SAMHSA Awards $42.3 Million to Advance 'Treatment First' Model

The Substance Abuse and Mental Health Services Administration on Friday announced $42.3 million in supplemental block-grant funding to states and territories to advance the "Treatment First" model for addressing homelessness and addiction, along with $2 million for the national network of addiction training centers — $44.3 million in new awards tied to President Trump's executive order "Ending Crime and Disorder on America's Streets."

The awards are the first direct federal funding attached to the White House's August "Best Practices Toolkit: Addressing Homelessness and Addiction through Treatment First," which urges states to make treatment and recovery the entry point for people living on the streets with serious mental illness and substance use disorders.

"President Trump has directed us to break the cycle of homelessness and addiction by putting treatment, recovery, and self-sufficiency first," Health and Human Services Secretary Robert F. Kennedy Jr. said in the announcement. "These investments will help states move people from crisis into treatment and from treatment into lasting recovery, stable housing, and work. We are funding results that help people reclaim their health and independence."

How the $42.3 million is split

The money flows through the two formula block grants that already fund much of the public behavioral health system, and each half has a distinct assignment.

The larger share — $25 million — goes to recipients of the Substance Use Prevention, Treatment, and Recovery Services Block Grant to expand capacity for safe, licensed, certified or chartered sober and recovery housing nationwide. States can also use it for training and technical assistance aimed at increasing the supply of recovery residences and strengthening quality and accountability standards for the homes that already exist.

The remaining $17.3 million supplements the Community Mental Health Services Block Grant, and it comes with an explicit restriction: the money is not for direct treatment services. Instead, states are to spend it on infrastructure — building systems and partnerships, workforce capacity, technical infrastructure, training, policy development and cross-system coordination among behavioral health, health care, housing, courts, law enforcement, homelessness services and community organizations.

The largest mental health block-grant supplements go to California ($2,434,140), Florida ($1,467,789) and New York ($1,120,027). On the substance use side, California again leads at $3,557,081, followed by Texas ($2,546,027) and Florida ($1,904,464). The two recipient tables are not identical: Texas appears only in the substance use block-grant list, while Georgia, Kentucky, Louisiana, Massachusetts, Tennessee and several other states appear only in the mental health table, and Alaska received a substance use supplement but no mental health one.

A workforce component through the ATTC Network

A separate $2 million goes to the Addiction Technology Transfer Center Network — $181,818 each to all 10 regional ATTC centers and the network's National Coordinating Office. The centers, housed at institutions including the University of Massachusetts Medical School in Worcester, the New York State Psychiatric Institute, the Danya Institute, Morehouse School of Medicine, the University of Wisconsin-Madison, the University of Texas at Austin, the University of Missouri-Kansas City, the University of North Dakota, UCLA and the University of Washington, will use the money for workforce training, support for licensure, certification and chartering efforts, and tools to measure outcomes.

That outcome-measurement piece reflects the announcement's emphasis on what SAMHSA called measurable progress: treatment engagement, recovery, stable housing, employment, self-sufficiency and reduced repeated homelessness.

"Treatment First means building a system that does not leave people cycling between homelessness, emergency rooms, and the criminal justice system," said Christopher D. Carroll, SAMHSA's Principal Deputy Assistant Secretary. "These investments will help states strengthen the infrastructure — partnerships, data, workforce, and recovery supports — needed to connect people with serious mental illness and addiction to effective treatment and support them on a path toward lasting recovery, stable housing, employment, and self-sufficiency."

A fifth funding round in five weeks — with a different shape

The awards continue a rapid series of HHS behavioral health announcements that began in mid-August: $96.7 million on August 17, $77 million on August 31, $383.4 million awarded on 988 Day for crisis lifeline, suicide prevention and substance use services, and a $1.5 million faith-based prevention round for three states announced earlier this week under the same executive order.

Friday's round is structurally different from those discretionary grant programs. By routing money through the block grants, SAMHSA is putting funds into formulas states already administer — and by dedicating $25 million specifically to certified recovery housing, the agency is backing the toolkit's argument that people discharged from treatment need a stable, substance-free place to live if recovery is going to hold. For people whose illness involves co-occurring mental health and addiction, that continuum — treatment, then supportive housing, then work — is precisely where the current system most often breaks down, and where the administration says it intends to measure results.