DEPARTMENT 

of HEALTH 

and HUMAN 

SERVICES 

Fiscal Year 

2022 

Substance Abuse and Mental Health 

Services Administration 

Justification of Estimates for 

Appropriations Committees 
ii 
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DEPARTMENT OF HEALTH AND HUMAN SERVICES 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 

Table of Contents 

Fiscal Year 2022 Budget Page 

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

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

Organization Chart.................................................................................................................... vi 

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

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

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

3. Overview of Performance...............................................................................................8 

4. All Purpose Table (APT)................................................................................................9 

B. Budget Exhibits.................................................................................................................10 

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

2. Language Analysis.......................................................................................................14 

3. Amounts Available for Obligation................................................................................16 

4. Summary of Changes...................................................................................................17 

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

6. Authorizing Legislation................................................................................................19 

7. Appropriations History.................................................................................................22 

8. Appropriations Not Authorized by Law........................................................................24 

C. Mental Health....................................................................................................................25 

1. Mental Health Programs of Regional and National Significance...................................28 

2. Children’s Mental Health Services.............................................................................110 

3. Project for Assistance in Transition from Homelessness.............................................117 

4. Protection and Advocacy for Individuals with Mental Illness.....................................123 

5. Certified Community Behavioral Health Clinic ..........................................................128 

6. Community Mental Health Services Block Grant .......................................................135 

D. Substance Abuse Prevention...........................................................................................150 

1. Substance Abuse Prevention Programs of Regional and National Significance...........152 

E. Substance Abuse Treatment ...........................................................................................189 

1. Substance Abuse Treatment Programs of Regional and National Significance............192 

2. State Opioid Response Grants....................................................................................268 

3. Substance Abuse Prevention and Treatment Block Grant ...........................................273 

F. Health Surveillance and Program Support....................................................................287 

1. Health Surveillance ....................................................................................................290 

2. Drug Abuse Warning Network (DAWN) ...................................................................299 

3. Performance and Quality Information Systems...........................................................302 

4. Program Support........................................................................................................308 

5. Public Awareness and Support ...................................................................................311 

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G. Drug Control Program........................................................................................................315 

H. Supplementary Tables.....................................................................................................332 

1. Budget Authority by Object Class .............................................................................333 

2. Salaries and Expenses..................................................................................................343 

3. Detail of Full-Time Equivalent Employment (FTE).......................................................345 

4. Detail of Positions .......................................................................................................346 

5. Physicians’ Comparability Allowance Worksheet .........................................................347 

I. Significant Items................................................................................................................. 348 

J. OPDIV Specific Requirements.......................................................................................358 

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Organizational Structure: 

Substance Abuse and Mental Health Services Administration 

(SAMHSA) 

OFFICE OF THE ASSISTANT SECRETARY 

Tom Coderre 

Acting Assistant Secretary for Mental 

Health and Substance Use 

Vacant 

Deputy Assistant Secretary for Mental 

Health and Substance Use 

Sonia Chessen, M.A. 

Chief of Staff 

OFFICE OF COMMUNICATIONS 

Charissa Pallas, M.M. 

Director 

OFFICE OF THE CHIEF MEDICAL 

OFFICER 

Neeraj Gandotra, M.D. 

Chief Medical Officer 

NATIONAL MENTAL HEALTH AND 

SUBSTANCE USE POLICY LABORATORY 

Thomas Clarke, Ph.D. 

Director 

Vacant 

Deputy Director (MD) 

OFFICE OF FINANCIAL RESOURCES 

Anne Herron, M.S. 

Acting Director 

Vacant 

Deputy Director (MG) 

OFFICE OF MANAGEMENT, 

TECHNOLOGY AND OPERATIONS 

Paolo del Vecchio, M.S.W. 

Director 

Vacant 

Deputy Director (MB) 

CENTER FOR SUBSTANCE ABUSE 

PREVENTION 

Dona Dmitrovic, M.H.S. 

Director 

Christopher O’Connell, M.B.A. 

Deputy Director (MP) 

CENTER FOR MENTAL HEALTH 

SERVICES 

Anita Everett, M.D. 

Director 

Anne Mathews-Younes, Th.D. 

Deputy Director (MS) 

CENTER FOR SUBSTANCE ABUSE 

TREATMENT 

Joseph Bullock, Ed.D. 

Director 

Meena Abraham 

Deputy Director (MT) 

CENTER FOR BEHAVIORAL HEALTH 

STATISTICS AND QUALITY 

Krishnan Radhakrishnan, M.D., Ph.D. 

Director 

Elizabeth Lopez, Ph.D. 

Deputy Director (MC) 

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Performance Budget Overview Executive Summary 

Introduction 

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. Individuals and families across the nation are struggling with the 

consequences of living with mental and substance use disorders. In 2019, National Survey on 

Drug Use and Health (NSDUH) data estimated 35.8 million Americans aged 12 or older, or 13.0 

percent, were current (past month) illicit drug users. In addition, an estimated 20.6 percent of 

adults ages 18 and older had some type of mental illness in the past year (51.5 million) and 5.2 

percent (13.1 million) of adults had serious mental illness. SAMHSA has a unique responsibility 

to focus on these preventable and treatable conditions, which, if unaddressed, lead to significant 

individual, societal, and economic consequences. 

Mission 

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

communities. SAMHSA accomplishes this through providing leadership and resources – 

programs, policies, information and data, funding, and personnel – to advance mental and 

substance use disorder prevention, treatment, and recovery services in order to improve individual, 

community, and public health. 

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Overview of Budget Request 

The FY 2022 budget request is $9.7 billion, an increase of $3.7 billion from the FY 2021 Enacted 

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

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

to prevent suicide, expanding access to telehealth, and expanding school-based mental health 

services. 

Key Budget Highlights 

State Opioid Response Grants 

The FY 2022 Budget Request is $2.3 billion, an increase of $750 million from the FY 2021 

Enacted budget. Of this amount, $75 million is set-aside for tribes and increase of $25 million 

over the 2021 Enacted level. Overdose deaths have accelerated during the COVID-19 pandemic. 

The Centers for Disease Control and Prevention (CDC) provisional data estimates 90,000 drug 

overdose deaths in the United States in the 12 months ending in September 2020, the highest 

number ever recorded in a 12-month period. This grant program aims to address the opioid crisis 

by increasing access to medication-assisted treatment using FDA-approved medications for the 

treatment of opioid use disorder, reducing unmet treatment needs, and reducing opioid overdose 

related deaths through the provision of prevention, treatment and recovery activities for opioid use 

disorder (OUD) (including prescription opioids, heroin and illicit fentanyl and fentanyl analogs). 

Funding is awarded to states and territories via formula. The program includes a 15 percent setaside for the 10 states with the highest mortality rates related to drug overdose deaths. States and 

communities across the country are also dealing with rising rates of stimulant use and its negative 

health, social, and economic consequences. To address the growing methamphetamine crisis, the 

budget continues to allow the use of State Opioid Response grants to include methamphetamine 

and other stimulants to give states and tribes flexibility to address their unique community needs. 

Substance Abuse Prevention and Treatment Block Grant (SABG) 

The FY 2022 Budget Request is $3.5 billion, which is an increase of $1.7 billion from FY 2021 

Enacted. This Budget Request builds on investments in the Coronavirus Response and Relief 

Supplemental Appropriations Act and the American Rescue Plan Act. SABG helps states in 

addressing the opioid epidemic and other substance use treatment and prevention needs through 

support of prevention, treatment and other services (e.g., recovery support services) not covered 

by commercial insurance and non-clinical activities and services that address the critical needs of 

state substance abuse prevention and treatment service systems. 

The SABG seeks to improve the health and lives of individuals with substance use disorders. The 

SABG supports state prevention, treatment and recovery systems’ infrastructure and capacity, 

thereby increasing availability of services, development and implementation of evidence-based 

practices, development and collection of specific outcome measures, and development and 

maintenance of state data management systems. Also, the SABG provides staffing requirements, 

resources, and federal guidance that can be leveraged to sustain and improve state systems. This 

funding will further contribute to the development and maintenance of successful state 

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collaborations with other agencies and stakeholders concerned with preventing, treating and 

recovering from substance use disorders. 

It is imperative that our addiction crisis response evolves from an acute short-term individualfocused treatment response to a broader community recovery response. Addiction is a chronic 

illness, and recovery often is a life-long process where external community and social determinants 

of health play a vital role in its sustainability. The Budget Request includes a new 10 percent set 

aside within the SABG for recovery support services in order to significantly expand the 

continuum of care both upstream and downstream. This new set-aside will support the 

development of local recovery community support institutions (i.e. recovery community centers, 

recovery homes, recovery schools, recovery industries, recovery ministries); develop strategies 

and educational campaigns, trainings, and events to reduce addiction/recovery-related stigma and 

discrimination at the local level; provide addiction treatment and recovery resources and support 

system navigation; make accessible peer recovery support services that support diverse 

populations and are inclusive of all pathways to recovery; and collaborate and coordinate with 

local private and non-profit clinical health care providers, the faith community, city, county, state, 

and federal public health agencies, and criminal justice response efforts. 

Substance Abuse Treatment Programs of National and Regional Significance (PNRS) 

The FY 2022 Budget Request is $651 million, which is an increase of $154 million above the FY 

2021 Enacted. CDC provisional data shows a 28 percent increase in the deaths related to overdoses 

in the past year. The FY 2022 budget includes increased funding for opioid treatment and recovery 

support activities, services, naloxone training and distribution, services for pregnant and postpartum women, and workforce training to expand access to evidence-based treatment and recovery 

support services. 

Community Mental Health Services Block Grant (MHBG) 

The FY 2022 Budget Request is $1.6 billion, which is an increase of $825 million above the FY 

2021 Enacted. This funding continues to serve as a safety net for mental health services for some 

of the nation’s most vulnerable populations. This Budget Request builds on investments in the 

Coronavirus Response and Relief Supplemental Appropriations Act and the American Rescue Plan 

Act. The COVID pandemic and the change in the daily lives of Americans have taken a toll on 

people’s mental health and created new barriers for those seeking mental health care. Stress and 

anxiety about the pandemic, coupled with job losses, losses of income, medical insurance, 

childcare, and the loss of loved ones have a devastating effect on mental health. 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 

helps reduce costs to society, as intervening early helps prevent deterioration of functioning in 

individuals experiencing a first episode of serious mental illness. 

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The budget also includes a set-aside of $75 million of MHBG funds to support state efforts to build 

much needed crisis systems to address the needs of individuals in mental health crisis in a high 

quality, expeditious manner. The development of these services will promote 24/7 access to 

well-trained mental health professionals in the time of acute mental health crisis. This funding 

supports the partnering of behavioral health providers with law enforcement. 

Criminal and Juvenile Justice Programs - Treatment of Mental Disorders in Prisons 

The FY 2022 Budget Request is $51 million which is an increase of $45 million from the FY 2021 

Enacted. Data indicate that a significant number of individuals who come in contact with law 

enforcement and the criminal justice system have a mental or substance use disorder. This 

proposed increase aligns with the Administration’s goal to address mental health needs among 

incarcerated youth and adults by providing services to ensure their successful transition into the 

community post-incarceration. This funding will establish pre-release relationships with 

community mental health providers and key stakeholders. With a commitment to health equity, 

SAMHSA will award a new cohort of grants to support the provision of services by communitybased behavioral health providers both within jails/prisons and post-incarceration. This activity 

will address the unmet treatment needs of incarcerated individuals and allow these individuals to 

continue access services from the same community-based providers post-incarceration for a 

seamless transition of care. The needs of individuals returning to society include the social 

determinants of recovery (i.e. housing, employment, access to health care) and other supportive 

resources for successful transition from incarceration. This funding will support up to 100 grantees 

to provide screening, assessment, treatment, and linkage to services for those with mental disorders 

in jails/prisons. Special importance will be paid towards ensuring a commitment to racial and 

economic justice, trauma-informed approaches, as well as cultural humility. SAMHSAwill also 

continue its existing criminal justice portfolio that focuses on early diversion and alternatives to 

incarceration. 

Certified Community Behavioral Health Clinics (CCBHCs) Expansion Grants 

The FY 2022 Budget Request is $375 million, which is an increase of $125 million from the FY 

2021 Enacted. This funding will support a new cohort of 158 grants and 22 continuation grants. 

While effective treatment and supportive services exist, many individuals with mental/substance 

use disorders do not receive the help they need. When they do try to access services, they may face 

significant delays and/or get connected to incomplete, disconnected, or uncoordinated care. Even 

people who receive some services, such as medication or psychotherapy, often do not have access 

to the complete range of supports they need, such as help to get them through a crisis, manage cooccurring physical health problems, find and sustain employment, and maintain a safe place to live 

in the community. 

The CCBHC Expansion program is designed to increase access to and improve the quality of 

community mental and substance use disorder treatment services. CCBHCs funded under this 

program must provide access to services for individuals with serious mental illness (SMI) or 

substance use disorders (SUD), including opioid use disorders; children and adolescents with 

serious emotional disturbance (SED); and individuals with co-occurring mental and substance use 

disorders. This program will improve the mental health of individuals across the nation by 

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providing comprehensive community-based mental and substance use disorder services; treatment 

of co-occurring disorders; advance the integration of mental/substance use disorder treatment with 

physical health care; assimilate and utilize evidence-based practices on a more consistent basis, 

and promote improved access to high quality care. 

Data from intake to most recent reassessment for individuals served in the CCBHC program 

demonstrate that as of January 2020, clients have a 61.6 percent reduction in hospitalization and a 

62.1 percent reduction in Emergency Department (ED) visits. Additionally, the data demonstrates 

that 15.2 percent had an increase in employment or started going to school, and a 30.4 percent 

increase in mental health functioning in everyday life. 

Project AWARE 

The FY 2022 Budget Request is $191 million, which is an increase of $61 million from the FY 

2021 Enacted. Project AWARE is comprised of the Project AWARE State Education Agency 

(SEA) grants, ReCAST grants, and the Mental Health Awareness Training (MHAT) grants. This 

funding level would support 106 additional grants across the three programs. Project AWARE 

SEA grants are awarded to State Education Agency/Authorities to promote comprehensive, 

coordinated, and integrated state efforts to make schools safer and increase access to mental health 

services. In FY 2021, a state may receive an additional AWARE grant if they propose to work 

with different Local Education Agencies/Authorities. Education agencies/authorities that serve 

AI/AN children and youth are also eligible to apply for AWARE funding. 

The MHAT grants train school personnel, emergency first responders, law enforcement, veterans, 

armed services members and their families to recognize the signs and symptoms of mental 

disorders, particularly serious mental illness (SMI) and/or serious emotional disturbances (SED). 

ReCAST assists high-risk youth and families to promote resilience and equity in communities 

struggling with civil unrest, trauma, and violence through implementation of evidence-based 

violence prevention and community youth engagement programs and linkages to trauma-informed 

mental health services. 

Suicide Prevention Activities 

The FY 2022 Budget Request is $173 million, which is an increase of $78 million above the FY 

2021 Enacted. According to 2018 CDC data, suicide is the 10th leading cause of death in the United 

States. Suicide is a critical public health issue involving multiple psychological and social factors. 

Suicide rates have increased steadily for individuals of all ages. This increase will be directed 

towards the Suicide Lifeline program. The National Suicide Hotline Designation Act of 2020 

requires that the current National Suicide Prevention Lifeline’s 10-digit number be replaced by a 

new three-digit dialing code 9-8-8 for suicide prevention and mental health crisis services. The 9-

8-8 code, an easier number to remember, will be available nationally by July 16, 2022. SAMHSA 

is working with states to establish 9-8-8 system in their jurisdictions; and this number may be 

available in some areas sooner than 2022. This Budget Request will provide Lifeline-member 

call centers with resources to help meet both the operational needs during the pandemic and the 

implementation of 9-8-8 across the U.S. This funding will be used to strengthen the infrastructure 

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of the existing Lifeline to increase the capacity of Lifeline centers to answer calls, chats, and texts, 

and provide specialized services. 

Assisted Outpatient Treatment (AOT) for Individuals with SMI 

The FY 2022 Budget Request is $21 million, which is an increase of $420,000 above the FY 2021 

Enacted. 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. Funding 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. 

Substance Abuse Prevention Programs of National and Regional Significance (PNRS) 

The FY 2022 Budget Request is $217 million, which is an increase of $8 million above the FY 

2021 Enacted. The Budget Request includes increased funding for activities that address youth 

substance use, HIV and Hepatitis C prevention, Tribal Behavioral Health, and workforce 

development. 

Health Surveillance and Program Support 

The FY 2022 Budget Request is $172 million, which is an increase of $10 million above the FY 

2021 Enacted. The FY 2022 Budget Request includes increased funding for data collection and 

additional FTE to improve program performance. 

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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. As impact is measured and reported, SAMHSA seeks 

to identify the conditions that foster success, address barriers, enable collaboration across 

programs, and promote overall efficiency. 

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

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

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

employment. Additionally, SAMHSA collects data on the number of people served, the number 

trained, and the number of training events held. 

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

its robust 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 the quality 

of service delivery. In FY 2018, SAMHSA strengthened its internal evaluation ability through the 

creation of an Office of Evaluation in the Center for Behavioral Health Statistics and Quality. This 

Office partners with the National Mental Health and Substance Use Policy Laboratory to ensure 

that all SAMHSA programs are evaluated for effectiveness and that findings related to the most 

effective evidence-based practices to treat mental illness and substance use disorders are 

disseminated to the field. SAMHSA will continue its efforts to improve upon data collection to 

better inform service delivery. 

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Programs of Regional and National Significance.................................. $529.661 $558.923 $60.000 $753.176 $194.253 

Children's Mental Health Services....................................................... 125.000 125.000 125.000 0.000 

Set-Aside for Youth in Prodrome Phase of Psychosis (non-add)..... 12.500 12.500 12.500 0.000 

Projects for Assistance in Transition from Homelessness.................... 64.635 64.635 64.635 0.000 

Protection and Advocacy for Individuals with Mental Illness.............. 36.146 36.146 36.146 0.000 

Community Mental Health Services Block Grant.................................. 722.571 757.571 1,500.000 1,582.571 825.000 

Budget Authority (non-add).............................................................. 701.532 736.532 1,500.000 1,561.532 825.000 

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

Certified Community Behavioral Health Clinics.................................. 200.000 250.000 420.000 375.000 125.000 

Total, Mental Health ............................................................................ 1,678.013 1,792.275 1,980.000 2,936.528 1,144.253 

Budget Authority (non-add)................................................................. 1,644.974 1,759.236 -- 2,903.489 1,144.253 

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

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

Substance Abuse Prevention 

Programs of Regional and National Significance.................................. 

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

206.469 208.219 216.667 8.448 

206.469 208.219 -- 216.667 8.448 

Programs of Regional and National Significance.................................. 479.677 496.677 650.864 154.187 

PHS Evaluation Funds (non-add).................................................... 2.000 2.000 2.000 --

State Opioid Response Grants.............................................................. 1,500.000 1,500.000 2,250.000 750.000 

Set-Aside for Tribes (non-add)...................................................... 50.000 50.000 75.000 25.000 

Substance Abuse Prevention and Treatment Block Grant..................... 1,858.079 1,858.079 1,500.000 3,508.079 1,650.000 

Budget Authority (non-add).............................................................. 1,778.879 1,778.879 1,500.000 3,428.879 1,650.000 

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

Total, Substance Abuse Treatment...................................................... 3,837.756 3,854.756 1,500.000 6,408.943 2,554.187 

SAT Budget Authority (non-add)......................................................... 3,756.556 3,773.556 -- 6,327.743 2,554.187 

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

Health Surveillance and Program Support 126.258 126.258 -- 130.913 4.655 

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

Public Awareness and Support............................................................. 13.000 13.000 -- 13.260 0.260 

Performance and Quality Information Systems...................................... 10.000 10.000 -- 10.200 0.200 

Behavioral Health Workforce Data and Development ......................... 1.000 1.000 -- 1.000 --

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

Drug Abuse Warning Network.............................................................. 10.000 10.000 -- 15.000 5.000 

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

COVID-19 Supplemental...................................................................... 

Total, Health Surveillance and Program Support................................ 

HSPS Budget Authority (non-add)...................................................... 

-- 425.000 -- 4,330.000 -- --

161.758 425.000 161.758 4,330.000 171.873 10.115 

128.830 128.830 4,330.000 138.945 10.115 

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

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

TOTAL, SAMHSA Program Level...................................................... 5,883.996 425.000 6,017.008 7,810.000 9,734.011 3,717.003 

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

Less Funds from Other Sources: 

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

PHS Evaluation Funds..................................................................... -133.667 -133.667 -133.667 --

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

TOTAL, SAMHSA Budget Authority.................................................. 5,736.829 425.000 5,869.841 7,810.000 9,586.844 3,717.003 

Substance Abuse and Mental Health Services Administration 

All Purpose Table 

(Dollars in millions) 

Account and Program Name 

FY 2020 FY 2021 FY 2022 

Final 1/ COVID-19 

Supplemental /2 Enacted Supplemental Funding /3 

President's 

Budget +/- FY 2021 

Mental Health 

Substance Abuse Treatment 

Health Surveillance and Program Support 

1/ Reflects amounts appropriated and any reprogrammings or reallocations notified to congress. 

2/ Excludes $5.0 million in permissive transfers or allotments from the Public Health and Social Services Emergency Fund (PHSSEF) to SAMHSA for 

Disaster Distress Helpline which are shown in PHSSEF. 

3/ This column includes both supplemental funding and mandatory funds appropriated in the American Rescue Plan Act of 2021, P.L. 117-2 posttransfer and post-reallocation. 

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Budget Exhibits 

Table of Contents 

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

2. Language Analysis.......................................................................................................14 

3. Amounts Available for Obligation................................................................................16 

4. Summary of Changes...................................................................................................17 

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

6. Authorizing Legislation................................................................................................19 

7. Appropriations History.................................................................................................22 

8. Appropriations Not Authorized by Law........................................................................24 

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Appropriation 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, [$1,759,236,000: Provided, 

That of the funds made available under this heading, $71,887,000 shall be for the National Child 

Traumatic Stress Initiative] $2,903,489,000: Provided further, That notwithstanding section 

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

available for carrying out section 1971 of the PHS Act: Provided further, That in addition to 

amounts provided herein, $21,039,000 shall be available under section 241 of the PHS Act to 

supplement funds otherwise available for mental health activities and to carry out subpart I of 

part B of title XIX of the PHS Act to fund section 1920(b) technical assistance, national data, 

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

section 1920(b) activities shall not exceed 5 percent of the amounts appropriated for subpart I of 

part B of title XIX: Provided further, That of the funds made available under this heading for 

subpart I of part B of title XIX of the PHS Act, [$35,000,000] $75,000,000 shall be available to 

support evidence-based crisis systems: Provided further, That up to 10 percent of the amounts 

made available to carry out the Children's Mental Health Services program may be used to carry 

out demonstration grants or contracts for early interventions with persons not more than 25 years 

of age at clinical high risk of developing a first episode of psychosis: Provided further, That 

section 520E(b)(2) of the PHS Act shall not apply to funds appropriated in this Act for fiscal 

year [2021: Provided further, That States shall expend at least 10 percent of the amount each 

receives for carrying out section 1911 of the PHS Act to support evidence-based programs that 

address the needs of individuals with early serious mental illness, including psychotic disorders, 

regardless of the age of the individual at onset] 2022: Provided further, That [$250,000,000] 

$375,000,000 shall be available until September 30, [2023] 2024 for grants to communities and 

community organizations who meet criteria for Certified Community Behavioral Health Clinics 

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

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

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

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

42 U.S.C. 290aa 22 note). 

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, and the 

SUPPORT for Patients and Communities Act, [$3,773,556,000] $6,327,743,000: Provided, That 

[$1,500,000,000] $2,250,000,000 shall be for State Opioid Response Grants for carrying out 

activities pertaining to opioids and stimulants undertaken by the State agency responsible for 

administering the substance abuse prevention and treatmentblock grant under subpart II of part B 

of title XIX of the PHS Act (42 U.S.C. 300x–21 et seq.): Provided further, That of such amount 

[$50,000,000] $75,000,000 shall be made available to Indian Tribes or tribal organizations: 

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Provided further, That 15 percent of the remaining amount shall be for the States with the highest 

mortality rate related to opioid use disorders: Provided further, That of the amounts provided for 

State Opioid Response Grants not more than 2 percent shall be available for Federal 

administrative expenses, training, technical assistance, and evaluation: Provided further, That of 

the amount not reserved by the previous three provisos, the Secretary shall make allocations to 

States, territories, and the District of Columbia according to a formula using national survey 

results that the Secretary determines are the most objective and reliable measure of drug use and 

drug-related deaths[: Provided further, That the Secretary shall submit the formula methodology 

to the Committees on Appropriations of the House of Representatives and the Senate not less 

than 15 days prior to publishing a Funding Opportunity Announcement]: Provided further, That 

prevention and treatment activities funded through such grants may include education, treatment 

(including the provision of medication), behavioral health services for individuals in treatment 

programs, referral to treatment services, recovery support, and medical screening associated with 

such treatment: Provided further, That each State, as well as the District of Columbia, shall 

receive not less than $4,000,000: Provided further, That in addition to amounts provided herein, 

the following amounts shall be available under section 241 of the PHS Act: (1) $79,200,000 to 

supplement funds otherwise available for substance abuse treatment activities to carry out 

subpart II of part B of title XIX of the PHS Act to fund section 1935(b) technical assistance, 

national data, data collection and evaluation activities, and further that the total available under 

this Act for section 1935(b) activities shall not exceed 5 percent of the amounts appropriated for 

subpart II of part B of title XIX; and (2) $2,000,000 to evaluate substance abuse treatment 

programs: Provided further, That each State that receives funds appropriated under this heading 

in this Act for carrying out subpart II of part B of title XIX of the PHS Act shall expend not less 

than 10 percent of such funds for recovery support services: Provided further, That none of the 

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

to section 241 of such Act. 

SUBSTANCE ABUSE PREVENTION 

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

[$208,219,000] $216,667,000. 

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 and the Protection and Advocacy for 

Individuals with Mental Illness Act in the Substance Abuse and Mental Health Services 

Administration, [$128,830,000] $138,945,000: Provided, That in addition to amounts provided 

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

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

program data, and to conduct public awareness and technical assistance activities: Provided 

further, That, in addition, fees may be collected for the costs of publications, data, data 

tabulations, and data analysis completed under title V of the PHS Act and provided to a public or 

private entity upon request, which shall be credited to this appropriation and shall remain 

available until expended for such purposes: Provided further, That amounts made available in 

this Act for carrying out section 501(o) of the PHS Act shall remain available through September 

30, [2022] 2023: 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". 

13 
 

 

[2021: Provided further, That States shall expend at 

least 10 percent of the amount each receives for 

carrying out section 1911 of the PHS Act to support 

evidence-based programs that address the needs of 

individuals with early serious mental illness, 

including psychotic disorders, regardless of the age 

of the individual at onset] 2022: 

 

 

 

 

 

 

 

 

 

 

 

 

 

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, [$1,759,236,000] $2,903,489,000: [Provided, 

That of the funds made available under this heading, 

$81,887,000 shall be for the National Child 

Traumatic Stress Initiative:] 

Identifies the purpose for which funds 

can be used for mental health. Language 

regarding the National Child Traumatic 

Stress Initiative is removed because a 

separate funding proviso is unnecessary 

and duplicative. 

Language is removed because the 10 

percent set-aside for early serious mental 

illness is Section 1920 of the 

authorization and therefore is 

unnecessary. 

Provided further, That in addition to amounts 

provided herein, $21,039,000 shall be available 

under section 241 of the PHS Act to supplement 

funds otherwise available for mental health 

activities and to carry out subpart I of part B of title 

XIX of the PHS Act to fund section 1920(b) 

technical assistance, national data, data collection 

and evaluation activities, and further that the total 

available under this Act for section 1920(b) 

activities shall not exceed 5 percent of the amounts 

appropriated for subpart I of part B of title XIX: 

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority for 

programs for mental health activities and 

programs authorized under title XIX as 

well as under titles III and V. 

14 
Language Provision Explanation 

Provided further, That in addition to amounts 

provided herein, the following amounts shall be 

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

$79,200,000 to supplement funds otherwise 

available for substance abuse treatment activities to 

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

Act to fund section 1935(b) technical assistance, 

national data, data collection and evaluation 

activities, and further that the total available under 

this Act for section 1935(b) activities shall not 

exceed 5 percent of the amounts appropriated for 

subpart II of part B of title XIX; 

Sets the amount of Public Health Service 

Evaluation Fund dollars allocated to 

supplement the budget authority 

available for programs and activities 

authorized under title XIX, titles III and 

V, and substance use disorder treatment 

activities. 

[: Provided further, That the Secretary shall submit 

the formula methodology to the Committees on 

Appropriations of the House of Representatives and 

the Senate not less than 15 days prior to publishing 

a Funding Opportunity Announcement]: 

Language is removed for Administrative 

flexibility 

Provided further, That each State that receives funds 

appropriated under this heading in this Act for 

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

PHS Act shall expend not less than 10 percent of 

such funds for recovery support services: 

Requires states to expend 10 percent of 

SABG funds on recovery support 

services. 

15 
General Fund Discretionary Appropriation: 

Appropriation ................................................................ $5,736,829,000 $5,869,841,000 $9,586,844,000 

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

Subtotal, Appropriation .............................................. 5,736,829,000 5,869,841,000 9,586,844,000 

Subtotal, adjusted appropriation.................................. 5,736,829,000 5,869,841,000 9,586,844,000 

Subtotal, adjusted appropriation.................................. 5,736,829,000 5,869,841,000 9,586,844,000 

Total, Discretionary Appropriation...................... 5,736,829,000 5,869,841,000 9,586,844,000 

Mandatory Appropriation: 

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

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

Offsetting collections from: 

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

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

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

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

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

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

 ---

 $5,883,996,000

 --- ---

 $6,017,008,000 $9,734,011,000 

Amounts Available for Obligation 

(Whole dollars) 

FY 2020 

Final 

FY 2021

 Enacted 

FY 2022 

President's 

Budget 

16 
2021 Enacted........................................................................................................................................................................ 

Total estimated budget authority........................................................................................................................................... $5,869,841,000 

(Obligations)........................................................................................................................................................................ 

2022 President's Budget....................................................................................................................................................... 

 5,869,841,000 

Total estimated budget authority........................................................................................................................................... $9,586,844,000 

(Obligations)........................................................................................................................................................................ 9,586,844,000 

Net Change........................................................................................................................................................................ +$3,717,003,000 

 

 

 

 

 

 

 

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

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

--- -692,031 

--- -692,031 

B. Program: 

1. Health Surveillance and Program Support............................... --- --- --- --- ---

2. Mental Health.......................................................................... --- --- --- --- ---

3. Substance Abuse Prevention.................................................... --- --- --- --- ---

4.Substance Abuse Treatment ..................................................... --- --- --- --- ---

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

Total Decreases................................................................... --- --- --- --- -692,031 

Net Change....................................................................... --- --- --- --- +$3,717,003,000 

Summary of Changes 

(Whole dollars) 

Increases: 

A. Built-in: 

FY 2021 FY 2021 FY 2022 

FY 2022 

+/-

FY 2021 

FY 2022 

+/-

FY 2021 

Enacted PB FTE PB BA FTE BA 

1. Annualization of 2020 commissioned corps pay increase....... $5,649,942 --- $5,777,065 --- +127,123 

2. Annualization of 2020 civilian pay increase........................... 

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

A. Program: 

75,320,999 --- 75,885,907 --- +564,908 

80,970,941 --- 81,662,972 --- +692,031 

1. Mental Health.......................................................................... 1,759,236,000 --- 2,903,489,000 --- +1,144,253,000 

2. Substance Abuse Prevention.................................................... 208,219,000 --- 216,667,000 --- +8,448,000 

3.Substance Abuse Treatment ..................................................... 3,773,556,000 --- 6,327,743,000 --- +2,554,187,000 

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

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

128,830,000 --- 138,945,000 --- +10,115,000 

5,869,841,000 --- 9,586,844,000 --- +3,717,003,000 

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

Decreases: 

A. Built-in: 

--- --- --- --- +3,717,695,031 

17 
Budget Authority by Activity 

(Dollars in thousands) 

FY2020 

Final 

FY 2021 

Enacted 

FY2022 

President's 

Budget 

Mental Healt.h 

Programs of Regional and National Significance .. _ ................. $529,661 $558,923 $753,176 

Children's Mental Health Se1v ices ...................................... 125,000 125,000 125,000 

Set-Aside/or Youth in Prodrome Phase of Psychosis (non-add) 12,500 12,500 12,500 

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

Protection and Advocacy for Individuals with Mental Illness 36,146 36,146 36,146 

Community Mental Health Se1vices Block Grant ................ 722,571 757,571 1,582,571 

Budget Authority (non-add) ............................................... ·-· .. ·-· .. 701,532 736,532 1,561,532 

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

Ce1tified Community Behavioral Health Clinics_ ................. 200,000 250,000 375,000 

Total, Mental Health --------------------------------------·----------------- 1,678,013 1,792,275 2,936,528 

Substance Abuse Prevention 

Programs of Regional and National Significance.·-················· 206,469 208,219 216,667 

Total, Substance Abuse Prevention ................................... 206,469 208,219 216,667 

Substance Abuse Treatment 

Programs of Regional and National Significance., _,., .............. 479,677 496,677 650,864 

State Opioid Response Grants ........................................... 1,500,000 1,500,000 2,250,000 

Set-Aside/or Tribes (non-add) ...... ........ ............. . ........ 50,000 75,000 

Substance Abuse Prevention and Treatment Block Grant. .... 1,858,079 1,858,079 3,508,079 

Budget Authority (non-add) .. ............. ............. .. .. . . '' ' ... ' ... ' .... ' .... ' . 1,778,879 1,778,879 3,428,879 

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

Total, Substance Abuse Treatment.. .................................. 3,837,756 3,854,756 6,408,943 

Health Surveillance and Proi:ram Su1mo11 

Health Smv eillance and Program Supp01t 126,258 126,258 130,913 

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

Public Awareness and Supp01t .......................................... 13,000 13,000 13,260 

Perfonnance and Quality lnfo1mation Systems .................... 10,000 10,000 10,200 

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

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

Drng Abuse Warning Network. .......................................... 10,000 10,000 15,000 

Total, Health Surveillance and Program Suooort.. ............ 161,758 161,758 171,873 

TOTAL, SAMHSA Pl'Og1·am Level.. ................................................ 5,883,996 6,017,008 9,734,011 

Nom·ecmTiug Expenses Fund (NEF) ................................................ --

Less Funds from Other Somces: 

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

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

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

TOTAL, SAMHSA Budget Authority .............................................. 5,736,829 5,869,841 9,586,844 

FTEs 452 484 615 

18 
1. Grants for the Benefit of Homeless 

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

$ 41,304,000 $ 36,386,000 $ 41,304,000 $ 37,114,000 

2. Residential Treatment Programs for Pregnant and 

Postpartum Women

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

 $ 29,931,000 $ 32,931,000 $ 29,931,000 $ 49,397,000 

3. Priority Substance Abuse Treatment Needs of 

Regional and National Significance 

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

$ 333,806,000 $ 496,677,000 $ 333,806,000 $ 650,864,000 

4. Substance Abuse Treatment Services for Children 

and Adolescents 

$ 29,605,000 $ 29,605,000 $ 29,605,000 $ 30,197,000 

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

5. Priority Substance Abuse Prevention Needs of 

Regional and National Significance 

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

$ 211,148,000 $ 208,219,000 $ 211,148,000 $ 216,667,000 

6. Sober Truth on Preventing Underage Drinking 

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

$ 7,000,000 $ 10,000,000 $ 7,000,000 $ 10,000,000 

7. Priority Mental Health Needs of Regional and 

National Significance 

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

$ 394,550,000 $ 466,036,000 $ 394,550,000 $ 645,353,000 

8. Suicide Prevention Technical Assistance Center 

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

$ 5,988,000 $ 9,000,000 $ 5,988,000 $ 9,180,000 

9. Youth Suicide Early Intervention and Prevention 

Strategies 

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

$ 30,000,000 $ 36,427,000 $ 30,000,000 $ 36,916,000 

10. Mental Health and Substance Use Disorder 

Services on Campus 

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

$ 7,000,000 $ 6,488,000 $ 7,000,000 $ 6,618,000 

11. National Suicide Prevention Lifeline Program 

PHS Act, Section 520E-3............................................. 

$ 7,198,000 $ 24,000,000 $ 7,198,000 $ 74,480,000 

Substance Abuse and Mental Health Services Administration 

Authorizing Legislation 

Activity 

FY 2021 

Amount 

Authorized 

FY 2021 Amount 

Appropriated 

FY 2022 Amount 

Authorized 

FY 2022 President's 

Budget 

19 
Activity 

12. Grants for Jail Diversion Programs 

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

$ 4,269,000 $ 6,269,000 $ 4,269,000 $ 51,394,000 

13. Mental Health Awareness Training 

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

$ 14,693,000 $ 23,963,000 $ 14,693,000 $ 35,945,000 

14. Promoting Integration of Primary and Behavioral 

Health Care 

$ 51,878,000 $ 54,868,000 $ 51,878,000 $ 55,922,000 

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

15. Adult Suicide Prevention 

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

$ 30,000,000 $ 23,200,000 $ 30,000,000 $ 42,554,000 

16. Assertive Community Treatment Grant Program 

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

$ 5,000,000 $ 9,000,000 $ 5,000,000 $ 9,000,000 

17. Projects for Assistance in Transition From 

Homelessness 

$ 64,635,000 $ 64,635,000 $ 64,635,000 $ 65,928,000 

PHS Act, Section 535(a).............................................. 

18. First Responder Training 

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

$ 36,000,000 $ 42,000,000 $ 36,000,000 $ 63,000,000 

19. Building Communities of Recovery 

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

$ 5,000,000 $ 10,000,000 $ 5,000,000 $ 20,000,000 

20. Community Mental Health Services for Children 

with Serious Emotional Disturbances 

$ 119,026,000 $ 125,000,000 $ 119,026,000 $ 127,500,000 

PHS Act, Section 565(f)(1).......................................... 

21. Grants to Address the Problems of Persons Who 

Experience Violence Related Stress 

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

$ 63,887,000 $ 718,887,000 $ 63,887,000 $ 81,887,000 

FY 2021 

Amount 

Authorized 

FY 2021 Amount 

Appropriated 

FY 2022 Amount 

Authorized 

FY 2022 President's 

Budget 

Substance Abuse and Mental Health Services Administration 

Authorizing Legislation 

20 
Activity Authorized Appropriated Authorized Budget 

22. Community Mental Health Services Block Grants $ 532,571,000 $ 757,571,000 $ 532,571,000 $ 1,582,571,000 

PHS Act, Section 1911................................................ 

23. Substance Abuse Prevention and Treatment Block $1,858,079,000 $ 1,858,079,000 $ 1,858,079,000 $ 3,508,079,000 

Grants 

PHS Act, Section 1921................................................ 

24. Assisted Outpatient Treatment Grant Program for $ 18,000,000 $ 21,000,000 $ 18,000,000 $ 21,420,000 

Individuals With SMI 

Section 224 of the Protecting Access to Medicare Act 

of 2014..................................................... 

25. Protection and Advocacy for Individuals with $ - $ 36,146,000 $ - $ 36,869,000 

Mental Illness* 

Section 117 of the Protection and Advocacy of 

Mentally Ill Individuals Act of 1986..................... 

26. Heath Surveillance Permanent $ 126,258,000 Permanent $ 130,913,000 

PHS Act, Section 501, 505........................................... 

27. Public Awareness and Support Indefinite $ 13,000,000 Indefinite $ 13,260,000 

PHS Act, Section 501, 509, 516, 520A......................... 

28. Performance and Quality Improvement Systems Indefinite $ 10,000,000 Indefinite $ 10,200,000 

PHS Act, Section 501, 509, 516, 520A......................... 

Substance Abuse and Mental Health Services Administration 

Authorizing Legislation 

FY 2021 

Amount FY 2021 Amount FY 2022 Amount FY 2022 President's 

* Sunset date: 2003 

21 
Appropriation History Table 

Budget Estimate 

to Congress House Allowance 

Senate 

Allowance Appropriation 

FY 2010 

General Fund Appropriation: 

Base P.L. 111-117....................... 

Subtotal........................................ 

$3,393,882,000 

$3,393,882,000 

$3,429,782,000 

$3,429,782,000 

$3,419,438,000 

$3,419,438,000 

$3,431,116,000 

$3,431,116,000 

/1 

FY 2011 

General Fund Appropriation: 

Base P.L. 112-10......................... 

Subtotal........................................ 

$3,541,362,000 

$3,541,362,000 

$3,565,360,000 

$3,565,360,000 

$3,576,184,000 

$3,576,184,000 

$3,386,311,000 

$3,386,311,000 

FY 2012 

General Fund Appropriation: 

Base P.L. 112-74......................... 

Subtotal........................................ 

$3,386,903,000 

$3,386,903,000 

$3,096,914,000 

$3,096,914,000 

$3,354,637,000 

$3,354,637,000 

$3,347,020,000 

$3,347,020,000 

/2 

FY 2013 

General Fund Appropriation: 

Base S.R. 112-176 ..................... 

Subtotal........................................ 

$3,151,508,000 

$3,151,508,000 

---

---

$3,472,213,000 

$3,472,213,000 

$3,172,154,778 

$3,172,154,778 

/3 

FY 2014 

General Fund Appropriation: 

Base S.R. 113-071....................... 

Subtotal........................................ 

FY 2015 

General Fund Appropriation: 

$3,347,951,097 

$3,347,951,097 

---

---

$3,529,944,000 

$3,529,944,000 

$3,434,935,000 

$3,434,935,000 

/4 

Base P.L. 113-235....................... 

Subtotal........................................ 

$3,297,669,000 

$3,297,669,000 

---

---

$3,431,878,000 

$3,431,878,000 

$3,474,045,000 

$3,474,045,000 

/5 

FY 2016 

General Fund Appropriation: 

Base P.L. 114-113....................... 

Subtotal........................................ 

$3,395,663,000 

$3,395,663,000 

$3,642,710,000 

$3,642,710,000 

$3,314,817,000 

$3,314,817,000 

$3,634,269,000 

$3,634,269,000 

/6 

FY 2017 

General Fund Appropriation: 

21st Century Cures Act................ 

Base P.L. 115-31......................... 

Subtotal........................................ 

$3,488,783,000 

$3,488,783,000 

$4,211,603,000 

$4,211,603,000 

$3,739,577,000 

$3,739,577,000 

$500,000,000 

$3,611,003,000 

$4,111,003,000 

/7 

/8 

22 
Budget Estimate Senate 

to Congress House Allowance Allowance Appropriation 

FY 2018 

General Fund Appropriation: 

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

Base P.L. 115-141....................... $3,770,668,000 $4,193,936,000 $4,279,092,000 $4,513,327,000 /9 

Subtotal........................................ $3,770,668,000 $4,193,936,000 $4,279,092,000 $5,013,327,000 

FY 2019 

General Fund Appropriation: 

Base P.L. 115-245....................... $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000 /10 

Subtotal........................................ $3,425,887,000 $5,319,561,000 $5,592,827,000 $5,596,829,000 

FY 2020 

General Fund Appropriation: 

Base............................................. $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000 /11 

Subtotal........................................ $5,534,908,000 $5,870,996,000 $5,856,496,000 $5,736,829,000 

FY 2021 

General Fund Appropriation: 

Base............................................. $5,597,651,000 $5,830,829,000 $5,853,840,000 $5,869,841,000 /12 

Subtotal........................................ $5,597,651,000 $5,830,829,000 $5,853,840,000 $5,869,841,000 

FY 2022 

General Fund Appropriation: 

Appropriation History Table (cont'd) 

Base............................................. $9,586,844,000 --- --- --- /13 

Subtotal........................................ $9,586,844,000 --- --- ---

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. 

5/ Reflects the whole year appropriation. 

6/ Reflects the whole year appropriation. 

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

 (Public Law 114–67), at a rate for operations of $500,000,000. 

8/ Reflects the whole year appropriation. 

9/ Reflects the Annualized Continuing Resolution. 

10/ Reflects the whole year approation. 

11/ Reflects the whole year approation. 

12/ Reflects the whole year approation. 

13/ Reflects the whole year approation. 

23 
Substance Abuse and Mental Health Services Administration 

Appropriations Not Authorized by Law 

(Whole dollars) 

Appropriations in 

Last Year of Authorization Last Year of Appropriations 

Program Authorization Level Authorization in FY 2021 

Protection and Advocacy for Individuals with Mental Illness Act 

P.L. 99-319, Sec. 117................................................... 2003 $ 19,500,000 $ 36,146,000 $ 36,146,000 

TOTAL, SAMHSA Budget Authority......................... $ 19,500,000 $ 36,146,000 $ 36,146,000 

24 
 

 

Mental Health 

Table of Contents 

1. Mental Health Appropriation.........................................................................................27 

2. Programs of Regional and National Significance (PRNS)..............................................28 

a) National Child Traumatic Stress Network..........................................................29 

b) Project AWARE and Mental Health Awareness Training...................................32 

c) Healthy Transitions............................................................................................35 

d) Children and Family Programs...........................................................................38 

e) Consumer and Family Network Grants ..............................................................40 

f) Project LAUNCH ..............................................................................................42 

g) Mental Health System Transformation and Health Reform ................................46 

h) Primary and Behavioral Health Care Integration ................................................49 

i) Suicide Prevention Programs.............................................................................52 

i. National Strategy for Suicide Prevention......................................................53 

ii. Garrett Lee Smith Youth Suicide Prevention – State/Tribal and Campus......55 

iii. Garrett Lee Smith Suicide Prevention Resource Center................................57 

iv. National Suicide Prevention - Lifeline..........................................................60 

v. American Indian/Alaska Native Suicide Prevention Initiative.......................63 

j) Homelessness Prevention Programs...................................................................67 

k) Minority AIDS...................................................................................................70 

l) Criminal and Juvenile Justice Programs.............................................................73 

m) Practice Improvement and Training ...................................................................77 

n) Consumer and Consumer-Supporter TA Centers................................................79 

o) Disaster Response..............................................................................................81 

p) Seclusion and Restraint......................................................................................83 

q) Assertive Community Treatment for Individuals with Serious Mental Illness.....84 

25 
 

r) Assisted Outpatient Treatment for Individuals with Serious Mental Illness ........87 

s) Tribal Behavioral Health Grants ........................................................................93 

t) Minority Fellowship Program ............................................................................96 

u) Infant and Early Childhood Mental Health.........................................................97 

PRNS Mechanism Tables ...................................................................................................99 

Grant Awards Table ..........................................................................................................109 

3. Children's Mental Health Services...............................................................................110 

4. Projects for Assistance in Transition from Homelessness (PATH)...............................117 

5. Protection and Advocacy for Individuals with Mental Illness (PAIMI)........................123 

6. Certified Community Behavioral Health Clinic (CCBHC)...........................................128 

7. Community Mental Health Services Block Grant (MHBG) .........................................135 

26 
 

 

 

Programs of Regional and National Significance........................... $529,661 $558,923 $753,176 $194,253 

Prevention and Public Health Fund (non-add)......................... 11,542 12,000 12,000 -

Children's Mental Health Services................................................. 125,000 125,000 125,000 -

Projects for Assistance in Transition From Homelessness............. 64,635 64,635 64,635 +0 

Protection and Advocacy For Individuals with Mental Illness....... 36,146 36,146 36,146 +0 

Certified Community Behavioral Health Clinics............................ 200,000 250,000 375,000 +125,000 

Community Mental Health Services Block Grant........................... 722,571 757,571 1,582,571 +825,000 

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

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

 21,039 21,039 21,039 -

 1,678,013 1,792,275 2,936,528 +1,144,253 

Mental Health Appropriation 

(Dollars in thousands) 

Programs of Regional & National Significance FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

The Mental Health FY 2022 Budget Request is $2.9 billion, an increase of $1.1 billion from the FY 2021 

Enacted. 

27 
 

 

 

 

Capacity 

National Child Traumatic Stress Network............................... $68,887 $71,887 $81,887 $10,000 

Project AWARE...................................................................... 102,001 107,001 155,502 48,501 

Project AWARE: State Grants(non-add)............................. 92,001 94,501 136,752 42,251 

Project AWARE: Civil Unrest(non-add).............................. 10,000 12,500 18,750 6,250 

Mental Health Awareness Training.......................................... 22,963 23,963 35,945 11,982 

Healthy Transitions.................................................................. 28,951 29,451 29,451 --

Children and Family Programs................................................. 7,229 7,229 7,229 --

Consumer and Family Network Grants.................................... 4,954 4,954 4,954 --

Project LAUNCH..................................................................... 23,605 23,605 23,605 --

MH System Transformation and Health Reform....................... 3,779 3,779 3,779 --

Primary and Behavioral Health Care Integration..................... 49,877 52,877 52,877 --

Suicide Prevention Programs................................................... 90,034 102,046 179,667 77,621 

National Strategy for Suicide Prevention.............................. 18,200 23,200 23,200 --

Zero Suicide (non-add)..................................................... 14,000 18,800 18,800 --

Zero Suicide AI/AN(non-add)..................................... 2,200 2,400 2,400 --

All Other NSSP (non-add)................................................ 2,000 2,000 2,000 --

GLS - Youth Suicide Prevention - States............................. 35,427 36,427 36,427 --

Budget Authority (non-add).............................................. 23,885 24,427 24,427 --

Prevention and Public Health Fund (non-add)................ 11,542 12,000 12,000 --

GLS - Youth Suicide Prevention - Campus.......................... 6,488 6,488 6,488 --

GLS - Suicide Prevention Resource Center........................ 7,988 9,000 9,000 --

Suicide Lifeline.................................................................... 19,000 24,000 101,621 77,621 

AI/AN Suicide Prevention Initiative.................................... 2,931 2,931 2,931 --

Homelessness Prevention Programs......................................... 30,696 30,696 30,696 --

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

Criminal and Juvenile Justice Programs.................................. 6,269 6,269 51,394 45,125 

Seclusion & Restraint.............................................................. 1,147 1,147 1,147 --

Assisted Outpatient Treatment for Individuals with SMI......... 19,000 21,000 21,420 420 

Assertive Community Treatment for Individuals with SMI...... 7,000 9,000 9,000 --

Comprehensive Opioid Recovery Centers............................... 2,000 -- -- --

Tribal Behavioral Health Grants.............................................. 20,000 20,750 20,750 --

Infant and Early Childhood Mental Health............................... 7,000 8,000 8,000 --

 

Science and Service: -

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

Practice Improvement and Training......................................... 7,828 7,828 7,828 --

Consumer and Consumer Support TA Centers......................... 1,918 1,918 1,918 --

Disaster Response.................................................................... 1,953 1,953 1,953 --

Homelessness........................................................................... 2,296 2,296 2,296 --

MH Minority Fellowship Program........................................... 9,059 10,059 10,663 604 

Subtotal, Science and Service 25,045 26,045 26,649 604 

Total, PRNS 529,661 558,923 753,176 194,253 

Mental Health Appropriation 

Programs of Regional and National Significance (PRNS) 

(Dollars in thousands)

 Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Subtotal, Capacity 504,616 532,878 726,527 193,649 

28 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

National Child Traumatic Stress Network 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

Request 

FY 2022 

+/- FY 2021 

National Child Traumatic Stress Network........................ $68,887 $71,887 $81,887 $10,000 

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

FY 2022 Authorization ........................................................................................................$63,887,000 

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 and is a serious public health challenge. 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 may lead to early childhood mental health, chronic 

medical, and social development problems - if not recognized and addressed early in life.1 

Epidemiological study results estimates as many as 80 percent of children and adolescents are exposed 

to traumatic events by the age of 23, with many exposed to multiple traumatic events.2 While the effects 

of trauma and exposure to violence are found in all child and adolescent populations and service sectors, 

it is particularly prominent among youth with mental illness and/or drug/alcohol addiction involved in 

the child welfare, and juvenile justice systems. Studies show that youth in foster care can have rates of 

Post-Traumatic Stress Disorder that are nearly double those of combat veterans.3 

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 

centers to 116 funded and over 150 affiliate centers located nationwide in universities, hospitals, and a 

range of 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 trauma1 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. 2 Fairbank, J.A. (2008). The epidemiology of trauma, and trauma related disorders in children and youth. PTSD Research 

Quarterly, (10), 1050-1835. 3 Pecora, P.J. Kessiler, 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 

https;/www.casey.org/resources/publications/ImprovingFamilyCare.htm. 

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informed child-serving systems. Network members work together within and across diverse settings, 

including a wide variety of governmental and non-governmental organizations. 

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

In FY 2020, NCTSN grantee sites provided trauma-informed training to over 570,000 individuals. Since 

its inception, the NCTSN has provided training on best practices and other aspects of child trauma to 

over 2 million participants throughout the country. The NCTSI Learning Center now has over 250,000 

users accessing evidence-based child trauma resource. 

Data collected in FY 2020 demonstrate that the current NCTSN grantees provided screening to over 

45,569 individuals and evidence-based treatment to over 50,000 children, adolescents, and family 

members. Over eighty percent reported positive functioning at six months. In addition, thousands more 

youth and families have benefited indirectly from the training and consultation provided by NCTSN 

grantees to organizations that deliver evidence-based trauma interventions to various communities 

throughout the country. 

In FY 2019, SAMHSA supported 100 grant continuations and provided supplemental awards for mental 

health services for unaccompanied migrant children, with a special focus on children who were separated 

from a parent or family unit and subsequently classified as unaccompanied migrant children; mental 

health services for children in Puerto Rico; and expanded access to tribal populations. In FY 2020, 

SAMHSA funded 100 grant continuations, awarded a new cohort of 16 grants, and provided 

supplemental funding for mental health services for unaccompanied migrant children, and the NCTSI 

Coordinating Center for increased coordination of training in evidence-based and trauma informed 

treatments and practices and dissemination of evidence-based and trauma-informed interventions and 

treatments. In FY 2021, SAMHSA will support 34 grant continuations and award a new cohort of 97 

grants. 

Funding History 

Fiscal Year Amount 

FY 2018 $53,887,000 

FY 2019 $63,887,000 

FY 2020 $68,887,000 

FY 2021 Enacted $71,887,000 

FY 2022 Budget Request $81,887,000 

Budget Request 

The FY 2022 budget request is $81.9 million, an increase of $10.0 million from the FY 2021 Enacted 

level. SAMHSA requests funding to support 127 grant continuations and 24 new grants for the 

improvement of mental disorder treatment, services, and interventions for children and adolescents 

exposed to traumatic events and to provide trauma-informed services for children and adolescents as well 

as training for the child-serving workforce. 

30 
 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: National Child Traumatic Stress Network 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.2.02a Percentage of children receiving trauma 

informed services who report positive 

functioning at 6-month follow-up (Outcome) 

FY 2020: 79.2 % 

Target: 

74 % 

(Target Exceeded) 

70 % 70 % Maintain 

3.2.23 Unduplicated count of the number of 

children and adolescents receiving traumainformed services (Outcome) 

FY 2020: 40,369 

Target: 

59,023 

(Target Not Met) 

40,000 45,000 + 5,000 

3.2.24 Number of child-serving professionals 

trained in providing trauma-informed services 

(Outcome) 

FY 2020: 294,580 

Target: 

276,791 

(Target Exceeded) 

294,000 296,000 + 2,000 

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Project AWARE and MHAT............................................ $124,964 $130,964 $191,447 $60,483 

Project AWARE............................................................ 102,001 107,001 155,502 48,501 

Project AWARE State Grants (non-add)................... 92,001 94,501 136,752 42,251 

Project AWARE - Civil Unrest (non-add)................. 10,000 12,500 18,750 6,250 

Mental Health Awareness Training............................... 22,963 23,963 35,945 11,982 

Project AWARE 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

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

FY 2022 Authorization ...................................... Project AWARE: $394,550,000; MHAT: $14,693,000 

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

Eligible Entities ............................................................................. State and Local Education Agencies, 

Local Governmental Entities, Community 

Organizations and Provider Organizations, 

Community Colleges, Networks, National 

Non-Profit Organizations, States and Tribes 

Program Description and Accomplishments 

In any given year the percentage of young people with mental, emotional, behavioral (MEB) disorders is 

estimated to be between 14 and 20 percent. MEB disorders among young people interfere with their 

ability to accomplish normal developmental tasks such as developing healthy interpersonal relationships, 

succeeding in school, and transitioning to the workforce (IOM 2007). Project AWARE is designed to 

identify children and youth in need of mental health services, increase access to mental health treatment, 

and promote mental health literacy among teachers and school personnel. 

Project AWARE is made up of three components: Project AWARE State Education Agency (SEA) 

grants, Mental Health Awareness Training (MHAT) Grants, and Resilience in Communities after Stress 

and Trauma (ReCAST) grants. 

Project AWARE SEA grants are awarded to State Education Agencies to promote comprehensive, 

coordinated, and integrated state efforts to make schools safer and increase access to mental health 

services. The program also includes a focus on the specific needs affecting rural communities. These 

communities struggle with access to mental health services in schools and access to qualified health 

professionals to provide such services. 

In FY 2020, Project AWARE grantees trained more than 53,900 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. COVID initially slowed down grantees’ ability to provide training. 

Since many activities now had to be conducted virtually, time was needed to get the digital infrastructure 

in place to ensure virtual participation. Grantees provided mental health literacy training to 238,505 

community members. In FY 2020, Project AWARE grantees in their first year of grant activities trained 

over 10,500 individuals in the mental health and related professions. Over the course of this program 

over 282,000 at-risk youth have been identified and referred for mental health services and supports.

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Fiscal Year Amount 

FY 2018 $90,964,000 

FY 2019 $91,964,000 

FY 2020 $124,964,000 

FY 2021 Enacted $130,964,000 

FY 2022 Budget Request $191,447,000 

 

 

 

 

The MHAT grants train school personnel, emergency first responders, law enforcement, veterans, armed 

services members and their families to recognize the signs and symptoms of mental disorders, particularly 

serious mental illness (SMI) and/or serious emotional disturbances (SED). 

In FY 2020, MHAT grantees trained 37,693 individuals in mental health or related professions in mental 

health literacy programs. Grantees provided mental health literacy training to 73,306 community 

members. Over 107,500 individuals have been referred to mental health services and supports as a result 

of the MHAT grant. 

ReCAST grants assist high-risk youth and families and promote 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. ReCAST grantees developed culturally responsive approaches to build capacity with 

community-based partners. 

In FY 2020, ReCAST grantees trained, 4,252, members of the mental health workforce in trauma 

informed approaches. Over 24,700 community stakeholders were trained in trauma-informed approaches, 

including violence prevention and mental health literacy. ReCAST grantees provided 17,621 at-risk 

youth and their family members with high-quality trauma-informed mental health services. Nearly 1,600 

new partnerships were established among local municipal organizations and community agencies to 

support high-risk youth and their families. 

In FY 2019, SAMHSA awarded 6 new AWARE-SEA and 18 new MHAT grants and supported the 

continuation of 173 grants, (24 AWARE, 138 MHAT, and 11 ReCAST grants). 

In FY 2020, SAMHSA funded 197 continuation grants (30 AWARE, 156 MHAT, and 11 ReCAST 

grants) and a new cohort of 31 grants (15 AWARE and 16 MHAT grants). 

In FY 2021, SAMHSA will support 79 continuation grants (42 AWARE, 34 MHAT, and three 

ReCAST grants) and a new cohort of 157 grants (seven AWARE, 142 MHAT and eight ReCAST). 

Funding History 

Budget Request 

The FY 2022 budget request is $191.4 million, an increase of $60.5 million from the FY 2021 Enacted 

level. Funding for this program will support Project AWARE State Grants, ReCAST, MHAT grants, 

and technical assistance on the provision of school-based mental health services. 

33 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Project AWARE 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

3.2.39 Number of individuals who have 

received training in prevention or mental health 

promotion (Outcome) 

FY 2020: 215,198 

Target: 

58,229 

(Target Exceeded) 

215,000 240,000 +25,000 

3.2.51 Number of individuals referred to 

mental health or related interventions (Output) 

FY 2020: 32,624 

Target: 

65,208 

(Target Not Met) 

32,000 37,000 +5,000 

34 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Healthy Transitions 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Healthy Transitions................................................................. $28,951 $29,451 $29,451 $0 

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

FY 2022 Authorization ......................................................................................................$394,550,000 

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

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

Program Description and Accomplishments 

Youth and young adults with Serious Emotional Disturbance (SED) or 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 serious disorder, such as schizophrenia, bipolar disorder, and major depression, that 

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

more likely to experience homelessness,4 

4 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. 

5 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.

be arrested,5 drop out of school,6 and be unemployed.7 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. 

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

treatment and related support services for young people aged 16 to 25 who either have, or are at risk of 

developing, a serious mental health condition. Grantees use these funds to provide services and supports 

to address serious mental health conditions, co-occurring disorders, and risks for developing serious 

mental health conditions among youth 16 – 25 years old. This will be accomplished by increasing 

awareness, screening and detection, outreach and engagement, referrals to treatment, coordination of care 

and evidence-informed treatment for this age group. Healthy Transitions will increase awareness about 

early indications of signs and symptoms for serious mental health concerns; identify action strategies to 

use when a serious mental health concern is detected; provide training to provider and community groups 

to improve services and supports specific to this age group; enhance peer and family supports, and 

develop effective services and interventions for youth, young adults and their families as these young 

people transition to adult roles and responsibilities. Since 2014, a total of 9,097 youth in 22 states, five 

territories, and six tribes have been served. 

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

(NCES 2008-031). 7 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 
 

 

 

 

 

 

 

 

 

 

 

 

 

FY 2019 data for grantee participants showed a 7.3 percent decrease in psychological distress, a 23.8 

percent improvement in functional outcomes, an increase in being in excellent or in very good health, 

and an increase in rates of employment (full or part-time). In addition, from baseline to 6-month followup there was a 14.6 percent decrease in the number of nights young adults reported being homeless. 

In FY 2019, SAMHSA awarded 15 new Healthy Transitions grants and 10 continuation grants. In FY 

2020, SAMHSA funded 25 continuation grants and awarded a new cohort of two grants. In FY 2021, 

SAMHSA will support 27 grant continuations. 

. 

Funding History 

Fiscal Year Amount 

FY 2018 $25,951,000 

FY 2019 $25,951,000 

FY 2020 $28,951,000 

FY 2021 Enacted $29,451,000 

FY 2022 Budget Request $29,451,000 

Budget Request 

The FY 2022 budget request is $29.5 million, level with the FY 2021 Enacted. SAMHSA requests 

funding 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 27 continuation grants and fund a new cohort of grants. 

36 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Healthy Transitions 

Measure Year and Most Recent Result / 

Target for Recent Result / 

(Summary of Result) 

FY 

2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

3.2.34 Percentage of clients receiving services 

who report positive functioning at 6 month 

follow-up. (Outcome) 

FY 2020: 58.6 % 

Target: 

66.7 % 

(Target Not Met) 

58.6 % 58.6 % Maintain 

3.2.35 Percentage of clients receiving services 

who had a permanent place to live in the 

community at 6 month follow-up. (Outcome) 

FY 2020: 36 % 

Target: 

35 % 

(Target Exceeded) 

35 % 35 % Maintain 

3.2.36 Percentage of clients receiving services 

who are currently employed at 6 month followup. (Outcome) 

FY 2020: 34.6 % 

Target: 

66.7 % 

(Target Not Met) 

34 % 34 % Maintain 

37 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Children and Family Programs 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Children and Family Programs......................................... $7,229 $7,229 $7,229 --

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

 FY 2022 Authorization.......................................................................................................$394,550,000 

 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 that 

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. In FY 2019, 1,100 individuals received training in mental 

health practices and activities that aligned with the goals of the program. In addition, 288 organizations 

collaborated and coordinated resources with other organizations. 

In FY 2019, SAMHSA supported 14 Circles of Care continuation grants. In FY 2020, SAMHSA funded 

a new cohort of 18 Circles of Care grants and supported one continuation grant. In FY 2021, SAMHSA 

will support 18 continuation grants continuations and award three new grants.

38 
 

Fiscal Year Amount 

FY 2018 $7,229,000 

FY 2019 $7,229,000 

FY 2020 $7,229,000 

FY 2021 Enacted $7,229,000 

FY 2022 Budget Request $7,229,000 

 

 

 

 

 

 

 

Funding History 

Budget Request 

The FY 2022 budget request is $7.2 million, level with the FY 2021 Enacted level. 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 support 21 Circles of Care continuation grants. 

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 89. 

39 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Consumer and Family Network Grants 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Consumer and Family Network Grants............................. $4,954 $4,954 $4,954 --

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

 FY 2022 Authorization ......................................................................................................$394,550,000 

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

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

Program Description and Accomplishments 

Across the healthcare arena, there is growing recognition and evidence that client-centered care positively 

influences an individual’s health outcomes, improves quality and efficacy of care received, and provides 

feedback to drive service and systems improvements. As with other health disciplines, people with 

serious mental illness (SMI) and their family members should have meaningful involvement in all aspects 

of their health care and treatment, including behavioral health care. 

The Consumer and Family Network Programs provide consumers, families, and youth with opportunities 

to participate meaningfully in the development of policies, programs, and quality assurance activities 

related to mental health systems across the United States. The Consumer and Family Network Programs 

support two primary grant programs, the Statewide Consumer Network (SCN) Program and the Statewide 

Family Network (SFN) Program. 

The SCN 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, policy makers, and providers in improving 

and transforming the mental health and related systems in their states. This network is a sustainable 

mechanism for integrating the consumer voice in state mental health and allied systems to: (1) expand 

service system capacity; (2) support policy and program development; and (3) enhance peer support. 

This program promotes skill development with an emphasis on leadership and business management, as 

well as on coalition/partnership-building and economic empowerment, as part of the recovery process 

for consumers. 

The SFN grant program provides education and training to increase family organizations’ capacity for 

policy and service development. This is accomplished by: (1) strengthening organizational relationships 

and business management skills; (2) fostering leadership skills among families of children and 

adolescents with SED; and (3) identifying and addressing the technical assistance needs of children and 

adolescents with SED and their families. The SFN program focuses on families, parents, and the primary 

caregivers of children, youth, and young adults. 

In FY 2020, SCN grantees trained 8,672 individuals in the mental health and related workforce.

40 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

In FY 2020, SFN grantees trained 19,762 individuals in the mental health and related workforce and 

12,344 consumers and family members were involved in ongoing mental health-related planning and 

advocacy activities. 

In FY 2019, SAMHSA supported 14 SCN continuations and 8 new grants, 11 SFN continuations and 18 

new grants. In FY 2020, SAMHSA funded 21 SCN and 28 SFN continuation grants. In FY 2021, 

SAMHSA will support eight SCN and 18 SFN grant continuations and award a new cohort of 12 SCN 

and10 SFN grants. 

