[Federal Register Volume 89, Number 150 (Monday, August 5, 2024)]
[Notices]
[Pages 63437-63438]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-17131]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Statement of Organization, Functions, and Delegations of 
Authority

AGENCY: Substance Abuse and Mental Health Services Administration 
(SAMHSA).

ACTION: Organization, functions, and delegations of authority.

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SUMMARY: SAMHSA has modified its organizational structure.

SUPPLEMENTARY INFORMATION: Part M of the Substance Abuse and Mental 
Health Services Administration (SAMHSA) Statement of Organization, 
Functions, and Delegations of Authority for the Department of Health 
and Human Services at 71 FR 19740-19741, April 17, 2006, is amended to 
reflect changes of the functional statements for the Center for 
Substance Abuse Treatment (CSAT). This amendment reflects the addition 
of one new division and two branches. CSAT has taken the lead in 
addressing the substance use disorder (SUD) treatment needs of 
Americans, focusing primarily on opioid treatment, developing a crisis 
continuum, improving adult and adolescent substance use treatment, and 
increasing access to and the quality of SUD treatment and recovery 
services. CSAT is dedicated to collaborating with grantees and 
stakeholders to enhance the accessibility of innovative services and 
evidence-based treatment modalities through grants and technical 
assistance.
    In order to enhance administrative and operational efficiencies, 
CSAT proposes that each supervisor within the center should have a 
staff to supervisor ratio of 1 supervisor to 10 staff person or less. 
There is currently a twelve to one staff to supervisor ratio in the 
Division of Services Improvement (DSI)--with one branch having 17 
staff. Managing 10 or more employees can be challenging for a first-
line supervisor, who must effectively handle employee management and 
oversee grants and contracts. By adding the Division of Health Systems 
Improvement (DHSI) and two branches, Integrated Care Branch (ICB) and 
Opioid Treatment Branch (OTB) the staff to supervisor ratio would 
decrease to eight to one. Moreover, streamlined and smaller divisions/
branches, with specific focus areas, will provide additional oversight 
and management by the second-level supervisor for these important 
Federal grants and contracts.

Center for Substance Abuse Treatment

Division of Health Systems Improvement

    The proposed DHSI will focus on equity, medications for opioid use 
disorder (MOUD), and the continuum of care consistent with and 
necessary for the achievement of goals outlined in the President's 
Unity Agenda and the Office of National Drug Control Policy's National 
Drug Control Strategy. Refining the alignment of grant portfolios by 
the scope and span of grants and function, subject matter areas, age 
group focus (adolescents versus adults), and geographic focus 
(community versus state) will allow for improved efficiencies and 
service. The two branches in DHSI will be ICB and OTB. The new division 
will allow for dedicated leadership focusing on opioid treatment, 
developing a crisis continuum, improving adult and adolescent substance 
use treatment, and increasing access to and the quality of SUD 
treatment and recovery services. The proposed new division and two new 
branches are better aligned based on content and goal; the major grant 
programs impacted by this change are described below.
    ICB will primairly focus on increasing access to and improving the 
quality of services of comprehensive, coordinated, patient-centered 
care across the continuum. The branch will manage the Minority AIDS 
Initiative (MAI) and Screening, Brief Intervention, and Referral to 
Treatment (SBIRT) programs both of which are authorized under the 
Public Health Service Act (PHSA), title V, section 509. MAI seeks to 
increase engagement in care for racial and ethnic underrepresented 
individuals with SUD and/or co-occurring substance use and mental 
disorders (COD) who are at risk for or living with HIV/AIDS and receive 
HIV/AIDS services/treatment. SBIRT is a comprehensive, integrated, 
public health approach to the delivery of early intervention and 
treatment services for persons with substance use disorders, as well as 
those who are at risk of developing these disorders.
     OTB will primarily focus on providing evidence-based

[[Page 63438]]

comprehensive care to individuals with opioid use disorder (OUD), 
reduce harm, and effectively address the opioid crisis through service 
grants primarily to community-based organizations. This includes 
service grants that support the provision of MOUD such as methadone, 
buprenorphine and naltrexone which allow patients to receive treatment 
while maintaining their daily responsibilities and lives. Work in this 
branch will include engaging in community outreach and education 
efforts to raise awareness about the opioid epidemic, prevention 
strategies, and available treatment options. This is different from the 
work done in our state-based funding programs (State Opioid Response 
and Substance Use Prevention, Treatment, and Recovery Services Block 
Grants) which are housed in the Division of State and Community Systems 
(DSCS) and separate from the focus of the Division of Pharmacologic 
Therapies (DPT) which works with Opioid Treatment Programs to provide 
regulatory and provider support and does not fund opioid treatment. 
There is no overlap in the work of the existing divisions, DSCS and 
DPT, and the proposed OTB within the proposed DHSI. The OTB will manage 
the Medication-Assisted Treatment--Prescription Drug and Opioid 
Addiction (MAT-PDOA) and Targeted Capacity Expansion: Special Projects 
(TCE-SP) programs, both of which are authorized under section 509 of 
the PHSA, as amended. The purpose of MAT-PDOA is to provide resources 
to help expand and enhance access to MOUD. It is expected that this 
program will help to (1) increase access to MOUD for individuals with 
OUD, including individuals from diverse racial, ethnic, sexual and 
gender minority communities; and (2) decrease illicit opioid use and 
prescription opioid misuse. The purpose of TCE-SP is to implement 
targeted strategies for the provision of SUD or COD harm reduction, 
treatment, and/or recovery support services to support an under-
resourced population or unmet need identified by the community.

Delegations of Authority

    All delegations and redelegations of authority to officers and 
employees of SAMHSA which were in effect immediately prior to the 
effective date of this reorganization shall continue to be in effect.
    Authority: 44 U.S.C. 3101.

Xavier Becerra,
Secretary of Health and Human Services.
[FR Doc. 2024-17131 Filed 8-2-24; 8:45 am]
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