15-Appendix G-SUPTRS-MHBG-SPF-PFS Federal Grant Conditions.docx

APPENDIX G- SUBSTANCE USE PREVENTION, TREATMENT AND RECOVERY SERVICES BLOCK GRANT (SUPTRS); BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES (MHBG); AND STRATEGIC PREVENTION FRAMEWORK PARTNERSHIPS FOR SUCCESS – DELAWARE (SPF-PFS-DE) OPERATIONAL CONDITIONS

SUBSTANCE USE PREVENTION, TREATMENT AND RECOVERY SERVICES BLOCK GRANT (SUPTRS)

2025 Operational Conditions and Guidance

Recipient Name: Delaware Department of Health and Social Services, Division of Substance Abuse and Mental Health Federal Award Title: Substance Abuse Prevention, Treatment, and Recovery Services (SUPTRS) Block Grant Unique Federal Award Identification Number (FAIN): B08TI088144 Assistance Listing Number (CFDA): 93.959 Statutory Authority: Subparts II&III,B,Title XIX,PHS Act/45 CFR Part96 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-96 Award Period: 10/01/2024 – 09/30/2026 Document Number: 25B1DESAPT Fiscal Year: 2025

EXPLANATION AND PURPOSE

The Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS) program’s objective is to help plan, implement, and evaluate activities that prevent and treat substance use. The SUPTRS is authorized by section 1921 of Title XIX, Part B, Subpart II and III of the Public Health Service (PHS) Act (PDF | 253 KB). The PHS Act required the secretary of the U.S. Department of Health and Human Services to create regulations as a precondition to making funds available to the states and other grantees under the SUBG. Title 45 Code of Federal Regulations Part 96 was published on March 31, 1993, and The Tobacco Regulations for Substance Use Prevention, Treatment, and Recovery Services Block Grant; Final Rule, 61 Federal Register 1492 (PDF |259 KB) was published on January 19, 1996.

SAMHSA's Center for Substance Abuse Treatment’s (CSAT) State Systems Partnership Branch (SSPB), in collaboration with the Center for Substance Abuse Prevention’s (CSAP) Division of Primary Prevention (DPP), administers the SUPTRS.

This award is pursuant to the authority of Subparts II&III,B,Title XIX,PHS Act/45 CFR Part96 and is subject to the requirements of this statute and regulation and of other referenced, incorporated or attached terms and conditions.

SUPTRS Grantee Requirements

· Have a designated unit of its executive branch that is responsible for administering the SUPTRS (for example, Division of Substance Abuse and Mental Health) work with the grantee’s department of health;

· Apply annually for SUPTRS funds;

· The receipt date for the FFY BG Application (“Combined Application “) for the Community Mental Health Services Block Grant (MHBG) and the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS) is not later than September 1 of each year (governed by the MHBG authorizing legislation; Section 1917(a)(1) of Title XIX, Part B, Subpart I of the PHS Act (42 USC 300x-6(a)(1).

· The eligible entity must submit:

· An annual application (with assurances, certifications, and planned expenditures)

· A bi-annual plan

· An annual report

· Have the flexibility to distribute the SUBG funds to local government entities, such as municipal, county, or intermediaries, including administrative service organizations; and

· Have SUBG sub-recipients, such as community- and faith-based organizations (non-governmental organizations), and deliver:

· Substance use prevention activities to individuals and communities impacted by substance use

· Substance use disorder (SUD) treatment and recovery support services to individuals and families impacted by SUDs

· The Delaware Behavioral Health Assessment and Plan is a web-based process and as such can be viewed at https://bgas.samhsa.gov

· To review the plans, please take the following steps:

· Go to https://bgas.samhsa.gov

· Enter the username and password (these are case sensitive):

· Username - citizende

· Password - citizen

· Select "View Existing Applications" from the top tabs

· Select "FFY 2024-2025 Behavioral Health Assessment and Plan"

· Select "View Application"

· To review the plan, click to download the pdf file.

Targeted Populations and Service Areas The SUPTRS program targets the following populations and service areas:

· Pregnant women and women with dependent children

· Injection drug users

· Tuberculosis services

· Early intervention services for HIV/AIDS

· Primary prevention services Primary Prevention SAMHSA requires that grantees spend no less than 20% of their SUPTRS allotment on substance use primary prevention strategies. These strategies are directed at individuals not identified to be in need of treatment.

Primary Prevention Strategies Grantees must develop a comprehensive primary prevention program that includes activities and services provided in a variety of settings. The program must target both the general population and sub-groups that are at high risk for substance use. The program must include, but is not limited to, the following strategies:

· Information Dissemination provides knowledge and increases awareness of the nature and extent of alcohol and other drug use, use, and addiction, as well as their effects on individuals, families, and communities. It also provides knowledge and increases awareness of available prevention and treatment programs and services. It is characterized by one-way communication from the information source to the audience, with limited contact between the two.

