Grants for behavioral health services: HRSA, SAMHA, and CDC

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There arethree main federal sources for behavioral health services grants: the Substance Abuse and Mental Health Services Administration (SAMHSA) is the most focused on funding direct behavioral health services; the?Centers for Disease Control (CDC) is the smallest with respect to funding for direct behavioral health services; and the Health Resources & Services Administration (HRSA) , which has the most behavioral health services funding, but tends to be oriented towards providing funding to federally qualified health centers (FQHCs) and other healthcare providers. HRSA grant writers should know about all three.

There are exceptions to these generalities, but they're useful ways of thinking about what the various branches of the federal government do regarding behavioral health services grants. Grant writers and grant seekers should be cognizant of the differences among the funders. This is a topic we can help with, as we have decades of experience in writing all types of behavioral health services grants. If your organization seeks behavioral health grants, call us at 800.540.8906, ext. 1, or email us at [email protected] for a fast and free fee quote. We'll write your entire proposal or edit your draft for a reasonable flat fee.

In recent years, federal agencies have grouped substance abuse prevention, substance abuse treatment, and mental health services under the umbrella term of "behavioral health services." This makes a certain amount of sense, because many people are co-diagnosed with substance abuse disorder/opioid use disorder (SUD/OUD) and severe and persistent mental illness (SPMI) and each challenge can and often does exacerbate the other. For example, the recent rise in phenyl-2-propanone—P2P—meth has often caused serious problems that mimic psychosis. As one writer says , "Now almost everyone we see when we do homeless outreach on the streets is on meth. Meth may now be causing long-term psychosis, similar to schizophrenia, that lasts even after they’re not using anymore." "P2P" meth came after the most serious part of the opioid crisis: that got started in the '90s and '00s, when Purdue Pharma began advertising supposedly "safe" opioid treatment like oxycontin and oxycodone as being less addictive than previous opioid formulations. They weren't. By now this tragic story of greed and manipulation has been told many times: millions of people were prescribed those drugs legally, but they can be addictive after one, or a few, uses. That, in turn, created millions of addicts, and the heroin supply chain eventually expanded to serve them. Can't get a prescription for oxycontin? There are still guys who deliver product, no prescription needed. Today, fentanyl and other opioids are widely available, along with P2P meth, which is produced in labs in Mexico and is much stronger than the home-brewed meth of the past.

Together, these problems have made SUD/OUD and associated overdoses (ODs) climb. Media and policymakers have noticed and HRSA has become one of the federal government's primary sources for behavioral health services grants; the three main federal funding agencies for such services are:

• Health Resources and Service Administration (HRSA): HRSA's grant programs for SUD, OUD, and SPMI prevention and treatment include basic Section 330 grants for FQHCs, as well as other special grant programs for SUD / OUD and other aspects of behavioral health. Some HRSA grant programs are for FQHCs only, but public agencies like states, municipalities, school districts are eligible for many HRSA programs, as are general-purpose nonprofits. HRSA has some grant programs for rural areas only, though most programs can include a mix of rural and urban target areas. HRSA programs may seek very specific target populations, like school students, or specific kinds of drug users, or persons with specific demographic characteristics. Many HRSA programs, however, are relatively open with respect to the target population. In recent years, HRSA has issued many NOFAs for Medication-Assisted Treatment (MAT) programs, which offer medication to opioid users in order to get those users off oxycodone, oxycontin, heroin, and related substances. The most frequently offered medication is Suboxone, although others are usually allowed.
• Substance Abuse and Mental Health Services Administration (SAMHSA): As we discussed above, and elsewhere, SAMHSA makes many behavioral health services grants. SAMHSA is further sub-divided into a trio of agencies: Center for Substance Abuse Prevention (CSAP), Center for Substance Abuse Treatment (CSAT), and Center for Mental Health Services (CMHS). CSAP and CSAT should be merged into a single organization, but they've not been, for bureaucratic historical reasons not relevant to grant writers. Recently, SAMHSA, like HRSA, has emphasized funding for "harm reduction ," including MAT programs, and that grant funding tends to be available to a wide range of applicant organizations. SAMHSA NOFOs ("Notices of Funding Opportunities," which is SAMSHA's preferred term) have relatively few grants available, but those grants are usually for high amounts. And other funders see successful SAMHSA grants as merit badges. Organizations thinking about behavioral health grants should seek SAMHSA grants, because if you get a SAMHSA award, other federal funders like HRSA and CDC are more likely to fund you.
• Centers of Disease Control and Prevention (CDC): The CDC tends to focus on research—but not all CDC funds are allocated to research purposes, and, in addition to that, some "research" can look a lot like providing direct human services. Learning to read between the lines of CDC RFPs is essential. Nonetheless, the CDC's grants can at times focus on direct service provision, which is an important aspect for behavioral health services grant seekers to know.

In short, all three major federal funders can be used for behavioral health services programs. Some behavioral health organizations also combine local funding—typically, but not always, at the county level—with state and federal funding. Although an organization shouldn't seek to "double bill" for a patient by seeking to count a given patient as someone who is served both by a county program and a HRSA program, we've heard from our clients that that often happens.