The Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment and Center for Mental Health Services is accepting applications for fiscal year (FY) 2014 Cooperative Agreements to Benefit Homeless Individuals for States (CABHI-States). The purpose of this jointly funded program is to enhance or develop the infrastructure of states and their treatment service systems to increase capacity to provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based treatment services; permanent housing; peer supports; and other critical services for the following: veterans who experience homelessness or chronic homelessness, and other individuals (non-veterans) who experience chronic homelessness. SAMHSA funds must be used to serve individuals with substance use disorders, serious mental illnesses (SMI), (e.g., diagnostic criteria including but not limited to schizophrenia, bipolar disorder, and SMI functional criteria), or co-occurring substance use and mental disorders. SAMHSA seeks to increase the number of program-enrolled individuals placed in permanent housing that supports recovery through comprehensive treatment and recovery-oriented services for behavioral health.
As a result of this program SAMHSA expects the following outcomes: 1) increased number of strategies associated with addressing the needs of veterans who experience homelessness, veterans who experience chronic homelessness and individuals who experience chronic homelessness who also have behavioral health disorder(s); 2) increased number of individuals who receive behavioral health and recovery support services in permanent housing; and 3) increased number of individuals placed in permanent housing and enrolled in Medicaid and other mainstream benefits (e.g., SSI/SSDI, TANF, SNAP).
The major goal of the CABHI-States program is to ensure, through state and local planning and service delivery, that veterans who experience homelessness or chronic homelessness, and other individuals (non-veterans) who experience chronic homelessness (hereinafter collectively referred to as “population of focus”) receive access to sustainable permanent housing, treatment, recovery supports, and Medicaid and other mainstream benefits. To achieve this goal, SAMHSA funds will support three primary types of activities:
- Enhancement or development of a statewide plan to ensure sustained partnerships across public health and housing systems that will result in short- and long-term strategies to support individuals (including veterans) who experience chronic homelessness and veterans who experience homelessness.
- Delivery of behavioral health, housing support, peer, and other recovery-oriented services.
- Assist the state Medicaid eligibility agency in developing a streamlined application process for the population of focus and assist providers (e.g., alcohol and drug treatment facilities, homeless service providers) seeking to become qualified Medicaid providers; engage and enroll eligible persons constituting the population of focus in Medicaid and other mainstream benefit programs (e.g., SSI/SSDI, TANF, SNAP).
Grant funds may not be used when individuals have access to other resources that cover the same services (e.g., HUD-Veterans Affairs Supportive Housing [VASH]). Grantees must use SAMHSA funds in a way that is complementary to Medicaid, HUD, VA and other benefits.
In 2010, the U.S. Interagency Council on Homelessness (USICH) approved Opening Doors, a Federal Strategic Plan to Prevent and End Homelessness. One of the goals of this Strategic Plan is to achieve the goal of ending homelessness for veterans and chronic homelessness in general by 2015. SAMHSA is committed in the effort to achieve this and other goals in the Federal Strategic Plan. This program prioritizes veterans who experience homelessness or chronic homelessness and other individuals (non-veterans) who experience chronic homelessness with serious mental illness, substance use disorders or co-occurring substance use and mental disorders.
On a single night in January 2013, there were an estimated 610,042 sheltered and unsheltered people who are homeless nationwide. Of those, approximately 109,132 were experiencing chronic homelessness and approximately 57,849 were identified as veterans experiencing homelessness.
Persons experiencing homelessness have higher rates of substance use and problems with mental health, physical health, legal, and employment issues than those with permanent housing. Although the relationship between housing status and clinical treatment outcomes is a complex one, some studies suggest that associations exist between stable housing, lower utilization of hospital services, and more positive treatment outcomes among certain populations. Permanent housing that is offered following or concurrent with recovery oriented and treatment focused integrated care models can result in improved clinical outcomes.
The linkage between stable permanent housing and behavioral health services is critical for recovery. For many in recovery from substance use disorders, drug-free housing can assist with achieving long-term recovery. Such “recovery housing” can be provided through a variety of models ranging from peer-run, self-supported, drug-free homes to community-based housing that includes a range of supportive services.
SAMHSA has demonstrated that behavioral health is essential to health, prevention works, treatment is effective, and people recover from mental, substance use, and co-occurring mental and substance use disorders. To continue to improve the delivery and financing of prevention, treatment and recovery support services, SAMHSA has identified eight Strategic Initiatives to focus the Agency’s work on people and emerging opportunities. More information is available at the SAMHSA Web site: http://beta.samhsa.gov/about-us/strategic-initiatives. This program specifically aligns with SAMHSA’s Recovery Support Strategic Initiative and addresses, the expected impact on behavioral health disparitites. See Appendix I of the RFA: Addressing Behavioral Health Disparities).
CABHI-States is one of SAMHSA’s services grant programs. SAMHSA intends that its services grants result in the delivery of services as soon as possible after award. Service delivery should begin by the 4th month of the project at the latest.
CABHI-States grants are authorized under Sections 509 and 520A of the Public Health Service Act, as amended. This jointly funded program will allow enrollment of individuals with substance use disorders or serious mental illnesses and/or co-occurring substance use and mental disorders. This announcement addresses Healthy People 2020 Mental Health and Mental Disorders Topic Area HP 2020-MHMD and Substance Abuse Topic Area HP 2020-SA.