FY 2005 Government Performance and Results Act (GPRA)

IV. PERFORMANCE PLAN AND REPORT
Substance Abuse Treatment

Programs included in this report are:

13. Targeted Capacity Expansion
14. Best Practices: Knowledge Application
15. Substance Abuse Prevention and Treatment Block Grant
16. Screening and Brief Intervention Referral to Treatment
17. Access to Recovery Voucher Program
18. Substance Abuse Set-Aside Data Activities

Treatment Capacity Priority Area
13. Targeted Capacity Expansion

Performance Goals (Capacity)	Targets	Actual Performance	Reference
1. Increase the number of clients served. (Annual) (E) Long-term Increase the number of clients served	FY 05: 30,158 FY 04: 29,567 FY 03: Maintain at 21,000 FY 02: Maintain at 21,000 FY 06: 30,761	FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 28,988 FY 02: 7,792 clients FY 06: TBR 10/06	HHS SP -1
2.Increase the percentage of adults receiving services who: (O) (a) were currently employed or engaged in productive activities; (b) had a permanent place to live in the community; (c) had no/reduced involvement with the criminal justice system. (d) experienced no/reduced alcohol or illegal drug related health, behavioral, social, consequences (e) had no past month substance use (Annual)	FY 05: 47% FY 04: 45% FY 03: Maintain at 35% FY 02: 35% FY 05: 91 % FY 04: 89% FY 03: Maintain at 35% FY 02: 35% FY 05: 98% FY 04: 96% FY 03: Maintain at 35% FY 02: 35% FY 05: 85% FY 04: 83% FY 03: Maintain at 35% FY 02: 35% FY 05: 65% FY 04: 63% FY 03: Maintain at 35% FY 02: 35%	FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 42.9% FY 02: 63% FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 87.4% FY 02: 63% FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 94.6% FY 02: 63% FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 81.5% FY 02: 63% FY 05: TBR 10/05 FY 04: TBR 10/04	HP 2 26-10c
Effectiveness 3. Increase the number of people who report no past month substance use (O) (Long Term; Developmental)	FY 06: +8% FY 03: Baseline	FY06: TBR: 10/06 FY 03: Baseline 61.1%
Efficiency (E) 4. Increase the percentage of grantees in appropriate cost bands (Long Term; Developmental)	FY 06: +60%* FY 03: Estab. Baseline	FY 06: TBR 10/06 FY 03: TBR 10/04*
Total Funding: Note: FY 2005 includes $4.3M from the PHS evaluation fund	2005: $468,538 2004: $370,826 2003: $263,947

Full Cost Table

13. Targeted Capacity Expansion Incorporates:	2003	2004	2005
13.1 (80%)	$226.0	$313.5	$392.3
13.2 (20%)	$56.5	$78.4	$98.1
13.3
13.4
Total Full Cost Funding  ($'s in Millions)	$282.49	$391.89	$490.32

CSAT has made considerable effort to move in the direction of coordinating performance and budget data by the introduction of an automated GPRA data collection and reporting system across all of its discretionary programs. With the introduction of the current GPRA data entry and reporting system, all data are now collected and reported near real time by summary to date as well as by fiscal years. Given the implementation of this new system, all of the Targeted Capacity Expansion (TCE) services program tables included in this report have been revised. The apparent discontinuity in the FY03 and later targets for TCE is the result of a shift in FY04 to using revised targets that are consistent with our long-term PART goals.

For FY05 CSAT has set four standard performance measures for the TCE program budget line: two performance measures for the services activities and two performance measures for the knowledge application activities. For this submission, CSAT has aggregated the reporting for programs so that there is one narrative and four measures tracking performance for the entire TCE program budget line. This has reduced the number of TCE measures from 21 to 6. We expect also each year to select programs of special interest for additional descriptive reporting. For example, in FY04, as data become available, we expect to include additional descriptive reporting on the new FY 2003 Screening and Brief Intervention, Referral and Treatment (SBIRT) and later, on the new FY 2004 Access to Recovery program.

