Transformation Transfer Initiative

In a continued effort to assist states in transforming their mental health systems of care the Substance Abuse and Mental Health Services Administration (SAMHSA) and its Center for Mental Health Services (CMHS) has created the Transformation Transfer Initiative (TTI). The TTI provides, on a competitive basis, modest funding awards to States, the District of Columbia, and the Territories not currently participating in the Mental Health Transformation State Incentive Grant* (T-SIG) program. To view the

These flexible TTI funds are to be used to identify, adopt, and strengthen transformation initiatives and activities that can be implemented in the State, either through a new initiative or expansion of one already underway, and should focus on one or multiple phases of system change. TTI recipients are chosen on the following criteria:

  • Transformation readiness, demonstrated by examples of transformation initiatives already underway using State funds, Block grant funds, other identified public or private resources;
  • Existing multi-agency collaboration on transformation initiatives;
  • Proposed initiatives rooted in systems change with the greatest quality impact;
  • Identification of other state resources and infrastructure which may leverage the TTI award funds for the proposed initiative; and
  • Realistic timeframes, concrete activities, and measurable outcomes for the proposed initiative.

For fiscal year 2010-2011, CMHS awarded TTI grants ranging from $115,000 (designated by a *** as a repeat recipient) or $221,000 (as a first time awardee) to the following twelve states:

  • Delaware – Created a recovery-oriented system by providing support and direction to the “budding” Delaware state consumer network as well as building on the initial integration of the employed Peer Specialists at the state hospital to provide hospital onsite services as well as bridge peer services that follow individuals upon their discharge from the hospital to assist them in their re-entry, as well as to identify gaps in services.
  • Idaho – Created a data warehouse to collect and process data from multiple state systems to allow reporting across systems within the Division of Behavioral Health for the first time ever.
  • Kansas – Improved health and wellness and coordination of physical and mental health treatment for persons with severe and persistent mental illness, provided training and technical assistance to mental health treatment providers and peer support organizers and advanced existing efforts in the development of an effective behavioral health home and care coordination model to inform policy decisions in Kansas.
  • Kentucky*** – Serviced enhancement with the co-occurring providers through NIATx and mini-grants and facilitated the establishment of Double Trouble in Recovery groups.
  • Minnesota*** – Jump-started a statewide public-private campaign known as the Minnesota 10x10 Initiative by focusing initially on assertive community treatment (ACT), strengthened the work of Minnesota’s 26 ACT teams in the goal area of physical health and wellness and extended the lessons learned in ACT to our entire state system.
  • New Hampshire – Implemented statewide client level outcome measures for adults and children/adolescents.
  • Pennsylvania*** – Implemented 6 goals in efforts to reduce barriers to treatment. Those goals are: train-the-trainer curriculum development, recruitment, pilot the train the trainer approach, follow-up evaluations, on-going COAPS training, and following up date collection and consultation. The Office of Mental Health and Substance Abuse Services (OMHSAS) has developed a cadre of older adult peer specialists to provide recovery services to older adults.
  • Rhode Island – Integrated behavioral health into rural primary care settings by increasing knowledge in the physical health professionals, increasing access to integrated physical and mental health services, early detection, increasing satisfaction of the integrated health team members, and reduced ER visits of patients with co-morbid disorders. 
  • South Carolina – Initiated a partnership and planning process with the South Carolina Primary Health Care Association: to identify, adapt or develop bidirectional models of integrated care for both Community Health Centers (CHC) and Community Mental Health Centers (CMHC); and provide statewide training forums.
  • Tennessee*** – Deployed a public health approach of early intervention to improve access to mental health and substance abuse services for youth in juvenile courts as well as to support follow-through with and participation in available services which contribute to diversion from the juvenile justice system and reduce recidivism.
  • Vermont – Established an independent, cooperative organization focused on mental health practice improvement and workforce development. This new organization will work with mental health providers, consumers, family members, and other service organizations to support the adoption of promising, evidence-based, and recovery-oriented practices within the state’s community mental health system and improve the quality of life outcomes for individuals receiving services from that system. The cooperative will also focus on establishing and supporting core competency training for Vermont’s community mental health providers to ensure that our workforce has the core values, skills and knowledge to meet the needs of the consumers they are working with.
  • Virginia – Embedded CIT within Virginia Communitiesand empower peers and families by overlapping and supporting NAMI Virginia’s annualstatewide conference with the CIT International and Statewide Conferences. Brought Virginia's consumers, family members, law enforcement personnel and mental health stakeholders together and provided a unique opportunity to focus on Virginia's behavioral health and criminal justice transformation challenges and opportunities.