· Education builds skills through structured learning processes. Critical life and social skills include decision making, peer resistance, coping with stress, problem solving, interpersonal communication, and systematic and judgmental capabilities. There is more interaction between facilitators and participants than there is for information dissemination.

· Alternatives provide opportunities for target populations to participate in activities that exclude alcohol and other drugs. The purpose is to discourage use of alcohol and other drugs by providing alternative, healthy activities.

· Problem Identification and Referral aims to identify individuals who have indulged in illegal or age-inappropriate use of tobacco or alcohol and individuals who have indulged in the first use of illicit drugs. The goal is to assess if their behavior can be reversed through education. This strategy does not include any activity designed to determine if a person is in need of treatment.

· Community-based Process provides ongoing networking activities and technical assistance to community groups or agencies. It encompasses neighborhood-based, grassroots empowerment models using action planning and collaborative systems planning.

· Environmental establishes or changes written and unwritten community standards, codes, and attitudes. Its intent is to influence the general population's use of alcohol and other drugs.

Grantees should use a variety of strategies that target populations with different levels of risk. Specifically, prevention strategies can be classified using the Institute of Medicine Model of Universal, Selective, and Indicated, which classifies preventive interventions by targeted population. The definitions for these population classifications are:

· Universal: The general public or a whole population group that has not been identified on the basis of individual risk

· Selective: Individuals or a subgroup of the population whose risk of developing a disorder is significantly higher than average

· Indicated: Individuals in high-risk environments who have minimal but detectable signs or symptoms foreshadowing disorder or have biological markers indicating predispositions for disorder but do not yet meet diagnostic levels

STANDARD TERMS AND CONDITIONS

1) SUPTRS Administrative Requirements This award is subject to the administrative requirements for HHS block grants under 45 CFR § 96, as applicable, and 45 CFR § 75.

Except for any waiver granted explicitly elsewhere in this section, this award does not constitute approval for waiver of any Federal statutory/regulatory requirements for a SUPTRS.

2) Flowdown of requirements to sub-recipients The grantee, as the awardee organization, is legally and financially responsible for all aspects of this award including funds provided to sub-recipients, in accordance with 45 CFR §§ 75.351- 75.353, Sub-recipient monitoring and management.

3) Availability of Funds Funds awarded under this grant must be obligated and expended by September 30, 2026.

4) Executive Pay The Consolidated Appropriations Act, 2023 (Public Law No: 117-328), signed into law on December 29, 2022, restricts the amount of direct salary to Executive Level II of the Federal Executive Pay scale. Effective January 1, 2023, the salary limitation for Executive Level II is $212,100. For awards issued prior to this change, if adequate funds are available in active awards, and if the salary cap increase is consistent with the institutional base salary, recipients may re-budget to accommodate the current Executive Level II salary level. However, no additional funds will be provided to these grant awards.

5) Marijuana Restriction SAMHSA grant funds may not be used to purchase, prescribe, or provide marijuana or treatment using marijuana. See, e.g., 45 CFR § 75.300(a) (requiring HHS to ensure that Federal funding is expended in full accordance with U.S. statutory and public policy requirements); 21 U.S.C. §§ 812(c)(10) and 841 (prohibiting the possession, manufacture, sale, purchase or distribution of marijuana).

6) Universal Identified and SAM Requirements This award is subject to requirements as set forth in 2 CFR § 25 – Universal Identifier and System of Award Management (SAM) Requirements.

A. SAM Requirement Unless you are exempted from this requirement under 2 CFR § 25.110, you, as the recipient, must review and update your information in SAM to ensure it is current, accurate, and complete until you submit the final financial report required under this award or receive the final payment, whichever is later. You are required to review and update the information at least annually after the initial registration, or more frequently if required by changes in your information or another award term.

B. Requirement for unique entity identifier If you are authorized (reference project description) to make subawards under this award, you:

1. Must notify potential subrecipients that no entity (see definition in paragraph C of this award term) may receive a subaward from you, unless the entity has provided its unique entity identifier to you; and

2. May not make a subaward to an entity unless the entity has provided its unique entity identifier to you.

C. Definitions.

For purposes of this award term:

1. System of Award Management (SAM) means the Federal repository into which an entity must provide information required for the conduct of business as a recipient. Additional information on SAM registration procedures may be found at: https://www.sam.gov.

2. Unique entity identifier means the identifier required for SAM registration to uniquely identify business entities.

3. Entity, as it is used in this award term, means all of the following, as defined at 2 CFR § 25, subpart D:

a. A governmental organization, which is a state, local government, or Indian Tribe;

b. A foreign public entity;

c. A domestic or foreign nonprofit organization;

d. A domestic or foreign for-profit organization; and

e. A Federal agency, but only as a subrecipient under an award or subaward to a non-Federal entity.

4. Subaward:

a. This term means a legal instrument to provide support for the performance of any portion of the substantive project or program for which you received this award and that you as the recipient award to an eligible subrecipient.

b. The term does not include your procurement of property and services needed to carry out the project or program (for further explanation, see 2 CFR § 200.1 and 2 CFR § 200.331).

c. A subaward may be provided through any legal agreement, including an agreement that you consider a contract.

