

(SEDSS). The NHCS is a survey that describes national patterns of healthcare delivery in hospitalbased settings, including inpatient, emergency, and outpatient departments. With SEDSS data, 

national level estimates of drug-related ED visits and mental illness can be published. 

In FY 2017, efforts focused on challenges that include recruiting hospitals to participate in the 

survey, developing an infrastructure to collect electronic health record (EHR) data for surveillance 

purposes, and developing methods to identify information about drug-related ED visits in EHR 

data. SAMHSA also worked with NCHS to fund a NCHS research data center to help prepare for 

analysis of the EHR data.

SAMHSA FY 2018 Annualized CR funding is $4.0 million and SAMHSA will discontinue

funding for SEDSS in FY 2019 with the plan to Implement the more robust Drug Abuse Warning 

Network. 

Community Behavioral Health Surveillance

SAMHSA coordinates public health response data efforts to create opportunities for cross-agency 

and public-private partnerships to address critical public health questions and use existing or 

decreasing resources more effectively. Surveillance of health conditions is critical to track 

aberrations, changes over time, impact of public health interventions, and national and regional 

differences. Currently, no such surveillance system exists for behavioral health data; national 

surveillance systems do exist, though, for 52 infectious diseases. 

In FY 2016, SAMHSA funded support for the Community Early Warning and Monitoring System 

(C-EMS), a cooperative initiative in which national level behavioral health indicators are being 

developed. In FY 2017, SAMHSA provided funding for a pilot program, establishing 

infrastructure and reporting mechanisms for data collection using this national behavioral health 

surveillance system. The pilot the results will be available for review. 

In FY 2016 and FY 2017, SAMHSA supported and reported on field investigations by deploying 

staff to New Mexico, Baltimore, and Flint, Michigan to assess the capacity of the local community 

to respond to behavioral health public health concerns. Additionally, SAMHSA supported and 

reported on field investigations related to suicide, opioid-overdose deaths, and an opioid-related 

HIV outbreak in Indiana. 

SAMHSA has also developed a community assessment tool (CAST)132 that provides a modeled 

“gold standard” for local-level community behavioral health infrastructure compared to an on-theground asset mapping. CAST allows for a local-level evaluation of gaps and overages in 

programmatic coverage, and facilitates community level discussions about resource management. 

The CAST tool, within the context of public health, can be used as a preparation, mitigation, 

response, or recovery tool. 

 

132 Green B, Lyerla R, Stroup DF, Azofeifa A, High PM. A Tool for Assessing a Community’s Capacity for 

Substance Abuse Care. Prev Chronic Dis 2016;13:160190. DOI: http://dx.doi.org/10.5888/pcd13.160190
239 

SAMHSA FY 2018 Annualized CR funding is $3.0 million and SAMHSA will discontinue

funding for C-EMS in FY 2019 with the plan to continue a partnership with state and territorial 

epidemiologists to explore the viability of this approach to collect local behavioral health 

indicators in future years. 

Behavioral Health Research and Dissemination

OMB’s Open Data Policy Memorandum (M-13-13) requires the Federal Government to make data 

it collects accessible and usable through dissemination activities. CBHSQ conducts 

epidemiological and health services research in the area of behavioral health. Results of these 

research studies inform policymakers, service providers, program developers, and the public about 

important behavioral health findings. 

CBHSQ is completing a research framework to feed into a broader SAMHSA learning agenda for 

research, statistical studies, and program evaluation. CBHSQ categorizes its research activities 

into four major portfolio areas: substance use, mental health, community behavioral health 

surveillance, and methodological studies. Additionally, several portfolio topic areas, subsets of

the portfolio areas, have been identified to represent a snapshot of current and past CBHSQ 

research endeavors. The portfolio topic areas allow CBHSQ to optimize resources and balance 

priorities. 

From FY 2012 – FY 2016, CBHSQ produced 64 articles; these articles were across the four 

Portfolio areas in the CBHSQ Research Framework. CBHSQ is projected to produce 64 articles 

in FY 2017 and 16 articles in FY 2018. Additionally, CBHSQ disseminates information through 

short reports and data spotlights using CBHSQ and other data sources that focus on topics 

impacting the behavioral health of the nation. Short reports describe trends in substance use, 

mental health, and treatment topics with in-depth analysis by age, gender, substance use initiation, 

socioeconomic status, and national and state estimates. Spotlights focus on a single topic with one 

chart or graph and a descriptive paragraph delineating public health significance. These are 

published on the SAMHSA website and at the National Library of Medicine. During the period 

FY 2012 – FY 2016, CBHSQ staff authored over 200 such reports. CBHSQ staff is projected to 

produce approximately 50 short reports and spotlights in FY 2017. 

The Analytical Support Contract will continue to provide support for these activities as well as 

support for ad hoc requests, short- and long-term analyses, special requests, and evaluation 

activities, a total of $3.5 million is requested for this contract, which is provided from the HSPS 

and SAT Appropriations. 

The Substance Abuse and Mental Health Data Archive (SAMHDA) serves as SAMHSA’s primary 

means for dissemination of data through Public-Use Files (PUF). From May 23, 2016 to October 

2016, users downloaded over 17,000 PUFs from SAMHDA and generated over 8,000 tables 

utilizing a web-based analytic tool launched September 15, 2016. Through SAMHDA, CBHSQ 

provides limited, no-cost, public access to confidential data for researcher analysis. A restricted 

version of the current web-based analytic tool launched in April 2017, and allows researchers to 

generate tables based on confidential data. 
240 

In FY 2017, web-based analytic tool improvements were implemented; and, projected FY 2017 

SAMHDA usage is over 50,000 public-use datasets downloaded by researchers and over 100,000 

tables generated using online analytic tools. CBHSQ will continue to incorporate SAMDHA 

improvements in FY 2018. In FY 2018 Annualized CR, a total of $0.55 million is requested for 

SAMHDA ($0.18 million from HSPS and $0.37 million from SAT). In FY 2019, funding will 

remain level from FY 2018 Annualized CR. 

Funding History

Fiscal Year Amount

FY 2015 $47,258,000

FY 2016

FY 2017

$47,258,000

$47,258,000

FY 2018 $46,937,071

FY 2019 $48,842,000

Budget Request 

The FY 2019 President’s Budget Request is $48.8 million, an increase of $1.9 million from the 

FY 2018 Annualized CR. This funding will support the continuation of the NSDUH, NREPP, 

BHSIS, and the Analytic Support Center contracts. The funding will also support $1.0 million to 

continue collaboration between HRSA and SAMHSA to collect and analyze data to examine the 

Behavioral Health Workforce. Funding has been prioritized to continue the NSDUH survey at its 

current sample size. In FY 2019, a total of $19.2 million is requested for BHSIS ($11.5 million in 

HSPS and $7.7 million from SAT). Additional funds totaling $8.5 million are provided by CMHS 

and CSAT from the MH and SAT appropriations to support state payment for data collection. In 

addition, in FY 2019, a total of $57.3 million is request for NSDUH ($13.0 million from HSPS 

and $44.3 million from SAT) to continue survey activities without reducing sample size, 

representing a decrease of $1.1 million from the FY 2018 Annualized CR. In FY 2019, SAMHSA 

will plan to roll out the results of the 2018 survey, field the 2019 survey, plan for the 2020 survey, 

and will continue to explore options for a future NSDUH redesign. 

The $15.0 million will be used to support the 21st Century Cures Act requirement for a Drug 

Abuse Warning Network (DAWN). This program will provide critical information on ED visits 

related to substance abuse, which will provide the necessary information for communities on early 

warning and potential intervention. Given the nature of the current opioid crisis, access to 

information on overdose deaths and any data available for early warning is critical to fully 

addressing the crisis. 

The Drug Abuse Warning Network (DAWN) survey is a national public health surveillance system 

that monitors drug-related visits to hospital emergency departments (EDs) and drug-related deaths 

recorded by medical examiners and coroners (ME/Cs). An important feature of DAWN is that it 

provides information on the immediate consequence as well as related physical and behavioral 

health outcomes and case disposition. Required in the 21st Century Cures Act, this system is now 

more critical than ever in the context of the recent opioid crisis. These data, which can serve as an 
241 

imperative tool for clinicians, are not currently available. Data may be used to provide critical 

information on areas of needed emphasis and can serve as a useful tool for early intervention. 

The initial purpose of DAWN was to track emergency department (ED) visits caused by drug 

abuse in order to identify the drugs being abused, determine patterns in selected metropolitan areas 

and changing trends across the country, including the detection of new substances of abuse and 

new combinations. Initially focusing on metropolitan areas only, the system was later expanded to 

produce estimates for the U.S. and to capture drug abuse-related deaths investigated by medical 

examiners/coroners in selected metropolitan areas. 

DAWN data elements include but are not limited to: patient demographics, visit characteristics, 

patient diagnosis, substances used, and visit disposition. SAMHSA’s last collection of DAWN 

data was in 2011. National health surveillance is a critical step in adequately addressing the opioid 

crisis; for that reason, SAMHSA is proposing a re-institution of the DAWN survey in its previous 

iteration.
242 

Mechanism Table for Health Surveillance

(Dollars in thousands)

Program Activity

FY 2017 

Final

FY 2018 

Annualized CR

FY 2019

President's 

Budget

No. Amount No. Amount No. Amount

Health Surveillance

Contracts

Continuations................................................ 5 $42,088 5 $46,937 5 $48,842 

New/Competing............................................. 2 5,170 --- --- --- ---

Subtotal...................................................... 7 47,258 5 46,937 5 48,842 

Total, Health Surveillance 7 47,258 5 46,937 5 48,842 
243 

Performance and Quality Information Systems

(Dollars in thousands) 

Program Activity

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Performance and Quality Information Systems....... $10,000 $9,932 $12,893 $2,961

 PHS Evaluation Funds (non-add)........................ --- --- 12,893 12,893

Authorizing Legislation ....................... Sections 501, 509, 516, 520A, and 543A of the Public Act 

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................................. Contracts 

Eligible Entities ......................................................................................................... Not Applicable

Program Description and Accomplishments 

The Performance and Quality Improvement Systems (PQIS) funding primarily supports the 

activities of the Center for Behavioral Health Statistics and Quality (CBHSQ). The detailed 

funding for each activity along with a detailed narrative description of each project follows.

Performance and Quality Information Systems 

Resources by Activity/Program

(Dollars in thousands)

Program Activity

FY 

2017 

Final

FY 2018 

Annualized 

CR

FY 2019

President's 

Budget

FY 2019

President's 

Budget

+/- 

FY 2018

Annualized 

CR

Performance and Quality Information Systems

Performance Measurement/Systems $8,116 $7,375 $6,619 -$756

SAMHSA Performance Accountability Reports System (SPARS)................ 8,116 7,375 6,619 -756

Evidence-Based Programs Resource Center 1,260 1,624 2,814 1,191

Behavioral Health Research and Dissemination --- --- 2,311 2,311

Analytic Support Center (ASC)................................................................ --- --- 2,311 2,311

Support 624 933 1,149 216

Operations..................................................................................................... 624 933 1,149 216

Total Performance and Quality Information Systems $10,000 $9,932 $12,893 $2,961
244 

Performance Measurement and Performance Systems

SAMHSA collects data on key output and outcome measures to monitor and manage grantee 

performance, improve the quality of services provided, and inform program evaluations. 

These data previously were collected by legacy systems, including Data Collection, Analyses, and 

Reporting (DCAR); Prevention Management Reporting and Training System (PMRTS); Services 

Accountability Improvement System (SAIS); and the Transformation Accountability System 

(TRAC). These legacy systems were migrated to a single system, the SAMHSA Performance 

Accountability Reports System (SPARS), in FY 2017 to meet SAMHSA’s vision of a more 

efficient, holistic approach to its performance data collection. 

In FY 2017, SPARS was deployed as a real-time data entry and reporting system for all of 

SAMHSA’s discretionary grant programs. Data collected through SPARS are used to monitor the 

progress of SAMHSA’s discretionary grants, serve as a decision-making tool on funding, and 

improve the quality of services provided through the programs. SAMHSA will continue to 

implement the 21st Century Cures Act and make any necessary changes to improve the 

performance metrics used and to evaluate effectiveness of SAMHSA programs.

Program Evaluations 

In FY 2012, SAMHSA established a policy for the development and management of evaluation 

and performance monitoring, with a specific focus on implementing rigorous and consistent 

program evaluation within SAMHSA. During the fall of 2016, CBHSQ developed an updated 

Evaluation Policy and Procedure (P&P) document to guide SAMHSA in developing a long-term 

evaluation plan based on the selection and use of the best methods for answering specific 

evaluation questions. The objectives of the Evaluation P&P are: to put into place a policy and a 

consistent business practice to: match the type of evaluation activity to the maturity of the 

program and to the nature of the research questions, determine the degree of independence of 

evaluation activities for different types of programs, incorporate these practices and considerations 

into the contract planning process, collect and disseminate meaningful and critical findings to 

colleagues and to the behavioral health and scientific fields, and develop a learning agenda to 

identify priorities for future evaluation activities. The updated Evaluation P&P will be fully 

implemented for the FY 2018 and FY 2019 planning cycles. 

SAMHSA program evaluations are primarily funded by SAMHSA’s other three programmatic 

appropriations: the Center for Mental Health Services (CMHS), Center for Substance Abuse 

Prevention (CSAP), and Center for Substance Abuse Treatment (CSAT). In FY 2017, the program 

Centers funded over a dozen evaluations covering a variety of programs (e.g., Strategic Prevention 

Framework for Prescription Drugs; Screening, Brief Intervention, and Referral to Treatment; 

Pregnant and Postpartum Women; Children’s Mental Health Initiative). CBHSQ has directly 

funded the Primary and Behavioral Health Care Integration (PBHCI) evaluation since FY 2015. 

The evaluation of the PBHCI as the program was eliminated in FY 2018. 

In FY 2017, CBHSQ conducted small-scale, time-limited assessments and evaluations in 

collaboration with the program Centers. These include a community assessment for the 
245 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction Program (MATPDOA), the CARA-required evaluation of the Pregnant and Post-Partum Women and Pilot 

(PPWP), and the State Targeted Response to Opioid Crisis (Opioid STR) program authorized by 

the 21st Cures Act. Activities also include an assessment of barriers and facilitators to 

implementing the Resiliency in Communities After Stress and Trauma (ReCAST) grants, an 

analysis of the facilitators to successful implementation of Assisted Outpatient Treatment (AOT) 

programs, and a study of state’s adoption of quality measures for behavioral health clinics. 

National Resource Center for Evidence-based Programs and Practices 

Section 7002 of the 21st Century Cures Act requires that SAMHSA shall, as appropriate, improve 

access to reliable and valid information on evidence-based programs and practices, including 

information on the strength of evidence associated with such programs and practices related to 

mental illness and drug/alcohol addiction for states, local communities, non-profit entities, and 

other stakeholders, by posting on SAMHSA’s website information on evidence-based programs 

and practices that have been reviewed.

In FY 2018, SAMHSA ended its existing approach to its National Registry of Evidence-based 

Programs and Practices (NREPP). That process lacked scientific rigor and resulted in programs 

with a weak evidence base listed on the registry. SAMHSA is committed to the identification and 

implementation of EBPs across communities. In FY 2018, funding supported efforts by 

SAMHSA’s newly authorized Policy Lab to develop a scientifically rigorous approach to the 

implementation of the new Evidence-Based Programs Resource Center.

Behavioral Health Quality Measures

Behavioral health quality activities are housed within CBHSQ. The Center 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. 