Summaries of FY 2010-2011 projects can be found here

In FY 2009-10, CMHS awarded TTI grants ranging from $115,000 (designated by a *** as a repeat recipient) or $221,000 to the following twelve states and the District of Columbia:

  • Alabama*** – Health Integration
  • Alaska – Telebehavioral Health and Medicaid
  • Arkansas – Consumer Empowerment and Leadership Training at the Community Level
  • Arizona – Whole Health Peer Support
  • DC – Health Integration and Peer Support
  • Florida*** – Trauma Informed Care and Peer Support
  • Illinois*** – Behavioral Health and Criminal Justice Collaboration
  • Indiana – Recovery-Based Care at the Community Level
  • Maine – Community Integration Services using a Recovery Framework
  • Massachusetts – Person Centered Planning
  • Mississippi – Transportation, Housing, and Co-Occurring Disorders
  • Montana – Behavioral Health and Corrections Collaboration
  • North Dakota*** – Transition-Aged Youth

Summaries of FY 2009-2010 projects are located here. 

In FY 2008-2009, CMHS awarded TTI grants, all in the amount of $221,000 to the following eleven states: 

  • Colorado - planning and implementation process for this transformation that includes the Behavioral Health Cabinet (Corrections, Medicaid, Human Services, Employment, Local Affairs, Public Health, and Public Safety),
  • Georgia - Integrating whole health concepts into Georgia’s Peer workforce 
  •  Louisiana - Provide training, through the Early Childhood Supports and Services (ECSS) program, for public and private sector clinicians in specific EBPs in order to achieve improved clinical and functional outcomes in preschool children (birth through five years)
  •  Michigan - Integration of physical and mental health care in selected Community Mental Health Services Programs (CMHSPs)
  •  Nebraska - Statewide Peer Support Training  
  •  New Jersey - Creation of and training of Peer Specialist Wellness Coaches
  • New York - "Recovery Centers” focused on consumer/family education, peer support and assistance with treatment planning
  • South Dakota - Strengthening rural MH transformation through the expansion of an existing System of Care Pilot Project by implementing Wraparound training in two regions of South Dakota that are actively working toward the creation of an integrated services system for children and their families
  • West Virginia - Integration of physical and mental health at CMHCs and rural primary health care clinics
  • Wisconsin - Integration of trauma informed care into the state system via Trauma Care Champions    
  • Wyoming - Developing a statewide housing network across Wyoming’s five regions designed to build a regional provider system for consumers and bolstering that effort with statewide SOAR training.

Summaries of FY 2008-2009 Outcomes can be found here.


In FY 2007-2008, CMHS awarded TTI grants, all in the amount of $105,000 to the following ten states and one territory: 

  • Kentucky - Peer Support Initiative with State Medicaid Office
  • Minnesota - Developing a valid and reliable fidelity scale for their 4 statewide EBP: ACT, Supportive Employment, Integrated Dual Disorder Treatment, and Illness Management and Recovery
  • Tennessee - Transforming their juvenile forensic mental health services by providing courts with alternatives through a program of outpatient screening and forensic evaluation
  • Pennsylvania - Older Adult Peer Support Services Initiative
  • Puerto Rico - Integration of behavioral health into primary care settings
  • North Dakota - Peer Support Training and collaboration with State Medicaid Office in a statewide peer support initiative
  • Illinois - Create a co-occurring strategic plan and develop a criminal justice workgroup with regional sessions to develop regional system mapping to identify service gaps and barriers
  • Florida - Development of Recovery and Resiliency Task Forces in Florida’s six regions
  • Alabama - Coordination of public mental health and primary care through one large Adult Psychiatric Conference, followed by regional roundtable discussions between family practice physicians and mental health clinicians to develop a plan of action
  • North Carolina - Training and support to the Local Management Entities (LMEs) to learn from each other and foster EBPs
  • Iowa - Development of emergency mental health crisis services through Iowa’s CMHCs and improve their children’s mental health systems

Summaries of FY 2007-2008 projects are located here.