Substance Use Prevention, Treatment and Recovery Services Block Grant (SUBG - formerly known as SABG)

Background

The SUBG is allocated to AHCCCS from the Substance Abuse and Mental Health Services Administration (SAMHSA) for the purpose of planning, implementing, and evaluating substance use disorder (SUD) services throughout the state. The grant provides for prevention, treatment, and recovery services. Grant funds are also used to provide early intervention services for HIV and tuberculosis (TB) in high-risk individuals who use substances. The following sections provide information on SUD treatment and recovery, the Independent Case Review, TB services, primary prevention, and the Synar Program, which is aimed at preventing underage access to tobacco/nicotine products.

Treatment

SUBG funds are used to ensure access to treatment and support services for uninsured and underinsured individuals. The grant includes priority populations to be served, established by SAMHSA and listed in order of priority:

  1. Pregnant women/teenagers who use drugs by injection,
  2. Pregnant women/teenagers who use substances,
  3. Other persons who use drugs by injection,
  4. Substance using women and teenagers with dependent children and their families, including females who are attempting to regain custody of their children, and
  5. All other individuals with a substance use disorder, regardless of gender or route of use, (as funding is available).

SUBG funds for treatment and recovery services are primarily allocated from AHCCCS to ACC-RBHAs and TRBHAs for the implementation of services. For more information about applying for SUBG funding for SUD treatment and recovery services, go to Behavioral Services Map link under resources and select the ACC-RBHA or TRBHA nearest you. Members can receive SUD services through SUBG while going through the enrollment process for AHCCCS or if denied eligibility as shown in the Accessing the Behavioral Health System link under resources.

Treatment Resources

Recovery

The SUBG may be used for SUD recovery services for uninsured and underinsured individuals in alignment with AHCCCS Covered Behavioral Health Services and additional SAMHSA guidance. SAMHSA defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery signals a dramatic shift in the expectation for positive outcomes for individuals who experience mental and substance use conditions or the co-occurring of the two.” According to SAMHSA, the four major dimensions of recovery are:

  1. Health - Overcoming or managing one’s disease(s) or symptoms – for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medication if one has an addiction problem – and for everyone in recovery making informed, healthy choices that support physical and emotional well-being
  2. Home - Having a stable and safe place to live
  3. 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
  4. Community - Having relationships and social networks that provide support, friendship, love, and hope

Pursuant to the 45 CFR Part 96 Sect. 127, AHCCCS is required to routinely make available tuberculosis services as defined in §96.121 to each individual receiving treatment for substance use, implement infection control procedures including the screening of patients, and identify those individuals who are at high risk of becoming infected.

AHCCCS contracts for the ICR to assess the quality, appropriateness, and efficacy of treatment services provided in the State to individuals under the SUBG. At least 5 percent of the entities providing services in the State under SUBG are reviewed annually. The programs reviewed shall be representative of the total population of such entities.

The review focuses on treatment programs and the substance use service system rather than on the individual practitioners. The intent of the ICR process is to continuously improve the treatment services to individuals with SUD “Quality,” for purposes of this section, is the provision of treatment services which, within the constraints of technology, resources, and patient/client circumstances, will meet accepted standards and practices which will improve patient/client health and safety status in the context of recovery. “Appropriateness,” for purposes of this section, means the provision of treatment services consistent with the individual's identified clinical needs and level of functioning.

The case reviewers are individuals with expertise in the field of alcohol and drug use treatment. Because treatment services may be provided by multiple disciplines, AHCCCS makes every effort to ensure that case reviewers are representative of the various disciplines utilized by the SUBG. Individual case reviewers are also knowledgeable about the modality being reviewed and its underlying theoretical approach to addictions treatment, and are sensitive to the cultural and environmental issues that may influence the quality of the services provided.

As part of the ICR, the reviewers review a representative sample of member records to determine quality and appropriateness of treatment services, while adhering to all Federal and State confidentiality requirements, including 42 CFR part 2. The reviewers examine the following:

  1. Admission criteria/intake process;
  2. Assessments;
  3. Treatment planning, including appropriate referral, e.g., prenatal care and tuberculosis and HIV services;
  4. Documentation of implementation of treatment services;
  5. Discharge and continuing care planning; and
  6. Indications of treatment outcomes.

AHCCCS ensures that the ICR will not involve practitioners/providers reviewing their own programs, or programs in which they have administrative oversight, and that there be a separation of case reviewers from funding decision-makers. In addition, AHCCCS ensures that the ICR is not conducted as part of the licensing/certification process.

The ICR is conducted each year for the time period of July 1 - June 30, and is published here as soon as it is available.

ICR Reports

Prevention

SABG Key Performance Measure Data July 1, 2022 – December 31, 2022

SABG Key Performance Measure Data July 1, 2021 – June 30th, 2022

SFY 2023 Quarter 1 (July-September 2022)

SABG Prevention Kick Off Meeting Part 1, July 7th 2021

  • Description: Start of video discussing MOU’s and Contractor Responsibilities, End of video who to share Deliverables with on AHCCCS Team

SABG Prevention Kick Off Meeting Part 2, July 7th 2021

  • Description: Start of video discussing Needs Assessment, leading to Financial CER portion, ending in Questions for AHCCCS presenters

SAMHSA requires that grantees spend no less than 20% of their SUBG allotment on substance use primary prevention strategies, which are strategies that are directed at individuals not identified to be in need of substance use disorder treatment. The SUBG primary prevention funds are used primarily to implement the SAMHSA Center for Substance Abuse Prevention (CSAP) strategies:

  • Information Dissemination providing awareness and knowledge of the nature, extent, and effects of alcohol, tobacco, and drug use, abuse, and addiction on individuals families and communities;
  • Education aimed at affecting critical life and social skills, such as decision making, refusal skills, critical analysis, and systematic judgment abilities;
  • Alternative programs that provide for the participation of target populations in activities that exclude alcohol, tobacco, and other drug use;
  • Problem Identification and referral that aims at identification of those who have indulged in illegal/age inappropriate use of tobacco or alcohol, and those individuals who have indulged in first use of illicit drugs, in order to assess if the behavior can be reversed by education to prevent further use;
  • Community-based Process that include organizing, planning, and enhancing effectiveness of program, policy, and practice implementation, interagency collaboration, coalition building, and networking; and
  • Environmental Strategies that establish or change 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.

Prevention Resources

The Synar Amendment was developed in the context of a growing body of evidence about the health problems related to tobacco use by youth, as well as evidence about the ease with which youth could purchase tobacco products through retail sources.

Pursuant to Public Health Services Act (42 U.S.C. 300x-26) and the Tobacco Regulation for the Substance Use Prevention, Treatment and Recovery Services Block Grant (SUBG) (45 C.F.R. 96.130) AHCCCS is required to comply with the Synar Amendment. The Synar Amendment and program is responsible for implementing the requirements of the Synar Agreement and requires States to:

  • Enact laws prohibiting any manufacturer, retailer, or distributor of tobacco products from selling or distributing such products to any individual younger than age 20
  • Enforce these laws
  • Conduct annual, unannounced inspections that provide a valid probability sample of tobacco sales outlets accessible to minors
  • Negotiate interim targets and a date to achieve a noncompliance rate (Retail Violation Rate (RVR)) of no more than 20%
  • Submit an annual report detailing activities to enforce the law

Synar Reports

Applications, Reports and Resources

Applications

Reports

Resources

ACC-RBHA SUBG Deliverable Templates


For additional questions about the SUBG, please contact the SUBG@azahcccs.gov email address.