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Substance Abuse Prevention and Treatment Block Grant
The current Substance Abuse Prevention and Treatment (SAPT) Block Grant regulations were released in the Federal Register in March 1993. The official citation of the regulations is Title 45 of the Code of Federal Regulations Part 96 (45 CFR Part 96), Substance Abuse Prevention and Treatment Block Grants; Interim Final Rule. The regulations authorize the Secretary of the U.S. Department of Health and Human Services (HHS) to provide Block Grants to States for the purpose of planning, carrying out, and evaluating activities to prevent and treat substance abuse.
- The Block Grant Application Process—Block Grant recipients include each of the 50 States, each U.S. territory, the District of Columbia, and the Red Lake Band of Chippewa Indians of Minnesota. The applicant’s chief executive officer (e.g., Governor) or designee must submit a signed application to SAMHSA no later than October 1 of the Federal fiscal year for which funding is being requested.
- Key Provisions of the SAPT Block Grant—As a condition of receiving the SAPT Block Grant, the single State authority (SSA) for substance abuse prevention and treatment in each jurisdiction must adhere to certain requirements.
- Management of the SAPT Block Grant—The SAPT Block Grant is managed by the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA/CSAT) with the responsibility for the prevention component delegated to the Center for Substance Abuse Prevention (CSAP).
- Substance Abuse Prevention and Treatment Block Grant Information
- Legislation
- Key Provisions of the SAPT Block Grant
- Web-based Block Grant Application System (Web BGAS)
- Core Elements Technical Review Project
- Division of State and Community Assistance Technical Assistance
- SAMHSA/ CSAT Guidance Documents
- Frequently Asked Questions (FAQ) about the SAPT Block Grant and Application Process
- Additional Resources
1. Substance Abuse Prevention and Treatment Block Grant Information
Please note that Block Grant information, including forms, is now located on the SAMHSA Block Grant Website at http://www.samhsa.gov/grants/blockgrant/
SAMHSA Provides New Information on How Grant Program Allotments are Calculated
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Office Of Applied Studies (OAS) is issuing a new guide providing updated information on the procedures used by that office to calculate allocations for some of the key block and formula grants the agency administers. The grant programs addressed in this new guide entitled Block Grants and Formula Grants: A Guide for Allotment Calculations include:
• The Substance Abuse Prevention and Treatment Block Grant
• The Mental Health Services Block Grant
• Protection and Advocacy for Individuals with Mental Illness Formula Grant
• Projects for Assistance in Transition from Homelessness Formula Grant
The guide provides a non-technical overview of the new calculation procedures, detailed descriptions of the four sets of formulas, and the data used in the process. Flow charts and other background information are also provided to give a clearer overall understanding of the calculation procedures and how they affect these grant programs.
Copies of the guide can be obtained at http://oas.samhsa.gov/BG_documentation_070809_final_psg.pdf.
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2. Legislation
Authorizing Legislation
Public Health Service Act (includes Title V and Title XIX) (.pdf)
Implementing Legislation
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3. Key Provisions of the SAPT Block Grant
- Obligate and expend each year’s SAPT Block Grant allocation within 2 Federal fiscal years.
- Maintain aggregate State expenditures for authorized activities that are no less than the average level of expenditures for the preceding 2 State fiscal years.
- Use at least 20 percent of the SAPT Block Grant on primary prevention activities.
- Have a law that prohibits the sale or distribution of tobacco products to individuals under the age of 18.
- Maintain a calculated base of expenditures for special treatment services for pregnant women and women with dependent children.
- Maintain a capacity management system for programs that treat intravenous drug abuse.
- Ensure that programs that use SAPT Block Grant funds to treat intravenous substance abuse conduct scientifically sound outreach activities to encourage individuals in need of such services to undergo treatment.
- Require SAPT Block Grant-funded treatment programs to routinely make TB services available to each substance abuse treatment client.
- Maintain a minimum level of State-appropriated funds for TB services for substance abuse treatment clients.
- Submit an assessment of statewide and locality-specific need for authorized [Block Grant] activities.
- Have an independent peer review system that assesses the quality, appropriateness, and efficacy of SAPT Block Grant-funded treatment services.
- Require SAPT Block Grant-funded programs to make continuing education available to their staffs.
- Coordinate with other appropriate services (health, mental health, criminal justice, etc.).
- Have a system to protect patient records from inappropriate disclosure.
- Restrict the use of the SAPT Block Grant to expenditures that are authorized by the grant.