Oversight of the agency’s measure development efforts includes current re-specification work 

funded by CSAT, re-specification of measures for Healthcare Effectiveness Data and Information 

Set (HEDIS) adoption, measures-conceptualization development work in suicide prevention in 

CMHS, and ongoing partnerships with the Center for Medicare & Medicaid Services (CMS) and 

the Assistant Secretary for Planning and Evaluation (ASPE), among other Federal partners, in 

quality measure work. CBHSQ 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. CBHSQ also represents SAMHSA on the HHS Measurement 

Policy Council, leading discussions related to behavioral health metrics and contributing to 

discussions focused on broader healthcare metrics. CBHSQ also participates on the Measures 

Application Partnership, a group convened to guide CMS on measure adoption. 

In response to the National Quality Strategy, SAMHSA developed its own specific quality 

strategy, the National Behavioral Health Quality Framework, a stand-alone document that 

recommends core and supplemental measures to be utilized at the payer, provider, and population 

level to track meaningful service delivery process and outcome measures in behavioral health. 
246 

This document is often referenced by NQF as a foundational document used to guide its behavioral 

health quality measures work. 

To date, a significant amount of behavioral health quality measure development has occurred, but 

gaps remain. A critical issue is field implementation; therefore, SAMHSA is focused on 

implementation issues since NQF measures have three years to demonstrate use by the field, after 

which they are retired. Challenges in implementation are frequently encountered due to the lack 

of infrastructure or personnel for collection and reporting in behavioral health programs. 

SAMHSA is jointly advancing behavioral health quality measure implementation by co-leading 

an HHS Behavioral Health Coordinating Council (BHCC) subcommittee on quality measures with 

ASPE and CMS which will result in recommendations about the uptake of consistent behavioral 

health quality measures related to alcohol misuse, tobacco cessation, depression measurement and 

management, and medication reconciliation across HHS programs, including CMS, HRSA, 

SAMHSA, and others. CBHSQ will continue to engage in these types of activities going forward.

CBHSQ staff provides internal collaborations across SAMHSA, advising on quality measure 

issues and identifying key next steps. Additionally, CBHSQ staff continues to serve as advisors 

for NQF projects jointly funded by ASPE and CMS and focused on a broad range of quality 

activities. CBHSQ staff regularly consults with other Federal agencies, the NQF, and other key 

stakeholders regarding behavioral health quality indicators, including barriers to and facilitators of 

data collection, tracking, and reporting. SAMHSA should continue its behavioral health quality 

measure activities through ongoing identification of behavioral health measurement gaps and the 

capacity to address such gaps. 

Funding History

Fiscal Year Amount

FY 2015 $12,918,000

FY 2016

FY 2017

$12,918,000

$10,000,000

FY 2018 $ 9,932,090

FY 2019 $12,893,000

Budget Request 

The FY 2019 President’s Budget Request is $12.9 million, an increase of $3.0 million from the 

FY 2018 Annualized CR. SAMHSA will use these funds to continue its performance 

management, quality improvement, and program evaluation activities. This funding will ensure 

that SAMHSA continues a strong focus on developing and implementing evidence-based practices 

and programs and continues its emphasis on performance management for quality improvement 

and program monitoring. 
247 

Mechanism Table for Performance and Quality Information Systems

(Dollars in thousands)

Program Activity

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019

President's 

Budget

No. Amount No. Amount No. Amount

Performance and Quality Information Systems

Contracts

Continuations........................................................................ --- 10,000 2 9,932 2 12,893 

New/Competing................................................................... --- --- --- --- --- ---

Subtotal........................................................................... --- 10,000 2 9,932 2 12,893 

Total, Performance and Quality Information Systems --- 10,000 2 9,932 2 12,893 
248 

The following table provides a detailed description of all funding sources supporting CBHSQ 

activities.

Center for Behavioral Health Statistics and Quality

Breakout by Activity/Program (all sources)

(Dollars in thousands)

Substance Abuse Treatment Appropriation

Substance Abuse Block Grant Set Aside

Population Data Collection, Analysis, and Dissemination.............. $40,356 $44,021 $41,798 -$2,223

PHS Evaluation (non add)............................................................. 39,657 44,021 41,798 -2,223

Treatment Services Data Collection, Analysis, and Dissemination 7,193 5,162 7,675 2,513

PHS Evaluation (non add)............................................................. 7,193 5,162 7,675 2,513

Emergency Department Data Collection, Analysis, and Dissemina 3,875 --- --- ---

PHS Evaluation (non add)............................................................. 3,875 --- --- ---

Behavioral Health Research and Dissemination............................... 1,802 892 883 -9

PHS Evaluation (non add)............................................................. 1,802 892 883 -9

Support ................................................................................................... 5,149 5,123 5,220 97

PHS Evaluation (non add)............................................................. 5,149 5,123 5,220 97

Total Substance Abuse Block Grant Set Aside 58,374 55,198 55,576 379

Total Substance Abuse Treatment PHS Evaluation 57,676 55,198 55,576 379

Health Surveillance and Program Support Appropriation

Health Surveillance

Population Data Collection, Analysis, and Dissemination.............. 14,718 11,890 12,992 1,102

PHS Evaluation (non add).............................................................. 5,326 2,939 640 -2,300

Treatment Services Data Collection, Analysis, and Dissemination 11,013 13,696 11,512 -2,184

PHS Evaluation (non add).............................................................. 11,013 13,696 11,512 -2,184

Emergency Department Data Collection, Analysis, and Dissemina 125 4,000 15,000 11,000

PHS Evaluation (non add)............................................................. 125 4,000 --- -4,000

Community Behavioral Health Surveillance....................................... 3,000 3,000 --- -3,000

PHS Evaluation (non add).............................................................. 3,000 1,000 --- -1,000

Behavioral Health Research and Dissemination............................... 3,903 3,142 929 -2,214

PHS Evaluation (non add).............................................................. 517 177 177 ---

Performance Measurement/Systems................................................... 1,756 441 --- -441

PHS Evaluation (non add).............................................................. 100 --- --- ---

Program Evaluations.............................................................................. 1,346 1,350 --- -1,350

PHS Evaluation (non add).............................................................. 1,346 1,350 --- -1,350

Evidence-Based Programs/Practices................................................... 2,258 1,191 --- -1,191

PHS Evaluation (non add).............................................................. 2,258 --- --- ---

Support.................................................................................................... 9,140 8,227 8,409 182

PHS Evaluation (non add).............................................................. 6,742 7,058 7,099 41

Total Health Surveillance 47,258 46,937 48,842 1,905

Performance and Quality Information Systems

Performance Measurement/Systems................................................... 8,116 7,375 6,619 -756

Program Evaluations.............................................................................. --- --- --- ---

Evidence-Based Programs/Practices................................................... 1,260 1,624 2,814 1,191

Behavioral Health Research and Dissemination............................... --- --- 2,311 2,311

Support.................................................................................................... 624 933 1,149 216

Total Performance and Quality Information Systems 10,000 9,932 12,893 2,961

Behavioral Health Workforce Data and Development

Behavioral Health Workforce Data Development............................. 1,000 993 998 5

PHS Evaluation (non add).............................................................. 1,000 993 998 5

Total Behavioral Health Workforce Data and Development 1,000 993 998 5

Total Health Surveillance and Program Support 58,258 57,862 62,733 4,871

Total Health Surveillance and Program Support PHS Evaluation 31,428 31,215 20,426 -10,789

Total Substance Abuse Block Grant Set Aside and

Health Surveillance and Program Support $116,632 $113,060 $118,309 $5,249

FY 2017

Final

FY 2019

President's 

Budget

FY 2019

 President's 

Budget

+/- 

FY 2018

 Annualized 

CR

FY 2018 

Annualized 

CR
249 

Outputs and Outcomes Table

Program: Performance and Quality Information Systems 

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

4.4.10 Increase the combined count of 

webpage hits, hits to the locator, and hits 

to Substance Abuse and Mental Health 

Data Archive (SAMHDA) for 

SAMHSA-supported data sets (Output)

FY 2017: 34,315 

Target: 1,700,000

(Target Not Met)

34,315 34,315 Maintain

4.4.11 Increase the number of evidencebased programs or practices in review 

(Output) 

FY 2017: 99 

Target: 55

(Target Exceeded)

99 99 Maintain
250 

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251 

Program Support

(Dollars in thousands)

Program Activity

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Program Support.......................................................... $77,000 $76,477 $73,043 -$3,434

Authorizing Legislation ............................................. Section 501 of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ....................................................... Direct Federal/Intramural, Contracts, Other 

Eligible Entities ......................................................................................................... Not Applicable

Program Description and Accomplishments

The Program Support budget supports the majority of 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, utilities, and miscellaneous charges. In addition, 

this budget supports the Unified Financial Management System, which covers administrative 

activities such as human resources, information technology, and the centralized services provided 

by HHS and the Program Support Center. 

SAMHSA supported 590 Full Time Equivalents (FTEs) in FY 2017. In FY 2018, in order to 

support staffing for areas such as the Office of the Chief Medical Officer and Cures 

implementation, SAMHSA projects support of 614 FTEs. Staff positions that are not covered 

through the Health Surveillance and Program Support appropriation are funded with Substance 

Abuse Prevention and Treatment and Mental Health Block Grant set-asides for activities 

associated with technical assistance, data collection, and evaluation. 

SAMHSA applies an estimated internal administrative charge for overhead expenses to all 

programs, projects, and activities.

Funding History

Fiscal Year Amount

FY 2015 $72,002,000

FY 2016

FY 2017

$79,559,000

$77,000,000

FY 2018 $76,477,000

FY 2019 $73,043,000
252 

Budget Request 

The FY 2019 President’s Budget Request is $73.0 million, a decrease of $3.4 million from the 

FY 2018 Annualized CR. This level of funding will continue to cover personnel, overhead costs 

associated with 5600 Fishers Lane, including rent, the Federal Acquisition Service loan repayment 

program, and security charges. Funding in FY 2016 and FY 2017 reflected an increase due to the 

agency’s relocation; given that these expenses will not be incurred in FY 2018, the funding request 

has been decreased. 

Mechanism Table for Program Support

(Dollars in thousands)

Program Activity

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019

President's 

Budget

No. Amount No. Amount No. Amount

Program Support

Contracts

Continuations..................................................... --- 77,000 --- 76,477 --- 73,043

New/Competing................................................................... --- --- --- --- --- ---

Subtotal............................................................................. --- 77,000 --- 76,477 --- 73,043 

Total, Program Support --- 77,000 --- 76,477 --- 73,043 
253 

Public Awareness and Support

(Dollars in thousands) 

Program Activity

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

Public Awareness and Support.................................. $13,000 $12,912 $11,572 -$1,340

Authorizing Legislation Sections 501, 509, 516, and 520A of the Public Health Service Act

FY 2019 Authorization .................................................................................................... Permanent

Allocation Method ............................................................................................................. Contracts 

Eligible Entities ......................................................................................................... Not Applicable

Program Description and Accomplishments

A part of SAMHSA’s mission is to raise the public’s understanding of mental illness and 

drug/alcohol addiction, serve as an expert on behavioral health issues, and lead public health 

efforts to advance the behavioral health of the nation.

Collaborating Across Agencies

In FY 2017, SAMHSA worked with the Office of the Surgeon General and other HHS agencies to 

release the Facing Addiction in America: Surgeon General’s Report on Alcohol, Drugs, and 

Health, the first ever Surgeon General’s report on this topic, to bring national attention to substance 

misuse and addiction. The report called on people throughout the U.S. to take action to end the 

public health crisis of addiction and discuss the importance of taking a comprehensive approach 

to the problem of substance abuse. SAMHSA also will promote the Report through conferences, 

grantee meetings, webinars, and social media.

Providing Critical Resources to the Behavioral Health Community

SAMHSA’s strategic communications plan ensures that the vital information and training 

materials produced through SAMHSA’s Centers and Offices are available to the behavioral and 

healthcare community through the Public Engagement Platform (PEP), which manages 

SAMHSA’s print and online information resources. The PEP contract is a resource for the public 

as well as the behavioral health workforce; it provides a warehouse of publications and access to 

the National Helpline. The PEP provides a customer-oriented order fulfillment system, including 

an online store, call-in contact center (the National Helpline), warehouse, and e-blasts to thousands 

of subscribers. The current opioid crisis has increased a demand for treatment services. The 

National Helpline provides free confidential treatment referral and information services in English 

and Spanish for individuals and families facing mental illness and/or drug/alcohol addiction. It is 

operational every day, 24/7. In FY 2016, SAMHSA’s Helpline responded to 752,096 inquiries, 

which was an increase in call volume of more than 25 percent during the course of the fiscal year. 

Although SAMHSA has instituted new technologies such as text messaging (SMS) and an 
254 

interactive voice response system as cost-effective solutions, SAMHSA will continue to explore 

innovative solutions to avoid any service disruption and to ensure callers get referred to treatment 

services.

SAMHSA is also responsible for managing the Disaster Distress Helpline to provide information 

and counseling referral to the public after tragic events. SAMHSA quickly mobilizes in the 

aftermath of a disaster to deliver behavioral health information and support services for responders 

and survivors. SAMHSA has adopted a rapid response practice which it will continue. When a 

disaster occurs, SAMHSA quickly disseminates an e-blast featuring SAMHSA’s Disaster Distress 

Helpline, links too many of SAMHSA’s resources, and a link to SAMHSA’s behavioral health 

treatment locator. The Helpline responded to over 16,000 text messages and calls in FY 2016. 

Over the last several years, SAMHSA has leveraged mobile technology to increase the reach of its 

resources by launching multiple mobile apps. Each app has had a greater reach than the ones that 

preceded it. In FY 2015, SAMHSA launched the “Suicide Safe” app for primary care and 

behavioral health providers. The Suicide Safe app is designed to help primary care and behavioral 

health providers address suicide risk and integrate suicide prevention strategies in patient care. 

Suicide Safe has been downloaded 50,033 times since its March 2015 launch. In FY 2017, 

SAMHSA launched MATx, an app that provides healthcare practitioners with immediate access 

to vital information about medication assisted treatment (MAT) for opioid addiction. The MATx 

app includes information on medications approved by FDA for use in treatment of opioid use 

disorders and treatment approaches for practitioners, a buprenorphine prescribing guide, clinical 

support tools, and access to critical helplines and SAMHSA treatment locators. MATx is available 

free for Apple and Android mobile devices. As of October 2016, MATx has been downloaded 

11,303. 

Leveraging SAMHSA’s Online Presence

Available 24/7, SAMHSA.gov is the public’s primary access point for behavioral health 

information from the federal government. SAMHSA’s website and social media presence on 

channels such as Facebook, Twitter, and YouTube are critical to efforts to engage with citizens 

about behavioral health. In addition to print and traditional media, social media is now 

incorporated in communications plans and is employed daily to communicate behavioral health 

messages and resources. The increasingly effective reach of these online channels is demonstrated 

by the fact that the number of people following SAMHSA on Twitter was 73,816 (an increase 

from 7,000 in 2013); the “likes” of SAMHSA’s Facebook page was 75,421 (an increase from 

20,000 in 2013); and the subscribers on SAMHSA’s YouTube were 6,300 (an increase from 800 

in 2013). 

In the course of prioritizing the internet as a strategic business initiative and communications asset, 

SAMHSA consolidated and modernized its web presence. In FY 2016, SAMHSA managed a 
255 

significant increase in web visits from the previous year: a 16 percent growth in annual web visits 

(over 33 million visits) and a 50 percent increase in unique visits (almost 9 million new visitors).

Dissemination of Behavioral Health Data and Surveillance

A goal of SAMHSA’s Public Awareness and Support effort is to make certain that valuable 

behavioral health data reach the widest number of Americans, enabling them to make informed 

decisions about the health and wellbeing of their loved ones and themselves. SAMHSA shares 

this vital information through the aforementioned vehicles (e.g., MDMS, PEP, the Web, and social 

media) and other program operations. These include press releases issued by SAMHSA to 

highlight recent findings from the National Survey on Drug Use and Health and SAMHSA’s 

Behavioral Health Barometer. These surveys provide data on behavioral health trends at the 

national level, by geographic region, and for each of the 50 states and the District of Columbia. 

