HHS/ASPE. U. S. Department of Health and Human Services.Background

Overview and Inventory of HHS Efforts to Assist Incarcerated and Reentering Individuals and their Families

Substance Abuse and Mental Health Services Administration

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Center for Mental Health Services

Jail Diversion and Trauma Recovery

Type of Activity:  Services

Funding Mechanism: Grants

Total Available Funding: $5.141 million

Number of Awards: 13

Average Award Amount per Year: $395,000 per year

Length of Project Period: Up to 5 years

Federal Partners: none

Summary: The purpose of this program is to support local implementation and State/Tribe-wide expansion of trauma-integrated jail diversion programs to address the needs of individuals with mental illness such as post traumatic stress disorder (PTSD) and trauma related disorders involved in the justice system.  In recognition of the dramatically higher prevalence of trauma related illnesses among veterans, this program prioritizes eligibility for veterans. This program focuses jail diversion programs on the underserved needs of veterans and others with PTSD involved in the justice system.

The program will also support states to pilot projects locally and to replicate them statewide. This two-pronged approach is necessary because diversion occurs locally in cities and counties where jails are operated and mental health services are delivered. However, policies and funding at the state level dramatically impact local operations and services. This approach brings together those who develop and define state policies and determine funding with stakeholders who are affected by the untreated trauma of veterans. Together they can develop knowledge dissemination and application strategies for the entire state.

Jail Diversion and Trauma Recovery is one of SAMHSA’s services grant programs. SAMHSA’s services grants are designed to address gaps in mental health prevention and treatment services and/or to increase the ability of States, units of local government, American Indian/Alaska Native Tribes and tribal organizations, and community- and faith-based organizations to help specific populations or geographic areas with serious, emerging mental health problems.

Background:  As of April 2008, approximately 1.64 million men and women have been deployed to serve in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) in support of the Global War on Terror.  Individuals returning from Iraq and Afghanistan are at increased risk for suffering post-traumatic stress and other related disorders.  Experts estimate that up to one-third of returning veterans will need mental health and/or substance abuse treatment and related services.  In addition, the family members of returning veterans have an increased need for related support services. 

With increasing numbers of combat veterans returning from duty overseas, there is growing concern that the community provide adequate supports to ensure their successful reintegration into American community life. For many returning veterans, PTSD and related disorders will go untreated, placing them at risk for involvement in the justice system. This grant addresses Healthy People 2010 focus area 18 (Mental Health and Mental Disorders).

Current Grantees:

FY 2008 — Colorado Department of Human Services, Denver, CO; Connecticut Department of Mental Health, Hartford, CT; Georgia Department of Human Resources, Atlanta, GA; Illinois Department of Human Services, Chicago, IL; Commonwealth of Massachusetts, Boston, MA; Vermont State Department of Health, Burlington, VT.

FY 2009 — Rhode Island State Department of Mental Health, Cranston, RI; Texas State Department of Health Services, Austin, TX; North Carolina Department of Health and Human Services, Raleigh, NC; Ohio State Office of the Governor, Columbus, OH; Florida State Department of Children and Families, Tallahassee, FL; New Mexico State Department of Health, Santa Fe, NW

FY 2010 — Pennsylvania Office of Mental Health, Harrisburg, PA

Evaluation Activities: Grantees report performance on the National Outcome Measures (NOMs) such as: behavioral health; employment/education; criminal justice involvement; stability in housing; access – number of persons served by age, gender, race, and ethnicity; rate of readmission to psychiatric hospitals; social support/social connectedness; and client perception of care. Grantees also participate in a cross-site evaluation and report program specific measures such as trauma history and recovery, as well as diversion approaches, treatment practices and support services. Data is collected at diversion, at 6 months and at discharge.

Future Prospects:  Jail Diversion and Trauma Recovery grants are authorized under 520G of the Public Health Service Act, as amended.

