[Federal Register Volume 71, Number 144 (Thursday, July 27, 2006)]
[Notices]
[Pages 42647-42651]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-6500]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Request for Comment From the Field on the Substance Abuse and 
Mental Health Services Administration's (SAMHSA) Addiction Technology 
Transfer Center (ATTC) Program

AGENCY: Substance Abuse and Mental Health Services Administration, HHS.

SUMMARY: This notice is to request comments from interested 
stakeholders in the substance use disorders treatment field regarding 
SAMHSA's ATTC Program. SAMHSA will be issuing a Request for 
Applications (RFA) for a new round of competitive cooperative agreement 
awards under the ATTC program in Federal fiscal year (FFY) 2007. To 
assist SAMHSA in developing the RFA, SAMHSA is seeking input from 
stakeholders and interested parties on a number of issues relating to 
these cooperative agreements.
    Program Title: Addiction Technology Transfer Centers (ATTC) 
Program.
    Catalog of Federal Domestic Assistance (CFDA) Number: 93.243.

    Authority: Section 5001(d)(5) of the Public Health Service Act, 
as amended.


FOR FURTHER INFORMATION CONTACT: Catherine D. Nugent, SAMHSA/CSAT/DSI, 
1 Choke Cherry Road, Room 5-1079, Rockville, MD 20857, phone: 240-276-
1577, e-mail: [email protected].

Introduction

    The Substance Abuse and Mental Health Services Administration 
(SAMHSA) is committed to building resilience and facilitating recovery 
for people with or at risk for substance use and mental disorders. 
SAMHSA collaborates with the States, national associations, local 
community-based and faith-based organizations, and public and private 
sector providers to implement initiatives in its priority areas, 
including development of the workforce serving individuals needing 
treatment and recovery for substance use disorders. The Center for 
Substance Abuse Treatment (CSAT) supports training and technology 
transfer activities to promote the adoption of evidence-based practices 
in substance use disorders treatment and, more broadly, to promote 
workforce development in the addiction treatment field. CSAT's 
Addiction Technology Transfer Centers (ATTCs), funded by CSAT since 
1993, are a major component of SAMHSA/CSAT's workforce development 
efforts.
    The ATTC Network is dedicated to identifying and advancing 
opportunities for improving addiction treatment. The vision of the 
ATTCs is to unify science, education and services to transform the 
lives of individuals and families affected by alcohol and other drug 
addition.
    Serving the 50 States, the District of Columbia, Puerto Rico, the 
U.S. Virgin Islands and the Pacific Islands, the ATTC Network operates 
as 14 individual Regional Centers and a National Office. At the 
regional level, individual Centers focus primarily on meeting the 
unique needs in their areas while also supporting national initiatives. 
The National Office leads the Network in implementing national 
initiatives and concurrently supports and promotes individual regional 
efforts.
    The current ATTC program is funded through cooperative agreements 
initially awarded in 2001 and 2002. These cooperative agreements will 
end in FFY 2007. SAMHSA/CSAT will be issuing a new funding announcement 
to re-compete the ATTCs in FY 2007. To assist CSAT in designing the

[[Page 42648]]

requirements and parameters for the next round of ATTCs, CSAT is 
requesting comments on the directions and priorities for the ATTC 
program and on meeting the workforce development needs of the addiction 
treatment field in an equitable manner across all the States, the 
District of Columbia, the Carribean Islands, and Pacific Islands.

DATES: Submit all comments on or before September 11, 2006.

ADDRESSES: Address all comments concerning this notice to: Catherine D. 
Nugent, SAMHSA/CSAT/DSI (ATTC Notice), 1 Choke Cherry Road, Room 5-
1079, Rockville, MD 20857.
    Electronic Access and Filing Address: You may submit comments by 
sending electronic mail (e-mail) to [email protected].

Overview

    The ATTC Network undertakes a broad range of initiatives that 
respond to emerging needs and issues in the substance use disorders 
treatment field. The ATTC Network is funded to upgrade the skills of 
existing practitioners and other health professionals and to 
disseminate the latest science to the treatment community. Resources 
are expended to create a variety of products and services that are 
timely and relevant to the many disciplines represented by the 
addiction treatment workforce.