Funding History 

Fiscal Year Amount 

FY 2018 $4,954,000 

FY 2019 $4,954,000 

FY 2020 $4,954,000 

FY 2021 Enacted $4,954,000 

FY 2022 Budget Request $4,954,000 

Budget Request 

The FY 2022 budget request is $5.0 million, level with the FY 2021 Enacted level. SAMHSA requests 

funding for 19 new SFN, nine new SCN, and 22 continuation 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. 

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 89. 

41 
 

 

 FY 2022 Authorization.......................................................................................................$394,550,000 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Project LAUNCH 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Project LAUNCH ............................................................ $23,605 $23,605 $23,605 --

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

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 14.8 Young children experiencing mental, emotional, or behavioral 

challenges are at high risk for preschool expulsion. In fact, the preschool expulsion rate 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 as girls; and African American preschoolers are almost twice as likely to be 

expelled as Caucasian preschoolers.9 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 childcare settings, increasing screening for 

developmental and social/emotional issues, and training people who interact with young children to 

promote optimal development and mental health are all critical elements to ensure children start life with 

the tools and skills needed to succeed. 

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

national initiative that has funded a total of 90 grantees in nine cohorts: this includes grantees in 38 states; 

23 tribal entities; 4 US territories; 3 Alaska/native communities; and the District of Columbia. Project 

LAUNCH Expansion grantees are five alumni states that are engaged in replication of successful Project 

LAUNCH prevention strategies in new communities within each state. All grantees are funded for a total 

of four or five years. 

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 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, recognize early 

signs of, and address mental, emotional, and behavioral disorders in early childhood and into the early 

elementary grades. 

8 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. 9 Gilliam, W. (2005). Pre-kindergarteners left behind: Expulsion rates in state prekindergarten systems. Foundation for Child 

Development.

42 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $23,605,000 

FY 2019 $23,605,000 

FY 2020 $23,605,000 

FY 2021 Enacted $23,605,000 

FY 2022 Budget Request $23,605,000 

Program Evaluation 

As of 2020, cumulative performance data for the program (2008-2020) indicate that more than 248,450 

children and parents have been screened or assessed for behavioral health concerns across a range of 

diverse settings (e.g., primary care, childcare, and home visiting). Child screenings are a critical step in 

the early recognition of social emotional concerns and create a pathway to prevention and treatment 

services. Adult screenings include screening for perinatal depression, substance use, and a range of social 

needs. More than 105,900 community providers have been trained on milestones of social/emotional 

development, early detection of behavioral health issues, and best practices for mental health treatment. 

Over 211,900 children and parents/caregivers have received evidence-based mental health-related 

services through the grant program, and approximately 11,300 new partnerships have been developed 

between organizations in order to improve care coordination and access to quality mental health services 

for young children and families. 

A multi-site evaluation of Project LAUNCH was completed in 2018 

(https://www.acf.hhs.gov/opre/research/project/cross-site-evaluation-of-project-launch-linking-actionsfor-unmet-needs-in). Phase one of the evaluation used a meta-analytical approach to assess the 

implementation of the program. The findings indicated that grantees successfully improved communityand state-level child and family-serving systems. In addition, grantees demonstrated improved social and 

academic functioning among young children, and over 75 percent reported decreases in problem 

behaviors. Phase two of the multi-site evaluation involved a quasi-experimental design, exploring 

whether children in 10 communities served by Project LAUNCH differed in social and emotional 

wellbeing from children in 10 socio-demographically matched communities. Results indicated that 

children living in Project LAUNCH communities received more developmental screening and supports 

than children living in matched comparison communities. Additionally, children served in LAUNCH 

communities had less need for early intervention services related to attachment, initiative and other 

indicators of resilience, particularly for young children ages birth to three. Parents in Project LAUNCH 

communities reported more involvement with their children and less parenting frustrations. 

In FY 2019, SAMHSA supported 14 Project LAUNCH continuation grants and 16 new Project 

LAUNCH grants. In addition, SAMHSA awarded the National Center of Excellence for Infant and Early 

Childhood Mental Health Consultation (CoE-IECMHC) to advance the implementation of high quality 

IECMHC across the nation through the development of tools, resources, training, and mentorship to the 

infant and early childhood mental health field. 

In FY 2020, SAMHSA supported 30 continuation grants and the CoE-IECHMHC. In FY 2021, 

SAMHSA will support 30 continuation grants and the CoE-IECMHC. 

Funding History 

43 
 

 

 

 

 

 

 

Budget Request 

The FY 2022 budget request is $23.6 million, level with the FY 2021 Enacted level. This funding will 

support 30 continuation grants and the CoE-IECMHC to 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 continued screening, prevention, early intervention for behavioral 

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

the U.S. through the CoE-IECMJH. 

44 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Mental Health-Project LAUNCH 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

2.3.94 Number of persons served (Output) FY 2020: 9,370 

Target: 

12,916 

(Target Not Met) 

9,300 9,370 +70 

2.3.95 Number of persons trained in mental 

illness prevention or mental health promotion 

(Outcome) 

FY 2020: 5,953 

Target: 

10,790 

(Target Not Met) 

5,900 5,900 Maintain 

2.4.00 Number of 0-8 year old children screened 

for mental health or related interventions 

(Outcome) 

FY 2020: 8,788 

Target: 

11,497 

(Target Not Met) 

8,700 8,700 Maintain 

2.4.01 Number of 0-8 year old children referred 

to mental health or related interventions 

(Outcome) 

FY 2020: 2,163 

Target: 

4,141 

(Target Not Met) 

2,160 2,160 Maintain 

45 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mental Health System Transformation and Health Reform 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Mental Health System Transformation and Health 

Reform..... $3,779 $3,779 $3,779 --

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

FY 2022 Authorization ..................................................................................................... $394,550,000 

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 these individuals who 

are employed (less than 20 percent). The benefits of steady competitive employment for this population 

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.10 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 or SED. These grants 

help people achieve their goals for competitive employment, building paths to self-sufficiency and 

recovery. They also support treatment and service providers and employers to prioritize employment as 

a standard of care by developing and maintaining sustained competitive employment opportunities for 

people with SMI or SED, primarily using the evidence-based Individual Placement and Support (IPS) 

model of supported employment. The grant program helps states to identify and implement the structural 

and financing changes that are essential to make evidence-based supported employment programs 

sustainable statewide. 

FY 2020 program data show that 4,371 members in the mental health and related workforce were trained 

and 518 programs or organizations implemented mental health practices consistent with program goals. 

In addition, over 50 percent of individuals served by the program were employed or in school at sixmonth follow-up; while, 61 percent reported positive functioning and 68 percent had a permanent place 

to live. Across the five years of the program, the number of individuals employed increased by over 110 

percent. 

In FY 2019, SAMHSA awarded seven new grants. In FY 2020, SAMHSA supported seven continuation 

grants. In FY 2021, SAMHSA will fund seven grant continuations. 

10 IPS Supported Employment: The Evidence-based Practice for Employment. (n.d.). Retrieved August 4, 2015

46 
 

Fiscal Year Amount 

FY 2018 $3,779,000 

FY 2019 $3,779,000 

FY 2020 $3,779,000 

FY 2021 Enacted $3,779,000 

FY 2022 Budget Request $3,799,000 

 

 

 

 

 

Funding History 

Budget Request 

The FY 2022 budget request is $3.8 million, level with the FY 2021 Enacted level. SAMHSA requests 

funding to support the continuation of seven Transforming Lives through Supported Employment grants 

that will enhance state and community capacity to provide evidence-based supported employment 

programs and mutually compatible and supportive evidence-based practices for adults and youth with 

SMI/SED and co-occurring mental and substance use disorders. 

47 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Mental Health System Transformation Grants and Health Reform 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

1.2.11 Number of persons in the mental health and 

related workforce trained in specific mental-health 

related practices/activities as a result of the grant 

(Outcome) 

FY 2020: 310 

Target: 

3,574 

(Target Not Met) 

310 310 Maintain 

1.2.21 Percentage of clients receiving services who 

report positive functioning at 6 month follow-up. 

(Outcome) 

FY 2020: 62.7 % 

Target: 

63.6 % 

(Target Not Met) 

62.7 % 62.7 % Maintain 

1.2.22 Percentage of clients receiving services who 

had a permanent place to live in the community at 6 

month follow-up. (Outcome) 

FY 2020: 54.1 % 

Target: 

63 % 

(Target Not Met) 

54 % 54 % Maintain 

1.2.23 Percentage of clients receiving services who 

are currently employed at 6 month follow-up. 

(Outcome) 

FY 2020: 31.6 % 

Target: 

52.8 % 

(Target Not Met) 

31.6 % 31.6 % Maintain 

48 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 49,877 52,877 52,877 -

 

Primary and Behavioral Health Care Integration 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Primary and Behavioral Health Care Integration 

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

Primary and Behavioral Health Care Integration TTA..... 

$51,868 

1,991 

$54,868 

1,991 

$54,868 

1,991 

$0 

-

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

FY 2022 Authorization ...................................................................................................... $51,878,000 

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

Eligible Entities .................................................. Qualified Community Mental Health Programs, 

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.11 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.12 

The Primary and Behavioral Health Care Integration (PBHCI) Portfolio began in FY 2009 to address this 

intersection between primary care and treatment for mental illness and co-occurring disorders. This 

program awards grants to community mental health centers and states. This program also supports 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. The PBHCI program 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. In 

FY 2017, PBHCI changed its name to Promoting the Integration of Primary and Behavioral Health Care 

(PIPBHC). In FY 2019, SAMHSA funded a new technical assistance grant, the National Center of 

Excellence for Integrated Health Solutions (CIHS), for up to $1,889,486 a year for up to five years. The 

purpose of this program is to advance the implementation of high quality, evidence-based treatment for 

individuals with co-occurring physical and mental health conditions, including substance use disorders. 

The goal of this grant is to ensure that these services are provided in the most effective manner possible. 

Technical assistance and training will be available to communities, individual practitioners, providers, 

and states on evidence-based and effective strategies to address the integration of primary and mental 

health care for individuals with mental disorders or co-occurring mental and substance use disorders. In 

2020, CIHS provided training to 23,880 individuals in the mental health and related workforce. Of those, 

88 percent of these individuals were able to demonstrate improvement in knowledge, attitudes, and 

beliefs related to prevention and mental health promotion. 

11 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.

12 E. Chesney et al., Risks of all-cause and suicide mortality in mental disorders: a meta-review, World Psychiatry; 2014: 

13:1153-160.

49 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$51,868,000 

 

 

 

 

Program Evaluation 

From 2015-2020, SAMHSA, in collaboration with Mathematica, conducted a cross-site grantee 

evaluation of PBHCI cohorts 1 - 8. Health outcome data indicated substantial improvements in physical 

health among clients. Diabetes and hypertension were comparable to national benchmarks. Clients also 

showed improvement in functioning and psychological distress. At 18 months of program participation, 

approximately 75 percent of clients had stable housing, 80 percent reported feeling socially connected 

and approximately 55 percent reported feeling healthy overall. Emergency room visits for psychiatric or 

emotional conditions and feelings of severe psychological distress were reduced. There was some 

improvement in substance misuse, however, rates of tobacco use remained high. 

The evaluation found that nearly 90 percent of grantees in cohorts 6-8 implemented screenings for 

physical health conditions and at least 80 percent provided preventative services and referrals for 

psychosocial services. Peer support staff played an important role in helping to integrate supportive care 

functions within agency settings. Wellness, physical and/or primary care, and mental health/substance 

use disorder services were provided by peer staff to clients. Wellness services included tobacco cessation, 

nutrition and/or exercise, and chronic disease self-management programming. 

In FY 2019, SAMHSA continued support for 15 PBHCI and 13 PIPBHC grants, awarded 6 new PIPBHC 

grants, and one new CIHS grant. In FY 2020, SAMHSA funded one PBHCI and 19 PIPBHC 

continuation grants, one CHIS continuation, and four new PIPBHC grants. In FY 2021, SAMHSA will 

fund one PBHCI and 23 PIPBHC grant continuations, one CHIS grant continuation, and a new cohort of 

one new PIPBHC. 

Funding History 

Fiscal Year Amount 

FY 2018 $51,868,000 

FY 2019 $51,868,000 

FY 2020 

FY 2021 Enacted $54,868,000 

FY 2022 Budget Request $54,868,000 

Budget Request 

The FY 2022 budget request is $54.9 million, level with the FY 2021 Enacted level. SAMHSA requests 

funding to support the continuation of 24 PIPBHC grants and one CIHS grant. The funding will also 

fund a new cohort of two PIPBHC grants. 

50 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Primary & Behavioral Health Care Integration (PBHCI) 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.2.41 Increase the percentage of clients 

receiving services who report positive 

functioning at 6 month follow-up. (Outcome) 

FY 2020: 59.1 % 

Target: 

57.4 % 

(Target Exceeded) 

57.4 % 57.4 % Maintain 

3.2.42 Increase the percentage of clients 

receiving services who are currently employed 

at 6 month follow-up. (Outcome) 

FY 2020: 28 % 

Target: 

27.7 % 

(Target Exceeded) 

27.7 % 27.7 % 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 2020: 68.4 % 

Target: 

71 % 

(Target Not Met but Improved) 

71 % 71 % Maintain 

51 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suicide Prevention Programs 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Suicide Prevention.................................................................................. $90,034 $102,046 $179,667 $77,621 

Suicide Lifeline (non-add).................................................................. 19,000 24,000 101,621 77,621 

GLS - Youth Suicide Prevention - States (non-add)........................... 35,427 36,427 36,427 -

Budget Authority (non-add)............................................................. 23,885 24,427 24,427 -

Prevention & Public Health Fund (non-add)................................. 11,542 12,000 12,000 -

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

GLS - Suicide Prevention Resource Center (non-add)...................... 7,988 9,000 9,000 -

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

National Strategy for Suicide Prevention (non-add)......................... 18,200 23,200 23,200 -

Zero Suicide (non-add).................................................................... 14,000 18,800 18,800 -

Zero Suicide -AI/AN (non-add).................................................. 2,200 2,400 2,400 -

All Other National Strategy for Suicide Prevention (non-add)...... 2,000 2,000 2,000 -

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 47,511 Americans died by suicide in 2019. From 1999 through 2019, the age adjusted 

suicide rate increased by over 30 percent from 10.5 to 13.9 per 100,000. In 2008, suicide became the 

10th leading cause of death in the United States and has remained so through 2019. Suicide is the second 

leading cause of death between age 10-34 and the fourth leading cause of death for ages 35-54. Among 

Native Americans, suicide is the 8th leading cause of death. Suicide is the first leading cause of death 

among Native Americans age 10-14-year-olds and the second leading cause of death among 35-44-yearolds. The 2019 National Survey on Drug Use and Health reported that approximately 1.4 million 

Americans age 18 and over attempted suicide over the previous 12 months, 12 million seriously 

considered suicide, and 3.5 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 

adults 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 both adults and youth to reduce suicide 

in America.

52 
 

 

National Strategy for Suicide Prevention................................................ $18,200 $23,200 $23,200 $0 

Zero Suicide (non-add).................................................................... 14,000 18,800 18,800 -

Zero Suicide -AI/AN (non-add).................................................. 2,200 2,400 2,400 -

All Other National Strategy for Suicide Prevention (non-add)............... 2,000 2,000 2,000 -

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

National Strategy for Suicide Prevention 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

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

FY 2022 Authorization ........................................................................................................$30,000,000 

Allocation Method ....................................................................................................Competitive Grants 

Eligible Entities .............................................................. Community –based primary care or behavioral 

health entity, Federally Recognized, American Indian/Alaska Native tribe or tribal organizations, State 

mental health or public health agency 

Program Description and Accomplishments 

Suicide has been increasing in the United States, particularly in adults and older adults. Suicide rates 

rose by over 30 percent during 1999-2019. 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 suicides nationally. The baby boomer generation has had high rates of suicide throughout the 

generational lifecycle and is entering the stage of life that has historically had the highest rate of suicide. 

There is a high risk that without significant targeted intervention toward adults, including older 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 the efforts of states, tribes, 

primary and behavioral healthcare organizations, public health agencies, and emergency departments to 

implement the NSSP. While the NSSP addresses all age groups and populations with specific needs, the 

goals and objectives of the NSSP grants focus on preventing suicide and suicide attempts among adults 

over the age of 25 who comprised more than 41,000 of the more than 48,000 suicides in the United States 

in 2018. 

In FY 2017, Congress appropriated $9.0 million to implement the Zero Suicide program in health care 

systems, including a $2.0 million tribal set-aside. The Zero Suicide model is a comprehensive, multisetting 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, collaborating for 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 2019, SAMHSA supported the continuation of five NSSP grants and 15 Zero Suicide continuation 

grants. In FY 2020, SAMHSA awarded 15 Zero Suicide continuation grants, a new cohort of five NSSP 

grants, and a new cohort of 15 Zero Suicide grants. In FY 2021, SAMHSA will support the continuation 

of five NSSP grants, 30 Zero Suicide continuation grants, and a new cohort of 10 Zero Suicide grants.

53 
 

 

 

 

 

 

 

Funding History 

Fiscal Year Amount 

FY 2018 $11,000,000 

FY 2019 $11,200,000 

FY 2020 $18,200,000 

FY 2021 Enacted $23,200,000 

FY 2022 Budget Request $23,200,000 

Budget Request 

The FY 2022 budget request is $23.2 million, level with the FY 2021 Enacted level. This funding will 

support 40 Zero Suicide continuation grants and five NSSP continuation grants. 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 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 6,488 6,488 6,488 -

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

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

GLS - Youth Suicide Prevention - States................................................ 

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

GLS - Youth Suicide Prevention - Campus............................................. 

$23,885 

11,542 

$24,427 

12,000 

$24,427 

12,000 

$0 

-

Authorizing Legislation .............................. Sections 520E and 520E-2 of the Public Health Service Act 

FY 2022 Authorization .................................................................................... $30,000,000; $7,000,000 

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.13 

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 230 grants to 50 states and the District of Columbia, 

63 unique tribes/tribal organizations, and two territories. These grants develop and implement youth 

suicide prevention and early intervention strategies involving public-private collaboration among youthserving institutions. As of FY 2020, the GLS Campus Suicide Prevention program has awarded 309 

grants to 269 institutions of higher education, including tribal colleges and universities, to prevent suicide 

and suicide attempts. 

Performance Evaluation 

SAMHSA’s evaluation of national youth suicide prevention efforts (age 10 to 24) have shown that 

counties implementing SAMHSA funded GLS youth suicide prevention activities have lower rates of 

youth suicide deaths than similar counties not implementing such activities. This impact is maintained 

for two years and the impact appears directly related to years of continued funding. Approximately 50 

percent of the counties in America have received at least one year of funding since the program started 

in 2005. 

Previous evaluation results have shown that counties who implemented GLS-supported activities had 

lower rates of suicide attempts among youth than matched counties that did not in the year following 

suicide prevention activities. 

Since 2005, over 1.6 million individuals participated in over 66,000 training events or educational 

seminars provided by grantees. In FY 2020, 158,764 youth were screened for suicide risk, 27,231 youth 

13 http://www.jaredstory.com/garrett_smith.html

55 
 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $41,915,000 

FY 2019 $41,915,000 

FY 2020 $41,915,000 

FY 2021 Enacted $42,915,000 

FY 2022 Budget Request $42,915,000 

 

 

 

 

 

 

were referred to services, and 64.7 percent received services. Grantees’ efforts are reducing the 

likelihood of at-risk youth falling through the gaps in the system. 

In FY 2019, SAMHSA supported the continuation of 19 GLS State/Tribal grants, 41 GLS Campus grants, 

and awarded 31 new GLS State/Tribal grants and 22 new GLS Campus grants. In FY 2020, SAMHSA 

funded 38 GLS State/Tribal continuation grants [32 with direct budget authority and six with Prevention 

and Public Health Funds (PPHF)], 46 GLS Campus continuation grants, awarded a new cohort of 10 GLS 

State and Tribal grants with PPHF, and 16 GLS Campus grants. In FY 2021, SAMHSA will support 43 

GLS State/Tribal continuation grants, 37 GLS Campus continuation grants, and award a new cohort of 

six GLS State and Tribal grants and 25 GLS Campus grants. 

Funding History 

Budget Request 

The FY 2022 budget request is $42.9 million, level with the FY 2021 Enacted level. SAMHSA requests 

funding for the continuation of 47 GLS State/Tribal grants and 41 GLS Campus grants, and a new cohort 

of two GLS State and Tribal grants, and 16 new GLS Campus grants to continue developing and 

implementing youth suicide prevention and early intervention strategies involving public-private 

collaboration among youth serving institutions. 

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Garrett Lee Smith Suicide Prevention Resource Center 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

GLS - Suicide Prevention Resource Center............................................ $7,988 $9,000 $9,000 $0 

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

FY 2022 Authorization ..........................................................................................................$5,988,000 

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. 

SAMHSA’s SPRC has played an important role in transforming suicide prevention and treatment across 

the lifespan, particularly for those at high risk for suicide. Efforts to advance suicide prevention include: 

• Developing and promoting the adoption of evidence-based resources, tools, and online 

trainings to support strategic, comprehensive, best practice suicide prevention programs 

around the country; 

• Building the capacity of suicide prevention programs nationwide by providing 

consultation, training, and resources to states, AI/AN communities, colleges and 

universities, health systems, and organizations serving groups at higher risk for suicide; 

• Improving care for those at risk for suicide, including promoting the Zero Suicide model 

for safer suicide care in health and behavioral health care systems; and 

• Providing leadership and operational support, which brings together more than 250 

national partners from the public and private sectors to advance implementation of the 

goals and objectives of the National Strategy. 

Performance Evaluation 

SAMHSA’s SPRC provides free online courses to prepare the clinical workforce to address suicide risk 

in effective ways. In FY 2020, a total of 22,877 individuals received training in the following areas:

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o Counseling on Access to Lethal Means 

o Locating and Understanding Date 

o Preventing Suicide in Emergency Department Patients 

o Strategic Planning for Suicide Prevention 

In FY 2020, the SPRC continued its work in advancing the Zero Suicide Framework. Efforts include: 

Care Transitions virtual learning lab (interactive online resource that provides more guidance on 

discharge planning, based on CT report from AASP) 

Treatment videos released: “Treating Suicidal Patients during COVID-19”, a video series with 

expert advice on treating patients at risk of suicide during the COVID-19 pandemic. Adapted 

from an SPRC webinar, the series includes three brief videos on initiating and maintaining 

remote contact with clients, assessing suicide risk, and developing a safety plan remotely. 

Delivered webinar hosted by SMI Advisor, titled “Zero Suicide: Taking a Systems Approach to 

Suicide Prevention in Health Care” focusing on evidence-based interventions for suicide 

screening and intervention in SMI populations. 

SAMHSA’s SPRC worked with state agencies, communities, and organizations in all 50 states, the 

District of Columbia, several U.S. territories, and over 140 SAMHSA grantees to build leadership, 

capacity, and coordination for strategic, evidence-based suicide prevention across the country. 

In addition, SAMHSA’s SPRC collaborates closely with a number of national and regional TA centers 

that focus on issues related to suicide prevention, such as mental health, injury prevention, substance use 

prevention and treatment, violence prevention, and others. SPRC’s collaboration included contacts with 

the coordinating offices of SAMHSA’s Mental Health Technology Transfer Centers (TTCs), Prevention 

TTCs, and Addiction TTCs; Service Member, Veterans, and their Families TA Center; Center for 

Integrated Health Solutions; and HRSA’s National Center for Fatality Review and Prevention. 

In FY 2020, approximately 24,308 individuals were exposed to mental health awareness messaging 

through SPRC, which includes downloading the following resources from SPRC’s website: 

• After a Suicide: A toolkit for Schools (second edition) 

• Suicide Prevention Resources for Teens 

• The Role of High School Teachers in Preventing Suicide 

• The Role of High School Mental Health Providers in Preventing Suicide 

• Zero Suicide Documents, such as Zero Suicide Data Elements Worksheet; Zero Suicide Work 

plan Template; What is Zero Suicide?; Quick Guide to Getting Started 

• Lived Experience: What it is and How to Include It 

• Aftercare That Makes a Difference 

• The Patient Safety Screener: A Brief Tool to Detect Suicide Risk in Acute Care Settings 

FY 2019, SAMHSA supported one continuation grant. In FY 2020, SAMHSA funded one new grant to 

promote the implementation of the NSSP and enhance the nation’s mental health infrastructure. In 

addition, funding supported the development and dissemination of resources for families and friends of 

58 
 

 

 

Fiscal Year Amount 

FY 2018 $5,988,000 

FY 2019 $5,988,000 

FY 2020 $7,988,000 

FY 2021 Enacted $9,000,000 

FY 2022 Budget Request $9,000,000 

 

 

 

 

 

 

individuals at risk of suicide, as well as the development of specialized training for LGBTQ youth. In 

FY 2021, SAMHSA will support one grant continuation. 

Funding History 

Budget Request 

The FY 2022 budget request is $9.0 million, level with the FY 2021 Enacted. This funding will support 

one continuation grant. 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. 

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National Suicide Prevention - Lifeline 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Suicide Lifeline...................................................................................... $19,000 $24,000 $101,621 $77,621 

Authorizing Legislation ............................................... Section 520E-3 of the Public Health Service Act 

FY 2022 Authorization ..........................................................................................................$7,198,000 

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. Launched in 2005, the National Suicide Prevention Lifeline 

(Lifeline), 1-800-273-TALK, coordinates a network of more than 175 crisis centers across the United 

States by providing suicide prevention and crisis intervention services for individuals seeking help at any 

time, day or night. In July of 2020, the Federal Communications Commission (FCC) designated the 

number 988 as the nation’s new, three-digit, national suicide prevention and mental health crisis number. 

By July 16, 2022, 988 must become operational across the country and must automatically funnel calls 

to the National Suicide Prevention Lifeline. 1-800-273-TALK will remain operational for the foreseeable 

future. Some telecommunication providers have already made 988 operational for almost 100 million 

Americans. The National Suicide Hotline Designation Act of 2020 provides States with the authority to 

collect fees from voice providers to support 988, similar to the method used in many regions to finance 

911. 

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. In FY 2018, the 

Lifeline averaged 185,367 calls per month for a total of 2,224,408 calls answered. In FY 2019, call 

volume averaged 179,575 per month for a total of 2,154,903 calls answered. In FY 2020, call volume 

averaged 182,086 per month for a total of 2,185,036 calls answered. 

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. 

SAMHSA evaluation studies have found that when a sample of suicidal callers who received follow-up 

calls from the Lifeline are asked, “...to what extent did calling the crisis hotline stop you from killing 

yourself?” a total of 82 percent responded either “a lot” (59 percent) or “a little” (22 percent). 

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. Hotline

60 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $7,198,000 

FY 2019 $12,000,000 

FY 2020 $19,000,000 

FY 2021 Enacted $24,000,000 

FY 2022 Budget Request $101,621,000 

evaluation efforts will continue to focus on imminent risk and follow up for suicidal callers and suicidal 

persons accessing the crisis chat service. 

In FY 2019, SAMHSA supported the continuation of the Suicide Lifeline grant and provided $5.4 million 

in supplemental funding to enhance access to the Lifeline and strengthen the capacity of the Lifeline 

network to answer calls as rapidly as possible. In addition, SAMHSA awarded two new Crisis Center 

Follow-up grants to provide an integrated hub that: (1) ensures systematic follow-up of suicidal persons 

who contact a NSPL Crisis Center; (2) provides enhanced coordination of crisis stabilization, crisis 

respite, and hospital emergency department services; and (3) enhances coordination with mobile on-site 

crisis response. The Crisis Center Follow-up grant program was initiated after SAMHSA evaluation 

results showed that while there were significant decreases in suicidal ideation during the Lifeline all, at 

four to six weeks follow-up 42 percent of suicidal callers were found to have experienced a recurrence 

of suicidal ideation but less than 25 percent had seen a mental health professional during this same time 

period. With the resources provided, the Crisis Center Follow-up grantees provide a hub that will not lose 

track of a person in a suicidal crisis as they interface with crisis systems. It is expected that this program 

will promote continuity of care to safeguard the well-being of individuals who are at risk of suicide. 

FY 2020 data for the Crisis Center Follow-up Expansion grant program indicates 7,542 individuals were 

screened for mental health and suicidal concerns, 1,055 individuals were referred to services, and 84.1 

percent received services. 

In FY 2020, SAMHSA funded the continuation of the Suicide Lifeline and provided $12 million in 

COVID supplemental funding to continue to enhance and increase the capacity and strengthen the 

Lifeline Network in states with highest need, as well as strengthening the Lifeline’s back up centers. 

SAMHSA also provided a supplement of $7 million using CARES Act funding to initiate a text service 

and to expand Lifeline’s crisis chat capacity. In addition, SAMHSA funded the continuation of two 

Crisis Center Follow-up grants and used CARES Act funding to provide multi-year funding to three 

additional Crisis Center Follow-up Expansion grants. In FY 2021, SAMHSA will award a new grant for 

the Suicide Lifeline and provide a $7 million supplement. In addition, SAMHSA will support two Crisis 

Center Follow-up grant continuations as well as the three multiyear funded grants funded in FY 2020. 

Funding History 

Budget Request 

The FY 2022 budget request is $101.6 million, an increase of $77.6 million from the FY 2021 Enacted 

level. SAMHSA is requesting funding to strengthen the National Suicide Prevention Lifeline (NSPL), 

which is a critical public health intervention to address suicide risk. As the backbone of 9-8-8, the NSPL 

serves as a critical safety net. When local crisis centers are unable to answer incoming contacts from 

individuals in distress, the NSPL utilizes a subnetwork of national backup centers to ensure capacity can 

meet demand. As preparation for 9-8-8’s launch intensifies, the $102 million requested will enhance the 

Suicide Lifeline’s infrastructure. These investments will help address challenges in meeting current 

61 
 

 

 

 

 

 

call/chat/text demand and expand capacity to manage the expected volume influx beginning in July 2022, 

as required by the National Suicide Hotline Designation Act of 2020. This funding will be used to 

strengthen the infrastructure of the existing Lifeline to increase the capacity of Lifeline centers to answer 

calls, chats, and texts, and provide specialized services. In addition, SAMHSA is requesting funding to 

fund two new Lifeline Crisis Center Follow-up grants that will focus on providing follow-up to suicidal 

people discharged from emergency rooms and inpatient units. 

In addition to NSPL's infrastructure enhancements, SAMHSA recognizes that local crisis centers – which 

face funding challenges and are often staffed by unpaid volunteers – also need support to ensure a 

successful 9-8-8 launch next July. The National Suicide Hotline Designation Act provides states with the 

authority to collect fees from voice providers to support 9-8-8, similar to the method used in many regions 

to finance 911. In the short time since the National Suicide Hotline Designation Act was signed into law 

in October 2020, several states are already deliberating the new authority to levy fees on cell phone bills 

to support the answering of 9-8-8 calls and related mental health crisis services. The FY 2021 

Appropriations Act also instituted for the first time a five percent set-aside to the SAMHSA Mental 

Health Block grant. This crisis set-aside is used to support crisis services planning and development in 

every state and MHBG grant recipient. SAMHSA will continue to assess the needs of local crisis centers 

as the 9-8-8 launch continues and as state planning efforts advance. 

While 988 affords an opportunity to significantly strengthen mental health crisis care, its success hinges 

on our nation's crisis infrastructure. 

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American Indian/Alaska Native Suicide Prevention Initiative 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

American Indian/Alaska Native Suicide Prevention Initiative.. $2,931 $2,931 $2,931 $0 

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

FY 2022 Authorization ......................................................................................................$394,550,000 

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 misuse, and suicide among American Indian/Alaska Native (AI/AN) youth. These plans 

mobilize tribal communities’ existing social and educational resources to meet their goals. 

From 2015 to 2020, 486 tribal communities have received specialized technical assistance and support 

in suicide prevention and related areas. In addition, more than 20,965 members of these communities 

received training in prevention and mental health promotion. 

In FY 2018, SAMHSA awarded a new contract to support this activity and awarded one Mental Health 

Transfer Technology Center (MHTTC) for Tribal Affairs to develop and maintain a collaborative 

network to support resource development and dissemination, training and technical assistance, and 

workforce development to the field and CMHS grant recipients. The MHTTC Tribal Affairs Center will 

coordinate and manage CMHS’s national efforts to ensure that high-quality, effective mental health 

disorder treatment and recovery support services, and evidence-based practices are available for all 

individuals with mental disorders including, in particular, those with serious mental illness. 

In FY 2019, SAMHSA continued support for this activity through the existing contract and the 

continuation of the MHTTC Tribal Affairs Center. In FY 2020, SAMHSA will fund the existing contract 

and the continuation of the MHTTC Tribal Affairs Center. In FY 2021, SAMHSA will fund a new 

contract and the existing continuation of the MHTTC Tribal Affairs Center.

63 
 

 

 

 

 

 

 

Funding History 

Fiscal Year Amount 

FY 2018 $2,931,000 

FY 2019 $2,931,000 

FY 2020 $2,931,000 

FY 2021 Enacted $2,931,000 

FY 2022 Budget Request $2,931,000 

Budget Request 

The FY 2022 budget request is $2.9 million, level with the FY 2021 Enacted. This funding will support 

the continuation of the MHTTC Tribal Affairs Center and continuation of the contract to provide 

comprehensive, broad, focused, and intensive training and technical assistance to federally recognized 

tribes and other AI/AN communities in order to address and prevent mental illness and alcohol/other drug 

addiction, prevent suicide, and promote mental health through the contract continuation. 

64 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Suicide Prevention 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.59 Number of individuals trained in youth 

suicide prevention (Outcome) 

FY 2020: 73,110 

Target: 

170,533 

(Target Not Met) 

73,000 73,000 Maintain 

2.3.60 Number of youth screened (Output) FY 2020: 137,790 

Target: 

195,517 

(Target Not Met) 

137,790 137,790 Maintain 

2.3.61 Number of calls answered by the 

suicide hotline (Output) 

FY 2019: 2,138,084 

Target: 

1,877,020 

(Target Exceeded) 

2,138,084 2,186,000 Maintain 

3.1.01 Number of individuals screened for 

mental health or related interventions 

(Intermediate Outcome) 

FY 2020: 798,525 

Target: 

254,868 

(Target Exceeded) 

798,525 798,525 Maintain 

3.1.02 Number of individuals referred to 

mental health or related services (Intermediate 

Outcome) 

FY 2020: 107,252 

Target: 

68,603 

(Target Exceeded) 

107,252 110,000 +2,748 

3.1.03 Number of organizations that establish 

management information/information 

technology system links across multiple 

agencies (Intermediate Outcome) 

FY 2020: 0 

Target: 

3 

3 3 Maintain 

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Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

(Target Not Met) 

3.1.04 Number of organizations or 

communities that demonstrate improved 

readiness to change their systems 

(Intermediate Outcome) 

FY 2020: 71 

Target: 

215 

(Target Not Met) 

71 71 Maintain 

3.2.37 Number of youths referred to mental 

health or related services (Output) 

FY 2020: 99,026 

Target: 

75,700 

(Target Exceeded) 

99,000 100,000 Maintain 

3.5.11 Percentage of respondents who say 

calling the lifeline stopped you from killing 

yourself a lot or a little (Outcome) 

FY 2019: 76.0 

Target: 

82.0 

(Target Not Met) 

76.0 82.0 Maintain 

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 30,696 30,696 30,696 -

 

Homelessness Prevention Programs 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

 Homelessness........................................................................... 

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

Homelessness........................................................................ 

$32,992 

2,296 

$32,992 

2,296 

$32,992 

2,296 

$0 

-

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

FY 2022 Authorization ..................................................................................................... $394,550,000 

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

Eligible Entities ................................................States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities 

Program Description and Accomplishments 

Although 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 between 

2019 and 2020 increased by just 2.2 percent (12,751 people). The increase in overall homelessness can 

be attributed to an increase in the number of unsheltered individuals. 

Many factors contribute to homelessness, including lack of affordable housing, foreclosures, rising 

housing costs, job loss, underemployment, domestic violence, mental illness, and addiction. Services are 

needed to link individuals to permanent housing and coordinate benefits, treatment, and supportive 

services. Many of these factors have been exacerbated by the COVID-19 pandemic. 

According to HUD, 580,466 individuals experienced homelessness on any given night in 2020 in the 

United States.

14 In addition, the number of individuals experiencing chronic homelessness was 105,583.15 

Additionally, the number of veterans experiencing homelessness was 37,252.

16 About 20 percent of 

individuals experiencing homelessness have a serious mental illness (SMI) and 15 percent struggle with 

chronic substance use and misuse. 17 

In FY 2018, SAMHSA initiated the CMHS-funded Treatment for Individuals Experiencing 

Homelessness (TIEH) program, to support the development and/or expansion of the local implementation 

of an infrastructure that integrates behavioral health treatment and recovery support services for 

individuals, youth, and families with a serious mental illness (SMI), serious emotional disturbance (SED), 

or co-occurring disorder (i.e., SMI and substance use disorder [SUD] or a SED and SUD) who are 

experiencing homelessness. 

The goal of the TIEH program is to increase capacity and provide accessible, effective, comprehensive, 

coordinated, integrated, and evidence-based treatment services, peer support and other recovery support 

services, and linkages to sustainable permanent housing. 

14.Ibid. 

15.Ibid. 

16 Ibid. 17 The U.S. Department of Housing and Urban Development, 2017 CoC Homeless Populations and Subpopulations 

Reports. Available at https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_201 

7.pdf

67 
 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $32,992,000 

FY 2019 $32,992,000 

FY 2020 $32,992,000 

FY 2021Enacted $32,992,000 

FY 2022 Budget Request $32,992,000 

 

 

 

 

 

 

 

FY 2020 data from the Treatment for Individuals Experiencing Homelessness (TIEH) grant program 

indicated that the number of individuals served by the program was 3,631. Moreover, the number of 

individuals who were homeless decreased 31.4 percent, and the rate of improvement in social 

connectedness increased by about 50 percent. Data also shows that 9,616 individuals were screened for 

mental health or mental health related interventions. 

In FY 2019, SAMHSA supported 16 Cooperative Agreements to Benefit Homeless Individuals (CABHI) 

and 24 TIEH grant continuations, awarded 19 new TIEH grants, and technical assistance activities. In 

FY 2020, SAMHSA funded 43 TIEH continuation grants, five new TIEH grants, and one new Housing 

and Homeless Resource Center (HHRC) and technical assistance activities. In FY 2021, SAMHSA will 

support 48 TIEH, one HHRC grant continuations and technical assistance activities. 

Funding History 

Budget Request 

The FY 2022 budget request is $33.0 million, level with the FY 2021 Enacted. With this funding, 

SAMHSA will support 48 continuation grants and technical assistance activities to increase capacity and 

provide accessible, effective, comprehensive, coordinated, integrated, and evidence-based treatment 

services, peer support and other recovery support services, and linkages to sustainable and permanent 

housing. Grantees will expand access to treatment and connect homeless individuals experiencing 

Serious Mental Illness with safe, secure housing. 

68 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Homelessness Prevention Programs 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.23 The number of clients served (Output) FY 2020: 3,634 

Target: 

3,521 

(Target Exceeded) 

3,521 3,758 +237 

3.4.24 Percentage of homeless clients 

receiving services who were currently 

employed or engaged in productive activities 

(Outcome) 

FY 2020: 30.3 % 

Target: 

20 % 

(Target Exceeded) 

34.4 % 34.4 % Maintain 

3.4.25 Percentage of clients receiving services 

who had a permanent place to live in the 

community (Outcome) 

FY 2020: 34.4 % 

Target: 

70 % 

(Target Not Met but Improved) 

31.1 % 36.1 % +5 % 

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Minority AIDS 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Minority AIDS........................................................................ $9,224 $9,224 $9,224 --

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

FY 2022 Authorization ......................................................................................................$394,550,000 

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

Eligible Entities ............................................. Community and faith-based organizations, Tribes, Urban, 

Indian organizations, Hospitals, Public and private universities and colleges 

Program Description and Accomplishments 

The Minority AIDS Initiative - Service Integration grant program (MAI-SI) is designed to meet the health 

needs of some of America’s most vulnerable individuals. Adults with serious mental illness (SMI) 

receiving public specialty mental health services are not tested for HIV regularly18MAI-SI makes HIV 

testing and treatment, PrEP and PEP, and Hepatitis vaccination and treatment available to this 

underserved population. Grantees include HIV/AIDS providers expanding mental health services to their 

clients. 

The Centers for Disease Control and Prevention (CDC) reports significantly higher rates of HIV/AIDS 

among racial/ethnic minorities compared with the general population. Only approximately 7 percent of 

people with severe mental illness receive HIV testing. And there are significant racial disparities: 

Asians/Pacific Islanders were 53 percent less likely and blacks were 82 percent more likely to be tested 

(ibid). African Americans accounted for 45 percent and Hispanics accounted for 23 percent of all 

HIV/AIDS cases diagnosed in 2013.19 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 MAI-SI program enhances and expands the provision of effective, culturally competent, HIV/AIDSrelated mental health services in racial and ethnic minority communities for people with a serious mental 

illness or co-occurring disorder who are living with or at high risk for HIV/AIDS. 

In FY 2018, SAMHSA awarded a new cohort of 18 grants focused on integrated evidence-based, 

culturally competency mental and substance use disorder treatment with HIV primary care and 

prevention services. The population of focus is individuals with a serious mental illness (SMI) or cooccurring disorder living with or at risk for HIV and/or hepatitis in at-risk populations, including racial 

and ethnic minority communities. The goal of this grant program is to reduce the incidence of HIV and 

improve overall health outcomes for individuals with SMI or co-occurring disorder. 

Required activities under this grant include HIV and hepatitis prevention services to include screening, 

risk assessment, prevention counseling, rapid testing, PrEP and hepatitis vaccination within a behavioral 

18 https://pubmed.ncbi.nlm.nih.gov/28093055/ 19 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.

70 
 

 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $9,224,000 

FY 2019 

FY 2020 $9,224,000 

FY 2021 Enacted $9,224,000 

FY 2022 Budget Request $9,224,000 

$9,224,000 

 

 

 

 

health setting. Grantees provide evidence-based mental and substance use disorder (SUD) treatment and 

practices that are trauma-informed and recovery-oriented. Grantees also implement outreach strategies 

to inform individuals of available behavioral health services and HIV and hepatitis primary care and 

prevention services. Grantees offer peer support and case management services to coordinate all aspects 

of care. 

Grantees collect data at baseline, 6-month reassessment, and discharge. FY 2019 reassessment data show 

53 percent of individuals receiving services are not experiencing serious psychological distress; 62 

percent reported an increase in everyday functioning; and 29 percent of individuals were being retained 

in the community. 

In FY 2019, SAMHSA continued support for 18 continuations grants. In FY 2020 and FY 2021, 

SAMHSA supported 18 grant continuations. 

Funding History 

Budget Request 

The FY 2022 budget request is $9.2 million, level with the FY 2021 Enacted level. SAMHSA will fund 

a new cohort of 18 grants focused on individuals with mental disorders and/or co-occurring disorders 

living with or at risk for HIV/AIDS. 

71 
 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Minority AIDS Initiative Service Integration 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.5.02 Percentage of clients receiving services 

who report positive functioning at 6 month followup. (Outcome) 

FY 2020: 67.3 

Target: 

61.8 

(Target Exceeded) 

67.0 67.0 Maintain 

3.5.03 Percentage of clients receiving services 

who had a permanent place to live in the 

community at six-month follow-up. (Outcome) 

FY 2020: 62.4 

Target: 

61.7 

(Target Exceeded) 

61.7 61.7 Maintain 

3.5.04 Percentage of clients receiving services 

who are currently employed at six-month followup. (Outcome) 

FY 2020: 38.7 

Target: 

36.4 

(Target Exceeded) 

38.7 38.7 Maintain 

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Criminal and Juvenile Justice Programs 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Criminal and Juvenile Justice Programs.................................. $6,269 $6,269 $51,394 $45,125 

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

FY 2022 Authorization ..........................................................................................................$4,269,000 

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 Units 

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.20 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.21 The costs 

associated with incarceration are high: state corrections budgets alone account for $39.0 billion in 

taxpayer costs.22,23 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. 

The purpose of SAMHSA’s Early Diversion grants is to establish or expand programs that divert adults 

with a serious mental illness (SMI) or a co-occurring disorder (COD) from the criminal justice system to 

community-based services prior to arrest and booking. Special consideration is given to applicants 

proposing to use grant funding to support early diversion services for veterans. 

Performance Evaluation 

SAMHSA completed an evaluation of the first cohort of Behavioral Health Treatment Courts 

Collaborative (BHTCC) grantees in September 2014. Findings of the evaluation demonstrate that 

20 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 21 The Role of Mental Health Courts in System Reform. (2003) The Bazelon Center for Mental Health Law. 

http://heinonline.org/HOL/LandingPage?handle=hein.journals/udclr7&div=10&id=&page= 22 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-of-recidivism 23 Henrichson, C., & Delaney, R. (2012). The price of prisons: What incarceration costs taxpayers. New York: Vera Institute 

of Justice.

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Fiscal Year Amount 

FY 2018 $4,269,000 

FY 2019 $4,269,000 

FY 2020 $6,269,000 

FY 2021 Enacted $6,269,000 

FY 2022 Budget Request $51,394,000 

 

 

 

 

 

 

 

 

 

 

 

grantees built multi-agency workgroups or collaborative 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 2,99724 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 months25. 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. 

In FY 2018, the Law Enforcement and Behavioral Health Partnerships (Early Diversion) grant program 

was initiated and funded 12 new grants. In FY 2019, these grantees screened over 1,400 clients and 

referred over 1,000 individuals to mental health services. 

In FY 2019, SAMHSA continued support for 11 Early Diversion grant continuations and technical 

assistance and evaluation activities. In FY 2020, SAMHSA funded 11 grant continuations, awarded a 

new cohort of seven grants, and conducted technical assistance activities. In FY 2021, SAMHSA will 

support 18 grant continuations, and conduct technical assistance activities. 

Funding History 

Budget Request 

The FY 2022 budget request is $51.4 million, an increase of $45.1 million from the FY 2021 Enacted 

level. This proposed increase aligns with the Administration’s goal to address mental health needs 

among incarcerated youth and adults by providing services to ensure their successful transition into 

community post-incarceration. This funding will establish pre-release relationships with community 

mental health providers and key stakeholders. With a commitment to health equity, SAMHSA will 

award a new cohort of grants to support provision of services by community-based behavioral health 

providers both within jails/prisons and post-incarceration. This activity will address the unmet 

treatment needs of incarcerated individuals and allow these individuals to continue to access services 

from the same community-based providers post-incarceration. The needs of individuals returning to 

society include the social determinants of recovery (i.e. housing, employment, access to health care) 

and other supportive resources for successful transition from incarceration. This funding will support 

up to 100 grantees to provide screening, assessment, treatment, and linkage to services for those with 

24 Cohort 2 data through November 15, 2017 25 Calculated as the change in percentage of individuals reporting alcohol or drug use from baseline to six-month follow-up. 

74 
 

 

 

 

mental disorders in jails/prisons. Special importance will be paid towards ensuring a commitment to 

racial and economic justice, trauma-informed approaches, as well as cultural humility. 

SAMHSA will also support the continuation of 18 Early Diversion grants and the continuation of the 

technical assistance center. 

75 
 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Criminal and Juvenile Justice 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 

2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

3.5.06 Percentage of clients receiving services 

who report positive functioning at 6 month followup (Outcome) 

FY 2020: 57.1 

Target: 

40.0 

(Target Exceeded) 

57.0 57.0 Maintain 

3.5.07 Percentage of clients receiving services 

who had a permanent place to live in the 

community at six-month follow-up. (Outcome) 

FY 2020: 38.9 

Target: 

40.0 

(Target Not Met) 

40.0 40.0 Maintain 

3.5.09 Number of individuals screened for mental 

health or related interventions. (Output) 

FY 2020: 2,405.0 

Target: 

1,438.0 

(Target Exceeded) 

2,400.0 2,700.0 +300 

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Practice Improvement and Training 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Practice Improvement and Training......................................... $7,828 $7,828 $7,828 --

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

FY 2022 Authorization ..................................................................................................... $394,550,000 

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 Historically Black Colleges and Universities-Center for Excellence (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 professions. The comprehensive focus of the HBCU-CFE 

program simultaneously expands service capacity on campuses and in other treatment venues. 

SAMHSA has worked to strengthen its clinical and science-based approach to addressing serious mental 

illness. In FY 2018, SAMHSA developed a Clinical Support Services TA Center to address SMI. This 

TA Center focuses specifically on the clinical treatment of SMI, including the use of medications. 

In FY 2019, SAMHSA continued support for the HBCU grant program and the Clinical Support Services 

TA Center. In FY 2020 and FY 2021, SAMHSA will fund the HBCU grant program and the Clinical 

Support Services TA Center.

77 
 

Fiscal Year Amount 

FY 2018 $7,828,000 

FY 2019 $7,828,000 

FY 2020 $7,828,000 

FY 2021 Enacted $7,828,000 

FY 2022 Budget Request $7,828,000 

 

 

 

 

 

 

Funding History 

Budget Request 

The FY 2022 budget request is $7.8 million, level with the FY 2021 Enacted level. Funding will support 

the continuation of the HBCU program, the continuation of the Clinical Support Services TA Center for 

SMI and provide supplemental funding for the school safety program. 

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 90. 

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Consumer and Consumer-Supporter TA Centers 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Consumer and Consumer-Supporter Technical Assistance 

Centers.. $1,918 $1,918 $1,918 --

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

FY 2022 Authorization ......................................................................................................$394,550,000 

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 FY 2020, the Consumer and Consumer-Supporter TA Centers provided training to approximately 

16,167 people. These trainings covered a range of topics, including peer support, the Wellness Recovery 

Action Plan, Emotional CPR, 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 $334 thousand in funding (non-grant). Due to this grant, 123 

consumers and family members holding positions within consumer or family organizations participated 

in mental health-related planning and systems improvement. 

In FY 2019 SAMHSA supported the continuation of five grants. In FY 2020, SAMHSA funded a new 

cohort of five grants. In FY 2021, SAMHSA will support five grant continuations.

79 
Fiscal Year Amount 

FY 2018 $1,918,000 

FY 2019 $1,918,000 

FY 2020 $1,918,000 

FY 2021 Enacted $1,918,000 

FY 2022 Budget Request $1,918,000 

 

 

 

 

 

 

Funding History 

Budget Request 

The FY 2022 budget request is $1.9 million, level with the FY 2021 Enacted. SAMHSA’s funding request 

will support five continuation grants to provide technical assistance to facilitate the quality improvement 

of the mental health system by promoting consumer-directed approaches for adults with SMI. 

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 90. 

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Disaster Response 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Disaster Response................................................................... $1,953 $1,953 $1,953 --

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

FY 2022 Authorization ..................................................................................................... $394,550,000 

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

Eligible Entities .............................................................. Domestic Public or Private Non-Profit Entities 

Program Description and Accomplishments 

Natural and human caused disasters and emergent events, including the COVID-19 pandemic; wildfires 

in California, Colorado, and Washington; hurricanes and tropical storms along the coast; and midwestern 

floods and tornadoes; strike without warning. These unexpected disasters and events leave individuals, 

families, and whole communities struggling to rebuild. 

SAMHSA helps ensure that the nation is prepared to address, as well as respond to the behavioral health 

needs that follow these disasters or events. SAMHSA focuses on three major programs; the Crisis 

Counseling Assistance and Training Program (CCP), the Disaster Distress Helpline (DDH) and the 

Disaster Technical Assistance Center (DTAC). These programs use appropriated funds to support 

survivors of natural and man-made disasters. 

SAMHSA provides Disaster Behavioral Health expertise around natural disasters, and emerging public 

health initiatives to develop and disseminate innovative consultation and technologies to communities, 

federal partners, and other stakeholders. SAMHSA, through an interagency agreement with the Federal 

Emergency Management Agency (FEMA), operates the CCP. This program assists individuals and 

communities to recover from presidentially declared disasters through the provision of community-based 

behavioral health outreach and psycho-educational services. SAMHSA provides technical assistance, 

program guidance and monitoring, and oversight of the CCP. SAMHSA funds the DDH, the nation’s 

first permanent hotline dedicated to providing immediate disaster crisis counseling. SAMHSA and 

FEMA jointly fund the DTAC, designed to provide additional technical assistance, strategic planning, 

consultation, and logistical support. 

During FY 2020, the CCP Online Data Collection and Evaluation System showed the following contacts 

and encounters funded by 73 CCP grants: 

• 502,154 in-person brief educational supportive contacts; 

• 193,810 telephone contacts and 610,071 e-mail contacts; 

• 138,320 individual and family crisis counseling encounters (lasting 15 to 60 minutes or more) 

serving 177,038 individuals; and 

• 9,342 group encounters (public education and group counseling) serving 244,415 individuals.

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Fiscal Year Amount 

FY 2018 $1,953,000 

FY 2019 $1,953,000 

FY 2020 $1,953,000 

FY 2021 Enacted $1,953,000 

FY 2022 Budget Request $1,953,000 

 

 

 

 

 

Individual and family crisis counseling encounters were most often conducted with adults ages 40 to 64 

(45 percent) followed by adults ages 65 and older (26 percent) and adults ages 18-39 (21 percent). 

Individual and family encounters occurred most often with female (58 percent) disaster survivors and 

most (59 percent) were conducted in Spanish due to the large CCP grant running in Puerto Rico. The 

three most common risk factors reported by counseling participants were other financial loss (18 percent), 

past trauma (17 percent), home damaged or destroyed (10 percent). Across the four major health concern 

categories (behavioral, emotional, physical, and cognitive), the highest number of reported disaster event 

reactions fell within the emotional category and was “anxious/fearful” (n = 80,638). The next most 

prevalent reaction was “preoccupied with death/destruction” (n= 56,478) under the behavioral category. 

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 2020, SAMHSA responded to over 48,000 calls and received close to 120,000 text 

messages to the Disaster Distress Helpline. SAMHSA has seen an over 300 percent increase in its 

Disaster Distress Helpline call volume this year during the Covid-19 pandemic, compared to the year 

prior. In addition, SAMHSA’s Disaster App (available on Apple and android platforms) provides 

evidence-informed and evidence-based resources in the Disaster Kit, along with additional partner 

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. 

In FY 2020, SAMHSA continued support for the National Disaster Distress Helpline. In FY 2021, 

SAMHSA will fund a new National Disaster Distress Helpline grant and continue to support the DTAC 

contract. 

Funding History 

Budget Request 

The FY 2022 budget request is $2.0 million, level with the FY 2021 Enacted. SAMHSA requests 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 90. 

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Seclusion and Restraint 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Seclusion and Restraint .......................................................... $1,147 $1,147 $1,147 --

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

FY 2022 Authorization ......................................................................................................$394,550,000 

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 people 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. 

The purpose of the MHTTC Network is technology transfer—disseminating and implementing evidencebased practices for mental disorders into the field. The MHTTC Network includes 10 Regional Centers, 

a National American Indian and Alaska Native Center, a National Hispanic and Latino Center, and a 

Network Coordinating Office. The collaborative network supports resource development and 

dissemination, training and technical assistance, and workforce development for the mental health field. 

It works with systems, organizations, and treatment practitioners involved in the delivery of mental health 

services to strengthen their capacity to deliver effective evidence-based practices to individuals. 

In FY 2019, SAMHSA supported the continuation for the 11 MHTTC grants. In FY 2020, SAMHSA 

funded 11 MHTTC continuation grants, and will fund the same amount in FY 2021. 

Funding History 

Fiscal Year Amount 

FY 2018 $1,147,000 

FY 2019 $1,147,000 

FY 2020 $1,147,000 

FY 2021 Enacted $1,147,000 

FY 2022 Budget Request $1,147,000 

Budget Request 

The FY 2022 budget request is $1.1 million, level with the FY 2021 Enacted level. SAMHSA’s funding 

request will provide support for the continuation of the 11 MHTTC grants.

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Assertive Community Treatment for Individuals with Serious Mental Illness 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Assertive Community Treatment for Adults with SMI..... $7,000 $9,000 $9,000 --

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

FY 2022 Authorization ........................................................................................................ $5,000,000 

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 Individuals with SMI program is authorized under the 

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

approaches to deliver services to individuals with the most severe impairments associated with SMI26 and 

has been disseminated by SAMHSA for widespread use through its Evidence-based Toolkit series27 

beginning in 2008. ACT was developed to reduce re-hospitalization and improve outcomes in 

community settings. It 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. An ACT team is composed of 10-12 multidisciplinary behavioral health staff, including 

psychiatrists, nurses, social workers, addiction counselors, employment/vocational supports, and peer 

specialists. These practitioners work together to deliver comprehensive, individualized, and recoveryoriented treatment and case management services to approximately 100 people with SMI in community 

settings. Caseloads are approximately one staff member to every 10 individuals. 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. 

FY 2020 data indicated that the number of individuals served by the program who reported improved 

functioning in everyday life increased by 52.5 percent, the number of individuals who had a stable place 

to live increased from 48 to 60 percent, and the rate of improvement in social connectedness increased 

by almost 44.8 percent. Data also showed that 582 individuals received evidence-based mental health 

related services and 528 individuals in the mental health workforce received training in mental health 

practices consistent with the goals of the program. 

In FY 2019, SAMHSA supported seven continuation grants. In FY 2020, SAMHSA funded seven 

continuation grants and award three new ACT grants. In FY 2021, SAMHSA will support 10 grant 

continuations and funded a new cohort of two ACT grants. 

26 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589962/ 27 http://store.samhsa.gov/product/Assertive-Community-Treatment-ACT-Evidence-Based-Practices-EBP-KIT/SMA08-

4345

84 
Fiscal Year Amount 

FY 2018 $5,000,000 

FY 2019 $5,000,000 

FY 2020 $7,000,000 

FY 2021 Enacted $9,000,000 

FY 2022 Budget Request $9,000,000 

 

 

 

Funding History 

Budget Request 

The FY 2022 budget request is $9.0 million, level with the FY 2021 Enacted. This funding will support 

the continuation of 12 grants to advance the ACT approach to address the needs of those living with SMI. 

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Outputs and Outcomes Table 

Program: Assertive Community Treatment Grants 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 

2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.13 Percentage of clients receiving services 

who report positive functioning at 6 month 

follow-up. (Outcome) 

FY 2020: 61.5 

Target: 

50.0 

(Target Exceeded) 

50.0 50.0 Maintain 

3.4.14 Percentage of clients receiving services 

who are currently employed at 6 month followup. (Outcome) 

FY 2020: 23.8 

Target: 

28.0 

(Target Not Met) 

23.0 23.0 Maintain 

3.4.15 Percentage of clients receiving services 

who have a permanent place to live in the 

community at 6 month follow-up. (Outcome) 

FY 2019: 45.8 

Target: 

45.8 

(Baseline) 

45.8 45.8 Maintain 

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Assisted Outpatient Treatment for Individuals with Serious Mental Illness 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Assisted Outpatient Treatment for Individuals with Serious 

Mental Illness.. $19,000 $21,000 $21,420 $420 

Authorizing Legislation .........................Section 224 of the Protecting Access to Medicare Act of 2014, 

FY 2022 Authorization ........................................................................................................$18,000,000 

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 serious mental illness (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 fouryear 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 non-adherence to treatment repeated hospitalizations or arrest. AOT involves 

petitioning local courts through a civil process to order individuals to enter and remain in treatment within 

the community for a specified period of time. This program 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 the 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 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.

87 
 

 

 

 

 

 

 

 

 

 

Program Evaluation 

Grantee performance data from SAMHSA’s Performance Accountability Reporting System (SPARS) 

was used to capture outcomes in the four areas listed below: 

1. Cost savings and public health outcomes including substance misuse, hospitalization, and use of 

services 

• 9.8 percent of AOT program participants reported spending at least one day in the hospital 

for mental health care in the past 30 days at their most recent reassessment compared to 65.3 

percent at intake. 

• 7.3 percent of AOT program participants reported spending at least one day in the 

emergency department for a psychiatric or emotional problem in the past 30 days at their 

most recent reassessment compared to 33.2 percent at intake. 

• 25 percent of AOT program participants reported using illegal substances 30 days before 

their most recent reassessment compared to 33.3 percent at intake. 

2. Rates of Incarceration 

• 7.1 percent of AOT program participants reported spending one or more nights in a 

correctional facility in the past 30 days at their most recent reassessment compared to 12.7 

percent at intake. 

3. Rates of Homelessness 

• 7.0 percent of AOT program participants reported spending one or more homeless nights in 

the past 30 days at their most recent reassessment compared to 13.6 percent at intake. 

4. Patient and family satisfaction with program participation 

• 91.8 percent of AOT program participants agreed or strongly agreed with the statement “I 

liked the services I received here” at their most recent reassessment. 

In FY 2019, SAMHSA funded 18 continuation grants. In FY 2020, SAMHSA funded a new cohort of 17 

grants and four continuation grants. In FY 2021, SAMHSA will support 20 grant continuations and award 

a new cohort of three grants. 

88 
 

 

 

 

 

 

Funding History 

Fiscal Year Amount 

FY 2018 $15,000,000 

FY 2019 $15,000,000 

FY 2020 $19,000,000 

FY 2021 Enacted $21,000,000 

FY 2022 Budget Request $21,420,000 

Budget Request 

The FY 2022 budget request is $21.4 million, an increase of $420,000 from the FY 2021 Enacted level. 

This funding will support a new cohort of three grants and 20 grant continuations to improve the health 

and social outcomes for individuals with SMI and continuation of the technical assistance center. 

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Outputs and Outcomes Table 

Program: Assisted Outpatient Treatment for Individuals with Serious Mental Illness 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.06 Percentage of clients receiving services 

who report positive functioning at 6 month 

follow-up. (Outcome) 

FY 2020: 70.0 

Target: 

70.0 

(Target Met) 

70.0 70.0 Maintain 

3.4.07 Percentage of clients receiving services 

who are maintained at six-month follow-up. 

(Outcome) 

FY 2020: 88.7 

Target: 

80.9 

(Target Exceeded) 

80.9 89.0 +8.1 

3.4.08 Number of people in the mental health 

and related workforce trained in mental healthrelated practices/activities. (Output) 

FY 2020: 2,724.0 

Target: 

2,180.0 

(Target Exceeded) 

2,180.0 2,180.0 Maintain 

3.4.09 Number of consumers/family members 

who provide mental health-related services. 

(Output) 

FY 2020: 72.0 

Target: 

99.0 

(Target Not Met) 

72.0 72.0 Maintain 

* Trained consumer/family members providing mental health-related services can assist in the attainment of treatment goals 

and promote improved role functioning in the home and in community settings. The number of consumers/family members 

providing mental-health related services reflects the AOT program’s access to these services, which could be a potential 

indicator of overall positive AOT outcomes for individuals with serious mental illness. 

90 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Mental Health – Other Capacity Activities 28 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.5.00 Number of people in the mental health 

and related workforce trained in mental healthrelated practices/activities that are consistent 

with the goals of the grant (Output) 

FY 2020: 28,746.0 

Target: 

22,124.0 

(Target Exceeded) 

28,746.0 28,746.0 Maintain 

3.5.01 Number of consumers/family members 

representing consumer/family organizations 

who are involved in ongoing mental healthrelated planning and advocacy activities as a 

result of the grant (Output) 

FY 2020: 12,334.0 

Target: 

15,812.0 

(Target Not Met) 

12,334.0 12,334.0 Maintain 

28 Includes the following: Children and Family, Consumer and Family Network, Consumer and Consumer-Supporter TA 

Centers, Practice Improvement Training, and Disaster Response. 

91 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Mental Health - Science and Service Activities 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 

2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

1.4.06 Number of people trained by CMHS 

Science and Service Programs (Output) 

FY 2020: 30,983 

Target: 

19,356 

(Target Not Met) 

30,983 30,983 Maintain 

1.4.14 Number of calls answered by the Disaster 

Distress Hotline (Output) 

FY 2020: 56,756 

Target: 

11,820 

(Target Exceeded) 

56,700 56,700 Maintain 

1.4.15 Number of text messages answered by the 

Disaster Distress Hotline (Output) 

FY 2020: 117,042 

Target: 

18,468 

(Target Exceeded) 

117,000 117,000 Maintain 

92 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tribal Behavioral Health Grants 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Tribal Behavioral Health Grants............................................... $20,000 $20,750 $20,750 $0 

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

FY 2022 Authorization ......................................................................................................$394,550,000 

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

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

Program Description and Accomplishments 

Suicide is now the first leading cause of death among American Indian/Alaska Native (AI/AN) youth 

ages ten to 14 years, and the second leading cause of death among American Indian/Alaska Native 

(AI/AN) youth ages 15 to 24.29 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students. 30 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).31 

Consistent with the goals of the Tribal Behavioral Health Agenda, the Tribal Behavioral Health Grant 

(TBHG/Native Connections (NC) program addresses the high incidence of substance use and suicide 

among AI/AN populations. Starting in FY 2014, this program supports tribal entities with the highest 

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

suicide and by promoting the mental health of AI/AN young people. 

The first cohort of TBHG/NC grants was provided 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 misuse, 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. 

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. 

29 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.

30 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.

31 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.

93 
 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $15,000,000 

FY 2019 $20,000,000 

FY 2020 $20,000,000 

FY 2021 Enacted $20,750,000 

FY 2022 Budget Request $20,750,000 

 

 

 

 

 

 

 

 

In FY 2016, SAMHSA expanded activities through the braided TBHG/NC funding ($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 

misuse, and promote mental health and resiliency among youth in tribal communities. 

In FY 2019, SAMHSA supported 109 grant continuations, 26 new grants, and technical assistance 

activities. In FY 2020, SAMHSA funded 121 grant continuations, technical assistance activities and 40 

new grants (jointly funded CSAP/CMHS). In FY 2021, SAMHSA will support 124 grant continuations 

and award a new cohort of six grants and technical assistance activities. 

Funding History 

Budget Request 

The FY 2022 budget request is $20.8 million, level with the FY 2021 Enacted. This request, combined 

with $21.1 million in the Substance Abuse Prevention will support technical assistance activities, 117 

continuation grants and award a new cohort of six grants that promote mental health and prevent 

substance use activities for high-risk AI/AN youth and their families. 

As a braided activity, SAMHSA is tracking separately any amounts spent or awarded under Tribal 

Behavioral Health Grants through the distinct appropriations and ensure that funds are used for purposes 

consistent with legislative direction and intent of these appropriations. 