Contact:

David Morrissette, Ph.D. LCSW
Commander, USPHS
Center for Mental Health Services, SAMHSA
1 Choke Cherry Road Room 6-1011
Rockville, MD. 20857
Phone: 240-276-1960 Fax 240-276-1970
Email: david.morrissette@samhsa.hhs.gov

Contents

Center for Substance Abuse Treatment

Access to Recovery III (ATR III) Grant Program

Type of Activity:  Services

Funding Mechanism:  Grant

Total Available Funding:  $94.8 million per year

Number of Awards:  30

Average Award Amount:  $3,352,000

Length of Project Period: Sept. 30, 2010 - Sept. 29, 2014 (4 years)

Federal Partners: There are no joint funders. Although, the terms and conditions of the Award encourage grantee partnerships with other grantees funded by Departments of Labor and Justice.

Summary: Access to Recovery III (ATR III) is a four-year discretionary grant program that provides individuals with vouchers to purchase treatment and recovery support services for substance use disorders at the provider of their choice.

ATR has three primary goals: 1) Expand consumer choice; 2) Track and improve outcomes; and 3) Increase capacity. ATR also aims to include faith-based and community-based providers in service delivery to reach populations that might otherwise not receive treatment or recovery support services. Monitoring outcomes, tracking costs and preventing fraud waste and abuse are also important elements of the ATR program. This is the third cohort of ATR funding. ATR was also funded in 2004 and 2007. See www.atr.samhsa.gov.

Under ATR II, approximately 1/3 of grantees served the criminal justice population. In ATR III, 20 grantees (of 30) proposed to target services to criminal justice populations.

Background:  The Nation’s substance abuse treatment system is shaped, supported, and maintained by the States. These services are funded primarily through state revenues and Federal programs, including SAMHSA’s Substance Abuse Prevention and Treatment Block Grant and Targeted Capacity Expansion grants, and Medicaid dollars. Although these resources continue to help millions of Americans obtain and sustain recovery from addiction, too many people who seek help are unable to find care. By providing individuals with vouchers to pay for the care they need, Access to Recovery is fostering consumer choice, improved service quality, and increased treatment capacity. Vouchers, along with other state operated programs, provide an unparalleled opportunity to create profound change in substance use disorders treatment and recovery financing and service delivery in America.

Current grantees:
Grantees City State First Year Awards
Research Foundation for Mental Hygiene, Inc at OASAS Albany NY $3,352,000
State of New Mexico Santa Fe NM $3,352,000
MD DHM-Alcohol & Drug Abuse Admin(ADAA) Catonsville MD $3,352,000
Massachusetts Depart of Public Health Boston MA $3,352,000
AR Dept of Human Services, Div of BHS Little Rock AR $3,352,900
Wisconsin Department of Health Services Madison WI. $3,352,000
Inter-Tribal Council of Michigan, Inc. Chippewa MI $3,352,000
California Dept. of Alcohol & Drug Programs Sacramento CA $3,352,000
Missouri Division of Alcohol & Drug Abuse Jefferson City MO $3,352,000
IL Dept of Human Service, Div of Alcohol & Substance Abuse Chicago IL $3,352,000
State of Oregon Dept of Human Services Salem OR $3,352,000
Southcentral Foundation Anchorage AK $2,261,186
Utah Div of Substance Abuse and Mental Health Salt Lake City UT $1,676,000
Aberdeen Area Tribal Chairmen's Health Board Rapid City SD $3,352,000
Conn. Dept of Mental Health & Addiction Services Hartford CT $3,352,000
Indiana Family & Social Services Administration Indianapolis IN $3,352,000
Pennsylvania Department of Health Harrisburg PA $2,617,201
Dept. of Social & Health Services Olympia WA $3,352,000
Government of the District of Columbia Washington DC $3,352,000
Montana Wyoming Tribal Leaders Council Billings MT $2,366,841
Iowa Dept of Public Health Des Moines IA $3,352,000
California Rural Indian Health Board, Inc. Sacramento CA $3,352,000
Florida Dept. of Children & Families Tallahassee FL $3,349,265
State of RI and Providence Plantation Cranston RI $3,352,000
State of CO, Div of Behavioral Health Denver CO $3,352,000
Ohio Dept of Alcohol & Drug Addiction Services Columbus OH $3,352,000
New Hampshire Dept of Health and Human Services Concord NH $3,075,248
Idaho Dept of Health and Welfare Boise ID $3,328,160
Office of the Governor, State of Hawaii Honolulu HI $2,932,999
Oglala Sioux Tribe Pine Ridge SD $2,788,926

Press Release: http://www.samhsa.gov/newsroom/advisories/1010081330.aspx

Location(s) of Projects:  See above

Evaluation Activities:  An independent evaluation of the 2004 cohort is in progress. Results are expected to be available by December 31, 2010.

