SAMHSA in 2026: Status, Funding Changes, and What to Do

The FY2026 appropriations law funded SAMHSA separately. Congress enacted that law on February 3, 2026. The Substance Abuse and Mental Health Services Administration (SAMHSA) announced grant awards on September 25, 2026. The U.S. Department of Health and Human Services (HHS) announced STREETS awards on October 2, 2026. HHS’s FY2027 budget request proposed an Administration for a Healthy America (AHA) merger. These dated documents distinguish enacted funding from proposed reorganization. They do not establish the outcome of later legislation or agency action.

This page replaces our March 2025 post on the proposed SAMHSA closure. It covers what changed in 2025 and 2026, the cited grant programs, and what treatment providers should do. Grant terms change often. Confirm current terms with the official notice, your grant officer, or your state agency before you act.

Dated funding and proposal records

• SAMHSA’s July 6, 2026 notice. SAMHSA called itself “a division within the U.S. Department of Health and Human Services” when it announced more than $281 million in funding opportunities for 15 grant programs (SAMHSA, July 6, 2026 ↗).
• FY2026 funding is law. The Consolidated Appropriations Act, 2026 (P.L. 119-75) ↗, signed February 3, 2026, funds SAMHSA through its own accounts.
• September and October 2026 award notices. SAMHSA announced $247.9 million in grant awards ↗ on September 25, 2026. HHS announced $96 million over four years for eight STREETS communities ↗ on October 2, 2026.
• The FY2027 budget proposed an AHA merger. HHS’s FY2027 Budget in Brief ↗ proposed combining SAMHSA, HRSA, the Office of the Assistant Secretary for Health (OASH), and parts of CDC into AHA. Check later appropriations and HHS notices for implementation.
• SOR continuation checks. Ask your state State Opioid Response (SOR) lead for the applicable award and continuation notice. Check the SAMHSA newsroom ↗ for subsequent announcements.

What SAMHSA Is and Does

SAMHSA stands for the Substance Abuse and Mental Health Services Administration. It is the HHS agency that funds, guides, and tracks substance use and mental health services in the United States. For a short definition, see our SAMHSA glossary entry. For how the agency affects facility operations, see our SAMHSA organization profile.

SAMHSA matters to treatment providers in five main ways:

• Funding. SAMHSA sends formula block grants to states and awards discretionary grants. Many providers receive SAMHSA money through a state agency, not directly.
• Opioid treatment programs. SAMHSA certifies opioid treatment programs (OTPs) that dispense methadone.
• Referrals. SAMHSA runs the National Helpline (1-800-662-4357) and the FindTreatment.gov locator.
• Clinical guidance. SAMHSA publishes Treatment Improvement Protocols (TIPs) and other practice guides.
• Data. SAMHSA runs national data programs such as the National Survey on Drug Use and Health (NSDUH).