Background

History

    SAMHSA/CSAT funded 11 centers, which were known as the Addiction 
Training Centers (ATCs), in 1993. These ATCs covered 19 States and 
Puerto Rico. In 1995, SAMHSA expanded the program to cover six 
additional States, which brought the total number of States served to 
25. In 1996, the program was renamed the Addiction Technology Transfer 
Center (ATTC) program. In 1998, a new round of cooperative agreements 
was funded and the ATTC network was expanded to include 13 Regional 
Centers and a National Office, serving 39 States, the District of 
Columbia, Puerto Rico, and the U.S. Virgin Islands. New cooperative 
agreements were funded in 2001 and 2002 for 14 ATTC Regional Centers 
and a National Office covering all 50 States, the District of Columbia, 
Puerto Rico, the U.S. Virgin Islands, and the Pacific Islands. The 
funding announcements for the ATTC cooperative agreements awarded in 
2001 and 2002 may be found on the SAMHSA Web site, http://www.samhsa.gov. Click on ``Grants'' at the top of the page and then on 
``SAMHSA Grant Archives'' to find a listing of SAMHSA funding 
announcements for 2001 and 20021.

Purpose of the ATTCs

    The primary purpose of the ATTCs is to enhance professional 
development by training the addiction treatment workforce to use 
evidence-based practices in providing treatment services and to train 
allied health professionals on the interdisciplinary foundation of 
addiction treatment, In 2001 and 2002, the ATTCs were tasked with the 
following:
     Building and maintaining collaborative networks with 
academic institutions, State and local governments, substance abuse/
mental health/primary care fields, counselor credentialing boards, 
professional, recovery, community and faith-based organizations, 
managed care and criminal justice entities;
     Creating linkages with and disseminating research from the 
National Institute on Drug Abuse (NIDA, the National Institute of 
Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Mental 
Health (NIMH), SAMHSA, and other government agencies;
     Developing and updating state-of-the-art research-based 
curricula, including curricula based on new and revised Treatment 
Improvement Protocols (TIPs), and developing faculty and trainers;
     Enhancing the clinical and cultural competencies of 
professionals from a variety of disciplines to help individuals with 
substance abuse problems;
     Upgrading standards of professional practice for 
addictions workers;
     Serving as technical resources to community-based and 
faith-based organizations, consumers and recovery organizations, and 
other stakeholders; and
     Providing feedback from the field to SAMHSA regarding the 
development of a comprehensive agenda for learning about and applying 
state-of-the-art treatment approaches.
    The ATTCs are currently organized as 14 Regional Centers and one 
national coordinating center (National ATTC Office--NATTC). This 
organizational structure was predicated on the belief that the ATTCs 
can more effectively advance the addiction field through a unified 
effort among a coordinated network of education and training centers 
than through a number of free-standing centers. The NATTC serves a 
coordinating function, building and maintaining a viable infrastructure 
that promotes internal and external communication among the ATTC 
Network and between the Network and its various audiences.

Core Priorities of the Current ATTCs

    A major focus of he ATTCs has been on professional development and 
training the workforce in the adoption of evidence-based practices to 
improve the provision of treatment for substance use disorders. In 
addition to training substance use disorders counselors, the ATTCs have 
trained professionals from related disciplines including social 
workers, criminal justice workers, nurses, and other allied health 
professionals. The blending of science and service is particularly 
evident in the NIDA/SAMHSA Blending Research and Practice Initiative 
carried out by the ATTCs. Using evidence-based protocols developed by 
NIDA's Clinical Trials Network (CTN), teams from the CTN and the ATTCs 
work together to create toolkits and training material for 
dissemination to the field. This project exemplifies collaboration 
between research and practice and serves as an illustration of 
technology transfer.
    Working with the International Coalition for Addiction Studies 
Education (INCASE), the ATTCs have promoted professional development 
activities for addictions educators. For example, they have conducted 
training for addictions educators and have disseminated ``curriculum 
infusion packages,'' resource materials on specific topics in 
addictions studies that educators can use to update their course 
materials. Several of the ATTCs provide pre-service training for 
individuals in academic settings preparing for a career as a substance 
use disorder professional. This training is provided both in classroom 
settings and through on-line courses.
    With the continuing aging of the addiction treatment workforce, the 
need for emerging leaders has been well noted. The ATTCs have offered a 
leadership training program in each region to help prepare the next 
generation of leaders in the field. This intensive program pairs 
emerging leaders with mentors, thereby offering opportunities for 
ongoing dialogue and support.
    In addition, many of the ATTCs have conducted workforce surveys in 
their respective regions that provide demographic, job satisfaction, 
training/educational, and retention and recruitment information. These 
surveys have been a vital source of data on workforce conditions and 
trends in the past several years, particularly in the absence of any 
national survey of the substance use disorders treatment workforce.