Funding History

Fiscal Year Amount

FY 2015 $13,482,000

FY 2016 $15,571,000

FY 2017

FY 2018

$13,000,000

$12,912,000

FY 2019 $11,572,000

Budget Request 

The FY 2019 President’s Budget Request is $11.6 million, a decrease of $1.3 million from the 

FY 2018 Annualized CR. Funds for Public Awareness and Support will allow SAMHSA to 

maintain and update its web presence, manage critical helplines, deliver publications and 

resources, expand its presence on social media, and provide other resources to support behavioral 

health and other health. SAMHSA will continue to collaborate with other agencies. These efforts 

will allow SAMHSA to broaden the reach of its four key messages: behavioral health is essential 

to health, prevention works, treatment is effective, and people recover. 

In FY 2019, through the Materials Development and Marketing Support (MDMS) contract, 

SAMHSA will continue to promote the Surgeon General’s Report through communication 

products such as fact sheets and infographics. SAMHSA will examine its current suite of opioid 

related products to identify gaps, to cross-promote, and to maximize promotional opportunities. 
256 

Mechanism Table for Public Awareness and Support

(Dollars in thousands) 

Program Activity

FY 2017 

Final

FY 2018 

Annualized 

CR

FY 2019

President's 

Budget

No. Amount No. Amount No. Amount

Public Awareness and Support

Contracts

Continuations....................................................................... 6 13,000 4 5,342 4 11,572 

New/Competing................................................................... --- --- 1 7,570 --- ---

Subtotal............................................................................. 6 13,000 5 12,912 4 11,572 

Total, Public Awareness and Support 6 13,000 5 12,912 4 11,572 
257 

Outputs and Outcomes Table

Program: Public Awareness and Support

NOTE: SAMHSA makes grant awards toward the end of the year and therefore, bases the FY 2018 targets on the 

FY 2017 Final and the FY 2019 targets are based on the FY 2018 Annualized CR.

Measure

Year and Most Recent Result 

Target for Recent Result 

(Summary of Result)

FY 2018

Target

FY 2019

Target

FY 2019

Target

+/- 

FY 2018

Target

4.4.12 Increase the number of 

individuals referred for behavioral 

health treatment resources. (Output)

FY 2016: 752,096

Target: 400,000

(Target Exceeded)

600,000 600,000 Maintain

4.4.13 Increase the total number of 

interactions through phone inquiries, eblasts, dissemination of SAMHSA 

publications, and total website hits. 

(Output) 

FY 2016: 41,437,011

Target: 33,000,000

(Target Exceeded)

33,430,000 33,430,000 Maintain
258 

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259 

SAMHSA 

Additional Opioids Allocation

(Dollars in thousands) 

Programs Activities

FY 

2017 

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

FY 2019 

President's 

Budget

+/- 

FY 2018 

Annualized 

CR

State Targeted Response to the Opioid Crisis............ -- -- $1,000,000 $1,000,000 

Reducing Injection Drug Use, HIV/AIDS, and Hepatitis

Opioid Overdose Reversal Expansion...........................

--

--

--

--

150,000

50,000 

150,000

50,000 

Drug Courts Expansion.................................................. -- -- 20,000 20,000 

Treatment for Pregnant and Post-Partum Women....... -- -- 20,000 20,000 

Total, Additional Opioids Allocation -- -- $1,240,000 $1,240,000 

Program Description 

The FY 2019 President’s Budget Request includes $10.0 billion in new resources investment 

across HHS for a variety of new and expanded efforts to fight the opioid crisis and address serious 

mental illness. As part of this effort, the FY 2019 President’s Budget Request would allocate $1.2

billion of that funding for activities in SAMHSA. 

This funding includes $1.0 billion to extend the State Targeted Response to the Opioid Crisis 

program. Funding will addresses the opioid crisis by 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 addiction. This allocation also includes 

$150.0 million for opioid-related services to reduce injection drug use and related HIV/AIDS and 

Hepatitis C infection rates.

In addition, also within SAMHSA, $90.0 million will be used to support efforts to: expand and 

enhance drug court programs, expand services for pregnant and post-partum women, and promote 

the use of life-saving overdose reversal drugs by first responders. 
260 

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SAMHSA 

Drug Control Programs 

(Dollars in millions) 

Resource Summary 

FY 2017 

Final 

FY 2018 

Annualized 

CR 

FY 2019 

President's 

Budget 

Drug Resources by Decision Unit and Function 

Programs of Regional and National Significance 

Substance Abuse Prevention...................................................... $221.869 $220.362 $120.885 

Substance Abuse Treatment....................................................... 350.427 348.047 255.318 

Total Programs of Regional and National Significance.................... 572.296 568.409 376.203 

Drug Free Communities1 .......................................................

State Targeted Response to the Opioid Crisis Grants............ 

Substance Abuse Prevention and Treatment Block Grant2 

500,000 496,605 ---

Prevention................................................................................. 371.616 369.092 371.616 

Treatment.................................................................................. 1,486.463 1,476.369 1,486.463 

Total, Substance Abuse Prevention and Treatment Block Grant..... 

Health Surveillance and Program Support3 

Prevention................................................................................. 20.547 20.413 21.086 

Treatment.................................................................................. 82.188 81.65 84.345 

Total, Health Surveillance and Program Support............................ 102.735 102.063 105.431 

Total Funding................................................................................ 

---

1,858.079 

$3,033.110 

---

1,845.461 

$3,012.538 

100,000 

1,858.079 

$2,439.713 

Drug Resources Personnel Summary 

Total FTEs4 

Drug Resources as a Percent of Budget 

420 474 476 

Total Agency Budget5 $4,258.17 $4,236.462 $4,788.052 

Drug Resources Percentage 71.2% 71.1% 51.0% 1 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in FY 2017 and at $96.3 

million under the FY 2018 Annualized CR. 

2 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the 

Treatment function. 

3 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and 

Substance Abuse as follows: Program Support, Health Surveillance and PQIS are split the same percentage split as between 

MH/SA appropriations. PAS, and Data Request and Publication User Fees are split 50/50 between MH/SA. The resulting 

Substance Abuse total is then divided between Prevention (20%) and Treatment (80%). 

4 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act Mental Health and 

Substance Use Policy Laboratory. It also represents the staffing needed to administer the $1.2 billion in discretionary 

funding. It differs from the reported figure in MAX, which does not include these elements. 

5 The FY 2019 President’s Budget Request includes $10.0 billion in new resources investment across HHS for a variety of 

new and expanded efforts to fight the opioid crisis and address mental illness. As part of this effort, the FY 2019 President’s 

Budget Request would allocate $1.2 billion of that funding for activities in SAMHSA. This funding is not reflected in this 

table. Funding will be reflected in Additional Opioid Allocation funding. 

261 
262

Drug Budget Split between Prevention and Treatment FY 2017-FY 2019 

(Dollars in thousands) 

Substance Abuse Prevention

FY 2017

Final

FY 2018

Annualized 

CR

FY 2019

President's 

Budget

Programs of Regional and National Significance (PRNS)

Strategic Prevention Framework........................................................................... $119,484 $118,672 $58,426

Strategic Prevention Framework Rx (non-add) ............................................... 10,000 9,932 10,000

Budget Authority (non-add) ......................................................................... 109,484 108,740 48,426

Federal Drug-Free Workplace............................................................................... 4,894 4,861 4,894

Minority AIDS...................................................................................................... 40,405 40,925 ---

Sober Truth on Preventing Underage Drinking ................................................... 7,000 6,952 7,000

Center for the Application of Prevention Technologies....................................... 7,493 7,442 7,493

Budget Authority (non-add) ......................................................................... 7,493 7,442 7,493

Science and Service Program Coordination.......................................................... 4,072 4,044 4,072

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths ............. 12,000 11,919 12,000

Tribal Behavioral Health Grants.......................................................................... 14,450 14,898 15,000

First Responder (Comprehensive Addiction and Recovery Act- CARA) ........... 12,000 11,919 12,000

SAP Minority Fellowship Program....................................................................... 71 71 ---

Total, Substance Abuse Prevention PRNS 221,869 221,703 120,885

Drug Free Communities1 --- --- 100,000

Substance Abuse Prevention and Treatment Block Grant2 371,616 369,092 371,616

PHS Evaluation Funds (non-add) ................................................................ 15,840 15,732 15,840

Total, Substance Abuse Prevention and Treatment Block Grant 371,616 369,092 371,616

Health Surveillance and Program Support3

Health Surveillance 6,687 6,646 8,005

Budget Authority (non-add) ......................................................................... 2,381 2,365 5,366

PHS Evaluation Funds (non-add) ................................................................ 4,305 4,281 2,639

Program Support................................................................................................... 10,895 10,822 9,923

Public Awareness and Support............................................................................. 1,300 1,291 1,157

Performance and Quality Information Systems................................................... 1,415 1,405 1,751

Data Request/Publication User Fees.................................................................... 150 149 150

Total, Health Surveillance and Program Support 20,547 20,413 21,086

Total, Substance Abuse Prevention $614,032 $611,208 $613,587 1 Drug Free Communities was funded in the Office of National Drug Control Policy at $97.0 million in FY 2017 and at $96.3 million under the 

FY 2018 Annualized CR. 

2

The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 3

The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows: 

Program Support, Health Surveillance and PQIS are split the same percentage split as between MH/SA appropriations. PAS, and Data Request 

and Publication User Fees are split 50/50 between MH/SA. The resulting Substance Abuse amount is then divided between Prevention (20%) 

and Treatment (80%). 
263

Drug Budget Split between Prevention and Treatment FY 2017-FY 2019 (Continued)

(Dollars in thousands)

Substance Abuse Treatment

FY 2017

Final

FY 2018

Annualized 

CR

FY 2019

President's 

Budget

Programs of Regional and National Significance (PRNS)

Opioid Treatment Programs/Regulatory Activities.................................................. $8,724 $8,665 $8,724

Screening, Brief Intervention and Referral to Treatment ......................................... 30,000 29,796 ---

Budget Authority (non-add) ............................................................................. 28,000 27,810 ---

PHS Evaluation Funds (non-add) ................................................................... 2,000 1,986 ---

Targeted Capacity Expansion..................................................................... 67,192 66,736 67,192

Medication-Assisted Treatment for Prescription Drug and Opioid

Addiction (non-add) ............................................................................................. 56,000 55,620 56,000

Pregnant and Postpartum Women............................................................................. 19,931 19,796 19,931

Comprehensive Addiction and Recovery Act (non-add) .................................. 4,000 3,973 4,000

Improving Access to Overdose Treatment................................................................ 1,000 993 1,000

Recovery Community Services Program.................................................................. 2,434 2,417 2,434

Children and Family Programs................................................................................. 29,605 29,404 29,605

Treatment Systems for Homeless ............................................................................ 36,386 36,139 36,386

Minority AIDS ......................................................................................................... 65,570 65,125 ---

SAP Minority Fellowship Program........................................................................... 3,539 3,515 ---

Criminal Justice Activities........................................................................................ 74,000 73,497 78,000

Addiction Technology Transfer Centers................................................................... 9,046 8,985 9,046

Building Communities of Recovery......................................................................... 3,000 2,980 3,000

Total, Substance Abuse Treatment PRNS 350,427 348,047 255,318

State Targeted Response to the Opioid Crisis Grants1 500,000 496,605 ---

Substance Abuse Prevention and Treatment Block Grant2 1,486,463 1,476,369 1,486,463

PHS Evaluation Funds (non-add) .................................................................... 63,360 62,930 63,360

Total, Substance Abuse Prevention and Treatment Block Grant 1,486,463 1,476,369 1,486,463

Health Surveillance and Program Support3

Health Surveillance 26,747 26,583 26,540

Budget Authority (non-add) ............................................................................. 9,526 9,462 15,983

PHS Evaluation Funds (non-add) .................................................................... 17,222 17,121 10,557

Program Support....................................................................................................... 43,581 43,288 45,171

Public Awareness and Support.................................................................................. 5,200 5,165 4,629

Performance and Quality Information Systems........................................................ 5,660 5,622 7,006

Data Request/Publication User Fees......................................................................... 600 596 600

Total, Health Surveillance and Program Support 82,188 81,650 84,345

Total, Substance Abuse Treatment4 $2,419,078 $2,402,670 $1,826,127 1

Additional funding is proposed for this program as part of the Additional Opioids Allocation funding request. That funding request is displayed 

in its entirety on page 259. 

2

The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function. 

3

The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows: 

Program Support, Health Surveillance and PQIS are split the same percentage split as between MH/SA appropriations. PAS, and Data Request 

and Publication User Fees are split 50/50 between MH/SA. The resulting Substance Abuse amount is then divided between Prevention (20%) 

and Treatment (80%).

4

The FY 2019 President’s Budget Request includes $10.0 billion in new resources investment across HHS for a variety of new and expanded 

efforts to fight the opioid crisis and address mental illness. As part of this effort, the FY 2019 President’s Budget Request would allocate $1.2 

billion of that funding for activities in SAMHSA. This funding is not reflected in this table. Funding will be reflected in Additional Opioid 

Allocation funding.
264 

Mission

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) mission is to 

reduce the impact of substance abuse and mental illness on America’s communities. SAMHSA 

supports the President’s National Drug Control Strategy through a broad range of programs 

focusing on prevention, treatment and recovery from substance abuse. Major programs for 

FY 2019 will include the Substance Abuse Prevention and Treatment Block Grant, Drug Free 

Communities, competitive grant programs reflecting Programs of Regional and National 

Significance (PRNS) and Health Surveillance and Program Support. SAMHSA’s Centers for 

Substance Abuse Prevention (CSAP) and Substance Abuse Treatment (CSAT) as well as through 

SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) and the Office of 

Communications administer these programs.

Methodology 

SAMHSA distributes drug control funding into two functions: prevention and treatment. Both 

functions include a portion of funding from the Health Surveillance and Program Support (HSPS) 

appropriation. 

The portion of the Health Surveillance and Program Support account attributed to the Drug Budget 

uses the following calculations: 

• The Health Surveillance, Program Support, and PQIS portions of the HSPS appropriation 

are divided between Mental Health and Substance Abuse using the same percentages 

splits as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. 

o The Substance Abuse portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively. 

• The PAS portion of the HSPS appropriation is divided evenly between Mental Health and 

Substance Abuse. 

o The Substance Abuse portion is then split 20 percent/80 percent into the two 

functions, prevention and treatment, respectively.

The prevention function also includes all of the Substance Abuse Prevention appropriation, 

including the Substance Abuse Prevention Programs of Regional and National Significance, Drug 

Free Communities, and 20 percent of the Substance Abuse Prevention and Treatment Block Grant 

funds specifically appropriated for prevention activities from the Substance Abuse Treatment 

appropriation. 

The treatment function also includes the Substance Abuse Treatment appropriation, including the 

Substance Abuse Treatment Programs of Regional and National Significance, and 80 percent of 

the Substance Abuse Prevention and Treatment Block Grant funds. 
265 

Budget Summary 

In FY 2019, SAMHSA requests a total of $2.4 billion for drug control activities, a decrease of 

$572.8 million from the FY 2018 Annualized CR. The budget directs resources to activities that 

have demonstrated improved health outcomes and that increase service capacity. SAMHSA has 

three major drug-related decision units: Substance Abuse Prevention, Substance Abuse Treatment, 

and Health Surveillance and Program Support. Each decision unit is discussed below:

Substance Abuse Prevention

Substance Abuse Prevention Programs of Regional and National Significance

FY 2019 Request: $120.9 million

(Reflects a $100.8 million decrease from the FY 2018 Annualized CR) 

The Substance Abuse Prevention Programs of Regional and National Significance support states 

and communities in carrying out an array of activities to improve the quality and availability of 

services in priority areas. The FY 2019 President’s Budget request for SAMHSA’s Substance 

Abuse Prevention Programs of Regional and National Significance includes $120.9 million for 

seven programmatic activities, and $100.8 million decrease from the FY 2018 Annualized CR. 

