8-Allowable Expenses.pdf

Allowable Recovery Support Services (RSS) Expenditures through the SUBG and the MHBG

Recovery and Recovery Support Services

The process of recovery is unique to each individual and can take different paths. It can involve clinical treatment, medications, faith-based approaches, peer and family support, self-care, and other methods. Recovery is characterized by continuous growth and improvement in health and well-being. Since recovery is highly personalized, the services and support offered must be suitable for different age groups and adaptable to ensure cultural relevance. Recovery support services are based in the community and occur across the lifespan of the individual. These services address an individual’s environment and provide emotional and practical support to sustain recovery. Recovery is defined as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential (SAMHSA, 2010). This definition does not describe recovery as a single point in time, but rather as an ongoing process. SAMHSA has identified four dimensions that support a life in recovery. Below are these dimensions outlining allowable costs for recovery support services:

The Four Major Dimensions of Recovery

• Health: Overcoming or managing one’s disease(s) or symptoms, and making informed, healthy choices that support physical and emotional well-being;

• Home: Having a stable and safe place to live;

• Purpose: Conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society;

• Community: Having relationships and social networks that provide support, friendship, love, and hope.

SAMHSA promotes recovery support systems that involve collaboration with individuals in recovery from mental and substance use disorders, as well as their family members. These systems aim to guide the behavioral health system and promote approaches at the individual, program, and system levels that foster health, wellness, and resilience. They also strive to increase supportive housing services, reduce barriers to employment, education, and other life goals, and establish necessary social supports within chosen communities.

Recovery support services are offered in various settings and help individuals enter and navigate care systems, remove obstacles to recovery, stay engaged in the recovery process, and lead fulfilling lives in their chosen communities. These non-clinical services are culturally and linguistically appropriate and assist individuals and families working towards recovery from mental and/or substance use problems. They encompass a wide range of social, legal, and other services that facilitate recovery, wellness, and connection between service providers and other supports known to enhance people's quality of life. Recovery support services can be provided before, during, or after clinical treatment, and may also be available to individuals who are not currently receiving treatment but seek support services. Professionals and peers deliver these services through various community and faith-based groups, treatment providers, schools, and specialized services. The diverse options for service delivery ensure that the life experiences of all individuals are respected and represented. The following are examples of recovery support services that could be covered by block grants (the list is not exhaustive).

August, 2023

Examples of Recovery Support Services That Are Allowable through the Center for Substance Abuse Treatment Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG)

The Consolidated Appropriations Act, 2023 includes language requiring SAMHSA block grant program recipients to report recovery support services delivered. This table identifies allowable services under the SUPTRS Block Grant for recovery support services. It includes several definitions that grantees will need to meet reporting requirements found in the FY 24-25 MHBG/SUBG Application and Reporting Package. Further instructions are found in the application. We look forward to beginning the process of capturing the data to measure the great recovery support service work happening throughout the country.

SUBG Recovery Support Service types listed below are subject to statutory and regulatory conditions, requirements, and restrictions, including Public Health Service Act, sections 1921–1935 and sections 1941–1954, 42 U.S.C. §300x-21 to §300x-35, §300x-51 to §300x-68, 45 C.F.R. Part 75, 45 C.F.R Part 96, Subpart C, §96.1 through §96.33, and 45 C.F.R. Part 96, Subpart L, §96.120 through §96.137, and Office of Financial Resources (OFR) policies, procedures, and SUBG Notice of Award (NoA) Terms and Conditions. All SUBG RSS expenditures are subject to SPO and GMS annual SUBG Plan approval.

Recovery Support Services

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

I. Home

Yes, allowable for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible SUD individuals (unless otherwise disallowed or restricted in this document, or through statute, regulation, or policy).

Recovery and Supportive Housing Assistance.

Examples of SUD recovery housing standards include:

Not allowable as support or assistance that is provided directly to a SUD individual, but rather must be provided to an eligible recovery housing organization.