Timeline: What Changed in 2025 and 2026

Date	What happened
March 27, 2025	HHS announced a restructuring plan that would combine OASH, HRSA, SAMHSA, the Agency for Toxic Substances and Disease Registry (ATSDR), and the National Institute for Occupational Safety and Health (NIOSH) into a new Administration for a Healthy America (HHS press release ↗).
July 24, 2025	President Trump signed Executive Order 14321, “Ending Crime and Disorder on America’s Streets.” It directs HHS to make sure SAMHSA discretionary grants do not fund so-called “harm reduction” or “safe consumption” efforts that only facilitate illegal drug use (90 FR 35817 ↗).
July 29, 2025	A SAMHSA Dear Colleague letter said SAMHSA funds will no longer support so-called “harm reduction” activities and that new award terms and conditions would set the details (SAMHSA letter ↗).
October 2025	STAT reported that fewer than half of SAMHSA’s roughly 900 staff from January 2025 remained (STAT, October 30, 2025 ↗).
November 2025	A funding law (H.R. 5371) voided reductions in force that federal agencies took between October 1, 2025, and the law’s enactment (law text ↗). That provision does not establish SAMHSA’s later staffing total.
January 2026	According to a January 20, 2026 letter from four U.S. senators ↗, SAMHSA issued termination notices for more than 2,000 active grants and reversed them within 24 hours. News reports valued the grants at roughly $2 billion (Behavioral Health Business ↗).
January 29, 2026	Executive Order 14379, “Addressing Addiction Through the Great American Recovery Initiative,” created the White House Great American Recovery Initiative, co-chaired by the HHS Secretary and the White House Senior Advisor for Addiction Recovery. The Initiative advises agencies, including on grants, and the order provides no new money (order text ↗).
February 3, 2026	The Consolidated Appropriations Act, 2026 (P.L. 119-75) became law. It funds SAMHSA as its own agency: $2.79 billion for mental health, $4.09 billion for substance abuse treatment, $240.9 million for prevention, and $171.6 million for program support (law text ↗). The Congressional Research Service says the budget’s proposed HHS reorganization was “largely not adopted” in the enacted FY2026 law (CRS R48970 ↗).
April 24, 2026	A SAMHSA Dear Colleague letter listed items that no HHS funds may buy or distribute, and items that stay allowable (SAMHSA letter ↗).
June 2026	SAMHSA’s FY2026 NOFO Application Guide, dated June 2026, sets FY2026 limits on certain “housing first” policies and on harm reduction (FY2026 Application Guide ↗).
July 6, 2026	SAMHSA announced more than $281 million in funding opportunities for 15 grant programs (SAMHSA ↗).
September 18, 2026	SAMHSA awarded $25 million in supplements to SUPTRS Block Grant recipients to expand capacity for safe, licensed, certified or chartered sober and recovery housing. The money supports training and technical assistance, not direct housing payments (SAMHSA ↗).
September 25, 2026	SAMHSA announced $247.9 million in grant awards, including $69.4 million for Medication-Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) (SAMHSA ↗).
October 2, 2026	HHS announced that eight communities will receive $96 million over four years through the STREETS program (SAMHSA ↗).

What the FY2027 budget proposed

HHS’s FY2027 Budget in Brief ↗ proposed two changes to SAMHSA funding:

• A new Administration for a Healthy America. AHA would combine the work of SAMHSA, HRSA, OASH, and several centers and programs that were formerly in CDC.
• A $4.6 billion Behavioral Health Innovation Block Grant. It would combine the Community Mental Health Services Block Grant, the SUPTRS Block Grant, and State Opioid Response.

Congress did not adopt the AHA merger in the FY2026 appropriations law (CRS R48970 ↗), and the FY2026 law sets aside $1.595 billion for State Opioid Response (law text ↗). Do not plan as if SOR or the SUPTRS Block Grant has ended.

Funding outlook: dated laws and requests

This section identifies the cited fiscal year 2026 and 2027 laws, requests, and notices. Check the linked official sources for amendments and later funding decisions.

Item	Cited law or request
FY2026 enacted	P.L. 119-75 ↗ funds SAMHSA through its own accounts. HHS lists $7.294 billion in SAMHSA budget authority for FY2026.
FY2027 request	$6.8 billion in discretionary funding for substance abuse prevention, treatment, recovery, and mental health services. It is a request only.
Continuing resolution	P.L. 119-103 ↗, signed September 2, 2026, set December 11, 2026 as its funding end date, subject to earlier applicable appropriations.
Administration for a Healthy America (AHA)	The FY2027 HHS budget request proposed the merger. The FY2026 appropriations law funded SAMHSA separately.
Medicaid work requirements	CMS’s June 3, 2026 interim final rule set January 1, 2027 as the state start deadline, subject to good-faith exemptions ending by December 31, 2028. Check subsequent rules and court orders.

SAMHSA budget for 2026. HHS’s FY2027 Budget in Brief ↗ lists SAMHSA budget authority of $7.294 billion for FY2026 and $7.392 billion for FY2025. A footnote says the FY2025 figure includes $163 million in advance appropriations, so compare the two years with care. The FY2027 table shows no separate SAMHSA figure because the request folds SAMHSA into AHA. The request keeps the 988 Suicide and Crisis Lifeline at $535 million.

FY2027 continuing resolution. Congress passed H.R. 6500, which became Public Law 119-103 on September 2, 2026. It set funding for covered HHS programs, including SAMHSA’s, at the FY2026 rate through December 11, 2026, subject to earlier applicable appropriations (law text ↗). Check Congress.gov ↗ for subsequent appropriations and changes to that schedule.

Great American Recovery Initiative. Executive Order 14379 gave the Initiative an Executive Director to run day-to-day operations (order text ↗). On February 2, 2026, HHS announced a $100 million STREETS investment as its plan’s centerpiece, plus a $10 million Assisted Outpatient Treatment grant program (HHS ↗). The timeline above covers the order’s advisory role and funding limits. To apply for program money, use each program’s notice of funding opportunity (see our SAMHSA grants guide). For the order itself, see our Great American Recovery Initiative guide.