5. Subrecipient means an entity that:

a. Receives a subaward from you under this award; and

b. Is accountable to you for the use of the Federal funds provided by the subaward.

7) Federal Financial Accountability and Transparency Act (FFATA) The Federal Funding Accountability and Transparency Act (FFATA) was signed on September 26, 2006. The FFATA Subaward Reporting System (FSRS) is the reporting tool federal prime awardees (i.e. prime contractors and prime grants recipients) must use to capture and report subaward and executive compensation data regarding their first-tier subawards to meet the FFATA reporting requirements.

Prime contract awardees must report against sub-contracts awarded. Prime grant awardees will report against sub-grants awarded. The sub-award information you enter in FSRS will display on USASpending.gov associated with the prime award

8) Mandatory Disclosures Consistent with 45 CFR § 75.113, applicants and recipients must disclose in a timely manner, in writing to the HHS Office of Inspector General (OIG), all information related to violations, or suspected violations, of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award. Subrecipients must disclose, in a timely manner, in writing to the prime recipient (pass through entity) and the HHS OIG, all information related to violations, or suspected violations, of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award. Disclosures must be sent in writing to the awarding agency and to the HHS OIG at the following addresses:

Attention:

SAMHSA U.S. Department of Health and Human Services Office of Inspector General ATTN: Mandatory Grant Disclosures, Intake Coordinator 330 Independence Avenue, SW, Cohen Building Room 5527 Washington, DC 20201 Fax: (202) 205-0604 (Include “Mandatory Grant Disclosures” in subject line) or email: MandatoryGranteeDisclosures@oig.hhs.gov

Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371 remedies for noncompliance, including suspension or debarment (see 2 CFR §§ 180 & 376 and 31 U.S.C. § 3321).

9) The Trafficking Victims Protection Act of 2000 (22 U.S.C. § 7104(G)), as amended, and 2 C.F.R. § 175 The Trafficking Victims Protection Act of 2000 authorizes termination of financial assistance provided to a private entity, without penalty to the Federal government, if the recipient or subrecipient engages in certain activities related to trafficking in persons. SAMHSA may unilaterally terminate this award, without penalty, if a private entity recipient, or a private entity subrecipient, or their employees:

A. Engage in severe forms of trafficking in persons during the period of time that the award is in effect;

B. Procure a commercial sex act during the period of time that the award is in effect; or, C. Use forced labor in the performance of the award or subawards under the award. The text of the full award term is available at 2 C.F.R. § 175.15(b). See http://www.gpo.gov/fdsys/pkg/CFR-2012-title2-vol1/pdf/CFR-2012-title2-vol1-sec175- 15.pdf.

10) Drug-Free Workplace Requirements The Drug-Free Workplace Act of 1988 (41 U.S.C. §§ 701 et seq.) requires that all organizations receiving grants from any Federal agency agree to maintain a drug-free workplace. When the AR signed the application, the AR agreed that the recipient will provide a drug-free workplace and will comply with the requirement to notify SAMHSA if an employee is convicted of violating a criminal drug statute. Failure to comply with these requirements may be cause for debarment. Government wide requirements for Drug-Free Workplace for Financial Assistance are found in 2 CFR § 182; HHS implementing regulations are set forth in 2 CFR § 382.400. All recipients of SAMHSA grant funds must comply with the requirements in Subpart B (or Subpart C if the recipient is an individual) of § 382.

11) Lobbying No funds provided under the attached Notice of Award (NoA) may be used by you or any subrecipient under the grant to support lobbying activities to influence proposed or pending federal or state legislation or appropriations. The prohibition relates to the use of federal grant funds and is not intended to affect your right or that of any other organization, to petition Congress or any other level of government, through the use of other nonfederal resources. Reference 45 CFR § 93.

12) Accessibility Provisions Grant recipients of Federal financial assistance (FFA) from HHS must administer their programs in compliance with Federal civil rights law. This means that recipients of HHS funds must ensure equal access to their programs without regard to a person’s race, color, national origin, disability, age, and in some circumstances, sex and religion. This includes ensuring your programs are accessible to persons with limited English proficiency. The HHS Office for Civil Rights also provides guidance on complying with civil rights laws enforced by HHS. Please see https://www.hhs.gov/civil-rights/for-individuals/section1557/index.html.

Recipients of FFA also have specific legal obligations for serving qualified individuals with disabilities. Please see https://www.hhs.gov/civil-rights/for-individuals/disability/index.html. Please contact the HHS Office for Civil Rights for more information about obligations and prohibitions under Federal civil rights laws at https://www.hhs.gov/civil-rights/index.html or call 1-800-368-1019 or TDD 1-800-537-7697. Also note that it is an HHS Departmental goal to ensure access to quality, culturally competent care, including long-term services and supports, for vulnerable populations.

