The block grant programs are administered at the Federal level by three branches of the Substance Abuse and Mental Health Services Administration. In order to understand the interplay of these agencies and its impact on administration of the block grants at the state level, a brief description of each Federal component is provided below.
The Substance Abuse and Mental Health Services Administration (SAMHSA) was established in 1992. SAMHSA is directed by Congress to target substance abuse and mental health services to the people most in need and to translate research in these areas more effectively and more rapidly into the general health care system.
Through its work, SAMHSA has demonstrated that:
- Prevention works
- Treatment is effective
- People recover from mental and substance use disorders
Central to SAMHSA’s work is the knowledge that behavioral health services improve health status and reduce health care and other costs to society. Continued improvement in the delivery and financing of prevention, treatment and recovery support services provides a cost effective opportunity to advance and protect the Nation's health.
To accomplish its work, SAMHSA administers a combination of competitive, formula, and block grant programs and data collection activities. The Agency's programs are carried out through its centers and offices.
The Center for Mental Health Services (CMHS) is the SAMHSA center that leads the Federal efforts to treat mental illnesses by promoting mental health and by preventing the development or worsening of mental illness when possible. CMHS pursues its mission by helping states improve and increase the quality and range of their treatment, rehabilitation, and support services for people with mental illness, their families, and communities. It is the center that administers the Community Mental Health Services Block Grant program. As of this writing (11/2013), North Dakota’s CMHS project officer is Ernest Fields.
The Center for Substance Abuse Treatment (CSAT) is the SAMHSA center that leads the Federal efforts to promote the quality and availability of community-based substance abuse treatment services for individuals and families who need them. CSAT works with states and community-based groups to improve and expand existing substance abuse treatment services under the Substance Abuse Prevention and Treatment Block Grant Program. As of this writing (11/2013), North Dakota’s CSAT project officer is Debra Bergen.
The Center for Substance Abuse Prevention (CSAP) is the SAMHSA center that provides national leadership in the Federal effort to prevent alcohol, tobacco, and drug problems. CSAP promotes a structured, community-based approach to substance abuse prevention through the Strategic Prevention Framework (SPF). The framework aims to promote youth development, reduce risk-taking behaviors, build assets and resilience, and prevent problem behaviors across the individual's life span. It is the center that administers the prevention portion of the Substance Abuse Prevention and Treatment Block Grant Program. As of this writing (11/2013), North Dakota’s CSAP project officer is William Reyes.
The Community Mental Health Services Block Grant (MHBG) and the Substance Abuse Prevention and Treatment Block Grant (SAPT) focus on different target populations.
The MHBG target populations are adults diagnosed with a serious mental illness (SMI) and children diagnosed with a serious emotional disorder (SED). The SAPT target populations are 1) those who are pregnant and inject drugs, 2) those who are pregnant and abuse substances, 3) those who inject drugs, and 4) all other individuals with substance use disorders. Another difference between the block grant programs is the requirement of a planning council. The MHBG program requires a state to have a planning council in order to receive block grant funding. This requirement is not found in the SAPT program.
Though there are a number of differences between the two block grant programs, the goals and purposes of the grants are generally the same. The goals of the grants are to ensure that those within the target populations have:
- A physically and emotionally healthy lifestyle (health)
- A stable, safe and supportive place to live (a home)
- Meaningful daily activities (a purpose); and
- Relationships and social networks (a community)
States are to use the Block Grant program for prevention, treatment, recovery supports and other services that will supplement services covered by Medicaid, Medicare and private insurance. Specifically the Block Grant funds are directed toward four purposes:
- Fund priority treatment and support services for individuals without insurance or for whom coverage is terminated for short periods of time.
- Fund those priority treatment and support services not covered by Medicaid, Medicare or private insurance for low income individuals and that demonstrate success in improving outcomes and/or supporting recovery.
- Fund primary prevention - universal, selective and indicated prevention activities and services for persons not identified as needing treatment.
- Collect performance and outcome data to determine the ongoing effectiveness of behavioral health promotion, treatment and recovery support services and plan the implementation of new services on a nationwide basis.
Until the 2012-2013 planning cycle, North Dakota operated the two block grant programs separately. At that time, SAMHSA provided the states with the option of submitting a combined two-year application. North Dakota took advantage of this opportunity and submitted a combined application in 2012.
The North Dakota Department of Human Services accepts written comments on the Fiscal Year 2018-2019 Combined Behavioral Health Assessment and Plan at any time.
Comments can be mailed to:
North Dakota Health and Human Services, Behavioral Health Division
600 E. Boulevard Ave., Dept. 325
Bismarck, ND 58505
Comments can be emailed to: firstname.lastname@example.org