SAMHSA logo Report to Congress - Nov 2002

 

 

 

 

REPORT TO CONGRESS ON THE PREVENTION AND TREATMENT OF CO-OCCURRING SUBSTANCE ABUSE DISORDERS AND MENTAL DISORDERS

 

 


Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services

Chapter 2 - The States Respond: The Impact of Federal Block Grants - The Community Mental Health Services Block Grant

 

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The Community Mental Health Services Block Grant

The Community Mental Health Services Block Grant, established in 1981, is the cornerstone of the Federal partnership with States to plan and deliver state-of-the art, community-based services to the most vulnerable individuals with mental illnesses. The Center for Mental Health Services allocates CMHS Block Grant funds based on a legislated formula to the 59 States and Territories to develop or expand community-based systems of care for adults with serious mental illnesses and children with serious emotional disturbances. States have a great deal of flexibility in their use of CMHS Block Grant funds.

CMHS Block Grant Support for People with Co-Occurring Disorders

The law reauthorizing SAMHSA and its programs resulted in changes that affect State planning for people who have co-occurring disorders. In particular, the new statute added a requirement that States include in their State mental health plans a description of their services for individuals with co-occurring substance abuse disorders and mental disorders. In addition, the statute now permits States to use their CMHS Block Grant funds to serve individuals with co-occurring disorders, as long as the funds are used "for the purposes for which they were authorized by law and can be tracked for accounting purposes" (Section 1956 of the legislation). This codified in law the previous SAMHSA policy that States could allocate CMHS Block Grant funds to serve individuals with co-occurring disorders.

State Plans

As part of their CMHS Block Grant application, States must submit a plan to delineate how they will create and maintain "an organized community-based system of care for individuals with mental illnesses and describe available services and resources in a comprehensive system of care, including services for dually diagnosed individuals (Section 1912 of the legislation; emphasis added). As an example, the State of Tennessee in fiscal year 1999 established the "Co-occurrence Subcommittee" of the Tennessee Statewide Mental Health Planning Council (CMHS Block Grant).

A review of State plans for fiscal year 2002 reveals that all 59 States and Territories described activities to address co-occurring disorders. The activities delineated generally fit into one or more of these categories: planning, training, service delivery, and outcomes measurement. Forty-one States reported on their service delivery system for individuals with co-occurring disorders; 31 States are actively engaged in strategic planning for co-occurring disorders; and 23 States are providing training to professionals serving individuals with co-occurring disorders. Seven States report that they are in the process of collecting data on co-occurring disorders outcomes, and three States (Kansas, Ohio, and Oregon) plan to establish multiple Centers of Excellence to deliver evidence-based practices to people with co-occurring substance abuse disorders and mental disorders.

More than half of the States (28) reported they are planning to provide or currently are providing integrated services for people with co-occurring disorders. Two States (Hawaii and New Hampshire) have designed co-occurring disorders programs specifically for adults who also are homeless; two States (New Jersey and Wisconsin) have created services for older adults with co-occurring disorders; and Minnesota is providing co-occurring services to members of an American Indian tribe (see Appendix V).

Technical Assistance, Data Collection, and Evaluation

Technical assistance, data collection, and evaluation activities support States and Territories and their representatives, and to Mental Health Planning Council members, consumers, and family members including:

The National Technical Assistance Center for State Mental Health Planning provides technical assistance to State mental health agencies to improve the design, delivery, and evaluation of mental health services-including services for people who have co-occurring disorders.

The Targeted Technical Assistance Project provides state-of-the-art guidance to State mental health agencies and other stakeholders to enhance systems of care for adults with serious mental illnesses and children with serious emotional disturbances, including those who have co-occurring disorders.

The Olmstead Project promotes the development of statewide coalitions, and provides technical assistance and training to State groups to design community integration plans for adults with serious mental illnesses and children with serious emotional disturbances, including those who have co-occurring substance abuse disorders and mental disorders.

The Mental Health Statistics Improvement Program is designed to develop state-level minimum data standards that provide a basis for uniform, comparable, high-quality statistics on mental health services, including co-occurring disorders.

The Technical Assistance Center for the Evaluation of Adult Mental Health Systems Change helps States conduct evaluations of programs and systems to improve the planning, development, and operation of adult services, including services for people who have co-occurring disorders, operated under the CMHS Block Grant.

 

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