For further guidance on providing culturally and linguistically appropriate services, recipients should review the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care at https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=1&lvlid=6.

13) Audits Non-Federal recipients that expend $750,000 or more in federal awards during the recipient's fiscal year must obtain an audit conducted for that year in accordance with the provisions of 45 CFR § 96.31. Recipients are responsible for submitting their Single Audit Reports and the Data Collections Forms (SF-FAC) electronically to the to the Federal Audit Clearinghouse Visit disclaimer page (FAC) within the earlier of 30 days after receipt or nine months after the FY's end of the audit period.

The FAC operates on behalf of the OMB. For specific questions and information concerning the submission process: Visit the Federal Audit Clearinghouse at https://harvester.census.gov/facweb or call FAC at the toll-free number: (800) 253-0696

14) Federal Financial Report (FFR) Recipients must liquidate all obligations incurred under an award not later than ninety (90) days after the end of the award obligation and expenditure period (i.e., the project period), which also coincides with the due date for submission of the FFR (SF-425). After ninety (90) days, letter of credit accounts are locked. SAMHSA does not approve extensions to the ninety (90) day post award reconciliation/liquidation period.

Accordingly, recipients are expected to complete all work and reporting within the approved project period and the ninety (90)-day post-award reconciliation/liquidation period. Recipient withdrawal requests occurring after the liquidation period are considered late and will be denied.

15) Annual Report There is an annual report due by December 1 of the fiscal year for which the State is seeking a grant. Grant awards will not be made without the report required under 45 CFR § 96.130(e). Title XIX, Part B, Subpart III of the Public Health Service Act (42 U.S.C. § 300x-52(a)), requires the secretary of the Department of Health and Human Services, acting through the Assistant Secretary of the Substance Abuse and Mental Health Services Administration (SAMHSA), to determine the extent to which states and jurisdictions have implemented the state plan for the prior fiscal year.

The purpose of the annual report is to provide information to assist the secretary in making this determination. States and jurisdictions are requested to prepare and submit their reports for the last completed state fiscal year (SFY), in the format provided in the guidance (https://www.samhsa.gov/grants/block-grants). The report must address the purposes for which the SUPTRS were expended, the recipients of grant funds, and the authorized activities conducted, and services purchased with such funds. Particular attention should be given to the progress made toward accomplishing the goals and performance indicators identified in the grantee’s SUPTRS application. Grantees are required to prepare and submit their respective reports utilizing SAMHSA’s Web Block Grant Application System (WebBGAS). This report must be received by SAMHSA no later than December 1, 2024, in order for the grantee to receive its next grant.

Failure to comply with these requirements may cause the initiation of enforcement actions that can culminate in discontinuation of SUBG grants. The report must be submitted via the electronic interface, WebBGAS by December 1, 2024.

16) Funding Limitations and Restrictions:

Cost principles describing allowable and unallowable expenditures for federal recipients, including SAMHSA recipients, are provided in 45 CFR Part 75 Subpart F, which are available at the Electronic Code of Federal Regulations webpage of the eCFR website: http://www.ecfr.gov/cgi-bin/text-idx?SID=06a0b0411d1520fae5e2799030e64ebf&node=pt45.1.75&rgn=div5 SUPTRS funds are subject to the administrative requirements for HHS block grants under 45 CFR Part 96, as applicable, and 45 CFR Part 75, as specified. Except for section 75.202 of Subpart C, and sections 75.351 through 75.353 of Subpart D, the requirements in Subpart C, Subpart D, and Subpart E do not apply to this program (reference 45 CFR Part 75 Subpart B, 75.101(d)). Except for any waiver granted explicitly elsewhere in this section, this award does not constitute approval for waiver of any Federal statutory/regulatory requirements for a SUPTRS.

17) Prohibited Uses of Grant Funds in Harm Reduction Activities SAMHSA recipients are strictly prohibited from using Federal funds, directly or indirectly, including through cost-sharing, matching funds, or subsequent reimbursement, to support so-called "harm reduction" or "safe consumption" efforts that facilitate illegal drug use.

Specifically, grant funds must not be used to purchase, distribute, or otherwise support the provision of drug paraphernalia as defined by applicable law. This includes, but is not limited to, syringes, needles, pipes, or other supplies used for the injection, inhalation, or ingestion of illicit drugs. Funds are also prohibited from being used for sterile water, saline, or ascorbic acid when intended to facilitate drug use. While these prohibitions are in effect, this does not preclude the use of grant funds for legally permissible supplies and activities that align with evidence-based practices, such as the provision of naloxone or nalmefene, fentanyl or other drug test strips, or the facilitation of referrals to treatment. Failure to comply with any of these terms and conditions, as well as the HHS Federal grant regulations and may result in one or more enforcement actions. These actions can include the suspension or termination of the award, the withholding of future payments, and the recoupment of any misused funds. For more information on this new policy, please review the recent notice from Principal Deputy Assistant Secretary, Art Kleinschmidt, Ph.D., found on our website at Dear Colleague Letter: Executive Order on Ending Crime and Disorder on America's Streets.

