Substance Use Prevention, Treatment and Recovery Services Block Grant
The SUPTRS Block Grant and Charitable Choice
The NC DHHS DMHDDSUS mission is to build systems, services, and supports that improve the well-being of North Carolinians affected by Mental Health (MH), Substance Use (SU) challenges, Intellectual/Developmental Disability (IDD), and Traumatic Brain Injury (TBI). This supports the DMH/DD/SUS vision for communities without stigma where all are supported to live healthier and happier lives.
As part of this mission, and in support of the vision, DMH/DD/SUS strives to promote evidence-based treatments for all individuals suffering from SU-related challenges. While all organizations participating in these evidence-based practices sponsored by the state have shown to embody the ideals and goals surrounding assistance for fellow North Carolinians, it is important that emphasis is placed on respect to the personal freedoms and rights for those seeking assistance.
General Grant Information
As a part of a continuous cycle, the NC DMH/DD/SUS Substance Use Prevention, Treatment, and Recovery Services (SUPTRS) team applies for, manages, and distributes the Substance Use Prevention, Treatment and Recovery Services (SUPTRS) block grant in cooperation with the federal government. The regulations and guidelines for this grant can largely be found in 45 CFR Part 96 but there are references to other public laws or CFRs for specific carve outs, exceptions, rules, and more. The Substance Abuse and Mental Health Services Administration (SAMHSA) also releases specific guidance and rules on the application of the SUPTRS grant. A comprehensive understanding of applicable regulation and guidelines leads to a better execution of requirements by North Carolina, and their grantees, resulting in less penalties and greater efficiency in service to our public stakeholders. A few, but not all, examples of the specialized/specific requirements include:
- Primary Prevention (20% of the grants must be expended on primary prevention services)
- Capacity management
- A target of certain populations or service areas:
- Pregnant women and women with dependent children
- Injection drug users
- Tuberculosis services
In addition to the inclusion of specific requirements there are also limitations – for example, 45 CFR 96.135 covers inappropriate use of funds (SAMHSA policy adds to and gives clarification to this).
Charitable Choice
45 CFR 96.18 discusses both limitations and rights of faith-based programs when it comes to the SUPTRS grant. The language in this section leads viewers to 42 CFR 54 which discusses Charitable Choice. Under this section, grant money is allowed and encouraged to go to faith-based organizations with the stipulation that they must meet all applicable state and federal regulations. Faith-based organizations are not allowed to require individuals to attend religious activities, such as worship, religious instruction, or proselytization and federal funds from the grant must not be comingled with funds supporting said activity. While attendance to certain activities cannot be a requirement this does not mean the organization must remove items in the facility that promote or embody the faith of that organization, however the organization may not use said items in pursuit of changing a person’s individual faith. Additionally, an individual’s faith or personal beliefs cannot be used as a factor in determining if an individual is eligible for the services provided by a faith-based organization that receives funding through the SUPTRS Block Grant.
If an individual being served by a faith-based organization objects to any of the religious characterizations of the program, they should request the faith-based organization refer them to a different program. Any program referral should result in a transfer to a program:
- That is reasonably accessible to the beneficiary.
- That has current capacity for the beneficiary.
- That can provide treatment deemed medically necessary by generally accepted evidence-based practices as well as adhering to any other applicable federal and/or state regulation.
To accomplish this, faith-based organizations should contact their appropriate LME/MCO (or other funding grantor) to find a suitable state-sponsored program (find your appropriate LME/MCO at the LME/MCO Directory). If the LME/MCO (or direct grantor) cannot provide a suitable alternative, then they must contact DMHDDSUS. If a referral has been made, the grantee will inform their grantor as required, and the faith-based organization should ensure the participant contacts the new provider.
Finally, if a participant in a faith-based program finds that any activities required conflict with 42 CFR 54 they should contact DMHDDSUS directly. Specific examples of when this contact should be made include (but are not limited to) requiring attendance to worship as a requirement to receive appropriately prescribed medication or a program refusal to refer an individual to an alternate provider after a request was made based on objection to the allowable faith characterizations within the facilities and programs.
Contact
Department of Mental Health, Developmental Disabilities, and Substance Use Services
Advocacy and Empowerment Section, Customer Service and Community Rights
Phone: 855-262-1946