Substance Abuse Prevention and
Treatment Block Grant (Set-aside)

(Dollars in thousands)

Authorizing Legislation - Section 1935 of the Public Health Service Act

Center for Substance Abuse Treatment

(Dollars in thousands)

Center for Substance Abuse Prevention

(Dollars in thousands)

Office of Applied Studies

(Dollars in thousands)

Purpose and Method of Operation...

Funding for set-aside activities totals $107.612 million, including $12.412 million from direct funding for the block grant and $95.200 million from PHS evaluation fund. The 5% set-aside of the Substance Abuse Prevention and Treatment Block Grant (SAPTBG) supports data collection, technical assistance, and program evaluation activities in CSAT, CSAP, and OAS. The SAPTBG set-aside also supports State activities for State data, State technical assistance and State evaluation. SAMHSA is the major source of national information in the United States on the extent and nature of substance abuse, the supply and cost of services for treating substance abuse, and the number and characteristics of persons in treatment. Information from SAMHSA surveys and other activities supported by the set-aside is used by the Department of Health and Human Services, the Office of National Drug Control Policy, the Drug Enforcement Agency, and State and local agencies to plan and evaluate programs to address health and social problems.

The growth in national data activities and other necessary projects continues to outpace the growth of the block grant set-aside. SAMHSA continues to prepare for implementation of performance partnership grants that are heavily dependent on data collection and analysis at both the state and national levels. To meet multiple needs as efficiently and economically as possible, SAMHSA is ensuring that to the extent possible, data requirements are aligned across programs. Nonetheless, it has become necessary for SAMHSA to draw upon multiple funding sources to accomplish activities that in theory could be funded by the set-aside. These sources have included, varying from year to year, Public Health Services Evaluation funds; program management funds; and PRNS funds in addition to block grant set-aside funds.

Consistent with SAMHSA's data strategy vision, SAMHSA will invest in measuring treatment outcomes for seven outcome domains consistently across all discretionary and formula funded programs employing a pre/post design. States and Territories will remain the key partner serving as a focal point for data compilation from direct service providers located within their jurisdiction or as the source of administrative data sets from which data will be extracted. As State data capabilities improve, the corresponding Federal data reporting programs will adjust to the common measures, improved reporting timelines, and other capabilities.

During FY 2003, SAMHSA initiated actions to implement the Vision. A complete review of the agency's data programs employing both internal and external workgroups was initiated. While the effort is not completed, substantial progress has been made. There is agreement with regard to addiction treatment that data collected from both the PPG/Block Grant and the discretionary programs must be uniform and well integrated, and work together to give a complete picture of treatment success and efficiency. Further agreement has been reached that treatment outcomes should be measured for seven domains: Drug/Alcohol Use, Employment/Education, Crime and Criminal Justice, Family and Living Conditions, Social Support, Access/Capacity, Retention. Specific measures for each of the seven outcome domains have been defined and will be published as Appendix C to the new Access to Recovery Program. Beginning in FY 04, CSAT and OAS will begin bringing their existing treatment data sets into alignment with the seven outcome measures and the pre/post design.

As acknowledged in the data vision, Federal reporting programs such as TEDS are constructed from State administrative data sets. To achieve the improvements in measurement, timeliness, and a pre/post design that SAMHSA desires, State data definitions, collection protocols, computer software, and analysis capabilities must be improved.

CSAT will have the lead in developing the required improvements for State data systems. The Technical Assistance to States for Performance Partnership project and other mechanisms as appropriate to individually assess the current capabilities of States and develop a plan to bring their data capabilities to the performance levels required by SAMHSA. These capabilities would include the seven common outcome measures and the ability to match records across programs and over time. CSAT's Web Technology contract has completed development of software for States to use to collect and manage data from their funded direct service providers thus expanding the information technology choices available to States. This software supports implementation of the outcome measures and a pre/post evaluation design. The Web Technology program offers the States an additional option to improve software capabilities to collect, compile, and manage data from direct service providers on admission and discharges in near real time. These resources should significantly increase the number of States that can report discharge data and the timeliness with which States can report to SAMHSA. FY 2005 program efforts will shift from development and testing to installation and operational support within States through the continuing Web Technology program and the State Data Capacity program.

OAS' DASIS/TEDS program will need to be brought into alignment with the seven common outcome measures as States implement the measures and the data management software. OAS is beginning to anticipate these developments in project management and planning.

Following termination of the original NTOMS contract, as part of the comprehensive review of all data programs, SAMHSA convened an outside group of senior scientists knowledgeable of the addiction outcome scientific literature, measurement, research designs, and sampling. ONDCP and SAMHSA agreed to the composition of the group. The group was charged with reviewing competing research designs for a national addiction treatment outcome monitoring system and developing a consensus recommendation for a research design for the Administrators consideration. The group is nearing completion of their final report. Approximately $22 million will be reserved for implementation of the design ultimately selected for a national outcome monitoring program for the next two years.

Rationale for the Budget Request
Funding available for set-aside activities will increase by $2.655 million over the FY 2004 Final Conference Action, from $104.957 million to $107.612 million. The OAS activities will decrease by $.435 million and CSAT activities will increase by $3.090 million. Funding from direct appropriation increases by $2.655, from $9.757 million to $12.412 million. Total funding of $95.200 million from the PHS evaluation fund is the same level as the FY 2004 Final Conference Action. This includes two transfers from the PHS evaluation fund: $16 million to program management for national surveys and $79.200 million to the SAPT block grant for data, technical assistance and evaluation activities. Funding from the PHS evaluation fund will account for approximately 88% of set-aside activities in FY 2005.

Accountability: Substance Abuse State Data Capacity Program. The FY 2005 Budget set-aside allocation to CSAT includes a total of $8.6 million for a State Data Capacity Program, which includes $6.6 million for State Data Strategy and continues Integration of State and Federal Data Systems begun in FY 2004. Because PART, GPRA, and the transition to Performance Partnership grants place new demands on data collection beyond descriptive statistics, States need infrastructure support to collect data that are sufficiently reliable and valid to be used for budget and other program management decisions at the State and Federal levels.

The proposed program will allow SAMHSA to support States in measuring treatment outcomes for seven outcome domains consistently across all discretionary and formula funded programs using a pre/post design. This program will be carried out via contracts, not grants. States and Territories will remain the key partner serving as a focal point for data compilation from direct service providers located within their jurisdiction or as the source of administrative data sets from which data will be extracted. As State data capabilities improve, the corresponding Federal data reporting programs will adjust to the common measures, improved reporting timelines, and other capabilities.

During FY 2004, CSAT and OAS will begin to bring their existing treatment data sets into alignment with the seven outcome measures and the pre/post design. In FY 2005, SAMHSA will begin to award contracts to implement needed systems and to obtain the data.