The 2002 OMB PART review of CSAT PRNS programs identified the need to develop long-term goals. These goals relate to the SAMHSA agency level goals for accountability, capacity and effectiveness. The goals are listed in the performance table.

Program Description and Context

Targeted Expansion program, begun in 1998, is designed to enhance or expand a community's ability to provide a comprehensive, integrated, creative, and community-based response to a targeted, well-documented substance abuse treatment capacity problem. The program addresses gaps in treatment capacity by supporting rapid and strategic responses to demands for substance abuse treatment services (including both alcohol and drugs) in communities with serious, emerging drug problems. The program also builds quality improvements into the treatment system, supporting SAMHSA's Effectiveness goal as well as the Capacity goal. Grantees include State, regional, and local government entities.

CSAT recognizes the disparity between the needs of certain under-served and under-represented minority populations and the ability to provide them treatment services. Within this budget line are the following programs:

TCE Programs Included in this Budget Line

General Population	Drug Courts	Rehabilitation and Restitution
HIV/AIDS	ADM disorders and violence	· Strengthening Minority Communities
· Addiction treatment for Homeless	· Adolescent Residential Treatment/ Youth	· Comprehensive Community Treatment programs
Strengthening Communities	Adolescent Treatment Models	Co-occurring Disorders Study

As discussed in the introduction, for the 2005 OMB submission, CSAT is aggregating performance reporting for the TCE services activities programs in this GPRA submission.

Performance Analysis

Measure 1: Increase the number of clients served

CSAT's primary mission is to bring effective alcohol and drug treatment to every community. The number of people served reflects the extent to which CSAT funding has supported the provision of service. This is measured through the GPRA Core Client Outcome Tool. The target of 21,000 set for FY 03 was exceeded, with an actual performance nearly 30,000 clients served.

Measure 2: Employed or engaged in productive activities; had a permanent place to live in the community; had no/reduced involvement with criminal justice system; experienced no/reduced alcohol or illegal drug related health, behavioral, social consequences; had no past month substance abuse

Indicators are reported at 6 months as a percentage. The target for each indicator was met for FY 03. Future targets are set based on the performance in FY03.

Measure 3: Increase the number of people who report no past month substance use

The target for this long term effectiveness measure is currently set at an increase of at least 8% over baseline in FY 2006.

Measure 4: Increase the percentage of grantees in appropriate cost bands.

The target for this long term efficiency measure is currently set at an increase of 60% over baseline for FY 2006. This target was based on preliminary estimates of grantee performance in the past. However, in the absence of more final data CSAT will report this information in October 6 as we are moving toward collecting better quality cost measures.

Treatment Capacity
14. Program Title: Best Practices

Performance Goals (Effectiveness)	Targets	Actual Performance	Reference
1. Increase the training provided (a) Number of individuals trained per year. (Annual) (E) (b) Increase number of events by 2006 (Long Term)	FY 05: 22,148 FY 04: 21,714 FY 03: Baseline FY 06: TBR 12/03	FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 21,289 FY 06: TBR 10/06	HHS SP -1
2. Increase the percentage of participants who: (O) (a) would rate the quality of the events as good, very good, or excellent (b) shared any of the information from the events with others (c) have used information from "Best Practice" events or activities to promote or effect change. (Annual) Long-Term By 2006, increase by 8% the number of participants who have used information from Best Practice events or activities to promote or effect change	FY 05: 85.4% FY 04: 83.4% FY 03: 80% FY 02: 70% FY 05: 22.98% FY 04: 20.98% FY 03: 80%* FY 02: 70% FY 05: 20.7% FY 04: 18.7% FY 03: 80%* FY 02: 70% FY 06: +8%	FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 81.4% FY 02: 86.3% FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 18.98% * FY 02: 86.3% FY 05: TBR 10/05 FY 04: TBR 10/04 FY 03: 16.74%* FY 02: 86.3% FY 06: TBR 10/06
Efficiency (E) 3. Increase the percentage of grantees in appropriate cost bands	FY 05: TBR 12/04 FY 04: TBR 12/04 FY 03: Establishing Baseline	FY 05: TBR 10/06 FY 04: TBR 10/05 FY 03: TBR 12/04
Total Funding:	2005: $48,494 2004: $48,392 2003: $53,331

