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SAMHSA News - March/April 2008, Volume 16, Number 2


President’s Budget Focuses on Priority Initiatives

SAMHSA recently presented its Fiscal Year (FY) 2009 Congressional Justification, outlining a budget request totaling $3.2 billion. The request reflects President George W. Bush’s focus on balancing the budget by 2012.

The Justification also echoes SAMHSA’s focus on sustaining important initiatives to build resilience and promote recovery for people across the Nation.

Although the budget request reflects a 6-percent reduction from the FY 2008 enacted level, it continues support for the priority initiatives identified by President Bush and Health and Human Services Secretary Michael O. Leavitt.

The President’s Budget also makes performance-driven, targeted reductions in areas where grantees have not demonstrated improved health outcomes, grant periods are ending, activities can be supported through other funding streams, or efficiencies can be realized.

With a focus on a life in the community for everyone, SAMHSA’s Congressional Justification provides a financial incentive for states and territories to improve their substance abuse prevention and treatment services.

The Justification also provides flexibility for states and localities to respond to their unique behavioral health needs. It also prioritizes programs that use local resources to achieve improved health outcomes.

“SAMHSA’s budget request is built around a public health approach that seeks to reduce the risk for substance abuse and mental illness in the community,” said SAMHSA Administrator Terry L. Cline, Ph.D. “This approach is comprehensive and also is designed to help those in need of treatment services to obtain them.”

The President’s FY 2009 Budget for SAMHSA’s Programs of Regional and National Significance proposes $155.3 million for the Center for Mental Health Services (CMHS), $158.0 million for the Center for Substance Abuse Prevention (CSAP), and $336.8 million for the Center for Substance Abuse Treatment (CSAT).

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New Programs

SAMHSA’s Congressional Justification supports several new programs.

Mental Health and Prevention Targeted Capacity Expansion (TCE). More than $14 million is proposed to help communities bridge gaps in mental health and prevention services. Grants will be awarded to state and local governments, communities, and tribes to provide evidence-based treatment and prevention practices to address emerging health needs.

Mental Health TCE. Up to 14 TCE grants will be awarded to address emerging mental health needs, including those for school violence, post-traumatic stress disorder, homelessness, and the needs of older adults.

Prevention TCE. Up to 14 TCE grants will be awarded to address needs related to methamphetamine or alcohol activities, or other local priority areas.

Data Evaluation. Slated to begin in 2009, $2.5 million is allotted for a comprehensive needs assessment and evaluation of substance abuse data surveillance systems across the Government in order to improve data collection, reduce costs, and eliminate duplicative systems.

All SAMHSA data collection programs will be evaluated, including the National Survey on Drug Use and Health (NSDUH), the Drug Abuse Warning Network (DAWN), the National Survey of Substance Abuse Treatment Services (N-SSATS), and the Treatment Episode Data Set (TEDS).

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Program Increases

SAMHSA’s Congressional Justification also provides additional funding for successful grant programs.

Screening, Brief Intervention, and Referral to Treatment (SBIRT). The FY 2009 budget includes $56.2 million for SBIRT, an increase of $27.0 million over FY 2008. Initiated in CSAT in 2003, the program educates patients about the consequences of substance abuse and integrates screening, brief intervention, referral, and treatment services into general medical and primary care settings. (See Screening Works: Update from the Field.)

The SBIRT approach allows providers to intervene early, before individuals become addicted, to help prevent the harmful effects of substance abuse.

Treatment Drug Courts. In support of increased collaboration and coordination with the U.S. Department of Justice, a total of $40.0 million is proposed for drug and mental health treatment courts—an increase of $30.0 million from FY 2008.

Mental Health Drug Courts. Of the total, $2.2 million is proposed for five grant awards to help ensure clients have access to a full range of mental health and recovery support services. Mental health courts seek to reduce recidivism by offering the possibility of dismissal of charges or reduced sentencing upon successful completion of mental health treatment.