Grant terminations and the HHS reorganization. Executive Order 14332 (August 7, 2025) told agencies to revise grant terms to permit immediate termination for convenience. It also requires senior appointees to review funding announcements (order text ↗). The January 20, 2026 senators’ letter cited above supplies the reported January termination count. In a separate 2025 case, a federal court found that SAMHSA carried out HHS’s March 2025 terminations for its own grants. On May 16, 2025, a preliminary injunction required those terminations to be treated as void, for the plaintiff states only (order ↗). That order does not establish later case outcomes. A separate July 1, 2025 order blocked HHS restructuring at CDC, the FDA’s tobacco center, Head Start offices, and ASPE (order ↗). SAMHSA was outside the scope of that order. Check later court orders before reliance.

Medicaid changes. Public Law 119-21, which Congress.gov lists under the popular title “One Big Beautiful Bill Act,” adds Medicaid work requirements. CBO’s October 28, 2025 estimate projected $886.8 billion in Medicaid deficit reductions over 2025–2034. It projected 7.5 million additional uninsured people in 2034, using the January 2025 baseline. For exemptions, state dates, and the two lawsuits against CMS’s rule, read our Medicaid work requirements guide.

Dates and documents to check

• December 11, 2026: the funding end date specified in P.L. 119-103. Check subsequent appropriations.
• FY2027 bills: whether Congress takes up the AHA merger or the $4.6 billion Behavioral Health Innovation Block Grant.
• State Opioid Response: the applicable FY2026 continuation notice and subsequent SAMHSA announcements. Confirm your state’s award terms.
• Medicaid: docket entry 143, entered October 8, 2026, scheduled a hearing for October 22, 2026 in Massachusetts v. Oz. Check later orders and CMS rules before reliance on the January 1, 2027 implementation schedule.
• Great American Recovery Initiative: new HHS announcements after its June 2026 request for ideas ↗, which specified July 5, 2026 as its comment deadline.

SAMHSA Grant Programs in the Cited Notices

Most providers touch SAMHSA money in one of three ways: a block grant that passes through the state, SOR money that passes through the state, or a discretionary grant that SAMHSA awards directly. The table identifies the dated funding documents used for this guide.

Program	How money reaches providers	Dated funding document	Your next step
SUPTRS Block Grant (also called SUBG; older names SABG and SAPT)	Formula grant to states; states contract with providers	SAMHSA uses this name on its block grant page ↗. The Consolidated Appropriations Act, 2023 renamed it (U.S. Code notes ↗). On September 18, 2026, SAMHSA awarded $25 million in supplements for sober and recovery housing capacity (training and technical assistance) (SAMHSA ↗).	Ask your single state agency how it funds providers.
Community Mental Health Services Block Grant (MHBG)	Formula grant to states	MHBG recipients received $17.3 million of SAMHSA’s September 18, 2026 supplements (SAMHSA ↗).	Ask your state mental health authority.
State Opioid Response (SOR)	Grant to state agencies and territories; tribes apply under Tribal Opioid Response	The FY2026 law sets aside $1.595 billion (law text ↗). SAMHSA announced $1.48 billion in FY2025 continuation funding (SAMHSA, September 2025 ↗). Confirm later continuation funding with your state SOR lead.	Ask your state SOR lead about subawards.
Discretionary grants (NOFOs)	SAMHSA awards directly to eligible applicants	SAMHSA announced FY2026 funding opportunities for 15 grant programs on July 6, 2026 (SAMHSA ↗). FY2026 applicants must follow the FY2026 Application Guide ↗.	Check eligibility in each NOFO. Some accept only governments or tribes.
STREETS	Local governments, tribes, and tribal organizations only	The FY2026 notice set July 17, 2026 as its application deadline (STREETS NOFO ↗). Eight awards were announced October 2, 2026 (SAMHSA ↗).	Partner with an awardee in your area.

If you run recovery housing: The FY2024 SOR funding notice (FY2024, TI-24-008 ↗) lists recovery housing as an allowable recovery support service. Recovery housing that gets SOR funds must give residents access to evidence-based treatment, including all forms of medication for opioid use disorder (MOUD). Your state decides which operators receive SOR money. STREETS allows sober or recovery housing, but not non-sober housing, and housing assistance under STREETS requires participation in treatment. For more options, see our grants guide for sober living homes and recovery housing.