Full Cost Table

14. Best Practices Incorporates:	2003	2004	2005
14.1 (50%)	$24.2	$25.6	$25.4
14.2 (50%)	$24.2	$25.6	$25.4
14.3
Total Full Cost Funding ($'s in Millions)	$48.4	$51,141	$50,741

Program Description and Context

The Best Practices Program was created to promote the adoption of best practices to improve the effectiveness of substance abuse treatment. This budget program combines the Addiction Technology Transfer Centers, Practice Improvement Collaboratives, Community Action Grants, Conference Grants, Recovery Community Support Programs and the STAR program. A key component in transferring addiction related technology is to provide evidence-based education and training to substance abuse treatment professionals.

These programs produce addiction-related publications to keep treatment professionals updated on the latest research and other cutting-edge issues that impact their work. These programs also provide ongoing education opportunities for the substance abuse field. Some of the innovative technologies utilized to provide education and training include: symposia, institutes, exhibit booths, newsletters, Web sites, meetings and technical assistance. Customers include a variety of professionals in fields such as addiction treatment, public health, and mental health, community corrections, social work, and criminal justice. These professionals connect with these programs individually or via Single State Authorities, academic institutions, community-based and managed care organizations, professional associations, and community organizations.

Program Performance Analysis

Measure 1: Increase: (a) the number of individuals trained per year and (b) the number of events per year.

This is a key measure tracking CSAT's mission of promoting effective treatment through the adoption of evidence-based practices. Tracking the number of individuals trained and training events is critical in documenting the delivery of service and dissemination of relevant information to the field. This is measured through the Core GPRA Customer Satisfaction Training Tool.

The baseline of 21, 289 participants reflects the actual performance of FY 03.

Measure 2: Increase percentage of stakeholders who (a) would rate the quality of the events as good, very good, or excellent; (b) shared any of the information from the events with others; (c) have used information from "Best Practice" events or activities to promote or effect change.

The FY 03 target of 80% satisfaction with the event was exceeded; however, the targets measuring use and sharing of the information were not met in FY 03. The reason for this is that targets needed to be reset so that they were consistent with those set in the OMB PART Review.

Measure 3: Increase the percentage of grantees in appropriate cost bands.

The target is currently set at 60% by the year 2006 with an annual incremental increase of 2% above the baseline set in the PART review. This is measured through the baseline number of clients served and a proportion (80%) of the budget dollars for the program going towards services for clients within these programs. The remaining 20% is for evaluation, and business expenditures such as overhead. This target was based on preliminary estimates of grantees performance in the past. However, in the absence of more final data, CSAT will report this information in October of 2006 as we are moving toward collecting better quality cost measures.

Treatment Capacity Priority Area
15. Substance Abuse Prevention and Treatment Block Grant