Also approved when provided under §96.129 “Revolving funds for establishment of homes in which recovering substance abusers may reside”.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv)

Recovery Support Services

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

• Nationally or state certified and/or licensed

• Peer Respite Centers

• Temporary housing assistance

• Deposits

• Assistance setting-up power (electricity, heating, internet, etc.)

as deemed appropriate and allocable

• Peer recovery efforts that engage culturally diverse and underserved populations

• Naloxone distribution

Recovery Housing* provides an individual or group in SUD recovery with recovery housing, delivered in an approved facility by an approved recovery housing organization. Recovery Housing facilities are required to be nationally or state certified and/or licensed as a SUD recovery housing facility by a government entity. Recovery Housing facilities are required to ensure that any approved activities are consistent with the definition of, and best practices for, recovery housing (42 U.S.C. 290ee-5; section 550 PHS Act, as amended), and meet the “Ten Guiding Principles” of SAMHSA’s Recovery Housing: Best Practices and Suggested Guidelines, 2018, THIS DOCUMENT IS IN THE PROCESS OF REVISION BY SAMHSA.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv);

§300x-25;

§96.129 42 U.S.C. 290ee-5; section 550 PHS Act, as amended

• Homeless outreach programs

• Peer recovery efforts that engage culturally diverse and underserved populations

Peer-to-Peer Support Individual* provides persons in or seeking SUD recovery with an individual recovery support service delivered by a peer recovery support specialist, family support provider, youth specialist, recovery coach or the equivalent. The RSS participant receives an approved RSS from a peer with lived experience in SUD recovery. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service.

The delivery of the service is time limited and cost approved.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

§300x-21 (b);

§300x-32 (b)(1)(A) (ii) and (iv)

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

II. Health

Federal 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). [From FY 23 SUBG Notice of Award Terms and Conditions]

SUBG Restriction on Purchase or Distribution of Hypodermic Needles or Syringes for Illicit Drug Use: No funds … shall be used to purchase sterile needles or syringes for the hypodermic injection of any illegal drug:

Provided, That such limitation does not apply to the use of funds for elements of a program other than making such purchases if the relevant State or local health department, in consultation with the Centers for Disease Control and Prevention, determines that the State or local jurisdiction, as applicable, is experiencing, or is at risk for, a significant increase in hepatitis infections or an HIV outbreak due to injection drug use, and such program is operating in accordance with State and local law. This restriction does not apply to the purchase or distribution of hypodermic needles or syringes, as part of an overdose reversal kit, that are purchased or distributed to be used in the legal administration of naloxone as an opioid overdose reversal agent.

45 CFR § 75.300 (a);

§96.135(a)(6) Peer-led support groups, both in-person and virtual.

Examples include but are not limited to:

Yes, allowable for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible SUD individuals (unless otherwise disallowed or restricted in this document, or through statute, regulation, or policy).

Not approved as a RSS when delivered as a SUBG clinical treatment service, a medical treatment service, or as an identified Primary Prevention Program strategy, activity, or service under §96.125.

• All Recovery Meetings

• Family Groups

(CRAFT, parenting classes, etc.)

• Gender specific support groups

• Youth and young adult groups

• Older adult groups

• Co-occurring peer support efforts

• Peer recovery efforts that engage culturally diverse and underserved populations

• Naloxone distribution

Peer-Led Support Group* provides persons in or seeking SUD recovery with group support delivered by a peer support specialist. The RSS participant receives an approved RSS from a peer with lived experience in SUD recovery. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited and cost approved.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements.

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

• Coordination and education on physical health for testing/treatment of:

o HIV/AIDS o HCV o STD o COVID (infectious diseases)

• Fitness activities including gyms, fitness groups

• Complementary and alternative approaches

• Peer recovery efforts that engage culturally diverse and underserved populations

• Naloxone distribution

• Smoking cessation education

Recovery Health and Wellness Educational Event or Activity** provides persons in or seeking SUD recovery with individual or group recovery health and wellness educational events or activities delivered by a qualified individual. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend the Block Grant on the following activities: To make cash payments to intended recipients of health services.

[Title 45, Subtitle A, Subchapter A, Part 96, Subpart L, §96.135(a)(2)]

Payments are restricted to approved vendors as described above and may not include payments to clients or client’s family members.