FY2026 rules on harm reduction and “housing first”

The rules differ by source. Some bind applicants and grantees. Others give direction to federal agencies. Always read your own NOFO and your award terms and conditions.

Rules that bind FY2026 SAMHSA NOFO applicants and their awards:

• FY2026 Application Guide (June 2026). Applicants may not use SAMHSA funds to support “housing first” policies that “fail to ensure accountability and fail to promote treatment, recovery, and self-sufficiency.” Applications must not support harm reduction as outlined in SAMHSA’s Dear Colleague letter, and an application that does not align will not receive funding. The Guide also bars SAMHSA funds for syringes or needles used to inject illicit drugs, safer-smoking supplies, and drug test strips intended for people who use drugs (FY2026 Application Guide ↗).
• Program NOFOs. The STREETS NOFO states that “Housing First approaches are not permitted under this program” (STREETS NOFO ↗). Other NOFOs can set their own terms.
• Statute. Division B, Section 525 of P.L. 119-75 bars the use of FY2026 Labor-HHS funds to buy sterile needles or syringes for injecting illegal drugs, with a limited outbreak exception (law text ↗).

Policy direction (binding only through NOFO terms, award terms, or statute):

• Executive Order 14321 (July 24, 2025) directs HHS to make sure SAMHSA discretionary grants do not fund so-called “harm reduction” or “safe consumption” efforts that only facilitate illegal drug use. It also directs HHS and HUD, to the extent permitted by law, to end support for “housing first” policies that deprioritize accountability and fail to promote treatment, recovery, and self-sufficiency. The order creates no enforceable rights, and agencies must carry it out consistent with applicable law (order text ↗).
• SAMHSA’s April 24, 2026 Dear Colleague letter says no HHS funding can be used to buy or distribute syringes or needles used to inject illicit drugs, pipes or other supplies for safer-smoking kits, or drug test strips intended for people who use drugs. It keeps naloxone, nalmefene, medication lock boxes, disposal kits, wound care, FDA-approved home HIV and hepatitis tests, condoms, and nicotine cessation therapies as allowable (SAMHSA letter ↗).

These rules are not one blanket ban. The Application Guide limits only “housing first” policies that fail to ensure accountability, while the STREETS NOFO does not permit Housing First approaches in that program. Check the exact words in the notice that applies to you.

Provider Preparation Steps

Not every step applies to every organization. Start with the steps that match your funding mix and patient population.

1. Map your funding sources

List every funding stream by type: direct federal grant, federal money passed through the state, Medicaid, Medicare, commercial insurance, private pay, foundation grants, and state funds. For each one, note the annual amount, the renewal date, and your risk level. A simple spreadsheet is enough. The goal is to know your exposure before a renewal date arrives.

2. Contact your grant officer and state agency

If you hold a direct federal award, contact your SAMHSA grant officer. If you receive pass-through funds, contact your state behavioral health agency. Ask about:

• The status of your award
• Whether payments are on schedule
• Changes to reporting requirements or award terms and conditions
• The timeline for renewal or continuation applications

If you apply for FY2026 SAMHSA funds, read the FY2026 Application Guide and the NOFO together. They set the binding rules described above.

3. Strengthen insurance billing and credentialing

Insurance revenue lowers your exposure to grant changes. Focus on three areas:

• Commercial payers. Many treatment centers are in network with only some of the commercial insurers in their area.
• Medicaid enrollment. Enroll eligible clinicians who are not yet enrolled.
• Billing accuracy. Review denial rates, coding accuracy, and time to payment.

This shift takes time, so start early. If you are comparing software for this work, review EHR, revenue cycle management, and CRM options, and see our guide to substance abuse treatment software.

4. Track outcomes and export your data for funder reports

Federal, state, and private funders often ask for outcome data at renewal. Choose the measures you will track, such as treatment completion, retention, and housing or employment status at follow-up. Collect them the same way for every client. Make sure you can export your data for funder reports without manual rework.

5. Diversify your funding

Federal grants are not the only non-insurance revenue. Consider:

• Private and community foundations that fund behavioral health services in your area
• Hospitals and health systems with community benefit programs
• County and city governments, which may have local behavioral health funds

For recovery housing funding, see our grants guide for sober living homes and recovery housing.