Future Prospects:  Future prospects are unknown at this time. However, it is hoped that state systems will adopt the ATR voucher model of service delivery.

Contact:

Catherine D. Nugent
Chief, Quality Improvement and Workforce Development Branch, CSAT, SAMHSA
Phone: 240-276-1577
Email: Cathy.nugent@samhsa.hhs.gov

Adult Criminal Justice Treatment Program (FY 08-11)

Funding Mechanism:  Grant

Total Available Funding:  $4 million

Number of Awards:  10

Average Award Amount per Year:  $400,000

Length of Project Period:  3 years

Federal Partners:  None

Summary:  The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) funded ten grants in FY 2008 for Adult Criminal Justice Treatment projects. This program is designed to address gaps in substance abuse treatment services for adult individuals involved with the criminal justice system by supporting rapid and strategic responses to demands for substance abuse (including alcohol and drug) treatment services in communities with serious, emerging drug problems as well as communities with innovative solutions to unmet needs. The purpose of this program is to expand and/or enhance the community’s ability to provide a comprehensive, integrated, and community-based response to a targeted, well-documented substance abuse treatment capacity problem and/or improve the quality and intensity or services for adult individuals in the community who are involved with the criminal justice system. To address the broad needs of this population, SAMHSA seeks to increase substance abuse treatment and recovery services for persons who are substance-involved, substance-dependent, have a substance abuse disorder or a co-occurring disorder, and are involved in community justice systems.

Background:  The Adult Criminal Justice Treatment (ACJT) grants are for adults who are under a form of the judicial or community justice supervision and who are screened and assessed as substance-involved and/or have been diagnosed with a substance abuse disorder or co-occurring disorders of substance abuse and mental health. These individuals must be under the supervision of the judiciary or community justices/corrections agencies (such as probation, parole, community corrections). SAMHSA funds treatment and recovery services for individuals in the community. Therefore, funding cannot be used for providing services to incarcerated populations (defined as those persons in jails, prison, detention facilities or in custody where they are not free to move about in the community). The ACJT grant programs is one of SAMHSA’s services grant programs. SAMHSA’s services grants are designed to address the gaps in substance abuse services and/or to increase the ability of states, localities, tribes, urban Indian centers and/or tribal organizations to help the specific populations or geographic areas with serious, emerging substance abuse problems. For example, a community might seek and Adult Criminal Justice Treatment grant to add state-of-the-art treatment approaches or new services to address the emerging trends or unmet need (e.g., intensive case management and referral to services to address related HIV, tuberculosis, hepatitis B and C, and other primary health care needs of substance abusing clients) and other co-occurring issues (substance abuse and mental health).

Grantees:
Grantees City State Total Award
EAC, INC. Hempstead NY $1,200,000
SPAN, INC. Boston MA $1,200,000
SPECIALIZED TREATMENT EDUC/PREV/SRVCS Orlando FL $1,057,604
CENTER FOR COMMUNITY ALTERNATIVES, INC. New York NY $1,200,000
OAKLAND FAMILY SERVICES Pontiac MI $1,199,815
PINELLAS COUNTY SHERIFF'S OFFICE Largo FL $1,176,847
CENTERSTONE COMMUNITY MENTAL HLTH CNTRS Nashville TN $1,200,000
VOLUNTEERS OF AMERICA OF LOS ANGELES Los Angeles CA $1,200,000
NORTH COUNTY SERENITY HOUSE, INC. Escondido CA $1,200,000
STAND, INC. Decatur GA $1,200,000

Evaluation Activities:  This discretionary grant program is not designated for an external evaluation study. Each grantee is responsible for performance measurement utilizing GPRA client level data administered at intake, six-month, and release from treatment mileposts. Additionally, each grantee is responsible for assessing performance using basic process and outcomes questions.

