Substance Abuse and Mental Health Services Administration
General Statement/Overview

(Dollars in thousands)

Agency Overview

Background

SAMHSA's vision as an agency of the Federal Government is "A Life in the Community for Everyone." SAMHSA's mission is to build resilience and facilitate recovery for people with or at risk for substance abuse and mental illness. SAMHSA was established in 1992 and reauthorized in 2000. SAMHSA administers a combination of competitive, formula, and block grant programs and data collection activities. Programs are carried out through the Center for Mental Health Services (CMHS); the Center for Substance Abuse Prevention (CSAP); the Center for Substance Abuse Treatment (CSAT); and the Office of Applied Studies (OAS). Reauthorization for SAMHSA and its programs will be considered in the next Congressional session.

SAMHSA provides services indirectly through grants and contracts. SAMHSA's resources enable service capacity expansion and the implementation of evidence-based practices. The agency seeks to engage all communities in providing effective services by facilitating access to the latest information on evidence-based practices and accountability standards.

In 2002, SAMHSA began to develop a strategic plan. Agency goals are Accountability, Capacity, and Effectiveness. A chart showing the vision, mission, goals and objectives may be found at the end of this section. Pending broad constituent and public input and HHS approval, SAMHSA intends to issue the new strategic plan in 2004. The FY 2004 and FY 2005 budget submissions align the budget request with the three goals.

SAMHSA's matrix of program priorities and cross-cutting principles has guided the agency's daily operations and overall program and management decisions for the past two years. The program categories used in the FY 2004 and FY 2005 budget requests align with the matrix. The updated matrix is included at the end of this section. Action plans are under development for each program priority area.

SAMHSA's planning and budget decisions also emphasize alignment with HHS goals. All of SAMHSA's activities directly support HHS strategic objectives 1.4, 1.5, and 3.5, and all management objectives.

In 2003, SAMHSA developed four standard announcements for grant programs that provide a framework for reviewing current PRNS programs and developing future activities. These standard announcements are being implemented for FY 2004 grant programs. The four mechanisms accomplish the necessary steps to move promising practices through an assessment process and into actual adoption in service settings.

Current Initiatives

The FY 2005 budget request is focused primarily upon four areas:

• President's Drug Treatment Initiative - FY 2005 is the fourth year of this five year initiative to increase substance abuse treatment capacity.

• Mental Health Systems Transformation - Implementation of the findings of the President's New Freedom Commission on Mental Health, including a proposed State Incentive Grants for Transformation program.

• Strategic Prevention Framework - A new approach to identifying and implementing improved prevention services.

• Performance Partnership Grants - Transformation of the current Block Grants in order to improve State and federal accountability and increase State flexibility in use of funds.

Further detail on each of these areas may be found in the budget narrative.

In July 2003, the President's New Freedom Commission on Mental Health released its final report, which highlights ways to ensure the promise of community living for individuals with serious mental illness or serious emotional disturbance. President Bush directed the Commission to study the problems and gaps in the mental health system and make concrete recommendations for immediate improvements. The Commission's conclusions are described in the CMHS section of this narrative. SAMHSA has the lead role for HHS in developing an action agenda to incorporate the Report's recommendations into HHS and other Departments' programs. In direct response to the Commission's findings, CMHS is proposing to implement a new program in FY 2005: State Incentive Grants for Transformation. The new program will support development of a comprehensive State mental health plan and far-reaching improvements to the mental health services infrastructure.

SAMHSA's Strategic Prevention Framework has been developed recently, based upon SAMHSA's goals of Accountability, Capacity, and Effectiveness. Through the Strategic Prevention Framework, which is described in the CSAP section of this narrative, SAMHSA builds capacity within States and the prevention field to promote resiliency and decrease risk factors in individuals, families, and communities. Funds were realigned in FY 2004 to implement the Framework, using a variety of programs. The State Incentive Grants (SIG) program will continue to be a major tool to help States and communities expand and improve services. In FY 2004 and 2005, prevention efforts will include a major emphasis on the prevention of underage drinking.

Summary of the Budget Request
The request includes a net increase of $50.0 million for mental health services; a net decrease of $2 million for substance abuse prevention services; a net increase of $151 million for substance abuse treatment services; and level funding for program management. Increases are recommended in direct support of two Presidential priorities. The table below shows the requested changes in the budget:

(dollars in millions)

The $30 million increase requested for mental health services Programs of Regional and National Significance (PRNS) reflects investment in a new State Incentive Grants for Transformation program, supporting the recommendations of the President's New Freedom Commission on Mental Health. This program will increase the number of persons served as well as improving outcomes for program participants. Specific targets have not been set, pending award of grants and collection of baseline data.

The $4 million increase requested for the Children's Mental Health Services Program will support the award of additional grants to implement comprehensive, community based systems of care for children and adolescents with serious emotional disturbance. Outcomes of this program (e.g., school performance; rate of arrests; problem behaviors) have been consistently positive.

The $5 million increase requested for the PATH program will result in 7,500 more homeless individuals with serious mental illness being contacted through outreach efforts, and an increase from 44% to 47% in those contacted who become enrolled in community based services.

The $1 million increase requested for the Mental Health Block grant will help to maintain the current level of services, which, according to new data, reach a system-wide total of about 4,276,000 individuals. This total includes those served in the public mental health system, which includes other funding sources such as Medicaid dollars.

The $10 million request for the Samaritan Initiative will fund the HHS contribution to this interagency initiative, which will permit States and localities to access the full range of services that chronically homeless people need.

The $98 million increase requested for substance abuse treatment services PRNS will provide most of the funding needed to bring total funding for the Access to Recovery program to $200 million in FY 2005. The requested increase supports the President's Drug Treatment Initiative.

The $53 million increase requested for the Substance Abuse Prevention and Treatment (SAPT) Block Grant will maintain current services. The requested increase supports the fourth year of the President's Drug Treatment Initiative, and will result in an estimated total of 1,950,000 individuals served through Block Grant funds.

FY 2006 Plans for Budget/Performance Integration

SAMHSA is prepared to submit a fully integrated performance budget for FY 2006. SAMHSA is in the process of incorporating performance planning and reporting within its budget plan. Mental health services, substance abuse prevention, and substance abuse treatment will remain SAMHSA's performance program areas. Each performance program area will contain goals, measures, and indicators consistent with SAMHSA's strategic goals: Accountability, Capacity, and Effectiveness.

A number of agency activities are facilitating SAMHSA's transition to a fully integrated performance budget. In 2002, SAMHSA developed and implemented a new statement of vision, mission, goals, and objectives, which was included in the FY 2004 budget submission. In applying that framework, SAMHSA developed standard grant announcements for its discretionary grants and mapped out a transition from the current substance abuse and mental health block grant programs to performance partnerships with States that emphasize flexibility and accountability. Concurrently, SAMHSA has been examining its program measures and developing a consolidated set, which will be applied, to the extent possible, across competitive and block/formula grant programs. These efforts have enabled SAMHSA to meet short term objectives such as reducing the number of measures in performance plans and including an efficiency measure for each program.

See Also:

Funding by Program Priority Area
Strategic Plan