Assisted Outpatient Treatment Program

The Assisted Outpatient Treatment (AOT) Program, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), is a federally funded initiative designed to facilitate the implementation of community-based mental health treatment programs for adults with serious mental illness (SMI). This effort is authorized under Section 224 of the Protecting Access to Medicare Act of 2014 and amended by the Consolidated Appropriations Act, 2023. SAMHSA’s overarching mission is to lead public health and service delivery efforts in mental health and substance use treatment. Through this cooperative agreement, the AOT program aligns with strategic national priorities to reduce the frequency and duration of psychiatric hospitalization, incarceration, and homelessness among individuals with SMI by supporting civil court-ordered outpatient treatment that emphasizes recovery and evidence-based care. Eligible applicants are limited to counties, cities, mental health systems (including authorities), mental health courts, or any entity with legal authority in its state to implement, monitor, and oversee assisted outpatient programs. Notably, only those jurisdictions that have not previously implemented an AOT program under specific past NOFOs are eligible to apply. This ensures funding supports new efforts in jurisdictions seeking to establish this model. Additionally, applicants from states lacking statutory authority for AOT implementation, or those proposing to serve individuals through criminal justice channels, are disqualified. This program provides up to $10 million in total funding, with awards ranging from $500,000 to $750,000 annually over a period of up to five years. Award amounts are determined based on program capacity: up to $500,000 for programs serving 50 or fewer patients annually, and up to $750,000 for programs serving more than 50 patients. The cooperative agreement structure entails significant SAMHSA involvement in oversight and implementation. Grantees must comply with stringent reporting and performance measurement protocols, including submission of client-level data into SAMHSA’s SPARS system at intake, 6 months, 12 months, and at program exit. Performance indicators focus on client outcomes, training completion, and perceptions of care. Applicants must implement all eleven required activities within specified timeframes, including forming an AOT management team, developing protocols and procedures, building a community support systems map, and establishing individualized treatment plans. AOT services must begin within eight months of receiving the award. Grantees are also expected to develop sustainability plans within the first year, ensuring the continuation of AOT services beyond the life of the grant. The use of funds is restricted and must align with federal regulations and executive directives; funding may not support harm reduction, racial preferences, “housing first” models without accountability, or services for individuals in the criminal justice system. Applications must be submitted electronically by April 20, 2026, with awards anticipated on August 30, 2026, and project start dates expected by September 30, 2026. Required application components include a project narrative (15 pages), budget narrative, timeline, letters of commitment from service providers, data instruments, and documentation of experience and licensing compliance. No cost share or match is required. Applicants must submit public health system impact statements (PHSIS) and coordinate with their state’s Single Point of Contact per Executive Order 12372, as applicable. The programmatic point of contact for eligibility and programmatic questions is David Barry at the Center for Mental Health Services, reachable at [email protected] or 240-276-0116. Budget and financial questions can be directed to the Office of Financial Resources at [email protected] or 240-276-1940. The full NOFO is accessible as a PDF through Grants.gov or SAMHSA's grant portal.

Ensure activities strictly follow SAMHSA guidance and exclude prohibited uses like harm reduction and housing-first models without accountability; strong documentation of legal authority is essential.