Not approved for the payment of fitness center, gym, or related fitness or recreational organization membership fees or equipment.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv);

§300x-31;

§96.135(a)(2)

• Peer support worker providing:

o Overdose Prevention o Naloxone distribution o Peer recovery efforts that engage culturally diverse and underserved populations o Naloxone distribution

Peer-Led Recovery Educational Workshop or Event** RSS provides persons in or seeking SUD recovery with recovery educational workshops or event services, delivered by a peer support specialist in SUD recovery. The RSS participant receives an approved RSS from a peer with lived experience in SUD recovery. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

• Culturally based recovery practices, such as:

o Learning Circles o Sweat lodge o Traditional healing ceremonies o Pow wows

• Peer recovery efforts that engage culturally diverse and under-resourced populations

• Naloxone distribution

Culturally Based Recovery Practice or Creative and Expressive Arts Recovery Activity** provides persons in or seeking SUD recovery with individual or group culturally based recovery practices or creative and expressive arts recovery activities, delivered by a qualified individual.

The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv)

III. Purpose

Yes, allowable for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible SUD individuals (unless otherwise disallowed or restricted in this document, or through statute, regulation, or policy).

Not approved for the payment of tuition, fees, loan repayments, or educational related costs for secondary school, college, technical school, or other educational institutions for SUBG supported staff or clients.

Not approved as a RSS when delivered as a SUBG clinical treatment service, a medical treatment service, or as an identified Primary Prevention Program strategy, activity, or service under §96.125.

• Educational

Workshops:

o Recovery 101 o Mutual aid groups o Wellness training o Shared Decision

Making o GED classes o Peer Provided Life

Skills o Stress Management o Stigma Reduction o Leadership

Development o Rights protection o Naloxone distribution

Peer-Led Recovery Educational Workshop or Event** RSS provides persons in or seeking SUD recovery with recovery educational workshops or event services, delivered by a peer support specialist in SUD recovery.

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

Federal Prohibition on Lobbying: SUBG funds may not be used to support advocacy or lobbying activities that are prohibited by federal law.

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

Recovery Friendly Workplace (RFW) and Supportive Employment

• Services such as:

resume building, on-the-job training, employment coaching

• Outreach to employers to hire individuals in recovery

• Supported Education and employment

• Naloxone distribution

Recovery Friendly Workplace (RFW) Initiative, Activity, or Supportive Employment Service** provides an individual in or seeking SUD recovery with Recovery Friendly Workplace (RFW) initiatives, activities, or supportive employment services. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv)

• Computer equipment to provide training for GED, job skills, resume development and job applications

Recovery Friendly Workplace (RFW) Initiative, Activity, or Supportive Employment Service** provides an individual in or seeking SUD recovery with Recovery Friendly Workplace (RFW) initiatives, activities, or supportive employment services

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

Yes, allowable for the purchase or leasing by SUBG grantees or approved subrecipient providers, for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible SUD individuals.

Not approved to allow for the purchase of electronic equipment, technology services, or technology services supports for clients or family members of clients.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv)

• Recovery high schools / RSS programs

• Collegiate recovery programs schools /

RSS

• Naloxone distribution

Secondary School, High School, or Collegiate Recovery Program Service or Activity* provides persons in SUD recovery with an individual or group Secondary School, High School, or Collegiate Recovery Program sponsored service or activity. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv)

• Training of Peer Specialists with guidance from model standards set forth by SAMHSA in June 2023

Peer-Led Training or Peer Certification Activity* provides persons in SUD recovery with an approved individual or group peer-led training or peer certification activity, that is delivered by a qualified training entity. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

IV. Community

Yes, allowable for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible SUD individuals (unless otherwise disallowed or restricted in this document, or through statute, regulation, or policy).

Not approved as a RSS when delivered as a SUBG clinical treatment service, a medical treatment service, or as an identified Primary Prevention Program strategy, activity, or service under §96.125.

• Peer-to-Peer Support to include peer specialists, peer coaches, family support providers, peer mentors, youth peer specialists, peer support specialists

• Telephonic and other technology-assisted recovery support including recovery check-ins

• Co-occurring peer support efforts

• Peer recovery efforts that engage culturally diverse and underserved populations

• Outreach

• Naloxone distribution

Peer-to-Peer Support Individual* provides persons in or seeking SUD recovery with an individual recovery support service delivered by a peer recovery support specialist, family support provider, youth specialist, recovery coach or the equivalent.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

• Information and Referral

• Recovery Community Organizations

• Recovery Cafes

• Drop-in centers

• Peer-led Warm lines

• Social support and social inclusion activities including support for Recovery Month activities and Recovery Community Centers (RCCs) events

• Naloxone distribution

Recovery Community Organization (RCO) or Recovery Community Center (RCC) Service or Activity** provides individual or group services and activities sponsored by an RCO or RCC. The grantee and/or subrecipient agency must approve the RSS and the RCO or RCC providing the service. The delivery of the service is time limited and cost approved.