94 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Tribal Behavioral Health 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.4.12 Percentage of youth age 10 - 24 who 

received mental health or related services after 

screening, referral or attempt (Output) 

FY 2020: 47 

Target: 

42 

(Target Exceeded) 

47 47 Maintain 

2.4.13 Number of programs/organizations that 

implemented specific mental-health related 

practices/activities as a result of the grant 

(Outcome) 

FY 2020: 3,076 

Target: 

6,880 

(Target Not Met) 

3,000 3,000 Maintain 

95 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Minority Fellowship Program 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Minority Fellowship Program................................................. $9,059 $10,059 $10,663 $604 

Authorizing Legislation.............................................................. Section 597 of the PHS Act 

FY 2022 Authorization ........................................................................................................$12,669,000 

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

Eligible Entities. ..............................................Organizations that represent individuals obtaining 

post-baccalaureate training (including for master’s and doctoral degrees) for mental and substance use 

disorder treatment professionals, including in the fields of psychiatry, nursing, social work, psychology, 

marriage and family therapy, mental health counseling, and substance use disorder and addiction 

counseling 

Program Description 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, marriage and family therapy, mental health counseling, psychology; and 

substance use/addiction counseling. 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 focus including youth and addiction 

counselors. In FY 2019, SAMHSA supported seven continuation grants and the technical assistance 

contract. In FY 2020, SAMHSA funded seven continuation grants, the technical assistance contract, and 

awarded one new grant to a current grantee to focus on interdisciplinary work. In FY 2021, SAMHSA 

will support eight grant continuations and the technical assistance contract. 

Funding History 

Fiscal Year Amount 

FY 2018 $8,059,000 

FY 2019 $8,059,000 

FY 2020 $9,059,000 

FY 2021 Enacted $10,059,000 

FY 2022 Budget Request $10,663,000 

Budget Request 

The FY 2022 budget request is $10.7 million, an increase of $604,000 from the FY 2021 Enacted level. 

SAMHSA requests funding to support eight continuation grants, a new cohort of one grant and the 

technical assistance contract.

96 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infant and Early Childhood Mental Health 

(Dollars in thousands) 

 Programs of Regional & National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Infant and Early Childhood Mental Health.............................. $7,000 $8,000 $8,000 --

Authorization Legislation............................................. Section 399Z-2 of the Public Health Service Act 

FY 2022 Authorization ........................................................................................................$20,000,000 

Allocation Method ....................................................................................................Competitive Grants 

Eligible Entities.................................Human Services Agencies and Non-profit Institutions 

Program Description and Accomplishments 

Nearly one in seven US children aged 2 to 8 years has a mental, behavioral, or developmental disorder.32 

It is also estimated that approximately 9.5 to 14.2 percent of children birth to 5 years old experience 

emotional, relational, or behavioral disturbance.33 Without proper intervention, these early childhood 

disorders can have negative impacts on all areas of a child’s development. Young children whose social 

and emotional development is compromised are at higher risk for school problems and juvenile 

delinquency later in life.34 Rising rates of substance-exposure in infants also require more intensive early 

childhood services to help improve the trajectories of the families where substance misuse is present. 

The authorization for this program was added to the Public Health Service Act by an amendment in the 

21st Century Cures Act. The first funding for this program was provided in FY 2018. The purpose of this 

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

early signs of, or have been diagnosed with a mental illness, including a serious emotional disturbance. 

Grantees improve outcomes for children through training early childhood providers and clinicians to 

identify and treat behavioral health disorders of early childhood, including in children with a history of 

in utero exposure to substances such as opioids, stimulants or other drugs that may impact development, 

and through the implementation of evidence-based multigenerational treatment approaches that 

strengthen caregiving relationships. 

SAMHSA expects this program will increase access to a range of evidence-based and culturally 

appropriate infant and early childhood mental health services and will aid in addressing the national 

shortage of mental health professionals with infant and early childhood expertise. 

32 Bitsko, RH, Holbrook, JR, Kaminski, J, Robinson, LR, Ghandour, R, Smith, C, Peacock, G. (2016) Health-care, Family 

and Community Factors associated with Mental, Behavioral and Developmental Disorders in Early Childhood – United 

States, 2011-2012. MMWR.; 65(9); 221-226. Available from https://www.cdc.gov/ncbddd/childdevelopment/features/keyfinding-factors-mental-behavioral-developmental-early-childhood.html. 33 Brauner, C. B., & Stephens, C. B. (2006). Estimating the prevalence of early childhood serious emotional/behavioral 

disorders: Challenges and recommendations. Public Health Reports, 121(3), 303–310. Available from 

www.ncbi.nlm.nih.gov/pmc/articles/PMC1525276 34 Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early Social-Emotional Functioning and Public Health: The 

Relationship Between Kindergarten Social Competence and Future Wellness. American Journal of Public Health, 105(11), 

2283–2290. http://doi.org/10.2105/AJPH.2015.302630

97 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $5,000,000 

FY 2019 $5,000,000 

FY 2020 $7,000,000 

FY 2021 Enacted $8,000,000 

FY 2022 Budget Request $8,000,000 

 

 

 

 

Because the wellbeing of caregivers dramatically impacts the development of infants and young 

children, this program also promotes a multigenerational approach that supports caregivers and other 

family members of infants and young children. 

In FY 2018 to 2020, grantees: 

• Trained more than 3,500 clinicians and early childhood providers on evidence-based mental 

health treatments for infants and young children; 

• Screened and assessed over 4,700 young children for developmental and behavioral disorders 

(including screening parents for behavioral health issues such as depression and substance 

misuse); 

• Referred approximately 2,450 children and parents for treatment; and 

• Provided infant and early childhood mental health treatment (including multigenerational 

therapies) to approximately 2,461 children and families. 

In FY 2019, SAMHSA supported the continuation of nine grants. In FY 2020, SAMHSA continued to 

support nine continuation grants and awarded a new cohort of four grants. In FY 2021, SAMHSA will 

support 13 grant continuations and provide supplement to support COE-CMHC technical assistance. 

Funding History 

Budget Request 

The FY 2022 budget request is $8.0 million, level with the FY 2021 Enacted. Funding will support the 

continuation of 13 grants and award a new cohort of two grants to increase access to a range of evidencebased and culturally appropriate infant and early childhood mental health services. 

98 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Infant and Early Childhood Mental Health 

Measure Year and Most Recent Result 

/ 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.16 Number of children screened for mental 

health or related interventions (Output) 

FY 2020: 4,719 

Target: 

2,500 

(Target Exceeded) 

4,700 4,700 Maintain 

3.4.17 Number of children referred to mental 

health or related interventions (Output) 

FY 2020: 2,339 

Target: 

1,034 

(Target Exceeded) 

2,300 2,300 Maintain 

3.4.18 Number of people in the mental health 

and related workforce trained in specific mental 

health-related practices/activities as a result of 

the program. (Output) 

FY 2020: 3,537 

Target: 

1,889 

(Target Exceeded) 

3,500 3,500 Maintain 

99 
 

 

 

 

Substance Abuse and Mental Health Services Administration 

Mental Health 

PRNS Mechanism Table Summary 

(Dollars in thousands) 

Program Activity 

FY 2020 Final 

No. Amount No. Amount 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

No. Amount 

Programs of Regional & National Significance 

Grants/Cooperative Agreements 

Continuations..................................................................... 765 352,562 643 378,511 870 494,884 

New/Competing................................................................. 203 120,210 334 131,821 243 212,315 

Supplements*..................................................................... --- 18,902 --- 8,552 --- 500 

Subtotal........................................................................... 968 491,674 977 518,884 1,113 707,698 

Contracts 

Continuations..................................................................... 7 37,681 4 35,398 7 45,478 

New/Competing.................................................................

Subtotal........................................................................... 

Total, Mental Health PRNS 

 --- 305 3 4,641 --- ---

7 37,987 7 40,039 7 45,478 

975 $529,661 984 $558,923 1,120 $753,176 

* Excluding Supplements number count to avoid duplication. 

100 
 

 

 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

No. Amount 

FY 2021 

Enacted 

No. Amount 

FY 2022 President's 

Budget 

No. Amount 

Capacity: 

National Child Traumatic Stress Network 

Grants 

Continuations............................................................... 100 $51,663 34 $16,147 127 $66,377 

New/Competing........................................................... 16 7,516 97 52,200 24 11,652 

Supplements*............................................................... --- 6,000 --- --- --- ---

Subtotal..................................................................... 116 65,180 131 68,347 151 78,029 

Contracts 

Continuations............................................................... --- 3,707 --- 3,540 --- 3,858 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 3,707 --- 3,540 --- 3,858 

Total ,National Child Traumatic Stress Network 116 68,887 131 71,887 151 81,887 

Project AWARE 

Grants 

Continuations............................................................... 197 84,930 79 85,117 220 126,717 

New/Competing........................................................... 31 33,758 157 39,323 136 55,661 

Supplements*...............................................................

Subtotal..................................................................... 

 --- 275 --- 75 --- 50 

228 118,963 236 124,515 356 182,428 

Contracts 

Continuations............................................................... --- 6,001 --- 6,449 --- 9,019 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 6,001 --- 6,449 --- 9,019 

Total, Project AWARE 228 124,964 236 130,964 356 191,447 

Healthy Transitions 

Grants 

Continuations............................................................... 25 25,381 27 27,243 27 27,266 

New/Competing........................................................... 2 2,000 --- --- 1 798 

Supplements*............................................................... --- --- --- --- --- ---

Subtotal..................................................................... 27 27,381 27 27,243 28 28,064 

Contracts 

Continuations............................................................... --- 1,570 --- 2,208 --- 1,387 

New/Competing...........................................................

Subtotal.....................................................................

Total, Healthy Transitions 

 --- --- --- --- --- ---

 --- 1,570 --- 2,208 --- 1,387 

27 28,951 27 29,451 28 29,451 

101 
 

 

 

Children and Family Programs 

Grants 

Continuations............................................................... 1 375 18 5,534 21 6,467 

New/Competing........................................................... 

Subtotal..................................................................... 

18 5,509 3 930 --- ---

19 5,884 21 6,464 21 6,467 

Contracts 

Continuations............................................................... --- 1,345 --- 765 --- 762 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 1,345 --- 765 --- 762 

Total, Children and Family Programs 19 7,229 21 7,229 21 7,229 

Consumer and Family Network Grants 

Grants 

Continuations............................................................... 49 4,647 26 2,466 22 2,071 

New/Competing...........................................................

Subtotal..................................................................... 

 --- --- 22 2,070 28 2,650 

49 4,647 48 4,537 50 4,721 

Contracts 

Continuations............................................................... --- 307 --- 417 --- 233 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 307 --- 417 --- 233 

Total, Consumer and Family Network Grants 49 4,954 48 4,954 50 4,954 

Project LAUNCH 

Grants 

Continuations............................................................... 31 22,420 31 22,287 31 22,493 

New/Competing........................................................... --- --- --- --- --- ---

Supplements*...............................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

31 22,420 31 22,287 31 22,493 

Contracts 

Continuations............................................................... --- 1,185 --- 1,318 --- 1,112 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 1,185 --- 1,318 --- 1,112 

Total, Project LAUNCH 31 23,605 31 23,605 31 23,605 

Mental Health System Transformation and Health 

Reform 

Grants 

Continuations............................................................... 3 3,589 3 3,593 3 3,601 

New/Competing........................................................... --- --- --- --- --- ---

Supplements*...............................................................

Subtotal..................................................................... 

 --- --- --- --- --- ---

3 3,589 3 3,593 3 3,601 

Contracts 

Continuations............................................................... --- 190 --- 186 --- 178 

New/Competing...........................................................

Subtotal.....................................................................

Total, Mental Health System Transformation and 

 --- --- --- --- --- ---

 --- 190 --- 186 --- 178 

3 3,779 3 3,779 3 3,779 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

No. Amount 

FY 2021 

Enacted 

No. Amount 

FY 2022 President's 

Budget 

No. Amount 

102 
 

 

 

FY 2020 FY 2021 FY 2022 President's 

Final Enacted Budget 

Programs of Regional & National Significance No. Amount No. Amount No. Amount 

Primary and Behavioral Health Care Integration 

Grants 

Continuations............................................................... 20 39,469 24 47,732 24 47,818 

New/Competing........................................................... 4 8,000 1 2,000 2 2,569 

Supplements*............................................................... --- --- --- --- --- ---

Subtotal..................................................................... 24 47,469 25 49,732 26 50,387 

Contracts 

Continuations............................................................... --- 2,408 --- 3,145 --- 2,490 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 2,408 --- 3,145 --- 2,490 

Total, PBHCI 24 49,877 25 52,877 26 52,877 

National Strategy for Suicide Prevention 

Grants 

Continuations............................................................... 15 7,792 35 16,768 45 21,658 

New/Competing........................................................... 20 8,965 10 4,840 --- ---

Supplements*...............................................................

Subtotal.....................................................................

 --- 450 --- 450 --- 450 

35 17,208 45 22,058 45 22,108 

Contracts 

Continuations............................................................... --- 992 --- 1,142 --- 1,092 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 992 --- 1,142 --- 1,092 

Total, National Strategy for Suicide Prevention 35 18,200 45 23,200 45 23,200 

GLS - Youth Suicide Prevention - States 

Grants 

Continuations............................................................... 38 26,459 43 30,195 47 32,638 

New/Competing........................................................... 

Subtotal..................................................................... 

10 7,448 6 4,305 2 2,074 

48 33,907 49 34,500 49 34,712 

Contracts 

Continuations............................................................... --- 1,520 --- 1,927 --- 1,715 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 1,520 --- 1,927 --- 1,715 

Total, GLS - States 48 35,427 49 36,427 49 36,427 

GLS - Youth Suicide Prevention - Campus 

Grants 

Continuations............................................................... 46 4,526 37 3,631 41 4,061 

New/Competing........................................................... 

Subtotal..................................................................... 

16 1,600 25 2,538 16 2,046 

62 6,126 62 6,169 57 6,108 

Contracts 

Continuations............................................................... --- 362 --- 319 --- 380 

New/Competing...........................................................

Subtotal.....................................................................

Total, GLS - Campus 

 --- --- --- --- --- ---

 --- 362 --- 319 --- 380 

62 6,488 62 6,488 57 6,488 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

103 
 

 

 

FY 2020 FY 2021 FY 2022 President's 

Final Enacted Budget 

Programs of Regional & National Significance No. Amount No. Amount No. Amount 

GLS - Suicide Prevention Resource Center 

Grants 

Continuations............................................................... --- --- 1 7,587 1 7,587 

New/Competing........................................................... 

Subtotal.....................................................................

1 7,587 --- 970 --- 989 

1 7,587 1 8,557 1 8,576 

Contracts 

Continuations............................................................... --- 401 --- 443 --- 424 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- --- --- --- ---

 --- 401 --- 443 --- 424 

Total, GLS - Suicide Prevention Resource Center 1 7,988 1 9,000 1 9,000 

Suicide Lifeline 

Grants 

Continuations............................................................... 3 5,969 2 667 1 21,973 

New/Competing........................................................... --- --- 1 15,151 3 74,864 

Supplements*...............................................................

Subtotal.....................................................................

 --- 12,077 --- 7,000 --- ---

3 18,046 3 22,818 4 96,836 

Contracts 

Continuations............................................................... --- 950 --- 1,182 --- 4,785 

New/Competing...........................................................

Subtotal.....................................................................

 --- 4 --- --- --- ---

 --- 954 --- 1,182 --- 4,785 

Total, Suicide Lifeline 3 19,000 3 24,000 4 101,621 

AI/AN Suicide Prevention Initiative 

Grants 

Continuations............................................................... 1 500 1 500 1 500 

New/Competing...........................................................

Subtotal..................................................................... 

 --- --- --- --- --- ---

1 500 1 500 1 500 

Contracts 

Continuations............................................................... 1 2,431 --- 144 1 2,431 

New/Competing...........................................................

Subtotal.....................................................................

 --- --- 1 2,287 --- ---

1 2,431 1 2,431 1 2,431 

Total, AI/AN 2 2,931 2 2,931 2 2,931 

Homelessness Prevention Programs 

Grants 

Continuations............................................................... 43 23,572 48 26,788 48 26,751 

New/Competing........................................................... 5 3,500 --- --- 1 322 

Supplements*...............................................................

Subtotal..................................................................... 

 --- --- --- --- --- ---

48 27,071 48 26,788 49 27,073 

Contracts 

Continuations............................................................... 1 3,625 1 3,908 1 3,623 

New/Competing...........................................................

Subtotal..................................................................... 

Total, Homelessness Prevention Programs 

 --- --- --- --- --- ---

1 3,625 1 3,908 1 3,623 

49 30,696 49 30,696 50 30,696 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

104 
105 

 

 

 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

No. Amount No. Amount 

FY 2021 

Enacted 

FY 2022 President's 

Budget 

No. Amount 

Comprehensive Opioid Recoverty Centers 

Grants 

Continuations............................................................... --- --- --- --- --- ---

2 1,700 --- --- --- ---

2 1,700 --- --- --- ---

 --- --- --- --- --- ---

 --- 300 --- --- --- ---

 --- 300 --- --- --- ---

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Total, Comprehensive Opioid Recoverty Centers 

Minority AIDS 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations............................................................... 

New/Competing...........................................................

Subtotal..................................................................... 

Total, Minority AIDS 

Criminal and Juvenile Justice Programs 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Total, Criminal and Juvenile Justice Programs 

Seclusion and Restraint 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Total, Seclusion and Restraint 

2 2,000 

18 8,685 

 --- ---

 --- ---

18 8,671

 --- ---

 --- ---

 --- ---

18 8,789 

18 8,685 18 8,671 18 8,789 

 --- 539

 --- ---

 --- 553

 --- ---

 --- 435

 --- ---

 --- 539 --- 553 --- 435 

18 9,224 

11 3,455 

7 2,261 

18 9,224

18 5,800 

 --- ---

18 9,224 

18 5,718 

 --- 43,100 

18 5,716 18 5,800 18 48,818 

1 553

 --- ---

 --- 315 

1 155

1 2,576 

 --- ---

1 553 1 469 1 2,576 

19 6,269 

11 1,043 

 --- ---

19 6,269 

11 1,080 

 --- ---

19 51,394 

11 1,093 

 --- ---

11 1,043 11 1,080 11 1,093 

 --- 104

 --- ---

 --- 67

 --- ---

 --- 54 

 --- ---

 --- 104 --- 67 --- 54 

11 1,147 11 1,147 11 1,147 
 

 

 

7 4,740 10 6,736 12 8,166 

3 1,995 2 1,356 --- 410 

10 6,735 12 8,092 12 8,576 

 --- 265 --- 908 --- 424 

 --- --- --- --- --- ---

 --- 265 --- 908 --- 424 

10 7,000 12 9,000 12 9,000 

4 2,849 20 17,436 20 17,616 

17 15,114 3 2,396 3 2,746 

 --- 100 --- 75 --- ---

21 18,063 23 19,906 23 20,363 

 --- 937 --- 522 --- 1,057 

 --- --- --- 572 --- ---

 --- 937 --- 1,094 --- 1,057 

21 19,000 23 21,000 23 21,420 

120 10,105 124 16,647 117 17,156 

40 7,251 6 1,452 6 889 

160 17,356 130 18,100 123 18,045 

1 2,643 --- 1,022 1 2,705 

 --- 1 1 1,629 --- ---

1 2,644 1 2,650 1 2,705 

161 20,000 131 20,750 124 20,750 

9 4,431 13 6,354 13 6,408 

4 1,949 1 1,252 2 1,216 

13 6,380 14 7,606 15 7,623 

 --- 620 --- 394 --- 377 

 --- --- --- --- --- ---

 --- 620 --- 394 --- 377 

13 7,000 14 8,000 15 8,000 

952 $504,616 961 $532,878 1,096 $726,527 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

No. Amount 

FY 2021 

Enacted 

No. Amount 

FY 2022 President's 

Budget 

No. Amount 

Assertive Community Treatment for Individuals with 

SMI 

Grants 

Continuations............................................................... 

New/Competing...........................................................

Subtotal..................................................................... 

Contracts 

Continuations...............................................................

New/Competing...........................................................

Subtotal.....................................................................

Total, Assertive Community Treatment for 

Assisted Outpatient Treatment for Individuals with 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Supplements*...............................................................

Subtotal.....................................................................

Contracts 

Continuations...............................................................

New/Competing...........................................................

Subtotal.....................................................................

Total, AOT for Individuals with SMI 

Tribal Behavioral Health Grants 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations............................................................... 

New/Competing...........................................................

Subtotal.....................................................................

Total, Tribal Behavioral Health Grants 

Infant and Early Childhood Mental Health 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations...............................................................

New/Competing...........................................................

Subtotal.....................................................................

Total, Infant and Early Childhood Mental Health 

Subtotal, Capacity 

106 
 

 

 

Science and Service: 

Primary and Behavioral Health Care Integration TA 

Grants 

Continuations............................................................... 

New/Competing...........................................................

Supplements*...............................................................

Subtotal..................................................................... 

Contracts 

Continuations............................................................... --- 102 --- 102 --- 102 

New/Competing...........................................................

Subtotal.....................................................................

Total, PBHCI TA 

 --- --- --- --- --- ---

 --- 102 --- 102 --- 102 

1 1,991 1 1,991 1 1,991 

Practice Improvement & Training 

Grants 

Continuations............................................................... 5 4,995 5 5,476 5 5,605 

New/Competing........................................................... --- 50 --- --- --- ---

Supplements*...............................................................

Subtotal..................................................................... 

 --- --- --- --- --- ---

5 5,045 5 5,476 5 5,605 

Contracts 

Continuations............................................................... 1 2,783 1 2,352 1 2,223 

New/Competing...........................................................

Subtotal..................................................................... 

Total, Practice Improvement & Training 

 --- --- --- --- --- ---

1 2,783 1 2,352 1 2,223 

6 7,828 6 7,828 6 7,828 

Consumer and Consumer-Supporter TA Centers 

Grants 

Continuations............................................................... --- --- 5 1,806 5 1,828 

New/Competing........................................................... 

Subtotal..................................................................... 

5 1,806 --- --- --- ---

5 1,806 5 1,806 5 1,828 

Contracts 

Continuations............................................................... --- 112 --- 112 --- 90 

New/Competing...........................................................

Subtotal.....................................................................

Total, CCSTAC 

 --- --- --- --- --- ---

 --- 112 --- 112 --- 90 

5 1,918 5 1,918 5 1,918 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

No. Amount 

FY 2021 

Enacted 

No. Amount 

FY 2022 President's 

Budget 

No. Amount 

1 1,889 1 1,889 1 1,889 

 --- --- --- --- --- ---

 --- --- --- --- --- ---

1 1,889 1 1,889 1 1,889 

107 
 

 

 

SAMHSA/Mental Health 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

No. Amount 

FY 2021 

Enacted 

No. Amount 

FY 2022 President's 

Budget 

No. Amount 

Disaster Response 

Grants 

Continuations............................................................... --- 828 --- --- --- 1,019 

New/Competing........................................................... ---

Subtotal..................................................................... ---

13 --- 1,038 --- ---

841 --- 1,038 --- 1,019 

Contracts 

Continuations............................................................... 

New/Competing...........................................................

Subtotal..................................................................... 

Total, Disaster Response 

Homelessness 

Grants 

Continuations...............................................................

New/Competing........................................................... 

Subtotal..................................................................... 

Contracts 

Continuations...............................................................

New/Competing...........................................................

Subtotal.....................................................................

Total, Homelessness 

Minority Fellowship Program 

Grants 

Continuations............................................................... 

New/Competing........................................................... 

Supplements*...............................................................

Subtotal..................................................................... 

Contracts 

Continuations............................................................... 

New/Competing...........................................................

Subtotal..................................................................... 

Total, Minority Fellowship Program 

Subtotal, Science and Service 

1 1,112 1 915 1 934 

 --- --- --- --- --- ---

1 1,112 1 915 1 934 

1 1,953 1 1,953 1 1,953 

 --- 1,416 1 2,138 1 2,188 

1 800 --- --- --- ---

1 2,215 1 2,138 1 2,188 

 --- 81 --- 158 --- 108 

 --- --- --- --- --- ---

 ---

1 

81

2,296 

 ---

1 

158

2,296 

 ---

1 

108 

2,296 

7 6,833 8 8,221 8 8,221 

1 1,388 --- --- 1 1,537 

 --- --- --- 952 --- ---

8 8,221 8 9,174 9 9,758 

1 838 1 885 1 905 

 --- --- --- --- --- ---

1 838 1 885 1 905 

9 9,059 9 10,059 10 10,663 

23 25,045 23 26,045 24 26,649 

Total, Mental Health PRNS 975 $529,661 984 $558,923 1,120 $753,176 

* Excluding Supplements number count to avoid duplication. 

108 
 

 

Grant Awards Table 

(Whole dollars)

 FY 2020 Final FY 2021 Enacted

 FY 2022 President's 

Budget 

Number of Awards 968 977 1113 

Average Awards $507,928 $531,099 $635,848 

Range of Awards $15,000 - $6,000,000 $15,000 - $6,000,000 $15,000 - $6,000,000 

109 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Children’s Mental Health Services 

(Dollars in thousands) 

FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Children's Mental Health Services............................................ $125,000 $125,000 $125,000 $---

Authorizing Legislation.......................................... Sections 561 of the Public Health Service Act 

FY 2022 Authorization............................................................................................ $119,026,000 

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 (SED) and their families to increase their access to evidence-based treatment and 

supports. 

The 21st Century Cures Act reauthorized the CMHI through FY 2022. It is estimated that 

approximately 9-13 percent of America’s youth have a 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, family-driven, 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 significantly decreased within 12 months after children and 

youth accessed CMHI-related SOC services. The proportion of children and youth who received 

good grades (defined as an average grade of C or better on the previous report card) significantly 

increased after 12 months of services, and arrest rates significantly decreased after 12 months of 

35 Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 

2016 National Survey on Drug Use and Health. 

110 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 youthserving 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 is in the final year of the national evaluation contract for the 2015 cohort, 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. 

The Annual Report to Congress for this program provides national data indicating that CMHI 

SOCs are successful and result in many favorable outcomes for children, youth, and their families, 

including the following: 

• Significant, overall improvement in mental, emotional, and behavioral functioning 

from intake to follow-up. 

o 12% decrease in total symptoms. 

o 12% decrease for externalizing symptoms. 

o 15% decrease for internalizing symptoms. 

o 11% decrease for attention problems. 

• Significant overall functional improvement from intake to follow-up: Impairment 

rate decreased from 21.9% to 18.2%, improvement by 3.7%. 

• Improvement in Overall Health: More children, youth, and young adults were healthy 

overall at follow-up (87.6%) compared to intake (81.5%), which represents a significant 

positive percent change of 7.46%. 

36 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 

(2016). The Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances 

Program, Report to Congress 2016. https://store.samhsa.gov/shin/content//PEP18-CMHI2016/PEP18-

CMHI2016.pdf. 

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• Improvement in Everyday Functioning: Children, youth, and young adults 

functioning in everyday life significantly improved at follow-up (67.6%) compared to 

intake (41.2%), which represents a positive change of 64.0%. 

• Improvement in Psychological Distress: More children, youth, and young adults 

reported no serious psychological distress at follow-up (89.1%) compared to intake 

(75.8%), which represents a positive change of 17.5%. 

• Improvement in Illegal Substance Use: More children, youth, and young adults 

reported that they were not using illegal substances at follow-up (78.8%) compared to 

intake (74.0%), which represents a positive change of 6.6%. 

• Improvement in Retention in Community: More children, youth, and young adults 

were retained in the community at follow-up (92.0%) compared to intake (85.3%), which 

represents a 10.4%. 

• Improvement in Education/Employment: More children, youth, and young adults were 

attending school regularly or were currently employed at follow-up (90.4%) compared to 

intake (83.3%), which represents an 8.5% improvement. 

• Improvement in Social Connectedness: More children, youth, and young adults 

reported being more socially connected at follow-up (89.2%) compared to intake 

(76.1%), which represents a significant positive percent change of 17.3%. 

In FY 2019, SAMHSA supported 49 continuation grants, 28 new grants, and 2 contracts. In FY 

2020, SAMHSA supported 44 continuation grants, 30 new grants, and a new technical assistance 

center. In FY 2021, SAMHSA will support 63 continuation grants, and award a new cohort of 10 

new grants, and a technical assistance center. 

Set-aside for Early Intervention Demonstration Program for Youth and Young Adults at Clinical 

High Risk for Psychosis 

In FY 2018, SAMHSA implemented the Community Programs for Outreach with Youth and 

Young Adults at Clinical High Risk for Psychosis (CHR-P) often referred to as the “prodrome 

phase;” which is when a disease process has begun but is not yet diagnosable or inevitable. 

SAMHSA awarded 21 grants funded from a 10 percent set-aside of the base CMHI program . The 

program addresses if community-based intervention during this phase can prevent the development 

of psychosis. Grantees focus on youth and young adults who are identified to be at clinical high 

risk for developing a fist episode of psychosis. Grantees 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. 

112 
 

 

 

 

Fiscal Year Amount 

FY 2018 $125,000,000 

FY 2019 $125,000,000 

FY 2020 $125,000,000 

FY 2021 Enacted $125,000,000 

FY 2022 Budget Request $125,000,000 

 

 

 

 

 

 

In FY 2019, SAMHSA funded 21 continuation grants funded from the 10 percent set-aside. In FY 

2020, SAMHSA funded 21 continuation grants. In FY 2021, SAMHSA will support 21 

continuation grants and award a new cohort of 10 grants. 

Funding History 

Budget Request 

The FY 2022 budget request is $125.0 million, level with the FY 2021 Enacted. The budget 

requests will support the continuations of 10 Clinical High Risk for psychosis (CHR-P) grants 

and fund a new cohort of 20 grants under the 10 percent set-aside. In addition, funding will 

support 67 CMHI continuation grants, a new cohort of eight CMHI grants, and a technical 

assistance center. 

113 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Children’s Mental Health Initiative Measure 

Measure Year and Most Recent Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

3.2.16 Number of children with severe 

emotional disturbance that are receiving 

services from the Children's Mental Health 

Initiative (Output) 

FY 2020: 11,332 

Target: 

12,690 

(Target Not Met) 

11,300 11,300 Maintain 

3.2.25 Percentage of children receiving 

services who report positive social support 

at 6 month follow-up (Outcome) 

FY 2020: 77.8 % 

Target: 

87.1 % 

(Target Not Met) 

77.0 % 77.0 % Maintain 

3.2.26 Percentage of children receiving 

Systems of Care mental health services who 

report positive functioning at 6 month 

follow-up (Outcome) 

FY 2020: 63.0 % 

Target: 

63.4 % 

(Target Not Met) 

63.4 % 63.4 % Maintain 

3.2.27 Number of people in the mental 

health and related workforce trained in 

specific mental health-related 

practices/activities as a result of the 

program (Output) 

FY 2020: 54,578 

Target: 

75,624 

(Target Not Met) 

54,500 54,500 Maintain 

114 
 

 

 

 

Contracts 

Continuations..................................................................... --- 6,579 --- 6,230 --- 5,960 

New/Competing.................................................................

Subtotal...........................................................................

Total, Children's Mental Health Services 

 --- --- --- --- --- ---

 --- 6,579 --- 6,230 --- 5,960 

96 $125,000 105 $125,000 106 $125,000 

Program Activity 

FY 2020 Final 

No. Amount No. 

FY 2021 

Enacted 

Amount 

FY 2022 

President's 

Budget 

No. Amount 

Children's Mental Health Services 

Grants/Cooperative Agreements 

Continuations..................................................................... 65 $74,925 85 $98,966 78 $100,893 

New/Competing................................................................. 

Subtotal........................................................................... 

31 43,496 20 19,804 28 18,147 

96 118,421 105 118,770 106 119,040 

SAMHSA/Mental Health 

Children’s Mental Health Services 

Mechanism Table 

(Dollars in thousands) 

115 
 

 

 FY 2022 President's 

 FY 2020 Final FY 2021 Enacted Budget 

Number of Awards 96 105 106 

Average Awards $1,233,547 $1,131,140 $1,123,016 

Range of Awards $330,000 - $2,000,000 $330,000 - $2,000,000 $330,000 - $2,000,000 

Grant Awards Table 

(Whole dollars)

116 
117 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Projects for Assistance in Transition from Homelessness 

(Dollars in thousands) 

FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

PATH........................................................................................ $64,635 $64,635 $64,635 $ 

Authorizing Legislation....................................... Section 535(a) of the Public Health Service Act 

FY 2022 Authorization.............................................................................................. $64,635,000 

Allocation Method ............................................................................................... Formula Grants 

Eligible Entities............................................................................................States and Territories 

Program Description and Accomplishments 

The Projects for Assistance in Transition from Homelessness (PATH) program was originally 

authorized by the Stewart B. McKinney Homeless Assistance Amendments Act of 1990 and has 

been reauthorized as part of the Public Health Service Act. The PATH program supports 56 grants 

to the 50 states, the District of Columbia, Puerto Rico, Guam, American Samoa, the United States 

Virgin Islands, and the Northern Mariana Islands, as well as centralized activities such as technical 

assistance and evaluation. 

PATH was reauthorized by the 21st Century Cures Act in December 2016. PATH funds 

community-based outreach, mental illness and substance use disorder treatment services, case 

management, assistance with accessing housing, and other supportive services. PATH helps to 

engage people with SMI into mental disorder treatment as well as persons with SMI with a cooccurring substance use disorder. PATH outreach workers are specialized in engaging those who 

are most vulnerable in their communities and who are least likely to seek out services on their own. 

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 2020, an estimated 580,466 individuals experienced homelessness on an average night, an 

increase of 2.2 percent, from 201937 The U.S. Department of Housing and Urban Development 

(HUD) defines a person as homeless if he or she “lacks a fixed, regular, and adequate nighttime 

residence”. On a single night each year, communities count and report their homeless population 

to HUD, including people who are unsheltered (in places not intended for human habitation such 

as sidewalks, parks, cars, or abandoned buildings) and people who are sheltered (in emergency 

shelters or transitional programs). 38 Data suggest that approximately 20 percent of individuals 

experiencing homelessness have a serious mental illness (SMI).

39 Mental illness affects 

37 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2020). The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files/pdf2020-AHAR-Part-1.pdf 

38 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2020). The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files/pdf/2020-AHAR-Part-1.pdf 

39 The U.S. Department of Housing and Urban Development, 2020 CoC Homeless Populations and Subpopulations 

Reports. Available at 

https://www.hudexchange.info/resource/reportmanagement/published/CoC_PopSub_NatlTerrDC_2020.pdf 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

individuals’ abilities to maintain stable relationships, perform daily living activities, and maintain 

stable employment. Symptoms of mental disorders also often cause individuals to become 

estranged from family members and caregivers, leaving them without a support system. As a 

result, individuals with a mental illness are more likely to experience homelessness than those 

without mental illness and experience homelessness longer than the rest of the homeless 

population. 

PATH program’s efforts to identify primary care, behavioral disorder treatment, and housing for 

individuals who experience chronic homelessness 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). 

Government wide efforts to target the most vulnerable, including people experiencing chronic 

homelessness and veterans, may have served to reduce the number of people on the streets. In 

2010, 106,107 of the people identified in the Point in Time (PIT) survey administered annually by 

HUD were experiencing chronic homelessness. By 2016, the number of people experiencing 

chronic homelessness was at its lowest, at 77,486. The following year, 2017, the number of 

individuals with chronic patterns of homelessness increased to 86.705. In 2018, the number 

increased to 88,640 followed by another increase in to 96,141 in 2019. This year is the first time 

since 2011 that the number of people with chronic patterns of homelessness exceeded 100,000. 

The number of people experiencing chronic homelessness in 2020 increased to 110,528, 

approximately 15 percent from 2019. The recent increase was driven by a considerable increase in 

the number of sheltered individuals with chronic patterns of homelessness. 40 

Veterans were first tracked in the 2011 Continuum of Care Homeless Assistance Programs report 

on homeless populations and subpopulations. That year, 65,455 veterans were identified during 

the PIT. By 2020, that number had dropped to 37,253 or by 57 percent. This may be attributed to 

the additional resources created at the federal level to address veteran homelessness. 

In FY 2020, PATH program staff contacted 116,109 persons experiencing homelessness; of those 

60,455 were actively enrolled in PATH at some point during the reporting period. 

40 The U.S. Department of Housing and Urban Development, Office of Community Planning and Development. 

(2020). The 2020 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Available 

at: https://www.huduser.gov/portal/sites/default/files/pdf/2020-AHAR-Part-1.pdf 

118 
 

 

 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $64,635,000 

FY 2019 $64,635,000 

FY 2020 $64,635,000 

FY 2021 Enacted $64,635,000 

FY 2022 Budget Request $64,635,000 

 

 

 

 

 

 

 

 

 

 

Of the 66,458 people who were actively enrolled in PATH in 2019, 26,963 were experiencing cooccurring drug/alcohol use disorders. Of those enrolled in PATH, 29,186 were receiving 

community mental health services, 6,793 received substance use disorder treatment and 8,847 

received referrals to substance use disorder treatment services in the community. PATH provided 

housing/moving assistance to 2,311 individuals, housing eligibility determination services to 

14,988 individuals, and one-time rent eviction support services to 1,258 individuals. In addition, 

17,234 PATH clients were referred to permanent housing and of those, 7,581 were able to attain 

permanent housing. Of the 12,597 PATH clients who were referred to temporary housing, 8,094 

attained the temporary housing. Services provided by the PATH program fill gaps in existing 

community resources and play a crucial role in communities’ strategic plans to end homelessness. 

Funding History 

Budget Request 

The FY 2022 budget request is $64.6 million, level with the FY 2021 Enacted. This formula-based 

funding to all fifty states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. 

Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands 

will continue to provide PATH services in over 500 communities to support outreach workers and 

mental health specialists who engage with individuals living with SMI or those living with both 

SMI and drug/alcohol addiction and are homeless or at imminent risk of becoming homeless. 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. 

119 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Projects for Assistance in Transition from Homelessness 

Measure 

Year and Most Recent Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 

2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.15 Percentage of enrolled homeless 

persons in the Projects for Assistance in 

Transition from Homelessness (PATH) 

program who receive community mental 

health services (Intermediate Outcome) 

FY 2020: 65 % 

Target: 

64 % 

(Target Exceeded) 

64 % 64 % Maintain 

3.4.16 Number of homeless persons 

contacted (Outcome) 

FY 2020: 127,256 

Target: 

125,000 

(Target Exceeded) 

125,000 125,000 Maintain 

3.4.17 Percentage of contacted homeless 

persons with serious mental illness who 

become enrolled in services (Outcome) 

FY 2020: 57 % 

Target: 

57 % 

(Target Met) 

57 % 57 % Maintain 

3.4.20 Number of Projects for Assistance 

in Transition from Homelessness (PATH) 

providers trained on SSI/SSDI Outreach, 

Access, Recovery (SOAR) to ensure 

eligible homeless clients are receiving 

benefits (Output) 

FY 2020: 2,647 

Target: 

2,214 

(Target Exceeded) 

2,647 2,647 Maintain 

120 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

FY 2022 PATH Formula Grant Estimate Allotments 

Appropriation Amount $64,635,000, State-Territory Total $61,597,847 

CFDA # 93.150 

State or Territory FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

FY 2022 +/-

FY 2021 

Alabama $613,087 $613,059 $613,059 $ -

Alaska 300,000 300,000 300,000 -

Arizona 1,349,348 1,349,288 1,349,288 -

Arkansas 303,956 303,942 303,942 -

California 8,813,505 8,813,107 8,813,107 -

Colorado 1,019,165 1,019,120 1,019,120 -

Connecticut 799,408 799,372 799,372 -

Delaware 300,000 300,000 300,000 -

District of Columbia 300,000 300,000 300,000 -

Florida 4,334,533 4,334,339 4,334,339 -

Georgia 1,670,086 1,670,011 1,670,011 -

Hawaii 300,000 300,000 300,000 -

Idaho 300,000 300,000 300,000 -

Illinois 2,705,316 2,705,195 2,705,195 -

Indiana 1,011,549 1,011,504 1,011,504 -

Iowa 334,573 334,559 334,559 -

Kansas 377,407 377,391 377,391 -

Kentucky 468,924 468,904 468,904 -

Louisiana 733,078 733,046 733,046 -

Maine 300,000 300,000 300,000 -

Maryland 1,271,592 1,271,535 1,271,535 -

Massachusetts 1,558,935 1,558,865 1,558,865 -

Michigan 1,729,644 1,729,567 1,729,567 -

Minnesota 811,023 810,987 810,987 -

Mississippi 300,000 300,000 300,000 -

Missouri 893,819 893,779 893,779 -

Montana 300,000 300,000 300,000 -

Nebraska 300,000 300,000 300,000 -

Nevada 615,965 615,938 615,938 -

New Hampshire 300,000 300,000 300,000 -

121 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

FY 2022 PATH Formula Grant Estimate Allotments 

Appropriation Amount $64,635,000, State-Territory Total $61,597,847 

CFDA # 93.150 

State or Territory FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

FY 2022 +/-

FY 2021 

New Jersey 2,138,248 2,138,153 2,138,153 -

New Mexico 300,000 300,000 300,000 -

New York 4,233,324 4,223,135 4,223,135 -

North Carolina 1,379,673 1,379,612 1,379,612 -

North Dakota 300,000 300,000 300,000 -

Ohio 1,986,586 1,986,497 1,986,497 -

Oklahoma 452,853 452,833 452,833 -

Oregon 631,039 631,011 631,011 -

Pennsylvania 2,367,006 2,366,900 2,366,900 -

Rhode Island 300,000 300,000 300,000 -

South Carolina 680,251 680,221 680,221 -

South Dakota 300,000 300,000 300,000 -

Tennessee 909,811 909,771 909,771 -

Texas 4,995,795 4,995,571 4,995,571 -

Utah 591,503 591,476 591,476 -

Vermont 300,000 300,000 300,000 -

Virginia 1,472,281 1,472,215 1,472,215 -

Washington 1,329,229 1,329,170 1,329,170 -

West Virginia 300,000 300,000 300,000 -

Wisconsin 836,690 836,653 836,653 -

Wyoming 300,000 300,000 300,000 -

Puerto Rico 891,161 891,121 891,121 -

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 -

122 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Protection and Advocacy for Individuals with Mental Illness (PAIMI) 

(Dollars in thousands) 

FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

PAIMI........................................................................................ $36,146 $36,146 $36,146 $ 

Authorizing Legislation........................................ The PAIMI Act, 42 U.S.C. 10801 et seq. 

FY 2022 Authorization.............................................................................................. $19,500,000 

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 significant mental illness and significant emotional 

impairment , especially those residing in public and private residential care and treatment facilities, 

are free from abuse, including inappropriate restraint and seclusion, neglect, and rights violations 

while receiving appropriate mental disorder treatment and discharge planning services. 

The Protection and Advocacy for Individuals with Mental Illness Act of 1986, as amended by the 

Children’s Health Act of 2000, extended the protections of the Developmental Disabilities (DD) 

Assistance Act of 1975 to individuals with significant mental illness (adults) and significant 

emotional impairments (children/youth) at risk for abuse, neglect, and rights violations while 

residing in public or private care treatment facilities; or living in a community setting, including 

their own homes. The PAIMI Act authorized the same governor-designated state protection and 

advocacy (P&A) systems established under the DD Assistance Act of 1975 to receive PAIMI 

Program formula grant awards from SAMHSA. 

The PAIMI Program supports legal-based advocacy services that are provided by the 57 governordesignated P&A systems, which include states, territories, and the District of Columbia. Each 

system is mandated to: (1) ensure that the rights of individuals with mental illness who are at risk 

of abuse, neglect, and rights violations while residing in public or private care or treatment 

facilities or living in a community setting are protected;(2) protect and advocate for the rights of 

these individuals through activities that ensure the enforcement of the Constitution and federal and 

state statutes; and (3) investigate incidents of abuse and/or neglect of individuals with mental 

illness. The priority for services are for individuals who are an in-patient or resident of public or 

private care and treatment facilities for individuals with mental illness. 

In FY 2020, the 57 state PAIMI Programs: 

• Served 9,821 PAIMI-eligible individuals/clients: 345 ages 0 to 10, 1,821 ages 11 to 22, 

6,866 age 23-64, 659 age 65 and older, and 130 individuals whose age is unknown. 

Grantees helped these individuals file 7,688 complaints alleging abuse, neglect, and/or 

rights violations. 

123 
 

 

 

 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $36,146,000 

FY 2019 $36,146,000 

FY 2020 $36,146,000 

FY 2021 Enacted $36,146,000 

FY 2022 Budget Request $36,146,000 

 

 

 

 

 

• Resolved 94 percent of abuse allegations, 91 percent of neglect allegations, and 95 

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 2020, SAMHSA funded 57 annual grants to states and territories as well as the training and 

technical assistance activities for the grantees. In FY 2021, SAMHSA anticipates the same funding 

at the same level as FY 2020 for 57 annual grants. 

Funding History 

Budget Request 

The FY 2022 budget request is $36.1 million, level with the FY 2021 Enacted. PAIMI programs 

will continue to focus on addressing abuse and neglect issues for vulnerable populations and 

advocate for the rights of individuals with mental illness as well as continue to assist individuals 

with serious mental illness increase access to treatment. 

124 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Protection and Advocacy for Individuals with Mental Illness 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 

2021 

Target 

3.4.12 Number of people served by the PAIMI 

program (Outcome) 

FY 2020: 9,821 

Target: 

10,450 

(Target Not Met) 

9,821 9,821 Maintain 

3.4.19 Number attending public 

education/constituency training and public 

awareness activities (Output) 

FY 2020: 267,308 

Target: 

100,000 

(Target Exceeded) 

267,308 267,308 Maintain 

3.4.21 Percentage of complaints of alleged 

abuse, neglect, and rights violations 

substantiated and not withdrawn by the client 

that resulted in positive change through the 

restoration of client rights, expansion or 

maintenance of personal decision-making, 

elimination of other barriers to personal 

decision-making, as a result of Protection and 

Advocacy for Individuals with Mental Illness 

(PAIMI) involvement (Outcome) 

FY 2020: 93 % 

Target: 

89 % 

(Target Exceeded) 

93 % 93 % Maintain 

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Substance Abuse and Mental Health Services Administration 

FY 2022 PAIMI Formula Grant Estimate Allotments 

Appropriation $36,146,000, State-Territory Total $35,333,102 

CFDA # 93.138 

State or Territory FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

FY 2022 +/-

FY 2021 

Alabama $454,402 $458,033 $458,033 $ -

Alaska 428,000 428,000 428,000 -

Arizona 641,505 654,516 654,516 -

Arkansas 428,000 428,000 428,000 -

California 3,043,159 3,019,439 3,019,439 -

Colorado 450,031 451,860 451,860 -

Connecticut 428,000 428,000 428,000 -

Delaware 428,000 428,000 428,000 -

District of Columbia 428,000 428,000 428,000 -

Florida 1,801,228 1,823,324 1,823,324 -

Georgia 931,818 936,003 936,003 -

Hawaii 428,000 428,000 428,000 -

Idaho 428,000 428,000 428,000 -

Illinois 1,031,488 1,024,388 1,024,388 -

Indiana 588,634 590,974 590,974 -

Iowa 428,000 428,000 428,000 -

Kansas 428,000 428,000 428,000 -

Kentucky 428,000 428,000 428,000 -

Louisiana 428,000 428,000 428,000 -

Maine 428,000 428,000 428,000 -

Maryland 462,191 461,915 461,915 -

Massachusetts 500,628 499,913 499,913 -

Michigan 869,127 870,556 870,556 -

Minnesota 448,703 448,602 448,602 -

Mississippi 428,000 428,000 428,000 -

Missouri 540,864 537,485 537,485 -

Montana 428,000 428,000 428,000 -

Nebraska 428,000 428,000 428,000 -

Nevada 428,000 428,000 428,000 -

New Hampshire 428,000 428,000 428,000 -

126 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

FY 2022 PAIMI Formula Grant Estimate Allotments 

Appropriation $36,146,000, State-Territory Total $35,333,102 

CFDA # 93.138 

State or Territory FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

FY 2022 +/-

FY 2021 

New Jersey 670,077 658,968 658,968 -

New Mexico 428,000 428,000 428,000 -

New York 1,476,892 1,441,606 1,441,606 -

North Carolina 917,038 927,784 927,784 -

North Dakota 428,000 428,000 428,000 -

Ohio 1,011,130 1,014,623 1,014,623 -

Oklahoma 428,000 428,000 428,000 -

Oregon 428,000 428,000 428,000 -

Pennsylvania 1,040,125 1,035,077 1,035,077 -

Rhode Island 428,000 428,000 428,000 -

South Carolina 463,238 467,601 467,601 -

South Dakota 428,000 428,000 428,000 -

Tennessee 590,472 599,542 599,542 -

Texas 2,437,992 2,449,916 2,449,916 -

Utah 428,000 428,000 428,000 -

Vermont 428,000 428,000 428,000 -

Virginia 677,110 679,379 679,379 -

Washington 578,507 581,605 581,605 -

West Virginia 428,000 428,000 428,000 -

Wisconsin 490,949 490,174 490,174 -

Wyoming 428,000 428,000 428,000 -

Puerto Rico 512,416 507,319 507,319 -

American Samoa 229,300 229,300 229,300 -

Guam 229,300 229,300 229,300 -

American Indian Consortium 229,300 229,300 229,300 -

Northern Mariana Islands 229,300 229,300 229,300 -

Virgin Islands 229,300 229,300 229,300 -

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Certified Community Behavioral Health Clinic (CCBHC) 

(Dollars in thousands) 

FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Certified Community Behavioral Health Clinic...................... $200,000 $250,000 $375,000 $125,000 

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

FY 2022 Authorization............................................................................................ $150,000,000 

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

Eligible Entities.......................................Certified Community Behavioral Health Clinics, 

Community-based Behavioral Health Clinics 

Program Description and Accomplishments 

It is estimated that more than 13 million adults 18 and older had a serious mental illness (SMI), 

more than 17 million adults misused prescription drugs, and about 19 million adults had an illicit 

drug or alcohol use disorder in the past year.41 While effective treatment and supportive services 

exist, many individuals with behavioral health conditions do not receive the help they need. When 

they do try to access services, they may face significant delays and/or get connected to incomplete, 

disconnected, or uncoordinated care. Even people who receive some services, such as medication 

or talk therapy, often do not have access to the complete range of supports they need, such as help 

to get them through a crisis, manage co-occurring physical health problems, find and sustain 

employment, and maintain a safe place to live in the community. 

Congress created a new approach to addressing these issues through Certified Community 

Behavioral Health Clinics (CCBHCs) as a part of the Protecting Access to Medicare Act of 2014. 

CCBHC’s ensure access to and coordination of care so that individuals receive timely diagnosis, 

treatment, and recovery support services. Through this program, HHS has established criteria for 

clinics to be certified as CCBHCs. These criteria cover six administrative areas that CCBHCs 

must address to be certified: (1) staffing; (2) availability and accessibility of services; (3) care 

coordination; (4) scope of services; (5) quality and other reporting; and (6) organizational 

authority. In FY 2016, SAMHSA assisted 24 states through planning grants to be eligible for a 

CCBHC demonstration, and in FY 2017, CMS launched the demonstration program, which 

supported CCBHCs in eight states through a Medicaid prospective payment system. 

The CCBHC-Expansion (CCBHC-E) program is designed to increase access to and improve the 

quality of community behavioral health services. CCBHC’s funded under this program must 

provide access to services for individuals with serious mental illness (SMI) or substance use 

disorders (SUD, including opioid disorders; children and adolescents with serious emotional 

disturbance (SED); and individuals with co-occurring mental and substance use disorders (COD). 

Crisis services are a required element of the CCBHC model. SAMHSA expects that this program 

will improve the behavioral health of individuals across the nation by providing increased access 

to a good range of services. These include comprehensive community-based mental and substance 

41 SAMHSA, Center for Behavioral Health Statistics and Quality. (2017, September 7). Results 

from the 2016 National Survey on Drug Use and Health: Detailed tables. Retrieved from 

https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf 

128 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

use disorder services; treatment of co-occurring disorders; advancing the integration of behavioral 

health with physical health care; assimilating and utilizing evidence-based practices on a more 

consistent basis and promoting improved access to high quality care. Broad uptake of the CCBHC 

model solves a number of access and quality problems that exist in our current national landscape 

of services for persons with SMI and SED. 

In FY 2018, SAMHSA implemented the CCBHC Expansion (CCBHC-E) grant program and 

awarded 52 grants to create new CCBHC expansions. In FY 2019, 12 new CCBHC-E grants were 

awarded, and eligibility was limited to the 24 states that participated in the FY 2016 Planning 

Grants for Certified Community Behavioral Health Clinics Grant program. In FY 2020, an 

additional 102 CCBHC-E grants were awarded by CMHS, but eligibility was not limited to the 24 

FY 2016 planning states. An additional 64 CCBHC-E grants were funded by CARES Act funding 

appropriated through the Health Surveillance and Program Support COVID-19. In addition, 

SAMHSA will award a new cohort through the Coronavirus Response and Relief Supplemental 

Appropriations Act, 2021 and the American Rescue Plan Act. 

. 

The table below provides a demographic breakdown of the clients served by the CCBHCs. 

Demographics % 

Race 

American Indian 4.4% 

Asian 1.4% 

Black 26.3% 

Native Hawaiian/ Alaska Native 1.0% 

White 75.0% 

Ethnicity 

Hispanic 13.4% 

Non-Hispanic 86.6% 

Gender 

Male 47.0% 

Female 52.3% 

Transgender 0.4% 

Other 0.3% 

Age 

17 and under 22.0% 

18 through 25 12.9% 

26 through 45 37.4% 

46 through 65 26.1% 

66 and older 2.8% 

The table below includes the amount of CCBHC-E funding awarded to community behavioral 

health clinics in each state for the grants initially awarded in FY 2018 and FY 2019, the grants 

awarded through the FY 2020 Budget, and FY 2020 CARES Act funding. The total awards 

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also include CARES Act funding that was appropriated to Health Surveillance and Program 

Support. 

States FY 2018 and FY 2019 Total 

Award 

FY 2020 Budget 

Award 

FY 2020 CARES Act 

Award 

Alaska - 2,000,000.00 4,000,000.00 

Arkansas - 3,784,113.00 4,000,000.00 

California - 5,995,620.00 8,000,000.00 

Colorado 4,000,000.00 2,000,000.00 4,000,000.00 

Connecticut 3,816,087.00 8,000,000.00 11,663,642.00 

Florida - 5,983,150.00 -

Georgia - 2,000,000.00 -

Illinois 4,000,000.00 4,000,000.00 12,000,000.00 

Indiana 7,487,309.00 5,754,223.00 11,049,390.00 

Iowa 5,995,754.00 9,842,453.00 7,992,877.00 

Kansas - 1,999,817.00 -

Kentucky 8,000,000.00 8,000,000.00 4,000,000.00 

Maryland 7,369,546.00 2,000,000.00 -

Massachusetts 13,815,812.00 19,836,454.00 11,907,664.00 

Michigan 30,810,057.00 19,582,567.00 38,530,722.00 

Minnesota 6,698,384.00 3,947,094.00 -

Missouri 10,705,359.00 5,986,083.00 7,849,834.00 

Nebraska - 3,999,607.00 -

Nevada 4,000,000.00 - -

New Jersey 21,659,768.00 11,675,742.00 14,343,311.00 

New York 25,175,329.00 37,035,028.00 54,609,663.00 

North Carolina 3,122,602.00 4,886,998.00 3,957,711.00 

Ohio - 2,000,000.00 4,000,000.00 

Oklahoma 14,974,106.00 5,822,801.00 8,000,000.00 

Oregon 6,861,840.00 3,340,879.00 4,000,000.00 

Pennsylvania 8,212,845.00 8,101,055.00 3,996,953.00 

Rhode Island 2,000,000.00 3,695,402.00 4,000,000.00 

Tennessee - - 8,000,000.00 

Texas 21,830,701.00 14,578,015.00 11,784,318.00 

Virginia 5,724,687.00 4,000,000.00 3,971,825.00 

Washington - 5,991,182.00 -

West Virginia - 3,999,871.00 -

Wisconsin - - 4,000,000.00 

Total 216,260,186.00 219,838,154.00 249,657,910.00 

Since its inception, CCBHC-E grantees have served over 54,000 individuals. CCBHC-E grantees 

have increased the availability of critical services, improved staffing and training, reduced wait 

times, enhanced the integration of physical and behavioral health care, expanded addiction 

treatment capacity including Medication Assisted Treatment (MAT) for opioid use disorder. 

CCBHC-E grantees have improved the use of data, improved services to veterans and service 

members, and provided increased outreach and engagement with a variety of vulnerable 

populations. 

130 
 

 

 

 

 

 

Fiscal Year Amount 

FY 2018 $100,000,000 

FY 2019 $150,000,000 

FY 2020 $200,000,000 

FY 2021 Enacted $250,000,000 

FY 2022 Budget Request $375,000,000 

 

 

 

 

In FY 2020, SAMHSA awarded a new cohort of 102 grants. SAMHSA also awarded 64 grants 

through the CARES Act. In FY 2021, SAMHSA will support 102 grant continuations, 22 new 

grants, and a Training and Technical Assistance Center. In addition, SAMHSA will award a new 

cohort through the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 and 

the American Rescue Plan Act. 

Funding History 

Budget Request 

The FY 2022 budget request is $375.0 million, an increase of $125.0 million from the FY 2021 

Enacted level to fund a new cohort of 158 grants and 22 continuation grants to continue the 

improvement of mental disorder treatment, services, and interventions for children and adults. 

131 
 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Certified Community Behavioral Health Clinic 

Measure Year and Most Recent Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.10 Percentage of clients receiving 

services who report positive functioning at 

6 months follow-up. (Outcome) 

FY 2020: 56.1 

Target: 

58.9 

(Target Not Met) 

56.0 56.0 Maintain 

3.4.11 Percentage of clients receiving 

services who are currently employed at 6 

month follow-up. (Outcome) 

FY 2019: 36.0 

Target: 

39.0 

(Target Not Met) 

36.0 36.0 Maintain 

3.4.12 Percentage of clients receiving 

services who have a permanent place to live 

in the community at 6 month follow-up. 

(Outcome) 

FY 2020: 64.9 

Target: 

60.6 

(Target Exceeded) 

60.6 60.6 Maintain 

3.5.10 Number of individuals served by the 

program (Output) 

FY 2020: 76,587.0 

Target: 

31,969.0 

(Target Exceeded) 

76,000.0 85,000.0 +9,000 

132 
 

 

 

 

SAMHSA/Mental Health 

Certified Community Behavioral Health Clinics 

Mechanism Table 

(Dollars in thousands) 

Program Activity 

FY 2020 Final 

No. Amount 

FY 2021 

Enacted 

No. Amount 

FY 2022 

President's 

Budget 

No. Amount 

Certified Community Behavioral Health Clinics 

Grants/Cooperative Agreements 

Continuations..................................................................... 

New/Competing................................................................. 

12 $23,023 

102 196,815 

102 $195,709 

23 44,172 

23 $46,586 

157 313,789 

Subtotal........................................................................... 114 219,838 125 239,881 180 360,375 

Contracts 

Continuations..................................................................... 

New/Competing.................................................................

 --- 6,751

 --- ---

 --- 7,706

 --- 3,000

 --- 14,625 

 --- ---

Subtotal........................................................................... --- 6,751 --- 10,706 --- 14,625 

Total, Certified Community Behavioral Health Clinics 114 $226,589 125 $250,587 180 $375,000 

Enacted $200,000 $250,000 

FY 2018 Carryover $1,048 

FY 2019 Carryover $25,541 

FY 2020 Carryover $587 

133 
 

 

Grant Awards Table 

(Whole dollars)

 FY 2020 Final FY 2021 Enacted

 FY 2022 President's 

Budget 

Number of Awards 114 125 180 

Average Awards $1,928,405 $1,919,047 $2,003,255 

Range of Awards $886,998-$2,000,000 $886,998-$2,000,000 $1,000,000-$2,000,000 

134 
135 

 

 

 701,532 736,532 1,561,532 825,000 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Community Mental Health Services Block Grant (MHBG) 

(Dollars in thousands) 

FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

$825,000 

Budget Authority (non-add)............................................. 

Community Mental Health Services Block Grant.................... $722,571 $757,571 $1,582,571 

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

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

FY 2022 Authorization ............................................................................................$532,571,000 

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 2019 National Survey on Drug Use and Health (NSDUH)42, 5.2% of adults aged 18 and older had a 

serious mental illness in 2019 (an estimated 11,131,000 individuals) and only 6,200,000 adults with SMI 

received services (47.7% received services in 2019). 

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.43 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 persons with 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 experience homelessness, those in rural and frontier areas, military 

families, and veterans). Through the administration of the MHBG, SAMHSA supports the 

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 more than eight million individuals with mental 

and substance use conditions in any given year. The MHBG’s flexibility and stability have made it a 

vital support for public mental health systems. States rely on the MHBG for delivery of services and for 

42 Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in 

the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01, 

NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental 

Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 43 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 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

an array of non-clinical coordination and support services that are not supported by Medicaid or other 

third-party insurance to strengthen their service. 

The MHBG statute provides for a five percent administrative set-aside that allows SAMHSA to assist the 

states and territories in the development of their mental health systems through the support of technical 

assistance, data collection, and evaluation activities. States also use block grant funds, with other funding 

sources, to support training for staff and implementation of evidence-based practices and other promising 

practices for the treatment of mental disorders, improved business practices, use of health information 

technology, and integration of physical and behavioral health services. 

SAMHSA’s MHBG and Substance 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 plan, 

and provide information regarding their efforts to respond to various changes in federal and state law.44,45 

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 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. 

44 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). 45 State Plan (Sec. 1932 (b) of Title XIX, Part B, Subpart II of the Public Health Service (PHS) Act (42 USC § 300x-32(b)). 

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According to the 2020 National Outcome Measures (NOMS) Report, the MHBG served 8,131,606 clients 

through the State Mental Health Systems. The table below provides 2019 demographics on the clients 

served. 

Mental Health Block Grant Demographics 

Adults 5,841,784 

Children 2,289,822 

Female 52.9% 

Male 47.1% 

Age 

0-12 16% 

13-17 12.2% 

18-20 4.7% 

20-24 5.7% 

25-44 31.4% 

45-64 24.5% 

65-74 3.7% 

75+ 1.6% 

The table below provides data on the FY 2020 evidence-based treatment services utilized by clients 

served by the MHBG. 

Evidence-based Treatment Services Utilized 

Adults 

Supported Housing 2.3% 

Supported Employment 1.9% 

Assertive Community Treatment 1.8% 

Family Psychoeducation 3.1% 

Dual Diagnosis Treatment 9.5% 

Illness Self-Management 19.1% 

Medications Management 31.3% 

Children 

Therapeutic Foster Care 1.7% 

Multi-systemic Therapy 4.1% 

Functional Family Therapy 5.8% 

Most block grant recipients are currently reporting on 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 2019 show that: 

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• For the 57 states and territories that reported data in the Employment Domain, 21.7 percent of 

the mental health consumers were in competitive employment; 

• For the 56 states and territories that reported data in the Housing Domain, 92 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 24.81people per 1,000 

population; 

• For the 50 states and territories that reported data in the Retention Domain, only 7.8 percent of 

the patients returned to a state psychiatric hospital within 30 days of state hospital discharge; 

and 

• For the 52 states and territories that reported data in the Perception of Care Domain, 75.4 

percent of adult mental health consumers improved functioning as a direct result of the mental 

health services they received. 

Beginning in September 2016, SAMHSA, in partnership with National Institute of Mental Health 

(NIMH) and the Office of the Assistant Secretary for Planning and Evaluation (ASPE), initiated a 3-year 

evaluation study of the First Episode Psychosis programs funded through the MHBG set-aside to 

ascertain the effectiveness of these programs. The study, which focused on services in 36 diverse 

programs, collected clinical outcome data and conducted fidelity assessments. The results indicate that 

these evidence based programs lead to statistically significant improvements in the health and well-being 

of individuals who participate in them, including reductions in hospitalization (-79%) and emergency 

room visits (-71%), criminal justice involvement (-41%), suicide attempts (-66%), and reductions in 

homelessness (-35%). 

Mental Disorders Prevalence Data Collection, Analysis, and Dissemination 

Section 505 of the Public Health Service Act (42 U.S.C. 290aa-4) requires SAMHSA, on an annual basis, 

to collect data on the prevalence of substance use and mental illness. To accomplish this, SAMHSA 

awarded a contract in FY 2018 to design a multi-component project that would provide local level 

psychiatric epidemiology information on incidence and prevalence of select mental disorders, substance 

use disorders, and services received for those disorders. 

In FY 2019, SAMHSA awarded a new contract to pilot the Mental Disorders Prevalence Survey 

(MDPS) design and methodology on a small scale using ten catchment areas that are a mix of rural and 

urban areas with both household and non-household populations. This project will serve as a 

foundation for future, larger scale efforts to assess incidence and prevalence of such disorders on a 

national scale. 

Crisis Services Set-Aside 

Starting in FY 2021, states were required to set-aside five percent of their total allocation for evidencebased crisis care programs addressing the needs of individuals with serious mental illnesses and 

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children with serious mental and emotional disturbances. The set-aside will fund some or all of a set of 

core crisis care elements including: centrally deployed 24/7 mobile crisis units, short-term residential 

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

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

A fully developed crisis response system is responsive any time and any place. SAMHSA expects that 

states will build on the emerging and growing body of evidence for effective community-based crisisintervention and response systems. SAMHSA recognizes that the development of fully accessible and 

responsive crises services involves complex problem solving with multiple entities and systems 

including a partnership between mental health and law enforcement. SAMHSA also recognizes that 

strategic crisis services implementation can result in better care and cost savings through the reduction 

in avoidable emergency department visits, psychiatric admissions, police engagement, arrests, 

incarcerations and 911 calls. 

Set-aside for Evidence-based Programs that Address the Needs of Individuals with Early Serious Mental 

Illness 

States are required to set aside ten percent of their MHBG funds to support “evidence-based programs 

that address the needs of individuals with early serious mental illness, including psychotic disorders.”46 

This totaled $68.5 million in FY 2020. SAMHSA is collaborating with the NIMH 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 use, 

increased hospitalizations, and reduced prospects for long-term recovery. 

Through this funding, 50 states, DC and Puerto Rico implemented fully operating first-episode treatment 

programs and SAMHSA continues to monitor and ensure that the set-aside program is solely used to 

address first-episode psychosis. 

46 http://www.samhsa.gov/sites/default/files/mhbg-5-percent-set-aside-guidance.pdf 

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The table below identifies activities, which have been implemented with the 10 percent set-aside. 

State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

Alabama $1,039,379 State uses the EASA and OnTrack USA. Services are delivered 

through a Coordinated Specialty Care Team that is reflective of 

the demographic mix of the community. 

Alaska $162,654 Use the OnTrAK model. The staffing structure highlights the 

realities of the Mat-Su Borough in size, scope, and incidence rate 

leading to the development of a task-based team approach focused 

on outcome. 

American 

Samoa 

$14,131 AS has adopted the Assertive Community Treatment (ACT) model 

for community mental health services for use with individuals 

with FEP. 