Future Prospects:  The FY 2011 President’s budget requests $3,177,000 for the continuation of a new three-year cycle of grants.

Contact:

Ken Robertson
Team Leader, Criminal Justice Programs
Division of Services Improvement, Center for Substance Abuse
Phone: (240) 276-1621
Email: Kenneth.Roberson@samhsa.hhs.gov

Offender Reentry Program (FY09-12 and FY 10-13)

Funding Mechanism:  Grant

Total Available Funding:  $9.6 million (FY 2009-2012 cohort)

$7.98 million (FY 2010-2013 cohort)

Number of Awards:  42 total

24 (FY 2009-2012)

18 (FY 2010-2013)

Length of Project Period:  3 years

Federal Partners:  None

Summary:  The Substance Abuse and Mental Health Services Administration (SAMSHA), Center for Substance Abuse Treatment (CSAT) funded 24 Offender Reentry Program (ORP) grants in 2009 and another 18 for FY 2010. This program is part of the Criminal Justice grant portfolio and is designed to address the needs of sentenced substance-abusing juveniles and adult offenders returning to their families and community from adult or juvenile incarceration in facilities including prisons, jails, or juvenile detention centers. The purpose of ORP is to expand and/or enhance substance abuse treatment and related recovery and reentry services to sentenced juvenile and adult offenders returning to the community from incarceration for criminal/juvenile offenses. Applicants are expected to form stakeholder partnerships that will plan, develop and provide a transition from incarceration to community-based substance abuse treatment and related reentry services for the populations of focus. Because reentry transition must begin in the correctional or juvenile facility before release, limited funding may be used for certain activities in institutional correctional setting in addition to the expected community-based services.

Background:  SAMHSA recognizes that there is a significant disparity between the availability of treatment services for persons with alcohol and drug use disorders and demand for such services. The disparity is also consistent for criminal justice populations, as estimates show only 10 percent of individuals involved with the criminal justice system who are in need of substance abuse treatment receive it as part of their justice system supervision. The Bureau of Justice Statistics (BJS) estimates that approximately 1 in 5 juveniles in the daily correctional population receive some form of substance abuse treatment (BJS, 2005; Taxman, NIDA CJDATS, 2007). Approximately one-half of the institutional treatment provided is educational programming (Taxman, NIDA CJDATS, 2007). By providing needed treatment services, this program intends to decrease the public health and social costs of substance abuse and dependence and increase public safety by reducing substance abuse related crime and violence. SAMHSA recognizes the need to successfully return and reintegrate individuals into the community by providing substance abuse treatment and other related reentry services, while also ensuring public safety for the community and family. This program builds on previous and ongoing SAMHSA/CSAT criminal and juvenile justice program initiatives (e.g., SAMHSA/CSAT FY 2004 YORP grant program), and builds on learning gained from these previous initiatives.

The Offender Reentry Program is one of SAMHSA’s services grant programs. SAMHSA’s services grants are designed to address gaps in substance abuse treatment services and/or to increase the ability of states, units of local government, American Indian/Alaska Native Tribes and tribal organizations, and community- and faith-based organizations to help specific populations or geographic areas with serious, emerging substance abuse problems.