Performance Goals Strategic Goal: Capacity	Targets	Actual Performance	Reference
1. Number of Clients served: (E) Note: Baseline, targets, and proxy performance data currently provided by TEDS data set (see text), which reports admissions data.	FY 05: 1,963,851 FY 04: 1,925,345 FY 03: 1,884,654 FY 02: 1,751,537 FY 01: 1,635,422 FY 00: 1,525,688	FY 05: TBR 9/07 FY 04: TBR 9/06 FY 03: TBR 9/05 FY 02: TBR 9/04 FY 01: 1,739,796 FY 00: 1,599,701 FY 99: 1,587,510 FY 98: 1,564,156 FY 97: 1,537,143	HHS SP -1
2. Increase the number of States and territories voluntarily reporting performance measures in their SAPT Block Grant application.	FY 05: 25 FY 04: 25 FY 03: 25 FY 02: 25 FY 01: 25 FY 00: 19 Baseline established	FY 05: TBR 9/06 FY 04: TBR 9/05 FY 03: TBR 9/04 FY 02: 26 States/Territories reported some or all information. FY 01: 25 States reported some or all information. FY 00: 24 States reported some or all information FY 99: 0 States
3. Increase the percentage of States that express satisfaction with Technical Assistance (TA) provided. (O)	FY 05: Maintain at 97% FY 04: Maintain at 97% FY 03: Maintain at 97% FY 02: Maintain at 97% FY 01: 97% FY 00: 90% FY 99: 85% Baseline established	FY 05: TBR 9/06 FY 04: TBR 9/05 FY 03: TBR 9/04 FY 02: 92% FY 01: 97% FY 00: 97% FY 99: 96%
4. Increase the percentage of TA events that result in systems, program or practice change. (O)	FY 05: Maintain at 95% FY 04: Maintain at 95% FY 03: Maintain at 95% FY 02: 95% FY 01: 85% FY 00: 70% FY 99: 66% Baseline established	FY 05: TBR 9/06 FY 04: TBR 9/05 FY 03: 91% FY 02: 97% FY 01: 96% FY 00: 84% FY 99: 66%
5. Increase the percentage of Block Grant applications that include needs assessment data.	FY 05: 97% FY 04: 95% FY 03: 93% FY 02: 90% FY 01: 85% FY 00: 80% FY 99: 72% Baseline established	FY 05: TBR 9/06 FY 04: TBR 9/05 FY 03: TBR 9/04 FY 02: 100% FY 01: 88% FY 00: 80% FY 99: 72%
6. Increase the percentage of States that indicate satisfaction with CSAT customer service, throughout the entire Block Grant process. (O)	FY 05: 98% FY 04: 98% FY 03: 96% FY 02: 95% FY 01: 93% FY 00: 91%	FY 05: TBR 9/06 FY 04: TBR 9/05 FY 03: TBR 9/04 FY 02: 95% FY 01: 91% FY 00: 91%
7. Increase the percentage of States reporting satisfaction with CSAT's responsiveness to State suggestions on services. (O) ·	FY 05: Maintain at 96% FY 04: Maintain at 96% FY 03: 96% FY 02: 95% FY 01: 94% FY 00: 93%	FY 05: TBR 9/06 FY 04: TBR 9/05 FY 03: TBR 9/04 FY 02: 91% FY 01: 90% FY 00: 93%
8. Increase the percentage of states in appropriate cost bands (Efficiency measure)	FY 05: 60% FY 04: Establish Baseline	FY 05: TBR 8/05 FY 04: TBR 10/05* *See narrative discussion
9. Percentage of clients reporting change in abstinence at discharge (Long-term)	FY 08: TBR 10/05 FY 05: Establish Baseline	FY 08; TBR 10/08 FY 05: TBR 10/05
Total Funding:	2005: $1,753,932 2004: $ 1,779,146 2003: $ 1,832,235	(Note: Funding also includes PHS Evaluation Funds)

Full Cost Table

15. Substance Abuse Prevention and Treatment Block Grant Incorporates:	2003	2004	2005
15.1 (40%)	$564.8	$573.1	$590.1
15.2 (10%)	$141.2	$143.3	$147.5
15.3 (10%)	$141.2	$143.3	$147.5
15.4 (10%)	$141.2	$143.3	$147.5
15.5 (10%)	$141.2	$143.3	$147.5
15.6 (10%)	$141.2	$143.3	$147.5
15.7 (10%)	$141.2	$143.3	$147.5
15.8
15.9
Total Full Cost Funding ($'s in Millions)	$1,412.1	$1,432.7	$1,475.2

Program Description and Context

The SAPT Block Grant, the cornerstone of State's substance abuse programs, is an integral part of the President's Drug Treatment Initiative. Block Grant funding accounts for approximately 40% of public funds expended for prevention and treatment. The SAPT Block Grant is allocated to the States by a formula prescribed in the Public Health Service Act. The grant provides States the flexibility to plan, carry out, and evaluate substance abuse services. More than 10,500 community-based organizations receive SAPT Block Grant funding from the States.