Arkansas $629,052 State ESMI/FEP program is contractually assigned to the 

Community Mental Health Centers. Evidenced-based treatment 

models are utilized for each client newly diagnosed with 

psychosis. 

California $9,419,007 State allocates MHBG funds to 57 local county subrecipients who 

administer their own Mental Health Plans that are unique to their 

particular geographic and population circumstances each year and 

utilize models, such as Portland Identification and Early Referral 

(PIER). 

Colorado $1,413,144 Providers have implemented CSC models with high fidelity. 

Connecticut $697,199 State implemented four programs based on two distinct CSC 

models (Potential and STEP). 

District of 

Columbia 

$170,233 The District’s early intervention program (EIP), the Youth 

Blossom program at Community Connections, is utilizing CSC 

model offers early treatment to young adults (age 16-25) 

experiencing their first psychotic break. 

Delaware $167,577 A statewide program, Community Outreach, Referral and Early 

Intervention (CORE), has been implemented. 

Florida $4,776,058 The State of Florida currently has 7 Coordinated Specialty Care 

teams. Six of the seven utilize the NAVIGATE model and one 

utilizes the OnTrack model. 

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State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

Georgia $2,300,633 State has now implemented ten (10) Coordinated Specialty Care 

teams around the state. All programs are based on the LIGHT-ETP 

model. 

Guam $46,645 State has begun providing services in the I Fine'na program, which 

is based on OnTrackNY, and offers Early Serious Mental Illness 

(ESMI) services through the OASIS Empowerment Center. 

Hawaii $362,111 State has implemented a program with three sites in Honolulu 

based on the OnTRACK model. 

Idaho $424,052 Four CSC programs have been implemented Idaho is 

implementing the STAR (Strength Through Active Recovery) 

program to provide FEP treatment based on the On-Track CSC 

treatment model. 

Indiana $1,288,471 State offers three programs based on the Prevention and Recovery 

Care (PARC) model and makes use of a "hub and spoke" design. 

Iowa $564,139 State has three functioning CSC programs based on the 

NAVIGATE model. 

Kansas $525,176 There are three teams in Kansas. The eligibility age was raised 

from 15 to 25-years-old to 15 to 36-years-old to increase access to 

women. 

Kentucky $934,076 Eight EASA CSC program sites are available throughout the state, 

with one in the installation phase. State is also using the MHBG to 

support data infrastructure to track outcomes. 

Louisiana $1,042,026 Six sites have been implemented. These programs are using the 

Navigate CSC model. 

Maine $282,072 State has implemented one program, Maine Medical 

Center/Portland Identification and Early Referral Program, based 

on the PIER Model in Portland. The state has also contracted with 

the PIER program to train staff at one other provider to provide 

FEP services. 

Marshall 

Islands 

$21,042 Use the set aside funding to develop first episode outreach 

practices and protocols for individuals experiencing FEP. 

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State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

Maryland $1,400,957 The state has implemented four CSC programs, two in Baltimore, 

one in Gaithersburg and one in Catonsville. 

Massachusetts $1,440,213 Seven Community Clinics with comprehensive specialized FEP 

services are in operation, and 3 outpatient hospital sites. 

Michigan $2,111,464 The State has implemented six CSC programs using the 

NAVIGATE CSC model. 

Federated 

States of 

Micronesia 

$28,815 Funds are being used to train staff on the OnTrack CSC model in 

four locations. The state also has developed outreach and 

screening processes in schools and in the community in Majuro, 

Ebeye and Outer Islands. 

Minnesota $1,089,245 State has implemented three CSC programs using the Navigate 

model. 

Missouri $1,210,697 State has established ten sites spread throughout the state that 

provide Assertive Community Treatment for Transitional Age 

Youth (ACT-TAY) for individuals experiencing an early serious 

mental illness. 

Montana $220,246 The state has implemented the NAVIGATE model in one site. 

Nebraska $330,252 The state has implemented OnTrackUSA in two of the six 

behavioral health service regions of the state. 

Nevada $760,827 The state has implemented three CSC programs: in the Reno area 

and Las Vegas area using the Recovery After Initial Schizophrenic 

Episode (RAISE) TEAM approach and a third CSC program in 

Carson City that follows the NAVIGATE model. 

New 

Hampshire 

$253,468 State currently has one FEP program at the Greater Nashua Mental 

Health Center (GNMHC), utilizing the NAVIGATE model. 

New Jersey $1,970,795 State has implemented three CSC teams that provide CSC service 

in all 21 NJ counties. 

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State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

New Mexico $437,403 State is expanding access to the NAVIGATE model for specialty 

coordinated care for individuals with FEP through the already 

implemented University of New Mexico EARLY program. 

New York $4,032,160 State is spending set-aside funds to expand its existing 

OnTrackNY program to two new sites, for 22 CSC sites statewide. 

North Carolina $2,092,398 North Carolina supports four CSC for FEP programs. 

North Dakota $124,874 State implemented CSC services in Fargo, which serves six 

counties in the state. 

Northern 

Mariana 

Islands 

$14,456 The Community Guidance Center implemented a psychoeducation 

group geared toward family education, which will help families 

and the community better identify FEP symptoms in their family 

or community leading to earlier treatment of the client. 

Oklahoma $791,316 State indicates they have expanded to 14 CSC and ESMI 

programs. 

Oregon $1,140,559 Oregon is integrating Coordinated Specialty Care teams in all 

counties using a standard model of care supported by the EASA 

Center for Excellence at Oregon Health & Science University and 

Portland State University. 

Palau $5,982 Supports one CSC team. 

Pennsylvania $2,359,765 State has 14 Coordinated Specialty Care Programs for First 

Episode Psychosis, serving 20 counties. 

Puerto Rico $915,984 Puerto Rico has implemented two Coordinated Specialty Care 

Programs using the OnTrack model. 

Rhode Island $267,129 Rhode Island will continue to use the entire set-aside amount to 

serve individual ages 16-25 experience a first episode of psychosis 

in the two CSC community health care centers. 

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State FY 2021 10% 

Set Aside 

Allotment 

Program Description 

South Carolina $1,082,125 State is funding four programs for individuals with an early 

serious mental illness, one of which uses the NAVIGATE model. 

South Dakota $155,104 State has implemented two CSC programs in Sioux Falls and 

Rapid City. They have been trained by OnTrackNY. 

Tennessee $1,374,292 State uses the MHBG funds to provide OnTrackTN in five sites 

across the state. 

Texas $6,489,575 State offers 24 CSC programs in rural and urban. These sites 

serve both indigent and Medicaid-eligible populations. 

Utah $649,072 State has 5 programs in total, all funded by MHBG. Four are FEP 

programs that follow the RAISE model and one is an ESMI 

program for Latinx youth (14-25). 

Vermont $123,198 State continues to partner with Vermont Corporative for Practice 

Improvement and Innovation to facilitate the initiative including 

targeted, research, implementation, workforce development, 

outreach and education. 

Virginia $1,802,793 Eight (8) Virginia community services boards (CSBs) operate 

CSC programs. 

Washington $1,672,613 State operates nine sites using the New Journeys model based on 

the NAVIGATE model. 

West Virginia $391,866 State has seven provider sites utilizing the FIRST CSC model 

ESMI services to fidelity. 

Wisconsin $1,240,805 State is continuing to fund the CSC model PROPS program 

operated by JMHC in Madison, which serves three rural counties 

north of Madison. In addition, the state is funding a CSC program 

in Milwaukee. 

Wyoming $91,246 The state has two providers providing CSC FEP programs: 

Southwest Counseling Service 

Yellowstone Behavioral Health Center. 

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Funding History 

Fiscal Year Amount 

FY 2018 $722,571,000 

FY 2019 $722,571,000 

FY 2020 $722,571,000 

FY 2021 Enacted $757,571,000 

FY 2022 Budget Request $1,582,571,000 

Budget Request 

The FY 2022 budget request is $1.6 billion, an increase of $825.0 million from the FY 2021 Enacted 

level. With this funding, SAMHSA will continue to address the needs of individuals with SMI and SED 

and will continue to maintain the 10 percent set-aside for 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. 

The Budget also set-asides $75 million, an increase of $40 million over FY 2021, of MHBG funds to 

support state efforts to build much needed crisis systems to address the needs of individuals in mental 

health crisis in a high quality, expeditious manner. In addition, this funding will support an ongoing 

partnership between mental health and law enforcement. The development of these services will promote 

24/7 access to well-trained mental health professionals in the time of acute mental health crisis. 

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Outputs and Outcomes Table 

Program: Mental Health Block Grant 

Measure 

Year and Most Recent Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.11 Number of evidence based 

practices (EBPs) implemented (Output) 

FY 2020: 5.0 per State 

Target: 

5.0 per State 

(Target Met) 

5.0 per State 5.0 per State Maintain 

2.3.14 Number of people served by the 

public mental health system (Output) 

FY 2020: 8,131,606 

Target: 

7,808,416 

(Target Exceeded) 

7,808,416 8,131,606 +323,190 

2.3.15 Rate of consumers (adults) 

reporting positively about outcomes 

(Outcome) 

FY 2020: 75.4 % 

Target: 

75.4 % 

(Target Met) 

75.4 % 75.4 % Maintain 

2.3.16 Rate of family members 

(children/adolescents) reporting 

positively about outcomes (Outcome) 

FY 2020: 71.9 % 

Target: 

72 % 

(Target Not Met) 

71 % 71 % Maintain 

2.3.19A: Supported Housing Supported 

Housing: Percentage of the population 

accessing selected evidence-based 

programs among people served by state 

mental health authorities (Outcome) 

FY 2020: 3.1 % 

Target: 

3.1 % 

(Target Met) 

3.1 % 3.1 % Maintain 

2.3.19B Supported Employment: 

Percentage of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities (Outcome) 

FY 2021: 2.0 % 

Target: 

2.0 % 

(Target Met) 

2.0 % 2.0 % Maintain 

2.3.19C Assertive Community 

Treatment: Percentage of the 

population accessing selected evidencebased programs among people served 

by state mental health authorities 

(Output) 

FY 2020: 1.9 % 

Target: 

1.9 % 

(Target Met) 

1.9 % 1.9 % Maintain 

2.3.19D Family Psychoeducation: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities (Outcome) 

FY 2020: 2.5 % 

Target: 

2.4 % 

(Target Exceeded) 

2.4 % 2.4 % Maintain 

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Measure 

Year and Most Recent Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.19E Dual Diagnosis Treatment: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities. (Outcome) 

(Outcome) 

FY 2020: 10.4 % 

Target: 

10.4 % 

(Target Met) 

10.4 % 10.4 % Maintain 

2.3.19F Illness Self-Management: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities. (Outcome) 

FY 2020: 18.9 % 

Target: 

18.0 % 

(Target Exceeded) 

18.0 % 18.0 % Maintain 

2.3.19G Medication Management: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities. (Outcome) 

FY 2020: 31.3 

Target: 

31.0 

(Target Exceeded) 

31.0 31.0 Maintain 

2.3.19H Treatment Foster Care: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities. (Outcome) 

FY 2020: 0.7 % 

Target: 

0.7 % 

(Target Met) 

0.7 % 0.7 % Maintain 

2.3.19I Multi-Systemic Therapy: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities. (Outcome) 

FY 2020: 4.2 % 

Target: 

4.2 % 

(Target Met) 

4.2 % 4.2 % Maintain 

2.3.19J Functional Family Therapy: 

Percent of the population accessing 

selected evidence-based programs 

among people served by state mental 

health authorities. (Outcome) 

FY 2020: 5.9 % 

Target: 

5.9 % 

(Target Met) 

5.9 % 5.9 % Maintain 

2.3.81 Percentage of service population 

receiving any evidence based practice 

(Outcome) 

FY 2020: 12.2 % 

Target: 

11.8 % 

(Target Exceeded) 

11.8 % 11.8 % Maintain 

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Substance Abuse and Mental Health Services Administration 

FY 2022 Mental Health Block Grant Estimate Allotments 

Appropriation $1,582,571,000, State-Territory Total $1,501,184,441 

CFDA # 93.959 

State/Territory FY 2020 

Final 

FY 2021 

Enacted1 

FY 2022 

President's 

Budget

 FY 2022 +/- FY 

2021 

Alabama $9,899,084 $10,393,794 $22,053,960 $11,660,166 

Alaska 1,480,885 1,626,540 3,702,025 2,075,485 

Arizona 18,493,829 19,762,210 37,417,906 17,655,696 

Arkansas 5,986,777 6,290,522 13,314,177 7,023,655 

California 91,832,541 94,190,067 197,169,806 102,979,739 

Colorado 13,283,889 14,131,439 29,622,324 15,490,885 

Connecticut 6,761,092 6,971,987 15,511,833 8,539,846 

Delaware 1,582,328 1,675,774 3,181,073 1,505,299 

District Of Columbia 1,603,015 1,702,334 3,665,552 1,963,218 

Florida 45,278,203 47,760,577 103,127,587 55,367,010 

Georgia 21,993,812 23,006,325 46,227,351 23,221,026 

Hawaii 3,533,598 3,621,113 7,584,318 3,963,205 

Idaho 3,957,780 4,240,521 8,197,068 3,956,547 

Illinois 24,466,019 25,297,546 47,522,585 22,225,039 

Indiana 12,129,344 12,884,705 30,094,890 17,210,185 

Iowa 5,271,887 5,641,385 12,071,618 6,430,233 

Kansas 4,988,410 5,251,758 11,127,703 5,875,945 

Kentucky 8,895,473 9,340,762 19,751,221 10,410,459 

Louisiana 9,780,411 10,420,263 19,740,178 9,319,915 

Maine 2,699,523 2,820,718 5,983,783 3,163,065 

Maryland 13,548,728 14,009,566 25,535,333 11,525,767 

Massachusetts 13,983,098 14,402,129 32,286,556 17,884,427 

Michigan 20,194,039 21,114,635 43,908,098 22,793,463 

Minnesota 10,358,721 10,892,453 24,490,201 13,597,748 

Mississippi 6,220,048 6,575,274 13,858,359 7,283,085 

Missouri 11,522,294 12,106,967 25,809,500 13,702,533 

Montana 2,054,853 2,202,462 5,485,391 3,282,929 

Nebraska 3,069,216 3,302,524 7,062,657 3,760,133 

Nevada 7,279,761 7,608,268 17,146,865 9,538,597 

New Hampshire 2,404,349 2,534,678 5,054,093 2,519,415 

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Substance Abuse and Mental Health Services Administration 

FY 2022 Mental Health Block Grant Estimate Allotments 

Appropriation $1,582,571,000, State-Territory Total $1,501,184,441 

CFDA # 93.959 

State/Territory FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget

 FY 2022 +/- FY 

2021 

New Jersey 19,362,783 19,707,954 41,575,650 21,867,696 

New Mexico 4,070,758 4,374,034 9,286,056 4,912,022 

New York 40,459,564 40,321,601 87,795,609 47,474,008 

North Carolina 19,801,355 20,923,981 44,819,741 23,895,760 

North Dakota 1,070,333 1,248,738 2,708,984 1,460,246 

Ohio 21,215,342 22,426,204 47,475,037 25,048,833 

Oklahoma 7,295,002 7,913,159 16,883,485 8,970,326 

Oregon 10,607,443 11,405,593 24,017,515 12,611,922 

Pennsylvania 22,533,122 23,597,645 51,073,462 27,475,817 

Rhode Island 2,567,486 2,671,294 5,302,613 2,631,319 

South Carolina 10,286,119 10,821,253 23,099,241 12,277,988 

South Dakota 1,446,803 1,551,040 3,306,664 1,755,624 

Tennessee 13,111,226 13,742,918 31,732,165 17,989,247 

Texas 59,374,828 64,895,752 123,518,410 58,622,658 

Utah 6,091,444 6,490,722 16,962,841 10,472,119 

Vermont 1,175,538 1,231,981 2,611,361 1,379,380 

Virginia 17,190,658 18,027,933 38,425,706 20,397,773 

Washington 16,051,771 16,726,128 36,946,285 20,220,157 

West Virginia 3,705,898 3,918,663 8,188,872 4,270,209 

Wisconsin 11,793,459 12,408,047 23,247,560 10,839,513 

Wyoming 812,359 912,460 1,985,406 1,072,946 

American Samoa 134,614 141,308 295,658 154,350 

Guam 437,419 466,446 991,602 525,156 

Northern Marianas 136,598 144,556 304,993 160,437 

Puerto Rico 8,760,573 9,159,843 19,108,582 9,948,739 

Palau 56,014 59,820 127,380 67,560 

Marshall Islands 194,820 210,419 452,973 242,554 

Micronesia 272,334 288,152 607,751 319,599 

Virgin Islands 280,363 297,421 628,828 331,407 

1. The amuonts in FY 2021 exclude supplemental funding. 

149 
 

Substance Abuse Prevention 

Table of Contents 

1. Substance Abuse Prevention Appropriation.......................................................................151 

2. Programs of Regional and National Significance (PRNS)..................................................152 

a) Strategic Prevention Framework..................................................................................153 

b) Federal Drug-Free Workplace......................................................................................159 

c) Minority AIDS ............................................................................................................163 

d) Sober Truth on Preventing Underage Drinking Act (Stop Act).....................................166 

e) Center for the Application of Prevention Technologies................................................172 

f) Science and Service Program Coordination .................................................................175 

g) Tribal Behavioral Health Grants ..................................................................................179 

h) Minority Fellowship Program......................................................................................183 

PRNS Mechanism Tables .......................................................................................................187

Grant Awards Table ................................................................................................................188 

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Substance Abuse Prevention Appropriation 

(Dollars in thousands) 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022

 President's 

Budget 

FY 2022 +/-

FY 2021 

Programs of Regional & National Sigificance $206,469 $208,219 $216,667 $8,448 

Total, Substance Abuse Prevention....................... $206,469 $208,219 $216,667 $8,448 

The Substance Abuse Prevention FY 2022 Budget Request is $216.7 million, an increase of $8.4 

million over the FY 2021 Enacted budget level. 

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Capacity: 

Strategic Prevention Framework.............................................................................. $119,484 $119,484 $126,674 $7,190 

 Non-SPF Rx (non-add)...................................................................................... 109,484 109,484 111,674 $2,190 

Budget Authority (non-add)........................................................................... 109,484 109,484 111,674 $2,190 

Strategic Prevention Framework Rx (non-add)................................................ 10,000 10,000 15,000 $5,000 

Budget Authority (non-add)........................................................................... 10,000 10,000 15,000 $5,000 

Federal Drug-Free Workplace................................................................................. 4,894 4,894 4,894 ---

Minority AIDS......................................................................................................... 41,205 41,205 42,029 $824 

Sober Truth on Preventing Underage Drinking Act (STOP Act) 9,000 10,000 10,000 ---

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths --- --- --- ---

Tribal Behavioral Health Grants............................................................................. 20,000 20,750 21,165 $415 

Programs of Regional and National Significance (PRNS) 

Substance Abuse Prevention Appropriation 

(Dollars in Thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Subtotal, Capacity 

Science and Service: 

194,583 196,333 204,762 8,429 

Center for the Application of Prevention Technologies........................................... 7,493 7,493 7,493 ---

SAP Minority Fellowship Program......................................................................... 321 321 340 $19 

Science and Service Program Coordination............................................................ 4,072 4,072 4,072 ---

Subtotal, Science and Service 11,886 11,886 11,905 $19 

Total, PRNS $206,469 $208,219 $216,667 $8,448 

Authorizing Legislation.........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

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 

152 
Strategic Prevention Framework (SPF) 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

________________________ 

Strategic Prevention Framework 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Strategic Prevention Framework............................................. $119,484 $119,484 $126,674 $7,190 

Strategic Prevention Framework Rx (non-add)................. $10,000 $10,000 $15,000 $5,000 

Authorizing Legislation.........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

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

Eligible Entities....................................................................................................States, Tribes, and Territories 

Program Description and Accomplishments 

Drug and alcohol use are significant public health challenges. 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 youth and adolescent drug and alcohol use underscore the need 

for effective prevention and treatment programs. 

Youth and adolescents use a variety of substances. In 2019, an estimated 35.8 million Americans 

aged 12 or older used illicit drugs in the past 30 days. The illicit drug use estimate for 2019 was 

driven primarily by marijuana use and the misuse of prescription pain relievers, with 31.6 million 

individuals aged 12 or older who currently used marijuana (i.e., past 30 day use) and 2.8 million 

people aged 12 or older who reported current misuse of prescription pain relievers. 

The 2019 National Survey on Drug Use and Health (NSDUH)52 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 2019, 18.5 percent of underage people reported 

current use of alcohol, 11.4 percent reported binge drinking, and 2.2 percent reported heavy alcohol 

use. 

Among people aged 12 or older, past month binge alcohol was 23.9 percent in 2019. Among people 

aged 12 or older, the percentage who were past month heavy alcohol users was 5.8 percent (or 

16.0 million people) in 2019. 

52 Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health 

indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. 

PEP 19-5068, NSDUH Series H-54). Rockville MD 20857 Retrieved from http://www.samhsa.gov/data. 

153 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Strategic Prevention Framework – Partnerships for Success (SPF-PFS) program helps states, 

tribes, and communities address locally identified prevention priorities through a data-driven 

process. Common priorities include underage drinking among youth and young adults age 12 to 

20, marijuana, or prescription drug misuse. In 2020 the SPF-PFS program supported a total of250 

new and continuing grants to state, community and tribal organizations to address underage 

drinking among youth and young adults ages 9 to 20 and allow communities, at their discretion, 

to use funds to target up to two additional data driven substance misuse prevention priorities 

addressing ages 9 and above. 

SPF-PFS is designed to ensure that prevention strategies and messages reach the populations most 

impacted by substance misuse. The program extends current established cross-agency and 

community-level partnerships by connecting substance misuse prevention programming to 

departments of social services and their community service providers. This includes working with 

populations disproportionately impacted by the consequences of substance use; i.e., children 

entering the foster care system, transition age youth, and individuals who support persons with 

substance use issues (e.g., women, families, parents, caregivers, and young adults). 

In FY 2020, SAMHSA awarded 92 new grants to state, tribal, and community organizations for 

preventing the onset and reducing the progression of substance use and its related challenges while 

strengthening prevention capacity and infrastructure at the community and state levels. In FY 

2021, SAMHSA will support the continuation of 92 grants and awarded 5 new SPF-PFS grants. 

Strategic Prevention Framework for Prescription Drugs (SPF Rx) 

From 1999 to 2017, drug-poisoning death rates more than tripled, from 6.1 per 100,000 to 21.7 per 

100,000. In 2017, there were 70,237 deaths due to drug poisoning.47 Also, from 1999 to 2017, 

the age-adjusted rate of drug-poisoning deaths increased from 8.2 per 100,000 to 29.1 per 100,000 

for males, and from 3.9 per 100,000 to 14.4 per 100,000 for females. In 2019, drug overdose deaths 

increased 4.3% from 2018 with a total of 76,630 deaths. 

The Strategic Prevention Framework for Prescription Drugs (SPF-Rx) assists grantees in 

developing capacity and expertise in the use of data from state run prescription drug monitoring 

programs (PDMP). Grantees have also raised 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 plans to maintain this level of support for SPF Rx through FY 2022. 

Program Evaluation 

Recipients of SPF-PFS grants measure the impact of their programs at the community-level. The 

goal of the SPF-PFS grant program is to support communities and tribes to identify and address 

their top substance misuse prevention priorities. In FY 2020, grantees in 234 communities 

reported improvements in one or more targeted national outcome measure (NOMs) indicators as a 

result of implementing more than 1,400 evidence-based interventions. Fifteen (15) states and 

47 https://www.cdc.gov/nchs/data-visualization/drug-poisoning-mortality/ 

154 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

fourteen (14) tribal communities focused on alcohol use and at least one other substance, and many 

focused their prevention efforts on racial, ethnic, sexual, and gender subpopulations. 

The Government Performance and Results Act (GPRA) requires reporting for the Strategic 

Prevention Framework for Prescription Drug (SPF-Rx) program for two measures. The number 

of funded states/tribes that incorporate Prescription Drug Monitoring Program (PDMP) data into 

their strategic plans, and the number of funded states/tribes reporting reductions in opioid 

overdoses. 

Since the start of the SPF-Rx program, grantees and their sub-recipients have implemented a total 

of 508 interventions. Over 400 of these interventions remained active at the end of FY 2019, with 

221 continuing from FY 2018. The most dramatic growth was in the first years of the program, 

as grantees added sub-recipients and they, in turn, developed their interventions. In FY 2019, 118 

sub-recipients reported 377 active interventions. The 404 grantee- and sub-recipient-level 

interventions active in FY 2019 most often involved the CSAP Strategies of information 

dissemination (191 interventions or 47 percent) and environmental strategies (121 interventions or 

30 percent). 

Regarding interventions implemented, over a third of both grantees and their sub-recipients 

targeted the entire population in the jurisdictions they represent (i.e., the state, the county, the tribal 

community). The medical community in particular is often a focus for information and training. 

Of the 404 prevention interventions that were active in FY 2019, the three most common 

intervention service types were media campaigns, prescription drug safe storage and/or disposal, 

and training/educating environmental influencers. 

The reach of the program interventions into their communities has been impressive. Without 

addressing duplicative counting of individuals receiving multiple interventions, the 358 active 

interventions in FY 2020 reached a total of 11.9 million individuals across the grantee and subrecipient sites. This total is impacted by a small number of interventions that reached a large 

number of individuals, notably the media campaigns. Most interventions reached fewer than 8,000 

individuals, many directed to specific health care professionals, such as prescribers, pharmacists 

and other direct influencers. In addition to the substantial media reach, almost 42,000 of the total 

individuals have been reached more directly through interventions such as trainings. 

One important aspect of community-level interventions is partnership with community agencies 

and stakeholders to create and execute their interventions. Of the 124 sub-recipients and singlecommunity grantees reporting in FY 2019, 89 percent reported partnering with at least one 

stakeholder organization, most often a substance use prevention organization (73.6 percent) and 

local law enforcement (72.7 percent). 

One of the goals of the SPF-Rx program is to increase PDMP-related infrastructure and improve 

PDMP use. In grantee-level interviews conducted in the first and second years of the project, SPFRx project directors reported PDMP data availability as a common challenge. These issues have 

improved: In FY 2019, both grantees and sub-recipients reported that PDMP data became less of 

a challenge for them in terms of quality, analysis/reporting, and ease of use. Many of the subrecipients, who as a group have the greatest challenges in accessing PDMP data, reported that their 

155 
 

 

 

Fiscal YearAmount 

FY 2018$119,484,000 

FY 2019$119,484,000 

FY 2020$119,484,000 

FY 2021Enacted $119,484,000 

FY 2022Budget Request $126,674,000 

 

 

 

 

 

access problems decreased; from 41 percent of sub-recipients reporting access problems in FY 

2017 to 28 percent in FY 2019. 

Funding History 

Budget Request 

The FY 2022 budget request is $126.7 million, an increase of $7.2 million over the FY 2021 

Enacted budget. Funding for the SPF Rx program is increased by $5 million for a total of $15 

million to support a new cohort of up to 26 grantees to be awarded in FY 2021, and 26 continuation 

and 12 new grants in FY 2022. 

156 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Partnerships for Success 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.79 Number of EBPs 

implemented by subrecipient communities 

(Output) 

FY 2020: 1,421 

Target: 

1,414 

(Target Exceeded) 

Discontinued Discontinued N/A 

2.3.80 Number of subrecipient communities 

that improved on one or 

more targeted NOMs 

indicators (Outcome) 

FY 2020: 234 

Target: 

3215 

(Target Not Met) 

Discontinued Discontinued N/A 

2.3.81 Increase in the 

percent of grantees that 

report at least 5% 

improvement in the past 

30 day use of targeted 

substance in target 

population (Outcome) 

FY 2021: Result Expected 

Dec 31, 2021 

Target: 

Set Baseline 

(Pending) 

Set Baseline Maintain 

Baseline 

N/A 

2.3.82 Increase in percent 

of grantees that report 

improvement of 

perception of risk from 

targeted substance use in 

target population 

(Outcome) 

FY 2021: Result Expected 

Dec 31, 2021 

Target: 

Set Baseline 

(Pending) 

Set Baseline Maintain 

Baseline 

N/A 

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Program: Strategic Prevention Framework Rx 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.3.12 Percent of funded 

states reporting 

reductions in opioid 

overdoses (Outcome) 

FY 2020: 56 % 

Target: 

62 % 

(Target Not Met) 

62 % 62 % Maintain 

3.3.13 Percent of grantees 

that reported taking steps 

to enhance access to and 

use of PDMP data at the 

grantee level. (Outcome) 

FY 2020: 73.70 

Target: 

88.2 

(Target not met) 

Discontinued Discontinued N/A 

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Federal Drug-Free Workplace 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Federal Drug-Free Workplace................................................. $4,894 $4,894 $4,894 $---

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

Allocation Method.................................................................................Inter-Agency Agreements/Contracts 

Eligible Entities....................................................................................Federal Agencies, Regulated Entities 

(e.g., Department of Transportation, Nuclear Regulatory Commission), 

HHS- Certified Laboratories 

Program Descriptions and Accomplishments 

The use of illicit, prescription, and over-the counter drugs, including polysubstance use, is 

widespread and has a variety of negative consequences, particularly in the workplace. This 

program continues to examine emerging issues especially among young adults and high risk 

workplaces such as: increased legal/illegal opioid/synthetic opioid use and polysubstance use 

leading to injuries, overdoses, and death. Employers with successful drug-free workplace 

programs report decreases in absenteeism, accidents, downtime, turnover, and theft; increases in 

productivity; and overall improved morale. Additionally, they report better health status among 

many employees and family members and decreased use of medical benefits. Many organizations 

with drug-free workplace programs qualify for health care incentives, for example, decreased 

premium costs for certain kinds of insurance, such as Workers’ Compensation. 

The Federal Drug-Free Workplace Programs (DFWP) ensure employees in national security, 

public health, and public safety positions are tested for the use of illegal drugs and the misuse of 

prescription drugs and ensure the laboratories that perform this regulated drug testing are inspected 

and certified by HHS. 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. 

Since 1987, SAMHSA has funded the Drug-Free Workplace drug testing activities including the 

NLCP and the Drug Testing Advisory Board (DTAB). Activities continued in FY 2020 under the 

NLCP contract. The NLCP oversees the certification of the labs that perform drug testing under 

the Drug-Free Workplace Programs. Also, in FY 2019, SAMHSA issued mandatory guidelines 

for oral fluid, and in FY 2020 the proposed mandatory guidelines for hair were issued, in 

accordance with the DTAB recommendations, to allow oral fluid and to pursue the use of hair as 

159 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

alternative specimens to urine. DTAB will continue to provide 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. 

CSAP’s Workplace Helpline supports the drug-free workplace program. The helpline is a tollfree telephone service (800-WORKPLACE) that answers questions from federal agencies, 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. 

The Drug Free Workplace Program (DFWP) helps individuals refrain from using illegal drugs and 

demonstrates that illegal drug use will not be tolerated in the federal workplace. The DFWP 

achieves this through policies and procedures including drug testing which allows for the drug 

testing of all executive branch agency employees. A key program aim is to eliminate illicit drug 

use in federal workplaces and oversee the NLCP, which certifies laboratories to conduct forensic 

drug testing for federal agencies and federally regulated industries. 

The program publishes mandatory guidelines to establish the scientific and technical regulatory 

aspects of the program, which includes specifying the drugs to be tested for and setting laboratory 

certification standards through the NLCP. Another key responsibility of the program is the 

development and oversight of the federal Custody and Control Form (CCF), the standardized 

OMB-approved form for specimen collectors to document the collection and forensic chain of 

custody of specimens at the collection site, for certified laboratories to report results, and for 

Medical Review Officers (MROs) to document and report verified results. SAMHSA allows the 

use of the CCF as a paper or electronic form. 

Additionally, the DFWP helps reduce health insurance costs, improves attendance and employee 

productivity, provides a safer workplace with reduced accidents and provides employee assistance 

programs (EAP) services to employees with substance use disorders. 

The benefits of this program include: 

• Implementation of urine, oral fluid, and hair drug testing programs with a federally 

supported performance testing program and a partial federally supported laboratory 

inspection program; 

• Certification of laboratories across the nation to conduct federal and federally regulated 

drug tests which may include urine, oral fluid, and hair; 

• Examining changes in drug testing methodologies, changes in law, and new and 

emerging issues related to marijuana (e.g., increased potency and use), cannabidiol 

(CBD) (e.g., increased availability due to the 2018 Farm Bill and possible risk of testing 

160 
 

 

 

 

 

 

 

 

 

FY 2018 $4,894,000 

FY 2019 $4,894,000 

FY 2020 $4,894,000 

FY 2021 Enacted $4,894,000 

FY 2022 Budget Request $4,894,000 

 

 

 

 

 

 

 

 

 

positive for marijuana), opioids, synthetic drugs, polysubstance use/misuse, and hair/oral 

fluid drug testing; 

• Continued use of subject matter experts and partnerships with other federal agencies to 

establish the scientific standards set out in the mandatory guidelines; 

• Proposing hair as an alternative specimen, subject to the legal and scientific 

supportability of this matrix for use in federal workplace drug testing programs; 

• Technical and scientific leadership for federal agencies on workplace drug testing; and 

• Analysis of and guidance on emerging issues (e.g. opioids/synthetic opiates; 

polysubstance use; young adults, high-risk workplaces) 

Funding History 

Fiscal Year Amount 

Budget Request 

The FY 2022 budget request is $4.9 million, level with the FY 2021 Enacted. Along with the 

implementation of the new oral fluid and hair drug testing programs, 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 designated 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 HHScertified laboratories. 

161 
 

 

 

 

 

 

 

 

 

 

 

 

 

Outputs and Outcomes Table 

Program: Federal Drug-Free Workplace 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

6.0 Number of HHS 

Certified Labs (Output) 

FY 2020: 24.0 certified labs 

Target: 

26.0 certified labs 

(Target Not Met). 

24.0 certified 

labs 

28.0 certified 

labs 

+2 Certified Labs 

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Minority AIDS 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Minority AIDS......................................................................... $41,205 $41,205 $42,029 $824 

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

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 needs of people living with HIV and those who are at-risk for infection continue to evolve. 

Substance use disorder treatment services are vital to ending the HIV epidemic. Approximately 

38,000 people become infected with HIV each year.48 In addition, because HIV and viral hepatitis 

share common modes of transmission, one third of HIV infected individuals are also infected with 

hepatitis C.49 The use of injection drugs is driving the increase in Hepatitis C cases. 

The Minority AIDS program supports activities that build a strong foundation for delivering and 

sustaining high- quality and accessible 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 misuse 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. The MAI program, along with many other HIV/AIDS programs across 

HHS, contributes to the goal to end the HIV epidemic in the United States. 

SAMHSA has helped to prevent HIV and hepatitis infection acquired through substance use and 

misuse. SAMHSA’s Minority AIDS and viral hepatitis prevention programs have included a focus 

on community-based organizations and minority serving institutions and a focus on the continuum 

of care. 

In FY 2018, SAMHSA supported the continuation of 105 grants and 37 new grants. In FY 2019, 

SAMHSA supported the continuation of 142 grants and 6 new grants awards. In FY 2020, 

48 CDC: HIV in the United States at a Glance: https://www.cdc.gov/hiv/pdf/statistics/overview/cdc-hiv-usataglance.pdf

49 U.S. Department of Health and Human Services: Secretary’s Minority AIDS Initiative Fund: 2017: HIV BASICS: 

Staying in HIV Care: Other Related Health Issues: Hepatitis B & C: Hepatitis B Virus and Hepatitis C Virus Infection, 

https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/hepatitis-b-and-c 

163 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMHSA supported the continuation of 93 grants and 84 new grants. In FY 2021, SAMHSA will 

support the continuation of 140 grants and 37 new grants. 

Program Evaluation 

Based on the latest data available, 24,162 persons received an HIV test in 2020 using grant funds, 

and of this number 8,917 people were tested for the first time. Grantees purchased 33,933 HIV test 

kits with grant funds and referred 100% of the people who tested positive for HIV to treatment. 

Participants averaged about 4 direct service encounters, with an average duration of 75 minutes 

per encounter. MAI grantees provided referrals to 4,180 participants for additional services, 

comprising 13,651 total referrals. 11,685 participants responded to surveys, with the findings 

summarized below: 

• At least 6,952 participants received substance misuse prevention education services 

(59.5 percent of survey respondents). 

• 57.8 percent of participants who reported binge drinking at baseline reported 

abstinence at follow-up. 

• The percentage of participants rating tobacco use once to twice weekly as a great risk 

increased 38.2 percent from baseline to follow-up. 

• The percentage of participants rating non-prescription opioid use once to twice 

weekly as a great risk increased 36.6 percent from baseline to follow-up. 

• 88 percent of participants rated taking a prescription opioid without a prescription 

once to twice weekly as a great risk at follow-up, a 27.7 percent increase from 

baseline. 

• 51.6 percent of participants rated binge drinking once to twice weekly a great risk at 

follow-up, a 28.9 percent increase from baseline. 

• 74.2% of participants strongly agreed they would refuse if someone wanted to have 

sex without a condom at follow-up, with 23.3 percent reporting a higher level of 

agreement at follow-up compared to baseline. 

Funding History 

Fiscal Year Amount 

FY 2018 $41,205,000 

FY 2019 $41,205,000 

FY 2020 $41,205,000 

FY 2021 Enacted $41,205,000 

FY 2022 Budget Request $42,029,000 

Budget Request 

The FY 2022 budget request is $42.0 million, an increase of $824,000 above the FY 2021 Enacted 

budget. SAMHSA plans to support 163 continuations and 27 new grant awards. 

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Outputs and Outcomes Table 

Program: Minority AIDS Initiative 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.56 Number of 

program participants 

exposed to substance 

abuse prevention 

education services 

(Output) 

FY 2020: 6,952 

Target: 

8,345 

(Target Not Met) 

8,345 8,345 Maintain 

2.3.85a Number of 

persons tested for HIV 

through the Minority 

AIDS Initiative 

prevention activities 

(Output) 

FY 2020: 24,162 

Target: 

31,514 

(Target Not Met) 

31,514 31,514 Maintain 

2.3.90 Percentage of 

program participants who 

reported reduced binge 

drinking at follow-up. 

(Outcome) 

FY 2019: 57.8% 

Target: 

64 % 

(Target Not Met) 

64 % 64 % Maintain 

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Sober Truth on Preventing Underage Drinking Act (STOP Act) 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Sober Truth on Preventing Underage Drinking Act $9,000 $10,000 $10,000 $---

Authorizing Legislation....................................................................................Section 519B of the PHS Act 

FY 2022 Authorization....................................................................................................................... $7,000,000 

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

Eligible Entities......................................................Current and former Drug Free Communities grantees 

Program Description and Accomplishments 

Among Americans under age 21, underage drinking is one of our nation’s significant public health 

challenges, and its associated problems have profound negative consequences not just for underage 

drinkers, but also for their families, their communities, and society as a whole. Alcohol continues 

to be the most widely used substance of misuse among America’s youth, and a higher proportion 

use alcohol than use tobacco or other drugs. Annually, alcohol is a factor in the deaths of 

approximately 3,500 youths in the United States, shortening their lives by an average of 60 years. 

Every day an estimated 2,125 children ages 12 through 14 begin using alcohol. Among 12- to 20-

year-olds, 18.8 percent reported using alcohol in the last month. These young people face a 

number of harmful potential consequences, including death or injury, impaired brain function, 

decreased academic performance, and increased risk of developing an alcohol use disorder later in 

life.50 

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 114-255) 

was the nation’s first comprehensive legislation on underage drinking. The STOP Act was 

reauthorized in 2016 as part of the 21st Century Cures Act (Public Law 114-255). The Act states, 

“A multi-faceted effort is needed to more successfully address the problem of underage drinking 

in the United States. A coordinated approach to prevention, intervention, treatment, enforcement, 

and research is key to making progress. This Act recognizes the need for a focused national effort, 

and addresses particulars of the federal portion of that effort, as well as federal support for state 

activities.” 

In keeping with the STOP Act’s language calling for a multi-faceted, coordinated approach, the 

Interagency Coordinating Committee for the Prevention of Underage Drinking (ICCPUD) 

developed a Comprehensive Plan in 2006, with updates in 2018, and a pending update for 2021. 

The plan includes consensus recommendations from the federal agency members as well as for all 

50 U.S. Department of Health and Human Services. (December, 2020). Report to Congress on the Prevention and 

Reduction of Underage Drinking, Rockville, MD: Substance Abuse and Mental Health Services Administration 

Retrieved from www.stopalcoholabuse.gov. (National Survey on Drug Use and Health [NSDUH]; Center for 

Behavioral Health Statistics and Quality [CBHSQ], 2019c) 

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interested parties identified in the STOP Act, and established the following overarching goals and 

objectives: 

1. Strengthen a national commitment to address the problem of underage drinking; 

2. Reduce demand for, the availability of, and access to alcohol by persons under the 

age of 21; 

3. Use research, evaluation, and scientific surveillance to improve the effectiveness of 

policies, programs, and practices designed to prevent and reduce underage drinking. 

The STOP Act requires the HHS Secretary, in collaboration with other federal officials enumerated 

in the Act, to “formally establish and enhance the efforts of the ICCPUD that began operating in 

2004.” In 2006, SAMHSA assumed leadership as the HHS Secretary’s designee. 

The STOP Act calls for data and information on individual state performance and the enforcement 

of drinking laws, steps to reduce alcohol’s availability to youth under the age of 21, research on 

underage drinking, and resources for local community efforts. The STOP Act also calls for four 

annual reports to Congress, which are developed under contract ($1 million/year): a report on the 

prevention and reduction of underage drinking, a report on state performance and best practices 

for the prevention and reduction of underage drinking, and a report series on state underage 

drinking prevention and enforcement activities. 

A report on the evaluation of the adult oriented national media campaign to prevent underage 

drinking that includes the production, broadcasting, and effectiveness of the campaign – also 

known as “Talk They Hear You.” The community-based coalition enhancement grant program 

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 national media campaign to prevent underage drinking, — “Talk They Hear You.” (TTHY) 

responds to directives set forth in Section 2(d) of the STOP Act ($2 million/year), to produce and 

oversee an adult-oriented national media campaign to provide parents and caregivers of youth 

under the age of 21 with information and resources to discuss the issue of alcohol with their 

children. The ICCPUD will continue to guide the development process of the national media 

campaign, and subsequent evaluation, which is included as Chapter 5 of the Report to Congress 

annually. 

In FY 2019, SAMHSA supported the continuation of 97 grants and 22 new grants. In FY 2020, 

SAMHSA supported the continuation of 39 grants and 95 new grants. In FY 2021, SAMHSA will 

fund 16 new grants and 117 continuing grants. 

In FY 2020, STOP Act grant recipients began reporting GPRA data in SAMHSA’s Performance 

Accountability and Reporting System (SPARS). 

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Program Evaluation 

FY 2017 data showed that 58 percent of coalitions report at least 5 percent improvement in the 30-

day use of alcohol in at least two grades, and 75% of coalitions reported improvement in youth 

perception of risk from alcohol in at least two grades. 

Under ICCPUD’s leadership, SAMHSA’s Center for Substance Abuse Prevention developed the 

TTHY campaign in response to directives set forth in Section 2(d) of the STOP Act, requiring the 

HHS Secretary to fund and oversee a national adult-oriented media public service campaign and 

to report annually on the production, broadcasting, and evaluation of this campaign. ICCPUD has 

been instrumental in the overall development of TTHY, using input from experts and organizations 

representing a wide range of parties, including public health advocacy groups, the alcohol industry, 

ICCPUD member agencies, the U.S. Congress, and subject matter experts (SMEs). TTHY 

addresses two of the core goals laid out in ICCPUD’s “Preventing & Reducing Underage Drinking 

2018 Comprehensive Plan”: 

• Goal 1: Strengthen a national commitment to address the problem of underage drinking; 

and 

• Goal 2: Reduce demand for, the availability of, and access to alcohol by persons under 

the age of 21. 

To maintain its lasting message and keep it consistent and relevant over time, the TTHY campaign 

trademarked its logo in 2016, making it the official property of HHS. This trademark instills trust 

in the campaign, lends credibility to TTHY materials, and promotes consistency when 

organizations implement TTHY in their communities. 

The “Talk They Hear You.” (TTHY) earned media campaign51 has yielded more than a $15-to-$1 

return on investment for every dollar invested. Key strategies of the earned media campaign were 

to (1) secure prominent campaign coverage in several major media outlets and (2) leverage 

regional relationships in communities through town hall meetings and public health observances 

(e.g., SAMHSA’s Prevention Day and National Prevention Week) to further educate parents and 

caregivers of children under 21 about why and how they should talk with their kids about the 

dangers of underage drinking and other substance use. The campaign also hosts community 

engagement meetings throughout the year to interact with local groups who are implementing the 

campaign locally and to learn specific details about their prevention efforts. 

Since the campaign’s inception, initial investment costs for development and implementation have 

been a little more than $1 million per year, totaling $12,5 million over a 12-year period. Earned 

media outreach efforts have generated an estimated $193.97 million in earned media placements 

on major networks and affiliates—with television, print, and radio PSAs having collectively 

garnered 14.9 billion impressions in all 50 states and in more than 300 cities. Distribution is 

augmented by community engagement, with groups such as the Community Anti-Drug Coalitions 

51 “Definition of earned media: Earned media, also referred to as media relations, word-of-mouth, public relations, or publicity, is 

an unpaid brand mention or recognition, such as a news article, published interview, or online review by a third party. In addition, 

earned media can also refer to a byline or article written by someone associated with the brand that is published by a third party.” 

(Top Rank Marketing, n.d.) 

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of America and the National Prevention Network, which have direct access to parents and 

caregivers. With partner engagement and outreach included, the campaign has earned more than 

39,270 donated labor hours from local community organizations since its inception, which equates 

to approximately 19 full-time employees and $885,539 in estimated salary. Disapproval of daily 

drinking and binge drinking post-intervention; and student perception of binge drinking being a 

health risk. 

Supporting the development and justification of the TTHY campaign involves a complex interplay 

of formative, process, and outcomes evaluation efforts. Evaluation findings to date suggest that 

SAMHSA has met many markers for early success, including strongly resonating with intended 

TTHY audiences. The growing body of evidence presented in the Report to Congress for the 

Prevention and Reduction of Underage Drinking 52 supports that key campaign messages serve as 

important cues to action that increase both the plans and actions of parents to talk with their 

children about underage drinking and other substance use. There is further evidence to suggest 

that TTHY increases parents’ confidence not only in talking with their children about underage 

drinking and other substance use but also in the behavioral efficacy of that action. 

In meeting the requirements of the STOP Act, SAMHSA, under the leadership of ICCPUD, will 

continue to garner support for program efficacy over the next year and implement evaluation plans 

for the upcoming 2021–2022 campaign evaluation cycle, which includes the case study replication 

and “Parents’ Night Out” field testing, will continue to establish links between TTHY exposure 

and the campaign’s stated outcomes in quantifiable ways. Armed with data from this and future 

efforts, SAMHSA will persist in its work to estimate overall campaign impact as well as to ensure 

that the TTHY campaign evolves in ways that resonate with its primary target audiences and meet 

the needs of the U.S. population at large. 

Funding History 

Fiscal Year Amount 

FY 2018 $7,000,000 

FY 2019 $8,000,000 

FY 2020 $9,000,000 

FY 2021 Enacted $10,000,000 

FY 2022 Budget Request $10,000,000 

52 U.S. Department of Health and Human Services. (December, 2020). Report to Congress on the Prevention and 

Reduction of Underage Drinking, Rockville, MD: Substance Abuse and Mental Health Services Administration 

Retrieved from www.stopalcoholabuse.gov. (National Survey on Drug Use and Health [NSDUH]; Center for 

Behavioral Health Statistics and Quality [CBHSQ], 2019c) 

169 
 

 

 

Budget Request 

The FY 2022 budget request is $10.0 million, level with the FY 2021 Enacted budget. SAMHSA 

will support 133 STOP Act grant continuations. 

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Outputs and Outcomes Table 

Program: Sober Truth on Preventing Underage Drinking (STOP Act) 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.3.01 Percent of 

coalitions that report at 

least 5% improvement in 

the past 30-day use of 

alcohol in at least two 

grades (Outcome) 

FY 2020: 62 % 

Target: 

57.7 % 

(Target Exceeded) 

57.7 % 57.7 % Maintain 

3.3.02 Percent of 

coalitions that report 

improvement in youth 

perception of risk from 

alcohol in at least two 

grades (Outcome) 

FY 2017: 46 % 

Target: 

75 % 

(Target Exceeded) 

75 % 75 % Maintain 

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Center for the Application of Prevention Technologies 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Center for the Application of Prevention Technologies........... $7,493 $7,493 $7,493 $---

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

Allocation Method................................................................................................................................... Contracts 

Eligible Entities....................................................................................................Domestic and Public Entities 

Program Description and Accomplishments 

In 2019, SAMHSA funded the Prevention Technology Transfer Centers (PTTC) cooperative 

agreements. The PTTC Network is comprised of 10 Domestic Regional Centers, 1 National 

American Indian and Alaska Native PTTC, 1 National Hispanic and Latino PTTC, and Network 

Coordinating Office. Together the Network serves the 50 U.S. states, the District of Columbia, 

Puerto Rico, the U.S. Virgin Islands, and the Pacific Islands of Guam, American Samoa, Palau, 

the Marshall Islands, Micronesia, and the Mariana Islands. 

The purpose of the PTTC Network is to improve implementation and delivery of effective 

substance misuse prevention interventions and provide training and technical assistance services 

to the substance misuse prevention field. This is accomplished by developing and disseminating 

tools and strategies needed to improve the quality of substance misuse prevention efforts; 

providing intensive technical assistance and learning resources to prevention professionals in order 

to improve their understanding of prevention science, epidemiological data, and implementation 

of evidence-based and promising practices; and, developing tools and resources to engage the next 

generation of prevention professionals. 

Program Evaluation 

The two-year evaluation for this program began on September 30, 2019. To date, the PTTC has 

delivered over 1,760 events and provided training/technical assistance to over 70,400 participants. 

Current program accomplishments include the following: 

The PTTC Network has developed many resources focusing on the prevention of vaping or 

tobacco use including over 15 webinars and several publications and newsletters. 

Together, the PTTC Network created a free online cultural competency program in order to support 

providers to improve the quality of care provided to clients from diverse backgrounds. The goal of 

this e-learning program is to help behavioral health professionals increase their cultural and 

linguistic competency. 

In response to COVID-19 pandemic, the PTTC Network developed several resources focused on 

“Bringing Prevention Virtual” to assist prevention professionals as they transition to delivering 

services and programming from face-to-face to virtual settings. 

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Among several events implemented and resources developed, the PTTC Network collaborates 

with the ATTC and the MHTTC to create a robust list of “Community Engagement Resources”. 

Providing equitable mental health and substance use prevention, treatment, and recovery services 

means engaging with all communities to make sure all people feel welcome and supported. 

Funding History 

Fiscal Year Amount 

FY 2018 $7,493,000 

FY 2019 $7,493,000 

FY 2020 $7,493,000 

FY 2021 Enacted $7,493,000 

FY 2022 Budget Request $7,493,000 

Budget Request 

The FY 2022 budget request is $7.5 million, level with the FY 2021 Enacted level. Prevention 

T/TA services are being conducted by the PTTCs. 

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Outputs and Outcomes Table 

Program: Center for the Application of Prevention Technologies (CAPT) 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.4.14 Number of people 

trained (Output) 

FY 2020: 70,400.0 

Target: 

70,400.0 

(Baseline) 

70,400.0 70,400.0 Maintain 

1.4.15 Percentage 

expecting to use 

information from training 

to change their practice. 

(Outcome) 

FY 2020: 69.0 

Target: 

Maintain Baseline 

Target Exceeded) 

Maintain Target Maintain Target Maintain 

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Science and Service Program Coordination 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Science and Service Program Coordination............................ $4,072 $4,072 $4,072 $---

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

Allocation Method................................................................................................................................... Contracts 

Eligible Entities....................................................................................................Domestic and Public Entities 

Program Description and Accomplishments 

SAMHSA has made preventing 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 of drinking by adolescents and young adults. Trend data report similar 

declines in underage binge and heavy drinking. In 2019, 139.7 million Americans aged 12 or older 

reported current use of alcohol, 65.8 million reported binge drinking and 16 million reported heavy 

drinking.53 Alcohol continues to be the most widely used substance of abuse among American 

youth, and a higher proportion use alcohol than use tobacco, marijuana, or other drugs.54 

The Science and Service Program Coordination program funds the provision of technical 

assistance and training to states, tribes, communities, and grantees around substance misuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance 

Center (TTTAC) and the Underage Drinking Prevention Education Initiatives (UADPEI). 

The TTTAC is an innovative training and technical assistance (TTA) project that helps tribal 

communities facilitate the development and implementation of comprehensive and collaborative 

community-based prevention plans to reduce violence, bullying, substance misuse, and suicide 

among American Indian/Alaska Native (AI/AN) youth, 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 UADPEI efforts 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. The UADPEI 

heavily promotes the adoption of evidence-based policies, programs, and practices by developing 

materials, resources, and other engagement tools to strengthen community-based prevention 

efforts on underage drinking and other substances. The initiative collaborates with other federal 

53 Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health 

indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication 

No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, 

Substance Abuse and Mental Health Services Administration. Retrieved from http://www.samhsa.gov/data 54 U.S. Department of Health and Human Services (HHS), SAMHSA. (2018). Report to Congress on the Prevention 

and Reduction of Underage Drinking. Retrieved from 

https://www.stopalcoholabuse.gov/resources/reporttocongress/rtc2018.aspx 

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agencies on underage drinking prevention strategy implementation through ICCPUD and the 

StopAlcoholAbuse.gov website. 

As part of its work to support SAMHSA and ICCPUD, the UADPEI develops new resources for 

prevention professionals that call out important trends from the NSDUH and emphasize new ways 

to approach underage and problem drinking prevention. These types of resources are audience 

specific and range from data visualizations and parent guides to the College Drinking: Prevention 

Perspectives (CD:PP) videos and discussion guides. CD:PP videos highlight evidence-based 

underage drinking prevention strategies at institutions of higher education, including historically 

black colleges and universities (HBCUs) while the discussion guides provide campus communities 

an opportunity to think critically about how these strategies can be adapted and modified to fit 

their own needs. 

The UADPEI also engages families, youth, youth-serving organizations, and institutions of higher 

education in initiatives such as SAMHSA’s Communities Talk to Prevent Underage Drinking. 

In FY 2019, community-based organizations registered to host 1,200 events and activities in all 50 

states, the District of Columbia, and three territories. Of the activities that took place, 

• 7 in 10 activities (67%) included youth in planning and/or hosting and almost 300 

included prevention messages related to marijuana, vaping and opioids, as well as mental 

health and wellness. 

An estimated 77,000 people participated in activities, either in person or virtually. SAMHSA 

garnered 2.1 million social media impressions through the #CommunitiesTalk and reached an 

estimated 19.8 million people through traditional media promoting Communities Talk. 

In FY 2020, SAMHSA modified the initiative to account for impacts on communities created by 

the COVID-19 pandemic. As a result, the 2021 cycle of Communities Talk places a higher 

emphasis on prevention activities that share important messages about underage drinking while 

accounting for social distancing guidelines, the limited capacity of prevention professionals and 

the new realities associated with underage and problem drinking. To do this, SAMHSA gathered 

insights from community- and state-level prevention professionals, including those that work at 

colleges and universities. Key changes to the initiative include additional support and resources 

for virtual activities (webinars, PSAs, interactive social media campaigns, etc.) and new messaging 

that creates a stronger link between overall wellness during the pandemic and substance use 

prevention. Since the initiative’s launch in February, more than 500 organizations have registered 

their participation. 

Program Evaluation 

In 2019 the UADPEI reached its goal of 1,000 organizations hosting underage drinking prevention 

events. More than 150 institutions of higher education also participated in the 2019 Communities 

Talk cycle. 

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Tribal Training and Technical Assistance Contract (TTAC) 

During FY 2020, GPRA data was collected from a total of 541 TTA participant questionnaires. 

The participant questionnaire results indicated an overall positive response to the TTA provided 

onsite and virtually. Respondents reported that the TTA improved their individual capacity and 

their organization’s capacity to do prevention work. Overall, about 95 percent of participants 

reported TTA was useful and improved capacity for themselves and their organizations. 

The total 541 TTA reported above also comprises the following FY 2020 activities. During FY 

2020, the Tribal TTA Center team reported data on 9 Broad TTA events, 12 Focused TTA events, 

31 Intensive TTA events, and 15 Opioids TTA events. The TTA Center collected GPRA measures 

on Onsite Broad TTA events serving a total of 123 participants representing 26 AI/AN 

communities over 10 days and 3 events. Six virtual Broad TTA events served a total of 244 

participants. Onsite Focused TTA events served a total of 123 participants representing 73 AI/AN 

communities over 19 days and 6 events. Seven Focused virtual TTA events served a total of 56 

participants. Intensive Virtual TA served 298 participants through 22 events and Intensive training 

served a total of 334 participants across 9 events. Onsite Opioids TTA events served a total of 309 

participants representing 105 AI/AN communities over 15 days and 7 events. Eight Opioids virtual 

TTA events served a total of 397 participants. 

Funding History 

Fiscal Year Amount 

FY 2018 $4,072,000 

FY 2019 $4,072,000 

FY 2020 $4,072,000 

FY 2021 Enacted $4,072,000 

FY 2022 Budget Request $4,072,000 

Budget Request 

The FY 2022 budget request is $4.1 million, level with the FY 2021 Enacted budget. This funding 

will support SAMHSA’s substance misuse prevention efforts and include a focus on preventing 

underage drinking and providing technical assistance and training to AI/AN communities. 

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Outputs and Outcomes Table 

Program: Prevention - Science and Service Activities 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.100 Number of 

organizations or 

communities that 

demonstrate improved 

readiness to change their 

systems (Output) 

FY 2020: 5.0 organizations 

Target: 

5.0 organizations 

(Target Met) 

5.0 

organizations 

5.0 

organizations 

Maintain 

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Tribal Behavioral Health Grants 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Tribal Behavioral Health Grants............................................. $20,000 $20,750 $21,165 $415 

Authorizing Legislation........................................................................................Section 516 of the PHS Act 

FY 2022 Authorization....................................................................................................................$211,148,000 

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.55 Further, AI/AN high school students report higher rates of suicidal 

behaviors than the general population of U.S. high school students. 56 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).57 

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 misuse, trauma, and 

suicide and by promoting the mental health of AI/AN young people. 

These five-year grants help grantees develop and implement a plan that addresses suicide and 

substance misuse, 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. 

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. 

55 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.

56 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. 57 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. 

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Fiscal YearAmount 

FY 2018$15,000,000 

FY 2019$20,000,000 

FY 2020$20,000,000 

FY 2021Enacted $20,750,000 

FY 2022Budget Request $21,165,000 

Since FY 2016, SAMHSA expanded activities through the braided TBHG funding from the 

Substance Abuse Prevention appropriation and the Mental Health appropriation) to allow tribes 

the flexibility to implement community-based strategies to address trauma, prevent substance 

misuse, and promote mental health and resiliency among youth in tribal communities. SAMHSA 

currently funds 185 active tribal grantees through this 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. 

Program Evaluation 

The SAMHSA Native Connections (NC) Team provided training and technical assistance (TTA) 

to 92 NC grantees for support in achieving the goals of the grant and disseminating best practices 

and lessons learned. TTA focuses on evidence-based and culturally informed policies and 

practices, and promoting mental, emotional, and behavioral health. It helps grantees shape and 

implement effective strategies to reduce the impact of substance use and misuse and mental illness, 

and to foster culturally responsive models to reduce and respond to the impact of trauma on AI/AN 

communities through a public health approach. During FY 2020, the NC Team delivered 4,958 

hours of virtual TTA to 92 grantees and developed and facilitated 13 live webinars. Ten individual 

podcasts featuring NC grantees were developed and accessed a total of 496 times throughout FY 

2020. Three national prevention events were designed to engage grantees and communities: 

National Prevention Month (Digital Storytelling Festival), Native American Heritage Month 

(Native American Heritage Month Toolkit), and National Drug and Alcohol Facts Week (fact 

sheets and eblasts). Regional Learning Communities were organized and facilitated for five 

grantee regions: Alaska, California, Arizona-New Mexico, Great Lakes- Northern Plains, and 

Oklahoma-Kansas. Twenty-two learning communities took place in FY 2020. Six National 

Learning Communities also took place in FY 2020. 

In FY 2020, grantees screened 46,887 individuals for mental health and suicide concerns; 466,861 

individuals were contacted through program outreach efforts, and 3,887 organizations 

implemented specific mental health related practices and activities that aligned with program 

goals. 

In FY 2019, SAMHSA supported 119 grant continuations, 26 new grants, and technical assistance 

activities. In FY 2020, SAMHSA supported 145 grant continuations, 40 new grants, and technical 

assistance activities. In FY 2021, SAMHSA plans to support 124 grant continuations, 29 new 

grants and technical activities. 

Funding History 

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Budget Request 

The FY 2022 budget request is $21.2 million, an increase of $415,000 above the FY 2021 Enacted 

budget. This request, along with $20.0 million in the Center of Mental Health Services will 

continue to support approximately 157 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. 

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Outputs and Outcomes Table 

Program: Tribal Behavioral Health Grants 

Measure Year and Most Recent 

Result / 

Target for Recent Result / 

(Summary of Result) 

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.4.12 Percentage of 

youth age 10 - 24 who 

received mental health 

or related services 

after screening, 

referral or attempt 

(Output) 

FY 2020: 47 

Target: 

42 

(Target Exceeded) 

47 47 Maintain 

2.4.13 Number of 

programs/organization 

s that implemented 

specific mental-health 

related 

practices/activities as a 

result of the grant 

(Outcome) 

FY 2020: 3,076 

Target: 

6,880 

(Target Not Met) 

3,000 3,000 Maintain 

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Minority Fellowship Program 

(Dollars in thousands) 

Program of Regional & National Sigificance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022

 +/-

FY 2021 

Minority Fellowship Program................................................. $321 $321 $340 $19 

Authorizing Legislation........................................................................................Section 597 of the PHS Act 

FY 2022 Authorization......................................................................................................................$12,669,000 

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

Eligible Entities.......Organizations that represent individuals obtaining post baccalaureate training 

(including for master’s and doctoral degrees) for mental and substance use disorder treatment 

professionals in the fields of psychiatry, nursing, social work, psychology, marriage and family 

therapy, mental health counseling, and substance use disorder and addiction counseling. 

Program Description 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 2019, SAMHSA funded seven continuation grants. SAMHSA supported the same level of 

effort in FY 2020. In FY 2020, SAMHSA supported 7 continuations and 1 new grant. SAMHSA 

will support 8 continuations in FY 2021. 

Funding History 

Fiscal Year Amount 

FY 2018 $71,000 

FY 2019 $321,000 

FY 2020 $321,000 

FY 2021 Enacted $321,000 

FY 2022 Budget Request $340,000 

Budget Request 

183 
 

 

 

 

 

 

FY 2022 

FY 2020 FY 2021 President's 

Programs of Regional & National Significance 

Final Enacted Budget 

No Amount No Amount No Amount 

Grants 

Continuations..................................................................... 469 128,736 641 157,128 712 176,277 

New/Competing................................................................. 307 53,067 114 25,967 65 15,302 

Supplements*..................................................................... 

Subtotal.......................................................................... 

 --- --- --- --- --- ---

776 181,803 755 183,095 777 191,579 

Contracts 

Continuations..................................................................... 10 23,677 12 21,135 13 19,393 

New................................................................................... 1 989 3 3,989 2 5,695 

Subtotal.......................................................................... 11 24,666 15 25,124 15 25,088 

Total, Substance Abuse Prevention PRNS 787 $206,469 770 $208,219 792 $216,667 

The FY 2022 budget request is $340,000, an increase of $19,000 over FY 2021 Enacted budget. 

Funding for this program will continue to support prevention related grants and support the 

provision of enhanced behavioral health services for racial and ethnic minority communities. 

SAMHSA/Substance Abuse Prevention 

PRNS Mechanism Table Summary 

(Dollars in thousands) 

184 
 

 

 

5 

5 

Capacity: 

Strategic Prevention Framework 

Grants 

Continuations..................................................................... 170 $82,105 230 $99,129 262 $111,155 

New/Competing................................................................. 87 28,939 32 12,186 13 $7,304 

Supplements....................................................................... 

Subtotal 257 111,044 262 111,315 275 118,459 

 --- --- --- --- --- ---

Contracts 

Continuations..................................................................... 3 8,440 3 7,015 3 8,215 

New................................................................................... ---

3 

260 

--- 1 

8,440 4 

119,484 266 

1,154 ---

8,169 3 

119,484 278 

---

8,215 

126,674 

Subtotal 

Total, Strategic Prevention Framework 

Federal Drug-Free Workplace 

Contracts 

Continuations..................................................................... 2 4,888 5 4,892 4 1,277 

New................................................................................... ---

2 

2 

6 ---

4,894 

4,894 

2 1 

4,894 5 

4,894 5 

3,617 

4,894 

4,894 

Subtotal.......................................................................... 

Total, Federal Drug-Free Workplace 

Minority AIDS 

Grants 

Continuations..................................................................... 94 22,482 147 31,784 163 34,656 

New/Competing................................................................. 

Subtotal.......................................................................... 

84 

178 

16,641 37 

39,123 184 

7,392 27 

39,176 190 

5,393 

40,049 

Contracts 

Continuations..................................................................... --- 2,069 --- 2,029 --- 1,980 

New................................................................................... --- 13 --- --- --- ---

 --- 2,082 --- 2,029 --- 1,980 

178 41,205 184 41,205 190 42,029 

Subtotal.......................................................................... 

Total, Minority AIDS 

Sober Truth on Preventing Underage Drinking Act 

Grants 

Continuations..................................................................... 39 1,833 117 5,772 133 6,577 

2 

New/Competing................................................................. 95 4,758 16 800 --- 43 

Subtotal.......................................................................... 134 6,591 133 6,572 133 6,620 

Contracts 

Continuations..................................................................... 1 1,439 2 3,428 2 3,380 

New................................................................................... 1 

2 

136 

970 ---

2,409

9,000 135 

--- ---

3,428 2 

10,000 135 

---

3,380 

10,000 

Subtotal.......................................................................... 