Grantees: (FY 09-12 and FY 10-13)
Grantees City State Total Award
Operation Par, Inc Pinellas Park FL 1,200,000
Gaudenzia, DRC, Inc Philadelphia PA 1,200,000
Illinois Department of Human Services Division of Alcoholism and Substance Abuse Chicago IL 1,200,000
Gaudenzia, DRC, Inc Philadelphia PA 1,200,000
Serving Children and Adolescents in Need Laredo TX 1,200,000
Guidance Clinic of The Middle Keys, Inc Marathon FL 1,199,268
Easter Seal-Goodwill Northern Rocky Mt Boise ID 1,198,849
Alethia House Birmingham AL 1,200,000
Health Services Center, Inc Hobson City AL 1,200,000
Volunteer Behavioral Health Care System Murfreesboro TN 1,200,000
Special Services For Groups, Inc Los Angeles CA 1,200,000
Intervention, Inc Westminster CO 1,177,890
Community Counseling Institute Tacoma WA 1,200,000
Boston Public Health Commission Boston MA 1,200,000
OIC- of Broward CO, Inc Oakland Park FL 1,200,000
Orange County BAR foundation Santa Ana CA 1,200,000
Southern California Alcohol and Drug Programs, Inc Downey CA 1,200,000
Greenhope Services for Woman New York NY 1,200,000
Milwaukee County Milwaukee WI 1,200,000
Argus Community, Inc Bronx NY 1,197,300
Fortune Society, Inc Long Island City NY 1,200,000
Indiana Family & Social Services Admin Indianapolis IN 1,200,000
Family Service Center Houston Tx 1,200,000
County of Chester West Chester PA 1,200,000
Tides Family Services West Warwick RI 1,198,637
Catholic Charities Services Corp Cleveland OH 1,200,000
New North Citizen’s Council, Inc Springfield MA 1,200,000
Women’s Treatment Center Chicago IL 1,200,000
Volunteers of America of LA Los Angeles CA 1,200,000
Phoenix Programs Inc Columbia MO 1,200,000
Casa Esperanza, Inc Roxbury MA 1,200,000
Institute for Health and Recovery Cambridge MA 1,200,000
Baptist Child & Family Services San Antonio TX 1,200,000
Homeboy Industries Los Angeles CA 1,199,982
University of Colorado-Denver Denver CO 1,200,000
Sanctuary , Inc of GUAM Chalan Pago GM 1,180,153
Institute for Child and Family Health Miami FL 1,169,340

Evaluation Activities: This discretionary grant program is not designated for an external evaluation study. Each grantee is responsible for performance measurement utilizing GPRA client level data administered at intake, six-month, and release from treatment mileposts. Additionally, each grantee is responsible for assessing performance using basic process and outcomes questions.

Future Prospects: Discussing with BJA the possibility of a future collaborative effort.

Contact:

Kenneth W. Robertson
Team Leader, Criminal Justice Programs
Division of Services Improvement, Center for Substance Abuse Treatment
Phone: 240-2761621
Email: Kenneth.robertson@samhsa.hhs.gov

Targeted Capacity for Substance Abuse Treatment and HIV/AIDS Services (TCE/HIV) National Minority AIDS Initiative

Type of Activity:  Services

Funding Mechanism:  Grant

Total Available Funding:  $ 61.6 million

Number of Awards:  140 grants

Award Amount:  Grants that provide outreach and pretreatment services are funded for an amount to pass $400,000/year/grant. Grants that provide clinical substance abuse treatment are funded up to $450,000/year/grant.

Length of Project Period: 5 Years

Federal Partners:  Department of Health and Human Services

Summary:  The TCE/HIV program implements the Congressional directive for the National Minority AIDS Initiative to enhance the quality of services and expand the service capacity of substance abuse treatment programs with a history of providing services to high risk communities of color that are severely impacted by substance abuse and HIV/AIDS. Projects address both the shortage of substance abuse treatment and HIV/AIDS services including, HIV counseling and testing, health education, and access and referral to STD, hepatitis B and C and TB testing in minority communities. All grantees under the program are required to offer rapid HIV testing, and do on-site testing for grantees within the FY 2008 and 2009 Cohorts. In addition, funds community providers/community-based organizations that serve predominantly racial and ethnic minorities to increase treatment capacity including outreach and pretreatment services for individuals living with HIV/AIDS or at risk for HIV/AIDS related to their substance abuse. Funds are also used to continue a multi-site prospective evaluation that will allow programs to address behavioral risk factors and other related information that affect treatment outcome.