**Included in the OMB approved FY 24-25 SUBG Application and Reporting Requirements, to be reported under “Other SAMHSA Approved RSS Event or Activity”.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv);

§96.135(a)(3)

• Social support and social inclusion activities including support for Recovery Month activities and Recovery Community Centers (RCCs) events

Recovery Social Support or Social Inclusion Activity* provides persons in or seeking SUD recovery with group recovery social support or social inclusion activities, through a recovery organization or recovery community center. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service. The delivery of the service is time limited, and cost approved.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv)

• Family Caregiver Support

RSS Childcare Fee or Family Caregiver Fee* provides funding to an approved childcare or adult care vendor that is authorized by a grantee or subrecipient agency for a limited defined fee payment agreement. No more than four (4) RSS community events per participant per month are eligible for reimbursement. Licensed Childcare and Adult Care Providers are required to obtain approval for childcare and adult care fees for RSS participants who are receiving services in the community, for a period of not more than one (1) calendar year.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend the Block Grant on the following activities: To make cash payments to intended recipients of health services.

[Title 45, Subtitle A, Subchapter A, Part 96, Subpart L, §96.135(a)(2)]

Payments are restricted to approved vendors as described above, and may not include payments to clients, participants, or their family members.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv);

§300x-31(a)(1)(B) §96.135(a)(2)

(RSS)

SUBG Allowable Expenditures SUBG Citation or Reference

• Transportation RSS Transportation Fee* provides funding to an approved transportation vendor that is authorized by a grantee or subrecipient agency for a limited defined fee payment agreement.

Funding is limited to no more than four (4) RSS community events per participant per month, for a bus pass, a taxicab voucher, or a Lyft or Uber charge. RSS transportation fees are required to be authorized as necessary as determined by the grantee or subrecipient agency for an RSS participant to receive RSS offered in the community, for a period of no more than one (1) calendar year.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend the Block Grant on the following activities: To make cash payments to intended recipients of health services.

[Title 45, Subtitle A, Subchapter A, Part 96, Subpart L, §96.135(a)(2)]

Payments are restricted to approved vendors as described above, and may not include payments to clients, participants, or their family members.

§300x-21 (b);

§300x-32 (b)(1)(A)(iv);

§96.135(a)(2)

• Other SAMHSA Approved SUD RSS Event or Activity

Other SAMHSA Approved SUD RSS Event or Activity* provides persons in or seeking SUD recovery with an RSS event or activity delivered by a peer support specialist. The grantee and/or subrecipient agency must approve the RSS and the group or organization providing the service.

The delivery of the service is time limited, and cost approved.

*Included in the OMB approved FY 24-25 SUBG Application and Reporting Package.

It is recommended that CSAT SPOs should be consulted by grantees regarding any planned expenditures of SUBG funds for any other Recovery Support Services, for the SPO to obtain OFR-DGM written preapproval for such expenditures.

Examples of Recovery Support Services Allowable through the Community Mental Health Services Mental Health Block Grant (MHBG)

Recovery support services are integral to the provision of comprehensive and high-quality mental health care. Recovery support services play an important role in assisting individuals with Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED) on their path to recovery. It is imperative for states to actively explore avenues to integrate recovery support services, including those delivered by peers, into their continuum of care. SAMHSA’s BG guidelines as demonstrated in the following MHBG table outline allowable recovery support services within the federal statutory and regulatory parameters. This concerted effort ensures that individuals receive holistic care, treatment, recovery, and other support services.

MHBG Recovery Support Service types listed below are subject to statutory and regulatory conditions, requirements, and restrictions, including 42 U.S.C. §300x to §300x-9, 45 C.F.R. §96.30, and Office of Financial Resources (OFR) policies, procedures, and MHBG Notice of Award (NoA) Terms and Conditions. In addition, please refer to 42 U.S.C §300x-5 for prohibited activities. All MHBG RSS expenditures are subject to SAMHSA approval.