Total, Sober Truth on Preventing Underage Drinking Act 

SAMHSA/Substance Abuse Prevention 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

No Amount No Amount No Amount 

185 
 

 

 

SAMHSA/Substance Abuse Prevention 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

No Amount No Amount No Amount 

Tribal Behavioral Health Grants 

Grants 

Continuations..................................................................... 145 14,983 124 12,625 132 16,093

New/Competing................................................................. 40 2,489 29 5,590 25 2,562

Subtotal.......................................................................... 185 17,472 153 18,214 157 18,654

Contracts 

Continuations..................................................................... 1 2,528 --- 1,022 1 2,511

New/Competing................................................................. --- --- 1 1,514 --- ---

Subtotal.......................................................................... 1 2,528 1 2,536 1 2,511

 Total, Tribal Behavioral Health Grants 186 20,000 154 20,750 158 

196,333 766 

21,165 

Subtotal, Capacity 762 194,583 744 204,762

Science and Service: 

Center for the Application of Prevention Technologies 

Grants 

Continuations..................................................................... 13 7,117 13 7,117 13 7,140

New/Competing................................................................. --- --- --- --- --- ---

Subtotal.......................................................................... 13 7,117 13 7,117 13 7,140

Contracts 

Continuations..................................................................... --- 376 --- 376 --- 353

New/Competing................................................................. --- --- --- --- --- ---

Subtotal.......................................................................... 

Total, Center for the Application of Prevention Technol 

 ---

13 

376 ---

7,493 13 

376 ---

7,493 13 

353 

7,493

SAP Minority Fellowship Program 

Grants 

Continuations..................................................................... 7 66 8 305 8 305 

New/Competing................................................................. 1 239 --- --- --- ---

Supplements*..................................................................... 

Subtotal.......................................................................... 

 --- --- --- --- --- ---

8 305 8 305 8 305 

Contracts 

Continuations..................................................................... --- 16 --- 16 --- 16 

New/Competing................................................................. 

Subtotal.......................................................................... 

Total, SAP Minority Fellowship Program 

 --- --- --- 313 --- 19 

 --- 16 --- 16 --- 35 

8 321 8 321 8 340 

186 
 

 

 

Programs of Regional & National Significance No Amount No Amount No Amount 

Science & Service Program Coordination 

Grants 

Continuations..................................................................... 1 150 2 396,366 1 352,230 

New/Competing................................................................. 

Subtotal.......................................................................... 

 --- --- --- --- --- ---

1 150 2 396 1 352 

Contracts 

Continuations..................................................................... 3 3,922 2 2,357 3 1,661 

New................................................................................... --- --- 1 1,319 1 2,059 

Subtotal.......................................................................... 3 3,922 3 3,676 4 3,720 

Total, Science & Service Program Coordination 4 4,072 5 4,072 5 4,072 

Subtotal, Science and Service 25 11,886 26 11,886 26 11,905 

Total, Substance Abuse Prevention 787 $206,469 770 $208,219 792 $216,667 

SAMHSA/Substance Abuse Prevention 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

187 
 

 

Grant Awards Table 

(Whole dollars) 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022

 President's Budget 

Number of Awards 787 770 792 

Average Award $234,282 $242,510 $246,562 

Range of Awards $50,000 - $2,300,000 $50,000 - $2,300,000 $50,000 - $2,300,001 

188 
 

 

Substance Abuse Treatment 

Table of Contents 

1. Substance Abuse Treatment Appropriation........................................................................191 

2. Programs of Regional and National Significance (PRNS)..................................................192 

a) Opioid Treatment Programs/Regulatory Activities .....................................................193 

b) Screening, Brief Intervention and Referral to Treatment.............................................196 

c) Targeted Capacity Expansion-General........................................................................200 

d) Pregnant and Postpartum Women...............................................................................205 

e) Recovery Community Services Program ....................................................................210 

f) Children and Families ................................................................................................213 

g) Treatment Systems for Homeless ...............................................................................218 

h) Minority AIDS...........................................................................................................221 

i) Criminal Justice Activities .........................................................................................223 

j) Building Communities of Recovery ...........................................................................231 

k) Minority Fellowship Program............................................................................................234 

l) Addiction Technology Transfer Centers.....................................................................236 

m) Improving Access to Overdose Treatment..................................................................239 

n) First Responder Training for Opioid Overdose Reversal Drug....................................242 

o) Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths .......................245 

p) Peer Support Technical Assistance Center..................................................................249 

q) Emergency Department Alternatives to Opioids.........................................................251 

r) Treatment, Recovery, and Workforce Support............................................................253 

s) Comprehensive Opioid Recovery Centers ..................................................................255 

t) Opioid Response Grants.............................................................................................258 

189 
PRNS Mechanism Tables..................................................................................................259 

Grant Award Table............................................................................................................267 

3. State Opioid Response Grants ...........................................................................................268 

4. Substance Abuse Prevention and Treatment Block Grant...................................................273 

190 
 

 

 

 

 

 

Programs of Regional and National 

Significance................... $479,677 $496,677 $650,864 $154,187 

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

State Opioid Response Grants............................................... 1,500,000 1,500,000 2,250,000 750,000 

Set-Aside forTribes (non-add) ......................................... 50,000 50,000 75,000 25,000 

Substance Abuse Prevention and Treatment Block Grant.... 1,858,079 1,858,079 3,508,079 1,650,000 

 Budget Authority (non-add) ............................................... 1,778,879 1,778,879 3,428,879 1,650,000 

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

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

79,200 79,200 79,200 ---

$3,837,756 $3,854,756 $6,408,943 $2,554,187 

 

 

 

Substance Abuse Treatment Appropriation 

(Dollars in thousands) 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

Request 

FY 2022 +/-

FY 2021 

The Substance Abuse Treatment FY 2022 Budget Request is $6.4 billion, an increase of $2.6 

billion from the FY 2021 Enacted. The request includes $3.4 billion in Budget Authority and 

$79.2 million in Public Health Service (PHS) Evaluation funds. 

191 
 

 

 

Capacity: 

Opioid Treatment Programs/Regulatory Activities........................................... $8,724 $8,724 $13,086 $4,362 

Screening, Brief Intervention and Referral to Treatment.................................. 30,000 30,000 30,560 560 

Budget Authority (non-add)......................................................................... 28,000 28,000 28,560 560 

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

Targeted Capacity Expansion-General............................................................. 100,192 102,192 147,916 45,724 

Other Targeted Capacity Expansion.......................................................... 11,192 11,192 11,416 224 

MAT for Prescription Drug and Opioid Addiction (non-add).................... 89,000 91,000 136,500 45,500 

MAT for Prescription Drug and Opioid Addiction (Tribes)(non-add). --- 11,000 16,500 5,500 

Pregnant and Postpartum Women...................................................................... 31,931 32,931 49,397 16,466 

Recovery Community Services Program.......................................................... 2,434 2,434 5,151 2,717 

Improving Access to Overdose Treatment........................................................ 1,000 1,000 1,500 500 

Building Communities of Recovery.................................................................. 8,000 10,000 20,000 10,000 

Children and Families...................................................................................... 29,605 29,605 30,197 592 

Treatment Systems for Homeless...................................................................... 36,386 36,386 37,114 728 

Minority AIDS.................................................................................................. 65,570 65,570 66,881 1,311 

Criminal Justice Activities............................................................................... 89,000 89,000 124,380 35,380 

Other Criminal Justice Activities (non-add)............................................... 19,000 19,000 19,380 380 

Drug Court Activities(non-add)................................................................... 70,000 70,000 105,000 35,000 

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths........... 12,000 12,000 18,000 6,000 

Peer Support TA Center................................................................................... 1,000 1,000 1,500 500 

Treatment, Recovery, and Workforce Support.................................................. 4,000 6,000 9,000 3,000 

Emergency Department Alternatives to Opioids............................................... 5,000 6,000 9,000 3,000 

Opioid Response Grants.................................................................................. --- 3,000 3,000 ---

Comprehensive Opioid Recovery Centers....................................................... --- 4,000 6,000 2,000 

First Responder Training (CARA)................................................................... 41,000 42,000 63,000 21,000 

First Responder Training (non-add)........................................................... 18,000 18,000 27,000 9,000 

Rural Set-Aside (non-add)........................................................................... 

Subtotal, Capacity 

23,000 24,000 36,000 12,000 

465,842 481,842 635,682 153,840 

Programs of Regional and National Significance (PRNS) 

Substance Abuse Treatment Appropriation 

(Dollars in thousands) 

Programs of Regional and National Significance FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 +/-

FY 2021 

Science and Service: 

SAT Minority Fellowship Programs................................................................ 

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

Subtotal, Science and Service 

4,789

9,046 

5,789 

9,046 

6,136 

9,046 

347 

---

13,835 14,835 15,182 347 

Total, PRNS $479,677 $496,677 $650,864 $154,187 

192 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Opioid Treatment Programs/Regulatory Activities 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget 

Request 

FY 2022+/-

FY 2021 

Opioid Treatment Programs/Regulatory Activities............. $8,724 $8,724 $13,086 $4,362 

Authorizing Legislation............................................Section 509 of the Public Health Service Act 

FY 2022 Authorization............................................................................................ $333,806,000 

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

Eligible Entities............................................................ American Society of Addiction Medicine, 

American Academy of Addiction Psychiatry, American Medical Association, American 

Osteopathic Association, American Psychiatric Association, American Dental Association 

Domestic Medical Schools, Physician Assistant Schools, and Schools of Nursing 

Program Description and Accomplishments 

The misuse of prescription opioid pain relievers and the use of illicit opioids, such as heroin and 

synthetic opioids, continues to be a major public health crisis. Communities continue to see 

growing overdose deaths58, infectious diseases59 and other injection drug use-related health 

concerns. 

With increasing incidence of opioid abuse, there is a corresponding increase in admissions for 

treatment of opioid abuse.60 Medication-assisted treatment (MAT) refers to the use of the Food 

and Drug Administration (FDA) approved pharmacotherapies (e.g. buprenorphine products, 

methadone, and naltrexone products) in combination with evidence-based psychosocial 

interventions for treatment of opioid use disorders. MAT is a safe and evidence-based strategy for 

decreasing the frequency and quantity of opioid use and reducing the risk of overdose and death. 

Approximately one million Americans need, but do not access, treatment for an opioid addiction.61 

Opioid treatment programs (OTPs) are the only means of providing medication-assisted treatment 

(MAT) with methadone. Buprenorphine can be prescribed in an office setting by qualified health 

care providers who have received a waiver under the Drug Addiction Treatment Act of 2000 

(DATA 2000) provision of the Controlled Substances Act. Most health care providers with a 

waiver to prescribe buprenorphine do not treat the maximum allowable number of patients. 

58 Centers for Disease Control and Prevention. Annual Surveillance Report of Drug-Related Risks and Outcomes, 

2019. Retrieved from https://www.cdc.gov/drugoverdose/pdf/pubs/2019-cdc-drug-surveillance-report.pdf. 59 National Institute on Drug Abuse. Health Consequences of Drug Misuse, 2017. Retrieved from 

https://www.drugabuse.gov/publications/health-consequences-drug-misuse/hiv-hepatitis-other-infectious-diseases. 60 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. 

193 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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). 

With the passage of the Substance Use Disorder Prevention that Promotes Opioid Recovery and 

Treatment for Patients and Communities (SUPPORT) Act in October 2018, the five-year limit on 

prescribing privileges for NPs and PAs was removed. Additionally, the SUPPORT Act expanded 

prescribing privileges to Clinical Nurse Specialists (CNSs), Certified Registered Nurse 

Anesthetists (CRNAs), and Certified Nurse Midwives (CNMs) until October 1, 2023. 

SAMHSA is responsible for regulating and certifying 1,823 OTPs as of April 2021 to use opioid 

agonist treatment medications and processing DATA waivers for qualifying practitioners and 

physician assistants who wish to treat opioid use disorder with buprenorphine. SAMHSA reviews 

new and renewal applications for OTPs and oversees their accreditation process. OTPs are 

required to be accredited as a condition of certification. SAMHSA’s OTP regulation 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 site 

visits to a percentage of programs that received accreditation review within that year; additionally, 

SAMHSA can conduct unannounced OTP site visits to investigate complaints and determine 

compliance with federal regulations in 42 CFR Part 8. 

SAMHSA implements DATA 2000 in coordination with the Drug Enforcement Administration 

(DEA). This includes approving waivers for qualified practitioners to provide medication-assisted 

treatment in office-based settings. 

In April 2021, SAMHSA released practice guidelines that allow for an alternative Notice of Intent 

(NOI) for those seeking to treat up to 30 patients: The customary NOI requires eligible providers 

to undertake required training activities prior to their application to prescribe Buprenorphine; the 

alternative type of NOI allows those providers who wish to treat up to 30 patients to forego the 

training requirement, as well as certification to counseling and other ancillary services (i.e., 

psychosocial services). Practitioners utilizing this training exemption are limited to treating no 

more than 30 patients at any one time (time spent practicing under this exemption will not qualify 

the practitioner for a higher patient limit). This exemption applies only to the prescription of 

Schedule III, IV, and V drugs or combinations of such drugs, covered under the CSA, such as 

buprenorphine. 

As of February 1, 2021, a total of 95,804 professionals were certified to prescribe buprenorphine, 

as follows: 62 63 

61 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. 62 This is a non-duplicated count of active practitioners. 

63 Data provided by Center for Behavioral Health Statistics and Quality 

194 
195 

• 50,748 physicians, 13,737 NPs, 3684 PAs, 113 CNMs, 58 CNSs, and 7 CRNAs were certified

to treat up to 30 patients;

• 12,941 physicians, 6115 NPs, 1586 PAs, 36 CNMs, 19 CNSs, and 8 CRNA were certified to

treat up to 100 patients; and

• 5259 physicians, 1199 NPs, and 304 PAs, and 1 CNS were certified to treat up to 275 patients. 

Provider’s Clinical Support System - Universities

SAMHSA supports the Providers’ Clinical Support System- Universities(PCSS-U) grant program. 

This program provides education, training and clinical mentoring to students of healthcare

professions seeking to treat opioid use disorder upon their graduation. 

Program Evaluation

The PCSS-U program integration of formal education on opioid treatment for future providers 

while they are in school. This assures students are prepared to obtain a DATA 2000 Waiver

allowing them to prescribe much needed medication to treat opioid use disorder, upon becoming 

licensed professionals. 

In FY 2020, SAMHSA funded 29 continuation grants and 2 contracts.

In FY 2021, SAMHSA anticipates funding 1 continuation and 36 new grants, and 2 contracts.

Funding History

Fiscal Year Amount

FY 2018 $8,724,000 

FY 2019 $8,724,000 

FY 2020 $8,724,000 

FY 2021 Enacted $8,724,000 

FY 2022 Budget Request $13,086,000 

Budget Request

The FY 2022 Budget Request is $13.1 million, an increase of $4.4 million from the FY 2021 

Enacted level. In FY 2022, SAMHSA will award approximately 36 continuation grants, 29 new

grants and two contracts. SAMHSA will use the increase in funding to hold at least 300 additional 

events and provide training for an additional 8,000 participants.
196 

Screening, Brief Intervention, and Referral to Treatment

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Screening, Brief Intervention and Referral to Treatment $30,000 $30,000 $30,560 $560 

Budget Authority (non-add) ................................... 28,000 28,000 28,560 560 

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

Authorizing Legislation............................................Section 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

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

Eligible Entities..................................... Single State Authority and Health Departments in States,

Territories, the District of Columbia, Federally Recognized American Indian/Alaska Native

Tribes or Tribal Organizations, Domestic Public and Private Non-Profit Entities, and Public and

Private Universities and Colleges

Program Description and Accomplishments

Among individuals age 12 or older, 30.5 million (11.2 percent) use illicit drugs, 66.6 million (47.4

percent of current alcohol users) binge drink, and 16.7 million (25.1 percent of current alcohol 

users) drink heavily.64 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, tobacco and alcohol costs society $740 billion each year.65 Of the individuals who

need treatment for substance use disorder, only 12.2 percent receive treatment in a specialty

treatment facility.66 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 long shown that this approach is effective in

helping reduce harmful alcohol consumption.67,68,69

64 Center for Behavioral Health Statistics and Quality. (2020). Key substance use and mental health indicators in the 

United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-

0012020).Retrieved from https://www.samhsa.gov/data/report/2019-nsduh-annual-national-report 65 National Institute on Drug Abuse (2017), Trends and Statistics, http://www.drugabuse.gov/related-topics/trendsstatistics.

66 Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug 

Use and Health Retrieved from http://www.samhsa.gov/data/ 67 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. 68 Kahan, M., Wilson, L., & Becker, L. (1995). Effectiveness of physician-based interventions with problem drinkers: 

A review. Canadian Medical Association Journal, 152, 851–859. 69 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. 
197 

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. 

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.70 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 use

disorder treatment and services.

Program Evaluation 

In FY 2020, the program served over 133,115 clients. At six-month follow-up, the rate of change 

for the National Outcome Measures was as follows: 27.8 percent of clients reported that they were

currently employed or attending school, 64.5 percent reporting that they had a permanent place to

live in the community; 31.8 percent reported abstinence from substance use, a 387.7 percent

increase from those reporting at intake; and 98.0 percent reported no past 30-day arrests, a 3.2 

percent increase from those reporting at intake.

 

In FY 2020, SAMHSA funded 32 continuation grants.

In FY 2021, SBIRT anticipates funding 27 continuations and 10 new grants. 

70 RTI International (2009). RTI International to Evaluate Comprehensive Substance Abuse Intervention Programs 

for SAMHSA. 
198 

Funding History

Fiscal Year Amount

FY 2018 $24,700,000 

FY 2019 $27,854,000 

FY 2020 $30,000,000 

FY 2021 Enacted $30,000,000 

FY 2022 Budget Request $30,560,000 

Budget Request

The FY 2022 Budget Request is $30.6 million, an increase of $560,000 from the FY 2021 Enacted

level. SAMHSA plans to use the increase in funds to award 37 continuation grants and one new

grant. 
199 

Outputs and Outcomes Table

Program: Screening, Brief Intervention and Referral to Treatment

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target

FY 2022 

Target

FY 2022 

Target

+/-FY 2021 

Target

1.2.40 The number of 

clients served (Output) 

FY 2020: 123,497 

Target:

73,462 

(Target Exceeded)

78,000 195,537 +117,537 

1.2.41 Percentage of

clients receiving services

who had no past month

substance use (Outcome) 

FY 2020: 37.2 % 

Target:

35.2 % 

(Target Exceeded)

41 % 41 % Maintain
200 

Targeted Capacity Expansion-General

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted

FY 2022 

President's 

Budget

FY 2022+/- 

FY 2021

Targeted Capacity Expansion-General.......................................................... $100,192 $102,192 $147,916 $45,724

Other Targeted Capacity Expansion.................................................... 11,192 11,192 11,416 224 

MAT for Prescription Drug and Opioid Addiction (non-add)................ 89,000 91,000 136,500 45,500

MAT for Prescription Drug and Opioid Addiction (Tribes)(non-add)... --- 11,000 16,500 5,500

Authorizing Legislation..........................................Sections 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

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 use disorder 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 use disorder 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 use disorder 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)

The MAT-PDOA program addresses treatment needs of individuals who have an opioid use

disorder (OUD) by expanding/enhancing treatment system capacity to provide accessible,

effective, comprehensive, coordinated/integrated, and evidence-based MAT and recovery support 

services.

 

MAT refers to the use of the Food and Drug Administration-approved pharmacotherapies (i.e.,

buprenorphine products, methadone, and naltrexone products) in combination with evidencebased psychosocial interventions for treatment of OUD. MAT is a safe and effective strategy for

decreasing the frequency and quantity of opioid misuse and reducing the risk of overdose and

death. Recovery support services include linking patients and families to social, legal, housing, 

and other supports to improve retention in MAT to increase the probability of positive outcomes. 
201 

Between 2016 and 2019, MAT use increased from 912,401 to 1,461,895.71 In 2019, there was a 

significant decrease in prescription opioid misuse across all age groups. However, overdose deaths

have been increasing. CDC preliminary data point to 90,000 overdose deaths for the 12 months 

ending last September – about 20,000 more than the same period the year before. Deaths involving 

synthetic opioids, likely driven by illicitly manufactured fentanyl (IMF), including fentanyl 

analogs, a main driver of the increase in overdose deaths. While prescription opioid overdoses are

falling, other overdose categories continue to show troubling increases especially with the onset 

of Covid19 Synthetic opiates including fentanyl continue to drive tens of thousands of deaths in

2018. Despite these troubling statistics, significant gaps persist between treatment need and

capacity.

The aim of the state MAT-PDOA continuation grants is to increase the number of individuals 

receiving services with pharmacotherapies approved by the Food and Drug Administration for the 

treatment of opioid use disorder (OUD); increase the number of individuals receiving integrated

care; decrease the illicit opioid drug use at 6-month follow-up; and decrease prescription opioid 

use in a non-prescribed manner at 6-month follow-up. 

The MAT-PDOA grants expand and enhance access to medication-assisted treatment (MAT)

services for persons with an opioid use disorder (OUD) seeking or receiving MAT. The desired

outcomes include: 1) an increase in the number of individuals with OUD receiving MAT, and 2) 

a decrease in illicit opioid drug use and prescription opioid misuse at six-month follow-up.

Program Evaluation

MAT-PDOA grants: In 2020, 8,150 clients were served through the MAT-PDOA grant program. 

At six-month follow-up, 66.3 percent of individuals served reported abstinence from alcohol or 

illegal drug use, an increase of 88.1 percent rate of change from intake. 

 

In FY 2020, SAMHSA continued funding for 156 continuation grants and awarded five new

grants.

In FY 2021, SAMHSA anticipates funding 30 continuation grants (on a 3-year grant cycle) and

135 new MAT-PDOA grants for 5 years. 

Targeted Capacity Expansion-Peer to Peer (TCE-PTP) 

Peer support is built on the premise that individuals in recovery from substance use disorders and

addiction issues can be of great value through the sharing of their lived 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 proven to reduce healthcare costs. Research

studies indicate that recovery support service adjuncts provide significant benefits over and above 

treatment alone. 

71 https://www.samhsa.gov/data/sites/default/files/reports/rpt29392/Assistant-Secretarynsduh2019_presentation/Assistant-Secretary-nsduh2019_presentation.pdf
202 

There is a growing need to train and certify existing peer providers to address the increasing

demand and diverse settings in which peer support specialists are employed. Since 2002, 

SAMHSA has awarded over 61 grants to community-based organizations that provide peer

recovery support services to individuals in or seeking recovery from substance use addiction and

to 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 grant program incorporates a 

peer-to-peer model, capitalizing on the expertise of those individuals with similar lived experience. 

The TCE-PTP program has reached over 16,000 individuals and their families. Significant strides

have been made in helping program participants secure and maintain long-term recovery, cultivate

employment and educational opportunities, enhance their sense of social connectedness, improve 

their housing stability, and decrease involvement with the criminal justice system. 

Program Evaluation 

Among the first of SAMHSA’s grant awards for recovery initiatives, the TCE Peer-to-Peer

program grants have supported individuals in achieving and sustaining recovery, and enhancing 

their education/employment opportunities, as well as their housing stability. As of FY 2020, four 

grants remained in the portfolio and all have been approved for FY 2021 continuations funded at

$250,000 annually. 

These programs represent Recovery Community Organizations (RCOs) that provide peer-to-peer

services to individuals in need of recovery support services (RSS) while addressing their substance 

use disorder (SUD) issues. Peer recovery support takes the form of outreach and engagement in a 

variety of settings (e.g. hospital emergency departments, jails, institutions, homeless shelters,

recovery homes, outpatient facilities, etc.), and peer recovery coaching to individuals can occur

before, during, after, or in lieu of treatment, as well as peer navigator services (i.e. assisting

individuals in recovery to obtain a driver’s license, employment, housing, childcare, etc.). 

Grantees are engaged in some or all of these activities. 

To date, this cohort of grantees has served 638 individuals (364 males and 269 females), which is

74.7 percent of the year to date program goal. In FY 2020, 362 clients were served. Of these

clients, 204 were males and 156 were females and represented 55.5 percent White, 23.2 percent

Black/African American, 19.3 percent selected none of the above, and the remaining individuals 

served were American Indian, Native Hawaiian or other Pacific Islander, multiracial or refused to

answer this question. 

 

From intake to discharge, clients reported an improved rate of change in all but one of SAMHSA’s

National Outcome Measures. At discharge, 100 percent of the participants had not been arrested

in the past thirty days, a 1.6 percent increase from intake. Eighty seven percent reported no health,

behavioral or social consequence as a result of alcohol or illegal drugs, a 96.4 percent increase

from intake to discharge. Over 82 percent of participants abstained from alcohol or illegal drug 

use and 55 percent reported having a permanent place to live in the community, a 150 percent

increase. Lastly, over 50 percent were currently employed or attending school, an increase of 18.5 

percent from intake. Participants’ social connectedness slightly decreased by 1.6 percent from 

intake to discharge although it remained high at 96.8 percent. This slight decrease is likely
203 

attributed to the COVID-19 pandemic and its continued social isolation and quarantining 

throughout the country. It is important to note that at the six-month follow-up, 8.6 percent of 

participants reported injecting illegal drugs, which is a 13.3 percent decrease from intake. 

Targeted Capacity Expansion – Special Projects

SAMHSA funded the TCE- Special Projects program beginning in FY 2019. The purpose of this

program is to develop and implement targeted strategies for substance use disorder treatment

provision to address a specific population or area of focus identified by the community. The 

purpose of the TCE program is to address an unmet need or underserved population; this program 

aims to enable a community to identify the specific need or population it wishes to address through 

the provision of evidence-based substance use disorder treatment and/or recovery support services.

In FY 2020, SAMHSA funded four continuation grants for TCE-PTP and 23 TCE-Special

Projects.

In FY 2021, SAMHSA anticipates funding three new grants and 23 continuation grants for TCE

Special Projects.

The output and outcome measures for TCE-PTP, and TCE - Special Projects are part of the 

Treatment - Other Capacity Outputs and Outcomes table shown on page 229. 

Funding History

Fiscal Year Amount

FY 2018 $95,192,000 

FY 2019 $100,192,000 

FY 2020 $100,192,000 

FY 2021 Enacted $102,192,000 

FY 2022 Budget Request $147,916,000 

Budget Request

The FY 2022 Budget Request is $147.9 million, an increase of $45.7 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to support the TCE-Special Projects

and MAT PDOA grants. Specifically, SAMHSA will fund 23 new and three continuation TCESpecial Projects grants. Also, SAMHSA plans to fund 107 new MAT-PDOA grants and 140 

continuation grants, making MAT services accessible to 40 percent more individuals suffering

from OUD. 

 
204 

Outputs and Outcomes Table

Program: Medication-Assisted Treatment for Prescription Drug and Opioid Addiction

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.3.01 Number of 

admissions for 

Medication Assisted

Treatment (Output) 

FY 2020: 2365 

Target:

3158 

(Target Not Met)

2500 3628 +1,128 

1.3.02 Number of clients

receiving integrated care

(Output) 

FY 2018: 1243 

Target:

1301 

(Target Not Met)

Discontinued Discontinued N/A

1.3.03 Illicit drug use at

6-month follow-up 

(Outcome) 

FY 2020: 66 % 

Target:

57 % 

(Target Not Met)

67 % 68 % +1 % 
205 

Pregnant and Postpartum Women 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Pregnant and Postpartum Women......................................... $31,931 $32,931 $49,397 $16,466 

Authorizing Legislation.................................. Section 508 of the Public Health Service Act 

FY 2022 Authorization..............................................................................................$ 29,931,000 

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

Eligible Entities.................................................. Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

Since 2003, the Pregnant and Postpartum Women program (PPW) has used a family-centered

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

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

family members (e.g., fathers of the children). The family-centered 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. 

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

post-partum women in need of residential substance use disorder treatment. The PPW familycentered approach includes a variety of services and case management for women, children, and

families. Services provided to women include: outreach; engagement; pre-treatment; 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 are family-focused programs that 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 traumainformed approach.

 

In FY 2020, SAMHSA funded four new and 39 residential treatment continuation grants and 

supplements for direct technical assistance.

In FY 2021, SAMHSA anticipates funding 43 continuation residential treatment grants and

supplements for direct technical assistance.
206 

Program Evaluation 

In FY 2017, SAMHSA began a three-year PPW cross-site evaluation to examine the effectiveness

of the PPW Pilot Program. The evaluation results will be used broadly to improve the collective

understanding about effective components of the continuum of care for pregnant and postpartum 

women with a primary diagnosis of a substance use disorder, including whether the PPW Pilot

Program is an effective approach to increase access to the use of medication-assisted treatment.

The Pregnant and Postpartum Women Program has enhanced and expanded statewide capacity to

offer comprehensive family-centered treatment, prevention and recovery services in residential

and nonresidential treatment settings for pregnant and postpartum women, their minor children

(age 17 and under), fathers of the children, partners of the women, and other family members of 

the women and children. The program has demonstrated benefits in the following: increasing

accessto medications for substance use disorders, mental disorders, and primary health conditions; 

integrating peer recovery approaches to engage and retain women in care; incorporating home 

visiting as part of the continuum of care, as a key strategy, to extend services to support recovery;

and providing opportunities to increase access to care for diverse populations of women, 

particularly for those living in rural and remote locations in southern states.

In FY 2020, the PPW program served 1,296 women. Of the women served:

• 6.2 percent used methamphetamine, 

• 5.6 percent used opioids, 

• 18.4 percent used marijuana, 

• 25.5 percent used alcohol, 

Four hundred and seventy-eight completed a 6-month follow-up. Of these women: 

34.1 percent at intake were abstinent from alcohol or illegal drug use. At 6-month followup 89.1 percent were abstinent of alcohol or illegal drug use. Between intake and 6-month 

follow-up there was a positive 161.3 percent rate of change in abstinence. 

89.6 percent at intake had no past 30-day arrests. At 6-month follow up, 99.4 percent had

no past 30-day arrests. Between intake and 6-month follow-up there was a positive 10.9 

percent rate of change in no past 30-day arrest. 

8.2 percent of the women at intake were either employed or attending school. At 6-month 

follow-up 20.5 were either employed or attending school. Between intake and 6-month 

follow-up there was a positive 151.3 percent rate of change in employment or school 

attendance. 

18.4 percent had a permanent place to live in the community at intake. At 6-month 

follow-up, 28.9 percent of the women had a permanent place to live. Between intake and

6-month follow-up there was a positive 56.8 percent rate of change in permanent housing. 
207 

Pregnant and Postpartum Women Pilot

Section 501 of the Comprehensive Addiction and Recovery Act (CARA) increased accessibility

and availability of services for pregnant women by expanding the authorized purposes of the PPW

program to include the provision of outpatient and intensive outpatient services for pregnant 

women. Historically, the PPW program has only supported the provision of residential treatment

services.

The PPW pilot provides grants to states 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. 

In FY 2020, SAMHSA funded five new and three pilot continuation grants.

In FY 2021, SAMHSA anticipates funding four new and five pilot continuation grants. 

Program Evaluation

In FY 2020, the PPW Pilot program served 476 women. 

• 18.8 percent used marijuana or hashish

• 16.3 percent used alcohol 

• 10.8 percent used opioids 

• 9.6 percent used methamphetamines

• 7.5 percent used cocaine/crack

Two hundred ninety-four women completed a 6-month follow-up in 2020. Of these women, 64.7 

percent at intake were abstinent from alcohol or illegal drug use. At 6-month follow-up, 85.3 

percent were abstinent of alcohol or illegal drug use. Between intake and 6-month follow-up, 

there was a positive 32 percent rate of change in abstinence. 

Of these women, 93.9 percent at intake had no past 30-day arrests. At 6-month follow-up 98.6 

percent, had no past 30-day arrests. Between intake and 6-month follow-up, there was a positive 

5 percent rate of change in no past 30-day arrest. 

At intake, 26.2 percent of the women were either employed or attending school. At 6-month 

follow-up 40.3 were either employed or attending school. Between intake and 6-month followup, there was a positive 53.8 percent rate of change in employment or school attendance. 
208 

Of these women, 39.9 percent at intake had a permanent place to live in the community. At 6-

month follow-up, 54.7 percent of the women had a permanent place to live. Between intake and

6-month follow-up, there was a positive 37.3 percent rate of change in permanent housing. 

Funding History

Fiscal Year Amount

FY 2018 $29,931,000 

FY 2019 $29,931,000 

FY 2020 $31,931,000 

FY 2021 Enacted $32,931,000 

FY 2022 Budget Request $49,397,000 

Budget Request

The FY 2022 Budget Request is $49.4 million, an increase of $16.5 million from the FY 2021 

Enacted level. SAMHSA plans to use the increased funding to award nine pilot continuation 

grants, 3 new pilot grants, 24 PPW residential treatment continuation grants, and 45 new residential

treatment grants to provide an array of services and supports to pregnant women and their families.
209 

Outputs and Outcomes Table

Program: Pregnant and Postpartum Women Program 

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.84 Number of admissions of 

women who are currently 

pregnant or have a child to

substance abuse treatment

programs (Output)

FY 2020: 1,672.0

Target:

800.0 

(Target Exceeded)

1,700.0 2,658.0 +958 

1.2.85 Percentage of PPW

clients reporting no drug use in

the past month at six month 

follow-up (Outcome) 

FY 2020: 89.2

Target:

90.0 

(Target Not Met but 

Improved) 

90.0 90.0 Maintain

1.2.86 Percentage of PPW

clients who reported substance

misuse at intake, percent who

report reduction in substance 

misuse at six month follow-up 

(Outcome) 

FY 2020: 93.6

Target:

87.0 

(Target Exceeded)

94.0 95.0 +1

1.2.87 Percentage of PPW

clients who reported 

child/children not living with

client at intake, percent who

report child/children is living

with client at six month followup (Outcome)

FY 2020: 53.9

Target:

47.0 

(Target Exceeded)

55.0 55.0 Maintain

1.2.88 Number of women who

are currently pregnant or have a 

child who receive SUD and

related treatment services

(Outcome) (Outcome)

FY 2020: 377.0 

Target:

1,800.0 

(Target Not Met but 

Improved) 

380.0 380.0 Maintain
210 

Recovery Community Services Program 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Recovery Community Services Program.............................. $2,434 $2,434 $5,151 $2,717 

Authorizing Legislation............................................Section 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

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

In 2018, an estimated 20 million people in the United States, indicated that they have a substance 

use disorder and the 2018 NSDUH reports that among those who self-identified as ever having an

alcohol or other drug problem, fully 87 percent reported having recovered or being in recovery in

recovery from addiction to alcohol and other drugs.72 As public education increases, there is

broader acknowledgement of addiction as a treatable condition that can be successfully managed

over the course of a lifetime with the appropriate resources. More people in recovery are now 

willing to be open about their own recovery and to share their experience to help others attempting

to achieve recovery. Through the use of their lived experience, individuals in recovery can provide 

support and hope to those newly seeking recovery. 

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 to strengthen their infrastructure and

provide peer recovery support services to those in or seeking recovery from substance use

disorders across the nation. The delivery of recovery support services (RSS) by people in recovery

is known as peer recovery support services (PRSS). PRSS are a vital component in helping 

individuals and families address substance use disorders 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 the RCSP-SN 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). 

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 broader effect. Many states finally recognized the value 

of addiction peer recovery services; however, further efforts are still required to realize the 

potential of these services and supports at a system-wide level. The infusion of these services into

state systems ensures the wide scale adoption of peer recovery support. By developing a workforce

72 Substance Abuse and Mental Health Services Administration. (2019). 2018 National Survey on Drug Use and 

Health: Methodological summary and definitions. Rockville, MD: Center for Behavioral Health Statistics and Quality, 

Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
211 

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. 

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 substance use addiction as key partners in state systems, as

well as building a peer workforce. SAMHSA supports this state system development effort

through the RCSP Statewide Network grant program. Since the inception of the RCSP, over 123 

grants have been awarded to RCOs to expand PRSS locally and lay the groundwork for a national 

network of PRSS programs. 

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 levels. 

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. The statewide networks help to ensure the development of a trained, qualified, and

effectively supervised peer workforce.

Workforce outcomes for the program include; expanding the extent of training provided, 

increasing the number of people trained, enhancing trainee satisfaction, and the effectiveness of 

positive information presented. Other key outcomes include: the number of RCOs that have been

linked across the state; the number of state-sponsored 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 addition to workforce development, the three current RCSP-SN grants enhance the presence of 

RCOs as key partners in treatment, recovery, and affiliated health systems. RCSP-SN grantees

are engaged in regional and/or statewide infrastructure or capacity building activities where

grantees seek to leverage resources, educate state legislatures and senior executive branch level

leaders, and the public about the importance of recovery supports. A primary goal for these grants 

is to ensure that those in their respective jurisdictions regard the stakeholders in the recovery

community as critical partners in state and local planning when discussing the funding of and

planning for treatment and recovery support services. In addition to public health messaging, all

grantees work to reduce stigma around SUDs by engaging family members, civic institutions, and

the public at large. Recovery Month activities, held each September, are another way these

programs enhance the voice of recovery through activities like recovery walks and rallies. These

projects continue to emphasize the importance of sustainability through the diversification of 

revenue streams by RCOs working with their state Medicaid Plan Offices and local Managed Care

Organizations interested in Recovery Support Services (RSS) to seek reimbursement for the 

delivery of peer-based recovery support services in statewide reform initiatives.

 
212 

Program Evaluation 

In FY 2020, RCSP-SN grantees held 296 events exceeding their programmatic goal, while

providing a mix of services to over 2,975 participants who responded to post-event forms. 

In FY 2020, SAMHSA funded six new RCSP grants and three RCSP-SN continuation grants. 

In FY 2021, SAMHSA anticipates funding two new RCSP and six continuation RCSP grants. 

The output and outcome measures for the Recovery Community Services Program are part of the 

Treatment - Other Capacity Outputs and Outcomes table shown on page 229. 

Funding History

Fiscal Year Amount

FY 2018 $2,434,000 

FY 2019 $2,434,000 

FY 2020 $2,434,000 

FY 2021 Enacted $2,434,000 

FY 2022 Budget Request $5,151,000 

Budget Request

The FY 2022 Budget Request is $5.2 million, an increase of $2.7 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to award eight continuations and nine 

new RCSP grants. This will allow SAMHSA to continue the efforts of building addiction recovery

networks throughout the nation and the collaboration among peer-run organizations. 
213 

Children and Families

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Children and Families.......................................................... $29,605 $29,605 $30,197 $592 

Authorizing Legislation.............................Sections 509 and 514 of the Public Health Service Act

FY 2022 Authorization....................................................................... $333,806,000, $29,605,000 

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

Eligible Entities............................................................................ Single State Agencies in States, 

Territories, District of Columbia, public and private non-profit entities, Federally Recognized

American Indian/Alaska Native Tribes Tribal Organizations, and health facilities or programs 

operated by or in accordance with a contract or grant with the Indian Health Service

Program Description and Accomplishments

Substance use plays a significant role in the lives of many children and youth (ages 12 to 25) 

throughout the nation. In 2018, approximately 8 percent of adolescents between the ages of 12 

and 17 and 24 percent of youth between the ages of 18 and 25 reported current illicit drug use. 

Less than two percent of adolescents between the ages of 12 and 17, and 10 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. Most substance use begins during 

adolescence, making this developmental period a critical time for intervention. Approximately

four percent of admissions to substance use treatment facilities were adolescents in 2017. Sixtyone 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. Of children removed from their household 

and placed in foster care, nearly 35 percent can attribute the removal to instances where one or

both parents had substance misuse or substance use disorders. 

 

SAMHSA’s Children and Families program makes appropriate treatment available to youth and

their families/caregivers to reduce the impact of substance use disorders and/or co-occurring 

mental and substance use disorders on communities in the U.S.

Substance Use Disorder Treatment for Youth 

The earlier youth start using substances, the greater their chances of continuing to use substances

and developing substance use conditions later in life. Among adolescents aged 12 to 17 in 2019, 

4.6 percent (or 1.1million people) needed substance use treatment in the past year. These estimates

in 2019 were similar to the estimates in 2015 to 2017, but they were higher than the estimates in

2018. Among young adults aged 18 to 25 in 2019, 14.4 percent (or 4.8 million people) needed

substance use treatment in the past year. This percentage in 2019 was lower than the percentages

in most years from 2015 to 2018. 

In 2019, adolescents aged 12 to 17 who had a SUD, 8.3 percent (or 93,000 people) received any

substance use treatment and 0.3 percent (or 68,000 people) received substance use treatment at a 

specialty facility. These estimates were similar to the estimates in 2015 to 2018. In 2019, young 

adults aged 18 to 25 who had a SUD, 8.7 percent (or 415,000 people) received any substance use
214 

treatment and 1.1 percent (or 357,000 people) received substance use treatment at a specialty

facility. These estimates were similar to the estimates in 2015 to 2018. 

Among the 397,000 adolescents aged 12 to 17 in 2019 who had a co-occurring SUD and an MDE

in the past year (2019 DT 11.9), 66.3 percent (or 263,000 people) received either substance use

treatment at a specialty facility or mental health services in the past year, 62.5 percent (or 249,000 

people) received only mental health services, and 2.4 percent (or 10,000 people) received only 

substance use treatment at a specialty facility.

73 

 

SAMHSA’s programs to treat youth with addiction and/or co-occurring substance use 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/another 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. 

In FY 2018, SAMHSA developed a new grant program called Enhancement and Expansion of

Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and their Families

(Youth and Family TREE). Its purpose is to enhance and expand comprehensive treatment, early

intervention, and recovery support services for adolescents (ages 12-18), transitional aged youth 

(ages 16-25), and their families/primary caregivers with SUD and/or co-occurring substance use 

and mental disorders. Eligibility includes public and private non-profit entities. Youth and Family

TREE is focused on: increasing the unduplicated number of individuals served with evidencebased services and practices; increasing abstinence from the use of opioids, alcohol, marijuana,

and other substances; increasing access, engagement, and retention in treatment, including 

medication assisted treatment; improving parenting skills and family functioning; improving 

mental health; and increasing access to health services for underserved populations, specifically

federally recognized American Indian/Alaskan Native tribes and tribal organizations. 

73 Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health 

indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. 

PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance 

Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
215 

Program Evaluation 

State Youth Treatment Implementation (SYT-I)

In FY 2020, the SYT-I program provided substance use disorder treatment, recovery, and family

support servicesto 800 program participants. Program data collected at 6-month follow-up showed 

a positive change in risky behaviors while identifying behaviors that require additional support. 

For example, having unprotected sexual contact with an individual who is or was HIV positive or

had AIDS (0 occurrences), had unprotected sexual contact with injected drug user (0 occurrences),

injection drug use: injected illegal drugs (1.3 percent). Areas of continued struggle are evident in

data in unprotected sexual contact (55.6 percent) and unprotected sexual contact with an individual 

high on some substance (25 percent). Favorable trends at discharge reveals positive effects and

gains in program participants overall functioning. Significant improvements in abstinence (77.6

percent), crime and criminal justice: had no past 30 day arrest (100 percent), employment and

education: were currently employed or attending school (88.2 percent), health/behavior /social

consequences (93.6 percent), social connect connectedness(76.1 percent) and stability in housing 

(71.2 percent).

 

Services for Adolescents, Transitional Aged Youth, and their Families (YFTREE)

In FY 2020, the YFTREE program provided substance use disorder treatment, recovery and family

support services to 1,790 program participants. Program data collected at six-months follow-up 

and discharge demonstrate program participantsreduced risky behaviors associated with substance 

use and have experienced improved functioning in many areas of their life. Outcome data from 

risky behavior categories at 6 months follow-up revealed decrease in injection drug use (1.0

percent), unprotected sexual contact (2.9 percent), unprotected sex with an individual who was

HIV positive or has AIDS (0 percent), unprotected sexual contact with injection drug user (1.0 

percent), unprotected sexual contact with an individual high or on some substance (15.8 percent). 

The data collected at discharge highlights successful outcomes in abstinence (83.2 percent),

decreased recent involvement in the criminal justice system (6.1 percent), improved employment 

and education advancements (76.8 percent), health/behavior/social consequences (87.5 percent),

increased social connectedness (76.6 percent) and stability in housing (63.6 percent).

Risky behavior categories and reduction outcomes at 6 months: Injection drug use (1.0 percent),

unprotected sexual contact (2.9 percent), unprotected sex with an individual who was HIV positive 

or has AIDS (0 percent), unprotected sexual contact with injection drug user (1.0 percent),

unprotected sexual contact with an individual high or on some substance (15.8 percent). The data

collected at discharge determined successful outcomes in abstinence (3.2 percent). 

National Center on Substance Abuse and Child Welfare

SAMHSA and the Administration for Children and Families (ACF) collaborate to support the 

National Center on Substance Abuse and Child Welfare (NCSACW). NCSACW provides training

and technical assistance (TA) to improve collaborative practices among agencies and organizations 

that serve families affected by substance use disorders and involvement with child welfare

services. 
216 

From September 2017 to September 2020, NCSACW responded to 2,021 training and technical

(TTA) requests from a wide range of disciplines and from all 50 states. It facilitated 73 events

(including site visits, conference presentations, webinars and virtual training) attended by 12,964 

people. As a result of the public health pandemic, NCSACW responded to significant shifts in TA

delivery by adopting virtual strategies, while pivoting from in-person to fully virtual events.

The NCSACW website increases availability of policy and practice resources, products, and TTA

services. From September 2017 to September 2020, the NCSACW website accumulated 272,147 

website visits with an average of 380 user visits per day. Since 2007, the NCSACW has provided 

three web-based tutorials on serving families affected by substance use disorders for specific

audiences: substance use disorder treatment, child welfare, and court professionals.

From 2007 through September 2020, there were 85,053 tutorial registrations for these courses. 

The tutorials were updated with new content in 2020. 

 

The NCSACW provides a child welfare training toolkit entitled Helping Child Welfare Workers

Support Families with Substance Use, Mental, and Co-Occurring Disorders Training Package to

educate child welfare professionals about substance use and mental disorders among families

involved in the child welfare. The toolkit was updated in 2019 to highlight new research and best

practices as well as provide special modules on working with families affected by opioid and

methamphetamine use disorders and infants with prenatal substance exposure and their families.

The toolkit has been downloaded 6,134 times since its re-release in 2019. 

 

The NCSACW’s activities have assisted professionals throughout the nation to improve crosssystem collaboration and meet child welfare requirements for timely child permanency decisions. 

The NCSACW continues to provide training and technical assistance to tribes, state agencies, and

communities to develop collaborative approaches to the treatment of pregnant women with opioid 

use disorders and their infants and families. Since August 2016, NCSACW has disseminated

SAMHSA’s publication, 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 use treatment, dependency court, and

medical professionals. The publication has been disseminated in TTA or downloaded 5,190 times

since its 2016 release through September 2020. 

Specific to infants with prenatal substance exposure, the NCSACW has provided in-depth TA on 

addressing the needs of pregnant and parenting women with opioid and other substance use

disorders and their infants and families to the thirteen states. From September 2016 to March

2020, the NCSACW has responded to 5 TA requests on Plans of Safe Care, the provisions related

to prenatal substance exposure in the Child Abuse and Prevention Treatment Act (CAPTA), and

infants with prenatal substance exposure. 
217 

The NCSACW has facilitated multiple state and regional meetings, including a tri-regional 

convening in regions 4, 6 and 7 in 2018, a regional convening in region 9 in 2019 and a regional 

training meeting for region 8 in 2019. NCSACW also planned and implemented two policy 

academies (2017 and 2020). These helped more than 200 individuals for 23 cross-systems teams

enhance capacity to meet the multiple and complex needs of pregnant and parenting women with

opioid and other SUDs, their affected infants, and family members. These convenings focused on 

changes to the Child Abuse Prevention and Treatment Act (CAPTA) as a result of the 

Comprehensive Addiction and Recovery Act (CARA), regarding identification, notification and

monitoring of plans of safe care for infants affected by substance use, withdrawal symptoms or 

fetal alcohol spectrum disorders. 

In FY 2020, SAMHSA funded 35 Youth and Family TREE continuation grants, 11 continuing 

State Youth Treatment Implementation grants and 1 contract.

In FY 2021, SAMHSA anticipates funding 17 new Youth and Family Tree (YFTREE) grants and

35 continuation grants. 

The output and outcome measures for Children and Families are part of the Treatment - Other

Capacity Outputs and Outcomes table shown on page 229. 

Funding History

Fiscal Year Amount

FY 2018 $29,605,000 

FY 2019 $29,605,000 

FY 2020 $29,605,000 

FY 2021 Enacted $29,605,000 

FY 2022 Budget Request $30,197,000 

Budget Request

The FY 2022 Budget Request is $30.2 million, an increase of $592,000 from the FY 2021 Enacted

level. SAMHSA plans to use the increase in funds to award two new and 52 continuation Youth 

and Family Tree grants. These grants will continue to support states and tribes who have not 

previously received funds under this initiative, and to address the gaps in substance use disorder 

treatment by providing services for youth, their families, and caregivers. 
218 

Treatment Systems for Homeless

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Treatment Systems for Homeless....................................... $36,386 $36,386 $37,114 $728 

Authorizing Legislation............................................Section 506 of the Public Health Service Act

FY 2022 Authorization.............................................................................................. $41,304,000 

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

Eligible Entities.......................................States, Domestic Public and Community Organizations, 

Private Nonprofit Entities, and Community-based Public or Nonprofit Entities

Program Description and Accomplishments

SAMHSA’s Treatment Systems for Homeless portfolio supports services for those with

alcohol/other drug addiction and who are experiencing homelessness, including youth, veterans,

and families.

The number of individuals experiencing chronic homelessness declined by 20 percent, or nearly

24,000 people, between 2007 and 2019.74 On a single night in January 2019, 567,715 people were

experiencing homelessness in the United States. Of these individuals, 105,583 were experiencing

chronic homelessness, 116,179 had severe mental illness, 88,873 were affected by chronic 

substance use, and 37,085 were veterans.75

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 

ending homelessness among veterans, people with disabilities, families with children,

unaccompanied youth, and all other 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: 

Grants for the Benefit of Homeless Individuals (GBHI)

The GBHI program supports the development and/or expansion of local implementation of a 

community infrastructure that integrates treatment and recovery support services for substance use

74 The U.S Department of Housing and Urban Development, Office of Community Planning and Development (2020). 

The 2019 Annual Homeless Assessment Report (AHAR) to Congress, Part 1. Retrieved from 

https://files.hudexchange.info/resources/documents/2019-AHAR-Part-1.pdf 75 U.S. Department of Housing and Urban Development (HUD) 2019 Continuum of Care (CoC) Homeless Assistance 

Programs Homeless Populations and Subpopulations Report – Retrieve from 

https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2019.pdf
219 

disorders or co-occurring mental and substance use disorders, permanent housing, and other 

critical services for individuals (including youth) and families experiencing homelessness. 

Program Evaluation 

Based on FY 2020 data for the GBHI program, 54.9 percent of clients reported abstinence from

substance use at a six-month follow-up, while approximately 29.1 percent of clients reported being 

employed or engaged in productive activities, and 34.8 percent of clients reported having a 

permanent place to live in the community.76

In FY 2020, SAMHSA funded 13 new GBHI grants and 72 continuation grants, and supplement 

for direct technical assistance.

In FY 2021, SAMHSA anticipates funding 85 continuations grants and supplements for direct

technical assistance.

Funding History

Fiscal Year Amount

FY 2018 $36,386,000 

FY 2019 $36,386,000 

FY 2020 $36,386,000 

FY 2021 Enacted $36,386,000 

FY 2022 Budget Request $37,114,000 

Budget Request

The FY 2022 Budget Request is $37.1 million, an increase of $728,000 from the FY 2021 Enacted

level. SAMHSA plans to use the increase in funds to support grants to reduce homelessness for 

nearly 5,000 people. SAMHSA intends to fund 20 new and 68 GBHI continuation grants with

grant supplements for direct technical assistance. 

 

76 SPARS. (2020). Retrieved from www.samhsa-gpra.samhsa.gov. 
220 

Outputs and Outcomes Table 

Program: Treatment System for Homelessness (GBHI)

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

3.4.23 The number of 

clients served (Output) 

FY 2020: 3634 

Target:

3521 

(Target Exceeded)

3521 3758 +237 

3.4.24 Percentage of

homeless clients

receiving services who

were currently employed

or engaged in productive 

activities (Outcome) 

FY 2020: 30.3 % 

Target:

20 % 

(Target Exceeded)

34.4 % 34.4 % Maintain

3.4.25 Percentage of

clients receiving services

who had a permanent

place to live in the 

community (Outcome) 

FY 2020: 34.4 % 

Target:

70 % 

(Target Not Met but 

Improved) 

31.1 % 36.1 % +5 % 
221 

Minority AIDS

(Dollars in Thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Minority AIDS................................................................... $65,570 $65,570 $66,881 $1,311 

Authorizing Legislation.................................. Section 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

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

Eligible Entities.................................................. Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

SAMHSA’s Minority AIDS Initiative (MAI) funded programs are making a significant

contribution in addressing HIV and hepatitis infection by facilitating the development and

expansion of culturally competent and effective community-based treatment systems for

substance use and co-occurring mental disorder treatment within racial and ethnic minority

communities. The purpose of the Targeted Capacity Expansion-HIV program is to increase

engagement in care for racial and ethnic minority individuals with substance use disorders (SUD)

and/or co-occurring substance use and mental disorders (COD) who are at risk for HIV or HIV

positive that receive HIV services/treatment. Populations of focus for the TCE-HIV programs 

include African American, Hispanic/Latina, and other racial/ethnic minority women ages 18 

years and older; black young men who have sex with men (YMSM) (ages 18-29); other high-risk

populations such as Latino YMSM and men who have sex with men (MSM) (ages 30 years and

older); and gay, bisexual, and transgender individuals who have a SUD or COD, are HIV positive 

or at risk for HIV/AIDS and hepatitis. The MAI program, along with many other HIV/AIDS

programs across HHS, supports and contributes to the primary goal to end the HIV epidemic in

the United States. 

Program Evaluation 

FY 2020, the TCE-HIV program served 18,230 clients. Significant steps have been taken to

increase abstinence, employment and educational opportunities, social connectedness and housing 

stability. In FY 2020, the percentage of clients who reported that they did not use alcohol or illegal

drugs within the past 30 days increased by 74.2 percent between intake to 6-month follow-up. 

Between intake and six-month follow-up, the percentage of clients who reported no arrests within

the past 30 days increased by 2.7 percent. In addition, the percentage of clients who were

employed or attending school increased by 15.3 percent between intake to 6-month follow-up. 

Those clients who reported being socially connected increased by 3.0 percent from intake to 6-

month follow-up. The percentage of clients who reported housing stability increased by 14.2

percent between intake and 6-month follow-up77. 

77 SAMHSA. (2020, November). CSAT GPRA Modernization Act Discretionary Services Tools. Retrieved from 

https://www.samhsa.gov/grants/gpra-measurement-tools/csat-gpra/csat-gpra-discretionary-services
222 

In FY 2020, SAMHSA funded 121 TCE-HIV continuation grants and supplements for direct

technical assistance.

In FY 2021, SAMHSA anticipates funding 121 TCE-HIV grant continuations and supplements for

direct technical assistance.

Funding History

Fiscal Year Amount

FY 2018 $64,534,000 

FY 2019 $65,570,000 

FY 2020 $65,570,000 

FY 2021 Enacted $65,570,000 

FY 2022 Budget Request $66,881,000 

Budget Request

The FY 2022 Budget Request is $66.9 million, an increase of $1.3 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to award 64 new grants and 62 

continuation grants. 
223 

Criminal Justice Activities

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Criminal Justice Activities.................................................. $89,000 $89,000 $124,380 $35,380 

Other Criminal Justice Activities (non-add) ............. 19,000 19,000 19,380 380 

Drug Court Activities (non-add) ................................... 70,000 70,000 105,000 35,000 

Authorizing Legislation............................................Section 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

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

Public or private universities and colleges and Community- and faith-based organizations. 

 

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.

Referral source for substance use disorder treatment

The criminal justice system was the major source of referrals to substance use disorder treatment,

with probation or parole referrals representing the largest proportion of criminal justice system

referrals to treatment.78 

Most probation or parole referrals to treatment were men between the ages of 18 and 44. The most

common substances reported by these referrals were alcohol, marijuana, and methamphetamine.79 

78 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.

79 SAMHSA. (2015). Criminal and Juvenile Justice. Retrieved from http://www.samhsa.gov/criminal-juvenile-justice
224 

Drug Courts 

According to a 2017 Bureau of Justice Statistics (BJS) Special Report, approximately 14 percent

of state and federal prisoners, and 26 percent of jail inmates reported experiences that met the 

threshold for serious psychological distress (SPD) in the 30 days prior to a survey that was

conducted between February 2011 and May 2012.80 More than half (58 percent) of state prisoners 

and two-thirds (63 percent) of sentenced jail inmates met the criteria for drug dependence or abuse,

according to data collected 2007-2009.81 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.82 According to

BJS, there were 10.6 million jail admissions in 2016.83 At mid-year 2016, city and county jails

held over 740,000 individuals.84 Although the corrections system faced a decline in its prison 

population for the third consecutive year, more than 1.5 million Americans were incarcerated in

2016.85 In 2016, the rate of imprisonment for adult Americans was 450 per 100,000 U.S.

residents.86 

Drug Court Purpose 

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, criminal behavior, 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. 

Drug Court Services

SAMHSA’s ATDC programs support a variety of services including direct treatment services for 

diverse populations, wraparound and recovery support services such as recovery housing and peer

recovery support services designed to improve access and retention, drug testing for illicit

substances, educational support, relapse prevention and long-term management, and HIV and viral

hepatitis B and C testing conducted in accordance with state and local requirements. 

80 Bronson, J., & Berzofsky, M., (2017). Indicators of Mental Health Problems Reported by Prisoners and Jail 

Inmates, 2011-12. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/imhprpji1112.pdf 81 Bronson, J., Stroop, J., Zimmer, S. & Berzofshi, M., (2017). Drug Us, Dependence, and Abuse AmongState 

prisoners and jail Inmates, 2007-2009. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/dudaspji0709.pdf

82 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 

83 Zeng, Z. (2018). Jail Inmates in 2016. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/ji16.pdf 84 Ibid. 

85 Carson, E. A. (2018). Prisoners in 2016. Washington, D.C.: Bureau of Justice Statistics. Available: 

https://www.bjs.gov/content/pub/pdf/p16.pdf 86 Ibid. 
225 

Medication-Assisted Treatment

SAMHSA’s grant programs are encouraged to use part of their annual award to provide 

medication-assisted treatment (MAT) and are required to ensure that drug courts funded by 

SAMHSA-funded drug courts cannot deny the use of Food and Drug Administration (FDA)-

approved medications for opioid addiction to drug court clients. Drug court judges, however, 

retain judicial discretion in cases where specified conditions for pharmacotherapy provisions were

not met. Drug courts funded in FY 2020 are required to provide MAT services.

Evidence-based Services

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

communications with the National Association of Drug Court Professionals to obtain and

incorporate the latest findings and field expertise. 

Program Evaluation 

Performance data show that these grant programs are effective in improving the lives of drug court 

participants. Based on FY 2020 SAMHSA data, 5,936 clients received services through 

SAMHSA’s Adult Treatment Drug Court Programs. Of these clients at six-month follow-up, 84.2

percent reported that they did not use alcohol or illegal drugs within the past 30 days, an increase

of 30.7 percent. Additionally, there was an 8.7 percent increase from intake that had no 

involvement with the criminal justice system, a 28.3 percent increase of adult clients that were

either employed or attending school, and a 34.2 percent increase in clients who had a permanent

place to live in the community. 

Criminal Justice Drug Court and Reentry funded programs expand and enhance substance use

disorder (SUD) treatment services to adults involved in the Criminal Justice system. They provide 

recovery support services, screening, assessment, case management, and program coordination to

defendants/offenders to facilitate successful reentry to their communities. The desired outcome is

to break the cycle of criminal behavior, alcohol and/or drug use, and incarceration or other 

penalties, and encourage stable work and home environments. 

Family Treatment Drug Courts 

The purpose of the Family Treatment Drug Court (FTDC) program is to expand substance use 

disorder (SUD) treatment services in existing family treatment drug courts, which use the family

treatment drug court model in order to provide alcohol and drug treatment (including recovery

support services, screening, assessment, case management, and program coordination) to parents

with a SUD and/or co-occurring SUD and mental disorders, who have had a dependency petition

filed against them or are at risk of such filing. FTDCs are expected to provide a coordinated, multisystem approach designed to combine the sanctioning power of treatment drug courts with

effective treatment services promoting successful family preservation and reunification. FTDCs

assist participants in reducing the rates of substance misuse, the severity of SUDs and co-occurring 

disorders, and decreasing out of home placements for children through family reunification and

preservation. This should also decrease the number of parents or guardians whose parental rights 

have been or will be terminated.
226 

Program Evaluation 

Based on FY 2020 data, 1,241 clients received services through SAMHSA’s Family Drug Court 

programs. Of these clients at six-month follow-up, 80.7 percent reported that they did not use

alcohol or illegal drugs within the past 30 days, an increase of 34.6 percent. Additionally, there

was a 4.8 percent increase from intake that had no involvement with the criminal justice system, a 

40.9 percent increase of adult clientsthat were either employed or attending school, and 6.4 percent

increase in clients who had a permanent place to live in the community.

In FY 2020, SAMHSA funded 15 new drug court (ATDC) grants, three new FTDC grants, and

four Tribes/Tribal organizations, 155 drug court (ATDC/FTDC) grant continuations, and one 

contract. 

In FY 2021, SAMHSA anticipates funding two new and 179 continuation ATDC and FTDC

grants. 

Reentry

Across the country, more than 600,000 Americans are released from prisons and jails every year,

and more than 4.5 million are serving a community supervision sentence.87 For these individuals, 

transitioning back to their communities following incarceration can be a challenge for a number 

of reasons. Often, when individuals are released, they face several critical barriers to successful

reentry that they will need to overcome. Some have substance use issues, others have no place to

live, and a criminal record makes it difficult for many to find a job.88 For most, it is only a matter

of time before they return to prison. According to the Bureau of Justice Statistics, 68 percent of

state prisoners are rearrested within three years of their release.89

Other Criminal Justice /Offender Reentry Program 

In addition to the drug court portfolio, SAMHSA supports the Offender Reentry Program (ORP)

grants, as well as other criminal justice activities, such as a regional and national criminal justice

technical support contract. Studies show that only about 10 percent of individuals involved with

the criminal justice system who are in need of substance use disorder treatment receive it as part

of their justice system supervision. Approximately one-half of the institutional treatment provided 

is educational programming.90 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 diverse populations reentering the community from

incarceration. ORP grant services include screening, comprehensive individual assessment for 

87 Danielle Kaeble and Lauren Glaze, Correctional Populations in the United States, 2015, Bulletin, Washington, DC: 

U.S. Department of Justice, Bureau of Justice Statistics, December 2016, NCJ 250374, https://www.bjs.gov/ 

content/pub/pdf/cpus15.pdf 

88 Blair Ames, “NIJ-Funded Research Examines What Works for Successful Reentry,” NIJ Journal 281, November 

2019, https:// nij.ojp.gov/topics/articles/nij-funded-researchexamines-what-works-successful-reentry. 89 Mariel Alper, Matthew R. Durose, and Joshua Markman, 2018 Update on Prisoner Recidivism: A 9-Year Followup Period (2005-2014), Special Report, Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, 

May 2018, NCJ 250975, https://www.bjs.gov/content/pub/ pdf/18upr9yfup0514.pdf.

90 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. 
227 

substance use and/or co-occurring mental disorders, program and case management, and alcohol 

and other drug treatment. Other supported services include wraparound and recovery support 

services such as recovery housing and peer recovery support designed to improve access and

retention, drug testing for illicit substances, educational support, relapse prevention and long-term

management, and HIV and viral hepatitis B and C testing conducted in accordance with state and

local requirements. SAMHSA’s ORP grants are encouraged to use part of their annual award to

provide medication-assisted treatment with FDA-approved medications.

Program Evaluation

Performance data show that these grant programs are effective in improving the lives of Offender

Reentry Program court participants. 

Based on FY 2020 data, 1,734 clients received services through SAMHSA’s Offender Re-entry

Programs. Of these clients at six-month follow-up, 75.3 percent reported that they did not use

alcohol or illegal drugs within the past 30 days, an increase of 125.4 percent. Additionally, there

was a 21.2 percent increase from intake that had no involvement with the criminal justice system,

a 144 percent increase of adult clients that were either employed or attending school, and 125 

percent increase in clients who had a permanent place to live in the community. 

 

In FY 2020, SAMHSA funded 10 new ORP grants and 23 ORP grant continuations, and one 

contract.

In FY 2021, SAMHSA anticipates funding 33 ORP continuation grants and one contract.

Funding History

Fiscal Year Amount

FY 2018 $89,000,000 

FY 2019 $89,000,000 

FY 2020 $89,000,000 

FY 2021 Enacted 

FY 2022 Budget Request

$89,000,000 

$124,380,000 

Budget Request

The FY 2022 Budget Request is $124.4 million, an increase of $35.4 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to support 94 new and 166 drug court 

continuation grants, and 33 continuation ORP grants, and one contract. SAMHSA estimates that

an additional 3,287 clients will be served per year with the additional funding.
228 

Outputs and Outcomes Table

Program: Criminal Justice – Drug Courts

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.72 Percentage of

adult clients receiving

services who were

currently employed or 

engaged in productive 

activities (Outcome) 

FY 2020: 58.4 % 

Target:

66.1 % 

(Target Not Met)

60.1 % 62 % +1.9 % 

1.2.73 Percentage of

adult clients receiving

services who had a 

permanent place to live in

the community

(Outcome) 

FY 2020: 45.2 % 

Target:

47.3 % 

(Target Not Met)

47.3 % 47.3 % Maintain

1.2.74 Percentage of

adult clients receiving

services who had no 

involvement with the

criminal justice system

(Outcome) 

FY 2020: 95.6 % 

Target:

85 % 

(Target Exceeded)

96 % 96 % Maintain

1.2.76 Percentage of

adult clients receiving

services who had no past

month substance use

(Outcome) 

FY 2020: 83.9 % 

Target:

87.3 % 

(Target Not Met)

87.3 % 89 % +1.7 % 

1.2.79 Number of adult

clients served (Output) 

FY 2020: 6,973 

Target:

5,700 

(Target Exceeded)

6,960 10,247 +3,287 
229 

Outputs and Outcomes Table

Program: Criminal Justice – Ex-Offender Re-Entry Program 

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.80 Number of clients

served (Outcome) 

FY 2020: 1,580 

Target:

1,300 

(Target Exceeded)

1,661 1,661 Maintain

1.2.81 Percentage of

clients who had no past

month substance use

(Outcome) 

FY 2020: 76.4 % 

Target:

70 % 

(Target Exceeded)

77.4 % 78.4 % +1 % 

1.2.84 Percentage of

clients receiving services

who had no involvement 

with the criminal justice

system (Outcome) 

FY 2020: 94.5 % 

Target:

93 % 

(Target Exceeded)

95 % 95 % Maintain
230 

Outputs and Outcomes Table

Program: Treatment – Other Capacity 

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.25 Percentage of

adults receiving services

who had no past month

substance use (Outcome) 

FY 2020: 63.3 % 

Target:

63.3 % 

(Baseline) 

63 % 63 % Maintain

1.2.26 Number of clients

served (Output) 

FY 2020: 1,357 

Target:

1,357 

(Baseline) 

1,357 1,357 Maintain

1.2.27 Percentage of

adults receiving services

who were currently 

employed or engaged in

productive activities

(Outcome) 

FY 2020: 48.3 % 

Target:

48.3 % 

(Baseline) 

48 % 48 % Maintain

1.2.28 Percentage of

adults receiving services

who had a permanent

place to live in the 

community (Outcome) 

FY 2020: 54 % 

Target:

54 % 

(Target Met)

54 % 54 % Maintain

1.2.29 The percentage of 

adults receiving services

who had no involvement 

with the criminal justice

system (Outcome) 

FY 2020: 98 % 

Target:

98 % 

(Baseline) 

98 % 98 % Maintain
231 

Building Communities of Recovery (BCOR)

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Building Communities of Recovery................................. $8,000 $10,000 $20,000 $10,000 

Authorizing Legislation..Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2022 Authorization................................................................................................ $5,000,000 

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

Eligible Entities. Recovery Community Organizations (RCOs) that are domestic private nonprofit 

entities in states, territories, or tribes that are led and governed by representatives of local

communities of recovery. Only organizations controlled and managed by members of the 

addiction recovery community are eligible to apply 

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 the first new cohort of grants through the Comprehensive 

Addiction Recovery Act (CARA) Building Communities of Recovery (BCOR) 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 individuals in recovery from SUDs who reflect the community

served. 

