FFY 2018-2019 Block Grant Application - SAMHSA

OMB Approval # 0930-0168

FFY 2018-2019 Block Grant Application

Community Mental Health Services Block Grant (MHBG)

Plan and Report Substance Abuse Prevention and Treatment Block

Grant (SABG) Plan and Report

U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration

OMB Approval # 0930-0168 i

OMB Approval # 0930-0168

Table of Contents

FFY2018-2019 Block Grant Application ....................................................................................................1 I. INTRODUCTION...................................................................................................................................1 A. Background............................................................................................................................................1 1. Leading Change 2.0 ? SAMHSA's Six Strategic Initiatives...........................................................2 B. Impact on State Authorities and Systems ..............................................................................................4 C. Block Grant Programs' Purposes ........................................................................................................11 II. SUBMISSION OF APPLICATION AND PLAN TIMEFRAMES....................................................12 III. BEHAVIORAL HEALTH ASSESSMENT AND PLAN ..................................................................14

Quality and Data Collection Readiness..............................................................................................14 A. Framework for Planning--Mental Health and Substance Use Prevention and Treatment ...........15 B. Planning Steps ...............................................................................................................................19

Planning Tables ..................................................................................................................................24 C. Environmental Factors and Plan....................................................................................................37 1. The Health Care System, Parity and Integration - Question 1 and 2 are Required .......................37 2. Health Disparities - Requested ......................................................................................................42 3. Innovation in Purchasing Decisions - requested............................................................................45 4. Evidence-Based Practices for Early Interventions to Address Early Serious Mental Illness

(ESMI)-10 percent set aside - Required MHBG ...........................................................................48 5. Person Centered Planning (PCP) ?Required (MHBG) .................................................................50 6. Self-Direction - Requested ..................................................................................................................51 7. Program Integrity - Required...............................................................................................................53 8. Tribes - Requested ...............................................................................................................................55 9. Primary Prevention-required (SABG only) .........................................................................................56

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OMB Approval # 0930-0168

10. Statutory Criterion for MHBG (Required MHBG) ...........................................................................64 11. Substance Use Disorder Treatment - Required SABG.......................................................................67 12. Quality Improvement Plan- requested................................................................................................77 13. Trauma -requested .........................................................................................................................77 14. Criminal and Juvenile Justice - Requested ....................................................................................79 15. Medication Assisted Treatment - Requested .................................................................................80 16. Crisis Services - Requested ...........................................................................................................82 17. Recovery - Required ......................................................................................................................83 18. Community Living and the Implementation of Olmstead- requested ...........................................86 19. Children and Adolescents Behavioral Health Services ?required MHBG, requested SABG .......87 20. Suicide Prevention ? (Required MHBG) ......................................................................................91 21. Support of State Partners - Required MHBG ................................................................................92 22. State Behavioral Health Planning/Advisory Council and Input on the Mental Health/Substance

Abuse Block Grant Application-required MHBG.........................................................................94 23. Public Comment on the State Plan- required.....................................................................................98 Acronyms ..................................................................................................................................................99 Resources ................................................................................................................................................ 103

1. Required Forms a. Face Page--Community Mental Health Services Block Grant b. Face Page--Substance Abuse Prevention and Treatment Block Grant c. Funding Agreements/Certifications--Community Mental Health Services Block Grant d. Funding Agreements/Certifications--Substance Abuse Prevention and Treatment Block Grant e. Assurances

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OMB Approval # 0930-0168

FFY2018-2019 Block Grant Application

I. INTRODUCTION

This is an application for SAMHSA's Community Mental Health Services Block Grant (MHBG) and Substance Abuse Prevention and Treatment Block Grant (SABG) as authorized by sections 1911-1920 of Title XIX, Part B, Subpart I of the Public Health Service Act (42 U.S.CF.?? 300x-300x-9) and sections 1921-1935 of Title XIX, Part B, Subpart II of the Public Health Service Act (42 U.S.C.? 300x21-35), respectively, and sections 1941-1956 of Title XIX, Part B, Subpart III of the Public Health Service Act (42 U.S.C.?? 300x-51-66). This block grant application includes four major parts: introduction; submission of application and plan timeframes; behavioral health assessment and plan; and report requirements. These sections include discussions and planning around the following policy topics: health care system, parity and integration; health disparities; innovations in purchasing decisions; evidence-based practices for early intervention (e.g., serious mental illness (SMI)); person centered planning and self-direction; program integrity; tribes; primary substance use disorder prevention, statutory criteria for MHBG; substance use disorder treatment; quality improvement; trauma; criminal and juvenile justice; medication-assisted treatment; crisis services; recovery; community living and Olmstead; children and adolescents behavioral health services; suicide prevention; support of state partners; state behavioral health planning/advisory council; and public comment .

A. Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) oversees two major block grants: the Substance Abuse Prevention and Treatment Block Grant (SABG) and the Community Mental Health Services Block Grant (MHBG). These block grants give states1 maximum flexibility to address the unique behavioral health2 needs of their populations. The MHBG and SABG differ in a number of their practices (e.g., targeted populations) and statutory authorities (e.g., method of calculating maintenance of effort (MOE), stakeholder input requirements for planning, set-asides for specific populations or programs, etc.).3 As a result, information on the services and clients supported by block grant funds has varied by block grant and by state.

SAMHSA believes it is vital to collect, report, and analyze data at the state and federal levels to ensure the nation's behavioral health system is providing the highest quality and most cost effective treatment and other services. State block grant expenditures should be based on the best possible evidence and

1 The term "state" means each of the several states, the District of Columbia and each of the territories of the United States. The term "territories of the United States" means each of the Commonwealth of Puerto Rico, Virgin Islands, American Samoa, Commonwealth of the Northern Marianas Islands, Federated States of Micronesia, Guam, Republic of the Marshall Islands and the Republic of Palau.

2 The term "behavioral health" in this document refers to a state of mental/emotional being and/or choices and actions that affect wellness. Behavioral health problems include substance abuse or misuse, alcohol and drug addiction, serious psychological distress, suicide, and mental and substance use disorders. This includes a range of problems from unhealthy stress to diagnosable and treatable diseases like Serious Mental Illnesses (SMIs) and substance use disorders (SUDs), which are often chronic in nature but that people can and do recover from. The term is also used to describe the service systems encompassing the promotion of emotional health; the prevention of mental and substance use disorders; substance use and related problems; treatments and services for mental and substance use disorders; and recovery support. In addition to statutory authority, SABG is detailed by comprehensive regulation.

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