Program Performance Analysis

CSAT has approached performance measures development using a two-pronged strategy. First, CSAT piloted the collection of performance-based measures through grants to States and Territories. Second, CSAT is promoting consensus-building efforts among key stakeholders to refine the measures. CSAT also piloted State capacity to collect data on a small subset of the core measures beginning with the FY00 Substance Abuse Prevention and Treatment (SAPT) Block Grant application. This effort resulted in FY03 in 26 States/Territories voluntarily reporting some or all of these performance measures (see Measure 2).

Three barriers to effective performance measurement remain. First, the cost of conducting client outcome studies is significant even on a small representative sample. Second, there is a need to develop data infrastructure and management within State systems. Third, State capacity to utilize performance measurement varies. A CSAT study through the National Association of State Alcohol and Drug Abuse Directors (NASADAD) found that 1) 24 of the 56 States reviewed reported that they were able to submit data for analysis; and 2) periodicity of studies conducted, methodologies, and measure definitions used, vary significantly across the States. Note that in FY 2005, $8.6 million in SAPTBG set-aside funds will provide data infrastructure support to States.

Measure 1: Number of clients served.

The FY 2001 target was exceeded. An estimated 1,739,796 clients were served. Future targets have been adjusted upward.

The number of client admissions reported is counted annually in the fiscal year being reported. The availability of TEDS data, like other major public health data sets such as births and deaths, reflects a 2 year lag period. Tracking numbers served is a critical component of any cost-benefit analysis.

Reporting of the exact number of clients served in Block Grant funded facilities remains under development. Tracking the unduplicated number of clients served by each State, which is the ideal way of reporting these data, requires that systems employ a unique client identifier. States are working toward providing unduplicated counts. Twenty-three States and Territories were able to report unduplicated counts in FY02. Some States are unable to report this information due to laws prohibiting the use of unique client identifiers and data system limitations. Therefore, the targets projected for the SAPT Block Grant continue to be based on the number of client admissions reported by TEDS data source.

Measure 2: Increase the number of States and territories voluntarily reporting performance measures in their SAPT Block Grant application.

The FY03 target was exceeded. Thirty-three States and the Virgin Islands reported on some or all of the measures, exceeding the target of 25, This is the fourth year States and Territories could report voluntarily on performance measures in their SAPT Block Grant application. A significant factor that may have affected State's interest in submitting these voluntary data is the evolving nature of the data elements. The FY03 Block Grant Application OMB approval will expire on July 31, 2004, including collection of this critical information on nine outcome measures. States may be waiting for final guidance from SAMHSA to finalize the Performance Partnership Grant plan before committing additional resources to collecting these data. The Performance Partnership Grant would focus on State systems accountability by requiring States to collect data in core client indicator areas and optional State-selected indices, measure current performance, set targets and adjust State system activities and priorities based on States performance relative to these targets.

Measure 3: Increase % of States that express satisfaction with Technical Assistance provided.

Customer satisfaction is a good measure of the responsiveness and utility of SAMHSA's technical assistance provided over the past 12 months. CSAT conducts an annual customer satisfaction survey with the States/Territories on the block grant activities. The data source is an OMB-approved Customer Service Survey that is mailed annually to State Substance Abuse Directors to complete and is forwarded to CSAT contractor for data analysis and a final report is prepared. Reliability and validity were assessed as part of survey design, development, and pilot implementation, and were determined to be high. The survey supports service improvements by allowing for a modification of the program process to better respond to customer needs. In FY02, 49 of the 60 jurisdictions, including the District of Columbia, and Puerto Rico (excluding the Pacific Basin, Red Lake and Virgin Islands) were surveyed.