SUPTRS Grant funds may not be used for the following:

1) To provide inpatient hospital services;

2) To make cash payments to intended recipients of health services;

3) To purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;

4) To satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds;

5) To provide financial assistance to any entity other than a public or nonprofit private entity;

6) To provide individuals with hypodermic needles or syringes so that such individuals may use illegal drugs, unless the Surgeon General of the Public Health Service determines that a demonstration needle exchange program would be effective in reducing drug abuse and the risk that the public will become infected with the etiologic agent for Acquired Immunodeficiency Syndrome (AIDS);

7) To purchase treatment services in penal or correctional institutions.

Additional Funding Restrictions:

1) SUPTRS funds cannot be used to make direct payments to individuals to enter treatment or continue to participate in prevention or treatment services.

2) Meals are generally unallowable unless they are approved as an integral part of a project or program, conference, or per diem for travel. SUPTRS funds may be used for light snacks, not to exceed $3.00 per person per day.

3) SUPTRS Block Grant funds cannot be used to fund group homes or transitional housing.

4) Pursuant to 45 CFR 75.352, a pass-through entity must ensure that each subrecipient has an approved federally recognized indirect cost rate negotiated between the subrecipient and the Federal Government or, if no such rate exists, either a rate negotiated between the pass-through entity and the subrecipient (in compliance with this part), or a de minimis indirect cost rate as defined in 45 CFR §75.414(f).

Federal Regulations Vendors receiving Substance Use Prevention, Treatment, and Recovery Support Block Grant (SUPTRS) funds must abide by all terms and conditions outlined in the Federal Regulations 45 CFR Part 96.

96.124 Certain allocations

All programs providing such services will treat the family as a unit and therefore will admit both women and their children into treatment services, if appropriate. The Vendor shall ensure that, at a minimum, treatment programs receiving funding for such services also provide or arrange for the provision of the following services to pregnant women and women with dependent children, including women who are attempting to regain custody of their children:

1) primary medical care for women, including referral for prenatal care and, while the women are receiving such services, child care;

2) primary pediatric care, including immunization, for their children;

3) gender specific substance abuse treatment and other therapeutic interventions for women which may address issues of relationships, sexual and physical abuse and parenting, and child care while the women are receiving these services;

4) therapeutic interventions for children in custody of women in treatment which may, among other things, address their developmental needs, their issues of sexual and physical abuse, and neglect; and

5) sufficient case management and transportation to ensure that women and their children have access to services provided by paragraphs (1) through (4) of this section.

96.125 Primary prevention

Primary prevention strategies shall be directed at individuals not identified to be in need of treatment. In implementing the prevention program the Vendor shall use a variety of strategies, as appropriate for each target group, including but not limited to the following:

Information Dissemination: This strategy provides awareness and knowledge of the nature and extent of alcohol, tobacco and drug use, abuse and addiction and their effects on individuals, families and communities. It also provides knowledge and awareness of available prevention programs and services. Information dissemination is characterized by one-way communication from the source to the audience, with limited contact between the two. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:

· Clearinghouse/information resource center(s);

· Resource directories;

· Media campaigns;

· Brochures;

· Radio/TV public service announcements;

· Speaking engagements;

· Health fairs/health promotion; and

· Information lines.

Education: This strategy involves two-way communication and is distinguished from the Information Dissemination strategy by the fact that interaction between the educator/facilitator and the participants is the basis of its activities. Activities under this strategy aim to affect critical life and social skills, including decision-making, refusal skills, critical analysis (e.g. of media messages) and systematic judgment abilities. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:

· Classroom and/or small group sessions (all ages);

· Parenting and family management classes;

· Peer leader/helper programs;

· Education programs for youth groups; and

· Children of substance abusers groups.

Alternatives: This strategy provides for the participation of target populations in activities that exclude alcohol, tobacco and other drug use. The assumption is that constructive and healthy activities offset the attraction to, or otherwise meet the needs usually filled by alcohol, tobacco and other drugs and would, therefore, minimize or obviate resort to the latter. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:

· Drug free dances and parties;

· Youth/adult leadership activities;

· Community drop-in centers; and

· Community service activities.

Problem Identification and Referral: This strategy aims at identification of those who have indulged in illegal/age inappropriate use of tobacco or alcohol and those individuals who have indulged in the first use of illicit drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include any activity designed to determine if a person is in need of treatment. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:

· Employee assistance programs;

· Student assistance programs; and

· Driving while under the influence/driving while intoxicated education programs.

Community-Based Process: This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment services for alcohol, tobacco and drug abuse disorders. Activities in this strategy include organizing, planning, enhancing efficiency and effectiveness of services implementation, inter-agency collaboration, coalition building and networking. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following:

· Community and volunteer training, e.g., neighborhood action training, training of key people in the system, staff/officials training;

· Systematic planning;

· Multi-agency coordination and collaboration;

· Accessing services and funding; and

· Community team-building.

