2.) The Children’s  Health Act of 2000 required SAMHSA to submit a plan to the Congress by  October 2002 describing the flexibility the performance partnership grants  would give the states, the performance measures that SAMHSA would use  to hold states accountable, the data that SAMHSA would collect from  states, definitions of the data elements, obstacles to implementing the  grants and ways to resolve them, the resources needed to implement the  grants, and any federal legislative changes that would be necessary. SAMHSA’s Strategic Planning Efforts Are Incomplete

SAMHSA has operated without a strategic plan since October 2002. For example,  SAMHSA’s priorities do not identify the approaches and resources needed  to achieve the long-term goals; the results expected from the agency’s  grant programs and a timetable for achieving those results; and an  assessment of key external factors, such as the actions of other federal  agencies, that could affect SAMHSA’s ability to achieve its goals. Without a  strategic plan that includes the expected results against which the  agency’s efforts can be measured, it is unclear how the agency or the  Congress will be able to assess the agency’s progress toward achieving its  long-term goals or the adequacy and appropriateness of SAMHSA’s grant  programs. Specifically, SAMHSA has not developed a detailed succession  strategy to prepare for the loss of essential expertise and to ensure that  the agency can continue to fill key positions. SAMHSA did not include a succession strategy in its strategic workforce  plan, and the agency has not yet developed such a strategy. Another shortcoming in SAMHSA’s strategic workforce planning is that  the agency has not fully developed hiring and training strategies to ensure  that its project officers will have the appropriate expertise to manage the  proposed performance partnership grants. In contrast, other aspects of SAMHSA’s performance management system  do not reinforce individual accountability for results. In addition, SAMHSA’s performance management system does not assess  staff performance in relation to specific competencies. SAMHSA’s funds are directed toward the provision of  substance abuse and mental health services for homeless people. SAMHSA Could More Effectively Manage Partnerships with State and Local Grantees

Officials from state mental health and substance abuse agencies and  community-based organizations identified opportunities for SAMHSA to  better manage its block and discretionary grant programs. Grantees Have Raised Concerns about SAMHSA’s Grant Processes

Officials from states and community-based organizations told us that  SAMHSA could improve administration of its grant programs, citing  concerns related to the agency’s grant application review processes, site  visits to review states’ compliance with block grant requirements, and the  availability of information on technical assistance opportunities. Discretionary Grant Applications

Grantees we talked to expressed concern that SAMHSA rejects  discretionary grant applications without reviewing them for merit if they  do not comply with administrative requirements. SAMHSA Is Preparing States for Performance Partnership Grants, but Has Not Finalized States’ Reporting Requirements

To prepare for the mental health and substance abuse performance  partnership grants—which SAMHSA plans to implement in fiscal years  2005 and 2006, respectively—SAMHSA has worked with states to develop  performance measures and improve states’ ability to report performance  data. In addition, SAMHSA has not completed plans to ensure that its workforce  has the appropriate expertise to manage the proposed performance  partnership grants, which would represent a significant change in the way  SAMHSA holds states accountable for achieving results. Finally, as SAMHSA makes efforts to increase program accountability, it is  in the agency’s interest to fund state and local programs that show the  most promise for improving the quality and availability of prevention and  treatment services. While early evidence  indicates that the new procedures are reducing the proportion of  applications rejected for administrative reasons, these procedures have  not eliminated such rejections. SAMHSA also provided technical comments.
Why GAO Did This Study

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency responsible for improving the quality and availability of prevention and treatment services for substance abuse and mental illness. The upcoming reauthorization review of SAMHSA will enable the Congress to examine the agency's management of its grant programs and plans for converting its block grants to performance partnership grants, which will hold states more accountable for results. GAO was asked to provide the Congress with information about SAMHSA's (1) strategic planning efforts, (2) efforts to manage its workforce, and (3) partnerships with state and community-based grantees.

What GAO Found

SAMHSA has not completed key planning efforts to ensure that it can effectively manage its programs. The agency has operated without a strategic plan since October 2002, and although SAMHSA officials are drafting a plan, they do not know when it will be completed. SAMHSA developed long-term goals and a set of priority issues that provide some guidance for the agency's activities, but they are not a substitute for a strategic plan. In particular, they do not identify the approaches and resources needed to achieve the agency's long-term goals and the desired results against which the agency's programs can be measured. SAMHSA also has not fully developed strategies to ensure it has the appropriate staff to manage the agency's programs. Although the proportion of SAMHSA's staff eligible to retire is increasing, the agency has not developed a detailed succession strategy to prepare for the loss of essential expertise and to ensure that the agency continues to have the ability to fill key positions. In addition, the proposed performance partnership grants will change the way SAMHSA administers its largest grant programs, but the agency has not completed hiring and training strategies to ensure that its workforce will have the skills needed to administer the grants. Finally, SAMHSA's system for evaluating staff performance does not distinguish between acceptable and outstanding performance, and the agency does not assess staff performance in relation to specific competencies--practices that would help reinforce individual accountability for results. SAMHSA has opportunities to improve its partnerships with state and community-based grantees. For example, grantees objected to SAMHSA's practice of rejecting discretionary grant applications that do not comply with administrative requirements--such as those that exceed page limitations--without reviewing them for merit. Rejecting applications solely on administrative grounds potentially prevents SAMHSA from supporting the most effective programs. SAMHSA's recent changes to the review process should reduce such rejections, but have not eliminated them. State officials are also concerned that SAMHSA has not finalized the performance data that states would be required to report under the proposed performance partnership grants. To comply, states will need to change their data systems, but they cannot complete these changes until SAMHSA finalizes the requirements. The Congress directed SAMHSA to submit a plan by October 2002 describing the final data reporting requirements and any legislative changes needed to implement the grants, but SAMHSA has not yet completed the plan. This delay could prevent the agency from meeting its current timetable for implementing the mental health and substance abuse performance partnership grants in fiscal years 2005 and 2006, respectively.