[[Page 42649]]

    ATTCs also work to support the recovery community through 
educational programs, development of materials, collaboration on 
special initiatives and support of Recovery Month activities.
    The NATTC serves a coordinating role for the ATTC Regional Centers 
and hosts a Web site that provides many important resources to the 
field, such as:
     Addiction Science Made Easy--a library of cutting-edge 
research articles taken from the Journal of Alcoholism: Clinical and 
Experimental Research and re-written in lay terms.
     Addiction ED--a catalogue of addiction-related distance 
education opportunities offered by organizations around the world.
     Certification Info--a listing of State, national and 
international licensing and credentialing information for alcohol and 
drug counselors.
     ATTC Publication Catalog--a directory of ATTC Network 
products and resources including curricula, videos, presenter 
materials, and trainings.
     Eye on the Field--a monthly electronic magazine which 
features important topics in substance abuse treatment and provides 
useful tools for practitioners and administrators.
    The National Office has also hosted committees with representation 
from the regional ATTCs and experts from the field that have produced 
such products as the TAP 21 Addiction Counseling Competencies and The 
Change Book. These publications have been milestones in the addiction 
treatment field, helping set national competency standards and a 
process to adopt evidence-based practices respectively.

New Request for Applications

    For FY 2007, SAMHSA will be issuing a new Request for Applications 
(RFA) for the ATTC program. The FY 2007 President's Budget requests 
approximately $8.1 million for the ATTCs, about the same funding level 
as the current program. At this time, SAMHSA does not anticipate 
changing the number of ATTCs from the current number (i.e., 14 Regional 
Centers and 1 national coordinating center); however, SAMHSA might 
consider changing the geographic areas each ATTC regional center 
covers. To assist SAMHSA in developing the RFA, SAMHSA is seeking input 
from stakeholders and interested parties on a number of issues relating 
to these cooperative agreements.
    SAMHSA wants to explore how the ATTCs can provide more equitable 
access to ATTC services throughout the States. The current ATTC regions 
vary greatly in population, square miles covered, and number of 
treatment facilities within their borders. Therefore, SAMHSA is seeking 
comments on possible alternative regional configurations that may 
address some of these differences.
    SAMSHA has researched the population, square miles covered, and 
number of treatment facilities in the current ATTC regions, as well as 
the regions used by CSAT's Division of State and Community Assistance 
(DSCA), the Department of Health and Human Services (DHHS) Public 
Health Service, and the DHHS Health Resources and Services 
Administration (HRSA) regions. This information is presented in the 
table below.

                    Table. 1.--Regions by Population, Square Miles, and Treatment Facilities
----------------------------------------------------------------------------------------------------------------
                                                                                                        Range of
                                                                    Range of         Range of square   treatment
                      Entity                        Number of   population in the     miles in the     providers
                                                     regions         regions             regions         in the
                                                                                                        regions
----------------------------------------------------------------------------------------------------------------
Current ATTCs.....................................       * 14  3,809,000-45,154,0       5,330-830,670  199-2,747
                                                                               00
DSCA..............................................          5  47,560,000-65,948,   178,510-1,542,760  2,764-4,1
                                                                              000                             33
HHS...............................................         10  9,327,000-53,252,0      61,400-824,290  915-3,152
                                                                               00
HRSA..............................................         11  9,987,000-47,241,0      56,070-971,540  386-2,938
                                                                               00
----------------------------------------------------------------------------------------------------------------
* Plus a Coordinating Center.

    The tables below give a state-by-state breakout for each of the 
four regional structures shown above.

------------------------------------------------------------------------
                 Region                               State
------------------------------------------------------------------------
                              ATTC Regions
------------------------------------------------------------------------
New England............................  ME, NH, VT, MA, CT, RI.
Northeast..............................  NY, NJ, PA.
Central East...........................  DC, DE, KY, TN, MD.
Mid-Atlantic...........................  VA, MD, NC, WV.
Southeast..............................  GA, SC.
Southern Coast.........................  AL, FL.
Caribbean Basin & Hispanic.............  PR, VI.
Great Lakes............................  IL, OH, WI, IN, MI.
Prairielands...........................  IA, NE, ND, SD, MN.
Mid-America............................  MO, KS, OK, AR.
Gulf Coast.............................  TX, LA, MS.
Pacific Southwest......................  CA, AZ, NM.
Mountain West..........................  NV, MT, WY, UT, CO.
Northwest Frontier.....................  AK, WA, OR, ID, HI, Pac. Isl.
------------------------------------------------------------------------

[[Page 42650]]

