FACT SHEET

Substance Abuse Prevention and Treatment Block Grant

Early Intervention Services for HIV

Program Intent

The Substance Abuse Prevention and Treatment Block Grant (SABG) program was 

established by Congress to provide funds to states, jurisdictions and one Indian tribe for 

the purpose of planning, carrying out and evaluating activities to prevent and treat 

substance abuse and related public health services, i.e., tuberculosis services and early 

intervention services for HIV. The SABG is the largest federal program dedicated to 

expanding existing and establishing new substance abuse prevention and treatment 

capacity in the states’ and jurisdictions’ healthcare delivery systems. 

Program Purpose

To provide early intervention services for HIV at the sites at which individuals receive 

substance use disorder treatment services

• The ADAMHA Reorganization Act of 1992 (P.L. 102-321) amended Title XIX of 

the Public Health Service Act and established the Substance Abuse Prevention 

and Treatment Block Grant (SABG) program.

• “The conferees intend for these services to include routine offering and 

encouragement of HIV counseling, testing (including confirmatory and diagnostic 

testing such as T cell counts), and the provision of prophylactic and anti-viral 

prescription drugs (such as those to prevent and treat opportunistic infections and 

to slow the progress of the illness). The conferees recognize that funds are 

extremely limited. In this program, especially in light of the number of substance 

abusers who are infected with HIV, and therefore understand that the services 

provided are not comprehensive but rather the minimum needed to encourage a 

substantial number of substance abusers to learn of their HIV infection, educate 

them in ways to avoid transmission of HIV to others, and maintain their health.” 

The ADAMHA Reorganization Act Conference Report (102-546). 

• Beginning in federal fiscal year (FY) 1993, states and jurisdictions with an AIDS 

case rate of 10 or more such cases per 100,000 individuals (“designated states”) 

were required to obligate and expend a percentage of their respective SABG 

allotments for early intervention services for HIV. The term “early intervention

services for HIV” means “(i) appropriate pretest counseling; (ii) testing 
individuals with respect t such disease, including tests to confirm the presence of 

the disease, tests to diagnose the extent of the deficiency in the immune system, 

and tests to provide information on therapeutic measures for preventing the 

deterioration of the immune system and for preventing and treating conditions 

arising from the disease; (iii) appropriate post-test counseling; and (iv) providing 

the therapeutic measures described in clause (ii).”

• Section 1924(a) of Title XIX, Part B, Subpart II of the PHS Act (42 USC § 300x24(a)) requires “designated states” to establish one or more projects designed to 

provide early intervention services for HIV at the site(s) at which individuals 

receive substance use disorder treatment services.

• The applicable percentage of the SABG that “designated states” were required to 

obligate and expend was equal to 2 to 5 percent. The applicable percentage was 

determined by the percent change in their respective fiscal year SABG allotments 

relative to their respective 1991 Alcohol, Drug Abuse and Mental Health Services 

(ADMS) Block Grant allotments.

• As the SABG appropriation increased, the applicable percentage change in the 

states’ and jurisdictions’ allotments increased and their respective increases were 

greater than 5 percent; therefore, all “designated states” are required to obligate 

and expend 5 percent of their respective SABG allotments for early intervention 

services for HIV. The set-aside is both a floor and ceiling. 

• The intent of the authorizing legislation is further operationalized by regulation. 

The Substance Abuse Prevention and Treatment Block Grant; Interim Final Rule 

(45 CFR § 96.128) 

• The states and jurisdictions are required to prepare and submit an annual report 

which provides a brief description of the community based organizations that 

received SABG funds for a project to provide early intervention services for HIV. 

• In the FY 2013 SABG Report, the “designate states” 

Surveys of States and Jurisdictions

SAMHSA’s Center for Substance Abuse Treatment designed two surveys administered to 

the states and jurisdictions and produced reports which were disseminated to the states 

and jurisdictions 

• Report on the Survey of Single State Authorities Regarding the HIV Set-Aside of 

the Substance Abuse Prevention and Treatment Block Grant, February 2000. 

• Report on the Survey of Single State Authorities Regarding the HIV Set-Aside of 

the Substance Abuse Prevention and Treatment Block Grant, April 2006 
Additional Resource Information 

National Association of State Alcohol and Drug Abuse Directors (NASADAD)

Research and Program Applications

HIV Coordinators