The FY02 target of 97% was not met. The overall satisfaction was found to be 92%. States reported that CSAT technical assistance improves their credibility within their state. Combining the two highest categories (to a great extent and to some extent), the overall satisfaction was found to be 92%. Although the achieved results narrowly missed the target, ninety percent of the States reported overall satisfied or very satisfied with technical assistance received by CSAT.

Measure 4: Increase % of Technical Assistance events that result in systems, program or practice change.

The target was narrowly missed. We have modified our technical assistance approval process that prioritizes technical assistance that focus on program improvements and systems change as a top priority. We expect that the performance will improve to previous target levels.

Measure 5: Increase percentage of Block Grant applications that include needs assessment data.

Section 1929 of the Block Grant legislation requires States to submit an assessment of the need in the State for authorized activities by the States and locality.

The data source is the annual uniform SAPT Block Grant Electronic Application System that generates aggregated reports on State's submission of treatment Needs Assessment Summary Matrix (TNASM) (form 8) and State Use of Needs Assessment Information (SUNAI) (form 10). States are required to report needs assessment data on the TNASM form. Reliability and validity of states and territories reporting on Form 10 was piloted and assessed in the FY99 SAPT block grant application that determined the baseline of 72%.

The FY02 target was exceeded. All of the States and Territories (100%) (met and exceeded target by 15%) reported in their FY03 SAPTBG application on some or all of the needs assessment summary data matrix form using the last calendar year for which the State have the data. States and Territories also reported on multiple uses of State needs assessment data on the SUNAI (form 10). Many States view state needs assessment data as a planning tool that assists in management decisions about resource and/or method allocation to better serve communities in greatest need of substance abuse services. A majority of the States (86%) use needs assessment data for services planning and public information. While 69% of the States use needs assessment data for legislative initiatives, a number of states continue to use needs assessment data to allocate new funding (58%) and/or allocate historical funding (48%) to treatment providers.

Measure 6: Increase percentage of States that indicate satisfaction with CSAT customer service, throughout the entire Block Grant process.

Customer satisfaction is a good measure of the responsiveness and utility of SAMHSA's service to the States throughout the entire Block process. CSAT conducts an annual customer satisfaction survey covering the past 12 months. The survey results support service improvements by altering program processes to better respond to customer needs.

The data source is the same as used in measures 3 and 4.

Measure 6: The FY02 performance target was met. The actual performance on this measure was 95%. In FY02, CSAT and CSAP developed new procedures for staff to follow that streamlined the review process of SAPTBG applications to improve efficiency of internal operations. In FY03 a CSAT and CSAP Block Grant Re-Engineering Workgroup was established to develop new guidelines for working with the States under the new performance partnership grant application plan. This process is expected to result in further improvement in satisfaction with CSAT customer service.

Measure 7: Increase percentage of States reporting satisfaction with CSATs responsiveness to State suggestions on services.

This measure reports State's satisfaction with CSATs responsiveness to State suggestions on services. CSAT conduct an annual customer satisfaction survey with the States/Territories on the block grant activities. The survey supports service improvements by altering the program process to better respond to customer needs. The data source is the same used for measures 3, 4, and 6.

The FY02 performance target of 95% was not met. The customer satisfaction data reported 91% of states are satisfied or very satisfied with the responsiveness of CSAT to State suggestions by combining the two highest categories (satisfied and very satisfied). The actual performance level achieved remains relatively high.

Measure 8: Increase the percentage of States in appropriate cost bands (efficiency measure)

The long-term 2006 target is current set at 60% with an annual incremental increase of 2% above the baseline estimated for the OMB PART review. The cost bands were estimated based on guidance provided by an expert panel looking at a series of national studies. The baseline was estimated to be approximately 54%, however, there is no empirical program data to support this. The program data is expected to be captured by the FY 2005 application.