 
                               HHS Regions
------------------------------------------------------------------------
I......................................  ME, NH, VT, MA, CT, RI.
II.....................................  NY, NJ, PR, VI.
III....................................  MD, VA, WV, PA, DE, DC.
IV.....................................  AL, FL, GA, KY, MS, NC, SC, TN.
V......................................  IL, IN, OH, MI, MN, WI.
VI.....................................  AR, LA, NM, OK, TX.
VII....................................  IA, KS, MO, NE.
VIII...................................  CO, MT, ND, SD, UT, WY.
IX.....................................  AZ, CA, HI, NV, Pac. Isl.
X......................................  AK, ID, OR, WA.
------------------------------------------------------------------------
                              DSCA Regions
------------------------------------------------------------------------
Northeast..............................  ME, NH, VT, MA, CT, RI, NY, NJ,
                                          PA, DC, DE, MD.
Southeast..............................  PR, VI, VA, WV, KY, TN, MS, AL,
                                          GA, SC, NC, FL.
Central................................  IA, ND, SD, MN, IL, OH, WI, IN,
                                          MI.
Southwest..............................  NE, CO, KS, MO, AR, OK, NM, TX,
                                          LA.
Western................................  CA, MT, WY, NV, UT, AZ, AK, WA,
                                          OR, ID, HI, Pac. Isl.
------------------------------------------------------------------------
                              HRSA Regions
------------------------------------------------------------------------
New England............................  ME, NH, VT, MA, CT, RI.
New York/New Jersey....................  NY, NJ.
Pennsylvania/Mid-Atlantic..............  PA, OH, WV, VA, MD, DC, DE.
Southeast..............................  KY, TN, NC, SC, AL, GA.
Florida/Caribbean......................  PR, VI, FL.
Delta Region...........................  AR, LA, MS.
Midwest................................  MN, WI, MI, IN, IL, IA, MO.
Oklahoma/Texas.........................  OK, TX.
Mountain Plains........................  ND, SD, WY, UT, CO, NE, KS, NM.
Pacific................................  CA, NV, AZ.
Northwest..............................  WA, ID, MT, OR.
------------------------------------------------------------------------

    In addition to the factors discussed above, there are a number of 
critical program priorities or cross-cutting principles affecting the 
addiction treatment field that need to be addressed by professionals 
providing services. SAMHSA is seeking guidance on whether it would be 
advisable to have the ATTCs house of Centers of Excellence on the 
critical priorities. The products and resources developed by these 
Centers of Excellence could then be disseminated throughout the ATTC 
Network and the field. This would avoid duplication of effort while 
addressing important clinical issues.
    SAMHSA also seeks input from the field on what the ATTC priorities 
should be. In view of the pivotal role the ATTCs have played in 
bridging the gap between science and service, and in gathering data on 
the workforce, they are an integral component of SAMHSA's workforce 
development efforts. Recruitment and retention, leadership and 
management skills, and increasing the diversity of the workforce have 
been identified as key workforce issues. What role, if any, should the 
ATTCs have on these subjects?
    SAMHSA funds the Centers for the Application of Prevention 
Technologies (CAPTs) through the Center for Substance Abuse Prevention. 
The CAPTs assist State/jurisdictions and community-based organizations 
in the application of evidence-based substance abuse prevention 
programs, practices, and policies. The CAPT system is a practical tool 
to increase the impact of the knowledge and experience that defines 
what works best in prevention programming. Because knowledge 
application is a prime focus of both the ATTCs and CAPTs, SAMHSA is 
seeking input on what the relationship should be between the ATTCs and 
the CAPTs.

Questions To Consider in Making Your Comments

    SAMHSA/CSAT is seeking response to questions on a number of issues 
regarding the configuration of the ATTC regions, the areas of emphasis, 
and the relationship with CAPTs, including the following:
     What should be the major areas of emphasis for the ATTCs?
     How well do the current priorities and activities of the 
ATTCs meet the needs of the field? Are there some activities the ATTCs 
are currently undertaking that are no longer necessary? Are there 
activities related to workforce development or other topics the ATTCs 
should be doing that they are not currently doing?
     How should ATTC activities be coordinated with those of 
the CAPTs and other similar centers maintained by other Federal 
agencies?
     Who should be the primary audiences for/recipients of ATTC 
services?
     Should the ATTCs be organized around Centers for 
Excellence? If so, what topics should these Centers address?
     What should the role of the National ATTC Coordinating 
Center be?
     What types of services and products should the ATTCs 
provide?
     Should the ATTCs function primarily as independent 
regional centers or as a unified network collaborating to provide 
services and products to the field a large?
     How well does the current geographic configuration of the 
regional ATTCs meet the needs of the various constituents, including 
the States, providers, and practitioners?
     How well does the current geographic configuration of the 
ATTCs provide effective and equitable delivery of technology transfer 
services throughout the State?
     Are there alternative regional configurations for the 
ATTCs that could provide more equitable access to ATTC services 
throughout the Nation?


[[Page 42651]]


    Dated: July 20, 2006.
Eric B. Broderick,
Acting Deputy Administrator, Assistant Surgeon General, Substance Abuse 
and Mental Health Services, Administration.
[FR Doc. 06-6500 Filed 7-26-06; 8:45 am]
BILLING CODE 4162-20-M