Environmental: This strategy establishes or changes written and unwritten community standards, codes and attitudes, thereby influencing incidence and prevalence of the abuse of alcohol, tobacco and other drugs used in the general population. This strategy is divided into two subcategories to permit distinction between activities which center on legal and regulatory initiatives and those which relate to the service and action-oriented initiatives. Examples of activities conducted and methods used for this strategy shall include (but not be limited to) the following:

· Promoting the establishment and review of alcohol, tobacco and drug use policies in schools;

· Technical assistance to communities to maximize local enforcement procedures governing availability and distribution of alcohol, tobacco and other drug use;

· Modifying alcohol and tobacco advertising practices; and

· Product pricing strategies.

96.126 Capacity of treatment for intravenous substance abusers Programs that treat individuals for intravenous substance abuse, upon reaching 90 percent of its capacity to admit individuals to the program, must provide notification of that fact to the State within seven days.

1) For the purposes of treating injecting drug abusers, Vendor will establish a waiting list that includes a unique patient identifier for each injecting drug abuser seeking treatment including those receiving interim services, while awaiting admission to such treatment. For individuals who cannot be placed in comprehensive treatment within 14 days, the Vendor shall ensure that the program provide such individuals interim services as defined in Sec. 96.121 and ensure that the programs develop a mechanism for maintaining contact with the individuals awaiting admission. The Vendor shall consult the capacity management system as provided in paragraph (a) of this section so that patients on waiting lists are admitted at the earliest possible time to a program providing such treatment within reasonable geographic area.

2) The Vendor that receives funding for treatment services for intravenous drug abuse shall carry out activities to encourage individuals in need of such treatment to undergo such treatment. The program shall use outreach models that are scientifically sound, or if no such models are available which are applicable to the local situation, to use an approach which reasonably can be expected to be an effective outreach method. The model shall require that outreach efforts include the following:

a. Selecting, training and supervising outreach workers;

b. Contacting, communicating and following-up with high risk substance abusers, their associates, and neighborhood residents, within the constraints of Federal and State confidentiality requirements, including 42 C.F.R. Part 2;

a. Promoting awareness among injecting drug abusers about the relationship between injecting drug abuse and communicable diseases such as HIV;

b. Recommend steps that can be taken to ensure that HIV transmission does not occur; and

c. Encouraging entry into treatment.

96.127 Requirements regarding tuberculosis

1) The Vendor receiving amounts from the grant for operating a program of treatment for substance abuse shall follow procedures developed by the principal agency of a State for substance abuse, in consultation with the State Medical Director for Substance Abuse Services, and in cooperation with the State Department of Health/Tuberculosis Control Officer, which address how the program--

a. Will, directly or through arrangements with other public or nonprofit private entities, routinely make available tuberculosis services as defined in Sec. 96.121 to each individual receiving treatment for such abuse;

b. In the case of an individual in need of such treatment who is denied admission to the program on the basis of the lack of the capacity of the program to admit the individual, will refer the individual to another provider of tuberculosis services; and

c. Will implement infection control procedures established by the principal agency of a State for substance abuse, in cooperation with the State Department of Health/Tuberculosis Control Officer, which are designed to prevent the transmission of tuberculosis, including the following:

d. Will conduct case management activities to ensure that individuals receive such services.

96.128 Requirements regarding human immunodeficiency virus

1) The Vendor receiving amounts from the Block Grant for operating a substance abuse treatment program shall follow procedures developed by the principal agency of a State for substance abuse, in consultation with the State Medical Director for Substance Abuse Services, and in cooperation with the State Department of Health/Communicable Disease Officer.

2) With respect to the provision of early intervention services for HIV disease to an individual, the Vendor shall ensure compliance with Sec. 96.137 regarding payment and Sec. 96.135 regarding restrictions on expenditure of grant. The Vendor shall also ensure that such services will be undertaken voluntarily by, and with the informed consent of, the individual, and undergoing such services will not be required as a condition of receiving treatment services for substance abuse or any other services.

96.131 Treatment services for pregnant women

1) The Vendor is required to, in accordance with this section, ensure that each pregnant woman in the State who seeks or is referred for and would benefit from such services is given preference in admissions to treatment facilities receiving funds pursuant to the grant. In carrying out this section, the program(s) that serve women and who receive such funds shall provide preference to pregnant women. Programs which serve an injecting drug abuse population and who receive Block Grant funds shall give preference to treatment as follows:

a. Pregnant injecting drug users;

b. Pregnant substance abusers;

c. Injecting drug users; and

d. All others.

The program is required to ensure that the availability of treatment to pregnant women is publicized by public service announcements (radio, television) or street outreach programs.