6. Stay engaged in advocacy

Join your state behavioral health or addiction treatment association. It is a low-cost way to get updates and share information with peers. National groups such as the National Council for Mental Wellbeing, the American Society of Addiction Medicine (ASAM), the National Association of Addiction Treatment Providers (NAATP), and the National Alliance on Mental Illness (NAMI) track federal policy and organize comments.

To reach your members of Congress, use congress.gov ↗. Share de-identified examples of how funding changes affect patients, and protect patient privacy. Respond to public comment requests from HHS and CMS. In many states, the legislature also funds behavioral health directly, so state advocacy can act faster than federal advocacy.

7. Plan for a grant reduction

Leadership should run financial scenarios that include grant loss. Answer three questions:

• How many months could you operate if all SAMHSA-dependent revenue stopped?
• Which programs would you close first, and what would happen to the patients in them?
• How would you tell staff, patients, and community partners about a large funding cut?

A written draft lets you act on a plan instead of deciding in a crisis.

8. Keep accreditation and licensure current

Accreditation from CARF or The Joint Commission and state licensure build trust with payers, state agencies, and private funders. Do not let accreditation lapse because a grant-funded quality position ends. A lapse is hard to reverse.

Alternative Funding Sources

These funding sources do not depend on SAMHSA. Eligibility and timing vary, so confirm terms with each funder. For HRSA, HUD, and DOJ programs and how to apply, see where behavioral health grant money comes from.

Funding source	Who qualifies	Where to start
Medicaid (state plan services and waivers)	Providers enrolled in Medicaid	State Medicaid agency
FQHC / CCBHC designation	Eligible primary care/BH providers	HRSA, state Medicaid
HRSA behavioral health and rural grants	Varies by program	HRSA and Grants.gov
Justice Department grants	Varies; some accept only governments, and nonprofits can join as subrecipients	Bureau of Justice Assistance funding notices
VA Community Care Network	Providers treating veterans	VA Community Care Program
Ryan White HIV/AIDS Program	Providers serving people with HIV	HRSA
Opioid settlement funds	Varies by state	State attorney general or health department
Commercial insurance and ACA Marketplace plans	Most licensed providers	Direct payer contracting

Two dated Justice Department notices provide examples. The FY2026 COSSUP solicitation accepted only state, local, and federally recognized tribal governments. It allowed no more than 30 percent of grant funds for transitional or recovery housing. It set the SF-424 Grants.gov deadline at September 24, 2026, 11:59 p.m. Eastern Time. It set the full JustGrants deadline at October 1, 2026, 8:59 p.m. Eastern Time (COSSUP NOFO ↗). The FY2026 Second Chance Act Community-based Reentry Program notice accepted eligible nonprofits and federally recognized tribal governments. It set the SF-424 deadline in Grants.gov at October 30, 2026, 11:59 p.m. Eastern Time. It set the full JustGrants deadline at November 6, 2026, 8:59 p.m. Eastern Time. It covered mentoring, transitional services, and housing referrals (Second Chance Act NOFO ↗). Check the BJA funding page ↗ and each listing for amendments and application status.

Opioid settlement funds come from settlements with opioid manufacturers and distributors, and states and local governments receive them over many years. They decide how to spend their share, and some run a process for treatment and recovery providers to apply. Ask your state behavioral health agency or attorney general’s office how your state distributes its share.

Funding Decisions for Providers

The FY2026 appropriations law funded SAMHSA separately. The June 2026 Application Guide, dated Dear Colleague letters, and program NOFOs described the cited funding terms. HHS’s FY2027 budget requested a merger and a consolidated block grant. Check enacted laws, current notices, and your award terms before a funding decision.

Providers that know their funding mix, read their award terms, build insurance revenue, and track outcomes will be ready whether Congress keeps SAMHSA as it is or adopts a reorganization later. None of these steps depends on knowing SAMHSA’s future structure.

Behave Health’s EHR, RCM, and CRM software is built for behavioral health organizations. It supports clinical documentation and insurance billing, and it lets you export your data for funder reports. For background on 2025 federal policy, see our overview of federal addiction and mental health treatment policies under the Trump administration.

The cited records have their own dates. The prior full fact review was October 10, 2026. For later notices and amendments, check samhsa.gov ↗ and your state behavioral health agency.