BCOR grants support linkages between recovery networks and a variety of other organizations, 

systems, and communities. These include primary care, specifically hospital emergency

departments, other recovery networks such as recovery community centers, the child welfare

system, the criminal justice system, recovery housing services, and education/employment 

systems. Grantees also work to reduce negative attitudes, discrimination, prejudice, and stigma

around addiction and recovery. These grants aim to mobilize resources within and outside of the 

recovery community and increase the prevalence and quality of long-term recovery support from

substance use and addiction. The programs support the development, enhancement, expansion, 

and delivery of recovery support services (RSS) as well as the promotion of, and education about, 

recovery. They are managed and implemented primarily by individuals with lived experience and

who are in recovery from substance use disorders and addiction and who reflect the community

being served. Grantees are using funds to 1) build connections and linkages between recovery

networks, between RCOs, and other Recovery Support Services (RSS); 2) reduce the stigma

associated with addiction and recovery; and 3) conduct public education and outreach on issues

relating to addiction and recovery. 
232 

Program Evaluation 

In FY 2020 and FY 2021, BCOR participants began collecting data for recovery support services. 

In FY 2020, a total of 1,280 clients were served for an intake coverage rate of 88 percent.

In FY 2021, a total of 1,568 clients were served for an intake coverage rate of 80 percent. Also, in 

FY 2021, BCOR grant recipients have provided peer-related services events to approximately 

3,000 program participants with a participant coverage rate of 100 percent. 855 events were held

with a coverage rate of 271 percent. At post event survey, 100 percent of all program participants

reported that the trainings were beneficial and relevant to their careers. 

At six-month follow-up participants have demonstrated a 74 percent improvement in obtaining 

education/employment, 16 percent remained abstinent and 16.3 percent with no past 30-day

criminal justice involvement. Participants reported a 3.6 percent rate of change in social

connectedness, and a 35 percent positive rate of change in housing stability was reflected. In an

effort to enhance program success and performance, as well as ensure long-term sustainability, the 

majority, 98 percent, of BCOR grantees have an external program evaluator.

In FY 2020, SAMHSA funded 13 new grants and 23 continuation grants and supplements for

direct technical assistance. 

FY 2021 SAMHSA anticipates funding 31 new grants and 18 continuations. 

Funding History

Fiscal Year Amount

FY 2018 $5,000,000 

FY 2019 $6,000,000 

FY 2020 $8,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$10,000,000 

$20,000,000 

Budget Request

The FY 2022 Budget Request is $20.0 million, an increase of $10.0 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to support 31 new grants and 19 

continuation grants for the Building Communities of Recovery program to develop, expand, and

enhance recovery support services. Building Communities of Recovery supports linkages between 

recovery networks and a variety of organizations, including primary care, other recovery networks, 

the child welfare system, the criminal justice system, housing services, and education/employment 

systems. This increase in funding will support further mobilization of resources within and outside 

the recovery community to increase the prevalence and quality of long-term recovery support from 

drug and alcohol addiction.
233 

Outputs and Outcomes Table 

Program: Building Communities for Recovery

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.80 Number of clients

receiving recovery 

services (Output) 

FY 2020: 453.0 

Target:

300.0 

(Target Exceeded)

1,175.0 2,275.0 +1,110.0 

1.2.81 Clients who report 

not having stable housing 

at baseline who report 

having stable housing at

six-month follow-up 

(Outcome) 

FY 2020: 37.7

Target:

27.0 

(Target Exceeded)

47.4 50.0 +2.6 

1.2.82 Percent of clients

who report not being

employed (full-time or

part-time) or in school at

baseline who report 

having employment or 

being in school at followup (Outcome)

FY 2020: 54.6

Target:

36.0 

(Target Exceeded)

64.5 67.0 +2.5 
234 

Minority Fellowship Program 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Minority Fellowship Program ....................................... $4,789 $5,789 $6,136 $347 

Authorizing Legislation............................................Section 597 of the Public Health Service Act

FY 2022 Authorization................................................................................................ $6,136,000 

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

Eligible Entities..... Organizations that represent individuals obtaining post-baccalaureate training

(including for master’s and doctoral degrees) for mental and substance use disorder treatment

professionals, including in the fields of psychiatry, nursing, social work, psychology, marriage

and family therapy, mental health counseling, and substance use disorder and addiction 

counseling 

Program Description 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 mental health and

substance use needs of racial and ethnic minority communities in the United States have been

historically underserved due to a variety of factors. These include a limited number of postbaccalaureate (including master’s and doctoral level) trained professionals in psychiatry, 

psychology, nursing, social work, marriage and family therapy, mental health counseling, and

substance use and addictions counseling who are equipped with the skills and cultural

competencies needed to deliver effective services. 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 specializing in addiction. In FY 2018, an additional program was created to address

specialized training in addiction psychiatry, psychology, and addiction medicine. Professional 

guilds receive competitively awarded grants, and then competitively award the stipends to graduate

and post-graduate students pursuing a degree in corresponding professional fields. 

This program is jointly administered by the Center for Substance Abuse Treatment (CSAT), the 

Center for Substance Abuse Prevention (CSAP), and the Center for Mental Health Services

(CMHS) at SAMHSA. CSAT also funded one additional grant to support the program that

specializes in fellowships for addiction psychiatry, psychology, and addiction medicine.

Combined, these programs will support fellowships for hundreds of students as well as support 

additional training through webinars on culturally appropriate services to thousands of students. 

In FY 2020, SAMHSA funded eight continuation grants, one new grant and one contract.

In FY 2021, SAMHSA anticipates funding nine continuation grants and one contract.
235 

Funding History

Fiscal Year Amount

FY 2018 $4,789,000 

FY 2019 $4,789,000 

FY 2020 $4,789,000 

FY 2021 Enacted

FY 2022 Budget Request

$5,789,000 

$6,136,000 

Budget Request

The FY 2022 Budget Request is $6.1 million, an increase of $347,000 from the FY 2021 Enacted

level. SAMHSA plans to use the increase in funds to support nine continuation grants, eight new

grants and one technical assistance contract.
236 

Addiction Technology Transfer Centers

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Addiction Technology Transfer Centers....................... $9,046 $9,046 $9,046 $--- 

Authorizing Legislation............................................Section 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

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

Eligible Entities.................................................. Domestic Public and Private Non-Profit Entities

Program Description and Accomplishments

The estimated cost of drug use in the United States - including illegal drugs, alcohol, and tobacco

- is more than $740 billion a year and growing.91 Substance misuse in the U.S. costs society in

increased healthcare costs, crime, and lost productivity. Recently, the nation’s attention has been

on the increase misuse of opioids. CDC preliminary data point to 90,000 overdose deaths for the 

12 months ending last September – about 20,000 more than the same period the year before. 

Opioids, particularly synthetic opioids such as fentanyl, are a main driver in the increase in

overdose deaths. The misuse of and addiction to opioids—including prescription pain relievers,

heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health

as well as social and economic welfare that likely was exacerbated by the ongoing COVID-19 

pandemic. The country will be dealing with the repercussions of the pandemic’s effect on 

substance use disorder for years to come. In the midst of these ongoing challenges, there is a 

critical need is to recruit, train, and support treatment providers in the use of evidence-based

practices. 

The purpose of the Technology Transfer Centers is to develop and strengthen the specialized

behavioral healthcare and primary healthcare workforce that provides prevention, treatment and

recovery support services for substance use disorder (SUD) and mental illness. The program’s 

mission is to help people and organizations to incorporate effective evidence based practices into

substance use disorder and mental health prevention, treatment and recovery services. Together 

the Network serves the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands,

the Pacific Islands of Guam, American Samoa, Palau, the Marshall Islands, Micronesia, and the 

Mariana Islands.

After over 26 years of conducting training workshops, translating research into bite-size pieces for 

curricula or stand-alone products, and creating opportunities for performance feedback to enhance

skill development, the Addiction Technology Transfer Centers (ATTCs) are improving and

updating their programs to offer novel training and technical assistance (TA) options that include 

multiple learning components in new delivery formats focused on changing practices. In response 

to the COVID-19 pandemic, the ATTC program has developed and implemented many alternative

ways to deliver training and technical assistance. A robust virtual platform has been used to

support healthcare professionals with telehealth strategies and many adaptations of evidence-based

91 (NIDA, Trends and Statistics. Published online, updated Feb. 2020)
237 

interventions for the virtual settings. The ATTC centers will continue the response to the 

differential impact of the pandemic by addressing the needs of the providers and continuing to

develop resources to help to address the needs of all communities.

In 2017, SAMHSA funded a new five-year cycle of the ATTC program (2017-2022) which is

comprised of ten regional centers (one in each HHS Region), one coordinating center, and two

national focus-area centers: the National American Indian and Alaska Native ATTC and the 

National Hispanic and Latino ATTC. SAMHSA recently completed the continuation application

for these 13 centers (FY 2020) which are entering their fourth year of their current program cycle. 

To date, under the current cycle (2017-2022), the 13 ATTCs combined have delivered over 4,400 

training and technical assistance (TA) events for over 12,000 healthcare professionals and

paraprofessionals who deliver services for patients with substance use disorders. Participant

satisfaction rates were consistently high, with over 90 percent of attendees reporting that they were

satisfied with their training or TA events.

Program Evaluation 

In FY 2019, SAMHSA funded a two-year grant to evaluate the ATTC program. The ATTC

evaluation started on September 30, 2019 and it will be completed by September 29, 2021. To date

the evaluation team has completed, transcribed, and reviewed semi-structured interviews and

began work on the analysis.

In FY 2020, SAMHSA funded 12 continuation grants. The ATTC program continued with its

mission of helping people and organizations to incorporate effective practices into substance use

disorder treatment and recovery services. Together the 13 centers coordinated several webinars

and learning collaborative series, developed several products and online trainings to address the 

opioid and COVID-19 crisis and provided consultation to professional and paraprofessional 

throughout the US and its territories.

In FY 2021, SAMHSA anticipates funding 12 continuation grants in the ATTC program (year 5 

of the current cycle) and the network will continue to focus on delivering training and technical

assistance for providers who are serving patients with substance use disorders by improving their

capacity and understanding of evidence based practices, especially practices that are effective in

combating the opioid crisis.

Building on a rich history, the ATTC Network continuously strives to improve the quality of 

addictions treatment and recovery services by facilitating alliances among front line counselors, 

treatment and recovery services agency administrators, faith-based organizations, policy makers,

the health and mental health communities, consumers and other stakeholders. By connecting these

providers to the latest research and information through activities such as skills training, academic

education, online and distance education, conferences, workshops, and publications, the ATTC

Network continues to respond to the emerging needs of the field.
238 

Funding History

Fiscal Year Amount

FY 2018 $9,046,000 

FY 2019 $9,046,000 

FY 2020 $9,046,000 

FY 2021 Enacted

FY 2022 Budget Request

$9,046,000 

$9,046,000 

Budget Request

The FY 2022 Budget Request is $9.0 million, level with the FY 2021 Enacted level. SAMHSA

plans to fund 11 new grants and one continuation grant. 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. 
239 

Improving Access to Overdose Treatment

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Improving Access to Overdose Treatment ........................ $1,000 $1,000 $1,500 $500 

Authorizing Legislation..Section 302 of the Comprehensive Addiction and Recovery Act of 2016 

FY 2022 Authorization.............................................................................................. $12,000,000 

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

Eligible Entities..................................Primary care, child welfare system, criminal justice system

Program Description and Accomplishments

CDC preliminary data point to 90,000 overdose deaths for the 12 months ending last September – 

about 20,000 more than the same period the year before. 

As part of SAMHSA’s response, the Opioid Overdose Prevention Toolkit was developed to help

reduce the number of opioid-related overdose deaths and adverse events. SAMHSA’s Improving 

Access to Overdose Treatment (ODTx) grant program utilizes this toolkit and other resources to

help grantees train and support health care providers and pharmacists on the prescribing of FDA

approved drugs or devices for the emergency treatment of known or suspected opioid overdose. 

In addition, the ODTx program 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 use disorder (including prescription

opioids as well as illicit drugs such as heroin). 

Program Evaluation

In FY 2020, 29 programs or best practices were developed for prescribing or co-prescribing FDAapproved opioid-overdose reversal drugs or devices. These best practices were used to train 2,274 

pharmacists and health care providers. Additionally, grant funding provided 768 naloxone (or 

other FDA-approved) kits. 

In FY 2020, SAMHSA funded five continuation grants. 

In FY 2021, SAMHSA anticipates funding five continuation grants. 
240 

Funding History

Fiscal Year Amount

FY 2018 $1,000,000 

FY 2019 $1,000,000 

FY 2020 $1,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$1,000,000 

$1,500,000 

Budget Request

The FY 2022 Budget Request is $1.5 million, an increase of $500,000 from the FY 2021 Enacted

level. SAMHSA plans to use the increase in funds to support five continuation grants and two new

grants to continue increasing access to treatment, reducing unmet treatment need, and reducing 

opioid overdose related deaths through the provision of prevention, treatment, and recovery

activities for opioid use disorder. With this additional funding, we anticipate an increase of 1,270 

individuals trained.
241 

Outputs and Outcomes Table

Program: Improving Access to Overdose Treatment (ODTx) 

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

5.2.0 Number of 

programs or best

practices developed for 

prescribing or coprescribing FDAapproved opioidoverdose reversal drugs 

or devices. (Output)

FY 2020: 29.0

Target:

35.0 

(Target Not Met)

Discontinued Discontinued N/A

5.2.1 Number trained on

prescribing FDAapproved opioidoverdose reversal drugs 

or devices for emergency

treatment of known or 

suspected opioid 

overdose. (Output) 

FY 2020: 2,274.0

Target:

2,141.0 

(Target Exceeded)

2,141.0 3,411.0 +1,270.0 
242 

First Responder Training for Opioid Overdose Reversal Drugs

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

First Responder Training (CARA)..................................... $41,000 $42,000 $63,000 $21,000 

First Responder Training (non-add) ......................... 18,000 18,000 27,000 9,000 

Rural Set-Aside (non-add) ............................................ 23,000 24,000 36,000 12,000 

Authorizing Legislation......................................................................Section 546 of the PHS Act

FY 2022 Authorization .............................................................................................$ 36,000,000 

Allocation Method............................................................................................Competitive Grants

Eligible entities.................................States, local government entities, federally recognized 

 American Indian/Alaska Native tribe or tribal organizations 

Program Description and Accomplishments

SAMHSA’s First Responders – Comprehensive Addiction and Recovery Act (FR-CARA)

program is an important part of the US government’s response to the opioid crisis. The FR-CARA

program trains and equips firefighters, law enforcement officers, paramedics, emergency medical

technicians, and other legally organized and recognized volunteer organizations in a position to

respond to adverse opioid-related incidents. This program also establishes processes, protocols, 

and mechanisms for referral to appropriate treatment and recovery communities. FR-CARA's

broader eligibility and rural-set asides ensure that much needed services reach rural and tribal

areas.

Training, technical assistance, and evaluation activities are also being supported to assist grantees,

determine best practices, and assess program outcomes. SAMHSA has awarded 69 state, rural and

tribal organizations over the past 3 years. Approximately 52 percent of the funds went to rural

entities hit particularly hard by the opioid crisis. 

Program Evaluation

To date, grantees report having trained 206,509 first responders and community members on the 

use of naloxone or other FDA approved drugs or devices, and how to respond to overdose 

emergencies. The program has equipped these communities with 187,243 FDA-approved 

overdose reversal kits since the start of the program. Of these, 70,218 kits have been administered

to treat suspected overdose cases, resulting in more than 24,965 confirmed overdose reversals.

Rural Emergency Medical Services Training Grant

SAMHSA recognizes the great need for emergency services in rural areas and the critical role

EMS personnel serve across the country. In FY 2020 SAMHSA funded the Rural Emergency

Medical Services Training Grant (EMS Training). The purpose of this one-year grant program is

to recruit and train emergency medical services (EMS) personnel in rural areas. SAMHSA funded 

27 grantees to ensure that EMS personnel are trained on mental and substance use disorders and

care for people with such disorders in emergency situations.
243 

In FY 2020, SAMHSA funded 59 continuation grants. In addition, SAMHSA funded six new FRCARA grants and 27 new grants for the Rural Emergency Medical Services Training Grant

program. 

In FY 2021, SAMHSA anticipates funding 20 new and 49 continuation FR-CARA grants, 27 new

grants for the Rural Emergency Medical Services Training Grant program. 

Funding History

Fiscal Year Amount

FY 2018 $41,000,000 

FY 2019 $41,000,000 

FY 2020 $41,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$42,000,000 

$63,000,000 

Budget Request

The FY 2022 Budget Request is $63.0 million, an increase of $21.0 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to award 46 continuation grants and

60 new grants. In addition, SAMHSA plans to fund 27 new Rural Emergency Medical Services

Training Grants.
244 

Outputs and Outcomes Table

Program: First Responder Training-CARA

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

5.0.1 Number of FDAapproved overdose 

reversing medication kits

distributed. (Output) 

FY 2020: 91,911.0 

Target:

73,845.0 

(Target Exceeded)

91,911.0 71,831.0 +79,920.0 

5.1.1 Number of first

responders trained how to

administer FDAapproved overdose 

reversing medication kits

(Output) 

FY 2020: 44,155.0 

Target:

16,759.0 

(Target Exceeded)

44,155.0 82,495.0 +38,340.0 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 

(Dollars in thousands) 

Programs of Regional & National Significance 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022+/-

FY 2021 

Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths....... $12,000 $12,000 $18,000 $6,000 

Authorizing Legislation............................................ Section 516 and Section 546 of the PHS Act 

FY 2022 Authorization......................................................................$ 211,148,000, $ 36,000,000 

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 remains a significant contributor to accidental deaths among those who use, 

misuse, or abuse illicit and prescription opioids (including synthetics such as fentanyl).92 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. While national data showed that overall numbers of overdose deaths and opioid 

involved deaths were beginning to decrease, an estimated 90,000 drug overdose deaths occurred 

in the United States in the 12 months ending in September 2020, the highest number of overdose 

deaths ever recorded in a 12-month period, according to recent provisional data from CDC. 

Provisional CDC data also indicate that 37 of 38 states reporting synthetic opioid data reported 

increases in overdose deaths tied to synthetic opioid use.93 Fentanyl has been a significant driver 

of this increase. 

SAMHSA supports 12 grants to 12 states for the Grants to Prevent Prescription Drug and Opioid 

Overdose-related Deaths program, which helps states identify communities of high need and 

provide education, training, and resources necessary 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, 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 their communities. The course uses SAMHSA’s Opioid Overdose Prevention Toolkit as a guide 

92 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 93 Centers for Disease Control (CDC). Overdose Deaths Accelerating During COVID-19. (2020) Available from 

URL: https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid19.html#:~:text=37%20of%20the%2038%20U.S.,in%20synthetic%20opioid%2Dinvolved%20deaths. 

245 
246 

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. 
247 

Program Evaluation 

In FY 2020, grantees reported that they held 9,982 trainings and grantees trained 26,445 on 

naloxone administration or on other opioid-overdose related topics. This number greatly exceeded

the 2020 target of 2,000 people trained. Grantees holding virtual trainings during the pandemic 

has increased capacity to reach a broader and harder to reach audiences. SAMHSA estimates that

this number of people will also be served in each of FY 2021 and FY 2022. Throughout FY 2020, 

grantees have acquired and distributed 52,750 Naloxone or other FDA-approved kits, which

surpasses our previous target of 44,348. Due to the kits purchased and trainings held, grantees have 

successfully conducted 4,629 opioid overdose reversals.

In FY 2020, SAMHSA funded 12 continuation awards. 

In FY 2021, SAMHSA anticipates funding 13 new grants. 

Funding History

Fiscal Year Amount

FY 2018 $12,000,000 

FY 2019 $12,000,000 

FY 2020 $12,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$12,000,000 

$18,000,000 

Budget Request

The FY 2022 Budget Request is $18.0 million, an increase of $6.0 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to support seven new and 13 

continuation grants across seven states to reduce the number of opioid overdose-related deaths. 

This will also help states purchase overdose reversing drugs, equip first responders in high-risk

communities, support education on the use of naloxone and other overdose-related death

prevention strategies, provide the necessary materials to assemble overdose kits, and cover

expenses incurred from dissemination efforts. SAMHSA estimates the increase in funding will 

result in an estimated increase of 2,695 overdose reversals, 7,662 more Naloxone kits distributed, 

and 4,166 more persons trained to administer Naloxone or other FDA approved drug or device. 
248 

Outputs and Outcomes Table

Program: PDO/Naloxone 

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

5.0 Number of Naloxone

(or other FDA-approved) 

kits distributed (Output) 

FY 2020: 52,750.0 

Target:

45,088.0 

(Target Exceeded)

45,088.0 52,750.0 +7,662.0 

5.1 Number of lay

persons trained how to

administer Naloxone (or

other FDA approved drug 

or device). (Output) 

FY 2020: 26,445.0 

Target:

22,279.0 

(Target Exceeded)

22,279.0 26,445.0 +4,166.0 
249 

Peer Support Technical Assistance Center

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Peer Support TA Center.................................................. $1,000 $1,000 $1,500 $500 

Authorizing Legislation...Section 7152 of the SUPPORT for Patients and Communities Act (Sec.

547A of the PHS Act)

FY 2022 Authorization................................................................................................ $1,000,000 

Allocation Method ......................................................................................... Competitive Grants

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

Program Description and Accomplishments

The purpose of this new program, which is authorized by section 7152 of the SUPPORT for

Patients and Communities Act (P.L. 115-271), is to provide funding for the creation of a National

Peer-Run Training and Technical Assistance Center for Addiction Recovery Support, or the 

Center. The Center provides technical assistance and support to recovery community organizations 

and peer support networks. The technical assistance is related to training, translation and

interpretation services, data collection, capacity building, and evaluation and improvement of the 

effectiveness of such services provided by recovery community organizations. 

In FY 2020, SAMHSA funded one new grant. 

In FY 2021, SAMHSA anticipates funding one continuation grant. 

Funding History

Fiscal Year Amount

FY 2018 ---

FY 2019 ---

FY 2020 $1,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$1,000,000 

$1,500,000 

Budget Request

The FY 2022 Budget Request is $1.5 million, an increase of $500,000 from the FY 2021 Enacted

level. SAMHSA continues to support the existing grantee in this program and increase the funding 

available for the grantee. 
250 

Outputs and Outcomes Table

Program: Peer Support Technical Assistance Center

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.1.0 Number of people

train for the support of 

the recovery community

organizations and peer

support networks 

(Output) 

FY 2020: Result Expected

Dec 31, 2021 

Target:

Set Baseline

(Pending) 

Maintain Baseline Maintain

Target* 

N/A

1.2.0 Number trained on

technical assistance,

translation and

interpretation services, 

data collection, capacity

building, and evaluation

and improvement of the

effectiveness of such

services provided by 

recovery community

organizations (Output)

FY 2020: Result Expected

Dec 31, 2021 

Target:

1,500.0 

(Pending) 

1,500.0 3,000.0 +1,500.0 

*Note: the target for FY22 has been maintained, may be increased 1-2% based on FY21 actuals. The difference 

between FY20 and FY22, reflect the increase in funding between FY21 and FY22.
251 

Emergency Department Alternatives to Opioids 

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY

2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Emergency Department Alternatives to Opioids.................. $5,000 $6,000 $9,000 $3,000 

Authorizing Legislation........... Section 7091 of the SUPPORT for Patients and Communities Act

FY 2022 Authorization................................................................................................ $5,000,000 

Allocation Method ......................................................................................... Competitive Grants

Eligible Entities................................................................ Hospitals and Emergency Departments

Program Description and Accomplishments

The purpose of this new program, which is authorized by section 7091 of the SUPPORT for

Patients and Communities Act (P.L. 115-271) is to provide funding to hospitals and emergency

departments, including freestanding emergency departments, to develop, implement, enhance, or 

study alternative pain management protocols and treatments that limit the use and prescribing of 

opioids in emergency departments. In addition, these funds will be used to target common painful 

conditions, train providers and other hospital personnel, and provide alternatives to opioids for 

patients with painful conditions. 

In FY 2020, SAMHSA funded 10 new grants. 

 

In FY 2021, SAMHSA anticipates funding 10 continuation grants and two new grants. 

Funding History

Fiscal Year Amount

FY 2018 ---

FY 2019 ---

FY 2020 $5,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$6,000,000 

$9,000,000 

Budget Request

The FY 2022 Budget Request is $9.0 million, an increase of $3.0 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to award six new and 12 continuation 

grants. 
252 

Outputs and Outcomes Table

Program: Emergency Department Alternative to Opioids

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.60.1 Number of 

providers trained on nonopioids therapies.

(Output) 

FY 2020: Result Expected

Dec 31, 2021 

Target:

Set Baseline

(Pending) 

Maintain

Baseline

Maintain

Baseline* 

Maintain

1.60.2 Number of 

patients who received

non-opioid therapies. 

(Output) 

FY 2020: Result Expected

Dec 31, 2021 

Target:

Set Baseline

(Pending) 

Maintain

Baseline

Maintain

Baseline* 

Maintain

*Note: the target for FY22 has been maintained, may be increased 1-2% based on FY21 actuals. The difference 

between FY20 and FY22, reflect the increase in funding between FY21 and FY22.
253 

Treatment, Recovery, and Workforce Support

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Treatment, Recovery, and Workforce Support....................... $4,000 $6,000 $9,000 $3,000 

Authorizing Legislation........... Section 7183 of the SUPPORT for Patients and Communities Act

FY 2022 Authorization................................................................................................ $6,000,000 

Allocation Method ......................................................................................... Competitive Grants

Eligible Entities........SSAs, Tribes and Tribal Organizations, Entities that offer treatment or other

services following a drug overdose (e.g., emergency departments) 

Program Description and Accomplishments

The purpose of this new program, which is authorized by section 7183 of the SUPPORT for

Patients and Communities Act, is to implement evidence-based programs to support individuals in

substance use disorder treatment and recovery to live independently and participate in the 

workforce. To achieve this objective, recipients must coordinate, as applicable, with Indian tribes

or tribal organizations, state and local workforce development boards, lead state agencies

responsible for a workforce investment activity, and state agencies responsible for carrying out 

substance use disorder prevention and treatment programs. The program launched in September

2020 with eight grant recipients, three grants in February 2021 and one additional grant will be 

awarded in 2021 for a total of twelve grants awarded.

In FY 2020, SAMHSA funded eight new awards. 

In FY 2021, SAMHSA anticipates funding four new and eight continuation grants. 

Funding History

Fiscal Year Amount

FY 2018 ---

FY 2019 ---

FY 2020 $4,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$6,000,000 

$9,000,000 

Budget Request

The FY 2022 Budget Request is $9.0 million, an increase of $3.0 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to award six new and 12 continuation 

grants. 
254 

Outputs and Outcomes Table

Program: Treatment, Recovery, and Workforce Support 

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.21.1 Number of people 

participate in the

workforce (Output) 

FY 2020: Result Expected

Dec 31, 2021 

(Pending) 

Set Baseline Maintain

Target* 

N/A

1.21.2 Number of people 

received treatment and

recovery to live

independently (Output) 

FY 2019: Result Expected

Dec 31, 2021 

(Pending) 

Set Baseline Maintain

Target* 

N/A

*Note: the target for FY22 has been maintained, may be increased 1-2% based on FY21 actuals. The difference 

between FY20 and FY22, reflect the increase in funding between FY21 and FY22.
255 

Comprehensive Opioid Recovery Centers

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Comprehensive Opioid Recovery Centers........................ $--- $4,000 $6,000 $2,000 

Authorizing Legislation........ ...Section 7121 of the SUPPORT Act (Section 552 of the PHS Act)

FY 2022 Authorization................................................................................................ $4,000,000 

Allocation Method ......................................................................................... Competitive Grants

Eligible Entities. Public and private nonprofit entities (that provide treatment for individuals 

with substance use disorders). 

Program Description and Accomplishments

For individuals with opioid use disorders, there is an increasing need for access to coordinated, 

comprehensive care services, including long-term care and support services that utilize the full 

range of FDA-approved medications and evidence-based treatments.

This program provides grants to nonprofit substance use disorder treatment organizations to

operate of comprehensive centers which provide a full spectrum of treatment and recovery support 

services for opioid use disorders. The funding represents the first year of a four-year project period. 

Grantees are required to provide outreach and the full continuum of treatment services including 

MAT; counseling; treatment for mental disorders; testing for infectious diseases, residential

rehabilitation, and intensive outpatient programs; recovery housing; peer recovery support 

services; job training, job placement assistance, and continuing education; and family support 

services such as child care, family counseling, and parenting interventions. Grantees must utilize

third party and other revenue to the extent possible. Grantees are required to report client-level

data, including demographic characteristics, substance use, diagnosis, services received, types of 

MAT received, length of stay in treatment, employment status, criminal justice involvement, and

housing. 

In FY 2020, SAMHSA funded two new grants. 

In FY 2021, SAMHSA anticipates funding two new and two continuation grants. 

Funding History

Fiscal Year Amount

FY 2018 ---

FY 2019 ---

FY 2020 ---

FY 2021 Enacted $4,000,000 

FY 2022 Budget Request $6,000,000 
256 

Budget Request

The FY 2022 Budget Request is $6.0 million, an increase of $2.0 million from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to support four continuations and two

new grants. These funds will also provide critical comprehensive care services, including longterm care and support services utilizing the full range of FDA-approved medications and evidencebased treatments and will cover the costs of critical linkage and system development not currently

covered by other sources of funding. These funds will extend the reach of MAT treatment and

recovery support services to address the opioid epidemic across systems and regional locations, 

reducing scattered, uncoordinated treatment efforts, and expanding access to care for people with

special needs and/or in rural areas. 
257 

Outputs and Outcomes Table

Program: Comprehensive Opioid Recovery Centers

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.1.1 Number of clients

served with MAT

(Output) 

FY 2020: Result Expected

Dec 31, 2021 

(Pending) 

Set Baseline Maintain

Target* 

N/A

1.2.1 Percentage of adults 

receiving services who

had no past month 

substance use at 6-month

follow-up (Output)

FY 2021: Result Expected

Dec 31, 2021 

Target:

Set Baseline

(Pending) 

Set Baseline Maintain

Target* 

N/A

1.3.1 Percentage of adults 

receiving services who

were currently employed

or engaged in productive 

activities at 6-month 

follow-up (Outcome) 

FY 2021: Result Expected

Dec 31, 2021 

Target:

Set Baseline

(Pending) 

Set Baseline Maintain

Baseline* 

N/A

1.4.1 Number of adults 

receiving recovery 

housing and community

based and peer recovery

support services at 6-

month follow-up 

(Output) 

FY 2021: Result Expected

Dec 31, 2022 

Target:

Set Baseline

(Pending) 

Set Baseline Maintain

Target* 

N/A

*Note: the target for FY22 has been maintained, may be increased 1-2% based on FY21 actuals. The difference 

between FY20 and FY22, reflect the increase in funding between FY21 and FY22.
258 

Opioid Response Grants

(Dollars in thousands) 

Programs of Regional & National Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

Opioids Response Grants....................................................... $--- $3,000 $3,000 $--- 

Authorizing Legislation............................................Section 509 of the Public Health Service Act

FY 2022 Authorization............................................................................................ $333,806,000 

Allocation Method ......................................................................................... Competitive Grants

Eligible Entities.....................................Limited to Single State Agencies (SSAs), Existing

USDA Cooperative Extension Grantees, and U.S.

 Territories, Tribes and tribal organizations are eligible to apply to set-aside funds described

below.

The Opioid Response Grants program is included in the State Opioid Response (SOR) narrative

section on page 266. 
259 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table Summary

(Dollars in thousands) 

Program Activity 

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget Request 

No. Amount No. Amount No. Amount

Grants/Cooperative Agreements: 

 Continuations.................................................. 825 $391,978 703 $324,914 786 $363,835 

 New/Competing.............................................. 132 54,566 308 139,944 577 254,396 

Supplements...................................................... --- 6,989 --- 5,387 --- 2,254 

 Subtotal......................................................... 957 453,532 1,011 470,245 1,363 620,485 

Contracts: 

 Continuations.................................................. 6 25,847 3 23,157 4 28,960 

 New/Competing.............................................. --- 298 1 3,274 --- 1,419 

 Subtotal......................................................... 6 26,145 4 26,432 4 30,379 

Total, Substance Abuse Treatment 963 $479,677 1,015 $496,677 1,367 $650,864 
260 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

F

Y 

2

Programs of Regional & National Significance 

FY 2020 

Final

No. Amount

FY 2021 

Enacted

No. Amount

FY 2022 

President's 

Budget

No. Amount

Capacity:

Opioid Treatment Programs/Regulatory Activities

 Grants

Continuations...........................................................................................

New/Competing.......................................................................................

Supplements*...........................................................................................

Subtotal.................................................................................................

 Contracts

Continuations...........................................................................................

New/Competing.......................................................................................

Subtotal.................................................................................................

Total, Opioid Treatment Programs/Regulatory Activities

Screening, Brief Intervention and Referral to Treatment 

 Grants

Continuations...........................................................................................

New/Competing.......................................................................................

Supplements*...........................................................................................

Subtotal.................................................................................................

 Contracts

Continuations...........................................................................................

New/Competing.......................................................................................

Subtotal.................................................................................................

Total, Screening, Brief Intervention and Referral to Treatment 

Targeted Capacity Expansion

 Grants

Continuations...........................................................................................

New/Competing.......................................................................................

Supplements*...........................................................................................

Subtotal.................................................................................................

 Contracts

Continuations...........................................................................................

New/Competing.......................................................................................

Supplements*...........................................................................................

Subtotal.................................................................................................

Total, Targeted Capacity Expansion 

29 $6,007 1 $2,000 36 $5,400

--- --- 36 5,400 29 6,093

--- 1,364 --- --- --- ---

29 7,371 37 7,400 65 11,493

2 1,327 2 1,257 2 1,569

--- 26 --- 67 --- 24

2 1,353 2 1,324 2 1,593

31 8,724 39 8,724 67 13,086

32 27,721 27 17,562 37 27,502

--- --- 10 9,950 1 1,400

--- 200 --- 200 --- 200

32 27,921 37 27,712 38 29,102

--- 1,511 --- 1,484 --- 1,391

--- 568 --- 804 --- 67

--- 2,079 --- 2,288 --- 1,458

32 30,000 37 30,000 38 30,560

183 91,818 53 24,621 143 76,227

5 3,142 138 72,458 130 64,533

--- 100 --- --- --- ---

188 95,060 191 97,079 273 140,760

--- 5,199 --- 5,207 --- 6,968

--- -67 --- -95 --- 188

--- --- --- --- --- ---

--- 5,132 --- 5,113 --- 7,156

188 100,192 191 102,192 273 147,916
261 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

0

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Pregnant and Postpartum Women 

 Grants

Continuations........................................................................................... 42 22,872 48 26,515 33 20,303

New/Competing....................................................................................... 9 6,500 4 3,600 48 26,197

Supplements*........................................................................................... --- 1,050 --- 975 --- 500

Subtotal................................................................................................. 51 30,422 52 31,090 81 47,000

 Contracts

Continuations........................................................................................... --- 1,656 --- 1,677 --- 2,327

New/Competing....................................................................................... --- -147 --- 164 --- 69

Supplements*........................................................................................... --- --- --- --- --- ---

Subtotal................................................................................................. --- 1,509 --- 1,841 --- 2,397

Total, Pregnant and Postpartum Women 51 31,931 52 32,931 81 49,397

Recovery Community Services Program

 Grants

Continuations........................................................................................... 3 450 6 1,788 8 2,399

New/Competing....................................................................................... 6 1,782 2 600 9 2,573

Supplements **........................................................................................ --- 75 --- --- --- ---

Subtotal................................................................................................. 9 2,307 8 2,388 17 4,973

 Contracts

Continuations........................................................................................... --- 127 --- 124 --- 172

New/Competing....................................................................................... --- --- --- -79 --- 6

Subtotal................................................................................................. --- 127 --- 46 --- 178

Total, Recovery Community Services Program

Children and Families

9 2,434 8 2,434 17 5,151

 Grants

Continuations........................................................................................... 46 26,263 35 18,454 52 27,766

New/Competing....................................................................................... --- 68 17 9,265 2 936

Supplements *.......................................................................................... --- 275 --- --- --- ---

Subtotal................................................................................................. 46 26,605 52 27,719 54 28,703

 Contracts

Continuations........................................................................................... 1 3,000 --- 1,512 --- 1,423

New/Competing....................................................................................... --- --- --- 373 --- 72

Subtotal.................................................................................................

Total, Children and Families

1 3,000 --- 1,886 --- 1,494

47 29,605 52 29,605 54 30,197

FY 2022 

President's 

Budget

F

Y 

2

FY 2020 

Final

 FY 2021 

Enacted
 

 

 

Treatment Systems for Homeless

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Treatment Systems for Homeless 

Minority AIDS

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Minority AIDS 

Criminal Justice Activities

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Criminal Justice Activities 

Improving Access to Overdose Treatment

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Supplements *.......................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Improving Access to Overdose Treatment 

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) F 

Y FY 2020 

Final 

 

2 

0 

Programs of Regional & National Significance No. Amount 

FY 2021 

Enacted 

 

No. Amount 

FY 2022 

President's 

Budget 

 

No. Amount 

72 28,353 85 33,807 68 26,799 

13 5,422 --- --- 20 7,859 

--- 720 --- 720 --- 550 

85 34,495 85 34,527 88 35,208

--- 1,891 --- 1,859 --- 1,827 

--- --- --- --- --- 79 

--- 1,891 --- 1,859 --- 1,906 

85 36,386 85 36,386 88 37,114 

121 59,681 121 59,837 62 30,645 

--- 32 --- --- 64 32,027 

--- 2,375 --- 2,375 --- 900 

121 62,088 121 62,212 126 63,572

--- 3,408 --- 3,350 --- 3,151 

--- 74 --- 9 --- 158 

--- 3,482 --- 3,358 --- 3,309 

121 65,570 121 65,570 126 66,881 

178 67,711 212 81,978 199 76,776 

32 15,109 2 799 94 40,000 

--- --- --- --- --- ---

210 82,820 214 82,778 293 116,776

2 6,180 --- 4,544 1 7,313 

--- --- 1 1,679 --- 291 

2 6,180 1 6,222 1 7,604 

212 89,000 215 89,000 294 124,380 

5 915 5 913 5 917 

--- --- --- --- 2 405 

--- 104 --- 104 --- 104 

5 1,019 5 1,017 7 1,427

--- 52 --- 51 --- 73 

--- -71 --- -68 --- ---

--- -19 --- -17 --- 73 

5 1,000 5 1,000 7 1,500 

262 
263 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

Programs of Regional & National Significance No. Amount No. Amount No. Amount

Building Communities of Recovery

 Grants

Continuations........................................................................................... 23 4,439 19 3,485 44 8,685

New/Competing....................................................................................... 14 2,725 30 6,013 52 10,360

Supplements *.......................................................................................... --- 425 --- --- --- ---

Subtotal................................................................................................. 37 7,589 49 9,498 96 19,044

 Contracts

Continuations........................................................................................... --- 411 --- 502 --- 942

New/Competing....................................................................................... --- --- --- --- --- 13

Subtotal................................................................................................. --- 411 --- 502 --- 956

Total,Building Communities of Recovery

Grants to Prevent Prescription Drug/Opioid Overdoes-Related 

Deaths

37 8,000 49 10,000 96 20,000

 Grants

Continuations........................................................................................... 12 11,253 --- 591 13 11,898

New/Competing....................................................................................... --- --- 13 11,050 7 6,102

Supplements *.......................................................................................... --- 300 --- --- --- ---

Subtotal................................................................................................. 12 11,553 13 11,641 20 18,000

 Contracts

Continuations........................................................................................... --- --- --- --- --- ---

New/Competing....................................................................................... --- 447 --- 359 --- ---

Subtotal................................................................................................. --- 447 --- 359 --- ---

Total, Grants to Prevent Prescription Drug/Opioid OverdoesRelated Deaths 12 12,000 13 12,000 20 18,000

First Responder Training (CARA)

 Grants

Continuations........................................................................................... 59 31,557 49 28,606 46 24,947

New/Competing....................................................................................... 33 9,816 47 13,394 87 38,053

Subtotal................................................................................................. 92 41,372 96 42,000 133 63,000

 Contracts

Continuations........................................................................................... --- --- --- --- --- ---

New/Competing....................................................................................... --- -372 --- --- --- ---

Subtotal.................................................................................................

Total, First Responder Training (CARA)

--- -372 --- --- --- ---

92 41,000 96 42,000 133 63,000

F

Y 

2

FY 2020 

Final

 FY 2021 

Enacted

 FY 2022 

President's 

Budget

 
 

 

 

Programs of Regional & National Significance No. Amount No. Amount No. Amount 

Peer Support TA Center

 Grants 

Continuations........................................................................................... --- --- 1 950 1 950 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

 Total, Peer Support TA Centers 

Treatment, Recovery, and Workforce Support

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Treatment, Recovery, and Workforce Support 

Emergency Department Alternatives to Opioids

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Emergency Department Alternatives to Opioids 

1 950 --- --- --- ---

1 950 1 950 1 950

--- 26 --- 49 --- 71 

--- 24 --- 1 --- 480 

--- 50 --- 50 --- 550

1 1,000 1 1,000 1 1,500 

--- --- 8 3,989 12 5,881 

8 3,951 4 1,862 6 3,000 

8 3,951 12 5,851 18 8,881

--- 103 --- 149 --- 204 

--- -54 --- --- --- -85 

--- 49 --- 149 --- 119 

8 4,000 12 6,000 18 9,000 

--- --- 10 4,759 12 5,713 

10 4,771 2 1,000 6 3,083 

10 4,771 12 5,759 18 8,796

--- 129 --- 149 --- 204 

--- 100 --- 92 --- ---

--- 229 --- 241 --- 204 

10 5,000 12 6,000 18 9,000 

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2022 

President's 

Budget 

FY 2020 

Final 

 FY 2021 

Enacted 

 

264 
 

 

 

Opioid Response Grants

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

Total, Opioid Response Grants 

Comprehensive Opioid Recovery Centers

 Grants 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal................................................................................................. 

 Contracts 

Continuations........................................................................................... 

New/Competing....................................................................................... 

Subtotal 

Total, Comprehensive Opioid Recovery Centers 

Total, Capacity 

--- --- --- --- 1 2,788 

--- --- 1 2,852 --- ---

--- --- 1 2,852 1 2,788

--- --- --- 148 --- 212 

--- --- --- --- --- ---

--- --- --- 148 --- 212 

--- --- 1 3,000 1 3,000 

--- --- 2 1,699 4 3,399 

--- --- 2 1,700 2 2,300 

--- --- 4 3,399 6 5,699

--- --- --- 215 --- 283 

--- --- --- 386 --- 18 

--- --- --- 601 --- 301 

--- --- 4 4,000 6 6,000 

941 465,842 993 481,842 1,337 635,682 

SAMHSA/Substance Abuse Treatment 

PRNS Mechanism Table by Program, Project, and Activity 

(Dollars in thousands) 

FY 2022 

President's 

Budget 

 FY 2020 

Final 

 FY 2021 

Enacted 

 

Programs of Regional & National Significance No. Amount No. Amount No. Amount 

265 
266 

SAMHSA/Substance Abuse Treatment

PRNS Mechanism Table by Program, Project, and Activity

(Dollars in thousands) 

Science and Service No. Amount No. Amount No. Amount

Addiction Technology Transfer Centers

 Grants

Continuations...........................................................................................

New/Competing.......................................................................................

Subtotal.................................................................................................

12 8,898 12 9,019 1 500

--- --- --- --- 11 8,093

12 8,898 12 9,019 12 8,593

 Contracts

Continuations........................................................................................... --- 471 --- 445 --- 426

New/Competing....................................................................................... --- -323 --- -419 --- 26

Subtotal.................................................................................................

 Total, Addiction Technology Transfer Centers

---

12

148

9,046

---

12

27

9,046

---

12

453

9,046

SAT Minority Fellowship Program

 Grants

Continuations........................................................................................... 8 4,042 9 4,340 9 4,340

New/Competing....................................................................................... 1 298 --- --- 8 1,379

Supplements *.......................................................................................... --- --- 0 1,012 --- ---

Subtotal................................................................................................. 9 4,340 9 5,353 17 5,719

 Contracts

Continuations........................................................................................... 1 357 1 436 1 404

New/Competing.......................................................................................

Subtotal.................................................................................................

--- 92 --- --- --- 13

1 449 1 436 1 417

Total, Minority Fellowship Program (MF)

Subtotal, Science and Service:

10 4,789 10 5,789 18 6,136

22 13,835 22 14,835 30 15,182

Total, Substance Abuse Treatment PRNS 963 $479,677 1,015 $496,677 1,367 $650,864

FY 2022 

President's 

Budget

FY 2020 

Final

 FY 2021 

Enacted

* Excluding Supplements number count to avoid duplication. 
267 

Grant Awards Table

(Whole Dollars)

` 

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 Budget

Request

Number of Awards 957 1,011 1,363 

Average Award $473,910.03 $465,128.69 $455,099.50 

Range of Awards $300,000-$600,000 $300,000-$600,000 $300,000-$600,000 
268 

State Opioid Response Grants

 (Dollars in thousands) 

Programs of Regional & National 

Significance

FY 2020 

Final

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022+/- 

FY 2021 

State Opioid Response Grants..................... $1,500,000 $1,500,000 $2,250,000 $750,000 

Set-Aside for Tribes (non-add) .............. 50,000 50,000 75,000 25,000 

Authorizing Legislation............................................Section 509 of the Public Health Service Act

FY 2022 Authorization.......................................................................................... $2,250,000,000 

Allocation Method ......................................................................................... Competitive Grants

Eligible Entities.....................................Limited to Single State Agencies (SSAs), Existing

USDA Cooperative Extension Grantees, and U.S.

 Territories, Tribes and tribal organizations are eligible to apply to set-aside funds described

below.

Program Description & Accomplishments

The State Opioid Response Grants (SOR) program was established by Congress in 2018 in order

to address the public health crisis caused by escalating opioid misuse and addiction across the 

nation. According to CDC provisional data, 90,000 overdose deaths for the 12 months ending last

September – about 20,000 more than the same period the year before. The SOR program provides 

resources to states, territories, and tribes to continue and enhance the development of 

comprehensive strategies focused upon preventing, intervening, and promoting recovery from

issues related to opioid misuse.

This program aims to address the opioid crisis by increasing access to medication-assisted

treatment using the three FDA-approved medications for the treatment of opioid use disorder, 

reducing unmet treatment need, and reducing opioid overdose related deaths through the provision 

of prevention, treatment and recovery activities for opioid use disorder (OUD) (including 

prescription opioids, heroin and illicit fentanyl and fentanyl analogs). In FY 2018, SAMHSA

started awarding grants to 57 states and territories via formula. The program includes a 15 percent

set-aside for the 10 states with the highest mortality rate related to drug overdose deaths.

The SOR program requires grantees to: use epidemiological data to demonstrate the critical gaps 

in availability of treatment for OUDs in geographic, demographic, and service level terms; utilize

evidence-based implementation strategies to identify which system design models will most

rapidly and adequately address the gaps in their systems of care; deliver evidence-based treatment

interventions that include medication(s) FDA-approved specifically for the treatment of OUD, and

psychosocial interventions; report progress toward increasing availability of medication-assisted

treatment for OUD and reducing opioid-related overdose deaths.

The program supplements activities pertaining to opioids currently undertaken by the state agency

and support a comprehensive response to the opioid epidemic. The program identifies gaps and

resources, while building upon existing substance use prevention and treatment activities as well

as community-based recovery support services. Grantees are required to describe how they will

expand access to treatment and recovery support services. Grantees are required to describe how 

they will advance substance misuse prevention in coordination with other federal efforts. 
269 

Grantees must use funding to supplement and not supplant existing opioid prevention, treatment,

and recovery activities in their state. Grantees are required to describe how they will improve 

retention in care, using a chronic care model or other innovative model that has been shown to

improve retention in care.

In addition to the grant program, SAMHSA supports a robust technical assistance and training

effort to enhance education across the country to address the opioid crisis. This effort began with

a $12 million investment in FY 2018 with STR funds and continued in FY 2019. SAMHSA has

identified local teams of experts on the ground in every state. These teams are comprised of

clinicians, preventionists, and recovery specialists to provide training and education not just to

practitioners but also to individuals and families. Providing this training ensures that local 

response to the opioid and substance use crisis is tailored to local needs. 

In FY 2020, SAMHSA funded a new cohort of SOR grants. In addition to addressing the opioid 

crisis, the program was expanded to support evidence-based prevention, treatment and recovery

support services to address stimulant misuse and use disorders, including cocaine and

methamphetamine misuse. In FY 2020, SAMHSA also continued to support SOR technical

assistance and training efforts.

Tribal Opioid Response Grants

The Tribal Opioid Response Grants (TOR) program addresses the public health crisis caused by 

escalating opioid misuse and addiction across tribal communities. The program aims to address

the opioid crisis in tribal communities by increasing access to culturally appropriate and evidencebased treatment, including medication-assisted treatment (MAT) using one of the three FDAapproved medications for the treatment of opioid use disorder (OUD). The intent of this program 

is to reduce unmet treatment need and opioid overdose related deaths through the provision of

prevention, treatment and/or recovery activities for OUD and stimulant misuse including 

methamphetamine and cocaine. According to the Centers for Disease Control and Prevention, 

American Indians and Alaska Natives (AI/AN) have had the highest drug overdose death rates in

2015 and the largest percentage increase in the number of deaths over time from 1999-2015 among 

all racial and ethnic groups. During that time, deaths rose more than 500 percent. 

American Indian/Alaska Native communities experience high rates of physical, emotional, and

historical trauma and significant socioeconomic disparities, which may contribute to higher rates

of drug abuse in the tribal communities94. The TOR program addresses the gaps in prevention, 

treatment, and recovery identified by the tribes and develop strategies to purchase and disseminate

naloxone and provide training on its use to first responders and other tribal members. 

Program Evaluation 

The SOR Evaluation Report to Congress is currently under development. As of April 2, 2021, 

grantees reported data on 157,333 people into the SPARS system.95 Since the SOR program began, 

approximately 646,854 patients have received treatment services, including 240,571 who have 

received medication-assisted treatment (MAT). Of that number, 107,905 received methadone, 

117,352 received buprenorphine, and 15,314 received naltrexone.96
270 

Rural Opioids Technical Assistance (ROTA) Grants

SAMHSA is collaborating with the United States Department of Agriculture (USDA) through the 

Rural Opioid Technical Assistance (ROTA) program. The USDA provides Cooperative Extension 

Services programs to improve the quality of people's lives by providing research-based knowledge 

to strengthen the social, economic and environmental well-being of families, rural communities,

and agriculture enterprises. Extension expertsfocus on issues which affect rural communities. The 

USDA has identified opioid misuse in rural America to be one of the areas of focus of these

programs. SAMHSA’s ROTA grants build upon these Cooperative Extension Services programs 

by expanding their reach. From 2018 to 2020 SAMHSA has funded three cohorts of ROTA

grantees. Together, they have implemented over 2,300 events and served over 60,400 community

members, including providers, in rural areas. In FY 2020, SAMHSA funded 16 grantees that will

remain active until 2022 to continue to develop and disseminate training and technical assistance

for rural communities on addressing opioid issues affecting these communities. Training and

technical assistance can also be geared toward addressing stimulant issues in these communities.

In FY 2020, SAMHSA funded 57 new SOR grants, and 92 new TOR grants, and technical

assistance and training grants. 

In FY 2021, additional funds from the Opioid Response Grants PRNS were appropriated for 

supplemental grants to states whose award from the State Opioid Response formula grant declined

by more than 40 percent in fiscal year 2021 in comparison to fiscal year 2019. 

In FY 2021, SAMHSA anticipates funding 57 SOR and 40 TOR continuation grants and continues 

to support technical assistance and training grants. 

Funding History

Fiscal Year Amount

FY 2018 $1,000,000,000 

FY 2019 $1,500,000,000 

FY 2020 $1,500,000,000 

FY 2021 Enacted

FY 2022 Budget Request

$1,500,000,000 

$2,250,000,000 

94 Whitesell NR, Beals J, Crow CB, Mitchell CM, Novins DK. Epidemiology and etiology of substance use among 

American Indians and Alaska Natives: risk, protection, and implications for prevention. Am J Drug Alcohol Abuse 

2012;38:376–82.

95 Data reported is based on GPRA data generated in SPARS on April 2, 2021 for clients who received services during 

both SOR and SOR20 grants.

96 Data is based on the FY18 SOR cohort year 1 and year 2 Performance Progress Report collected from September 

30, 2018 to September 29, 2020.
271 

Budget Request

The FY 2022 Budget Request is $2.3 billion, an increase of $750.0 million from the FY 2021 

Enacted level. The FY 2022 budget includes $75 million for TOR, a $25.0 million increase for 

tribes. SAMHSA plans to fund new grants to continue to support states and territories, including 

a 15 percent set-aside for the 10 states with the highest mortality rates related to drug overdose 

deaths. The allowable uses of this program will continue to include state efforts to address

stimulants, including methamphetamine, and cocaine. Stimulants are an increasing source of 

concern and are responsible for more deaths than opioids in a growing number of states, even as

opioid overdose deaths are continuing to increase. The additional funding will enhance states’

ability to address stimulants, as well as other issues related to the opioid epidemic that have been

compounded due to COVID-19. 

In FY 2022, SAMHSA will continue to fund supplemental grants to states whose award from the 

State Opioid Response formula grant declined by more than 40 percent in fiscal year 2021 in

comparison to fiscal year 2019. 
272 

Outputs and Outcomes Table

Program: State Opioid Response Grants

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.70 Number of 

admissions for OUD

treatment (Output)

FY 2020: 90,487.0 

Target:

20,959.0 

(Target Exceeded)

90,487.0 99,536.0 +9,049.0 

1.2.71 number of clients

receiving recovery 

services (Output) 

FY 2020: 38,147.0 

Target:

10,213.0 

(Target Exceeded)

38,147.0 38,147.0 Maintain

1.2.73 Illicit drug use at 6 

months follow-up

(Output) 

FY 2020: 70.0

Target:

41.3 

(Target Exceeded)

70.0 70.0 Maintain
273 

Substance Abuse Prevention and Treatment Block Grant

(Dollars in thousands 

Program 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

Budget

Request

FY 2022 

+/- 

FY 2021 

Substance Abuse Prevention and Treatment Block Grant... $1,858,079 $1,858,079 $3,508,079 $1,650,000 

 Budget Authority (non-add) ................................... 1,778,879 1,778,879 3,428,879 1,650,000 

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

Authorizing Legislation..........................................Section 1935 of the Public Health Service Act

FY 2022 Authorization.......................................................................................... $3,508,079,000 

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 Substance Abuse Prevention and Treatment Block Grant (SABG) program distributes funds 

to 60 eligible states, territories and freely associated states97, 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 and treatment, and recovery support services for 

individuals, families, and communities impacted by substance misuse. The SABG’s overall goal 

is to support and expand substance use disorder (SUD) 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 15 percent of total state substance 

abuse agency funding98 and on average 68 percent of total state SUD prevention and public health

funding. 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

97 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. . U.S. Department of Interior. 

Office of Insular Affairs. (n.d.). Islands We Serve. Retrieved from http://www.doi.gov//oia/islands/index.cfm 98 Web Block Grant Application System (WebBGAS) FY 2020 SABG State Agency Reported Expenditures by Target 

Activity Within Source of Funds, State/Jurisdiction Selection: All States/Jurisdictions.
274 

of physical and behavioral health.99 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: 

• Fund priority treatment and support services for individuals without insurance or for 

whom coverage is terminated for short periods of time; 

• 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; 

• Fund primary prevention for individuals not identified as needing treatment (which may

include universal programs that are targeted to the general public or a whole population 

group that has not been identified on the basis of individual risk, selective activities that

are targeted to individuals or a subgroup of the population whose risk of developing a 

disorder is significantly higher than average, and indicated prevention activities that are

targeted to individuals in high-risk environments, identified as having minimal but 

detectable signs or symptoms foreshadowing disorder or having biological markers

indicating predisposition for disorder but not yet meeting diagnostic levels); and 

• 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: 

• Strengthen current activities that facilitate and allow the pursuit of recovery through 

personal choice, regarding issues that matter most to people in their lives, that enhance

their health, wellness, and quality of life, and provide increased support for many

pathways of recovery, including recovery check-ups, mutual aide, peer based recovery,

peer coaching, services supporting recovery residences, recovery community centers, and

recovery supports in educational settings; 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. 

Funding Allocations and Requirements

The authorizing statute and implementing regulation governing the SABG includes a number of 

prescriptive performance and expenditure requirements as well as explicit expenditure 

99 Substance Abuse and Mental Health Services Administration. Case Studies of Three Policy Areas and Early State 

Innovators: 2014 State Profiles of Mental Health and Substance Use Disorder Agencies. HHS Publication No. SMA15-4418. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. 
275 

prohibitions. The states and jurisdictions have the flexibility to plan, carry out, and evaluate

substance use disorder treatment and recovery support 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 statute and

regulation prioritize 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 

statute and regulation prioritize 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 use disorder treatment and recovery

support services for adolescents and transitional age youth. Some states and jurisdictions are also

developing peer-to-peer recovery support services to facilitate individuals’ entry to substance use

disorder 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 misuse.

Formula: SABG funds are distributed100 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. The formula calculates states shares based on three

components derived from state-level data: the size of the population needing services, the cost of 

services, and the state’s fiscal capacity. 101 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 authorizing legislation and implementation regulation for the SABG

requires states to maintain its expenditures for certain SUD 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 implementing

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. 102 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 for women’s services. There are also

requirements and a potential penalty reduction of the block grant allotment if the state failsto enact

and enforce laws prohibiting the sale or distribution of tobacco products to individuals under the 

age of 18. 

100 Block Grants and Formula Grants: A Guide for Allocation Calculations; 2007 Department of Health and Human 

Services, SAMHSA.

101 Substance Abuse and Mental Health Services Administration. (2017). Block Grant Laws and Regulations. 

Retrieved April 6, 2020 from http://www.samhsa.gov/grants/block-grants/laws-regulations. 102 Substance Abuse and Mental Health Services Administration. (2017). Block Grant Laws and Regulations. 

Retrieved April 6, 2020 from http://www.samhsa.gov/grants/block-grants/laws-regulations. 
276 

The FY 2022 Budget includes a new 10 percentset-aside for recovery support services(see below). 

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. 

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

billing data systems, state mental health and SUD treatment data systems), ensures consistency in

the use of measures, and provides a more complete perspective of the delivery of mental and

substance use disorder treatment services.

 

An independent evaluation of the SABG demonstrated how states leveraged the statutory

requirements 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.103 SAMHSA data

show that on average, the SABG has been successful in expanding treatment capacity by annually 

supporting approximately two million104 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 the FY 2020 SABG Annual 

Report, which reflects State Fiscal Year (SFY) 2019 data, at discharge, clients demonstrated above 

average abstinence rates from both illegal drug (54 percent) and alcohol (78 percent) use. 

State substance abuse authorities reported in the FY 2020 SABG Annual Report the following 

outcomes for services105 provided during SFY 2019, the most recent year for which data is

available: 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands that

reported data concerning abstinence from alcohol use, 50 of the 60 jurisdictions identified

improvements in client abstinence;

• Similarly, for the 50 states, American Samoa, the District of Columbia, Guam, Marshall

Islands, Micronesia, Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin

Islands that reported data concerning the abstinence from drug use, 42 of 60 jurisdictions

identified improvements in client abstinence;

103 Center for Substance Abuse Treatment and Center for Substance Abuse Prevention. Independent Evaluation of the 

Substance Abuse Prevention and Treatment Block Grant Program: Final Evaluation Report. Rockville, MD: Substance 

Abuse and Mental Health Services Administration, 2009.

104 Web Block Grant Application System (WebBGAS) FY 2015 - 2019 SABG Treatment Utilization Matrix 

Admissions & Persons Served, State/Jurisdiction Selection: All States/Jurisdictions. 105 Services include services from Short-term residential, Long-term residential, Outpatient, and Intensive outpatient 

only. 
277 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands that

reported employments data, 51 of 60 jurisdictions identified improvements in client

employment; 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Palau, and Puerto Rico that reported criminal justice

data, 50 of 58 jurisdictions reported an increase in clients with no arrests based on data

reported to TEDS;106 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands that

reported housing data, 53 of 60 jurisdictions identified improvements in stable housing 

for clients based on data reported to TEDS; and 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Puerto Rico, and Red Lake that reported recovery

support data, 58 states out of 60 jurisdictions identified improvements in client

engagement in recovery support programs. 

In FY 2020, states expended: 

• $681,310,520 for primary prevention activities;

• $3,517,692 for tuberculosis services;

• $44,302,915 for early intervention services for HIV; and 

• $384,188,055 for state-level administration. 

All states admitted 61,664,415 total clients, specifically: 107 

• 282,211 persons to detoxification services;

• 675,559 persons to rehabilitation/residential services; 

• 50,359,565 persons to ambulatory services; and 

• 10,347,080 persons to opioid replacement therapy.

106 The States of Oregon and Washington did not provide data. 107 WebBGAS FY 2020 SABG Behavioral Health Report – Table 10 Treatment Utilization Matrix Admissions & 

Persons Served by Level of Care. The State of Kentucky did not provide data.
278 

FY 2020 SABG Demographics108,109

Total Persons Served (Adults and Children) 1,709,397 

Female 41.9% 

Male 58.1% 

Race

White 64.5% 

Blacks or African Americans 17.9% 

American Indian/Alaska Natives 3.6% 

Asians 0.7% 

Native Hawaiian/Other Pacific Islanders 0.5% 

Unknown 10.7% 

Multi-Racial 2.2% 

Ethnicity

Not Hispanic or Latino 86.3% 

Hispanic or Latino 13.7% 

Age

17 and Under 4.9% 

18 - 24 11.6% 

25 - 44 55.7% 

45 - 64 25.9% 

65 and Over 1.9% 

20 Percent Primary Prevention Set-Aside

SAMHSA is responsible for managing the 20 percent primary prevention set-aside of the SABG. 

The 20 percent set-aside requires SABG grantees to spend at least 20 percent of their SABG

expenditures to develop and implement a comprehensive substance misuse prevention program, 

which includes a broad array of prevention strategies directed at individuals not identified to be in

need of treatment.110 The prevention set-aside is one of SAMHSA’s main vehicles for supporting 

SAMHSA’s initiatives aimed at preventing substance misuse and mental illness. The 20 percent

set-aside is focused only on substance misuse prevention. States use these funds to develop 

infrastructure and capacity and to fund programs specific to primary substance misuse 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 

108 Source: FY 2020 SABG Report – Table 10 - Treatment Utilization Matrix has been used to reflect official total 

number of persons served. Kentucky did not supply data. Historically, Table 10 has been used to reflect official 

numbers of persons served. Furthermore, the table does not break out persons served by age or gender. The total 

reflects adults and children served.

109 Source: FY 2020 SABG Report - Table 11 – Unduplicated Count of Persons Served for Alcohol and Other Drug 

Use. Kentucky did not supply data. Table 11 is the only table that collects gender and age data. Hence, gender and age 

percentages are calculated based on data from Table 11.

110 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
279 

the Institute of Medicine report, Preventing Mental, Emotional, and Behavioral Disorders among 

Young People.111 SAMHSA regularly works with states to improve their accountability systems

for prevention and to establish necessary reporting capacities. 

10 Percent Recovery Support Services Set-Aside

The 2022 budget includes a new 10 percent set-aside for non-clinical recovery support services. 

The 10 percent set-aside will require SABG grantees to spend at least 10 percent of their SABG

expenditures for recovery community organizations or peer recovery support services. Recovery

support systems partner people in recovery from mental and substance use disorders, as well as

their family members, with recovery services. These services may include recovery community

centers, recovery homes, recovery schools, recovery industries, recovery ministries. These

programs utilize individual, community, and system-level approaches to increase the four 

dimensions of recovery as defined by SAMHSA: health (access to quality health and SUD

treatment); home (housing with needed supports); purpose (education, employment, and other 

pursuits); and community (peer, family and other social supports)112 States will use these funds to

develop local recovery community support institutions, provide system navigation resources and

supports, and to collaborate and coordinate with local private, public, non-profit, and faith

community response efforts. This new set-aside will build upon the more than two decades of 

practice based research that began when SAMHSA awarded the first Recovery Community

Services Program (1998) discretionary grants and to expand access to long-term recovery services,

a necessary component to extend the continuum of care. This set-aside will help increase access

to recovery support services across the country and complement the existing efforts to respond to

the ongoing opioid crisis that has accelerated during the COVID-19 pandemic. 

Synar Program Overview

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 the federal legal age of sale.113

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 retailsources. 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 consultation to states to ensure 

compliance with the Synar requirements. 

While the national weighted retailer violation rate declined steadily from 40.1 percent in the 

program’s baseline year in FY 1997 through FY 2011, the rate increased from an all-time low of 

8.5 percent in FY 2011 to 9.6 percent in FY 2018. Although the rate has declined in each year

since FY 2015, it has not returned to the historic low of FY 2011. One of the greatest predictors 

111 "Front Matter." Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and 

Possibilities. Washington, DC: The National Academies Press, 2009. Retrieved from 

https://www.ncbi.nlm.nih.gov/books/NBK32775/.

