Lack of Qualified Management at SAMHSA

Following are issues raised about SAMHSA by someone with knowledge.

SAMHSA has Unqualified Leadership

SAMHSA moved away from a skill based system of hiring to a purely political one.  The person managing the prescription drug initiative is neither a physician or a nurse. The person managing criminal justice is neither a lawyer or trained in criminal justice.  The person managing the HIV initiative is neither a true public health person or someone with a medical background. The person managing the health information technology issue has no health information technology background. SAMHSA hired a Chief Medical Officer, but she left in disgust.

SAMHSA Diverts funds away from Congressionally Approved Expenditures

Congress appropriated $3.5 million to conduct “Military Families Initiatives Policy Academies” Alcoholism and Drug Abuse Weekly (1/16) wrote an article about SAMHSA getting the $3.5 million for military families policy academies. At the end of the article SAMHSA Regional Administrator Kathryn Power stated

“The balance of the $3.5 million, after the $2 million is spent on two policy academies, will be used for “more intense and detailed technical assistance, perhaps a demonstration project, maybe some peer support.” Said Power (citing Kathryn Power). “These are things I’m thinking about as strategic lead.”

SAMHSA should not be considering doing anything else with the appropriated funds when the language specifically targets policy academies. In fact, the 2012 appropriations conference language states:

“The conferees expect that SAMHSA shall not make changes to any program, project, or activity as outlined by the budget tables included in this Statement of the Managers without prior notification to the House and Senate Committees on Appropriations.”

The SAMHSA website notes that the FY 2012 President’s Budget request included $10 million for a Military Families Initiative ($3.5 million for Policy Academies and $6.5 million for direct service grants). The Congress chose to fund only the policy academies ($3.5 million) and not the direct service grants.  Had the Congress believed that both activities should be funded at the reduced level of $3.5 million, it would have simply appropriated that amount for the Military Families Initiatives, leaving it up to SAMHSA to divide up the reduced amount.

SAMHSA duplicates efforts of other departments

Both Congress and the President have stated a desire to reduce duplication of effort and diffusion of responsibility among government agencies. Both CDC and HRSA do substance abuse prevention and behavioral health statistics and SAMHSA is moving back to the same building that houses HRSA by 2015. SAMHSA’s role is duplicative.  It would be an ideal time to eliminate SAMHSA and start merging it’s functions elsewhere.  Congress can streamline the government by using a small agency like SAMHSA as an example. We have previously cited benefits of moving Evidence Based Practices Program to NIMH, PAIIMI, to the Attorney General’s Office, and other efficiencies