Treatment Drug Courts. The allotment will fund all grant and contract continuations and create 82 new grants. SAMHSA’s criminal justice program grantees focus on diversion and reentry for adolescents and adults with substance use disorders. Treatment drug courts are designed to combine the sanctioning power of courts with effective treatment services to break the cycle of child abuse and neglect or criminal behavior, alcohol and drug use, and incarceration. (See SAMHSA News online, March/April 2006.)

Children’s Mental Health. The budget includes $114.5 million, an increase of $12.2 million from FY 2008, to fund 75 children’s mental health services grants and contracts. This program directly supports SAMHSA’s Children and Families priority area.

First authorized in 1992, the program supports the development of comprehensive, community-based systems of care for children and adolescents with serious emotional disorders and their families. (See SAMHSA News online, May/June 2007.)

Projects for Assistance in Transition from Homelessness (PATH). In FY 2009, the PATH formula grant program is allotted $59.7 million, an increase of $6.4 million from FY 2008. These funds are expected to allow the program to contact approximately 150,000 people.

Established in 1991, PATH funds community-based support services to individuals with serious mental illnesses who are homeless or at risk of becoming homeless. Grantees help link hard-to-reach people who are homeless with mental health and substance abuse treatment and housing, regardless of the severity and duration of these individuals’ illnesses.

Substance Abuse Prevention and Treatment (SAPT) Block Grant. The budget includes $1.8 billion, an increase of $20 million from FY 2008, for the SAPT Block Grant. The program’s overall goal is to support and expand substance abuse prevention and treatment services while providing maximum flexibility to the states, territories, and tribes receiving funding.

The SAPT Block Grant program has expanded treatment by supporting more than 1.8 million client admissions to treatment programs that receive public funding.

Access to Recovery (ATR). The President’s ATR initiative, which gives vouchers to clients in substance abuse treatment so they can access treatment and support services, is slated to be funded at $99.7 million in FY 2009.

This funding will support 24 continuation grants to states and tribal organizations and includes $1.7 million in Public Health Service evaluation funds.

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Other Funding

Science and Service Activities. Science and Service programs promote the identification and increase the availability of practices that are thought to have broad potential for service improvement.

SAMHSA’s Congressional Justification requests funding for Science and Service programs for CMHS ($8.6 million), CSAP ($13.2 million), and CSAT ($14.1 million).

Funding supports various activities, including those related to fetal alcohol spectrum disorders, the National Registry of Evidence-Based Programs and Practices, HIV/AIDS education, the SAMHSA Health Information Network, and Addiction Technology Transfer Centers.

SAMHSA’s Congressional Justification is available at http://samhsa.gov/Budget/FY2009/index.aspx.

For more detailed information about the President’s FY 2009 Budget, visit www.hhs.gov/budget/09budget/2009BudgetInBrief.pdf.

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SAMHSA Budget Authority by Activity
(Dollars in Millions)

  2007 2008 2009
Substance Abuse:      
  Substance Abuse Block Grant $1,759 $1,759 $1,779
  Programs of Regional and
  National Significance:
     
    Treatment 399 400 337
    Prevention 193 194 158
Subtotal, Substance Abuse $2,350 $2,353 $2,273
Mental Health:      
  Mental Health Block Grant $428 $421 $421
  PATH Homeless Formula Grant 54 53 60
  Programs of Regional and
  National Significance
263 299 155
  Children's Mental Health
  Services
104 102 114
  Protection and Advocacy 34 35 34
Subtotal, Mental Health $884 $911 $784
  Program Management $93 $93 $97
Total, Program Level $3,327 $3,356 $3,158
Less Funds Allocated from Other Sources:      
  PHS Evaluation Funds -121 -122 -133
Total, Budget Authority $3,206 $3,234 $3,025
FTE 528 534 528
Source: U.S. Department of Health and Human Services Web site, “Budget in Brief,” at www.hhs.gov/budget/09budget/2009BudgetInBrief.pdf (page 43, PDF format).
 

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