Measure 9: Percentage of clients reporting change in abstinence at discharge (long-term).

The measure is based on State reports within the annual block grant application that are reported annually on October 1. The FY06 and FY07 targets will be set based on data received in the annual application on October 1, 2005.

16. Screening and Brief Intervention, Referral and Treatment

Performance Goals Strategic Goal: (Capacity)	Targets	Actual Performance	Reference
1. Increase the number of clients served. (E)	FY 05: TBR 11/04 FY 04: TBR 11/04 FY 03: Establish baseline	FY 05: TBR 10/06 FY 04: TBR 10/05 FY 03: TBR 10/04	HHS SP -1
2. Increase the percentage of clients receiving services who: had no past month substance use (O)	FY 05: TBR 11/04 FY 04: TBR 11/04 FY 03: (Establish baseline	FY 05: TBR 10/06 FY 04: TBR 10/05 FY 03: TBR 10/04
Total Funding:	See PRNS program for budget information.

Full Cost Table*

This program is funded out of PRNS, therefore, full costs are assigned to the block grant program measures on page 80.

16. Screening, Brief Intervention, Referral & Treatment (SBIRT) Incorporates:	2003	2004	2005
16.1 (50%)
16.2 (50%)
Total Full Cost Funding  ($'s in Millions)

Program Description and Context

Screening, Brief Intervention, Referral and Treatment (SBIRT) is a new program initiated at the
end of FY03. Data collection for this program has not yet begun as the grants were not awarded until late in FY03. There is an emerging body of research and clinical experience that supports use of the SBIRT approach as providing effective early intervention for those persons who are nondependent users of illicit drugs. These cooperative agreements are to expand and enhance State substance abuse treatment service systems by developing the State's continuum of care to include screening, brief intervention, referral, and treatment (SBIRT) in general medical and other community settings (e.g., community health centers, school-base health clinics and student assistance programs, occupational health clinics, hospitals, emergency departments); supporting clinically appropriate treatment services for nondependent substance users (i.e., persons with a Substance Abuse Disorder diagnosis) as well as for dependent substance users (i.e., persons with a Substance Dependence Disorder diagnosis); improving linkages among community agencies performing SBIRT and specialist substance abuse treatment agencies; and identifying systems and policy changes to increase access to treatment in generalist and specialist settings. It is estimated that approximately 7 States/Indian Tribes received awards in FY 2003.

Program Performance Analysis

Measure 1: Increase the number of clients served.

The number of people served reflects the extent to which CSAT funding has supported the provision of service. This will be measured through the collection of Core GPRA Client Outcome Tool data.

Measure 2: Increase the percentage of clients receiving services who had no past month substance use.

The percentage of clients receiving services who had not used substances in the past month at 6 months post admission reflects the extent to which CSAT funding has supported the provision of effective service. This will be measured through the collection of Core GPRA Client Outcome Follow Up Tool.

17. Access to Recovery Voucher Program
Program Description and Context

This measures for this program are developmental and will be included in a performance table when complete.

As envisioned, Access to Recovery (ATR) will be a voucher program administered by the States. The initiative would allow individuals seeking clinical treatment and recovery support services to exercise choice among qualified community provider organizations, including those that are faith-based. An initial assessment will be conducted for each individual to determine the appropriate level of service for that individual, which would include a range of possibilities including recovery support services, brief interventions and more intensive clinical treatment. This increase is part of the President's commitment to provide an additional treatment services over five years. This program will complement the State Targeted Capacity Expansion Program. Both are key components of the Presidential initiative to increase substance abuse treatment capacity, consumer choice, and access to a comprehensive continuum of treatment options, including faith-based programmatic options. The measures for this program are developmental, and will be included in a performance table when complete. First grants are expected to be awarded in FY 2004.

