SAMHSA logo Report to Congress - Nov 2002








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 Substance Abuse Prevention and Treatment Block Grant


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The Substance Abuse Prevention and Treatment Block Grant

The Substance Abuse Prevention and Treatment Block Grant, established in fiscal year 1993, is the cornerstone of the States' programs for substance abuse treatment and prevention. Funds are allocated to the States, Territories, the District of Columbia, and one Indian tribe based on a congressionally mandated formula, and the program is administered by SAMHSA's Center for Substance Abuse Treatment and Center for Substance Abuse Prevention. Currently, more than 10,500 community-based organizations receive SAPT Block Grant funds from the States.

SAPT Block Grant funds are intended to be used for a wide range of activities related to the abuse of alcohol, the use or abuse of illicit drugs, the abuse of licit drugs, and the use or abuse of tobacco products. Funding agreements with States through the SAPT Block Grant also include a number of provisions relating to intravenous substance abuse and tuberculosis and human immunodeficiency virus (HIV) testing and services, group homes for recovering substance abusers (made optional under the Children's Health Act of 2000), and peer review requirements.

The SAPT Block Grant provides States with the flexibility to plan, carry out, and evaluate substance abuse prevention and treatment services provided to individuals and families. The grant also provides a 20 percent set-aside for support of substance abuse prevention. States are required to expend their primary prevention services funds using six specific strategies. These include: community-based processes, information dissemination, education, alternative activities, problem identification and referral, and environmental strategies. A seventh category labeled "other" strategies can also be approved but on a limited basis. In Federal fiscal year 1997 (the most recent expenditure data available), States expended $262 million in these particular categories. The activities reported do not vary greatly from year to year. A summary of each strategy and their reported expenditures is presented below. Although not targeted specifically to co-occurring disorders, all activities critical to prevention promote positive mental health and substance abuse prevention.

Community-based processes comprised 17 percent of the total expended by the States. This strategy includes working with communities to effectively address alcohol treatment outcome data prevention efforts. Examples are training of volunteers, the development of community coalitions, and neighborhood action training.

States expended 18 percent of the total for information dissemination activities. This activity includes, but is not limited to, the development of educational brochures, pamphlets, and other media materials for dissemination to youth, parents, teachers, and the general public.

States expended 34 percent of their prevention funding applying educational strategies. This includes, but is not limited to, education and training in life skills, problem solving and developing peer resistance skills.

States expended 10 percent of their funds for alternative activities. This includes activities such as drug free dances, leadership activities, and drop-in centers.

A total of 13 percent was expended for problem identification and referral. This strategy often includes the identification of individuals at-risk for substance use and referring those individuals to appropriate services and counseling.

The balance of expenditures was divided between the last two strategies - environmental strategies, and the "other" category. A total of 6 percent was expended in the "other" category which may include such initiatives as HIV prevention efforts. Environmental strategies were 2 percent of the total expended. These activities include maximizing enforcement of tobacco and alcohol access laws and modifying alcohol and tobacco advertising practices.

Technical Assistance Activities in Support of Co-Occurring Disorders

SAMHSA's State Systems Development Program (SSDP) - an enhanced technical assistance program involving conferences and workshops, development of training materials and knowledge transfer manuals, and on-site consultation assists States with the administration and implementation of SAPT Block Grant activities. The SSDP plays a critical role in helping States address the issue of co-occurring substance abuse disorders and mental disorders.

The Treatment Improvement Exchange (TIE), another aspect of SSDP, facilitates and promotes information exchange between CSAT and State and local alcohol and substance abuse agencies. The TIE program is the hub for the full range of SSDP technical assistance services including information development and dissemination; State, regional, and national conferences; and on-site expert consultation.

In August 2000, the TIE launched the Co-Occurring Dialogues discussion list, a moderated group accessed through electronic mail. The list provides a forum to discuss the broad range of issues related to the prevention and treatment of co-occurring disorders. Subscription to the list is free and unrestricted. Members include consumers; family members; treatment providers; researchers; local, State, tribal, and national organizations; and others with a special interest in the subject of co-occurring disorders. Today, the discussion group includes more than 700 members, with approximately 150 messages processed per month. The list continues to grow and provides a valuable forum for information exchange and for dialogue on topics of special interest to the field.


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