112 Substance Abuse and Mental Health Services Administration FFY 2020-2021 Block Grant Application.

Retrieved from https://www.samhsa.gov/sites/default/files/grants/ffy_2020-

2021_block_grant_application_and_plan.pdf

113 Substance Abuse and Mental Health Services Administration (2015). Synar Program. Retrieved from 

http://www.samhsa.gov/synar 
280 

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 their enforcement programs and this may be 

contributing to the higher rates 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. Asstates 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 since FY 2011. 

SAMHSA is addressing this increase by providing consultation 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. 

Technical Assistance

In addition to the states’ and jurisdictions’ plans and reports, the authorizing legislation provides 

SAMHSA with significant resources to support 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 use disorder treatment and recovery support services.

SAMHSA’s Knowledge Application Program (KAP) (https://www.samhsa.gov/kap) produces the 

Technical Assistance Publication Series that provide practical guidance and information related to

the delivery of substance use disorder 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.

Program Evaluation 

The SABG provides for the planning and development of a comprehensive statewide system of 

care and services that emphasizes the importance of the provision of a broad continuum of services

and supports encompassing prevention, treatment, and recovery across the population age range.

Among the critical populations identified as priorities for outreach and intervention are pregnant 

and postpartum women, persons who inject drugs, persons at risk for HIV, justice-involved 

populations, people with co-occurring mental disorders, and persons experiencing homeless. 

The SABG: 

• Contributes to positive effects on the health and lives of individuals with substance use

disorders as evidenced by demonstrated positive client outcomes in all six treatment

domains; 

• Acts as a major impetus for improving state prevention and treatment systems’

infrastructure and capacity thereby increasing availability of services, development and

implementation of evidence-based practices, development and collection of specific

outcome measures, and development and maintenance of state data management systems; 

• Aids states in leveraging requirements, resources, and federal guidance can be leveraged

to sustain and improve state systems further emphasizing the importance of the SABG in

the development of the same; and
281 

• Contributes to the development and maintenance of successful state collaborations with

other agencies and stakeholders concerned with preventing and treating substance use

disorders.

Funding History

Fiscal Year Amount

FY 2018 $1,858,079,000 

FY 2019 $1,858,079,000 

FY 2020 $1,858,079,000 

FY 2021 Enacted $1,858,079,000 

FY 2022 Budget Request $3,508,079,000 

Budget Request

The FY 2022 Budget Request level is $3.5 billion, an increase of $1.7 billion from the FY 2021 

Enacted level. SAMHSA plans to use the increase in funds to continue serving as a source of 

safety-net funding, including providing assistance to states in addressing and evaluating activities

to prevent, treat, and provide recovery support services for individuals, families, and communities

that are adversely impacted by substance use disorders (SUDs), and related conditions such as

opioid use disorder. The need and demand for treatment and recovery support services for SUDs

continues to grow, as exacerbated by the coronavirus pandemic. SAMHSA will continue to assist

states and jurisdictions in planning for, expanding, enhancing, and building capacity in their

service systems to address these burgeoning needs. 

The budget includes a new ten percent set aside within the SABG for recovery support services. 

This set-aside will significantly expand the continuum of care for substance use disorder, both 

upstream and downstream. States will use this funding to support the development of local

recovery community support institutions (i.e. recovery community centers, recovery homes,

recovery schools, recovery industries, recovery ministries); develop strategies and provide 

educational campaigns, trainings, and events to reduce addiction/recovery-related stigma and

discrimination at the local level; provide addiction treatment and recovery resources, and support 

system navigation needs; provide accessible peer recovery support services that are diverse and

inclusive of all pathways to recovery delivered in person or using technology; collaborate and

coordinate with local private and non-profit clinical health care providers and the faith community, 

in addition to city, county, state, and federal public health and criminal justice response efforts. 

Recent studies indicate the critical impact and important contribution of recovery support services

in assisting individuals in gaining and maintaining critical improvements in functioning and wellbeing across a variety of life domains. It is anticipated that the implementation of recovery support 
282 

services in all 50 states, territories, and eligible tribes will significantly strengthen and enhance the

entire prevention, treatment, and recovery supports continuum of services.114

114 March 25, 2021 issue of Alcohol Research, Volume 41, Issue 1.
283 

Outputs and Outcomes Table

Program: Prevention Set-Aside

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.63 Percent of states

showing an increase in

state level estimates of 

survey respondents who

rate the risk of substance 

abuse as moderate or

great (age 12-17) 

(Outcome) 

FY 2020: 41.1 % 

Target:

37.3 % 

(Target Exceeded)

41.1 % 41.1 % Maintain

2.3.65 Percent of states

showing a decrease in

state level estimates of 

percent of survey 

respondents who report 

30 day use of alcohol 

(age 12-17) (Outcome) 

FY 2020: 51.8 % 

Target:

53 % 

(Target Not Met)

67.5 % 67.5 % Maintain

2.3.67 Percent of states

showing a decrease in

state level estimates of 

percent of survey 

respondents who report 

30 day use of other illicit

drugs (age 12-17) 

(Outcome) 

FY 2020: 50 % 

Target:

43 % 

(Target Exceeded)

63 % 63 % Maintain

2.3.68 Percent of states

showing a decrease in

state level estimates of 

percent of survey 

respondents who report 

30 day use of other illicit

drugs (age 18+)

(Outcome) 

FY 2020: 19.6 % 

Target:

25 % 

(Target Not Met)

43 % 43 % Maintain
284 

Outputs and Outcomes Tables

Program: Treatment Activities

Measure Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

1.2.43 Number of 

admissions to substance 

abuse treatment programs 

receiving public funding 

(Output) 

FY 2020: 1,948,531 

Target:

1,880,000 

(Target Exceeded)

2,065,199 2,271,192 +206,520 

1.2.48 Percentage of

clients reporting no drug 

use in the past month at

discharge (Outcome)

FY 2020: 53.6 % 

Target:

74 % 

(Target Not Met)

55.7 % 54.7 % -1 % 

1.2.49 Percentage of

clients reporting no 

alcohol use in the past

month at discharge 

(Outcome) 

FY 2020: 78.4 % 

Target:

78 % 

(Target Exceeded)

77.3 % 77.9 % +0.6 % 

1.2.50 Percentage of

clients reporting being 

employed/in school at

discharge (Outcome)

FY 2020: 35.4 % 

Target:

40 % 

(Target Not Met but 

Improved) 

36 % 36 % Maintain

1.2.51 Percentage of

clients reporting no 

involvement with the

Criminal Justice System

(Outcome) 

FY 2020: 93.2 % 

Target:

92 % 

(Target Exceeded)

95.5 % 95.5 % Maintain

1.2.85 Percentage of

clients receiving services

who had a permanent

place to live in the 

community (Outcome) 

FY 2020: 88.4 % 

Target:

92 % 

(Target Not Met but 

Improved) 

89 % 89 % Maintain
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

FY 2021 Substance Abuse Prevention and Treatment Block Grant Final Allotment 

Appropriation Amount $3,508,079,000, State-Territory Total $3,327,669,730 

CFDA # 93.959 

State/Territory FY 2020 

Final 

FY 2021 

Enacted1 

FY 2022 

President's 

Budget

 FY 2022 +/- 

FY 2021 

Alabama $23,090,733 $23,091,681 $44,441,997 $21,350,316 

Alaska 5,889,392 5,889,634 13,155,296 7,265,662 

Arizona 40,428,835 40,591,646 84,907,396 44,315,750 

Arkansas 13,525,228 13,525,784 25,736,964 12,211,180 

California 254,428,502 254,438,953 461,097,985 206,659,032 

Colorado 28,916,325 28,917,513 65,040,308 36,122,795 

Connecticut 18,213,209 18,213,957 37,316,441 19,102,484 

Delaware 6,968,173 6,968,459 13,155,296 6,186,837 

District Of Columbia 6,968,173 6,968,459 13,155,296 6,186,837 

Florida 111,385,315 111,389,890 211,449,950 100,060,060 

Georgia 57,155,304 57,157,652 101,749,094 44,591,442 

Hawaii 8,582,682 8,583,035 15,101,219 6,518,184 

Idaho 8,536,299 8,536,650 16,248,082 7,711,432 

Illinois 67,649,432 67,652,211 106,653,108 39,000,897 

Indiana 32,247,828 32,249,153 66,537,770 34,288,617 

Iowa 13,094,055 13,094,593 25,138,925 12,044,332 

Kansas 11,900,305 11,900,794 23,645,562 11,744,768 

Kentucky 20,379,475 20,380,312 38,263,658 17,883,346 

Louisiana 25,027,783 25,028,811 40,866,880 15,838,069 

Maine 6,968,173 6,968,459 13,155,296 6,186,837 

Maryland 34,081,826 34,083,226 56,664,856 22,581,630 

Massachusetts 39,847,237 39,848,874 80,007,593 40,158,719 

Michigan 56,055,882 56,058,184 95,527,406 39,469,222 

Minnesota 24,103,340 24,104,330 48,456,340 24,352,010 

Mississippi 13,804,308 13,804,875 25,522,882 11,718,007 

Missouri 26,549,909 26,550,999 52,296,110 25,745,111 

Montana 6,968,173 6,968,459 13,155,296 6,186,837 

Nebraska 7,641,653 7,641,967 15,240,998 7,599,031 

Nevada 17,004,311 17,005,009 36,290,415 19,285,406 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Substance Abuse and Mental Health Services Administration 

FY 2021 Substance Abuse Prevention and Treatment Block Grant Final Allotment 

Appropriation Amount $3,508,079,000, State-Territory Total $3,327,669,730 

CFDA # 93.959 

State/Territory FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget

 FY 2022 +/- 

FY 2021 

New Hampshire 6,968,173 6,968,459 13,155,296 6,186,837 

New Jersey 48,066,790 48,068,764 93,453,090 45,384,326 

New Mexico 9,565,630 9,566,023 18,680,978 9,114,955 

New York 111,836,103 111,840,696 193,522,391 81,681,695 

North Carolina 44,994,339 44,996,187 93,502,793 48,506,606 

North Dakota 6,533,901 6,534,169 13,155,296 6,621,127 

Ohio 64,539,223 64,541,874 98,502,099 33,960,225 

Oklahoma 17,150,267 17,150,971 33,994,397 16,843,426 

Oregon 20,579,458 20,580,303 47,429,091 26,848,788 

Pennsylvania 59,103,394 59,105,822 107,006,582 47,900,760 

Rhode Island 7,598,886 7,599,198 13,287,318 5,688,120 

South Carolina 23,719,055 23,720,029 46,753,828 23,033,799 

South Dakota 6,042,037 6,042,285 13,155,296 7,113,011 

Tennessee 31,979,975 31,981,289 64,189,070 32,207,781 

Texas 144,716,491 144,722,435 290,288,425 145,565,990 

Utah 16,589,477 16,590,158 45,425,206 28,835,048 

Vermont 6,460,223 6,460,488 13,155,296 6,694,808 

Virginia 41,982,172 41,983,896 85,184,035 43,200,139 

Washington 37,786,705 37,788,257 76,240,247 38,451,990 

West Virginia 8,433,135 8,433,481 14,634,927 6,201,446 

Wisconsin 27,199,453 27,200,570 48,711,037 21,510,467 

Wyoming 4,197,785 4,197,957 13,155,296 8,957,339 

Red Lake Indians 594,059 594,083 1,194,271 600,188 

American Samoa 346,037 346,584 655,384 308,800 

Guam 1,124,417 1,144,043 2,198,081 1,054,038 

Northern Marianas 351,136 354,549 676,077 321,528 

Puerto Rico 22,519,704 22,466,159 42,357,918 19,891,759 

Palau 143,987 146,718 282,363 135,645 

Marshall Islands 500,800 516,092 1,004,102 488,010 

Micronesia 700,055 706,745 1,347,200 640,455 

Virgin Islands 720,695 729,480 1,393,921 664,441 

1. The amuonts in FY 2021 exclude supplemental funding. 

286 
287 

SAMHSA 

Health Surveillance and Program Support

Table of Contents

1. Health Surveillance Appropriation ............................................................................... 289 

2. Health Surveillance ..................................................................................................... 290 

3. Drug Abuse Warning Network ................................................................................... 299 

4. Performance and Quality Information Systems............................................................ 302 

5. Program Support.......................................................................................................... 308 

6. Public Awareness Support ........................................................................................... 311 
288 

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Health Surveillance and Program Support Appropriation 

(Dollars in thousands) 

Program Name FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

Health Surveillance and Program Support $126,258 $126,258 $130,913 $4,655 

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

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

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

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

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

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

Drug Abuse Warning Network....................................................... 10,000 10,000 15,000 5,000 

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

Total, Health Surveillance and Program Support ..................... $161,758 $161,758 $171,873 $10,115 

The Health Surveillance and Program Support Budget Request is $171.9 million, an increase of 

$10.1 million from the FY 2021 Enacted budget. 

289 
290 

Health Surveillance

(Dollars in thousands) 

Authorizing Legislation.............................Sections 501 and 505 of the Public Health Service Act

FY 2022 Authorization................................................................................................. Permanent

Allocation Method ................................................... Federal/Intramural, Contracts, Grants, 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.

Program Name

Health Surveillance.................................................................

FY 2020 

Final

FY 2021 

Enacted

FY 2022 

President's 

Budget

FY 2022

+/- FY 2021

$47,258 $47,258 $47,595 $337

Budget Authority (non-add)............................................... 16,830 16,830 17,167 337

PHS Evaluation Funds (non-add)...................................... 30,428 30,428 30,428 ---
291 

Health Surveillance

Resources by Activity/Program 

(Dollars in thousands)

FY 2020 Final

FY 2021 

Enacted

FY 2022 

President’s 

Budget

FY 2022

+/- FY 2021

Health Surveillance

Population Data Collection, Analyis, and Dissemination $16,320 $13,287 $6,925 -$6,362

National Survey on Drug Use and Health (NSDUH).................................... 14,595 11,237 6,925 -4,312

Treatment Services Data Collection, Analysis, and Dissemination 13,741 8,313 9,493 1,179

Behavioral Health Services Information System (BHSIS)............................ 13,741 8,313 9,493 1,179

Behavioral Health Data Dissemination 1,707 1,332 2,174 843

Substance Abuse and Mental Health Data Archive (SAMHDA).................... 1,707 1,332 2,174 843

Performance Measurement/Systems 2,458 4,069 2,474 -1,595

SAMHSA Performance Accountability Reports System (SPARS).................. --- 1,605 --- -1,605

WebBGAS....................................................................................................... 466 476 487 10

Program Evaluations 750 --- --- ---

TTC Evaluation............................................................................................... 750 --- --- ---

Drug Abuse Warning Network 2,545 2,997 --- -2,997

PHS Evaluation (non add)....................................................................... --- 452 --- -452

Support 9,737 17,260 26,529 9,269

Operations..................................................................................................... 9,737 17,260 26,529 9,269

Total Health Surveillance $47,258 $47,258 $47,595 $337

Overview

The Center for Behavioral Health Statistics and Quality (CBHSQ) is the government’s lead agency

for behavioral health statistics. Authorized by Section 505 of the Public Health Service Act, which

was reauthorized and amended by Section 6004 of the 21st Century Cures Act, CBHSQ performs 

activities that: (1) coordinate SAMHSA’s integrated data strategy, including collecting data each

year; (2) provide statistical and analytical support for SAMHSA’s activities; (3) manage 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, National Mental Health

and Substance Use Policy Lab, and SAMHSA’s Chief Medical Officer, as appropriate, to improve 

the quality of data collection services and evaluations of SAMHSA activities. 

for Health Surveillance (HS), the Drug Abuse Warning Network (DAWN), and Performance and

Quality Information Systems (PQIS) within the Health Surveillance and Program Support 

appropriation (HSPS) 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; and Behavioral Health Data

Dissemination. Under PQIS, CBHSQ activities include Performance Measurement/Systems,

Behavioral Health Data Dissemination, and Evidence-Based Programs/Practices.
292 

The FY 2022 budget request is $178.9 million, which is $55.0 million higher than the FY 2021 

Enacted, and includes $73.8 million from Health Surveillance and Program Support (HSPS)

Appropriation and $105.1 million from the Substance Abuse Treatment (SAT) Appropriation. 

Population Data Collection, Analysis, and Dissemination

National Survey on Drug Use and Health: Section 505 of the Public Health Service Act (42 USC

290aa-4) requires SAMHSA to annually collect prevalence data on substance use and mental

illness. To accomplish this data collection, 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 illicit

drugs, alcohol, and tobacco, certain mental health issues, co-occurring drug/alcohol addiction and

mental illness, and treatment for mental and substance use disorders. NSDUH data provide 

estimates at the national, state, and sub-state level and among demographic, socioeconomic or 

geographic subgroups, as well as trend estimates over time. State-specific NSDUH data provide 

states the opportunity to focus on their leading public health challenges. 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. In 2018, SAMHSA began a NSDUH redesign to ensure the survey is clinically up to

date, through alignment of questions with the Diagnostic and Statistical Manual of Mental 

Disorders, Fifth Edition (DSM-5), along with several other updates. In an effort to expedite these

critical revisions, the DSM-5 Substance Use Disorder module was added to NSDUH in 2020 and

data will be available in 2021, four years ahead of the previously planned 2025 redesign target

date. 

Based on the 2019 NSDUH survey data, among the 20.4 million people aged 12 or older with a 

past year substance use disorder (SUD), 71.1 percent had a past year alcohol use disorder and 40.7

percent had a past year illicit drug use disorder. In addition, among adults aged 18 or older, the 

percentage who had any mental illness (AMI) in the past year increased from 17.7 percent in 2008 

to 20.6 percent in 2019. From 2008 to 2019, serious mental illness among people aged 18 and

older (SMI) increased from 3.7 percent to 5.2 percent.

In December 2013, the Senate Appropriations Committee encouraged SAMHSA to

consider fully incorporating Puerto Rico and the U.S. Territories into the redesign of the NSDUH

(https://www.congress.gov/113/crpt/srpt71/CRPT-113srpt71.pdf ) 

SAMHSA recognizes the importance of expanding data collection to include Puerto Rico and the 

US Territories. In 2022, NSDUH plans to add Puerto Rico to the data collection and explore 

expanding NSDUH to the US Territories in phases for the following years.

SAMHSA is continuously improving the quality of the NSDUH questionnaire, to ensure collection

of the highest quality data and to address emerging and critical data needs related to mental health

and substance use behaviors. In 2019, SAMHSA included medication-assisted treatment (MAT),

perceived recovery, and Kratom questions in the survey. In 2020, questions about vaping, 

including vaping nicotine or tobacco, were added. In addition, questions on synthetic marijuana,
293 

synthetic stimulants, marijuana withdrawal symptoms, prescription tranquilizer misuse,

withdrawal symptoms, and craving for all substances were added. These additions reflect the 

DSM‐5 diagnostic criteria for substance use disorders. In 2020, the NSDUH questionnaire added

items to assess the impact of the COVID-19 pandemic on mental health and substance use.

COVID-19 questions were added to assess changes in substance use frequency due to COVID-19, 

the use of telehealth for treatment, and suicidal ideation and behavior related to COVID-19 among 

both youth and adults. In 2021, vaping questions will be expanded to include marijuana and other 

flavorings, and questions on prescription and non-prescription fentanyl use will be expanded. 

NSDUH data collection was discontinued in March 2020 due to the COVID-19 pandemic. When

data collection resumed in July 2020, SAMHSA responded quickly by implementing a new web

survey mode, in order to reach areas where face-to-face interviews were not deemed safe.

The 2020 NSDUH data collection covers two of the four calendar-year quarters (together with a 

small number of cases in July). In October 2020 (quarter 4), multi-mode NSDUH data collection

was instituted, by combining web-based interviewing for the entire sample with in-person 

interviewing in areas safe for field data collection.

Data Dissemination: 

SAMHSA is committed to facilitating broader data use and dissemination. NSDUH data are

released in three different formats: person-level analytic files, interactive online tools, and

products. Person-level data are optimal for complex analyses and are released in two different

versions: public use- and restricted-use files. Public-use files are available at SAMHSA’s web

pages, while restricted-use files are accessible through Federal Statistical Research Data Centers

(FSRDCs). The public can readily access NSDUH data via SAMHSA’s interactive online tools, 

specifically designed for customized analyses of substance use and mental health indicators, 

without needing to download any data. In addition, SAMHSA disseminates annual reports, data

visualizations, slide decks, data tables and other types of reports—products created using 

NSDUH data. In FY 2020, over 149,000 NSDUH files were downloaded from SAMHDA and

the SAMHSA Data webpage, and NSDUH webpages received over 650,000 page views. In FY

2020, the SAMHSA Data Web page received over 1.4 million page views overall, with over 67% 

of the traffic consisting of new visitors to the website. There were over 260,000 files total

downloaded in FY 2020. 

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 health and substance use disorder treatment services. For this purpose, CBHSQ

developed the Behavioral Health Services Information System (BHSIS). Data collected through 

BHSIS provides information to the public on treatment services through the Behavioral Health

Treatment Services Locator, which is part of the National Treatment Referral Service. The Locator

provides accurate, timely, and regularly updated information on mental health and substance use

disorder treatment facilities across the country. 

BHSIS includes multiple data collection programs and information resources. The data collections

comprise: (1) the National Mental Health Services Survey (N-MHSS), which provides information
294 

on all public and private specialty mental health disorder treatment facilities in the United States;

in 2020, the overall response rate was 90 percent; (2) the National Survey of Substance Abuse 

Treatment Services (N-SSATS), which provides information on all public and private substance 

use disorder treatment facilities in the United States; in 2020, the overall response rate was 91 

percent; (3) the Treatment Episode Data Set (TEDS), which provides demographic, clinical, and

substance use characteristics on publicly funded admissions and discharges from substance use 

disorder treatment facilities; (4) the Mental Health Treatment Episode Data Set (MH-TEDS) and

the Mental Health Client Level Data (MH-CLD), which provide demographic characteristics and

outcomes of individuals served by state mental health agencies (SMHAs) for mental health

treatment; and (5) the Uniform Reporting System (URS), which provides a set of standardized data

tablessubmitted annually by states and territories as part of their Mental Health Block Grant annual 

implementation reports. In 2021, SAMHSA is combining the two surveys, N-SSATS and NMHSS, into the National Substance Use and Mental Health Services Survey (N-SUMHSS), in

order to reduce respondent burden and duplication of effort for facilities that provide both 

substance use and mental health treatment services and thus respond to both surveys. This 

streamlining of the two surveys will also improve overall quality of the data, which serve as the 

principal data source for the SAMHSA Behavioral Health Treatment Locator. SAMHSA is

initiating data collection on the combined survey in April 2021. 

In FY 2020, the Behavioral Treatment Locator homepage received more than 4 million page views,

while the locator map had over 950,000 page viewsfrom individuals, families, community groups, 

and organizations, in order to identify appropriate treatment services.

In FY 2020, the data webpage received over 1.4 million page views. Through this webpage the 

public downloaded more than 41,000 BHSIS publications, including 7,498 downloads of TEDS

publications, 9,886 downloads of N-MHSS publications, 12,211 of N-SSATS publications, and

7,456 URS tables. In FY 2020, SAMHSA awarded a new BHSIS contract that includes the newly

combined annual N-SSATS and N-MHSS, the N-SUMHSS, and TEDS, MH-CLD, MH-TEDS,

URS, and the Behavioral Health Treatment Locator. 

Behavioral Health Data Dissemination

The Substance Abuse and Mental Health Data Archive (SAMHDA) makes public-use data files,

available in a variety of formats, that anyone can download and use their software to analyze and

explore the data. Through SAMHDA, CBHSQ provides access to a data visualization tool and to

public- and restricted-use data through a web-based analytic tool. The analytic tool was launched

in April 2017 and allows researchers to generate tables based on these data through an online 

interface. 

Historically, CBHSQ has managed two separate websites/interfaces for data dissemination to the 

public. There is a data webpage, which makes reports, survey information, and supporting 

documentation available. This site currently resides at https://www.samhsa.gov/data/. There is also

a data archive, the Substance Abuse and Mental Health Data Archive (SAMHDA), which makes

public-use files and analytic tools available. This site currently resides at

https://datafiles.samhsa.gov/. While SAMHDA’s target population is researchers, the analytic

tools available for access can be useful to various public audiences. SAMHSA removed
295 

overlapping functions and combined the SAMHDA and data webpage into a single contract in FY

2020. This migration provided cost savings, eliminated duplicate work, allows for easier, more 

efficient access to all SAMHSA data in one place, and promotes the goal of expanding 

dissemination of data relevant to behavioral health. SAMHSA has also been conducting user

testing and through the implementation of user centric design, is launching a refresh of SAMHDA

in FY 2021, which will allow for easier access to a wider audience and will promote increased use

and access to behavioral health data.

 

In a united effort to support broader use of restricted-use NSDUH data, SAMHSA collaborates

with other federal agencies. Researchers apply for, and obtain access to, restricted-use NSDUH

data via Federal Statistical Research Data Centers (FSRDCs). SAMHSA promotes data use by 

aiding researchers in navigating resources, accessing relevant substance use and mental health

indicators, and completing important public health investigations, while also protecting privacy

and minimizing disclosure risk.

Buprenorphine Waiver Notification (BWNS) Beginning in August 2020, CBHSQ assumed data

management of the inventory of practitioners permitted to provide medication-assisted treatment

to individuals with Opioid Use conditions. SAMHSA implements DATA 2000 in coordination 

with the Drug Enforcement Administration (DEA), including approving waivers for qualified

practitioners to provide medication-assisted treatment in office-based settings. As of March

2021, there were over 98,000 practitioners with an active waiver to prescribe buprenorphine to

patients with opioid use disorder (OUD). Among these practitioners, 71% can treat up to 30 

patients, 22% can treat up to 100 patients, and 7% can treat up to 275 patients. Almost three

quarters of practitioners with waivers are physicians (72%), while advanced practice registered

nurses (APRNs) and physician assistants (PAs) comprise 22% and 6%, respectively, of waivered

practitioners. 
296 

Funding History

Fiscal Year Amount

FY 2018 $47,258,000 

FY 2019 $47,258,000 

FY 2020 $47,258,000 

FY 2021 Enacted budget $47,258,000 

FY 2022 Budget Request $47,595,000 

Budget Request

The FY 2022 budget request is $47.6 million, which is an increase of $337,000 from the FY 2021 

Enacted level. SAMHSA intends to provide support to states for the development of data

infrastructure efforts, including an emphasis on using data to improve health equity. In addition, 

these funds will support exploring the expansion of NSDUH to include data from Puerto Rico and

the other territories, and the continuation of the BHSIS and SAMHDA contracts.
297 

Mechanism Table

Health Surveillance

(Dollars in thousands) 

FY 2022 

FY 2020 FY 2021 Budget

Program Activity 

Final Enacted Request

No. Amount No. Amount No. Amount

Health Surveillance 

Grants 

Continuations.................................................................... 1 $750 --- $--- --- $--- 

New/Competing................................................................ --- --- --- --- --- --- 

Subtotal......................................................................... 1 750 --- --- --- --- 

Contracts 

Continuations.................................................................... --- $39,327 22 $45,653 --- $47,595 

New/Competing................................................................ 1 7,181 --- 1,605 --- --- 

Subtotal.........................................................................

Total, Health Surveillance

1 46,508 22 47,258 --- 47,595 

2 47,258 22 47,258 --- 47,595 

 
298 

Outputs and Outcomes Table

Program: National Survey on Drug Use and Health Measures

Measure

Year and Most Recent

Result / 

Target for Recent Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

2.3.19L Percentage of 

adults with Serious 

Mental Illness (SMI)

receiving mental health

services (Outcome) 

FY 2019: 65.5 % 

Target:

68.0 % 

(Target Not Met but 

Improved) 

75.0 % 76.0 % +1 % 

2.3.19M Percentage of

people who meet criteria

for needing substance use

treatment who receive

treatment from a 

specialty substance use

disorder treatment

provider (Outcome) 

FY 2018: 11.1 % 

Target:

11.5 % 

(Target Not Met)

11.1 % 11.1 % Maintain

2.3.19N Past year

prescription pain reliever

misuse (age 12 and older) 

(Outcome) 

FY 2018: 2,000,000.0 

Target:

9,500,000.0 

(Target Exceeded)

2,000,000.0 2,000,000.0 Maintain

2.3.19O Percent of youth 

ages 12-17 who

experienced major

depressive episodes with

severe impairment in the

past year receiving 

treatment for depression.

(Outcome) 

FY 2019: 49.7 % 

Target:

48.5 % 

(Target Exceeded)

55.0 % 56.0 % +1 % 
299 

Drug Abuse Warning Network (DAWN)

(Dollars in thousands) 

Authorizing Legislation.................................. Section 505 of the Public Health Service Act

FY 2022 Authorization.............................................................................................. $15,000,000 

Allocation Method .........................................................................................................Contracts

Eligible Entities.....................................................................................................Not Applicable 

Program Description and Accomplishments 

SAMHSA re-established DAWN in 2018 as a nationwide public health surveillance system to

monitor emergency department (ED) visits related to recent substance use, including those related

to opioids. Authorized by the 21st Century Cures Act, DAWN provides necessary information

such as patient demographic details and substances used in order to respond effectively to the 

opioid and addiction crises in the United States and to better inform public health, clinicians,

policymakers, and other stakeholders to respond to emerging substance use trends. There are

several important improvements for the new DAWN, including timeliness of data, data available

at more frequent intervals, and data abstracted from a wider range of geographic area types—

urban, suburban and rural. Having data available more quickly means that DAWN can serve as a 

true “early warning” system and inform local public health response efforts.

DAWN data are abstracted from hospital emergency department records. Hospital participation

is optional. SAMHSA currently is at 98% in achieving targeted hospital participation and

anticipates being at 100% by the middle of CY 2021. By using data abstracted directly from ED

records, DAWN captures detailed information about the substances involved in ED visits, and

serves as an early warning system for the emergence of new and novel psychoactive substances.

It monitors the geographic, temporal and demographic characteristics of drug-related ED visits.

Unlike other public health surveillance systems, DAWN captures both ED visits that are directly

caused by drugs, such as overdoses, and those in which drugs are a contributing factor but not the 

direct cause of the ED visit, such as a motor vehicle crash involving a driver who had combined 

medications with alcohol. These criteria encompass all types of drug-related events, from

substance use and misuse to substance-related suicide attempts. In CY 2021, DAWN surveillance

of ED visits was expanded to include those visits to due to alcohol use by individuals 21 years and

older. Complete implementation of this critical data abstraction expansion should be completed by 

Q3 of FY2021. The detailed information captured by DAWN is used to assess health hazards

associated with specific substances and monitor the impact of drug use and misuse on the Nation's 

health care system. As of February 2021, the DAWN surveillance system has reviewed more than

1,823,000 ED records from 51 participating hospitals (24 urban, 11 suburban and 16 rural) and

abstracted over 114,000 DAWN cases (5.3% of total ED records reviewed). Preliminary analysis

demonstrates that the most common substances associated with DAWN cases are illicit substances 

(53,430 cases, 47%) and Central Nervous System (CNS) agents (9,329 cases, 17%); among illicit

Program Name

FY 2020 

Final

FY 2021 

Enacted

FY 2022 

President's 

Budget

FY 2022

+/- FY 2021

Drug Abuse Warning Network................................................ $10,000 $10,000 $15,000 $5,000

PHS Evaluation Funds (non-add).................................. --- --- --- ---
300 

drugs, stimulants were the most commonly associated with DAWN cases, with the majority

involving methamphetamine. 

Funding History

Fiscal Year Amount

FY 2018 $10,000,000 

FY 2019 $10,000,000 

FY 2020 $10,000,000 

FY 2021 Enacted budget $10,000,000 

FY 2022 Budget Request $15,000,000 

Budget Request

The FY 2022 budget request is $15.0 million, an increase of $5.0 million over the FY 2021 Enacted

level. SAMHSA will be able to improve and enhance the DAWN data abstraction system including 

increasing the participating hospitals, leveraging advanced technologies in EHR data review and

retrieval, and support the continued abstraction of alcohol-related ED visits.
301 

Mechanism Table

Drug Abuse Warning Network

(Dollars in thousands) 

Program Activity

FY 2020 

Final

FY 2021 

Enacted

FY 2022 

Budget

Request

No. Amount No. Amount No. Amount

Drug Abuse Warning Network 

Contracts

Continuations.................................................................... 1 $10,000 1 $10,000 1 $15,000 

New/Competing................................................................ --- --- --- --- --- --- 

Subtotal......................................................................... 1 10,000 1 10,000 1 15,000 

Total, Drug Abuse Warning Network 1 10,000 1 10,000 1 15,000 
302 

Performance and Quality Information Systems

(Dollars in thousands) 

Authorizing Legislation..................Sections 501, 505, 509, 516, 520A, and 543A of the PHS Act

FY 2022 Authorization................................................................................................... Indefinite 

Allocation Method .........................................................................................................Contracts

Eligible Entities.....................................................................................................Not Applicable 

Program Description and Accomplishments 

The Performance and Quality Information Systems (PQIS) funding primarily supports the 

activities of the Center for Behavioral Health Statistics and Quality (CBHSQ). The detailed

narrative description of each project follows. 

Performance and Quality Information Systems

Resources by Activity/Program 

(Dollars in thousands)

FY 2022 FY 2022 

FY 2020 FY 2021 Budget +/- FY

 Final Enacted Request 2021 

Performance and Quality Information Systems 

Performance Measurement and Performance Systems........................ $6,022 $6,898 $7,338 $439 

 SAMHSA Performance Accountability Reports System (SPARS)... 6,022 6,898 7,338 439 

Evidence-Based Programs/Practices.................................................. 1,745 1,789 2,110 321 

 Evidence Based Resource Center.................................................. 1,745 1,789 2,110 321 

Behavioral Health Data Dissemination............................................... 101 --- --- --- 

DAWN................................................................................................ 1,530 690 --- -690 

 DAWN............................................................................................. 1,530 690 --- -690 

Support............................................................................................... 602 623 752 129 

 Operations...................................................................................... 602 623 752 129 

Total Performance and Quality Information Systems $10,000 $10,000 $10,200 $200 

Performance Measurement and Performance Systems

SAMHSA collects data on key output and outcome measures to monitor and manage discretionary

grant performance, improve the quality of treatment services, and inform the public and

stakeholders on the impact of financial investments. SAMHSA collectsthese data in the SAMHSA

Performance Accountability and Reporting System (SPARS).

Program Name

FY 2020 

Final

FY 2021 

Enacted

FY 2022 

President's 

Budget

FY 2022

+/- FY 2021

Performance and Quality Information Systems........................ $10,000 $10,000 $10,200 $200
303 

Data collected and analyzed through SPARS allow SAMHSA to monitor the progress of 

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

understanding of the quality of services delivered through the programs. SAMHSA continues to

implement the 21st Century Cures Act through continuously evaluating and improving the 

performance of SAMHSA programs, including updates to modernize the SPARS data collection

system. Recent advances to automated reporting and scheduled reminders encourage greater

access to data and assist in achieving real-time outcome reporting. 

In addition, the CBHSQ Office of Evaluation provides support to the three program centers,

CMHS, CSAT, and CSAP, and the Office of Tribal Affairs and Policy’s (OTAP) grantees and

project officers, by initiating enhancements to the SPARS system. These enhancements improve 

the end-user experience by enabling easier access to reports, as well as greater data visualization

options for examination of demographic data on both adult and youth participants for a single year

or for multiple years of funding. 

The SPARS team provides technical support, grantee and staff training, and help-desk assistance

to ensure SAMHSA effectively manages its grant portfolio and provides timely, accurate

information to policy makers and stakeholders. 

Program Evaluation

The CBHSQ Office of Evaluation (OE) is responsible for providing centralized planning and

management of program evaluation activity across SAMHSA, including the evaluation reports for 

Projects for Assistance in Transition from Homelessness (PATH), Garret Lee Smith, and the state

Pilot for Pregnant and Postpartum Women (PPW-PLT). In partnership with the program centers,

OE provides oversight and management of agency quality improvement and performance 

management activities and advances agency goals and objectives relating to performance

measurements and quality improvement. In FY 2020, the OE team collaborated with CBHSQ’s

Office of Program Analysis and Coordination (OPAC) and CMHS staff to acquire the PATH Data

Exchange (PDX) from prior private contractor management of the system. OPAC manages PDX

now, and OE provides evaluation expertise and support to grantees and CMHS staff. OE activities

include development of evaluation language for funding announcements, to ensure a clear

statement of evaluation objectives, development and implementation of standard measures for 

evaluating program performance and improvement of services. OE identifies and maintains

performance indicators to monitor each SAMHSA program, and develops periodic evaluation

reports for use in agency planning, program change, and reporting to departmental and external

organizations. In FY 2020, OE developed Program Profiles for grant programs administered by 

SAMHSA. These documents offer internal and external audiences an overview of the goal of each

program, as well as a summary of the demographic and program outcome data associated with

each grant program. OE works collaboratively with the National Mental Health and Substance 

Use Policy Laboratory and the Office of the Chief Medical Officer to provide support for

SAMHSA evaluation activities.
304 

Evidence-Based Practice Resource Center (EBPRC) 

Section 7002 of the 21st Century Cures Act directs SAMHSA to promote access to reliable and

valid information on evidence-based programs and practices and share information on the strength 

of evidence associated with such programs and practices related to mental illness and drug/alcohol 

addiction. To fulfill this charge, SAMHSA has developed the Evidence-Based Practices Resource 

Center (EBPRC), which provides information on evidence-based programs and practices to states,

local communities, non-profit entities, and other stakeholders. 

The EBPRC, which is managed by the National Mental Health and Substance Use Policy

Laboratory (NMHSUPL), provides communities, clinicians, policy-makers and others in the field

with the information and tools that they need to incorporate evidence-based practices in their

communities or clinical settings. As part of this effort, SAMHSA develops and disseminates

resources, such as new or updated Treatment Improvement Protocols, guidance documents, 

clinical practice policies, toolkits, systematic reviews, data reports and other actionable materials

that incorporate the latest scientific evidence on mental health and substance use and address

priority areas where more information or guidance is needed to help the field move forward. This 

approach enables SAMHSA to quickly develop and disseminate expert consensus on the latest

prevention, treatment, and recovery sciences. The EBPRC currently includes 149 resources.

SAMHSA expects to add at least 15 more resources over the next two years to the EBPRC,

including five SAMHSA-developed Guidebooks each year.

SAMHSA convenes bimonthly committee meetings with staff from across the agency to review

potential new resources on different topics related to mental illness and substance use for inclusion 

in EBPRC. The EBPRC enables SAMHSA to collaborate with experts in the field, to rapidly 

translate science into action. The EBPRC provides communities and practitioners with tools to

facilitate comprehensive needs assessment, matches interventions to those needs, supports 

implementation, and incorporates continuous quality improvement into its prevention, treatment,

and recovery efforts. This strategy, coupled with SAMHSA’s regional and locally based training

and technical assistance efforts, ensures that communities and practitioners are equipped to bring

about the improvements in mental health and substance use prevention, treatment, and recovery

that our Nation requires. The EBPRC website has recently been updated with new content and

improvements to its functionality, which will enable a broad audience to easily access needed

materials. 
305 

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. 

This work includes partnerships with the Center for Medicare & Medicaid Services (CMS) and

the Assistant Secretary for Planning and Evaluation (ASPE), among other federal partners, in

quality measures work. 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 participates in the Measures

Application Partnership, a group convened to guide HHS on measures adoption. 

CBHSQ staff provides internal collaborations across SAMHSA, advising on quality measure

issues and identifying key next steps. CBHSQ staff regularly consult 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 continues 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 2018 $10,000,000 

FY 2019 $10,000,000 

FY 2020 $10,000,000 

FY 2021 Enacted budget $10,000,000 

FY 2022 Budget Request $10,200,000 

Budget Request

The FY 2022 budget request is $10.2 million, an increase of $200,000 over the FY 2021 Enacted

level. SAMHSA will use these funds for modernization efforts and continuation of the SPARS

and EBPRC contracts.
306 

Mechanism Table

Performance and Quality Information Systems

(Dollars in thousands)

FY 2022 

FY 2020 FY 2021 Budget

Program Activity

Final Enacted Request

No. Amount No. Amount No. Amount

Performance and Quality Information Systems 

Contracts 

Continuations.................................................................... 2 $9,899 1 $3,102 2 $10,200 

New/Competing................................................................ --- 101 1 6,898 --- --- 

Subtotal......................................................................... 2 10,000 2 10,000 2 10,200 

Total, Performance and Quality Information Systems 2 10,000 2 10,000 2 10,200 
 

 

 

 

Substance Abuse Treatment Appropriation 

Substance Abuse Block Grant Set Aside 

Population Data Collection, Analysis, and Dissemination................. $43,493 $45,410 $52,824 $7,414 

PHS Evaluation (non add)............................................................ 43,493 45,410 52,824 7,414 

Treatment Services Data Collection, Analysis, and Dissemination ... 

PHS Evaluation (non add)............................................................ 

7,724 

7,724 

6,841 

6,841 

47,701 40,861 

21,698 14,857 

Behavioral Health Data Dissemination.............................................. 381 357 357 ---

PHS Evaluation (non add)............................................................ 381 357 357 ---

Support .............................................................................................. 3,998 2,996 4,202 1,206 

PHS Evaluation (non add)............................................................ 3,998 2,996 4,202 1,206 

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) 

FY 2020 Final 

FY 2021 

Enacted 

FY 2022 

President’s 

Budget 

FY 2022 

+/- FY 2021 

Total Substance Abuse Block Grant Set Aside 

Total Substance Abuse Treatment PHS Evaluation 

55,596 

55,596 

55,603 

55,603 

105,084 

79,081 

49,481 

23,478 

Health Surveillance and Program Support Appropriation 

Health Surveillance 

Population Data Collection, Analysis, and Dissemination................. 16,320 13,287 6,925 -6,362 

PHS Evaluation (non add)............................................................. 14,595 11,237 6,925 -4,312 

Treatment Services Data Collection, Analysis, and Dissemination.... 13,741 8,313 9,493 1,179 

PHS Evaluation (non add)............................................................. 7,788 8,313 9,493 1,179 

Behavioral Health Data Dissemination.............................................. 1,707 1,332 2,174 843 

PHS Evaluation (non add)............................................................. 1,707 1,332 2,174 843 

Performance Measurement/Systems................................................... 2,458 4,069 2,474 -1,595 

PHS Evaluation (non add)............................................................. 2,159 3,763 2,162 -1,601 

Program Evaluations.......................................................................... 750 --- --- ---

PHS Evaluation (non add)............................................................. 750 --- --- ---

Drug Abuse Warning Network........................................................... 2,545 2,997 --- -2,997 

PHS Evaluation (non add)............................................................. --- 452 --- -452 

Support............................................................................................... 9,737 17,260 26,529 9,269 

PHS Evaluation (non add)............................................................. 3,428 5,331 9,674 4,343 

Total Health Surveillance 47,258 47,258 47,595 337 

Drug Abuse Warning Network 

PHS Evaluation (non add)............................................................. 

10,000 

---

10,000 

---

15,000 

---

5,000 

---

Total Drug Abuse Warning Network 10,000 10,000 15,000 5,000 

Performance and Quality Information Systems 

Performance Measurement/Systems................................................... 6,022 6,898 7,338 439 

Evidence-Based Programs/Practices.................................................. 

Behavioral Health Data Dissemination.............................................. 

1,745 

101 

1,789 

---

2,110 

---

321 

---

DAWN............................................................................................... 1,530 690 --- -690 

Support............................................................................................... 602 623 752 129 

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

Behavioral Health Workforce Data and Development 

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

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

Total Behavioral Health Workforce Data and Development 1,000 1,000 1,000 ---

Total Health Surveillance and Program Support 68,258 68,258 73,795 5,537 

Total Health Surveillance and Program Support PHS Evaluation 31,428 31,428 31,428 ---

Total Center for Behavioral Health Statistics and Quality $123,854 $123,861 $178,879 $55,018 

307 
308 

Program Support

(Dollars in thousands) 

............................................

Program Name

Program Support.....................................................................

FY 2020 

Final

FY 2021 

Enacted

FY 2022 

President's 

Budget

FY 2022

+/- FY 2021

$79,000 $79,000 $83,318 $4,318

Authorizing Legislation Section 501 of the Public Health Service Act

FY 2022 Authorization.............................................................................................. $83,318,000 

Allocation Method .........................................Direct Federal/Intramural, Contracts, Grants, 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 452 Full Time Equivalents (FTEs) in FY 2020. SAMHSA is in the process

of adding additional FTEs in to support staffing for areas such as the Office of the Chief Medical

Officer and Cures implementation. 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 2018 $79,000,000 

FY 2019 $79,000,000 

FY 2020 $79,000,000 

FY 2021 Enacted budget $79,000,000 

FY 2022 Budget Request $83,318,000 
309 

Budget Request 

The FY 2022 budget request is $83.3 million, an increase of $4.3 million with the FY 2021 Enacted

level. This investment in program support will increase available staff to administer and manage

SAMHSA’s diverse array of programs. This increase for personnel costs would be the first

increase in four years. An investment in SAMHSA’s staff will ensure that the agency can

efficiently and effectively respond to the evolving and growing opioid crisis, as well as provide 

the significant resources, technical assistance, and leadership within the mental health and

behavioral health public health sphere. This level of funding will also continue to cover overhead

costs associated with 5600 Fishers Lane, including rent, the Federal Acquisition Service loan

repayment program, and security charges. 
310 

Mechanism Table

Program Support

(Dollars in thousands)

FY 2022 

FY 2020 FY 2021 Budget

Program Activity 

Final Enacted Request

No. Amount No. Amount No. Amount

Program Support 

Grants 

Continuations.................................................................... 10 $2,359 21 $2,787 1 $800 

New/Competing................................................................ 1 800 --- --- 8 1,987 

Subtotal......................................................................... 11 3,159 21 2,787 9 2,787 

Contracts 

Continuations.................................................................... --- 73,677 --- 76,213 --- 80,531 

New/Competing................................................................ --- 2,164 --- --- --- --- 

Subtotal.........................................................................

Total, Program Support

 --- 75,841 --- 76,213 --- 80,531 

11 79,000 21 79,000 9 83,318 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Public Awareness and Support 

(Dollars in thousands) 

Program Name 

FY 2020 

Final 

FY 2021 

Enacted 

FY 2022 

President's 

Budget 

FY 2022 

+/- FY 2021 

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

Authorizing Legislation........ Sections 501, 509, 516, and 520A of the Public Health Service Act 

FY 2022 Authorization...................................................................................................Indefinite 

Allocation Method .........................................................................................................Contracts 

Eligible Entities..................................................................................................... Not Applicable 

Program Description and Accomplishments 

Part of SAMHSA’s mission is to raise the public’s understanding of mental and substance use 

disorders, serve as an expert on mental and substance use disorders, lead public health efforts to 

advance the health of the nation, and inform and equip the healthcare workforce. SAMHSA’s 

Office of Communications (OC) staff ensure that the vital information, publications, and training 

materials produced through SAMHSA’s Centers and Offices are available to the healthcare 

workforce, people in treatment and recovery, people in crisis or in areas affected by disasters, 

SAMHSA grantees, and the public. OC staff communicate information on mental and substance 

use disorders and products through various channels. These channels include print, radio, and 

television media; social media platforms; the SAMHSA.gov website; the SAMHSA Store, the 

subscription-based e-blast system; and the inquiries received through the National Helpline. In 

addition, the OC staff manage SAMHSA events to interact with stakeholders, media organizations, 

and the public and assist in the development and execution of materials, products, and campaigns. 

The OC media team evaluates and acts upon media inquiries; develops and issues press releases, 

news bulletins, and media advisories; and provides in-house media support to the Centers and 

Offices. The team builds relationships with representatives of the media; identifies and seeks 

corrections to inaccuracies about SAMHSA in media products, when necessary; works to add 

SAMHSA’s life-saving resources to journalistic and entertainment products; supports broad HHS 

and administration communications priorities; and collaborates with other departmental OpDivs. 

The media team collaborates with SAMHSA staff when a disaster occurs to quickly disseminate 

press releases and social media featuring SAMHSA’s Disaster Distress Helpline and links to 

relevant SAMHSA resources. 

OC manages SAMHSA’s social media presence on Facebook, Twitter, LinkedIn, Instagram and 

YouTube. In addition to print and traditional media, social media messaging is now incorporated 

in communications plans and is employed daily to communicate messages about mental and 

substance use disorders and resources. OC has staff who specialize in monitoring social media 

conversations, writing social media messages, participating in twitter chats, and writing and 

posting blogs on SAMHSA.gov. 

OC is responsible for managing the SAMHSA.gov website via the Web Management and Support 

contract. The contract provides enterprise-wide content and technical support for SAMHSA.gov 

and other related public-facing websites. Key activities include website operations and 

311 
312 

maintenance updates, development and enhancements, and Section 508 remediation. On a daily

basis OC staff add, update, and manage content for the SAMHSA website, in addition to technical

maintenance and enhancements as needed.

OC also manages the Public Engagement Platform (PEP) contract and the Contact Center contract.

The PEP is a large-scale information dissemination program. PEP provides the public and other

stakeholders with one-stop, quick access to mental and substance use disorder prevention, 

treatment, and recovery information, materials, and services. It operates a customer-oriented order

fulfillment/distribution center, which includes an online store (store.SAMHSA.gov) and

warehouse, the SAMHSA listserv and subscriber database system, and mobile applications. 

The Contact Center contract supports the National Helpline (1-800-662-HELP) and the 1-877-

SAMHSA-7 line. The National Helpline provides free, confidential treatment referral and

information services in English and Spanish for individuals and families facing mental illness

and/or substance use disorders. It is operational 365 days-a-year, 24/7. The 1-877-SAMHSA-7 

line is the single point of entry for SAMHSA’s information services and is operated Monday 

through Friday, 8:00 am to 8:00 pm (except for federal holidays). 

OC manages the SAMHSA Public Awareness and Support Activities contract that enables the 

agency to develop and disseminate public service announcements (PSAs) for television and radio. 

Topics, audiences, and formats range but all phases from creative concepts to storyboards as well

as focus group testing are included. As an example, in the past there have been PSAs targeted to

providers on the use of naltrexone for opioid use disorder, PSAs targeted to the public on the 

danger of methamphetamine, and PSAs targeted to pregnant women on the dangers of substance 

use. This contract also enables SAMHSA to conduct national campaigns. 

Funding History

Fiscal Year Amount

FY 2018 $10,000,000 

FY 2019 $10,000,000 

FY 2020 $13,000,000 

FY 2021 Enacted budget $13,000,000 

FY 2022 Budget Request $13,260,000 

Budget Request

The FY 2022 budget request is $13.3 million, an increase of $260,000 from the FY 2021 Enacted

level. SAMHSA intends to fund 6 contracts that will allow SAMHSA to manage media

relationships, maintain its web and social media presence, manage critical helplines, deliver

publications and resources, produce and deliver PSAs, and conduct national campaigns
313 

Mechanism Table

Public Awareness and Support

(Dollars in thousands) 

FY 2022 

FY 2020 FY 2021 Budget

Program Activity 

Final Enacted Request

No. Amount No. Amount No. Amount

Public Awareness and Support 

Contracts 

Continuations.................................................................... 6 $13,000 3 $6,729 5 $9,804 

New/Competing................................................................ --- --- 3 6,271 1 3,456 

Subtotal.........................................................................

Total, Public Awareness and Support

6 13,000 6 13,000 6 13,260 

6 13,000 6 13,000 6 13,260 
314 

Outputs and Outcomes Table

Program: Public Awareness and Support

Measure Year and Most

Recent Result / 

Target for Recent

Result / 

(Summary of Result)

FY 2021 

Target 

FY 2022 

Target 

FY 2022 

Target 

+/-FY 2021 

Target 

4.4.12 The number of individuals referred for

behavioral health treatment resources. (Output) 

FY 2020: 784,638 

Target:

667,783 

(Target Exceeded)

784,638 784,638 Maintain

4.4.13 The total number of interactions through phone 

inquiries, e-blasts, dissemination of SAMHSA

publications, and total website hits (Output)

FY 2020: 55,238,274 

Target:

45,000,000 

(Target Exceeded)

55,238,274 55,238,274 Maintain
315 

Drug Control Program 

Substance Abuse and Mental Health Services Administration

(Dollars in millions)

Resource Summary 

1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the Treatment function.

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and Substance Abuse as follows:

The Drug Abuse Warning Network is allocated fully to substance abuse. Program Support, Health Surveillance and PQIS are split the same

proportion as drug control to the overall SAMHSA budget as defined by the substance abuse portions divided by the mental health and substance

abuse portions combined. Public Awareness and Support, Behavioral Health Workforce Data and Development and Data Request, and Publication

User Fees are allocated 50% to drug control activities. The drug control total for HSPS after these calculations is allocated between Prevention

(20%) and Treatment (80%). 

Budget Authority (in millions)

FY 2020 FY 2021 FY 2022

Supplemental Supplemental Budget 

Final Funding Enacted Funding Request

Drug Resources by Decision Unit and Function

Programs of Regional and National Significance

Substance Abuse Prevention $206.47 - $208.22 - $216.67

Substance Abuse Treatment $479.68 - $496.68 $30.00 $650.86

Total Programs of Regional and National Significance $686.15 - $704.90 $30.00 $867.53

State Opioid Response Grants $1,500.00 - $1,500.00 - $2,250.00

Substance Abuse Prevention and Treatment Block Grant

Prevention $371.62 - $371.62 $630.00 $701.62

Treatment $1,486.46 - $1,486.46 $2,520.00 $2,806.46

Total, Substance Abuse Prevention and Treatment Block Grant $1,858.08 - $1,858.08 $3,150.00 $3,508.08

Health Surveillance and Program Support

Prevention $22.81 - $22.46 - $24.13

Treatment $91.24 - $89.84 - $96.53

Total, Health Surveillance and Program Support $114.05 - $112.30 - $120.66

Total Drug Resources by Unit and Function $4,158.27 - $4,175.27 $3,180.00 $6,746.27

Drug Resources Personnel Summary

Total FTEs 428 - 336 - 426

Drug Resources as a Percent of Budget

Total Agency Budget $5,884.00 $6,017.01 $3,180.00 $9,734.01

Drug Resources Percentage 70.7% 69.4% 100.0% 69.3%
316 

Drug Budget Split between Prevention and Treatment

(Dollars in millions)

Substance Abuse Prevention

 FY 2020

Final 

 FY 2021

Enacted 

 FY 2022 

President's 

Budget 

 Programs of Regional and National Significance (PRNS) 

Strategic Prevention Framework....................................................... $119.48 $119.48 $126.67

Strategic Prevention Framework Rx (non-add).............................. 10.00 10.00 15.00

Budget Authority (non-add)....................................................... 10.00 10.00 15.00

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

Federal Drug-Free Workplace.......................................................... 4.89 4.89 4.89

Minority AIDS................................................................................ 41.21 41.21 42.03

Sober Truth on Preventing Underage Drinking ................................. 9.00 10.00 10.00

Center for the Application of Prevention Technologies....................... 7.49 7.49 7.49

Science and Service Program Coordination........................................ 4.07 4.07 4.07

Tribal Behavioral Health Grants....................................................... 20.00 20.75 21.17

SAP Minority Fellowship Program.................................................... 0.32 0.32 0.34

Total, Substance Abuse Prevention PRNS 206.47 208.22 216.67

Substance Abuse Prevention and Treatment Block Grant1 371.62 371.62 701.62

 PHS Evaluation Funds (non-add) 15.84 15.84 15.84

Total, Substance Abuse Prevention and Treatment Block Grant 371.62 371.62 701.62

Health Surveillance and Program Support 2

Health Surveillance and Program Support 17.85 17.52 18.14

Health Surveillance....................................................................... 6.68 6.56 6.60

Budget Authority (non-add)....................................................... 2.38 2.34 2.38

PHS Evaluation Funds (non-add).............................................. 4.30 4.22 4.22

Program Support........................................................................... 11.17 10.96 11.55

Public Awareness and Support......................................................... 1.30 1.30 1.33

Performance and Quality Information Systems................................... 1.41 1.39 1.41

Behavioral Health Workforce Data and Development......................... 0.10 0.10 0.10

PHS Evaluation Funds (non-add)................................................. 0.10 0.10 0.10

Drug Abuse Warning Network.......................................................... 2.00 2.00 3.00

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

Data Request/Publication User Fees................................................. 0.15 0.15 0.15

Total, Health Surveillance and Program Support 22.81 22.46 24.13

Total, Substance Abuse Prevention 600.90 602.29 942.41

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and 

Substance Abuse as follows: The Drug Abuse Warning Network is allocated fully to substance abuse. Program 

Support, Health Surveillance and PQIS are split the same proportion as drug control to the overall SAMHSA budget 

as defined by the substance abuse portions divided by the mental health and substance abuse portions combined. 

Public Awareness and Support, Behavioral Health Workforce Data and Development, and Publication User Fees are 

allocated 50% to drug control activities. The drug control total for HSPS after these calculations is allocated 

between Prevention (20%) and Treatment (80%).

1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the 

Treatment function.
 

 

 Programs of Regional and National Significance (PRNS) 

Opioid Treatment Programs/Regulatory Activities............................. $8.72 $8.72 $13.09 

Screening, Brief Intervention and Referral to Treatment ..................... 30.00 30.00 30.56 

Targeted Capacity Expansion........................................................... 100.19 102.19 147.92 

Pregnant and Postpartum Women...................................................... 31.93 32.93 49.40 

Improving Access to Overdose Treatment......................................... 1.00 1.00 1.50 

Recovery Community Services Program............................................ 2.43 2.43 5.15 

Children and Family Programs.......................................................... 29.61 29.61 30.20 

Treatment Systems for Homeless ..................................................... 36.39 36.39 37.11 

Minority AIDS ............................................................................... 65.57 65.57 66.88 

SAT Minority Fellowship Program................................................... 4.79 5.79 6.14 

Criminal Justice Activities............................................................... 89.00 89.00 124.38 

Addiction Technology Transfer Centers............................................ 9.05 9.05 9.05 

Building Communities of Recovery................................................... 8.00 10.00 20.00 

Peer Support TA Center................................................................... 1.00 1.00 1.50 

Treatment, Recovery, and Workforce Support................................... 4.00 6.00 9.00 

Emergency Department Alternatives to Opioids................................. 5.00 6.00 9.00 

Opioid Response Grants................................................................................... 0.00 3.00 3.00 

Comprehensive Opioid Recovery Centers........................................................ 0.00 4.00 6.00 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths 12.00 12.00 18.00 

First Responder Training.................................................................. 41.00 42.00 63.00 

Total, Substance Abuse Treatment PRNS 479.68 496.68 650.86 

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

Substance Abuse Prevention and Treatment Block Grant1 

1,500.00 1,500.00 2,250.00 

1,486.46 1,486.46 2,806.46 

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

Total, Substance Abuse Prevention and Treatment Block Grant 

63.36 63.36 63.36 

1,486.46 1,486.46 2,806.46 

Health Surveillance and Program Support2 

Health Surveillance and Program Support 71.39 70.09 72.57 

Health Surveillance....................................................................... 26.72 26.23 26.38 

Budget Authority (non-add)....................................................... 9.52 9.34 9.52 

PHS Evaluation Funds (non-add).............................................. 17.20 16.89 16.87 

Program Support........................................................................... 44.67 43.85 46.18 

Public Awareness and Support......................................................... 5.20 5.20 5.30 

Performance and Quality Information Systems................................... 5.65 5.55 5.65 

Behavioral Health Workforce Data and Development......................... 0.40 0.40 0.40 

PHS Evaluation Funds (non-add)................................................. 0.40 0.40 0.40 

Drug Abuse Warning Network.......................................................... 8.00 8.00 12.00 

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

Data Request/Publication User Fees................................................. 0.60 0.60 0.60 

Drug Budget Split between Prevention and Treatment (continued) 

(Dollars in millions) 

Substance Abuse Treatment

 FY 2020 

Final 

 FY 2021 

Enacted 

 FY 2022 

President's 

Budget

Total, Health Surveillance and Program Support 91.24 89.84 96.53 

Total, Substance Abuse Treatment 3,557.38 3,572.98 5,803.85 

1 The Substance Abuse Prevention and Treatment Block Grant is split 20% to the Prevention function and 80% to the 

Treatment function. 

2 The Health Surveillance and Program Support Appropriation funded activities are split between Mental Health and 

Substance Abuse as follows: The Drug Abuse Warning Network is allocated fully to substance abuse. Program 

Support, Health Surveillance and PQIS are split the same proportion as drug control to the overall SAMHSA budget 

as defined by the substance abuse portions divided by the mental health and substance abuse portions combined. 

Public Awareness and Support, Behavioral Health Workforce Data and Development, and Publication User Fees are 

allocated 50% to drug control activities. The drug control total for HSPS after these calculations is allocated 

between Prevention (20%) and Treatment (80%). 

317 
318 

The FY 2022 Budget Request is $6.7 billion, an increase of $2.7 billion from FY 2021 Enacted

level.

The budget directs resources to activities that have demonstrated improved health outcomes and

that increase service capacity. SAMHSA has three major drug-related portfolios, and attendant

decision units: Substance Abuse Prevention, Substance Abuse Treatment, and Health Surveillance

and Program Support. 

Each decision unit is discussed below: 

Substance Abuse Prevention

Programs of Regional and National Significance

Strategic Prevention Framework

FY 2022 Budget Request: $126.7 million, an increase of $7.2 million from the FY 2021 

Enacted Level

SAMHSA’s Strategic Prevention Framework (SPF) grant programs support activities to help

grantees build a solid foundation for delivering and sustaining effective substance 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. 

Strategic Prevention Framework for Prescription Drugs

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 

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 data into needs assessments and strategic plans as

indicators of program success. 
319 

Federal Drug-Free Workplace 

FY 2022 Budget Request: $4.9 million, the same with the FY 2021 Enacted level

SAMHSA’s activities related to the Federal Drug-Free Workplace support two principal activities

mandated by Executive Order (E.O.) 12564 and Public Law (P.L.) 100-71. This includes: 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 HHSCertified Laboratories. 

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 designated 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. 

Sober Truth on Preventing Underage Drinking

FY 2022 Budget Request: $10.0 million, the same with the FY 2021 Enacted level

The Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006 (Public Law 109 - 

422) was the nation’s first comprehensive legislation on underage drinking. One of the primary

components of the STOP Act is the community-based coalition enhancement grant program, which

provides up to $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.

Centers for the Application of Prevention Technologies 

FY 2022 Budget Request: $7.5 million, the same with the FY 2021 Enacted level

In 2019, Center for the Application of Prevention Technologies (CAPT) changed how it delivered

services and began providing science-based training and technical assistance through Prevention 

Technology Transfer Centers (PTTC) cooperative agreements. SAMHSA leadership established

the PTTC the previous year to expand and improve implementation and delivery of effective

substance abuse prevention interventions and provide training and technical assistance

services to the substance abuse prevention field. The PTTC does this by developing and

disseminating tools and strategies needed to improve the quality of substance abuse

prevention efforts; providing intensive technical assistance and learning resources to

prevention professionals in order to improve their understanding of prevention science,

epidemiological data, and implementation of evidence-based and promising practices; and,

developing tools and resources to engage the next generation of prevention professionals. 
320 

Science and Service Program Coordination 

FY 2022 Budget Request: $4.1 million, the same with the FY 2021 Enacted level

The Science and Service Program Coordination program funds the provision of technical

assistance and training to states, tribes, communities, and grantees around substance abuse 

prevention. Specifically, the program supports the Tribal Training and Technical Assistance

Center and the Underage Drinking Prevention Education Initiatives (UADPEI). 

This funding 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

FY 2022 Budget Request: $21.2 million, an increase of $0.4 million from the FY 2021 

Enacted level

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. 

This request, along with $21.2 million in the Center of Mental Health Services will continue to

support grants that promote mental health and prevent substance use activities for high-risk AI/AN

youth and their families.

Performance
321 

Substance Abuse Treatment

Substance Abuse Prevention and Treatment Block Grant FY 2022 Budget Request: $3.5

billion, an increase of $1.65 billion from the FY 2021 Enacted level.

SABG serves 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 non-clinical activities and services that address the critical

needs of state substance abuse prevention and treatment service systems. 

Funding will aid in having a positive effect on the health and lives of individuals with substance 

use disorders as evidenced by demonstrated positive client outcomes in all six treatment domains; 

greater provide as a major impetus for improving state prevention and treatment systems’

infrastructure and capacity thereby increasing availability of services, development and

implementation of evidence-based practices, development and collection of specific outcome 

measures, and development and maintenance of state data management systems; strengthen the 

requirements, resources, and federal guidance that can be leveraged to sustain and improve state

Prevention: Selected Measures of Performance

Program 

SPF: Partnerships for Success FY 2020 

Target

FY 2020 

Achieved

» Increase the number of sub-recipient communities that

 improved one or more targeted NOMs indicators 

» Increase the number of EBPs implemented by sub-recipient

communities

315 

1,414

234 

1,421

SPF: Rx FY 2020 

Target

FY 2020 

Achieved

» Increase the percent of funded states reporting reductions in

opioid overdoses 

62% 56% 

STOP Act FY 2020 

Target

FY 2020 

Achieved

» Increase the percent of coalitionsthat report at least a 5 percent

improvement in the past 30-day use of alcohol in at least 2 

grades

58% 62% 

» Increase the percent of coalitions that report improvement in

youth perception of risk from alcohol in at least two grades

75% 46% 

Tribal Behavioral Health Grants FY 2020 

Target

FY 2020 

Achieved

» Increase the number of programs/organizations that

implemented specific mental health-related

practices/activities as a result of the grant

6,880 3,076 
322 

systems and emphasize the importance of the SABG in the development of the same; and further 

contribute to the development and maintenance of successful state collaborations with other 

agencies and stakeholders concerned with preventing and treating substance use disorders. 

Performance

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

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 leveraged the statutory

requirements 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.115 SAMHSA data

show that on average, the SABG has been successful in expanding treatment capacity by annually 

supporting approximately two million116 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 2019, at discharge,

clients demonstrated above average abstinence rates from both illegal drug (56 percent) and

alcohol (77 percent) use. State substance abuse authorities reported in the FY 2020 SABG Annual 

Report the following outcomes for services117 provided during FY 2019, the most recent year for 

which data is available: 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands that

reported data concerning abstinence from alcohol use, 50 of the 60 identified improvements

in client abstinence;

• Similarly, for the 50 states, American Samoa, the District of Columbia, Guam, Marshall

Islands, Micronesia, Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands 

that reported data concerning the abstinence from drug use, 42 of 60 identified

improvements in client abstinence;

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands that

reported employments data, 53 of 60 identified improvements in client employment;

115 Substance Abuse and Mental health Administration. Retrieved from 

https://www.samhsa.gov/sites/default/files/grants/sapt-bg-evaluation-final-report.pdf. 116 Source: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services 

Administration, Treatment Episode Data Set (TEDS). Data received through 01 May 2018. 117 Services include services from Short-term residential, Long-term residential, Outpatient, and Intensive outpatient 

only. 
323 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Palau, and Puerto Rico that reported criminal justice data,

50 of 58 reported an increase in clients with no arrests based on data reported to TEDS; 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia Northern Marianas, Palau, Puerto Rico, Red Lake, and Virgin Islands that

reported housing data, 53 of 60 identified improvements in stable housing for clients based

on data reported to TEDS; and 

• For the 50 states, American Samoa, the District of Columbia, Guam, Marshall Islands,

Micronesia, Northern Marianas, Puerto Rico, and Red Lake that reported recovery support 

data, 58 states out of 60 identified improvements in client engagement in recovery support 

programs. 