The request includes: $58.4 million for Strategic Prevention Framework, $4.9 million for the 

Federal Drug-Free Workplace Program, $7.0 million for Sober Truth on Preventing Underage 

Drinking, $7.5 million to continue provision of technical assistance to maximize effectiveness 

through the Centers for the Application of Prevention Technologies, $4.1 million for Science and 

Service Program Coordination, $12.0 million for Grants to Prevent Prescription Drug/Opioid 

Overdose Related Deaths, $15.0 million for Tribal Behavioral Health Grants, $12.0 million for 

First Responder Training (Comprehensive Addiction and Recovery Act).

Strategic Prevention Framework (PRNS non-add)

FY 2019 Request: $58.4 million

(Reflects a $60.2 million decrease from the FY 2018 Annualized CR) 

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help 

grantees build a solid foundation for delivering and sustaining effective substance abuse 

prevention services and reducing substance abuse problems. The Strategic Prevention Framework 

– Partnerships for Success program addresses underage drinking among youth and young adults 

age 12 to 20 and allows states to prioritize State-identified top data driven substance abuse target 

areas. 

See page 129 in the CSAP chapter for the start of the full description of this program. 

Strategic Prevention Framework for Prescription Drugs (PRNS non-add)

Due to alarming trends related to prescription drug misuse and overdoses involving opioids, 

SAMHSA is prioritizing efforts to address prescription drug misuse. SAMHSA implemented the 

Strategic Prevention Framework for Prescription Drugs to raise awareness about the dangers of 
266 

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 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 Program (PDMP) data into needs assessments and 

strategic plans as indicators of program success. SAMHSA awarded 25 grants in FY 2016. In 

FY 2017 and under the FY 2018 Annualized CR level, SAMHSA will support 25 grant 

continuations. 

See page 130 in the CSAP chapter for the start of the full description of these efforts. 

Budget Request 

The FY 2019 President’s Budget Request is $58.4 million, a decrease of $60.2 million from the 

FY 2018 Annualized CR. Funding for the SPF Rx program will be maintained in its entirety 

($10.0 million). Funding will support 25 Strategic Prevention Framework for Prescription Drugs

continuation grants at a reduced rate, technical assistance, and evaluation to build capacity to 

address prescription drug misuse and overdose prevention efforts, in conjunction with other state 

and local partners. 

Federal Drug-Free Workplace (PRNS non-add)

FY 2019 Request: $4.9 million

(Reflects a $33,000 increase from the FY 2018 Annualized CR) 

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.) 100-71. This 

include: 1) 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 HHS-Certified Laboratories. 

See page 134 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $4.9 million, an increase of $33,000 from the FY 2018 

Annualized CR. In FY 2019, SAMHSA will 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 designed testing positions of national security, public health, and public safety, 

and testing for illegal drug use and the misuse of prescription drugs. SAMHSA will continue its 

oversight role for the inspection and certification of the HHS-certified laboratories. 
267 

First Responder Training (Comprehensive Addiction and Recovery Act- CARA)

FY 2019 Request: $12.0 million

(Reflects a $81,000 increase from the FY 2018 Annualized CR) 

First Responder Training Comprehensive Addiction and Recovery Act (CARA), SAMHSA is 

authorized to support additional efforts to prevent opioid overdose-related deaths by providing 

grants to train first responders. In FY 2017, SAMHSA funded 21 grants for the First Responder 

CARA grant program (FR-CARA). The purpose of this program is to allow 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 

overdose. Grantees will 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 overdose. Grantees will 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 FY 2018 Annualized 

CR level would support continuation grants to 20 grantees to address the opioid crisis in this 

country. 

See page 153 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $12.0 million, an increase of $81,000 from the 

FY 2018 Annualized CR. This funding will provide continuation grants to 21 grantees and support 

the continuation of training, technical assistance and evaluation activities to address the opioid 

crisis in this country. 

Sober Truth on Preventing Underage Drinking (PRNS non-add)

FY 2019 Request: $7.0 million

(Reflects a $48,000 increase from the FY 2018 Annualized CR) 

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 $50,000 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. 

See page 140 in the CSAP chapter for the start of the full description of this program. 
268 

Budget Request 

The FY 2019 President’s Budget Request is $7.0 million, an increase of $48,000 from the FY 2018 

Annualized CR. In FY 2019, SAMHSA will support 95 STOP Act grant continuations. This 

funding will continue to strengthen SAMHSA’s commitment to reduce and prevent underage 

drinking. 

Centers for the Application of Prevention Technologies (PRNS non-add)

FY 2019 Request: $7.5 million

(Reflects a $51,000 increase from the FY 2018 Annualized CR) 

The Center for the Application of Prevention Technologies (CAPT) program provides state-ofthe-art training and technical assistance to build the capacity of SAMHSA grantees and develop 

the skills, knowledge, and expertise of the prevention workforce. The program builds capacity 

and promotes the development of substance abuse prevention professionals in the behavioral 

health field through three core strategies: 1) establishing technical assistance networks using local 

experts; 2) developing and delivering targeted training and technical assistance activities; and 3) 

using communication media such as teleconference and video conferencing, online events, and 

web-based support. These activities help ensure the delivery of effective prevention programs and 

practices and the development of accountability systems for performance measurement and 

management.

See page 143 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $7.5 million, an increase of $51,000 from the FY 2018 

Annualized CR. The program will continue to provide technical assistance and training to over 

9,000 individuals in the prevention field. 

Science and Service Program Coordination (PRNS non-add)

FY 2019 Request: $4.1 million

(Reflects a $28,000 increase from the FY 2018 Annualized CR) 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around substance abuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance 

Center and the Underage Drinking Prevention Education Initiatives (UADPEI). 

See page 146 in the CSAP chapter for the start of the full description of this program. 
269 

Budget Request

The FY 2019 President’s Budget Request is $4.1 million, an increase of $28,000 from the FY 2018 

Annualized CR. These funds will support SAMHSA’s substance abuse prevention efforts and 

include a focus on preventing underage drinking and providing technical assistance and training 

to American Indians/Alaska Native communities. 

Tribal Behavioral Health Grants (PRNS non-add)

FY 2019 Request: $15.0 million

(Reflects a $102,000 increase from the FY 2018 Annualized CR) 

SAMHSA’s Tribal Behavioral Health Grants (TBHG) program addresses the high incidence of 

substance abuse 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 abuse, trauma, and suicide and by promoting the mental health of 

AI/AN young people. 

See page 148 in the CSAP chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $15.0 million, an increase of $102,000 from the 

FY 2018 Annualized CR. This request, combined with $15.0 million in the Center of Mental 

Health Services will continue support 76 grants that promote mental health and prevent substance 

use activities for high-risk AI/AN youth and their families.

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths (PRNS non-add)

FY 2019 Request: $12.0 million

(Reflects a $81,000 increase from the FY 2018 Annualized CR) 

Opioid overdose is a significant contributor to accidental deaths among those who use, misuse, or 

abuse 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 the overdose 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 kits.

See page 151 in the CSAP chapter for the start of the full description of this program. 

Budget Request

The FY 2019 President’s Budget Request is $12.0 million, an increase of $81,000 from the 

FY 2018 Annualized CR. This funding will provide continuation grants to 12 states to reduce the 

number of opioid overdose-related deaths. Funding will help states purchase overdose reversing 

drugs, equip first responders in high-risk communities, support education on the use of naloxone 
270 

and other overdose-related death prevention strategies, provide the necessary materials to assemble 

overdose kits, and cover expenses incurred from dissemination efforts. 

Drug Free Communities

FY 2019 Request: $100.0 million

(Reflects a $100.0 million increase from the FY 2018 Annualized CR) 

The goal of the program is to establish and strengthen collaboration among communities, public 

and private non-profit agencies, as well as federal, state, local, and tribal governments to support 

the efforts of community coalitions working to prevent and reduce substance abuse among 

youth. In addition, the program aims to reduce substance abuse among youth and, over time, 

reduce substance abuse among adults by addressing the factors in a community that increase the 

risk of substance abuse and promoting the factors that minimize the risk of substance abuse. The 

program also includes the Drug Free Communities Mentoring (DFC-M) Program. The purpose of 

this program is to provide grant funds to existing DFC recipients so they may serve as mentors to 

newly-formed and/or developing coalitions that have never received a DFC grant. It is the intent 

of the DFC-M Program that, at the end of the Mentoring grant, each Mentee coalition will meet 

all of the statutory eligibility requirements of the DFC Support Program and be fully prepared to 

compete for a DFC grant on their own. 

See page 157 in the CSAP chapter for the start of the full description of this program. 

Budget Request

The FY 2019 President’s Budget Request is $100.0 million. This activity was funded at $96.3 

million in the Office of National Drug Control Policy (ONDCP) under the 2018 Annualized CR. 

SAMHSA has administered this program for several years on behalf of ONDCP. The FY 2019 

Budget proposes to directly appropriate these funds to SAMHSA to streamline program 

management and create administrative efficiencies. Funding will be used to continue both the 

DFC and DFC-Mentoring programs. 
271 

Substance Abuse Treatment

Substance Abuse Treatment Programs of Regional and National Significance

FY 2019 Request: $255.3 million

(Reflects a $96.7 million decrease from the FY 2018 Annualized CR) 

The Substance Abuse Treatment Programs of Regional and National Significance (PRNS) support 

states and communities in carrying out an array of activities to improve the quality and availability 

of services in priority areas. The FY 2019 Budget Request for SAMHSA’s Substance Abuse 

Treatment PRNS includes $255.3 million, a decrease of $96.7 million from the FY 2018 

Annualized CR. Specific PRNS activities are described below.

Opioid Treatment Programs/Regulatory Activities (PRNS non-add)

FY 2019 Request: $8.7 million

(Reflects a $59,000 increase from the FY 2018 Annualized CR) 

As part of its regulatory responsibility, SAMHSA certifies Opioid Treatment Programs that use 

methadone, buprenorphine, or buprenorphine/naloxone to treat patients with opioid dependence. 

SAMHSA carries out this responsibility by enforcing regulations established by an accreditationbased system. This is accomplished in coordination with the Drug Enforcement Administration, 

states, territories, and the District of Columbia. SAMHSA also funds the Opioid Treatment 

Programs Medical Education and Supporting Services project aimed at preparing Opioid 

Treatment Programs to achieve accreditation and providing technical assistance and clinical 

training to enhance program clinical activities. Additionally, SAMHSA funds grants and contracts 

that support the regulatory oversight and monitoring activities of Opioid Treatment Programs. 

See page 169 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $8.7 million, an increase of $59,000 from the FY 2018 

Annualized CR. SAMHSA intends to continue to support the Secretary’s five-prong strategy to 

address the opioid crisis priorities through regulatory activities, ongoing training, certification, and 

technical assistance to provider groups and communities impacted by the opioid crisis.

Targeted Capacity Expansion (PRNS non-add)

FY 2019 Request: $67.2 million

(Reflects a $456,000 increase from the FY 2018 Annualized CR)

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 medication-assisted 

treatment (MAT) for opioid use disorders; 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.
272 

See page 176 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $67.2 million, an increase of $456,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund 32 continuation MAT PDOA grants, 13 new 

TCE-TAC grants, and 17 TCE-PTP new grants. 

Treatment Systems for Homeless (PRNS non-add)

FY 2019 Request: $36.4 million

(Reflects a $247,000 increase from the FY 2018 Annualized CR)

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with substance 

use disorders and who are experiencing homelessness, including veterans, and those experiencing 

chronic homelessness. 

See page 189 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $36.4 million, an increase of $247,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund 65 continuation grants (17 CABHI and 48 

GBHI). SAMHSA also plans to award 37 new CABHI grants. Additional funds will support two 

contracts including the continuation of cross-center contracts for national evaluation and technical 

assistance.

Pregnant and Postpartum Women Comprehensive Addiction and Recovery Act (PRNS nonadd)

FY 2019 Request: $19.9 million

(Reflects a $135,000 increase from the FY 2018 Annualized CR) 

The Pregnant and Postpartum Women Pilot, Comprehensive Addiction and Recovery Act (CARA) 

address the substance use and addiction across the country through the implementation of 

prevention, treatment, and recovery programs. In FY 2017, SAMHSA funded three new state 

PPW pilot grants to: 1) support family-based services for pregnant and postpartum women with a 

primary diagnosis of a substance use disorder, including opioid disorders; 2) help state substance 

abuse agencies address the continuum of care, including services provided to women in 

nonresidential-based settings; and 3) promote a coordinated, effective and efficient state system 

managed by state substance abuse agencies by encouraging new approaches and models of service 

delivery. An evaluation of this program is underway to determine the effectiveness of the pilot. 

Under the FY 2018 Annualized CR level, SAMHSA plans to fund three continuation state PPW 

pilot grants, and one continuation evaluation contract.

See page 181 in the CSAT chapter for the start of the full description of this program. 
273 

Budget Request 

The FY 2019 President’s Budget Request is $19.9 million, an increase of $135,000 from the 

FY 2018 Annualized CR. SAMHSA intends to fund two new residential treatment PPW grants 

and 26 continuation PPW grants. These funds also support the continuation of the three PPW Pilot 

grants ($4.0 million) to provide an array of services and supports to pregnant women and their 

children. 

Building Communities of Recovery (PRNS non-add) 

FY 2019 Request: $3.0 million

(Reflects a $20,000 increase from the FY 2018 Annualized CR) 

In FY 2017, SAMHSA funded a new cohort of grant through the Comprehensive Addiction 

Recovery Act (CARA) Building Communities of Recovery program. 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 addiction. 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 SUDs 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. Grantees will also work to reduce 

negative attitude, discrimination, and prejudice around addiction and addiction recovery. Under 

the FY 2018 Annualized CR level, SAMHSA will support five continuation grants. 

See page 203 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $3.0 million, an increase of $20,000 from the FY 2018 

Annualized CR. These funds will be used to support seven new grants and five continuation grants 

the Building Communities of Recovery Program to develop, expand, and enhance recovery 

support services. 

Criminal Justice Activities (PRNS non-add)

FY 2019 Request: $78.0 million

(Reflects a $530,000 increase from the FY 2018 Annualized CR) 

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.

See page 195 in the CSAT chapter for the start of the full description of this program. 
274 

Drug Court Activities 

FY 2019 Request: $60.0 million

(Reflects a $122,000 increase from the FY 2018 Annualized CR) 

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment 

services for diverse populations, wraparound/recovery support services designed to improve 

access and retention, drug testing for illicit substances, education support, relapse prevention and 

long-term management, pharmacotherapy), and HIV testing conducted in accordance with state 

and local requirements. The program seeks to address behavioral health disparities among racial 

and ethnic minorities by encouraging the implementation of strategies to decrease the differences 

in access, service use, and outcomes among the racial and ethnic minority populations served. 

Under the FY 2018 Annualized CR level, SAMHSA plans to fund 101 drug court grants 

continuation, 80 new drug court grants, and three contracts. 

See page 195 in the CSAT chapter for the start of the full description of this program. 

Ex-Offender Re-Entry Program 

FY 2019 Request: $18.0 million

(Reflects a $408,000 increase from the FY 2018 Annualized CR) 

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. In FY 2017, SAMHSA funded 11 new ORP grants and 27 ORP grant continuations. 

In FY 2018, SAMHSA plans to fund 27 new ORP grants, 11 continuation OFR grants, and contract 

activities. 

