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Provide overview of the block grant statute requiring
planning councils
Provide overview of statutory responsibilities of
planning councils
Describe context for changes in block grant
Provide considerations in combined Behavioral Health
Planning Council
SAMHSA’s Strategic Initiatives
Block Grant - Impact on State Authorities and Systems
Block Grant Programs’ Goals
◦ The block grant is a formula grant awarded to States
based upon an allotment calculated for each fiscal year by
a legislated formula.
◦ Awards are made in response to the States’ applications
and to the implementation reports submitted by the
States for the previous fiscal year
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As a result of federal law 99-660 in 1986, continuing
through Public Law 101-639 and Public Law 102-321 in
1992, and continued in the current 106-310:
Mental health planning and advisory councils (PACs)
exist in every State and U.S. Territory.
Current SAMHSA reauthorization bill again includes
councils.
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The law requires States to perform mental health planning in
order to receive federal Mental Health (MH) Block Grant funds
Each State or U.S Jurisdiction has submitted an annual MH Block
Grant application plan due September 1 of each year.
 Substance Abuse Prevention and Treatment (SAPT)
application has been due December 1.
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Each State submits an MH implementation report due Dec. 1
reporting on the previous year’s block grant fund expenditures
and implementation
Planning
Councils must contain the following people:
•Representatives
from the following State agencies:
 Mental Health, Education, Vocational Rehabilitation,
Criminal Justice, Housing, Social Services, and the State
Medicaid Agency
 Because of cultural factors, several jurisdictions do not
include a housing representative
•Public and private entities concerned with the need, planning,
operation, funding, and use of mental health services and
related support services
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Adults with serious mental illness who are receiving (or have
received) mental health services.
Families of such adults and families of children with serious
emotional disturbance:
 The ratio of parents of children with serious emotional
disturbance to other members of the council must be
sufficient to provide adequate representation of such
children.
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Most importantly, the law states that not less than 50% of the
members of the councils are individuals who are NOT State
employees or providers of mental health services.
 How to define “providers” ?
 Peer providers?
1. To review the Mental Health Block Grant Plan and to make
recommendations.
2. To serve as an advocate for adults with a serious mental
illness, children with a serious emotional disturbance, and
other individuals with mental illnesses.
3. To monitor, review, and evaluate, not less than once each
year, the allocation and adequacy of mental health services
within the State.
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Affordable Care Act signed in to law and recently
upheld by the Supreme Court
Increased focus on integration of services and
development of Health Homes
Greater emphasis on prevention and wellness
Emphasis on recovery focus and expansion of peer
services
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SAMHSA is urging States to integrate MH and SA into
Behavioral Health Planning Councils
There are some challenges in doing so, as statute
requires MH planning council but not SA
Behavioral health planning councils must still meet the
statutory requirements for MH planning councils
Colorado has taken a lead to integrate and created a
behavioral health planning and advisory council
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SAMHSA has created an combined substance abuse
treatment and prevention and mental health block grant
application, in part in preparation for possible ACA
implementation
As of Sept. 1, 2011, 22 States submitted a combined
application
SAMHSA has adopted a new submission schedule for the
combined BG application
Combined application is for a two year period and can be
updated by the State during the two year period
Colorado has combined its application
Prevention
of Substance Abuse and Mental Illness
Trauma and Justice
Military Families
Recovery Support
Health Reform
Health Information Technology
Data, Outcomes, and Quality
Public Awareness and Support
States should be more strategic in their efforts to
purchase services
States should think more broadly than the
populations they have historically served through
Federal Block Grants and other funding.
States should design and develop collaborative plans
for health information systems. Interoperable
information technology systems that allow for the
effective exchange and utilization of health data.
States may form strategic partnerships in order for
individuals to have access to a good and modern
services system.
State authorities should focus more on recovery from
mental health and substance use problems.
State authorities should monitor the coverage of
behavioral health services offered by qualified health
plans and Medicaid to ensure that individuals with
behavioral health conditions have adequate coverage
and access to services
States should make primary substance abuse
prevention a priority.
State authorities should be strategic in leveraging
scarce resources to fund prevention services.
State authorities should monitor Exchanges to ensure
that individuals with behavioral health conditions are
aware of their eligibility, able to get enrolled, and able
to stay enrolled.
State authorities should make every effort to ensure
that the right recipient is receiving the right payment
for the right reason at the right time.
State authorities should use evidence to support their
funding and purchasing decisions.
State authorities should ensure that they comport
with changes in quality reporting.
State authorities should pay particular attention to
trauma.
State authorities should collaborate closely with their
counterparts in the criminal and juvenile justice
systems.
States authorities should monitor compliance with the
federal parity law to ensure that individuals with
behavioral health conditions are receiving the
mandated coverage and access
State authorities should be key players in primary and
behavioral health care integration activities.
Population changes in many states have created a
demographic imperative to focus on improving
behavioral health care for diverse racial, ethnic, and
LGBTQ populations with the goal of reducing
disparities for these subpopulations.
State authorities are encouraged to implement, track,
and monitor recovery-oriented, quality behavioral
health care services within their states as authorized
under the SABG and MHBG.
State authorities should ensure that their states have
a system of care approach to children’s and
adolescents’ behavioral health services.
The
components of a healthy life are the dimensions of
recovery:
A physically and emotionally healthy lifestyle
(health);
o A stable, safe and supportive place to live (a home);
o Meaningful daily activities such as a job, school,
volunteerism, family caretaking, or creative
endeavors and the independence, income, and
resources to participate in society (a purpose);
o Relationships and social networks that provide
support, friendship, love, and hope (a community).
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Additional
aims of the Block Grant programs:
o The focus is about everyone, not just those with an
illness or disease, but the whole population.
o The focus is on prevention and wellness activities.
o The activities are data driven: a public health agency
uses surveillance data as well as an analysis of other
public health drivers/levers to inform targets of
opportunity.
o There is an emphasis on access to services and
availability.
o There is an emphasis on policy impact and support:
an analysis of the laws, rules, and infrastructure
which informs and supports the work.).
Chris Habgood
Director of Public Policy and Planning