Federal Funding Streams: Building Blocks for Coordinated Treatment

1. Federal Funding Streams: Building Blocks for Coordinated Treatment Doreen Cavanaugh, Ph.D. Alexandria, VA June 13, 2006

2. Resources • Insurance • Private • Public • Medicaid • SCHIP • Non-Insurance based public funding

3. Types of Non-Insurance Based Federal Funding Sources • Entitlements • Block grants • Categorical funding • Discretionary grants • Demonstration grants • Research

4. Treatment for with SU/MH Disorders: Federal Policy Domains Housing Labor Health Justice Family Support & Child Welfare Education

5. Health • Substance Abuse Prevention and Treatment Performance Partnership Block Grant ( FY 05 - $1.776 Billion) • Community Mental Health Services Performance Partnership Block Grant (FY 05- $433 Million)

6. Health • CSAT Discretionary Grants • Substance Abuse Coordination State Infrastructure Grants • Strengthening Communities for Youth • Targeted Capacity Expansion • Screening, Brief Intervention and Treatment • Strengthening Treatment Access and Recovery • Access to Recovery • Drug Courts • Addiction Technology Transfer Centers

7. Health • CMHS Discretionary Grants • Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbance Grants • Mental Health Transformation State Incentive Grants • CSAT/CMHS Joint Discretionary Grants • Child/Adolescent State Incentive Grants • Co-occurring Disorders State Incentive Grants

8. Juvenile Justice • Juvenile Accountability Block Grant • OJJDP • Must sub-grant not less than 75% to units of local government or have waiver • $54 million in FY 05 • Accountability of system and offender • 16 purpose areas • Drug courts • Needs assessment ( includes tx)

9. Juvenile Justice • Justice Assistance Formula Grant Under PL 108-447 replaces: • Local Law Enforcement Block Grant Program • Funds units of local government • Local decision making • $115 million in FY04 • 7 purpose areas to reduce crime and improve public safety • May fund drug courts (tx only if component of drug court) • Byrne Block Grant • OJP • $651 million in FY 03 • Requires 25 % match • 29 purpose areas • Includes treatment (Purpose 13)

10. Juvenile Justice • Young Offender Reentry Program • Grants to serve youth who are reentering the community after being incarcerated • $6 million in FY 2004

11. Justice • Adult Drug Courts • Juvenile Drug Courts

12. Justice • Residential Substance Abuse Treatment of State Prisoners Program • Treatment in state and local treatment correctional and detention facilities • Requires 25% match • $25 million in FY 2005 • Strict requirements

13. Child Welfare • Runaway and Homeless Youth Program • Grants to establish or strengthen local programs that address the immediate needs of runaway and homeless youth • Counseling allowed • $104 million in FY 2005

14. Child Welfare • Title IV-B: Child Welfare Services/ Safe and Stable Families • Grants to establish or strengthen child welfare services/ enhance family functioning, prevent out-of-home placement • Funds used to meet criteria of Child and Family Service Reviews (safety, permanence, well-being) • $290/ $404 million in FY 2003

15. Child Welfare • Title IV-E: Foster Care and Adoption Assistance • Supports the foster care/adoption infrastructure • Provides funds for staff training • Waivers allow more flexible use of funds • Special interest in integrated treatment for behavioral health • Approximately $6.08 Billion in FY05

16. Child Welfare • Temporary Assistance to Needy Families • Grants to provide assistance to needy families with children • States have very broad discretion on use of funds • Some funds may be transferred to the SSBG, Title XX • Approximately $17.278 Billion in FY05

17. Child Welfare • Title XX: Social Services Block Grant • Funds may be used flexibly for a variety of social service problems • States may transfer up to 10% for services including substance abuse and mental health services • Approximately $1.7 Billion in FY 05

18. Education • Vocational Rehabilitation Grants to States • Grants to assist states to assess, plan, and deliver vocational rehabilitation services to individuals with disabilities • Eligibility is based on the presence of a physical and/or mental impairment • States may transfer up to 10% for services including substance abuse and mental health services • Approximately $2.6 Billion in FY 05

19. Education • Individuals with Disabilities Education Act • Funds may be used for treatment of primary disabling conditions • Mental health disorders considered primary disabling condition • Substance use disorders may be treated only if secondary to a primary disabling condition • $10.6 Billion in FY 05

20. Housing • The Housing and Community Development Act: Community Development Block Grant Entitlement Communities Program • The Housing and Community Development Act: Community Development Block Grant Program, State Administered Grants

21. Labor • Workforce Investment Act • Youth Activities: $996 million in FY05 • Job Corps • $1.575 Billion in FY05

22. Pulling the Funding Together • Coordinating funds for efficient, effective services • The North Carolina Model

23. Financial Mapping • Identify what is being spent for treatment of mental health/substance use/co-occurring disorders • Coordinate existing resources • Develop plan to improve access • Identify resources to implement plan