HIV-designated States (States with 10 or more HIV cases per 100,000 people) must also do the following:
- Provide one or more HIV early intervention project at substance abuse treatment sites.
- Maintain a minimum level of State-appropriated expenditures for HIV early intervention service.
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4. Web-based Block Grant Application System (BGAS)
- The Web Block Grant Application System (Web BGAS) has been developed to facilitate States’ completion, submission and revision of their Block Grant applications. This application system is used to service the States, SAMHSA project officers and grant managers, program directors and reviewers. The BGAS operates a help desk for support and training to both State and Federal users. The Web BGAS can be accessed at http://bgas.samhsa.gov.
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5. Core Elements Technical Review Project
The Core Elements Technical Review Project is designed to promote compliance with the SAPT Block Grant requirements, as well as to assess State and local program adherence to generally accepted clinical, fiscal and management practices while promoting strengthening of State alcohol and drug service delivery systems. The results of the technical reviews conducted under this Project will be used by CSAT as an adjunct to State monitoring and, in particular, to identify problems or exemplary practices. The Project will also assist States in analyzing weaknesses or problems, in responding to systems changes that impact the delivery of substance abuse services, and in planning and implementing solutions, or new approaches.
Each State is reviewed every 3-4 years to determine compliance with selected statutory requirements and to gather information on organizational activities that CSAT has identified as "core" issues, e.g., State fiscal monitoring systems, needs assessment, technology transfer and technical assistance. An additional component of the current technical reviews effort is assistance to States in responding to their most pressing State-identified needs such as linkage between substance abuse treatment and criminal justice or adaptation of systems to managed care and welfare reform. The technical reviews result in "diagnostic technical assistance" that occurs on-site in the form of discussions of potential options for action or changes as well as a series of recommendations for subsequent technical assistance.
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6. Division of State and Community Assistance Technical Assistance
CSAT’s DSCA offers a wide range of technical assistance (TA) to help State substance abuse treatment systems build and maintain the capacity to plan, implement, and manage those systems. Because States confront varied programmatic, policy, financial, infrastructure, and management issues, TA approaches must be flexible and far-reaching in scope. Thus, DSCA has worked with States to plan and deliver TA specifically targeted to the States’ needs. Typically, this TA is grouped into one or more of the following categories:
- Consulting and training services
- Training, Workshop, and Meeting facilitation and support—This form of support may consist of assistance with planning and managing training and workshop activities, assistance in facilitating meetings (including multi-state meetings), and/or providing support to individuals attending trainings, meetings, or conferences.
Examples of Available TA—The breadth of possible TA activities is extensive. The focus of TA can range from issues affecting the entire system of care to issues that address a very specific treatment approach. For instance, DSCA TA attempts to help State substance abuse treatment systems achieve the following aims:
- Resolve pressing issues that impact service delivery, management, and financing.
- Anticipate and prepare for major policy, organizational, and economic shifts.
- Adopt evidence-based practices.
- Comply with Federal requirements, including the SAPT Block Grant and NOMs.
Accessing Technical Assistance—In addition to technical assistance that may be recommended as a result of a Core Technical Review, State Directors and their designees can electronically request technical assistance.
- Technical Assistance Requests
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7. SAMHSA / CSAT Guidance Documents
8. Frequently Asked Questions (FAQ) about the SAPT Block Grant and Application Process
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9. Additional Resources
- SAMHSA-HRSA Center for Integrated Health Solutions: CIHS Billing Worksheets Make Financing Integrated Services Easier
Financing is one of the key elements in integrating primary and behavioral healthcare services. Once you determine the best clinical model for your program, it is necessary to determine how the financing supports it. And while financing is often viewed as a barrier to sustaining primary and behavioral healthcare integration activities, there are nearly always means of reimbursement.
To help you bill Medicare and Medicaid optimally for integrated services, the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) has developed customized billing and financial worksheets for each state that identify existing billing opportunities for services provided in integrated healthcare settings. For more information, go to http://www.integration.samhsa.gov.
- Summary of topic specific TA provided (pending)
- Rate / unit / cost setting
- Quality/performance improvement
- Cultural competency
- Information on Privacy and Security standards (Health Information Technology / Electronic Health Records--PDF)
- Applying the Substance Abuse Confidentiality Regulations 42 CFR Part 2 (REVISED) - Frequently Asked Questions (FAQ) (PDF)
- The documents below were created to assist organizations to know what is required by the Substance Abuse Prevention and Treatment Block Grant (SAPT BG); what items are monitored for adherence, and what should be in contracts:
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