NOTE: The SAPTBG is also discussed in the CSAT SAPTBG section and in the
separate SAPTBG Set-aside section.
Purpose and Method of Operation
CSAP administers the primary prevention component of the SAPT Block Grant. As
required by legislation, 20 percent of Block Grant funds allocated to States
must be spent on substance abuse primary prevention services. Prevention
service funding varies significantly from State to State. Some States rely
solely on the Block Grant's 20 percent set-aside to fund their entire
prevention system; others use the funds to target gaps and enhance existing
program efforts.
Funds Distributed through Formula
CSAP requires under regulation that the States use their Block Grant funds to
support a range of prevention services and activities in six key areas to
ensure that each State offers a comprehensive system for preventing substance
abuse. The six areas are information dissemination, community-based process,
environmental strategies, alternative activities, education, and problem
identification and referral. SAPT Block Grant funds are the foundation of most
States' prevention systems, driving their prevention planning processes and
setting standards and priorities for their overall prevention systems.
A measurable outcome resulting from the Block Grant is the success demonstrated
by States in reducing the rate at which retailers sell tobacco products to
minors, as required under the Block Grant's Synar Amendment. Enacted in 1992,
the Amendment requires that States enact and enforce laws that prohibit the
sale or distribution of tobacco products to minors. Each State has negotiated
annual targets for reducing illegal retail sales, and the law specifies
penalties for failure to reach these targets. Since FY 1997, States have
reduced retailer violation rates from an average of 40.1 percent to 16.3
percent (as reported in FY 2002). In FY 2003, 46 States achieved a retail sales
violation rate of 20% or less. These numbers reflect not only a substantial
change in retailers' sales patterns but also a swift and dramatic change in
tobacco enforcement programs, which in most States and jurisdictions were
nonexistent prior to the Synar program.
Development and implementation of performance measures continues to be an area
of highest priority for CSAP. Following pilot studies and other measurement
development efforts carried out in part through the State Incentive Grants
program, CSAP has been working closely with NASADAD and the States to reach
consensus on common outcome and process measures, data definitions, data
collection and reporting methods, and ways to achieve greater flexibility and
accountability. CSAP is continuing to work with a State group focusing on
policy and an expert group focusing on data methodology, and will be working
with this group and CSAP's Data Coordinating Center to finalize environmental
measures. CSAP will also continue to provide assistance to the States for data
infrastructure development through the State Incentive Grants program.
Transition to Performance Partnerships
The Children's Health Act of 2000 required the development and submission to
Congress of a report on plans for transforming SAMHSA's two block grants into
Performance Partnerships. The draft Report to Congress, which is in final
review, is to include:
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The flexibility that would be given to the States under the plan;
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The common set of performance measures that would be used for accountability;
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The definitions of the data elements to be used under the plan;
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The obstacles to implementation of the plan and the manner in which such
obstacles would be resolved;
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The resources needed to implement the performance partnerships under the plan;
and
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An implementation strategy, complete with recommendations for any necessary
legislation.
Essential to the transition to PPGs is support for State data infrastructure to
implement needed data collection and performance measures. One of the
permissible uses for the Strategic Prevention Framework SIG grants (within the
PRNS budget line) is for data infrastructure support, which will be funded at
$7.6 million in FY 2005.
5% Set-aside for Data Collection, Technical Assistance, and Evaluation
The 5% Set-aside provides funding to support State Data Systems, Technical
Assistance and Program Evaluation. A detailed listing of those activities and
funding levels is provided in the set-aside chapter. SAMHSA is allocating $10.6
million for CSAP activities. This represents no increase over FY 2004.
PART Review
The SAPT Block Grant, including the 20% Prevention Set-aside, was reviewed by
OMB in the FY 2005 PART review. The review assessed strengths and identified a
number of areas needing improvement. Although the overall rating was
"Ineffective," the main area identified as requiring improvement related to
performance measures that were not finalized until late in FY 2003 as part of
the PPG process. States are heavily dependent upon the SAPTBG funding for
substance abuse services that are urgently needed.
The PART review was helpful to SAMHSA in identifying the need for specific
management actions. For example, in response to a PART finding, the program is
expediting the posting of disaggregated State specific descriptive data on the
Internet so that the data are fully accessible and transparent to the public.
Also, the assessment found that SAMHSA faces continuing challenges in
collecting performance data. SAMHSA's proposed Performance Partnerships will
address this problem over time by implementing new measures, and improving data
collection, analysis, and utilization. The assessment developed new performance
measures that will be used for making future budget decisions. SAMHSA has made
significant progress with the States in determining performance measures for
the SAPT Block Grant program and States will begin reporting data in FY 2005.
In addition, SAMHSA has initiated funding for a national evaluation of the
Block Grant in response to an OMB finding.
Rationale for the Budget Request
Funding for the 20% Prevention set-aside is dependent upon the funding for the
SAPT block Grant as a whole. The requested funding increase for the SAPT Block
Grant ($53 million) would generate $10.6 million increase for the 20%
Prevention set-aside, over the FY 2004 Conference Action. This amount is
sufficient to maintain current services. A detailed listing of those activities
and funding levels for the CSAP portion of the 5% set-aside is provided in the
set-aside chapter.
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