96.136 Independent Peer Review

1) The Vendor will provide for complete and un-obscured access to patient/client records for the purpose of an Independent Peer Review, for quality, appropriateness and efficacy of services, pursuant to CFR 45, section 96.136. The Vendor will provide for a clean and suitable private area for the review(er) / team to conduct their business, so that patient/client files can be handled with the utmost care and confidentiality. During such review the Vendor will not attempt to influence the independent review in any manner or fashion. Any attempt to influence the independent peer review in any manner or fashion will result in consequences up to and possibly including termination of this contract.

BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES (MHBG)

2025 Operational Conditions and Guidance

Recipient Name: Delaware Department of Health and Social Services, Division of Substance Abuse and Mental Health Federal Award Title: Block Grants for Community Mental Health Services Unique Federal Award Identification Number (FAIN): B09SM090322 Assistance Listing Number (CFDA): 93.958 Statutory Authority: Subparts II&III,B,Title XIX,PHS Act/45 CFR Part96 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-96 Award Period: 10/01/2024 – 09/30/2026 Document Number: 25B1DECMHS Fiscal Year: 2025

EXPLANATION AND PURPOSE

The Community Mental Health Services Block Grant (MHBG) program's objective is to support the grantees in carrying out plans for providing comprehensive community mental health services. The MHBG program is authorized by sections 1911-1920 of Title XIX, Part B, Subpart I and III of the Public Health Service (PHS) Act.

SAMHSA's Center for Mental Health Services’ (CMHS) Division of State and Community Systems Development (DSCSD) administers MHBG funds. Grantees can be flexible in the use of funds for both new and unique programs or to supplement their current activities.

In addition to providing MHBG awards, CMHS provides recipients with technical assistance (TA). The TA supports the use of evidence-based programs.

This award is pursuant to the authority of Subparts II&III,B,Title XIX,PHS Act/45 CFR Part96 and is subject to the requirements of this statute and regulation and of other referenced, incorporated or attached terms and conditions.

MHBG Grantee Requirements

· MHBG Grantees must have a designated unit of its executive branch that is responsible for administering the MHBG (for example, the Division of Substance Abuse and Mental Health) work with the grantee’s department of health to;

· They must submit a plan explaining how they will use MHBG funds to provide comprehensive, community mental health services to adults with serious mental illnesses and children with serious emotional disturbances. SAMHSA also requires recipients to provide annual reports on their plans.

· The receipt date for the FFY BG Application (“Combined Application “) for the Community Mental Health Services Block Grant (MHBG) and the Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUPTRS) is not later than September 1 of each year (governed by the MHBG authorizing legislation; Section 1917(a)(1) of Title XIX, Part B, Subpart I of the PHS Act (42 USC 300x-6(a)(1).

· The eligible entity must submit:

· An annual application (with assurances, certifications, and planned expenditures)

· A bi-annual plan

· An annual report

· They may distribute funds to local government entities and non-governmental organizations.

· They must ensure that community mental health centers provide such services as screening, outpatient treatment, emergency mental health services, and day treatment programs.

· They must comply with general federal requirements for managing grants. They must also cooperate in efforts by SAMHSA to monitor use of MHBG funds. For example, each year, CMHS conducts investigations (site visits) of at least ten grantees receiving MHBG funds. This is to assess how they are using the funds to benefit the population. These evaluations include careful review of the following:

· How the grantees are tracking use of MHBG funds and their adult and child mental health programs

· Data and performance management systems

· Collaboration with consumers and the grantees' mental health planning council

· Grantees receiving MHBG funds are required to form and support a state or territory mental health planning council.

· The Delaware Behavioral Health Assessment and Plan is a web-based process and as such can be viewed at https://bgas.samhsa.gov

· To review the plans, please take the following steps:

· Go to https://bgas.samhsa.gov

· Enter the username and password (these are case sensitive):

· Username - citizende

· Password - citizen

· Select "View Existing Applications" from the top tabs

· Select "FFY 2024-2025 Behavioral Health Assessment and Plan"

· Select "View Application"

· To review the plan, click to download the pdf file.

Targeted Populations and Service Areas The MHBG program, along with subrecipients are charged with targeting the following populations and service areas:

· Adults with serious mental illnesses. Includes persons age 18 and older who have a diagnosable behavioral, mental, or emotional condition—as defined by the Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders. Their condition substantially interferes with, or limits, one or more major life activities, such as:

· Basic daily living (for example, eating or dressing)

· Instrumental living (for example, taking prescribed medications or getting around the community)

· Participating in a family, school, or workplace

· Children with serious emotional disturbances. Includes persons up to age 18 who have a diagnosable behavioral, mental, or emotional issue (as defined by the DSM). This condition results in a functional impairment that substantially interferes with, or limits, a child’s role or functioning in family, school, or community activities.

SAMHSA’s definitions of children with serious emotional disturbances and adults with serious mental illness were provided in a 1993 Federal Register notice (May 20, 1993; 58 FR 29422).

MHBG Funding The MHBG program’s objective is to assist states with reducing psychiatric inpatient services by supporting the development of effective community-based mental health services and programs.