See page 197 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $78.0 million ($60.0 million for Drug Courts 

Activities and $18.0 million for Other Criminal Justice Activities), an increase of $530,000 from 

the FY 2018 Annualized CR. SAMHSA intends to support 44 new drug court grants, 115 drug 

court continuation grants, and three contracts. SAMHSA intends to fund 27 ORP continuation 

grants. 
275 

Other PRNS Treatment Programs (PRNS non-add)

FY 2019 Request: $41.1 million 

(Reflects a $279,000 increase from the FY 2018 Annualized CR)

The FY 2019 budget includes resources of $41.1 million for several other Treatment Capacity 

programs including: Recovery Community Services Program; Children and Families; and 

Addiction Technology Transfer Centers. The FY 2019 Budget includes funds for continuing 

grants and contracts in these programs. Grant funding will enhance overall drug treatment quality 

by incentivizing treatment and service providers to achieve specific performance targets. 

Examples of grant awards could include supplements for treatment and service providers who are 

able to connect higher proportions of detoxified patients with continuing recovery-oriented 

treatment; or for outpatient providers who are able to successfully retain greater proportions of 

patients in active treatment participation for longer periods. 

Substance Abuse Prevention and Treatment Block Grant

FY 2019 Request: $1.9 billion

(Reflects a $12.6 million increase from the FY 2018 Annualized CR)

The Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds 

to 60 eligible states, territories and freely associated states, the District of Columbia, and the Red 

Lake Band of Chippewa Indians of Minnesota (referred to collectively as states) to plan, carry out, 

and evaluate substance use disorder prevention, treatment, and recovery support services for 

individuals, families, and communities impacted by substance misuse and substance use disorders. 

The SABG’s overall goal is to support and expand substance abuse prevention and treatment 

services while providing maximum flexibility to grantees. 

See page 219 in the CSAT chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget request is $1.9 billion, an increase of $12.6 million from the

FY 2018 Annualized CR. SABG funds will continue to serve as a source of safety net funding, 

including assistance to states in addressing the opioid epidemic, and will continue to support 

certain services (e.g., recovery support services) not covered by commercial insurance and nonclinical activities and services that address the critical needs of state substance abuse prevention 

and treatment service systems.
276 

Health Surveillance and Program Support Appropriation

The FY 2019 Budget Request is $105.4 million, an increase of $3.4 million from the FY 2018 

Annualized CR, which represents the Substance Abuse 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 (PRNS non-add)

FY 2019 Request: $89.6 million

(Reflects a $2.3 million increase from the FY 2018 Annualized CR) 

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. This request represents the total funding 

available for these activities first divided between Mental Health and Substance Abuse using the 

same percentages splits that exist between the Mental Health and Substance Abuse (Prevention 

and Treatment) appropriation amounts. The Substance Abuse portion is then split 20 

percent/80 percent into the two functions, prevention and treatment, respectively. 

See page 233 in the HSPS chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $89.6 million, an increase of $2.3 million from the 

FY 2018 Annualized CR. Health Surveillance funding will support the continuation of the 

NSDUH, NREPP, BHSIS, C-EMS, and the Analytic Support Center contracts as well as operations 

and payroll Program Support funding will continue to cover overhead costs associated with 

5600 Fishers Lane, including rent, the Federal Acquisition Service loan repayment program, and 

security charges. 

Public Awareness and Support 

FY 2019 Request: $5.8 million

(Reflects a $670,000 decrease from the FY 2018 Annualized CR) 

Public Awareness and Support provides funding to support the unified communications approach 

to increase awareness of behavioral health, mental disorders and substance abuse issues. This 

represents the total funding available for these activities first divided evenly between Mental 

Health and Substance Abuse. The Substance Abuse portion is then split 20 percent/80 percent into 

the two functions, prevention and treatment, respectively. 

See page 253 in the HSPS chapter for the start of the full description of this program. 
277 

Budget Request 

The FY 2019 President’s Budget Request is $5.8 million, a decrease of $670,000 from the FY 2018 

Annualized CR, which supports the President’s initiative and will allow SAMHSA to continue to 

streamline its web presence, develop innovative mobile apps, expand its presence on social media, 

and provide other critical resources to support behavioral health and other health. 

Performance and Quality Information Systems 

FY 2019 Request: $8.8 million

(Reflects a $1.7 million increase from the FY 2018 Annualized CR) 

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 that will reduce the 

backlog of interventions accepted but not reviewed under the previous contract. SPARS will 

provide a common data and reporting system for all SAMHSA discretionary grantees and allow 

programmatic technical assistance (TA) on use of the data to enhance grantee performance 

monitoring and improve quality of service delivery. This request represents the total funding 

available for these activities first split into Mental Health and Substance Abuse using the same 

percentages splits as between the Mental Health and Substance Abuse (Prevention and Treatment) 

appropriation amounts. The Substance Abuse portion is then split 20 percent/80 percent into the 

two functions, prevention and treatment, respectively.

See page 243 in the HSPS chapter for the start of the full description of this program. 

Budget Request 

The FY 2019 President’s Budget Request is $8.8 million, an increase of $1.7 million from the 

FY 2018 Annualized CR. SAMHSA will use these funds for system development, training and 

TA to support operations, National Registry of Evidence-Based Programs (NREPP) and SPARS. 

Data Request and Publication User Fees

FY 2019 Request: $750,000 

(Reflects a $5,000 increase from the FY 2018 Annualized CR) 

The FY 2019 President’s Budget Request is $750,000, an increase of $5,000 from the FY 2018 

Annualized CR. SAMHSA will collect and retain fees for extraordinary data and publications 

requests. This represents the total funding estimated for these activities first divided evenly 

between Mental Health and Substance Abuse. The Substance Abuse portion is then split 

20 percent/80 percent into the two functions, prevention and treatment, respectively.
278 

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279 

SAMHSA

Supplementary Tables 

Table of Contents 

1. Budget Authority by Object Class.................................................................................. 281 

2. Salaries and Expenses..................................................................................................... 290 

3. Detail of Full-Time Equivalent (FTE) Employment ...................................................... 292 

4. Details of Positions......................................................................................................... 293 

5. Programs Proposed for Elimination ................................................................................ 294 

6. Physicians’ Comparability Allowance (PCA) Worksheet.............................................. 297 
280 

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281 

Budget Authority by Object Classification Tables

Substance Abuse and Mental Health Services Administration

Total Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2017

Final

FY 2018 

Annualized CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)............................................... $46,242 $49,002 $49,234 

Other than full-time permanent (11.3)............................ 2,630 2,800 2,813 

Other personnel compensation (11.5)............................ 1,077 1,140 1,146 

Military personnel (11.7).................................................. 3,304 3,399 3,485 

Special personnel services payments (11.8) ................ --- --- --- 

Subtotal personnel compensation:

Civilian benefits (12.1)...................................................... 15,535 16,467 16,545 

Military benefits (12.2)..................................................... 1,627 1,663 1,705 

53,253 56,340 56,678 

Subtotal Pay Costs:

Travel and transportation of persons (21.0)................. 1,567 1,330 1,356 

Transportation of things (22.0)....................................... 6 12 11 

Rental payments to GSA (23.1)....................................... 6,494 6,760 7,356 

Rental payments to Others (23.2)................................... 4 --- --- 

Communication, utilities, and misc. charges (23.3)...... 374 381 385 

Printing and reproduction (24.0)..................................... 1,372 1,345 1,373 

Other Contractual Services:

Advisory and assistance services (25.1)...................... 29,262 31,169 31,373 

Other services (25.2)......................................................... 190,965 182,692 198,355 

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 44,787 46,578 48,441 

Operation and maintenance of facilities (25.4)............. 170 312 317 

Research and Development Contracts (25.5)............... --- --- --- 

Operation and maintenance of equipment (25.7)......... 441 420 427 

70,415 74,470 74,928 

Subtotal Other Contractual Services: 265,625 261,172 278,914 

Supplies and materials (26.0)........................................... 213 712 712 

Equipment (31.0)............................................................... 131 473 478 

Grants, subsidies, and contributions (41.0).................. 3,776,693 3,755,560 3,060,374 

Interest and dividends (43.0).......................................... 109 --- --- 

Subtotal Non-Pay Costs 4,052,588 4,027,745 3,350,959 

Total Direct Obligations $4,123,003 $4,102,214 $3,425,887 

1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds.
282 

Substance Abuse and Mental Health Services Administration

Mental Health Services

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)................................................ $1,269 $1,225 $1,230 

Other than full-time permanent (11.3)............................. 43 41 42 

Other personnel compensation (11.5)............................ 18 18 18 

Military personnel (11.7).................................................. --- --- --- 

Special personnel services payments (11.8) ................ --- --- --- 

Subtotal personnel compensation: 1,330 1,284 1,290 

Civilian benefits (12.1)...................................................... 413 399 401 

Military benefits (12.2)..................................................... --- --- --- 

Subtotal Pay Costs:

Travel and transportation of persons (21.0)................. 263 179 186 

Transportation of things (22.0)....................................... 1 --- --- 

Rental payments to GSA (23.1)....................................... 64 67 72 

Rental payments to Others (23.2)................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)...... 339 345 349 

Printing and reproduction (24.0)..................................... 387 303 303 

Other Contractual Services:

Advisory and assistance services (25.1)....................... 13,883 14,438 15,016 

Other services (25.2)......................................................... 70,384 73,199 76,127 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 15,221 15,830 16,463 

Operation and maintenance of facilities (25.4).............. 132 137 140 

Research and Development Contracts (25.5)................ --- --- --- 

Operation and maintenance of equipment (25.7).......... 23 48 49 

1,743 1,683 1,691 

Subtotal Other Contractual Services: 99,643 103,653 107,794 

Supplies and materials (26.0)........................................... 42 25 25 

Equipment (31.0)................................................................ 35 108 110 

Grants, subsidies, and contributions (41.0).................. 1,054,482 1,044,674 933,352 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 1,155,255 1,149,354 1,042,192 

Total Direct Obligations $1,156,998 $1,151,036 $1,043,883 

1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds.
283 

Substance Abuse and Mental Health Services Administration

Substance Abuse Prevention

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)................................................ $--- $--- $--- 

Other than full-time permanent (11.3)............................. --- --- --- 

Other personnel compensation (11.5)............................ --- --- --- 

Military personnel (11.7).................................................. --- --- --- 

Special personnel services payments (11.8) ................. --- --- --- 

Subtotal personnel compensation: --- --- --- 

Civilian benefits (12.1)...................................................... --- --- --- 

Military benefits (12.2)...................................................... --- --- --- 

Subtotal Pay Costs:

Travel and transportation of persons (21.0)..................

 --- --- --- 

 --- --- --- 

Transportation of things (22.0)....................................... --- 5 5 

Rental payments to GSA (23.1)....................................... --- --- --- 

Rental payments to Others (23.2).................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)....... 33 34 34 

Printing and reproduction (24.0)..................................... 368 457 465 

Other Contractual Services:

Advisory and assistance services (25.1)....................... 5,580 5,804 6,036 

Other services (25.2)......................................................... 30,963 32,202 33,490 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 6,976 7,255 7,545 

Operation and maintenance of facilities (25.4).............. 7 69 70 

Research and Development Contracts (25.5)................ --- --- --- 

Operation and maintenance of equipment (25.7).......... 146 148 

Subtotal Other Contractual Services: 43,527 45,475 47,289 

Supplies and materials (26.0)........................................... --- --- --- 

Equipment (31.0)................................................................ 140 143 

Grants, subsidies, and contributions (41.0)................... 177,941 175,592 172,950 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 221,869 221,703 220,885 

Total Direct Obligations 221,869 221,703 220,885 

1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds.
284 

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

Personnel compensation:

Full-time permanent (11.1)................................................ $2,749 $3,251 $3,267 

Other than full-time permanent (11.3)............................. 237 280 281 

Other personnel compensation (11.5)............................ 47 55 55 

Military personnel (11.7).................................................. 115 175 180 

Special personnel services payments (11.8) ................. --- --- --- 

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Subtotal personnel compensation: 3,147 3,761 3,783 

Civilian benefits (12.1)...................................................... 953 1,127 1,132 

Military benefits (12.2)...................................................... 36 54 55 

Subtotal Pay Costs:

Travel and transportation of persons (21.0).................. 326 331 336 

Transportation of things (22.0)....................................... 1 --- 

Rental payments to GSA (23.1)....................................... 1,654 1,722 1,873 

Rental payments to Others (23.2).................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)....... 2 2 2 

Printing and reproduction (24.0)..................................... 533 542 550 

Other Contractual Services:

Advisory and assistance services (25.1)....................... 8,811 9,163 9,530 

Other services (25.2)......................................................... 49,491 42,645 43,327 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 17,727 18,436 19,174 

Operation and maintenance of facilities (25.4).............. 31 31 32 

Research and Development Contracts (25.5)................ --- --- --- 

Operation and maintenance of equipment (25.7).......... 208 200 203 

4,135 4,942 4,970 

Subtotal Other Contractual Services: 76,268 70,476 72,266 

Supplies and materials (26.0)........................................... 38 49 50 

Equipment (31.0)................................................................ 82 80 78 

Grants, subsidies, and contributions (41.0)................... 2,544,270 2,535,294 1,954,072 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 2,623,171 2,608,495 2,029,227

Total Direct Obligations $2,627,306 $2,613,437 $2,034,197

1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds.
285 

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)................................................ $42,225 $44,526 $44,737 

Other than full-time permanent (11.3)............................. 2,350 2,478 2,490 

Other personnel compensation (11.5)............................ 1,012 1,067 1,072 

Military personnel (11.7).................................................. 3,189 3,224 3,306 

Special personnel services payments (11.8) ................. --- --- --- 

Subtotal personnel compensation: 48,776 51,295 51,605 

Civilian benefits (12.1)...................................................... 14,169 14,941 15,012 

Military benefits (12.2)...................................................... 1,592 1,609 1,650 

Subtotal Pay Costs: 64,537 67,845 68,267 

Travel and transportation of persons (21.0).................. 979 820 833 

Transportation of things (22.0)....................................... 5 6 6 

Rental payments to GSA (23.1)....................................... 4,776 4,972 5,410 

Rental payments to Others (23.2).................................... 4 --- --- 

Communication, utilities, and misc. charges (23.3)....... 1 1 1 

Printing and reproduction (24.0)..................................... 85 43 55 

Other Contractual Services:

Advisory and assistance services (25.1)....................... 987 1,764 792 

Other services (25.2)......................................................... 40,127 34,646 45,411 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 4,863 5,057 5,260 

Operation and maintenance of facilities (25.4).............. --- 75 76 

Research and Development Contracts (25.5)................ --- --- --- 

Operation and maintenance of equipment (25.7).......... 210 26 27 

Subtotal Other Contractual Services: 46,187 41,568 51,565 

Supplies and materials (26.0)........................................... 134 638 637 

Equipment (31.0)................................................................ 14 145 147 

Grants, subsidies, and contributions (41.0)................... --- --- --- 

Interest and dividends (43.0)........................................... 109 --- --- 

Subtotal Non-Pay Costs 52,293 48,193 58,655 

Total Direct Obligations $116,830 $116,037 $126,922 

1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds. 
286 

Substance Abuse and Mental Health Services Administration

Total PHS Evaluation Funds – Object Class 

(Dollars in thousands)

Object Class - PHS Evaluation Funds

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel Compensation:

 Full Time Permanent (11.1)................................................ $10,762 $9,506 $9,551 

 Other than Full-Time Permanent (11.3)........................... 681 617 620 

 Other Personnel Compensation (11.5)............................ 211 193 194 

 Military Personnel Compensation (11.7)........................ 621 501 513 

Special personnel services payments (11.8) ....................

