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III. Goals

SAMHSA has three strategic goals: Accountability, Capacity, and Effectiveness (ACE). The goals are connected to SAMHSA’s performance budget submissions and to the Administrator’s performance contract. This Strategic Plan contains a limited number of significant general goals, measures, and targets, organized by the ACE goals, that, when achieved, will constitute major programmatic and management accomplishments. Consistent with OMB guidance, the projected levels of goal achievement are consistent with anticipated resource levels.

SAMHSA’s budget submission aligns each major program with the strategic goal that best represents the program’s primary purpose. Program level performance measures with annual targets track contributions toward achievement of that goal. Program types include:

• Block/formula grants primarily support Capacity and are awarded to States or other entities designated by the program’s authorizing legislation. The legislation prescribes a formula used to determine allocations. A 5% set-aside from each of the two block grants supports technical assistance, data collection, and evaluation.

• Competitive grant programs provide funding to address targeted needs. SAMHSA currently uses four standard grant announcements as the basis for developing and continuing these programs: services grants and infrastructure grants, which support the Capacity goal; and best practice planning and implementation grants and service to science grants, which support the Effectiveness goal. Specific funding opportunities are announced at www.grants.gov. SAMHSA’s web site, which contains information about SAMHSA’s programs, including how to apply for funding, may be accessed at www.samhsa.gov.

• Substance abuse and mental health surveys provide critical demographic, epidemiological, and other information to the agency, to the substance abuse and mental health fields, and to the public, primarily supporting SAMHSA’s Accountability goal.

Accountability

The Accountability goal ensures focus on data strategy, data collection, evaluation, and performance measurement. A central element of SAMHSA’s data strategy is the collection of National Outcome Measures (NOMS) across SAMHSA programs. This goal also promotes management excellence. Success is measured through a variety of assessment mechanisms: the Office of Management and Budget (OMB) Program Assessment Rating Tool (PART); the Administrator’s annual performance contract; results from program performance measures; and other program and management assessments and evaluations. OMB reviews selected major programs each year through the PART process. SAMHSA then develops recommendations to address any negative findings. The purpose of the OMB process is to improve Federal programs over time.

General Goals and Performance Measures: Accountability

1. Achieve and maintain programmatic and management excellence

• Achieve and maintain an overall assessment of “Excellent” on the annual HHS Operating Division Organizational Assessment.

• Achieve and maintain at least a “Moderately Effective” PART rating on all programs by FY 2010 (i.e., reviews completed in FY 2010 for the FY 2012 budget submission).

• Implement PART program review findings and achieve milestones according to a schedule agreed upon with OMB.

2. Implement National Outcome Measures in SAMHSA programs

• Implement National Outcome Measures in Block Grant programs by the end of FY 2007

• Implement National Outcomes Measures in new competitive grant programs

Capacity

The Capacity goal contributes to increased service availability for people with or at risk for substance abuse and mental illnesses. The ability to collect unduplicated counts of persons served has been a major challenge for the substance abuse and mental health fields. Another measurement issue that surfaced as a result of the OMB PART reviews is the need for all Federal programs to have a sound efficiency measure. Accordingly, SAMHSA’s first general goal for Capacity deals with these key measurement issues.

SAMHSA’s most important programmatic activity within the Capacity goal is the implementation and future growth of a set of four major new capacity programs (“Redwoods”) designed to enhance access and service delivery to consumers, and result in sustained recovery. These programs, which build in sound outcome measures and data collection from the outset, will all be implemented by the end of FY 2005. The second general Capacity goal, accordingly, focuses on the implementation and subsequent performance of these programs. SAMHSA reviews its other programs as part of the budget planning process to determine whether they would have greater impact as separate programs or as part of one of the “Redwood” programs.

The capacity goal is supported by block and formula grant programs, and by two types of discretionary grant programs: services programs and infrastructure programs. Capacity efforts address areas such as resource and needs assessment; services expansion; services organization and financing; and education and retention of service providers.

Success is determined by measures of service expansion and/or infrastructure improvements (e.g., individuals served; community-based organizations funded; providers trained; cross system collaboration). Many services programs also collect and track client outcome data. To ensure quality, capacity programs utilize services that have been determined to be effective.

General Goals and Performance Measures: Capacity

1. Increase total number of persons served by SAMHSA services programs (competitive and block/formula) in each SAMHSA program priority area each year.

• Ensure that all SAMHSA services programs collect unduplicated counts of persons served. Obtain baseline data for programs currently without these data and set annual targets by the end of FY 2006.

• Ensure that all SAMHSA programs reviewed by PART have an efficiency measure, obtain baseline data, and set annual targets by the end of FY 2007.

2. Implement three new “Redwood” capacity programs (Access to Recovery and Strategic Prevention Framework State Incentive Grants, with first grants awarded at the end of FY 2004; Mental Health Systems Transformation State Incentive Grants, with first grants to be awarded at the end of FY 2005) and establish data reporting for the fourth “Redwood” program, the Co-occurring State Incentive Grants.

• Report baseline data and establish annual targets for the three new “Redwood” programs by the end of the first full year after first grants are awarded.

• Establish baselines and annual targets for the number of persons who receive assessment, and treatment if needed, for co-occurring disorders in SAMHSA’s Co-occurring State Incentive Grants program by the end of FY 2006.

• Establish baselines and targets for the number of persons who receive assessment, and treatment if needed, for co-occurring disorders in at least one CMHS and one CSAT service program by the end of FY 2007.

• Develop an outcome measure for individuals with co-occurring disorders that will be added to SAMHSA’s list of NOMS by the end of FY 2007.

Effectiveness

The Effectiveness goal contributes to the improvement of service quality. The general goals for Effectiveness address improved outcomes in programs that provide funds for direct services, as measured by SAMHSA national outcome measures; and the continuing documentation of effective practices. Two standard discretionary grant program types directly support this goal: Best Practices Planning and Implementation programs and Service to Science programs. Objectives for the Effectiveness goal span the transition from a promising idea or research finding to documentation and implementation of an improvement at the system/provider level. Objectives include identification and promotion of effective approaches, and implementation and evaluation of innovative services.

Success in Best Practices Planning and Implementation programs is measured primarily through evidence that the grantee has implemented an identified change successfully. Success in Service to Science requires adequate documentation and dissemination of potential service improvements to the field, and transfer of information about practices needing further study to services researchers.

General Goals and Performance Measures: Effectiveness

1. Improve outcomes for SAMHSA services programs as measured by SAMHSA National Outcome Measures (NOMS).

• Improve outcomes in each program priority area as measured by NOMS.

• With respect to the Substance Abuse Prevention and Treatment Block Grant program and the Mental Health Block Grant program, by FY 2007, a majority of States that can report baseline plus at least two years of NOMS performance data will reach their NOMS performance targets.

2. Increase the number of documented service improvements that are included in the SAMHSA National Registry for Effective Programs and Practices.

• By FY 2007, increase the total number of qualified programs that are included in the SAMHSA National Registry for Effective Programs and Practices by at least 10% from a FY 2005 baseline.

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