MHBG programming should focus on recovery, and providing services to adult individuals with SMI, or children with SED that are uninsured or underinsured and not covered by third-party payment.

· Outpatient mental health services, care management, emergency mental health services, day treatment programs community transition services.

· Integrated care to expand recovery support services for individuals with SMI or SED, including peer specialists, peer-operated programs including mental health clubhouse services, warm lines, supported housing, supported employment, supported education, transportation, shared decision-making, and family caregiving.

· Crisis services such as crisis outreach, peer crisis respite programs, warm-lines, prevention and postvention efforts, access to mobile response teams, crisis receiving, crisis stabilization, and other behavioral health services.

· Prevention and early intervention activities and services for persons living with SMI/SED to avoid future crises.

· MHBG requires that 10 percent be set aside to develop programs and services for First Episode Psychosis/Early Serious Mental Illness.

· Services to monitor or evaluate progress in implementing a comprehensive, community-based mental health system.

· Resource Development

· Infrastructure Support

· Information Systems

· Community Partnerships

· Quality Assurance

· Research and Evaluation

· Training and Education

Any cost allocable to other federal grant awards or programs may not be charged to MHBG to overcome any restrictions, to fund deficiencies, to avoid restrictions imposed by law or terms of the federal awards, or for other reasons.

STANDARD TERMS AND CONDITIONS

1. MHBG Administrative Requirements This award is subject to the administrative requirements for HHS block grants under 45 CFR § 96, as applicable, and 45 CFR § 75.

2. Early Serious Mental Illness Set-Aside Pursuant to the 21st Century Cures Act, P.L. 114-255 amended § 1920(c) of the Public Health Service Act (42 U.S.C. § 300x 9(c)), States must set-aside not less than ten percent (10%) of their total MHBG allocation amount for each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at onset. In lieu of expending ten percent (10%) of the amount the States receives for a fiscal year, States have the flexibility to expend not less than 20 percent (20%) of such amount by the end of the succeeding fiscal year (September 30, 2025).

3. Crisis Services Set-Aside States must set-aside not less than 5 percent (5%) of their total MHBG allocation amount for each fiscal year to support evidence-based programs that address the crisis care needs of individuals with serious mental illnesses and children with serious emotional disturbances, which may include individuals (including children and adolescents) experiencing mental health crises demonstrating serious mental illness or serious emotional disturbance, as applicable. This 5% set aside may be used to fund some, or all of the core crises care service components, as applicable and appropriate including crisis call centers, 24/7 mobile crisis services, crisis stabilization programs offering acute care or subacute care in a hospital or appropriately licensed facility, as determined by such State, with referrals to inpatient or outpatient care. In lieu of expending 5 percent of the amount the State receives for a fiscal year to support evidence-based programs as required, State may elect to expend not less than 10 percent of such amount to support such programs by the end of two consecutive fiscal years.

4. Flowdown of requirements to sub-recipients The grantee, as the awardee organization, is legally and financially responsible for all aspects of this award including funds provided to sub-recipients, in accordance with 45 CFR §§ 75.351- 75.353, Sub-recipient monitoring and management.

5. Availability of Funds Funds awarded under this grant must be obligated and expended by September 30, 2025.

6. Executive Pay The Consolidated Appropriations Act, 2023 (Public Law No: 117-328), signed into law on December 29, 2022, restricts the amount of direct salary to Executive Level II of the Federal Executive Pay scale. Effective January 1, 2023, the salary limitation for Executive Level II is $212,100. For awards issued prior to this change, if adequate funds are available in active awards, and if the salary cap increase is consistent with the institutional base salary, recipients may re-budget to accommodate the current Executive Level II salary level. However, no additional funds will be provided to these grant awards.

7. Marijuana Restriction SAMHSA grant funds may not be used to purchase, prescribe, or provide marijuana or treatment using marijuana. See, e.g., 45 CFR § 75.300(a) (requiring HHS to ensure that Federal funding is expended in full accordance with U.S. statutory and public policy requirements); 21 U.S.C. §§ 812(c)(10) and 841 (prohibiting the possession, manufacture, sale, purchase or distribution of marijuana).

8. Universal Identified and SAM Requirements This award is subject to requirements as set forth in 2 CFR § 25 – Universal Identifier and System of Award Management (SAM) Requirements.

A. SAM Requirement Unless you are exempted from this requirement under 2 CFR § 25.110, you, as the recipient, must review and update your information in SAM to ensure it is current, accurate, and complete until you submit the final financial report required under this award or receive the final payment, whichever is later. You are required to review and update the information at least annually after the initial registration, or more frequently if required by changes in your information or another award term.

B. Requirement for unique entity identifier If you are authorized (reference project description) to make subawards under this award, you:

1. Must notify potential subrecipients that no entity (see definition in paragraph C of this award term) may receive a subaward from you, unless the entity has provided its unique entity identifier to you; and

2. May not make a subaward to an entity unless the entity has provided its unique…