Subtotal Personnel Compensation: 

 Civilian Personnel Benefits (12.1).................................... 3,519 3,086 3,100 

 Military Personnel Benefits (12.2) ................................. 323 266 273 

Subtotal Pay Costs: 

Travel (21.0)....................................................................... 263 266 217 

Transportation of things (22.0)....................................... --- --- 

Rental payments to GSA (23.1)....................................... --- --- --- 

Communications, Utilities and Misc. Charges (23.3)... --- --- --- 

Printing and Reproduction (24.0).................................... 20 30 29 

Other Contractual Services:

Advisory and assistance services (25.1)....................... --- --- --- 

Other services (25.2)......................................................... 30,955 34,830 25,607 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 191 140 142 

Operation and maintenance of equipment (25.7).......... --- 2 2 

78 --- --- 

12,352 10,817 10,879 

16,194 14,169 14,252 

 --- --- --- 

 Subtotal Other Contractual Services:............................. 31,146 34,972 25,751 

Supplies and Materials (26.0).......................................... 22 26 25 

Equipment (31.0)................................................................ --- 2 2 

Grants, Subsidies, and Contributions (41.0)................... 86,023 83,296 80,390 

Subtotal Non-Pay Costs 117,473 118,591 106,413 

Total Reimbursable Obligations $133,667 $132,759 $120,665 

 --- 
287 

Substance Abuse and Mental Health Services Administration

Mental Health Services

PHS Evaluation Funds – Object Class 

(Dollars in thousands)

Object Class - PHS Evaluation 

Personnel compensation:

Full-time permanent (11.1)............................................... $1,899 $2,011 $2,021 

Other than full-time permanent (11.3)............................ 71 75 76 

Other personnel compensation (11.5)............................ 29 31 31 

Military personnel (11.7).................................................. 100 170 174 

Special personnel services payments (11.8) ................ --- --- --- 

Subtotal personnel compensation: 2,100 2,287 2,302 

Civilian benefits (12.1)...................................................... 643 681 685 

Military benefits (12.2)..................................................... 59 100 103 

Subtotal Pay Costs:

Travel and transportation of persons (21.0)................. 29 38 38 

Transportation of things (22.0)....................................... --- --- 

Rental payments to GSA (23.1)....................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)...... --- --- --- 

Printing and reproduction (24.0)..................................... 15 28 25 

Other Contractual Services:

Advisory and assistance services (25.1)...................... --- --- --- 

Other services (25.2)......................................................... 10,708 11,984 13,203 

 Purchase of Goods & Svcs. from Govt. Accts (25.3).. 53 --- --- 

Operation and maintenance of equipment (25.7)......... --- --- --- 

Subtotal Other Contractual Services:

Supplies and materials (26.0)........................................... 4 8 7 

Equipment (31.0)............................................................... --- --- --- 

Grants, subsidies, and contributions (41.0).................. 7,428 5,771 4,678 

Subtotal Non-Pay Costs 18,237 17,827 17,951 

Total Reimbursable Obligations $21,039 $20,896 $21,039 

FY 2017

Final

2,802 

10,761 

FY 2018 

Annualized 

CR

3,068 

11,984 

FY 2019 

President's 

Budget

3,089 

13,203 

 --- 
288 

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

PHS Evaluation Funds – Object Class 

(Dollars in thousands)

Object Class - PHS Evaluation 

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)............................................. $3,381 $3,942 $3,961 

Other than full-time permanent (11.3).......................... 120 140 $141 

Other personnel compensation (11.5)......................... 58 67 $67 

Military personnel (11.7)............................................... 190 94 $97 

Special personnel services payments (11.8) .............. 78 --- --- 

Subtotal personnel compensation: 3,827 4,243 4,265 

Civilian benefits (12.1)................................................... 1,067 1,245 1,250 

Military benefits (12.2)................................................... 102 51 52 

Subtotal Pay Costs: 4,996 5,538 5,568 

Travel and transportation of persons (21.0)............... 206 200 150 

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)...................................................... 370 400 833 

 Purchase of Goods & Svcs. from Govt. Accts (25.3) --- --- --- 

Operation and maintenance of equipment (25.7)....... --- 2 2 

Subtotal Other Contractual Services: 370 402 835 

Supplies and materials (26.0)........................................ 2 --- --- 

Equipment (31.0)............................................................. --- 2 2 

Grants, subsidies, and contributions (41.0)................ 75,625 74,507 72,646 

Subtotal Non-Pay Costs 76,203 75,110 73,632 

Total Reimbursable Obligations $81,200 $80,649 $79,200 
289 

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

PHS Evaluation Funds – Object Class 

(Dollars in thousands)

Object Class - PHS Evaluation 

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1).................................................. $5,482 $3,552 $3,569 

Other than full-time permanent (11.3)............................... 489 402 $404 

Other personnel compensation (11.5).............................. 124 96 $96 

Military personnel (11.7).................................................... 331 236 $242 

Special personnel services payments (11.8) ................... --- --- --- 

Subtotal personnel compensation: 6,426 4,287 4,312 

Civilian benefits (12.1)........................................................ 1,808 1,160 1,165 

Military benefits (12.2)........................................................ 162 115 118 

Subtotal Pay Costs: 8,395 5,562 5,596 

Travel and transportation of persons (21.0).................... 28 28 28 

Transportation of things (22.0)......................................... --- --- --- 

Rental payments to GSA (23.1)......................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)......... --- --- --- 

Printing and reproduction (24.0)....................................... 4 2 4 

Other Contractual Services:

Advisory and assistance services (25.1)......................... --- --- --- 

Other services (25.2)........................................................... 19,877 22,447 11,571 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 138 140 142 

Operation and maintenance of equipment (25.7)............ --- --- --- 

Subtotal Other Contractual Services: 20,014 22,587 11,713 

Supplies and materials (26.0)............................................. 16 18 18 

Equipment (31.0).................................................................. --- --- --- 

Grants, subsidies, and contributions (41.0)..................... 2,970 3,018 3,066 

Subtotal Non-Pay Costs 23,033 25,653 14,830 

Total Reimbursable Obligations $31,428 $31,215 $20,426 
290 

Substance Abuse and Mental Health Services Administration

Salaries and Expenses Tables

Direct Budget Authority – Object Class

(Dollars in thousands)

Object Class - Direct Budget Authority1,2

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)................................................ $46,242 $49,002 $49,234 

Other than full-time permanent (11.3)............................. 2,630 2,800 2,813 

Other personnel compensation (11.5)............................ 1,077 1,140 1,146 

Military personnel (11.7).................................................. 3,304 3,399 3,485 

Special personnel services payments (11.8) ................. --- --- --- 

Subtotal personnel compensation 53,253 56,340 56,678

Civilian benefits (12.1)...................................................... 15,535 16,467 16,545 

Military benefits (12.2)...................................................... 1,627 1,663 1,705 

Subtotal Pay Costs: 70,415 74,470 74,928

Travel (21.0)........................................................................ 1,567 1,330 1,356 

Transportation of things (22.0)....................................... 6 12 11 

Rental payments to Others (23.2).................................... 4 --- --- 

Communication, utilities, and misc. charges (23.3)....... 374 381 385 

Printing and reproduction (24.0)..................................... 1,372 1,345 1,373 

Other Contractual Services:

Advisory and assistance services (25.1)....................... 29,262 31,169 31,373 

Other services (25.2)......................................................... 190,965 182,692 198,355 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 44,787 46,578 48,441 

Operation and maintenance of facilities (25.4).............. 170 312 317 

Research and Development Contracts (25.5)................ --- --- --- 

Operation and maintenance of equipment (25.7).......... 441 420 427 

Subtotal Other Contractual Services: 265,625 261,172 278,914 

Supplies and materials (26.0)........................................... 213 712 712

Subtotal Non-Pay Costs 269,162 264,952 282,752

Total Salary and Expenses 339,577 339,422 357,680 

Rental Payments to GSA (23.1)....................................... 6,494 6,760 7,356 

Grand Total, Salaries & Expenses and Rent $346,071 $346,182 $365,036 

Direct FTE3

....................................................... 482 501 511 1

 Does not include PHS EVAL Funds.

2

 Includes Prevention and Public Health Funds.

3

 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act Mental 

Health and Substance Use Policy Laboratory. It also represents the staffing needed to administer the $1.2 

billion in discretionary funding. It differs from the reported figure in MAX, which does not include these 

elements.
291 

Substance Abuse and Mental Health Services Administration

Salaries and Expenses Tables

PHS Evaluation Funds – Object Class 

(Dollars in thousands)

Object Class1

FY 2017

Final

FY 2018 

Annualized 

CR

FY 2019 

President's 

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $10,762 $9,506 $9,551 

Other than full-time permanent (11.3)........................ 681 617 620 

Other personnel compensation (11.5)....................... 211 193 194 

Military personnel (11.7)............................................. 621 501 513 

Special personnel services payments (11.8) ........... 78 --- --- 

Subtotal personnel compensation 12,352 10,817 10,879 

Civilian benefits (12.1)................................................. 3,519 3,086 3,100 

Military benefits (12.2)................................................ 323 266 273 

Subtotal Pay Costs: 16,194 14,169 14,252 

Travel (21.0).................................................................. 263 266 217 

Transportation of things (22.0).................................. --- --- 

Rental payments to Others (23.2).............................. --- --- --- 

Communication, utilities, and misc. charges (23.3). --- --- --- 

Printing and reproduction (24.0)................................ 20 30 29 

Other Contractual Services:

Advisory and assistance services (25.1).................. --- --- --- 

Other services (25.2).................................................... 30,955 34,830 25,607 

Purch. Goods & Svcs. Govt. Accts (25.3)................ 191 140 142 

Operation and maintenance of facilities (25.4)......... --- --- --- 

Research and Development Contracts (25.5)........... --- --- --- 

Operation and maintenance of equipment (25.7)..... --- 2 2 

Subtotal Other Contractual Services: 31,146 34,972 25,751

Supplies and materials (26.0)...................................... 22 26 25 

Subtotal Non-Pay Costs 31,450 35,293 26,021 

Total Salary and Expenses 47,644 49,462 40,273 

Rental Payments to GSA (23.1).................................. --- --- --- 

Grand Total, Salaries & Expenses and Rent $47,644 $49,462 $40,273 

Reimbursable FTE2

...................................... 108 113 124

1

 Does not include Other reimbursable FTEs (30) and associated Object Class cost.

2

 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act 

Mental Health and Substance Use Policy Laboratory. It also represents the staffing needed to administer 

the $1.2 billion in discretionary funding. It differs from the reported figure in MAX, which does not 

include these elements.
292 

Detail of Full Time Equivalent Employee (FTE)

FY 2017 

Final 

Civilian

FY 2017 

Final 

Military

FY 2017 

Final 

Total

FY 2018 

Est. 

Civilian

FY 2018 

Est. 

Military

FY 2018 

Est. 

Total

FY 2019 

Est. 

Civilian

FY 2019 

Est. 

Military

FY 2019 

Est. 

Total

Health Surveillance and Program Support...

 Direct:.............................................................. 413 30 443 428 30 458 436 31 467

Reimbursable:................................................. 52 4 56 51 5 56 52 5 57

 Total:............................................................. 465 34 499 479 35 514 488 36 524

 

 

Mental Health Services...................................

 Direct:.............................................................. 13 0 13 12 0 12 12 0 12

 Reimbursable:................................................. 17 1 19 18 2 20 25 3 28

 Total:............................................................. 30 1 31 30 2 32 37 3 40

Substance Abuse Prevention........................

 Direct:.............................................................. 0 0 0 0 0 0 0 0 0

 Reimbursable:................................................. 0 0 0 0 0 0 0 0 0

 Total:............................................................. 0 0 0 0 0 0 0 0 0

Substance Abuse Treatment.........................

 Direct:.............................................................. 26 1 26 30 1 31 31 1 32

 Reimbursable:................................................. 31 2 33 36 1 37 38 1 39

 Total:............................................................. 57 3 60 66 2 68 69 2 71

SAMHSA FTE Total1........................ 552 38 590 575 39 614 594 41 635

1

 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act Mental Health and Substance 

Use Policy Laboratory. It also represents the staffing needed to administer the $1.2 billion in discretionary funding. It differs from 

the reported figure in MAX, which does not include these elements.
293 

Detail of Positions 

FY 2017 Final

FY 2018 

Annualized CR

FY 2019 President's 

Budget

Executive Level IV 1 1 1

Subtotal 1 1 1

Total - Exec Level Salaries $155,500 $155,500 $155,500

SES 16 18 18

Subtotal 16 18 18

Total, SES salaries

GM/GS-15/EE 64 67 68

GM/GS-14 122 123 124

GM/GS-13 205 208 212

GS-12 54 56 62

$3,804,874 $4,280,483 $4,280,483

GS-11 21 26 31

GS-10 1 1 1

GS-09 20 20 25

GS-08 18 18 18

GS-07 16 23 20

GS-06 11 11 11

GS-05 3 3 3

GS-04 0 0 0

GS-03 0 0 0

GS-02 0 0 0

GS-01 0 0 0

Subtotal 535 556 575

Total, GS salaries $77,328,239 $78,623,896 $79,023,609

CC-08/09

CC-07

1

 0

1

 0

1

 0

CC-06 15 14 15

CC-05 11 11 11

CC-04 9 11 12

CC-03 2 2 2

CC-02 0 0 0

CC-01 0 0 0

Subtotal 38 39 41

Total, CC salaries $5,475,627 $5,578,569 $5,720,822

Total Positions1 590 614 635

Average ES level ES ES ES

Average ES salary $155,500 $155,500 $155,500

Average SES level SES SES SES

Average SES salary $237,805 $237,805 $237,805

Average GS grade 13.5 13.6 13.6

Average GS salary $144,539 $141,410 $137,432

Average CC level 5 5 5

Average CC salaries $144,095 $143,040 $139,532 1

 This figure accounts for the staff needed to ensure the full functioning of the 21st Century Cures Act 

Mental Health and Substance Use Policy Laboratory. It also represents the staffing needed to 

administer the $1.2 billion in discretionary funding. It differs from the reported figure in MAX, which 

does not include these elements.
294

Programs Proposed for Elimination

The following table shows the programs proposed for elimination in the FY 2019 Budget Request. 

Terminations of these programs total $279.6 million across the three appropriations: Mental 

Health, Substance Abuse Prevention, and Substance Abuse Treatment. 

The following is a brief summary of the program and rational for the elimination proposal. 

(Dollars in thousands)

Program

FY 2018 

Annualized CR

Project AWARE .................................................................... $71,475 

Primary and Behavioral Health Care Integration....................... 51,516 

MH Minority AIDS................................................................. 9,161 

MH Minority Fellowship Program............................................ 8,004 

SAP Minority AIDS................................................................ 40,925 

SAP Minority Fellowship Program........................................... 71 

SAT Minority AIDS ............................................................... 65,125 

SAT Minority Fellowship Program........................................... 3,515 

Screening, Brief Intervention and Referral to Treatment............ 29,796 

Total $279,588 

Project AWARE 

SAMHSA awarded these grants to 20 State Education Authorities (SEAs) to promote 

comprehensive, coordinated, and integrated state efforts to make schools safer and increase access 

to mental health services. Mental Health First Aid (MHFA) supports widespread dissemination of 

the MHFA curriculum. The MHFA curriculum prepares teachers and other individuals who work 

with youth to help schools and communities understand, recognize, and respond to signs of mental 

illness and/or drug/alcohol addiction in children and youth, including how to talk to adolescents 

and families experiencing these problems so that they are more willing to seek treatment. 

SAMHSA is proposing an elimination of Project AWARE ($71.5 million). SAMHSA has 

developed significant knowledge and evidence for states to begin implementing and bringing to 

scale these efforts; SAMHSA will continue to ensure this knowledge is disseminated.