Substance Abuse Prevention and Treatment Block Grant:

Selected Measures of Performance

Prevention Set-Aside

FY 2020

Target

FY 2020

Achieved

» Increase the percent of states showing a decrease in state

level estimates of percent of survey respondents to report

30 day use of other illicit drugs (age 12 – 17)

43% 50%

» 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+)

25% 20%

Treatment Activities

FY 2020

Target

FY 2020

Achieved

» Percentage of clients reporting no drug use in the past

month at discharge.

74% 54%

» Increase the percentage of clients reporting being

employed/in school at discharge.

40% 35%

» Increase the percentage of clients reporting no

involvement with the criminal justice system.

92% 93%

» Increase the percentage of clients receiving services who

had a permanent place to live in the community.

92% 88%
324 

State Opioid Response

FY 2022 Budget Request: $2.25 billion, an increase of $750 million from FY 2021 Enacted

level

Substance Abuse and Mental Health Services Administration established the State Opioid 

Response Grants (SOR) program in FY 2018. This program aims to address the opioid crisis by 

increasing access to medication-assisted treatment using the three FDA-approved medications for

the treatment of opioid use disorder, reducing unmet treatment needs, and reducing opioid 

overdose related deaths through the provision of prevention, treatment and recovery activities for 

opioid use disorder (OUD) (including prescription opioids, heroin and illicit fentanyl and fentanyl 

analogs). Funding is awarded grants to states and territories via formula. The program also includes 

a 15 percent set-aside for the 10 states with the highest mortality rates related to drug overdose 

deaths. The program also includes a $75 million set-aside for tribes. Given the varying nature of 

substance misuse across the United States, the budget continues to allow the use of State Opioid 

Response grants to include methamphetamine and other stimulants, giving states and tribes

flexibility to address their unique community needs. States and communities across the country 

are dealing with rising rates of stimulant use and its negative health, social, and economic 

consequences. 

Programs of Regional and National Significance

Targeted Capacity Expansion 

The FY 2022 Budget Request: $148 million, an increase of $45.7 million from the FY 2021 

Enacted level

The Targeted Capacity Expansion (TCE) program provides rapid, strategic, comprehensive, and

integrated community-based responses to gaps in and capacity for SUD treatment and recovery

support services. Examples of such needs include limited or no access to 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. This will continue 

support for TCE-PTP and TCE-Special Projects

Opioid Treatment Programs/Regulatory Activities

FY 2022 Budget Request: $13.1 million, an increase of $4.4 million from the FY 2021 

Enacted level

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. 
325 

This request supports the Secretary’s five-prong strategy to address the opioid crisis priorities. In

this program, this is through regulatory activities, ongoing training, certification, and technical

assistance to provider groups and communities impacted by the opioid crisis.

Treatment Systems for Homeless

FY 2022 Budget Request: $37.1 million, an increase of $0.73 million from the FY 2021 

Enacted level

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. This funding is to support grants to reduce homelessness for nearly 4,000 

people. 

Pregnant and Postpartum Women

FY 2022 Budget Request: $49.4 million, an increase of $16.5 million from the FY 2021 

Enacted level

The Pregnant and Postpartum Women supports grants for residential treatment and the Pregnant 

and Postpartum Women Pilot, authorized in the Comprehensive Addiction and Recovery Act

(CARA), helps state substance abuse agencies address the continuum of care, including services

provided to women in nonresidential-based settings and 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. In FY 2018, SAMHSA funded new state PPW pilot grants and

continuation state PPW pilot grants for program implementation, supplement for direct technical

assistance, and continuation evaluation contract to provide an array of services and supports to

pregnant women and their children. 

Building Communities of Recovery

FY 2022 Budget Request: $20.0 million, an increase of $10.0 million from FY 2021 Enacted

level

The Building Communities of Recovery program mobilizes 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. These funds will support continuation grants for the Building 

Communities of Recovery program to develop, expand, and enhance recovery support services. 
326 

Criminal Justice Activities

FY 2022 Budget Request: $124.4 million, an increase of $35.4 million from the FY 2021 

Enacted level

SAMHSA’s Criminal Justice portfolio includes several grant programs that focus on diversion, 

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

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

includes Treatment Drug Courts and the Offender Re-Entry Programs. 

Drug Court Activities

SAMHSA’s Adult Drug Court programs support a variety of services including direct treatment

services for diverse populations, wraparound/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. 

Ex-Offender Re-Entry Program 

In addition to the drug court portfolio, SAMHSA supports Offender Reentry Program (ORP)

grants, as well as other criminal justice activities, such as evaluation and behavioral health

contracts. These grants will provide screening, assessment, comprehensive treatment, and recovery

support services for diverse populations reentering the community from incarceration. Other

supported services include wraparound and recovery support services such as recovery housing 

and peer recovery support designed to improve access and retention, drug testing for illicit

substances, educational support, relapse prevention and long-term management, and HIV and viral

hepatitis B and C testing conducted in accordance with state and local requirements. 

SAMHSA budget request continues to support grants and contracts of the program.

First Responder Training 

FY 2022 Budget Request: $63.0 million, an increase of $21.0 million from the FY 2021 

Enacted level

First Responder Training supports efforts to help first responders and members of other key

community sectors to administer a drug or device approved or cleared under the Federal Food, 

Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose. Grantees

train and provide resources to first responders and members of other key community sectors at the 

state, tribal, and local governmental levels on carrying and administering a drug or device approved 

or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or

suspected opioid overdose. Grantees also establish processes, protocols, and mechanisms for

referral to appropriate treatment and recovery communities. Training, technical assistance, and

evaluation activities are also being supported to assist grantees, determine best practices, and

assess program outcomes. 
327 

Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths

FY 2022 Budget Request: $18.0 million, an increase of $6.0 million from the FY 2021 

Enacted level

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 materialsto assemble and disseminate overdose kits. 

This funding will provide grants to 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. 

Other PRNS Treatment Programs 

FY 2022 Budget Request: $45.9 million, an increase of $3.8 million from the FY 2021 

Enacted level

The budget request includes resources for several Treatment Capacity programs including: 

Recovery Community Services Program; Children and Families; Improving Access to Overdose 

Treatment; and Addiction Technology Transfer Centers. The 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 recoveryoriented treatment; or for outpatient providers who are able to successfully retain greater

proportions of patients in active treatment participation for longer periods. 

Peer Support Technical Assistance Center

FY 2022 Budget Request: $1.5 million, an increase of $0.5 million from the FY 2021 Enacted

level

The program is authorized by section 7152 of the SUPPORT for Patients and Communities Act

(P.L. 115-271), is to provide funding for the creation of a National Peer-Run Training and

Technical Assistance Center for Addiction Recovery Support, or the Center. The Center provides 

technical assistance and support to recovery community organizations and peer support networks. 

The technical assistance is related to training, translation and interpretation services, data

collection, capacity building, and evaluation and improvement of the effectiveness of such services

provided by recovery community organizations. 
328 

Treatment, Recovery, and Workforce Support

FY 2022 Budget Request: $9.0 million, an increase of $3.0 million from the FY 2021 Enacted

level

The program is authorized by section 7081 of the SUPPORT for Patients and Communities Act,

is to support the implementation of voluntary programs for care and treatment of individuals after

a drug overdose, as appropriate, which may include utilizing recovery coaches, establishing

policies and procedures that address the provision overdose reversal medication and FDAapproved medications to treat substance use disorders, and establishing integrated models of care

for individuals who have experienced a non-fatal drug overdose. SAMHSA is directed, in

consultation with the Secretary of Labor, to award competitive grants to entities to carry out 

evidence- based programs to support individuals in substance use disorder treatment and recovery

to live independently and participate in the workforce.

Emergency Department Alternatives to Opioids

FY 2022 Budget Request: $9.0 million, an increase of $3.0 million from the FY 2021 Enacted

level

The program is authorized by section 7091 of the SUPPORT for Patients and Communities Act

(P.L. 115-271) is to provide funding to hospitals and emergency departments, including 

freestanding emergency departments, to develop, implement, enhance, or study alternative pain

management protocols and treatments that limit the use and prescribing of opioids in emergency

departments. In addition, these funds will be used to target common painful conditions, train

providers and other hospital personnel, and provide alternatives to opioids for patients with painful 

conditions. 

Performance

Treatment: Selected Measures of Performance

Criminal Justice

FY 2020 

Target

FY 2020 

Achieved

» Drug Courts: Increase the percentage of adult clients

receiving services who had no past month substance use

87% 84% 

» Offender Reentry: Increase the percentage of adult clients

receiving services who had no past month substance use

70% 76% 

Health Surveillance and Program Support Appropriation 

The FY 2022 Budget Request is $120.7 million, an increase of $8.4 million from the FY 2021 

Enacted level. The budget request 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. 
329 

Health Surveillance and Program Support 

FY 2022 Budget Request: $90.7 million, an increase of $3.1 million from the FY 2021 

Enacted level

Health Surveillance and Program Support (HSPS) provides funding for personnel costs, building 

and facilities, equipment, supplies, administrative costs, and associated overhead to support 

SAMHSA programmatic activities, as well as provide funding for SAMHSA national data

collection and survey systems, funding to support the Center for Disease Control and Prevention’s 

National Health Information Survey, and the data archive. 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 Drug Control portion is then split 20 percent/80

percent into the two functions, prevention and treatment, respectively. 

SAMHSA intends to continue funding the continuation of the NSDUH, BHSIS, SAMHDA, and

EBPRC contracts 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 2022 Budget Request: $6.6 million, an increase of $0.1 million from FY 2021 Enacted

level

Public Awareness and Support provides funding to support the unified communications approach

to increase awareness of behavioral health, mental disorders and substance abuse issues. This 

represents the total funding available for these activities first divided evenly between Mental

Health and Substance Abuse. The Drug Control portion is then split 20 percent/80 percent into

the two functions, prevention and treatment, respectively. The funding for Public Awareness and

Support will support contracts that will allow SAMHSA to manage media relationships, maintain

its web and social media presence, manage critical helplines, and deliver publications and

resources. 

Performance and Quality Information Systems

FY 2022 Budget Request: $7.1 million, an increase of $0.1 million from the FY 2021 Enacted

level

Performance and Quality Information Systems provides funding to support SAMHSA’s

Performance Accountability and Reporting System (SPARs) related activities, as well as provide 

support for the National Registry of Evidence-based Programs and Practices 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)
330 

appropriation amounts. The Drug Control portion is then split 20 percent/80 percent into the two

functions, prevention and treatment, respectively.

SAMHSA will use these funds to continue its performance management, quality improvement,

and 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. 

Drug Abuse Warning Network

FY 2022 Budget Request: $15.0 million, an increase of $5.0 million from the FY 2021 Enacted

level

DAWN is a nationwide public health surveillance system that will improve emergency department

monitoring of substance use crises, including those related to opioids. Authorized by the 21st 

Century Cures Act, this program is necessary to respond effectively to the opioid and addiction 

crisis in the United States and to better inform public health, clinicians, policymakers, and other 

stakeholders to respond to emerging substance use trends. This request represents the total funding 

available for these activities. The Drug Abuse Warning Network is allocated fully to substance 

abuse. This funding will continue to support contract to fund the expansion of additional hospitals 

for FY 2021 to inform stimulant abuse prevention and response strategies. DAWN’s expansion to

additional hospitals will allow for SAMHSA DAWN data-based estimates to be more 

generalizable and more representative across the country and will also allow SAMHSA to produce 

more accurate and complete assessment of geographic patterns (e.g. substance use disparities in

urban, suburban and rural areas) and temporal trends (e.g. emerging or new substance misuse or 

abuse) in substance use related ED visits in the United States. 

Behavioral Health Workforce Data and Development

FY 2022 Budget Request: $0.5 million, the same as of the FY 2021 Enacted level

The purpose of this program is to provide comprehensive data and analysis on individuals who

comprise the prevention and treatment fields to address mental and substance use disorders. The 

goal of the program is to provide valid data on the existing practitioners and usable information to

SAMHSA on which to make policy and planning decisions. 

Data Request and Publication User Fees

FY 2022 Budget Request: $0.75 million, the same from the FY 2021 Enacted level

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 Drug Control portion is then split 20 percent/80 percent into

the two functions, prevention and treatment, respectively.
331 

Performance

Health Surveillance and Program Support: Selected Measures of Performance

Public Awareness and Support

FY 2020

Target

FY 2020

Achieved

» Increase the number of individuals referred for behavioral

health treatment resources.

667,783 784,638

» Increase the total number of interactions through phone

inquiries, e-blasts, dissemination of SAMHSA

publications, and total website hits.

45,000,000 55,238,274
332 

Supplementary Tables

Table of Contents

1. Budget Authority by Object Class ............................................................................. 333 

2. Salaries and Expenses.................................................................................................. 343 

3. Detail of Full-Time Equivalent Employment (FTE)....................................................... 345 

4. Detail of Positions....................................................................................................... 346 

5. Physicians’ Comparability Allowance Worksheet ......................................................... 347 
333 

Object Class - Direct Budget Authority1,2

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1).................................................. $48,082 $48,563 $49,048 

Other than full-time permanent (11.3).................................. 2,061 2,081 2,102 

Other personnel compensation (11.5).................................. 1,260 1,273 1,286 

Military personnel (11.7).................................................... 3,401 3,503 3,609 

Special personnel services payments (11.8) ....................... 18 19 19 

Subtotal personnel compensation: 54,823 55,439 56,063 

Civilian benefits (12.1)....................................................... 15,961 16,137 16,478 

Military benefits (12.2)....................................................... 1,792 1,846 1,901 

Subtotal Pay Costs: 72,575 73,422 74,442 

Travel and transportation of persons (21.0)........................ 222 225 229 

Transportation of things (22.0)............................................ 8 8 8 

Rental payments to GSA (23.1)........................................... 5,653 5,744 5,853 

Rental payments to Others (23.2)......................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)............. 312 317 323 

Printing and reproduction (24.0).......................................... 488 496 506 

Other Contractual Services:

Advisory and assistance services (25.1).......................... 35,557 35,821 36,502 

Other services (25.2)....................................................... 94,712 94,459 92,336 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 33,156 33,391 34,025 

Operation and maintenance of facilities (25.4)................ 58 59 60 

Research and Development Contracts (25.5)................... --- --- --- 

Operation and maintenance of equipment (25.7).............. 924 939 957 

Subtotal Other Contractual Services: 164,407 164,669 163,880 

Supplies and materials (26.0).............................................. 147 150 153 

Equipment (31.0)................................................................. 118 109 111 

Grants, subsidies, and contributions (41.0)......................... 5,504,898 5,624,702 9,341,339 

Interest and dividends (43.0)............................................... --- --- --- 

Subtotal Non-Pay Costs 5,676,254 5,796,420 9,512,402 

Total Direct Obligations $5,748,829 $5,869,841 $9,586,844 1

 Does not include PHS Evaluation Funds.

2

 Does not include Prevention and Public Health Funds.

Substance Abuse and Mental Health Services Administration

Summary Direct Budget Authority

(Dollars in Thousands)

Budget Authority by Object Class
334 

Object Class - Direct Budget Authority1,2

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1).............................................. $1,396 $1,410 $1,424 

Other than full-time permanent (11.3)............................. 27 27 27 

Other personnel compensation (11.5).............................. 18 18 18 

Military personnel (11.7)................................................ --- --- --- 

Special personnel services payments (11.8) .................. --- --- --- 

Subtotal personnel compensation: 1,441 1,455 1,470 

Civilian benefits (12.1)................................................... 456 460 470 

Military benefits (12.2)................................................... --- --- --- 

Subtotal Pay Costs: 1,896 1,915 1,940 

Travel and transportation of persons (21.0).................... 66 67 69 

Transportation of things (22.0)........................................

Rental payments to GSA (23.1)....................................... 150 152 155 

Rental payments to Others (23.2).................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)......... 265 269 274 

Printing and reproduction (24.0)..................................... 248 252 257 

Other Contractual Services: $--- $--- 

Advisory and assistance services (25.1)......................... 17,157 17,432 17,763 

Other services (25.2)...................................................... 24,754 25,150 25,628 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 13,982 14,206 14,476 

Operation and maintenance of facilities (25.4)............... 40 41 41 

Research and Development Contracts (25.5).................. --- --- --- 

Operation and maintenance of equipment (25.7)............. 72 73 75 

Subtotal Other Contractual Services: 56,006 56,902 57,983 

Supplies and materials (26.0)......................................... 33 34 34 

Equipment (31.0)............................................................. 84 85 87 

Grants, subsidies, and contributions (41.0)..................... 1,586,226 1,699,558 2,842,690 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 1,643,078 1,757,320 2,901,549 

Total Direct Obligations $1,644,974 $1,759,236 $2,903,489 1

 Does not include PHS Evaluation Funds.

2

 Does not include ACA or PPHF

Budget Authority by Object Class

Substance Abuse and Mental Health Services Administration

Mental Health 

(Dollars in Thousands)
335 

Object Class - Direct Budget Authority1

FY 2020

 Final

FY 2021

Enacted

FY 2022

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)........................................ --- --- --- 

Rental payments to GSA (23.1)....................................... --- --- --- 

Rental payments to Others (23.2)..................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)......... --- --- --- 

Printing and reproduction (24.0)...................................... 156 159 162 

Other Contractual Services:

Advisory and assistance services (25.1)......................... 5,162 5,244 5,344 

Other services (25.2)....................................................... 14,474 14,705 14,985 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 4,501 4,573 4,660 

Operation and maintenance of facilities (25.4)................ --- --- --- 

Research and Development Contracts (25.5)................... --- --- --- 

Operation and maintenance of equipment (25.7).............. --- --- --- 

Subtotal Other Contractual Services: 24,136 24,522 24,988 

Supplies and materials (26.0).......................................... 2 2 2 

Equipment (31.0)............................................................. --- --- --- 

Grants, subsidies, and contributions (41.0)..................... 182,174 183,536 191,515 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 206,469 208,219 216,667 

Total Direct Obligations $206,469 $208,219 $216,667 1

 Does not include PHS Evaluation Funds.

Budget Authority by Object Class

Substance Abuse and Mental Health Services Administration

 Substance Abuse Prevention

(Dollars in Thousands)
336 

Object Class - Direct Budget Authority1

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1).............................................. $3,182 $3,214 $3,246 

Other than full-time permanent (11.3).............................. 85 86 87 

Other personnel compensation (11.5).............................. 55 55 56 

Military personnel (11.7)................................................ --- --- --- 

Special personnel services payments (11.8) ................... --- --- --- 

Subtotal personnel compensation: 3,323 3,356 3,389 

Civilian benefits (12.1)................................................... 1,037 1,064 1,086 

Military benefits (12.2)................................................... --- --- --- 

Subtotal Pay Costs: 4,359 4,419 4,475 

Travel and transportation of persons (21.0).................... 5 5 6 

Transportation of things (22.0)........................................ --- --- --- 

Rental payments to GSA (23.1)....................................... 138 140 143 

Rental payments to Others (23.2)..................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)......... 2 2 2 

Printing and reproduction (24.0)...................................... 83 85 86 

Other Contractual Services:

Advisory and assistance services (25.1)......................... 11,692 11,879 12,105 

Other services (25.2)....................................................... 13,455 13,670 13,930 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 10,957 11,133 11,344 

Operation and maintenance of facilities (25.4)................ 18 19 19 

Research and Development Contracts (25.5)................... --- --- --- 

Operation and maintenance of equipment (25.7).............. 251 255 259 

Subtotal Other Contractual Services: 36,373 36,955 37,658 

Supplies and materials (26.0).......................................... - - - 

Equipment (31.0)............................................................. --- --- --- 

Grants, subsidies, and contributions (41.0)..................... 3,715,595 3,731,950 6,285,374 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 3,752,197 3,769,137 6,323,267 

Total Direct Obligations $3,756,556 $3,773,556 $6,327,743 1

 Does not include PHS Evaluation Funds.

Budget Authority by Object Class

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

(Dollars in Thousands)
337 

Object Class - Direct Budget Authority1

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1).............................................. $43,503 $43,938 $44,377 

Other than full-time permanent (11.3).............................. 1,949 1,969 1,988 

Other personnel compensation (11.5).............................. 1,188 1,200 1,211 

Military personnel (11.7)................................................ 3,401 3,503 3,609 

Special personnel services payments (11.8) ................... 18 19 19 

Subtotal personnel compensation: 50,060 50,628 51,205 

Civilian benefits (12.1)................................................... 14,468 14,613 14,922 

Military benefits (12.2)................................................... 1,792 1,846 1,901 

Subtotal Pay Costs: 66,320 67,087 68,027 

Travel and transportation of persons (21.0).................... 150 152 155 

Transportation of things (22.0)........................................ 7 8 8 

Rental payments to GSA (23.1)....................................... 5,365 5,451 5,555 

Rental payments to Others (23.2)..................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)......... 46 46 47 

Printing and reproduction (24.0)......................................

Other Contractual Services:

Advisory and assistance services (25.1)......................... 1,246 1,266 1,290 

Other services (25.2)....................................................... 42,028 40,933 37,793 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 3,425 3,479 3,546 

Operation and maintenance of facilities (25.4)................ --- --- --- 

Research and Development Contracts (25.5)................... --- --- --- 

Operation and maintenance of equipment (25.7).............. 602 611 623 

Subtotal Other Contractual Services: 47,301 46,289 43,251 

Supplies and materials (26.0).......................................... 112 114 116 

Equipment (31.0)............................................................. 24 24 25 

Grants, subsidies, and contributions (41.0)..................... 9,505 9,657 21,761 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 62,511 61,743 70,918 

Total Direct Obligations $128,830 $128,830 $138,945 1

 Does not include PHS Evaluation Funds.

Budget Authority by Object Class

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

(Dollars in Thousands)
338 

Object Class - Direct Budget Authority1

FY 2020

 Final

FY 2021

Enacted

FY 2022

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)........................................ --- --- --- 

Rental payments to GSA (23.1)....................................... --- 

Rental payments to Others (23.2)..................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)......... --- --- 

Printing and reproduction (24.0)...................................... --- --- --- 

Other Contractual Services:

Advisory and assistance services (25.1)......................... 300 305 311 

Other services (25.2)....................................................... --- --- --- 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)...... 291 296 301 

Operation and maintenance of facilities (25.4)................ --- --- --- 

Research and Development Contracts (25.5)................... --- --- --- 

Operation and maintenance of equipment (25.7).............. --- --- --- 

Subtotal Other Contractual Services: 591 601 612 

Supplies and materials (26.0).......................................... --- --- --- 

Equipment (31.0)............................................................. 11 11 11 

Grants, subsidies, and contributions (41.0)..................... 11,398 11,388 11,377 

Interest and dividends (43.0)........................................... --- --- --- 

Subtotal Non-Pay Costs 12,000 12,000 12,000 

Total Direct Obligations $12,000 $12,000 $12,000 1

 Does not include PHS Evaluation Funds.

Budget Authority by Object Class

Substance Abuse and Mental Health Services Administration

Prevention and Public Health Funds

(Dollars in Thousands)
339 

Object Class - PHS Evaluation Funds

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel Compensation:

 Full Time Permanent (11.1)............................................. $11,940 $8,040 $12,179 

 Other than Full-Time Permanent (11.3)........................... 641 470 654 

 Other Personnel Compensation (11.5)............................. 234 186 239 

 Military Personnel Compensation (11.7)......................... 345 356 448 

Special personnel services payments (11.8) .................. --- --- --- 

Subtotal Personnel Compensation: 13,160 9,052 13,520 

 Civilian Personnel Benefits (12.1).................................. 3,966 1,571 4,061 

 Military Personnel Benefits (12.2) ................................ 221 161 234 

Subtotal Pay Costs: 17,346 10,785 17,815 

Travel (21.0)................................................................... 31 32 32 

Transportation of things (22.0)........................................ --- --- --- 

Rental payments to GSA (23.1)....................................... --- --- --- 

Communications, Utilities and Misc. Charges (23.3)...... --- --- --- 

Printing and Reproduction (24.0).................................... 634 645 646 

Other Contractual Services: --- --- --- 

Advisory and assistance services (25.1)......................... --- --- --- 

Other services (25.2)...................................................... 82,241 89,875 83,939 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 2,344 2,382 1,694 

Operation and maintenance of equipment (25.7)............. 10 10 10 

 Subtotal Other Contractual Services:............................ 84,595 92,268 85,643 

Supplies and Materials (26.0)......................................... 23 24 24 

Equipment (31.0)............................................................. 6 6 6 

Grants, Subsidies, and Contributions (41.0)..................... 31,030 29,908 29,502 

Subtotal Non-Pay Costs 116,320 122,882 115,852 

Total PHS Evaluation Funds $133,667 $133,667 $133,667 

Budget Authority by Object Class

Substance Abuse and Mental Health Services Administration

Summary PHS Evaluation Funds

(Dollars in Thousands)
340 

Object Class - PHS Evaluation 

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1)............................................. $1,611 $1,627 $1,643 

Other than full-time permanent (11.3)............................. --- --- --- 

Other personnel compensation (11.5)............................. 24 24 25 

Military personnel (11.7)................................................ 107 110 114 

Special personnel services payments (11.8) .................. --- --- --- 

Subtotal personnel compensation: 1,742 1,762 1,782 

Civilian benefits (12.1)................................................... 549 554 560 

Military benefits (12.2)................................................... 62 63 65 

Subtotal Pay Costs: 2,352 2,379 2,406 

Travel and transportation of persons (21.0).................... 1 1 1 

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)...................................................... 8,373 8,507 8,669 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)..... 49 50 51 

Operation and maintenance of equipment (25.7).............

Subtotal Other Contractual Services: 8,422 8,557 8,719 

Supplies and materials (26.0).........................................

Equipment (31.0)............................................................ --- --- --- 

Grants, subsidies, and contributions (41.0)..................... 10,264 10,102 9,912 

Subtotal Non-Pay Costs 18,687 18,660 18,632 

Total PHS Evaluation Funds $21,039 $21,039 $21,039 

Substance Abuse and Mental Health Services Administration

Mental Health

(Dollars in Thousands)

Budget Authority by Object Class
341 

Object Class - PHS Evaluation 

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1)........................................... $3,029 $3,059 $3,090 

Other than full-time permanent (11.3)........................... 96 97 98 

Other personnel compensation (11.5)........................... 62 63 63 

Military personnel (11.7).............................................. 175 180 186 

Special personnel services payments (11.8) ................ --- --- --- 

Subtotal personnel compensation: 3,362 3,399 3,437 

Civilian benefits (12.1)................................................. 967 992 1,002 

Military benefits (12.2)................................................. 95 98 101 

Subtotal Pay Costs: 4,424 4,489 4,540 

Travel and transportation of persons (21.0).................. 10 10 10 

Transportation of things (22.0)..................................... --- --- --- 

Rental payments to GSA (23.1).................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)...... --- --- --- 

Printing and reproduction (24.0)................................... 419 426 427 

Other Contractual Services: --- --- 

Advisory and assistance services (25.1)...................... --- --- --- 

Other services (25.2).................................................... 60,296 61,260 61,441 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)... 263 268 268 

Operation and maintenance of equipment (25.7)........... --- --- --- 

Subtotal Other Contractual Services: 60,559 61,528 61,710 

Supplies and materials (26.0)....................................... --- --- --- 

Equipment (31.0).......................................................... --- --- --- 

Grants, subsidies, and contributions (41.0)................... 15,787 14,746 14,513 

Subtotal Non-Pay Costs 76,776 76,710 76,660 

Total PHS Evaluation Funds $81,200 $81,200 $81,200 

Substance Abuse and Mental Health Services Administration

Substance Abuse Treatment

(Dollars in Thousands)

Budget Authority by Object Class
342 

Substance Abuse and Mental Health Services Administration

Health Surveillance and Program Support

(Dollars in Thousands)

Object Class - PHS Evaluation 

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1)................................................ $7,300 $3,354 $7,447 

Other than full-time permanent (11.3)................................ 545 374 556 

Other personnel compensation (11.5)................................ 148 100 151 

Military personnel (11.7).................................................. 63 65 148 

Special personnel services payments (11.8) .................... --- --- --- 

Subtotal personnel compensation: 8,056 3,892 8,302 

Civilian benefits (12.1)..................................................... 2,450 25 2,499 

Military benefits (12.2)..................................................... 64 --- 68 

Subtotal Pay Costs: 10,570 3,917 10,869 

Travel and transportation of persons (21.0)...................... 20 21 21 

Transportation of things (22.0)..........................................

Rental payments to GSA (23.1)......................................... --- --- --- 

Communication, utilities, and misc. charges (23.3)........... --- --- --- 

Printing and reproduction (24.0)....................................... 215 218 219 

Other Contractual Services:

Advisory and assistance services (25.1)........................... --- --- --- 

Other services (25.2)......................................................... 13,572 20,108 13,830 

 Purchase of Goods & Svcs. from Govt. Accts (25.3)........ 2,032 2,065 1,375 

Operation and maintenance of equipment (25.7)............... 10 10 10 

Subtotal Other Contractual Services: 15,614 22,183 15,215 

Supplies and materials (26.0)............................................ 23 23 23 

Equipment (31.0)............................................................... 6 6 6 

Grants, subsidies, and contributions (41.0)....................... 4,980 5,060 5,075 

Subtotal Non-Pay Costs 20,859 27,511 20,559 

Total Reimbursable Obligations $31,428 $31,428 $31,428 

Budget Authority by Object Class
343 

Object Class - Direct Budget Authority1,2

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1).................................................. $48,082 $48,563 $49,048 

Other than full-time permanent (11.3).................................. 2,061 2,081 2,102 

Other personnel compensation (11.5).................................. 1,260 1,273 1,286 

Military personnel (11.7)..................................................... 3,401 3,503 3,609 

Special personnel services payments (11.8) ....................... 18 19 19 

Subtotal personnel compensation 54,823 55,439 56,063 

Civilian benefits (12.1)........................................................ 15,961 16,137 16,478 

Military benefits (12.2)........................................................ 1,792 1,846 1,901 

Subtotal Pay Costs: 72,575 73,422 74,442 

Travel (21.0)........................................................................ 222 225 229 

Transportation of things (22.0)............................................. 8 8 8 

Rental payments to Others (23.2)......................................... --- --- --- 

Communication, utilities, and misc. charges (23.3).............. 312 317 323 

Printing and reproduction (24.0).......................................... 488 496 506 

Other Contractual Services:

Advisory and assistance services (25.1).......................... 35,557 35,821 36,502 

Other services (25.2)........................................................ 94,712 94,459 92,336 

Purchase of Goods & Svcs. from Govt. Accts (25.3)....... 33,156 33,391 34,025 

Operation and maintenance of facilities (25.4)................. 58 59 60 

Research and Development Contracts (25.5)................... --- --- --- 

Operation and maintenance of equipment (25.7).............. 924 939 957 

Subtotal Other Contractual Services: 164,407 164,669 163,880 

Supplies and materials (26.0).............................................. 147 150 153 

Subtotal Non-Pay Costs 165,585 165,865 165,099 

Total Salary and Expenses 238,160 239,287 239,541 

Rental Payments to GSA (23.1)........................................... 5,653 5,744 5,853 

Grand Total, Salaries & Expenses and Rent $243,813 $245,030 $245,393 

Direct FTE....................................................... 396 429 499

1

 Does not include PHS Evaluation Funds.

2

 Does not include Prevention and Public Health Funds.

Substance Abuse and Mental Health Services Administration

(Dollars in Thousands)

Salaries and Expenses Tables
344 

Object Class - PHS Evaluation 

FY 2020

 Final

FY 2021

Enacted

FY 2022

President's

Budget

Personnel compensation:

Full-time permanent (11.1)......................................... $11,940 $8,040 $12,179 

Other than full-time permanent (11.3)......................... 641 470 654 

Other personnel compensation (11.5)......................... 234 186 239 

Military personnel (11.7)........................................... 345 356 448 

Special personnel services payments (11.8) .............. --- --- --- 

Subtotal personnel compensation 13,160 9,052 13,520 

Civilian benefits (12.1).............................................. 3,966 1,571 4,061 

Military benefits (12.2).............................................. 221 161 234 

Subtotal Pay Costs: 17,346 10,785 17,815 

Travel (21.0).............................................................. 31 32 32 

Transportation of things (22.0)................................... --- --- --- 

Rental payments to Others (23.2)................................ --- --- --- 

Communication, utilities, and misc. charges (23.3).... --- --- --- 

Printing and reproduction (24.0)................................. 634 645 646 

Other Contractual Services:

Advisory and assistance services (25.1).................... --- --- --- 

Other services (25.2).................................................. 82,241 89,875 83,939 

Purch. Goods & Svcs. Govt. Accts (25.3).................. 2,344 2,382 1,694 

Operation and maintenance of facilities (25.4)........... 10 10 10 

Research and Development Contracts (25.5).............. --- --- --- 

Operation and maintenance of equipment (25.7)......... 23 24 24 

Subtotal Other Contractual Services: 84,618 92,291 85,667 

Supplies and materials (26.0)..................................... 23 24 24 

Subtotal Non-Pay Costs 85,307 92,991 86,368 

Total Salary and Expenses 102,653 103,777 104,183 

Rental Payments to GSA (23.1).................................. --- --- --- 

Grand Total, Salaries & Expenses and Rent $102,653 $103,777 $104,183 

Reimbursable FTE...................................... 56 55 116

Substance Abuse and Mental Health Services Administration

(Dollars in Thousands)

Salaries and Expenses Tables
345 

FY 2020 

Actual 

Civilian

FY 2020 

Actual 

Military

FY 2020 

Actual 

Total

FY 2021 

Est. 

Civilian

FY 2021 

Est. 

Military

FY 2021 

Est. 

Total

FY 2022 

Est. 

Civilian

FY 2022 

Est. 

Military

FY 2022 

Est. 

Total

Health Surveillance and Program Support...... 

 Direct:.......................................................... 357 28 385 377 26 403 419 30 449

 Reimbursable:.............................................. 1 2 3 40 2 42 40 4 44

 Total:......................................................... 358 30 388 417 28 445 459 34 493

Mental Health Services.................................. 

 Direct:.......................................................... -- -- -- -- -- -- 14 -- 14

 Reimbursable:.............................................. 14 1 15 2 1 3 22 2 24

 Total:......................................................... 14 1 15 2 1 3 36 2 38

Substance Abuse Prevention........................... 

 Direct:.......................................................... -- -- -- -- -- -- -- -- --

 Reimbursable:.............................................. 21 1 22 -- -- -- 21 1 22

 Total:......................................................... 21 1 22 -- -- -- 21 1 22

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

 Direct:.......................................................... 11 -- 11 25 1 26 34 2 36

 Reimbursable:.............................................. 15 1 16 9 1 10 25 1 26

 Total:......................................................... 26 1 27 34 2 36 59 3 62

SAMHSA FTE Total........................ 419 33 452 453 31 484 575 40 615

Detail of Full Time Equivalents (FTE)

Substance Abuse and Mental Health Services Administration
346 

FY 2020

 Final

FY 2021

 Enacted

FY 2022

 President's Budget

Executive Level IV 1 1 1

Subtotal 1 1 1

Total - Exec Level Salaries $170,800 $170,800 $170,800

SES 6 10 20

Subtotal 6 10 20

Total, SES salaries $1,235,149 $2,058,582 $4,117,164

GM/GS-15/EE 49 54 64

GM/GS-14 91 96 122

GM/GS-13 163 164 205

GS-12 45 54 54

GS-11 18 28 27

GS-10 -- -- 1

GS-09 12 16 27

GS-08 12 8 18

GS-07 18 21 22

GS-06 2 11 11

GS-05 3 3 3

GS-04 -- -- --

GS-03 -- -- --

GS-02 -- -- --

GS-01 -- -- --

Subtotal 413 455 554

Total, GS salaries $55,732,857 $61,861,110 $75,885,907

CC-08/09 -- 1 1

CC-07 -- -- --

CC-06 15 16 18

CC-05 5 5 9

CC-04 9 9 9

CC-03 3 2 3

CC-02 -- -- --

CC-01 -- -- --

Subtotal 32 33 40

Total, CC salaries $4,420,492 $4,661,202 $5,777,065

Total Positions1 452 499 615

Average ES level ES ES ES

Average ES salary $170,800 $170,800 $170,800

Average SES level SES SES SES

Average SES salary $205,858 $205,858 $205,858

Average GS grade 13.6 13.6 13.6

Average GS salary $134,946 $135,958 $136,978

Average CC level 5 5 5

Average CC salaries $138,140 $141,249 $144,427 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.

Detail of Positions

Substance Abuse and Mental Health Services Administration
347 

Physicians’ Comparability Allowance (PCA) Worksheet

1) Department and component: 

HHS/Substance Abuse and Mental Health Services Administration

2) Explain the recruitment and retention problem(s) justifying the need for the PCA pay authority. 

(Please include any staffing data to support your explanation, such as number and duration of unfilled positions 

and number of accessions and separations per fiscal year.)

We have to offer PCAs because our salaries are not competitive with the private sector. 

3-4) Please complete the table below with details of the PCA agreement for the following years:

 

 

FY 2020 

(Final) 

FY

2021118

(Enacted) 

FY 2022 

(Budget Request) 

3a) Number of Physicians Receiving PCAs 1 1 1 

3b) Number of Physicians with One-Year PCA Agreements 

3c) Number of Physicians with Multi-Year PCA Agreements 1 1 1 

4a) Average Annual PCA Physician Pay (without PCA payment) 157,709 157,709 157,709 

4b) Average Annual PCA Payment 16,000 16,000 16,000 

5) Explain the degree to which recruitment and retention problems were alleviated in your agency through 

the use of PCAs in the prior fiscal year. 

(Please include any staffing data to support your explanation, such as number and duration of unfilled positions 

and number of accessions and separations per fiscal year.) We have to offer PCAs because our salaries are not

competitive with the private sector (e.g., we might offer 75% of a physician's salary on the outside). In addition, 

physicians of interest to SAMHSA often have income from consulting as well. The PCA is the only way to raise

the government income so as to make the offer acceptable.

6) Provide any additional information that may be useful in planning PCA staffing levels and amounts in

your agency. 

N/A

 

118 FY 2021 data will be approved during the FY 2022 Budget cycle
348 

Significant Items

Joint Explanatory Statement

1. Mental Health Awareness Training: SAMHSA is directed to continue 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 and armed services personnel and their family members. (Page 75 JES)

Actions Taken or to be taken

SAMHSA included eligible grantees as directed. The Funding Opportunity Announcement (FOA)

included as eligible grantees: local law enforcement agencies, fire departments, and emergency

medical units with a special emphasis on training for crisis de-escalation techniques. In addition, the 

allowable activities in the FOA include training for veterans, service members, and their family

members. In FY 2020, SAMHSA funded the continuation of 156 Mental Health Awareness Training 

grants to entities including local law enforcement, fire departments, and emergency medical units. 

 

2. Medication-Assisted Treatment for Prescription Drug and Opioid Addiction: Within the 

amount, the agreement includes $11,000,000 for grants to Indian Tribes, Tribal Organizations, or 

consortia. The agreement directs SAMHSA to ensure grants allow the use of medication-assisted

treatment and other clinically appropriate services to achieve and maintain abstinence from all 

opioids, including programs that offer low-barrier or same day treatment options. (Page 80 JES)

Actions Taken or to be taken

SAMHSA is requiring that for CSAT’s services programs, grants support the delivery of medicationassisted treatment and other clinically appropriate services to achieve and maintain abstinence. The

MAT-PDOA program’s focus is on funding organizations and tribes/tribal organizations within

states identified as having the highest rates of primary treatment admissions for heroin and opioids 

per capita and includes those states with the most dramatic increases for heroin and opioids. 

3. Treatment for Hepatitis: The agreement encourages SAMHSA to work with CDC to develop a 

plan to increase hepatitis A and B vaccinations among those populations targeted through 

SAMHSA's overdose prevention and substance use treatment programs. SAMHSA is further

encouraged to promote awareness about the importance of hepatitis A and B vaccination among 

medical and health professionals, communities at high risk, and the general public. The agreement

requests an update on these efforts in the fiscal year 2022 Congressional Justification. (Page 81 

JES)

Actions Taken or to be taken

SAMHSA has worked to decrease the prevalence of viral hepatitis and increase awareness about the 

importance of hepatitis vaccination. SAMHSA has worked with several partners including CDC in

developing the Office of Infectious Disease Policy- Viral Hepatitis National Strategic Plan.

SAMHSA has continued to work to increase vaccination through our grants and technical assistance. 

Also, through the Minority Aids Initiative SAMHSA grant funding can be used for hepatitis

screening and testing, and hepatitis vaccination. SAMHSA will continue these efforts and strive to

increase awareness and the importance of hepatitis vaccinations but has yet to develop a formal plan

with CDC as SAMHSA already participates regularly in the Federal Viral Hepatitis Implementation

Workgroup (VHIG), Viral Hepatitis Affinity Group and frequently amplifies CDC messaging
349 

around these issues. SAMHSA recently published a health advisory based on TIP 53, Addressing 

Viral Hepatitis in People with Substance Use Disorders promoting education, screening, treatment

and vaccination. It offers guidance to providers and administrators in substance use disorder 

treatment programs on screening for, and treating clients with, hepatitis A, hepatitis B, and hepatitis

C infections. SAMHSA published this advisory which was widely disseminated, and references

CDC data and guidance. 

4. Treatment, Recovery, and Workforce Support: The agreement includes an increase to

implement section 7183 of the SUPPORT Act (P.L. 115-271). SAMHSA is directed to, in

consultation with the Secretary of Labor, award competitive grants to entities to carry out evidencebased programs to support individuals in substance use disorder treatment and recovery to live

independently and participate in the workforce. (Page 81 JES)

Actions Taken or to be taken

SAMHSA launched the Treatment, Recovery, and Support Workforce Support Initiative.

(Workforce Support) in FY 2020. As of FY 2021, twelve grants will have been awarded and

continued funding is requested for FY 2022. 

5. Pregnant and Postpartum Women: The agreement encourages SAMHSA to prioritize States that

support best-practice collaborative models for the treatment and support of pregnant women with

opioid use disorders. SAMHSA is also encouraged to fund an additional cohort of States under the 

pilot program authorized by the Comprehensive Addiction and Recovery Act (P.L. 114-198). 

(Page 81 JES)

Actions Taken or to be taken

SAMHSA continues to prioritize states that support best-practice collaborative models for the

treatment, as well as, provide support to pregnant women with opioid use disorder. In FY 2021, 

SAMHSA awarded nine PPW pilot grants and SAMHSA plans to fund three new PPW-PLT

programs in FY 2022. 

House Appropriations Committee, Labor/HHS/Education Subcommittee (H. Rept. 116-450) 

1. Criminal and Juvenile Justice Programs: The Committee strongly encourages SAMHSA’s

Criminal Justice Activities to prioritize funding for centers that provide assistance to those with

severe mental health needs who are at risk of recidivism. These mental health centers can provide, 

but are not limited to, the following services: crisis care, residential treatment, outpatient mental

health and primary care services, and community re-entry supports. The Committee strongly 

encourages SAMHSA to prioritize applications from areas with high rates of uninsured individuals, 

poverty, and substance use disorders. (Page 147 H. Rept.)

Actions Taken or to be taken

CSAT continues to fund its Drug Court grants and its Offender Reentry programs. These programs 

are designed to serve individuals with substance use disorders (SUDs) as their primary diagnosis. 

These grants may also serve individuals with co-occurring SUDs and mental disorders. However,

CMHS’s criminal justice portfolio focuses on individuals with mental disorders and co-occurring 

SUDs as a primary population of focus. In FY 2018, CMHS awarded Law Enforcement Behavioral

Health Partnerships for Early Diversion (Short Title: Early Diversion) grants. Early Diversion 
350 

participants are individuals with Serious Mental Illness (SMI) or a Co-occurring Disorder (COD). 

The program is intended to divert participants from arrest and booking, thereby keeping them out of 

the criminal justice system. Many participants are homeless and repeat offenders without insurance 

or a source of income. In FY 2021, SAMHSA proposes to place a greater emphasis on those with

SMI who are at greater risk of becoming involved in the criminal justice system.

2. Now is the Time: The Committee encourages SAMHSA to sustain and strengthen its Project

AWARE grant and other programs that support school-based and campus-based services aimed at

preventing and treating mental health challenges experienced by younger Americans. The 

Committee is concerned that some States were notified that they would not be receiving already 

approved funding due to a new requirement and urges SAMHSA to not change requirements midaward cycle. In addition, the Committee supports the Healthy Transitions program, which provides 

grants to states and tribes to improve access to mental disorder treatment and related support 

services for young people aged 16 to 25 who either have, or at risk of developing a serious mental

health condition. (Page 148 H. Rept.)

Actions Taken or to be taken

SAMHSA believes that America’s schools should be safe and secure settings where children can

focus on learning and develop their full potential and helping them stay on a positive trajectory that

supports academic success. 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. The program also includes a focus on 

the specific needs affecting rural and tribal communities, which struggle with access to mental health

services in schools and access to qualified health professionals to provide such services. In addition, 

SAMHSA funds three other programs with an emphasis on school mental health: Mental Health

Awareness Training grants that provide training to teachers and other school staff, Resiliency in

Communities After Stress and Trauma (ReCAST) grants and provides technical assistance to

develop school-based mental health models. Healthy Transition grantees (states and federally

recognized tribes) also help youth and young adults between the ages of 16 and 25, who have serious 

emotional disturbance or serious mental illness, by providing outreach, youth engagement, referrals

to treatment, coordination of care, and evidence informed treatment using culturally appropriate 

practices.

3. Suicide Prevention: The Committee urges SAMHSA to develop and disseminate programs to

provide specialized training and resources on identifying and responding to people at risk of suicide 

for families and friends of at-risk individuals. The Committee includes an increase of $5,000,000 for 

the implementation the Zero Suicide model, a comprehensive, multi-setting approach to suicide 

prevention in health care systems. The Committee includes an increase of $2,000,000 and recognizes

the importance of the Suicide Lifeline to provide rapid access at any time of the day or night to crisis

intervention, and when needed, emergency response. The Committee is concerned by recent data

from CDC and the National Survey on Drug Use and Health indicating a significant rise in youth 

suicide reported over the last decade. The Committee encourages that SAMHSA, in consultation 

with the U.S. Department of Education, to develop a standard for providing all school-based 

teachers and nurses with suicide prevention training to treat mental health challenges experienced

by younger Americans. In House Report 116–62, the Committee urged SAMHSA to provide specific

training programs for Suicide Lifeline counselors to increase competency in serving LGBTQ youth 

through the utilization of existing specialized resources. The Committee also urged SAMHSA to
351 

consider the diversion of calls to specialty partners who are best situated to serve the LGBTQ

community. As the Lifeline continues to anticipate higher call volume, both due to mental health 

stresses caused by COVID–19 and the potential transition to a three digit code, it is now more

important than ever that SAMHSA work to implement LGBTQ competency training for counselors 

and an Integrated Voice Response option for LGBTQ youth callers. (Page 148-149 H. Rept.)

Actions Taken or to be taken 

In FY 2020, SAMHSA developed and disseminated programs to provide specialized training and

resources on identifying and responding to people at risk for suicide for families and friends of at

risk individuals. This included a Psychoeducational Toolkit for Families with a Loved One Who is

Suicidal, as well as specialized resources for LGBTQ youth. In FY 2020, SAMHSA will assure

specific training is provided to the National Suicide Prevention Lifeline counselors to increase

competency in serving LGBTQ youth. SAMHSA will also review options for the diversion of calls

to specialty LGBTQ providers. 

4. Mental Health Block Grant: The Committee continues the ten percent set-aside within the Mental 

Health Block Grant total for evidence-based programs that address the needs of individuals with

early serious mental illness, including psychotic disorders. The Committee expects SAMHSA to

continue its collaboration with the National Institute of Mental Health to encourage States to use 

this block grant funding to support programs that demonstrate strong evidence of effectiveness.

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

crisis care programs addressing the needs of individuals with serious mental illnesses and children

with serious mental and emotional disturbances. The Committee directs SAMHSA to use the setaside to fund, at the discretion of eligible States and Territories, some or all of a set of core crisis

care elements including: centrally deployed 24/7 mobile crisis units, short-term residential crisis

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

and regional or State-wide crisis call centers coordinating in real time. (Page 149-150 H. Rept.)

Actions Taken or to be taken

Through the ten percent set-aside, SAMHSA continues to assist states in implementing and

sustaining evidence-based practice models to address early serious mental illness including first

episode psychosis. SAMHSA continues to collaborate with the National Institute of Mental Health

(NIMH) to identify and support the implementation and sustainability of evidence-based programs 

that support early serious mental illness, including first episode psychosis. The 2021 Budget includes 

a five percent set aside for evidence-based crisis care programs that provide persons in a psychiatric 

crisis a set of core services including statewide call centers, 24/7 mobile crisis teams, and crisis

stabilization or residential beds that help mitigate the crisis. SAMHSA will continue to work with

states to develop state-wide call center and evidence-based crisis intervention treatment services that

address the needs of persons with acute psychiatric crisis, including those with acute suicide 

ideation. 

5. Health Care Disparities: The Committee believes that addressing health care disparities 

experienced by racial and ethnic minorities should be a priority in programs funded by federal

agencies, including programs funded in whole or part by the Community Mental Health Services

Block Grant authorized under 42 U.S.C. 300x–1. The Committee directs SAMHSA to require, in the 

reporting mandated of states receiving the Mental Health Block Grant under 42 U.S.C. 300x–1, that 

State Mental Health Agencies report on services provided to individuals from racial and ethnic 
352 

minorities, including the extent to which those services are provided to individuals from racial and 

ethnic minorities and the outcomes experienced by individuals from racial and ethnic minorities as a 

result of those services being provided. SAMHSA shall direct that impact and outcomes be reported 

for racial and ethnic minority adults with serious mental illness and racial and ethnic minority 

children with serious emotional disturbance in reports of data submitted relating to systems of care,

diversions from hospitalization and criminal justice system involvement, treatment for first episode 

psychosis, reductions in suicide and treatment for suicidal ideation, response through crisis services,

and treatment of homeless individuals and individuals residing in rural communities. State Mental 

Health Agencies shall also report on outreach to, and the hiring of, racial and ethnic minority 

providers of mental health services. (Page 150 H. Rept.)

Actions Taken or to be taken

Currently, SAMHSA Mental Health Block Grant grantees are collecting and reporting data on racial,

ethnic, age, and sex demographics; criminal justice involvement; and homelessness. SAMHSA will

explore the remaining items for future data collections. 

6. Child Victims of Disaster: The Committee recognizes the ongoing threat to mental health posed to

our nation’s children and families as a result of increasing frequency and intensity of natural and 

manmade technological disasters. Children who experience traumatic stress may struggle with a 

wide range of childhood developmental capabilities, including social and educational functioning, 

and are at higher risk of later adverse physical, mental, and behavioral health outcomes if not 

recognized and addressed at an early stage. For this reason, the Committee strongly encourages 

that funding for the National Child Traumatic Stress Network be used to address child trauma as a 

result of natural and technological manmade disasters. (Page 150 H. Rept.)

Actions Taken or to be taken

SAMHSA believes that child traumatic stress is a pervasive and potentially life changing experience

that affects tens of thousands of children each year and is a serious public health challenge. There is

strong evidence that the negative impact of child trauma may lead to early childhood mental health,

chronic medical, and social development issues - if not recognized and addressed early in life. The

National Child Traumatic Stress Initiative (NCTSI) aims to improve and create access to evidencedbased behavioral health services and interventions for children and adolescents exposed to traumatic

events. In addition to funding grants for the three NCTSI Categories in FY 2019 and FY 2020, 

SAMHSA funded supplemental NCTSI grants to improve the mental health services of 

unaccompanied migrant children. In FY 2021, SAMHSA proposes to continue supporting children, 

youth and families who may experience traumatic stress due to natural or technological manmade

disasters. SAMHSA also proposes to fund additional supplemental grants to: (a) broaden the reach

of trauma treatment and services for this population in areas not currently covered; and (b) offer

mental health service provider training for direct-care providers serving this population. 

7. Certified Community Behavioral Health Clinics: The Committee is pleased that the Certified

Community Behavioral Health Clinics (CCBHC) program is expanding access to mental health and 

addiction treatment services and significantly reducing hospital emergency room utilization while

assisting local law enforcement agencies nationwide....The Committee directs SAMHSA to prioritize

resources to entities within States that are part of section 223(a) of the Protecting Access to

Medicare Act of 2014 (P.L. 113–93) demonstration and to entities within States that were awarded 

planning grants. (Page 151 H. Rept.)
353 

Actions Taken or to be taken

In FY 2020, SAMHSA released a new Funding Opportunity Announcement that prioritized entities

within states that are part of the Protecting Access to Medicare Act of 2014 demonstration and to

entities within states that were awarded planning grants. 

8. State Opioid Response Grants: The Committee is concerned longstanding guidance to the 

Department to avoid a significant cliff between States with similar mortality rates was overlooked in

the award of fiscal year 2020 funds. For future awards, the Committee directs the Assistant 

Secretary to award funds to address funding cliffs between States with similar mortality rates. 

(Page 152 H. Rept.)

Actions Taken or to be taken

SAMHSA will review the formula and its impact on states with similar mortality rates.

9. Criminal Justice Activities: The Committee continues to direct SAMHSA to ensure that all funding 

appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance use 

disorder as their primary condition. The Committee 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 153 H. Rept.)

Actions Taken or to be taken

SAMHSA will continue to ensure that all funding appropriated for Drug Treatment Courts is

allocated to serve people diagnosed with a substance use disorder as their primary condition. Future 

SAMHSA drug court FOAs will direct all Drug Treatment Court grant recipients to work directly

with the corresponding state substance abuse agency in the planning, implementation, and evaluation

of the grant. SAMHSA currently provides training and technical assistance to drug treatment courts 

across the nation through the GAINS Center for Behavioral and Justice Transformation Center

contract. SAMHSA will ensure that the GAINS Center provide SAMHSA grant recipients training

and technical assistance to ensure evidence-based practices are fully implemented.

10. Emphasis on Comprehensive Services: In recent fiscal years, the Committee has provided historic

resources to combat the opioid epidemic, with a particular focus on expanding access to treatment,

and treating and preventing comorbidities that can be associated with injection drug use. At the 

Committee’s urging, the Department has rightfully prioritized efforts that increase access to

treatment and recovery services. For all programs not focused exclusively on prevention of 

substance abuse, the Committee directs the Department to continue its emphasis on evidence-based 

medical interventions, and to ensure that all such interventions, including programs that focus on 

harm reduction, provide referral to treatment and recovery services. (Page 153 H. Rept.)

Actions Taken or to be taken

SAMHSA continues to emphasize evidence-based medical interventions that promoted referral to

treatment and recovery services. For example, SAMHSA’s criminal justice portfolio includes drug 

court grants that focus on diversion and alternatives to incarceration for adolescents and adults with

drug/alcohol addiction and/or co-occurring drug/alcohol addiction and mental illness. The Offender

Reentry Program (ORP) grants provide screening, assessment, comprehensive treatment, and recovery
354 

support services for diverse populations reentering the community from incarceration. Grantees are

encouraged to use grant funds to provide medication-assisted treatment with FDA-approved 

medications. In July 2019, SAMHSA published an Evidence-based Practice Guidebook focused on 

medication-assisted treatment (MAT) implementation in criminal justice settings.

SAMHSA’s Improving Access to Overdose Treatment (CARA) grant program increases access to

treatment, reduces unmet treatment need, and reduces opioid overdose related deaths. Grantees utilize

SAMHSA’s Opioid Overdose Prevention Toolkit as a guide and includes a comprehensive prevention 

program that focuses on prevention, treatment, and recovery services to decrease the likelihood of 

drug overdose recurrence. SAMHSA’s Substance Abuse Prevention and Treatment Block Grant

(SABG) funds priority treatment and support services for individuals without insurance or for whom 

coverage is terminated for short periods of time. The SABG 20 percent primary prevention set-aside

requires that grantees spend at least 20 percent of their SABG expenditures to develop and implement

a comprehensive substance misuse prevention program. It is imperative that our addiction crisis

response evolve from an acute short-term individual-focused treatment response to a broader 

community recovery response. Addiction is a chronic illness, and recovery often is a life-long process

where external community and social determinants of health play a vital role in its sustainability. The

budget request includes a new 10% set aside within the SABG for recovery support services in order 

to significantly expand the continuum of care both upstream and downstream. This new set-aside will:

support the development of local recovery community support institutions (i.e. recovery community 

centers, recovery homes, recovery schools, recovery industries, recovery ministries); develop 

strategies and educational campaigns, trainings, and events to reduce addiction/recovery-related

stigma and discrimination at the local level; provide addiction treatment and recovery resources and

support system navigation; make accessible peer recovery support services that support diverse 

populations and are inclusive of all pathways to recovery; and collaborate and coordinate with local

private and non-profit clinical health care providers, the faith community, city, county, state, and

federal public health agencies, and criminal justice response efforts.

Additionally, SAMHSA, along with other HHS agencies, has developed guidance for grantees

regarding use of grant funds to support syringe services programs, testing kits for HIV, navigation 

services to ensure linkage to HIV and viral hepatitis prevention, testing, treatment and care services,

including antiretroviral therapy for HIV, pre-exposure prophylaxis (PrEP), post‐exposure

prophylaxis (PEP), prevention of mother to child transmission and partner services; substance use 

disorder treatment, and medical and mental health care.

11. Grants to Prevent Prescription Drug/Opioid Overdose and First Responder Training: The 

Committee notes strong concerns about the increasing number of unintentional overdose deaths 

attributable to prescription and nonprescription opioids. 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 facilitate linkage to treatment and recovery services. (Page 153 H. Rept.)

Actions Taken or to be taken

SAMHSA ensures that SABG recipients are addressing the opioid crisis by monitoring recipient’s

adherence to their respective SABG application. The application explicitly states that “states continue 

to make primary substance use disorder prevention a priority. To respond to the primary prevention 

set-aside requirement of the SABG, states should keep in mind that the backbone of a prevention 

system is an infrastructure with the ability to collect and analyze epidemiological data on substance 
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use and its associated consequences. The system must also be able to use this data to identify areas of 

greatest need, and to identify, implement, and evaluate evidence-based programs, practices and

policies that have the ability to reduce substance use and improve health and well-being in all

communities.” Also, written in the application, “state authorities are strategic in leveraging scarce

resources to fund prevention services.” SAMHSA works with state authorities to ensure that they

comport with changes in quality reporting. States are required to utilize the National Behavioral Health

Quality Framework (NBHQF) as a mechanism for to examine, prioritize, and report on approaches to

prevention, treatment, and recovery processes through the SABG as well as discretionary and formula

grantees. As a result, SAMHSA SABG funded recipients are able to utilize substance prevention block 

grant dollars 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. In addition, to this tool, SAMHSA has been working with states and

state representative organizations to identify and implement a core set of measures, which includes 

approved quality measures to assess outcomes and quality in programming. This effort guides and

aligns the measurement requirements of Medicaid and Medicare. Also, SAMHSA continues to

encourage SABG recipients to incorporate evidence-based intervention training and facilitate linkage 

to treatment and recovery services.

The PTTC Network delivers training and technical assistance on practices that have proven effective

in transferring knowledge and skills, tailored to the local needs of specific technical assistance

recipients. A primary goal of the PTTC Network is to help prevention organizations make effective

changes that produce measurable changes in outcomes. In addition, CSAP Project Officers during 

their monitoring calls (monthly for newer grantees) and quarterly, remind, as well as, continue to

encourage grantees to be sure to incorporate evidence-based intervention training and to facilitate

linkage to treatment and recovery services. SAMHSA’s 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 meet their specific needs. Grant funds may be used

for purchasing overdose reversing drugs, equipping first responders with them, providing training on 

their use, developing other overdose-related death prevention strategies, and providing materials to

assemble and disseminate overdose kits. A growing evidence base suggests that overdose reversal

drugs are a cost-effective method to reducing opioid overdose deaths. Grantees are also required to

develop a dissemination plan and a training course tailored to meet the needs of first responders in

their communities. 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. SAMHSA also funds First

Responder Training grants and Improving Access to Overdose Treatment grants, which also increase

access to treatment, reduce unmet need, and reduce opioid overdose related deaths through the use of 

evidence-based training. 

12. Screening, Brief Intervention, and Referral to Treatment: The Committee directs $2,000,000 for 

implementing grants to pediatric health care providers in accordance with the specifications 

outlined in Section 9016 of P.L. 114–255, Sober Truth in Preventing Underage Drinking 

Reauthorization. Training grants should focus on screening for underage drinking, opioid use, and 

other drug use, and be managed by CSAT within the existing SBIRT program. (Page 154 H. Rept.)

Actions Taken or to be taken

The SBIRT program in CSAT is currently accepting applications for FY 2021. This program is to

implement screening, brief intervention, and referral to treatment services for children, adolescents,

and/or adults in primary care and community health settings with a focus on screening for underage 
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drinking, opioid use, and other substance use. SAMHSA plans to award 10 new grants to support 

this program. 

13. Targeted Capacity Expansion: The Committee includes an increase of $2,000,000 for grants to

Indian tribes, tribal organizations, or consortia. 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 154 H. Rept.)

Actions Taken or to be taken

SAMHSA supports the use of Medication Assisted Treatment (MAT) to assist individuals who have 

an opioid use disorder. In fact, within SAMHSA service funding opportunity announcements, 

SAMHSA stipulates that a grantee can not deny any appropriate and eligible client access to their

program because of their use of Food and Drug Administration approved medications (e.g.,

methadone, injectable naltrexone, non-injectable naltrexone, disulfiram, acamprosate calcium,

buprenorphine, etc.) that were appropriately authorized through prescription of a licensed prescriber. 

Additionally, MAT must be permitted to be continued for as long as the prescriber determines that

the medication is clinically beneficial.

14. Pregnant and Postpartum Women: The Committee recognizes SAMHSA for its work managing 

the Pregnant and Postpartum Women program which utilizes a family-centered approach to provide 

comprehensive residential substance use disorder treatment services for pregnant and postpartum 

women, their minor children and for other family members. A provision in the Comprehensive 

Addiction and Recovery Act (CARA) authorized SAMHSA to allocate a portion of these resources for 

a pilot program to State alcohol and drug agencies to support outpatient, intensive outpatient and 

related services in a family-centered approach. The Committee encourages SAMHSA to fund an 

additional cohort of States above and beyond those pilots already funded. (Page 154 H. Rept.)

Actions Taken or to be taken

SAMHSA continues to prioritize states that support best-practice collaborative models for the

treatment, as well as, provide support to pregnant women with opioid use disorder. In FY 2021, 

SAMHSA awarded nine PPW pilot grants and SAMHSA plans to fund three new PPW-PLT

programs in FY 2022. 

15. Family Support Services for Addiction: As many resources have been disbursed to state and local 

agencies, the Committee urges SAMHSA, in accordance with the Public Health Service Act, to

ensure these family community organizations also have access to these funds to develop, expand, 

and enhance their services for families of those struggling with substance use disorder. 

(Page 154-155 H. Rept.)

Actions Taken or to be taken

Many of SAMHSA's FOAs are open to domestic public and private non-profit entities, which would 

include family community organizations. SAMHSA has two programs that provide funding to

community-based organizations- 1) Enhancement and Expansion of Treatment Recovery Services

for Adolescents, Transitional Aged Youth, and Their Families and 2) Pregnant and Postpartum 

Women’s (PPW) Residential Program. Both programs focus on advancing service delivery from a 

family-centered perspective to ensure the inclusiveness of comprehensive substance use disorder 

treatment services for the primary populations and their family members. Additionally, SAMHSA
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provides funding to states, territories, and tribes, which support multiple community-based

organizations in delivering family-centered substance use disorder treatment services through two

programs-1) Cooperative Agreements for Adolescents and Transitional-Aged Youth Treatment

Implementation and 2) state Pilot Grant Program for Treatment for PPW (outpatient program). One

of the main goals of these two programs is to build long-term sustainable capacity. In the future,

SAMHSA will continue to provide support in encouraging the participation of family community

organizations in SAMHSA’s funded programs, including through technical support provided by 

SAMHSA’s existing Addiction Technology Transfer Centers.
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPDIV Specific Requirements 

PPHF 

GLS - Youth Suicide Prevention 

- States (PPHF) 

FY 2022 

FY 2020 Final FY 2021 Enacted President's Budget 

Grants 11,397,473.00 11,409,087.00 11,434,674.00 

PHS Eval Tap 300,000.00 300,000.00 300,000.00 

CCB Tap 302,527.00 290,913.00 265,326.00 

Total 12,000,000.00 12,000,000.00 12,000,000.00 

The Garrett Lee Smith (GLS) Memorial Act (Public Law 108-35) authorizes SAMHSA to award 

grants to states tribes and manage this grant program through a competitive process. This grant 

funded is the major federal support for youth suicide prevention efforts in the United States. The 

GLS Youth Suicide Youth Suicide Prevention State and Tribal grant program develops and 

implements youth suicide prevention and early intervention strategies involving public-private 

collaborations among youth serving institutions. In FY 2019, the GLS Youth Suicide Prevention 

State and Tribal grant program was funded at $12 million from the Prevention and Public Health 

Fund (PPHF) and $22 million from SAMHSA’s base budget. In FY 2020 and FY 2021, 

SAMHSA also funded the GLS Youth Suicide Prevention State and Tribal grant program at $12 

million from the PPHF and $22 million from SAMHSA’s base budget. In FY2022, SAMHA is 

also requesting $12 million from the PPHF 

SAMHSA’s evaluation of national youth suicide prevention efforts (age 10 to 24) have shown that 

counties implementing SAMHSA funded GLS youth suicide prevention activities have lower rates 

of youth suicide deaths than matched counties not implementing such activities. This impact is 

maintained for two years and the impact appears directly related to years of continued funding. 

Approximately 50 percent of the counties in America have received at least one year of funding 

since the program started in 2005. Since 2005 over 1.6 million individuals participated in over 

39,000 training events or educational seminars provided by grantees. In FY 2019, 195,000 youth 

were screened for suicide risk, 30,362 youth were referred to services, and 76.3 percent received 

services. Grantees’ efforts are reducing the likelihood of at-risk youth falling through the gaps in 

the system through the provision of proactive follow up after Emergency Room and Inpatient 

discharge. 

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