DEPARTMENT of HEALTH and HUMAN SERVICES - Substance Abuse and Mental ...

DEPARTMENT of HEALTH and HUMAN SERVICES

Fiscal Year

2013

Substance Abuse and Mental Health Services Administration

Justification of Estimates for

Appropriations Committees

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SAMHSA

Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road ? Rockville, MD 20857 ? 1-877-SAMHSA-7 (1-877-726-4727)

Letter from the Administrator

This letter presents the SAMHSA FY 2013 Budget Request. A total of $3,151,508,000 is requested from Budget Authority funds, which reflects an overall reduction of $195,512,000 below the FY 2012 Enacted Level. The FY 2013 Request reflects the four Appropriations: Mental Health ($902,856,000), Substance Abuse Prevention ($463,378,000), Substance Abuse Treatment ($1,711,045,000), and Health Surveillance and Program Support ($74,229,000). This request maintains the budget structure in the FY 2012 Consolidated Appropriations Act and program priorities reflected in the FY 2012 President's Budget. Prevention remains SAMHSA's top priority and funding is provided for three major prevention programs requested in the FY 2012 President's Budget. The proportion of funding for mental health and substance abuse for FY 2013 is generally comparable to the FY 2012 Enacted funding level (29.42 percent Mental Health; 70.58 percent Substance Abuse).

After careful review of SAMHSA's entire portfolio in FY 2012, strategic reductions are proposed in FY 2013 while maintaining support for the highest priority strategic initiative goals for Prevention and for Trauma and Justice. The SAMHSA FY 2013 Budget Request also maintains level funding for the States to support the infrastructure necessary to maintain and improve access to quality behavioral health services. As other programs are reduced, restructured, or eliminated, it will be necessary to rethink performance targets to reflect realistic expectations and viable management paradigms.

In addition, this budget includes a request of $105,000,000 from the Affordable Care Act (ACA) Prevention Fund reflecting an increase of $17,000,000 over FY 2012. This funding includes $28,000,000 for Primary and Behavioral Health Care Integration (PBHCI), $7,000,000 for the Sober Truths on Preventing (STOP) Under Age Drinking Act, $30,000,000 for Screening, Brief Intervention, Referral and Treatment, and $40,000,000 for the establishment of the Behavioral Health-Tribal Prevention Grant program.

The SAMHSA request maintains level funding in Budget Authority for both Block Grants, i.e., the Mental Health Block Grant (MHBG) and Substance Abuse Block Grant (SABG). These programs' contribution to the PHS evaluation tap will increase from 1.25 percent in FY 2012 to 3.2 percent in FY 2013.

This budget requests funding for the creation of three State and Tribal Prevention Grants. Consistent with the FY 2012 President's Budget and the FY 2012 Consolidated Appropriations Act budget structure, SAMHSA is requesting that these State and Tribal Prevention Grants be funded as separate lines within the new Mental Health, Substance Abuse Prevention, and Health Surveillance and Program Support appropriations. These important prevention programs will ensure that States and Tribes can implement and sustain evidence-based prevention practices in high need communities. The three programs will bring the successes realized in SAMHSA's discretionary

Behavioral Health is Essential To Health ? Prevention Works ? Treatment is Effective ? People Recover

grant programs to a broader scale. Funding is requested to continue existing Project LAUNCH and Strategic Prevention Framework (SPF) program grants (consistent with the FY 2012 President's Budget). SAMHSA looks forward to working with Congress and stakeholders to discuss how best to strengthen our Nation's prevention capacity.

Consistent with the Trauma and Justice Strategic Initiative, funding is also requested for a new program, Grants for Adult Trauma Screening and Brief Intervention (GATSBI). The GATSBI program will advance the knowledge base to address trauma and interpersonal violence for women in common healthcare settings such as emergency departments, primary care, and OB/GYN offices. The concept and design for these grants is being developed by SAMHSA in consultation with its federal partners. Funding is continued for the National Child Traumatic Stress Network in FY 2013 at the 2012 Enacted Level.

In addition, funding is requested for a nationally available disaster distress crisis counseling telephone line. The need for this initiative has been documented through the Assistant Secretary for Preparedness and Response after various emergency conditions throughout the U.S. The request for FY 2013 will expand an existing SAMHSA pilot program to make this response line available for any disaster, anywhere in the U.S., through a connection to local crisis lines throughout the country.

Budget Authority funding in FY 2013 is reduced for selected discretionary programs such as PBHCI and Children's Mental Health Services. These reductions are largely from grants coming to a natural end. Funding for substance abuse technical assistance is maintained but at a lower level [Center for the Application of Prevention Technologies (CAPT) and the Addiction Technology Transfer Centers (ATTCs)], allowing SAMHSA to continue promulgating the adoption of evidence-based approaches in the Nation's behavioral health system. Total funding for the Minority AIDS Initiative is maintained with some rebalancing of funds across CSAT and CMHS to support ongoing collaboration with CDC. Statutory authority is requested to charge and collect fees for selected data and publication user requests beyond the normal requests from the general public. Through close management of operating costs and contracts, program support is also reduced.

This budget reflects the Administration's priorities in tight and difficult economic times, and it reflects a commitment to supporting states and communities in improving health and health care in all America's communities.

Behavioral Health is Essential To Health ? Prevention Works ? Treatment is Effective ? People Recover

DEPARTMENT OF HEALTH AND HUMAN SERVICES SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Table of Contents

Fiscal Year 2013 Budget

Letter From the Administrator Table of Contents Organizational Chart

A. Executive Summary 1. Introduction and Mission ......................................................................................................... page 1 2. Discretionary All Purpose Table ........................................................................................... page 5 3. FY 2013 Budget Request Overview ..................................................................................... page 6 4. FY 2013 Performance Overview ........................................................................................... page 9 5. Summary of Changes ............................................................................................................ page 13

B. Budget Exhibits 1. Appropriations Language ..................................................................................................... page 15 2. Language Analysis ................................................................................................................. page 18 3. Amounts Available for Obligation ...................................................................................... page 19 4. Summary of Changes ............................................................................................................ page 20 5. Budget Authority by Activity .............................................................................................. page 21 6. Authorizing Legislation ........................................................................................................ page 22 7. Appropriations History Table .............................................................................................. page 25 8. Appropriations Not Authorized by Law ............................................................................. page 26

C. Mental Health 1. Mental Health Programs of Regional and National Significance ................................... page 35 2. Mental Health -State Prevention Grants ............................................................................. page 61 3. Children's Mental Health Services ..................................................................................... page 67 4. PATH Homeless Grants ....................................................................................................... page 71 5. PAIMI ...................................................................................................................................... page 77 6. Mental Health Block Grant .................................................................................................. page 83

D. Substance Abuse Prevention 1. Substance Abuse Prevention Programs of Regional and National Significance .......... page 95 2. Substance Abuse - State Prevention Grants ..................................................................... page 107

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