Primary and Behavioral Health Care Integration 

The Primary and Behavioral Health Care Integration (PBHCI) program began in FY 2009 to 

address specifically this intersection between primary care and mental disorder treatment. The 

program supports two activities: grants to community mental health centers and the PBHCI 

Training and Technical Assistance (TTA) Center, which is co-funded through a competitive 

cooperative agreement with the Health Resources and Services Administration (HRSA). These 

two activities collectively support the coordination and integration of primary care services into 

publicly funded community behavioral health settings for individuals with SMI and/or people with 

co-occurring disorders served by the public mental health system. PBHCI seeks to improve health 

outcomes for people with SMI by encouraging grantees to engage in necessary collaboration, 
295 

expand infrastructure, and increase the availability of primary healthcare and wellness services for 

individuals with mental illness.

The Primary and Behavioral Healthcare Integration ($51.5 million) program is being proposed for 

elimination, as this program is potentially fundable through other sources of funds including the 

Substance Abuse Block Grant and Certified Community Behavioral Health Center funding. 

SAMHSA will continue to disseminate the lessons learned from this program.

Minority AIDS (MAI) 

In FY 2014, SAMHSA’s Centers for Mental Health Services, Centers for Substance Abuse 

Prevention, and Centers for Substance Abuse Treatment supported the Minority AIDS Initiative 

Continuum of Care Pilot (MAI CoC). The MAI CoC supports behavioral health screening, primary 

prevention, and treatment for racial/ethnic minority populations with or at high risk for mental 

illness and drug/alcohol addiction and HIV/AIDS. MAI CoC supports substance abuse treatment, 

primary prevention/treatment service programs, community mental health programs, and 

HIV/AIDS integrated programs that either can co-locate or have fully integrated HIV/AIDS 

prevention and medical care services. SAMHSA supports a consolidated evaluation of its 

HIV/AIDS programs. This comprehensive process and outcome evaluation will assess the degree 

to which SAMHSA is providing effective and efficient mental and substance abuse treatment 

services and prevention programs to those with and at risk of HIV/AIDS. 

SAMHSA is proposing an elimination of the MAI programs in Mental Health, Substance Abuse 

Prevention and Substance Abuse Treatment ($115.2 million). States will be able to provide 

services to reduce injection drug use and related HIV/AIDS and Hepatitis C infection rates through 

$150 million in new funding proposed as part of the Additional Opioid Allocation described on 

page 259. 

Minority Fellowship Program 

SAMHSA’s Minority Fellowship Program (MFP) increases behavioral health practitioners’ 

knowledge of issues related to prevention, treatment, and recovery support for mental illness and 

drug/alcohol addiction among racial and ethnic minority populations. The program provides 

stipends to funding increases the number of culturally competent behavioral health professionals 

who teach, administer, conduct services research, and provide direct mental illness or substance 

abuse treatment services for minority populations that are underserved. This will result in 

improved quality of mental and substance abuse prevention and increased treatment delivered to 

ethnic minorities. 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, and psychology. In 2006, the program expanded to include 

marriage and family therapists and later added professional counselors. These individuals often 

serve in key leadership positions in mental illness and substance abuse treatment services, services 

supervision, services research, training, and administration. Professional guilds receive 

competitively awarded grants, and then competitively award the stipends to post-graduate students 

pursuing a degree in that professional field. 
296 

SAMHSA is proposing to eliminate the MFP in Mental Health, Substance Abuse Prevention and 

Substance Abuse Treatment ($11.6 million) because these programs are duplicative of other 

federal programs. 

Screening, Brief Intervention and Referral to Treatment (SBIRT) 

In 2003, SAMHSA started the Screening, Brief Intervention and Referral to Treatment (SBIRT) 

program, which is intended to help primary care physicians identify individuals who misuse 

substances and help them intervene early with education, brief treatment, or referral to specialty 

treatment. The program’s goal is to increase the number of individuals who receive treatment and 

reduce the rate of substance misuse. The SBIRT program seeks to increase the use of SBIRT in 

medical settings by promoting wide dissemination and adoption of the practice across the spectrum 

of primary care services. To achieve this, SAMHSA awards state implementation grants to 

encourage adoption of SBIRT by healthcare providers in each state. SAMHSA has demonstrated 

the effectiveness of SBIRT and continues to disseminate SBIRT practices.

SAMHSA is proposing to eliminate the SBIRT program ($29.8 million) as significant knowledge 

has been developed and disseminated for this program and it has been brought to scale in hundreds 

of communities across the nation. In addition, public and third party insurance can pay for this 

activity. SAMHSA will continue to disseminate SBIRT program information as necessary. 
297 

Physicians’ Comparability Allowance (PCA) Worksheet

Substance Abuse and Mental Health Services Administration

(Whole dollars)

PY 2017

Final

CY 2018

Annualized 

CR

BY 2019

President's 

Budget

2 1 1

--- --- ---

2 1 1

$145,616 $141,894 $141,894

$15,000 $16,000 $16,000

Category I Clinical Position --- --- ---

Category II Research Position --- --- ---

Category III Occupational Health --- --- ---

Category IV-A Disability Evaluation --- --- ---

Category IV-B Health and Medical Admin. 2 1 1

10) Explain the degree to which recruitment and retention problems were alleviated in your agency through the use of PCAs in the 

prior fiscal year.

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 so as to make the offer acceptable. 

11) Provide any additional information that may be useful in planning PCA staffing levels and amounts in your agency.

N/A

7) If applicable, list and explain the necessity of any additional physician categories designated by your agency (for categories 

other than I through IV-B). Provide the number of PCA agreements per additional category for the PY, CY and BY.

N/A

8) Provide the maximum annual PCA amount paid to each category of physician in your agency and explain the reasoning for 

these amounts by category.

$30.000.00 - based on years of education, experience, and the position held by the incumbent. Amount is required to retain the 

employee.

9) Explain the recruitment and retention problem(s) for each category of physician in your agency (this should demonstrate that a 

current need continues to persist).

We have to offer PCAs because our salaries are not competitive with the private sector.

1) Number of Physicians Receiving PCAs

5) Average Annual PCA Payment

4) Average Annual PCA Physician Pay (without PCA payment)

3) Number of Physicians with Multi-Year PCA Agreements

2) Number of Physicians with One-Year PCA Agreements

6) Number of Physicians 

Receiving PCAs by Category 

(non-add)
298 

SAMHSA

Significant Items 

House Appropriations Committee, Labor/HHS/Education Subcommittee (H. Rept. 115-244) 

1. Funding Opportunity Announcements - The Committee directs SAMHSA, where statute 

allows, when issuing new funding opportunity announcements, to include as eligible 

applicants, States, political subdivisions of States such as local government or 

communities, Indian Tribes or tribal organizations, health facilities, or programs operated 

by or in accordance with a contract or grant with the Indian Health Service, or other public 

or nonprofit private entities. (Page 74, H. Rept. 115-244) 

Action taken or to be taken 

SAMHSA follows open eligibility principles as described above unless otherwise indicated 

by statute or compelling program justification. 

2. Mental Health - The Committee requests an update in the fiscal year 2019 Congressional 

Justification information on the costs to law enforcement, first responders, judicial 

systems, and health systems that accrue due to recidivist clients, including potential options 

for more cost-effective solutions to providing care for such clients. (Page 75, H. Rept. 115-

244)

Action taken or to be taken

Research indicates that the top 5 percent of all patients account for 50 percent of total U.S. 

health expenditures and that the annual mean expenditure for them was a staggering 

$41,000 in 2010, as the federal Agency for Healthcare Research and Quality reported in 

August. AHRQ reports the costliest of all patients are the top 1 percent, who account for 

21 percent of health care expenditures in the United States. The annual mean expenditure 

for high utilizers is $88,000, 10 times the $8,508 that is the average cost of care for a typical 

American, according to a recent report from the Commonwealth Fund.133 Many of these 

individuals have behavioral health disorders including serious mental illness. In addition 

to the financial costs, there are significant costs to individuals with these conditions and 

their families including early mortality, criminal justice involvement, homelessness, and 

unemployment. 

In response to these high need patients,, in FY 2016, SAMHSA implemented an Assisted 

Outpatient Treatment Grant Program for Individuals with Serious Mental Illness and 

awarded 17 grants to eligible entities such as a county, city, mental health system, mental 

health court, or any other entity with authority under the law of the state in which the 

grantee is located. This four-year pilot program is intended to implement and evaluate 

new AOT programs and identify evidence-based practices in order to reduce the incidence 

and duration of psychiatric hospitalization, homelessness, incarcerations, and interactions 

with the criminal justice system while improving the health and social outcomes of 

individuals with an SMI. SAMHSA has partnered with the Assistant Secretary for 

 

133 https://www.managedcaremag.com/archives/2014/1/high-utilizing-patients-where-are-savings 
299 

Planning and Evaluation to implement a cross-site evaluation which will assess the 

effectiveness and impact of the AOT program. 

In FY 2018, SAMHSA is awarding a new cohort of Law Enforcement and Behavioral 

Health Partnerships for Early Diversion grants. The purpose of this program is to design 

or expand programs that divert adults with a SMI or a co-occurring disorder from the 

criminal justice system to community-based services prior to arrest and booking. The U.S. 

Department of Justice, Office of Justice Programs, reported that one in seven state and 

federal prisoners (14 percent) and one and four jail inmates (26 percent) reported 

experiences that met the threshold for serious psychological distress. Approximately one 

quarter of a million individuals with serious mental illnesses are incarcerated at any given 

moment—about half arrested for non-violent offenses, such as trespassing or disorderly 

conduct. 

The Assertive Community Treatment (ACT) for Adults with Serious Mental Illness (SMI) 

was authorized under the 21st Century Cures Act of 2016. ACT is an evidence-based 

practice considered one of the most effective approaches to deliver services to people with 

SMI. ACT was developed to reduce prehospitalization and improve outcomes soon after 

discharge. In the FY 2018 President’s Budget, SAMHSA has proposed to award grants 

to states, counties, cities, tribes and tribal organizations, mental health systems, health care 

facilities and entities to establish, maintain or expand ACT programs. If appropriation for 

this effort occurs, special consideration will be given to applicants that serve those adults 

with SMI who are high utilizers of health and social services including homeless and 

justice involved populations. 

SAMHSA continues to work collaboratively with the Centers for Medicare & Medicaid 

Services and the Assistant Secretary for Planning and Evaluation (ASPE) on Section 223 

of the Protecting Access to Medicare Act (PAMA) of 2014 (Public Law 113-93, Section 

223). In FY 2016, SAMHSA awarded 24 Planning Grants to support states to certify 

clinics as certified community behavioral health clinics (CCBHCs), to establish 

prospective payment systems for Medicaid reimbursable services, prepare to collect data 

and submit an application to participate in a two year demonstration program. In FY 2017 

eight states from the 24 planning grant states were selected to participate in the 

demonstration program. The eight states are Minnesota, Missouri, Nevada, New Jersey, 

New York, Oregon, Oklahoma, and Pennsylvania. The evaluation by ASPE on the impact 

of the Demonstration program is in the initial stages. 
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3. Mental Health First Aid - In continuing competitive funding opportunities, SAMHSA is 

directed to include as eligible grantees local law enforcement agencies, fire departments, 

and emergency medical units with a special emphasis on training for crisis de-escalation 

techniques. SAMHSA is also encouraged to allow training for veterans, armed services

personnel and their family members. Any qualified community mental health education 

program should be considered as eligible for funding under the Mental Health First Aid 

program. (Page 75, H. Rept. 115-244)

Action taken or to be taken

Funding is not included in the President’s Budget for this program; however, should 

Congress appropriate the funding, the guidance above will be followed in the Funding 

Opportunity Announcement. 

4. Targeted Capacity Expansion—SAMHSA should target States with the highest rates of 

admissions and that have demonstrated a dramatic increase in admissions for the 

treatment of opioid use disorders. The Center for Substance Abuse Treatment is directed 

to include as an allowable use medication-assisted treatment and other clinically 

appropriate services to achieve and maintain abstinence from all opioids and heroin and 

prioritize treatment regimens that are less susceptible to diversion for illicit purposes. 

(Page 78, H. Rept. 115-244)

Action taken or to be taken 

SAMHSA’s previous funding opportunity included eligibility based on data which 

demonstrated the above criteria. The announcement also included an expectation to 

prioritize treatment regimens that are less susceptible to diversion for illicit purposes; the

announcement also included as an allowable activity the use of medication-assisted 

treatment and other clinically appropriate services to achieve and maintain abstinence from 

all opioids and heroin. SAMHSA continues to work with its grantees to monitor these 

activities. 

5. Drug Courts - The Committee directs SAMHSA to ensure that all drug treatment court 

grant recipients work directly with the corresponding State substance abuse agency in the 

planning, implementation, and evaluation of the grant. The Committee further directs 

SAMHSA to expand training and technical assistance to drug treatment court grant 

recipients to ensure evidence based practices are fully implemented. (Page 78, H. Rept. 

115-244)

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, ensures that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a 

substance use disorder as their primary condition. In addition, grantees in the program are 

expected to work with the state substance abuse agency in planning, implementation and 

evaluation of the grants. SAMHSA also continues to provide training and technical 

assistance to Drug Treatment Court grantees.
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6. Viral Hepatitis Screening - The Committee encourages SAMHSA to continue its work 

with grantees to incorporate hepatitis screening into programmatic activities and requests 

a report on the implementation of hepatitis screening activities in the fiscal year 2019 

Congressional Justification. (Page 79, H. Rept. 115-244)

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, implements the 

Department of Health and Human Services’ Hepatitis Action Plan which notes that people 

with HIV are disproportionally affected by viral hepatitis and related adverse conditions. 

Through the Center for Substance Abuse Treatment’s Minority AIDS program, grantees 

are required to implement hepatitis screening as a condition of the award. 

7. Peer Recovery Support Services - The Committee requests information in the fiscal year 

2019 Congressional Justification on the amount of funds from the Substance Abuse 

Prevention and Treatment Block Grant used for peer recovery support services. (Page 79, 

H. Rept. 115-244)

Action taken or to be taken 

SAMHSA encourages all grantees, including the SABG recipients, to utilize peer recovery 

coaches and/or peer recovery specialists in their respective systems of care. Peer recovery 

support services are a critical part of a comprehensive plan to support the recovery of 

people with substance use disorders. While states and jurisdictions are not required to 

report the specific dollar amount expended on PRSS, most states and jurisdictions are 

implementing elements of PRSS as part of their substance abuse treatment systems of care. 

In addition, SAMHSA encourages discretionary grantees to use their funds to support 

PRSS are part of the treatment and recovery continuum of care. In FY 2017, 47 states 

proposed to do recovery support services. Of those states, 36 states proposed peer support 

specialist credentialing and 33 states proposed peer coaching in their BG 

applications/plans. 

8. Pregnant Women - The Committee requests information in the fiscal year 2019 

Congressional Justification on the amount of funds from the Substance Abuse Prevention 

and Treatment Block Grant used for pregnant women and women with dependent children, 

including information on how States are implementing these requirements, funding level 

by State, and information on availability of treatment, and barriers to treatment. (Page 79, 

H. Rept. 115-244)

Action taken or to be taken 

In FY 2017, $183 million of the Substance Abuse Block Grant funds were used for 

treatment of pregnant and postpartum women and woman with dependent children. States 

are implementing this requirement by making available gender specific treatment services, 

support for transportation and childcare, wrap around services to include public health and 

children serving agencies, primary pediatric care, including immunization, for children and 

case management. Common barriers to treatment for pregnant women and women with 

children are the lack of comprehensive wrap-around services and services for family 

members, including children. In particular, lack of support services such as parenting skill 
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development, employment and housing assistance, and child care are common barriers to 

treatment for this population. 