Activities: 

Background:  In 2008, the Centers for Disease Control and Prevention (CDC) with the use of new technology estimated that approximately 56,300 new HIV infections occurred in the U.S. in 2006 — a figure that is 40% higher than CDC’s former estimate of 40,000 new infections per year.  These new estimates indicate that there are about 1,106,400 adults and adolescents living with HIV infection in the United States (CDC’s MMWR, October, 2008). These new findings also indicated that African Americans and Hispanics/Latino populations continue to be disproportionately affected by HIV infection. Recent estimates showed that African Americans represented 46% and Hispanics/Latinos 18% of new HIV infections, respectively.  In 2008, an estimated 18,341 blacks and 7,864 received an AIDS diagnosis (CDC, June 2008). Individuals with substance use disorders are also at increased risk for HIV/AIDS as a result of either sharing contaminated syringes or by exhibiting impaired judgment while under the influence of a legal or illegal drug with abuse potential (e.g., alcohol, cocaine, methamphetamine, marijuana, and/or other non-injection drugs) which may increase high risk sexual behavior associated with HIV infection or transmission.  This public health concern is supported by the CDC 2006 estimated HIV prevalence in the United States, which found that people infected with HIV through injection drug use accounted for 12% of annual new HIV infections and 19% of all people living with HIV (204,600 persons; 131,500).

FY 2009 Grantees:
Grantee City State Award Amount
Wyckoff Heights Medical Center Brooklyn NY $350,000
Positive Impact, Inc. Atlanta GA $350,000
Muscogee Creek Nation Okmulgee OK $450,000
East Bay Community Recovery Project Oakland CA $450,000
Recovery Consultants of Atlanta, Inc. Decatur GA $450,000
AIDS Service Center of Lower Manhattan New York NY $350,000
University of Tennessee Knoxville Knoxville TN $448,146
Street Works Nashville TN $350,000
Center for Great Expectations Somerville NJ $450,000
Vocational Instruction Project Community Services Bronx NY $450,000
San Francisco Dept. of Public Health San Francisco CA $450,000
TASC, Inc. Chicago IL $350,000
Catholic Community Services Miami Shores FL $445,510
Center for AIDS Research, Education & Services Sacramento CA $366,426
Latino Health Institute, Inc. Boston MA $450,000
CODAC Behavioral Health Services, Inc. Tucson AZ $450,000

Location(s) of Projects:  See above

Evaluation Activities:  For the multi-site evaluation, design the overall evaluation, identify a coordinating center, prepare OMB clearance documents, develop a standardized survey instrument, design a data analysis plan, and develop reporting protocols, and a dissemination strategy. Multi-Site Evaluation was awarded in FY 08 for $3,000,000/year.

Future Prospects:  Current activities are funded under a fixed line item in the SAMHSA budget. However, the recently released Presidential National HIV/AIDS Strategy (July, 2010) makes a series or recommendations for SAMHSA. Future funding and activities will be determined by the gaps in services documented through increased and improved local, State and National surveillance. An overall goal of the plan is to increase access to care and optimizing health outcomes for people living with HIV while reducing health disparities. The accompanying Vision Statement is also quite simple but will have short and long range implications on how SAMHSA operates. The Vision: The United States will become a place where new HIV infections are rare and when the do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identify or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free for stigma and discrimination.

More Information: No grants were funded in FY 2010 through the SAMHSA TCE-HIV program. URL for grants funded for FY 2006 to FY 2009 can be found at the following links and contains the name of grantee, location, contact information and amount of award.

FY 2009 http://www.samhsa.gov/Grants/2009/awards/ti0806.aspx

FY 2008 http://www.samhsa.gov/Grants/2008/awards/ti08006.aspx

FY 2007 http://www.samhsa.gov/grants/2007/awards/ti07004.aspx

FY 2006 http://www.samhsa.gov/Grants/2006/TI_06_010.aspx

Contact: 

David Thompson
Team Leader, TCE-HIV Program
Division of Services Improvement, Center for Substance Abuse Treatment
Phone: 240-276-1623
Email: David.Thompson@samhsa.hhs.gov


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Last updated:  02/25/2011