Recovery Support Services (RSS) MHBG Allowable Expenditure MHBG Citation or Reference

I. Home Yes, allowable for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible MHBG individuals (unless otherwise disallowed or restricted in this document, or through statute, regulation, or policy

• Peer Respite Centers The RSS participant with SMI/SED receives an approved RSS from a peer with lived experience in mental health recovery. The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED

§300x–2(b) (1) Services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs)

• Supported Housing Permanent Supportive Housing (PSH) including case management services for individuals with SMI/SED are allowable expenditures

§300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance

• Homeless outreach programs Yes, if it for individuals with SMI/SED §300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance

Recovery Support Services (RSS) MHBG Allowable Expenditure MHBG Citation or Reference

II. Health Federal 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).

Peer-led support groups, both in-person and virtual. Examples include but are not limited to:

• All Recovery Meetings

• Family Groups (CRAFT, parenting classes, etc.)

• Gender specific support groups

• Youth and young adult groups

• Older adult groups

• Co-occurring peer support efforts

• Peer recovery efforts that engage culturally diverse and underserved populations

Peer-Led Support Groups provide persons/families seeking mental health recovery with group support delivered by a peer support specialist. The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED

§300x–2(b) (1) Services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs)

• Tobacco Cessation Tobacco cessation programs provided as part of treatment and recovery support services for individuals with SMI/SED is an allowable expenditure

§300x–66. Services for individuals with co-occurring disorders §300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance

• Clinician training on recovery-based approaches

Clinician training as an educational activity is an allowable expenditure as long as the training is for providers and employees who are providing services to individuals with

SMI/SED

§300x-(b) (4) Planning, administration, and educational activities related to providing services under the plan

• Person-Centered Planning Person-Centered Planning for those with SMI/SED is an allowable expenditure.

42 CFR § 441.725 SAMHSA is adopting the definition of person-centered planning in CMS medical assistance programs

Peer support worker providing:

• Overdose Prevention Peer-Led Recovery Educational Workshop or Event RSS provides persons in or seeking mental health or co-occurring (MH/SUD) recovery with recovery educational workshops or event services, delivered by a peer support specialist for individuals with SMI/SED.

§300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance §300x–66. Services for individuals with co-occurring disorders

• Outreach Outreach to people with SMI/SED for recovery support services and treatment is an allowable expenditure.

§300x-(b) (1) Providing community mental health

• Culturally based recovery practices, such as:

o Learning Circles o Sweat lodge o Traditional healing ceremonies o Pow wows

The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED

Please note:

1. Restriction on Cash Payments to Clients: The State

[or subrecipients] shall not expend MHBG to make cash payments to intended recipients of health services. [300x-5]

§300x–2(b) (1) Services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs) 45 CFR Part 96.30 – Block Grants § 96.30 Fiscal and administrative requirements.

300x-5 Restrictions on Use of Payments

III. Purpose

Educational Workshops:

• Recovery & Self-Management

• WRAP

• E-CPR

Training as an educational activity is an allowable expenditure as long as it is for individuals with SMI/SED, providers, and/or employees who are providing services to individuals with SMI/SED

Please note:

1. Restriction on Cash Payments to Clients: The State

[or subrecipients] shall not expend MHBG to make cash payments to intended recipients of health services. [300x-5]

2. Not approved for the payment of tuition, fees, loan repayments, or educational related costs for secondary school, college, technical school, or other educational institutions for MHBG supported staff or clients.

§300x-(b) (4) Planning, administration, and educational activities related to providing services under the plan 45 CFR Part 96

• Recovery 101

• Mutual aid groups

• Wellness training

• Shared Decision Making

• GED classes (as part of supported education)

• Peer Provided Life Skills

• Stigma Reduction

• Stress Management

Peer-Led Recovery Educational Workshop or Event RSS provides persons with SMI/SED in or seeking mental health recovery with recovery educational workshops or event services, delivered by a peer support specialist in mental health recovery.

The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED

§300x-(b) (4) Planning, administration, and educational activities related to providing services under the plan 45 CFR Part 96

Recovery Friendly Workplace (RFW) Initiatives and Supportive Employment/Education:

• Services such as: resume building, on-the-job training, employment coaching

• Outreach to employers to hire individuals in recovery

• Training of Peer Specialists with guidance from model of standards set forth by SAMHSA in May 2023.