9. Federal Drug Free Workplace - The Committee strongly encourages the Secretary to 

expeditiously produce the technical guidelines for the use of hair testing as a Federally 

accepted drug testing method. The Committee requests an update on this effort in the fiscal 

year 2019 Congressional Justification. (Page 80, H. Rept. 115-244)

Action taken or to be taken 

SAMHSA Mandatory Guidelines for Federal Workplace Drug Testing Programs using 

Hair has been proposed and has gone through internal review but lacks some acceptable 

forensic and scientific supportability on key issues. SAMHSA has received over 250 

internal comments and recommendations from the Drug Testing Advisory Board, ExOffices of DTAB, Office of General Council, federal agencies, and federally regulated 

entities. The development of the scientifically supported hair drug testing guidelines have 

required addressing several significant scientific, legal, and policy issues including: 

a. Contamination – Hair testing is susceptible to contamination through 

environmental exposure to a substance (drug) rather than use. External contamination of 

the hair could cause a false positive drug test, or in other words, a drug test that falsely 

identifies an individual as a drug user. SAMHSA is considering approaches that might be 

used to distinguish external contamination from drug use, but such approaches are in need 

of further scientific research and study. 

b. Hair Color Bias – If hair color influences drug incorporation into hair, 

individuals with darker hair could be more likely to test positive than an individual with 

lighter colored hair. Additional studies are needed to determine procedures that would 

effectively rule out, or account for hair color bias. 

c. Unique Metabolites/Biomarkers – Additional funding may be needed in 

order to develop and proceed with the Hair MG resulting from the need to conduct 

additional scientific studies and performance testing on unique metabolites showing use of 

a drug 

d. Acceptable reasons for using a hair drug test – Hair tests have a much longer 

window of detection than urine or oral fluid. Therefore, hair is most useful for preemployment testing. Some stakeholders may have concerns related to detection of drugs 

that were used as prior to employment or during medical leave.

e. Collection protocols/Donor hair availability/Religious – To address privacy 

concerns, SAMHSA would propose collecting hair only from the head, and collecting 

another specimen type (urine or oral fluid) from donors with insufficient head hair. 

However, this approach may exempt large swaths of the population from hair testing. 

f. Impact of hair treatments – The variability of cosmetic and hygienic hair 

treatments may impact the results of the hair test, thereby impacting the accuracy or 

reliability. Additional research is needed to resolve this issue.

g. Training for collectors – The final burden estimate for training collectors on 

hair testing has not yet been determined. Stakeholders may have concerns about their 

ability to train on the use of and implementation of hair testing procedures.
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SAMHSA has been able to answer many of the key concerns, comments and 

recommendations listed above. The internal review process may take some time. 

SAMHSA has continued to discuss the concerns and efforts with stakeholder 

organizations, members of Congress and the Department of Transportation. SAMHSA 

recognizes the urgency to publish the Federal Workplace Drug Testing Program. 

10. Overdose Fatality Prevention - SAMHSA is urged to take steps to encourage and support 

the use of Substance Abuse and Prevention Block Grant funds for opioid safety education 

and training, including initiatives that improve access for licensed healthcare professionals, 

including paramedics, to emergency devices used to rapidly reverse the effects of opioid 

overdoses. Such initiatives should incorporate robust evidence based intervention training, 

and must facilitate linkage to treatment and recovery services. (Page 80, H. Rept. 115-244) 

Action taken or to be taken 

By statute, the Substance Abuse Block Grant prevention set-aside must be spent on 

“primary prevention” services or services for individuals who have not been identified as 

needing treatment. States have the flexibility to use data to decide how to spend funds based 

on their local needs. Categories include; information dissemination, education, 

alternatives, problem identification, community-based process, and environmental. 

Additionally, SAMHSA encourage states to use their block grant substance abuse 

prevention set aside funds for activities that will lead to a reduction in access to alcohol, 

tobacco, and drugs to include the abuse of opioids; change social attitudes; raise awareness 

about the consequences of substance abuse to include opioid abuse; and build 

communities’ capacities to effectively deal with opioid misuse disorders. States are 

encouraged to focus on opioid safety education and training, including initiatives that 

support the improved access for licensed healthcare professionals, including paramedics, 

to emergency devices used to rapidly reverse the effects of opioid overdoses, such as 

education and training on the distribution and use of naloxone. 

Also, states are encouraged within their initiatives to incorporate a robust evidence based 

intervention training that contributes to the development and success of state collaborations 

with other agencies and stakeholders including those agencies and stakeholders that 

facilitate linkage to treatment and recovery services.

11. Strategic Prevention Framework -The Committee directs SAMHSA to provide 

continuation grants for Strategic Prevention Framework activities in fiscal year 2018. 

(Page 80, H. Rept. 115-244)

Action taken or to be taken

SAMHSA’s Strategic Prevention Framework State Incentive Grants (SPF-SIG) and 

Strategic Prevention Framework Partnerships for Success (SPF-PFS) programs continue to 

address the nation’s top emerging substance abuse priorities including underage drinking 

and prescription drug misuse. SAMHSA continues to focus exclusively on: addressing 

State- and community-level indicators of alcohol, tobacco, and drug use; targeting and 

implementing appropriate universal prevention strategies; building infrastructure and 
304 

capacity; and preventing substance use and abuse. SAMHSA provides support for grantees 

to strengthen substance abuse prevention infrastructure and capacity using the strategic 

prevention framework. 

Senate Appropriations Committee, Labor/HHS/Education Subcommittee, S. Rept. 115-150 

12. Mental Health First Aid - The Committee is pleased with the progress of Mental Health 

First Aid. In issuing new competitive funding opportunities SAMHSA is directed to include 

as eligible grantees local law enforcement agencies, fire departments, and emergency 

medical units with a special emphasis on training for crisis de-escalation techniques. 

SAMHSA is also encouraged to prioritize training for veterans, armed services personnel, 

and their family members within the Mental Health First Aid program. (Page 117, S. Rept. 

115-150)

Action taken or to be taken 

Funding is not included in the President’s Budget for this program; however, should 

Congress appropriate the funding, the guidance above will be followed in the Funding 

Opportunity Announcement. 

13. Community Mental Health Services Block Grant - The Committee directs SAMHSA to 

continue its collaboration with NIMH to ensure that funds from this set-aside are only used 

for programs showing strong evidence of effectiveness and that target the first episode of 

psychosis. SAMHSA shall not expand the use of the set-aside to programs outside of the 

first episode psychosis. The Committee directs SAMHSA to include in the fiscal year 2019 

CJ a detailed table showing at a minimum each State’s allotment, name of the program 

being implemented, and a short description of the program. (Page 118, S. Rept. 115-150) 

Action taken or to be taken

SAMHSA in collaboration with NIMH continues to provide technical assistance to states 

for implementation of evidence-based Coordinated Specialty Care (CSC) programs that 

specifically address treatment, services, and supports to individuals who are diagnosed with 

first-episode psychosis. Since the set-aside was enacted in FY 2014, the number of states 

with fully implemented operating CSC treatment programs has steadily increased and 

SAMHSA continues to monitor and ensure that the set-aside program is solely used to 

address first-episode psychosis. Beginning in September 2016, SAMHSA, in partnership 

with NIMH, initiated a three year evaluation study of CSC programs funded through the 

MHBG set-aside to ensure that funds are only used for programs showing strong evidence 

of effectiveness and target first episode of psychosis. SAMHSA developed a “snapshot” 

of all the First Episode Psychosis programs, detailing each State’s allotment, name of the 

program being implemented, and a short description of the program. The requested table 

is part of SAMHSA’s FY 2019 CJ. 
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14. Children’s Mental Health Services - The Committee includes a 10 percent set-aside for 

an early intervention demonstration program with persons not more than 25 years of age 

at clinical high risk of developing a first episode psychosis. SAMHSA is directed to work 

with NIMH on the implementation of this set-aside. (Page 118, S. Rept. 115-150) 

Action taken or to be taken 

SAMHSA is pleased with the opportunity to implement this new set-aside and will work 

with NIMH as directed. 

15. Combating Opioid Abuse - The Committee continues to direct CSAT to ensure that these 

grants include as an allowable use the support of medication assisted treatment and other 

clinically appropriate services. These grants should target States with the highest age 

adjusted rates of admissions and that have demonstrated a dramatic age adjusted increase 

in admissions for the treatment of opioid use disorders. (Page 119, S. Rept. 115-150) 

Action taken or to be taken

SAMHSA’s previous funding opportunity included eligibility based on data which 

demonstrated the above criteria. The announcement also included an expectation to 

prioritize treatment regimens that are less susceptible to diversion for illicit purposes; the 

announcement also included as an allowable activity the use of medication-assisted 

treatment and other clinically appropriate services to achieve and maintain abstinence from 

all opioids and heroin. SAMHSA continues to work with its grantees to monitor these 

activities. 

16. Drug Courts - SAMHSA is directed to ensure that all drug treatment court funding is 

allocated to serve people diagnosed with a substance use disorder as their primary 

condition. SAMHSA is further directed to ensure that all drug treatment court grant 

recipients work directly with the corresponding State substance abuse agency in the 

planning, implementation, and evaluation of the grant. SAMHSA should expand training 

and technical assistance to drug treatment court grant recipients to ensure evidence-based 

practices are fully implemented. (Page 120, S. Rept. 115-150)

Action taken or to be taken 

SAMHSA, through the Center for Substance Abuse Treatment, ensures that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a 

substance use disorder as their primary condition. In addition, grantees in the program are 

expected to work with the state substance abuse agency in planning, implementation and 

evaluation of the grants. SAMHSA also continues to provide training and technical 

assistance to Drug Treatment Court grantees. 
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17. Handheld Analyzers - The Committee encourages SAMHSA to support the use of block 

grant funds and funds authorized under section 1003 of the 21st Century Cures Act for 

handheld analyzers. SAMHSA shall provide an update on these efforts in the fiscal year 

2019 CJ. (Page 120, S. Rept. 115-150)

Action taken or to be taken 

All recipients of SAMHSA discretionary and formula grant funds have the flexibility to 

use funds for authorized activities to prevent and treat conditions associated with opioid 

use disorders and other substance use disorders, including mobile technology devices, in 

support of substance use disorder treatment outcomes such as screening and testing for 

alcohol and drug use. SAMHSA encourages grantees to provide an array of screening, 

testing, treatment, and recovery support services for the treatment of substance use 

disorders, and especially opioid use disorder. 

18. State Targeted Response to the Opioid Abuse Crisis Grants - The Committee 

encourages HHS to ensure that these grants are focused on activities that can continue to 

provide opioid related treatment and abuse prevention services after Federal funding has 

ended. The Committee strongly encourages HHS and SAMHSA to refrain from any action 

that would require States and Territories to resubmit a grant proposal for the second year 

of State grant funding. By doing so, States could reduce administrative burdens and the 

Department could focus on promoting and implementing already approved plans. The 

Committee directs the agency to ensure States provide funds directly to local communities 

and counties to address the opioid crisis in areas of unmet need, and to report the 

Committee on such plans 1 year after enactment; SAMHSA is also directed to provide State 

agencies with technical assistance concerning how to enhance outreach and direct support 

to rural and underserved communities and providers in addressing this crisis. Further, the 

Committee is concerned that SAMHSA has restricted State flexibility for addressing the 

opioid crisis by limiting the amount of funding that can be used for opioid prevention 

activities. (Page 121, S. Rept. 115-150)

Action taken or to be taken 

SAMHSA continues to work with its Opioid STR grantees to monitor activities to ensure 

that the most evidence-based prevention, treatment, and recovery support services are 

being provided to address the nation’s opioid crisis. In January 2018, SAMHSA 

announced the implementation of a new TA Center for the program which capitalizes on 

the use of local experts to ensure EBPs are being used in the most effective manner 

possible. Additionally, SAMHSA also announced that grantees would not need to resubmit 

a competitive application for funding; rather, grantees will submit a noncompetitive 

continuation for the second year of STR funding. 

19. Treatment Facility Expansion - The Committee requests that SAMHSA explore ways that 

grantees could access Federal funding for the capital costs of new treatment facilities, 

including planning, construction, repair, preventive maintenance, environmental support, 

improvement, extension, alteration, purchase of fixed equipment or facilities, as well as the 

acquisition of land. SAMHSA shall provide an update on these efforts, including any 

recommendations, in the fiscal year 2019 CJ. (Page 121, S. Rept. 115-150)
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Action taken or to be taken 

SAMHSA recognizes the importance of safe and structurally sound treatment facilities in 

an effort to expand access to vital substance use disorder treatment and works with states 

to leverage local and state funding opportunities to build and expand treatment facilities 

within their respective communities. Through state and local collaborations, SAMHSA 

grantees are encouraged to enter into partnerships with municipal, private sector, and/or 

not for profit entities and other entities to provide support capital costs for new treatment 

facilities not otherwise authorized through SAMHSA grant programs. SAMHSA can 

provide training and technical assistance to grantees to facilitate and develop these 

partnerships. 

20. Combating Opioid Abuse - SAMHSA is directed to ensure applicants outline how 

proposed activities in the grant would work with treatment and recovery communities in 

addition to first responders. (Page 123, S. Rept. 115-150)

Action taken or to be taken 

Separate funding was not provided for this program; however, if Congress appropriates 

such funding, this guidance will be incorporated. 

21. Opioid Prevention Grants - SAMHSA shall award opioid prevention grants to 

communities and community coalitions based on the current state of evidence-based and 

promising practices. Further, the Committee directs SAMHSA to continue providing 

technical assistance to communities and coalitions by developing and distributing a list of 

best practices to prevent opioid abuse. SAMHSA is directed to work with NIDA, other 

Federal agencies, appropriate stakeholder groups, and States, in implementing these 

grants and developing best practices. Furthermore, SAMHSA should update this list based 

on new research findings, including the evaluation of the opioid prevention program 

grants. (Page 123, S. Rept. 115-150)

Action taken or to be taken 

SAMHSA will implement this program if funding is appropriated. 

22. Methamphetamine Abuse - The Committee requests that SAMHSA, in partnership with 

the National Center for Health Statistics at CDC, investigate the establishment of a 

comprehensive survey of the rates of methamphetamine abuse and its related indicators. 

The Committee requests an update on the feasibility of such a survey in the fiscal year 2019 

CJ. (Page 124, S. Rept. 115-150)

Action taken or to be taken 

No current funding exists for this effort; however, if funding is appropriated, SAMHSA 

will implement as directed.

23. Pediatric Psychiatric Beds - The Committee understands there is a shortage of 

psychiatric beds, particularly pediatric psychiatric beds, which help treat children with 

mental health and substance abuse issues. The Committee recommends SAMHSA review 
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the best practices of pediatric psychiatric programs and provide an update in the fiscal 

year 2019 Congressional Justification on this topic.

Action taken or to be taken 

SAMHSA conducted an analysis of psychiatric bed capacity that covered both adults and 

children (please see attached). The analysis reviewed:

1. Trends in access to psychiatric inpatient services to identify barriers to access;

2. Options for assisting state, local and tribal governments in ensuring equitable access 

to inpatient services; and 

3. Options for addressing these issues in regions with low numbers of inpatient beds. 

SAMHSA also reviewed children’s mental health programs to identify urgent needs 

including prevalence trends, workforce, access, family caregiving, integrated care and 

special populations. This includes participating in the development of the report of the 

Interdepartmental Serious Mental Illness Coordinating Committee’s report to 

Congress (https://store.samhsa.gov/shin/content/PEP17-ISMICC-RTC-ES/PEP17-

ISMICC-RTC-ES.pdf) that included issues impacting children and youth with serious 

emotional disturbance (SED). In addressing these needs, in FY ’18, SAMHSA, among 

other efforts, is planning on awarding grants to expand evidence-based systems of care for 

children with SED in states and communities, transition age youth, college mental health, 

family networks, and mental health awareness. In addition, SAMHSA is partnering with 

NIMH to identify effective practices for youth who are at clinically high risk for developing 

psychosis in order to provide early interventions to prevent long term disability.