Substance Abuse National Data Collection

Surveys conducted by OAS are the only source of national data on the extent of substance abuse in the general population and the characteristics of the treatment system. They also provide critical information for evaluating the success of Federal and State substance abuse programs.

18 Program Title: Substance Abuse National Data Collection

Performance Goals (Accountability)	Targets	Actual Performance	Reference
1: Availability and timeliness of data for the: (a) National Survey on Drug Use and Health (b) Drug Abuse Warning Network (c) Drug and Alcohol Services Information System (O,E)	FY 05: (a) 8 months; (b) 9 months; (c) 16 months FY 04: (a) 8 months; (b) 9 months; (c) 16 months FY 03: (a) 8 months; (b) 9 months; (c) 16 months FY 02: (a) 8 months; (b) 9 months; (c) 16 months FY 01:: (a) 8 months; (b) 9 months; (c) 16 months	FY05:TBR September 2005 FY04:TBR September 2004 FY03: (a) 8 months; (b) 8 months; (c)11months FY 02: (a) 8 months; (b) 8 months; (c) 13 months FY 01: (a) 8 months; (b) 7 months; (c) 12 months FY 98: Baseline: (a) 8 months (b) 12 months; (c) 13 months
Total Funding: Req:	See SAPTBG set-aside for budget information.

Full Cost Table

18. Substance Abuse National Data Collection	2003	2004	2005
Incorporates:
18.1
Total Full Cost Funding ($'s in Millions)

This program is funded out of the SAPTBG, therefore, full costs are assigned to the block grant program measures on page 80.

Program Description and Context

The National Survey on Drug Use and Health (NSDUH) is conducted under the legislative authorization of Section 505 of the Public Health Service Act (42 U.S.C. 290aa-4) which authorizes data collection for monitoring the prevalence of use of illicit substances and the abuse of licit substances in the United States population. The goal of the NSDUH is to provide critical estimates of the prevalence of substance abuse at the national level and in the 50 States and the District of Columbia. This survey collects annual data on substance abuse based on a nationwide probability sample of the civilian population age 12 and older. The survey provides data on the extent of substance abuse and perceptions of risk in the population, and the sociodemographic characteristics, criminal, and other behavioral activities of individuals with a substance abuse problem. The product of this initiative is important, accurate, and timely data to be used as performance measures by the Office of National Drug Control Policy and other Federal and State agencies engaged in efforts to reduce substance abuse.

The Drug Abuse Warning Network (DAWN) is authorized by Section 505(c)(1)(A) and (B) of the Public Health Service Act (42 USC 290aa-4), which require the annual collection of data on the number of individuals admitted to emergency rooms of hospitals as a result of the abuse of alcohol or other drugs and the number of deaths occurring as a result of substance abuse, as indicated in reports by coroners. The goal of this program is to provide timely estimates of drug-related emergency department visits at the national level, and for 21 large metropolitan areas. DAWN data are especially important in detecting new or emerging problems and establishing priorities for area surveillance.

The Drug and Alcohol Services Information System (DASIS) is authorized by of Section 505(c)(1)(C) through (F) of the public Health Service Act (42 USC 290aa-4) which require annual collection of information on the services available for substance abuse treatment in the United States, and on the characteristics of patients admitted to treatment. This program provides both national and State level information on the substance abuse treatment system. DASIS contains information on the characteristics and services of all known treatment programs in the country, and information on patients admitted to treatment programs receiving public funds.

DASIS also provides data necessary for the calculation of the treatment gap, a performance measure used by the Office of National Drug Control Policy to assess progress in the effort to reduce substance abuse. Information from DASIS is also used to compile the National Directory of Drug Abuse and Alcoholism Treatment and Prevention Programs, which is used extensively for treatment referrals

Program Performance Analysis

All three surveys have consistently met their targets for availability of data, despite the complexity of collecting, editing, and processing large data sets.