Recovery Friendly Workplace (RFW) Initiative, Activity, or Supportive Employment Services: Provides an individual in or seeking mental health recovery with Recovery Friendly Workplace (RFW) initiatives, activities, or supportive employment/education services. The service must be part of a recognized non-clinical, evidence-based practice for individuals with SMI/SED (for example, as part of Psychosocial Rehabilitation, Supported Employment or Case Management)

Training as an educational activity is an allowable expenditure as long as the training is for individuals with SMI/SED as part of Supported Education, Supported Employment and/or Psychosocial Rehabilitation.

Please note:

1. Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend MHBG to make cash payments to intended recipients of health services. [300x-5]

2. Not approved for the payment of tuition, fees, loan repayments, or educational related costs for secondary school, college, technical school, or other educational institutions for MHBG supported staff or clients.

§300x-(b) (4) Planning, administration, and educational activities related to providing services under the plan 45 CFR Part 96

• Supported Education and employment

Supported Employment and Supported Education are allowable expenditures as long as these are for individuals with SMI/SED.

Please note:

1. Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend MHBG to make cash payments to intended recipients of health services. [300x-5]

2. Not approved for the payment of tuition, fees, loan repayments, or educational related costs for secondary school, college, technical school, or other educational institutions for MHBG supported staff or clients.

§300x-(b) (1) Providing community mental health

• Computer equipment to provide training for GED, job skills, resume development and job applications

Allowable if it is for a psychosocial rehabilitation program provider.

Please note:

Purchasing computer equipment, software, Wi-Fi are not allowable for individual clients. (Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend MHBG to make cash payments to intended recipients of health services. [300x-5])

§300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance §300x-(b) (4) Planning, administration, and educational activities related to providing services under the plan

IV. Community

Yes, allowable for the provision of recognized non-clinical RSS evidence-based practices and activities for eligible individuals with SMI/SED (unless otherwise disallowed or restricted in this document, or through statute, regulation, or policy).

• Peer-to-Peer Support to include peer specialists, youth peer specialists, peer coaches, peer mentors, peer support specialists

• Drop-in centers

• Peer recovery efforts that engage culturally diverse and underserved populations

• Co-occurring peer support efforts

• Telephonic and other technology-assisted recovery support including recovery check-ins

• Social support and social inclusion activities including support for Recovery Month activities and Recovery Community Centers (RCCs) events

• Peer-led Warm lines

Peer-to-Peer Support Individual provides persons in or seeking mental health recovery with an individual recovery support service delivered by a peer recovery support specialist, youth specialist, recovery coach or the equivalent.

The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED

§300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance §300x–2(b) (1) Services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs)

• Information and Referral Information and Referral is an allowable expenditure when providing these services for individuals with SMI/SED.

§300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance §300x-(b) (4) Planning, administration, and educational activities related to providing services

• Peer-Operated Services including Recovery Community Organizations

The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED.

§300x–2(b) (1) Services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs) §300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance 45 CFR Part 96 – Block Grants § 96.30 Fiscal and administrative requirements.

• Family Caregiver Support The service must be part of a recognized non-clinical, evidence-based practice for individuals with SMI/SED (for example, psychoeducation). The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED.

Please note:

1. Restriction on Cash Payments to Clients: The State

[or subrecipients] shall not expend MHBG to make cash payments to intended recipients of health services. [300x-5]

2. The grantee (state) must approve the RSS and the group or organization providing the service as a mental health provider and an approved service for people with SMI/SED.

§300x-(b) (4) Planning, administration, and educational activities related to providing services

Recovery Support Services (RSS)

MHBG Allowable Expenditure MHBG Citation or Reference

• Transportation RSS Transportation Fee provides funding to an approved transportation vendor that is authorized by a grantee or subrecipient agency for a limited defined fee payment agreement. Funding is limited to a bus pass, a taxicab voucher, or a Lyft or Uber charge.

RSS transportation fees are required to be authorized as necessary as determined by the grantee or subrecipient agency for an RSS participant to receive RSS offered in the community.

Please note: Restriction on Cash Payments to Clients: The State [or subrecipients] shall not expend the Block Grant on the following activities: To make cash payments to intended recipients of health services. [300x-5]. Payments are restricted to approved vendors as described above, and may not include payments to clients, participants, or their family members.

§300x-(b) (1) Providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance