Center for Mental Health Services Programs of Regional & National Significance (PRNS)

(Dollars in thousands)

Authorizing Legislation - Sections 501, 506, 520A, 581, 582, 1971 of the PHS Act
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2005 Authorization (Sections 501, 506, 520A, 520G, 581 and 1971) Expired
2005 Authorization (Section 582) Such sums as necessary

Purpose and Method of Operation

The PRNS budget proposal accounts for the majority of the CMHS discretionary budget. The proposed PRNS increase is $30 million above the FY 2004 final conference level. The proposed budget will support 412 grants and contracts, consisting of 330 continuations and 82 new/competing.

In SAMHSA, there are two program categories within Programs of Regional and National Significance. The first category promotes capacity expansion through services programs, which provide funding to implement a service improvement using a proven evidence based approach; and through infrastructure programs, which identify and implement needed systems changes. Key success indicators for most programs of this type are positive systems changes, enhanced capacity, and improved client outcomes. The second category promotes effectiveness through local best practices programs, which help communities and providers to identify, adapt, implement, and evaluate best practices; and service to science programs, which document innovative practices thought to have potential for broad service improvement. In general, the outcomes of these programs are measured by indicators such as the identification of a practice to be implemented and pilot adoption; satisfaction with information or assistance received; actual changes to practice that have occurred; and client outcome data. While many activities contribute to CMHS' accomplishments, several major programs account for the majority of funding.

As mentioned previously, the PRNS increase will be utilized to initiate a State Incentive Grants for Transformation program to implement the Mental Health Commission's findings. A description of this program, which is proposed to be funded at $43.8 million dollars in FY 2005, may be found later in this section.

Approximately $15 million are expended for the Co-occurring State Incentive Grants Program, administered jointly with CSAT. This program enables States to develop and enhance their service system infrastructure in order to increase their capacity to serve people with co-occurring substance abuse and mental disorders.

$30 million are expended for the National Child Traumatic Stress Initiative program. This program has established 54 treatment development and community service centers to treat children who have experienced trauma. The program also supports the National Center for Child traumatic Stress, which coordinates a national network of grantees. Approximately 40,000 children and adolescents were served by this program in 2003.

$95 million support the School Violence initiative, including the Safe Schools/Healthy Students interdepartmental program. The program was created in 1999 as a collaborative effort of the Federal Departments of Education, Justice, and Health and Human Services. Local education authorities that apply for the SS/HS grants are required to have formal partnerships with local mental health and law enforcement agencies. As a result of these partnerships, comprehensive plans have been developed and implemented with the goals of promoting the healthy development of children and youth, fostering their resilience in the face of adversity, and preventing violence.

$11 million support State Data Infrastructure grants, which are enabling States to report data on the characteristics and performance of their mental health systems. States are adopting common data and information technology standards with a focus on improving information from the local provider sector.

The CMHS PRNS program has not yet been reviewed by the OMB PART review process.

Funding levels for the PRNS program over the past five fiscal years were as follows:

Funding FTEs

2000 - $136,733,000 -
2001 - 203,390,000 -
2002 - 229,507,000 -
2003 - 244,443,000 -
2004 - 240,796,000 -

Rationale for the Budget Request

Mental Health Systems Transformation Priority Area
Capacity: Mental Health State Incentive Grants for Transformation Program (Total funding: $43.8 million, including $30 million from the PRNS increase)

The goal of this new program is to create comprehensive State mental health plans that will enhance the use of existing resources to serve persons with mental illnesses. These plans will increase the flexibility of resources at the State and local levels, hold State and local level of government more accountable, and expand the option and array of available services and supports.

In the first year, the development of the plan will require Statewide planning efforts across multiple service systems and State agencies to help the State better meet the complex needs of individuals with serious mental illnesses and children with serious emotional disturbances and their families. In subsequent years, States will be permitted to use a portion of the funds to support the work of community-based programs as outlined by the State plan, while the remaining funds will continue to support State planning and coordination activities. With an optimally effective State infrastructure and plan in place, federal, State and local resources can be utilized and leveraged in the most effective way to improve mental health services. For example, by facilitating systems change, States could use Block grant funds more effectively. Over time, the goal would be to award a grant to each State. In FY 2005, it is expected that 14 grants will be awarded.

See Also:

CMHS Program Priority Areas
Mechanism Tables
PRNS Program Priority by Best Practices
PRNS Program Priority by Targeted Capacity Expansion
Summary Listing of Activities