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.

In FY 2018-2019, CMS awarded TTI grants to the following twenty-three states:

  • Alabama – Will develop an inpatient services need methodology to identify the number of inpatient psychiatric beds needed to ensure quality inpatient psychiatric care.
  • Connecticut – Will develop a psychiatric bed registry based off an existing state substance abuse services registry, and will partner with the University of Connecticut School of Social Work to evaluate. 
  • Delaware – Will expand their existing Delaware Treatment and Referral Network to include additional peer support services and other social services, and integrate vulnerable populations into the existing system.
  • Florida – Will convert their existing registry into a centralized, web-enabled platform which will enable real-time registry of psychiatric and acute care beds that are vacant and occupied statewide.
  • Georgia – Will integrate three separate, existing bed boards into one single unit, and will create an automated screening process for medical clearance and a secure interface for external partners to communicate on crisis admissions.  
  • Idaho – Will develop a statewide psychiatric bed registry and facilitate the use of the portal across community mental health agencies, crisis centers, jails, community hospitals, and state hospitals statewide.
  • Indiana – Will expand the existing substance use disorder registry with a psychiatric bed registry for twenty private inpatient sites throughout Indiana.
  • Maryland – Will expand an existing bed registry in Anne Arundel County registry statewide, and will include substance use disorder and mental health treatment providers in the registry.
  • Massachusetts – Will expand the existing registry by adding a registry of outpatient providers that offer open access appointments and adding a registry of medication-assisted treatment providers in the state.
  • Mississippi – Will develop a statewide web-based bed registry incorporating inpatient psychiatric beds in state hospitals, crisis stabilization units, and crisis respite services.
  • Nebraska – Will partner with Region 6 to pilot a bed registry to track acute psychiatric hospital beds for youth and adults in the region.
  • Nevada – Will develop an online real-time bed registry designed to adequately assess, treat, ensure rapid placement at appropriate levels of care, and facilitate transitions of care across the continuum for individuals with SMI and SED.
  • New Jersey – Will establish a psychiatric bed registry of short term psychiatric and crisis respite beds statewide, and expand the existing Bed Enrollment Data System, which tracks community-based housing.
  • New Mexico – Will fund and establish a substance abuse bed registry, including administration, monitoring, data collecting, and training.
  • New York – Will hire staff to assist current OMH staff assigned to their already-established bed registry system, and will train hospital staff.
  • North Carolina – Will expand and improve their existing bed registry system, including improving the existing referral and search features, adding a secure messaging feature, and expanding the use of the system to include transportation for individuals.
  • Ohio – Will establish a psychiatric bed registry, based off an already established registry in one Ohio county, with the capacity to add community-based crisis resources in one region of the state.
  • Oklahoma – Will expand their current database to include inpatient psychiatric beds for children in need of acute care.
  • Rhode Island – Will establish a bed registry which will provide real-time data on bed availability.
  • Tennessee – Will update their existing registry to become a real-time psychiatric bed availability system, with the ultimate goal of including information specific to crisis and substance abuse disorder services.
  • Utah – Will create an electronic bed registry system which will track the availability of mental health inpatient beds, substance use treatment beds, detox bed, outpatient beds, and social resources.
  • Vermont – Will perform an evaluation of their existing electronic bed registry system and will either perform maintenance, update, or replace the current system based on their findings.
  • West Virginia – Will develop a statewide crisis line and psychiatric bed registry connecting resources available to children experiencing serious emotional disturbance into a single database.


In FY 2017-2018, CMHS awarded TTI grants, all in the amount of $220,000, to the following six states: 

  • Georgia – Will target specific groups of providers that we have not trained to date as well as expand the capacity of staff certified in CT-R. 
  • Massachusetts – Will partner with The Bridge of Central MA, Inc. to develop in-state capacity for the CT-R trainers to expand delivery of this evidence-based practice within the community-based service delivery system for people with severe mental illness. 
  • Montana – Will enhance the skill set of MSH and community staff at various levels of training and experience, improve outcomes of individuals with serious mental illness, while additionally promoting and improving continuity of care. 
  • New Jersey – Will focus on health integration and culminate into the hosting of a CT-R consumer outcome Summit as well as the development of a Behavioral Health Home Toolkit featuring the integration of CT-R in integrated settings, as well as peer-delivered CT-R within clinical teams. 
  • New York – Will expand the use and availability of CT-R provided to individuals with serious mental illness to assist their transition from inpatient hospitalization and improve their community tenure.
  • Vermont – Will strengthen the promotion of recovery by implementing and sustaining Recovery-Oriented Cognitive Therapy (CT-R) strategies for adults with serious mental illness (SMI) enrolled in Community Mental Health Centers (CMHC) initially in four regions of the state and eventually statewide. 

In FY 2016-2017, CMHS awarded TTI grants, all in the amount of $221,000, to the following six states: 

  • District of Columbia – Identifying Individuals with co-occurring disorders and histories of trauma
  • Kentucky – Improving the System of Care to Serve Children and Youth with Co-Occurring Disorders
  • Louisiana – Cross-System Training and Education for Behavioral Health Clinicians, Administrators and Direct-Support Professionals
  • Missouri – Expanding Use of the department’s co-occurring protocol
  • New Jersey – Providing Family/Caregiver education and support to those who are providing care to loved ones with dual diagnosis of a developmental disability and mental illness
  • Utah – Strengthening Family Supports statewide and Initiating Family Peer Support in 2 Urban Areas and in a rural area


In FY 2015-2016, CMHS awarded TTI grants, all in the amount of $221,000, to the following two states: 

  • Illinois - Expanding statewide Warm Line using a smartphone app to connect with homeless youth.
  • New York – Improving statewide clinical data infrastructure to support a newly developing Behavioral Health Crisis Intervention System.


In FY 2014-2015, CMHS awarded TTI grants, all in the amount of $221,000, to the following six states: 

  • Idaho – Developing 3 Specialty CPS Certifications: 1) Crisis Intervention 2) Forensic 3) Co-Occurring
  • Kentucky – Young Adult Peer to Peer Crisis Support Services
  • Missouri – Linking Peer Services to the Traditional Crisis Intervention System 
  • New Jersey – Developing Curricula and Training Forensic Peer Bridgers
  • Pennsylvania – Training and Using CPSs in Behavioral Health Crisis Services
  • Tennessee – Placing Peer Bridgers into Crisis Stabilization Units 


In FY 2013-2014, CMHS awarded TTI grants, all in the amount of $221,000 to the following five states: 

  • Michigan – Self-Directed Care in Behavioral Health
  • New York – Self Directed Care for individuals with serious mental illness 
  • Pennsylvania – expanding its current Self-Directed Care (SDC) project in Delaware County
  • Texas – Sustainable Self Directed Care program for possible participation in a multisite evaluation of the model. 
  • Utah – Self-directed care service within Medicaid

Summaries of FY 2013-2014 Projects:



In FY 2012-13, CMHS awarded TTI grants, all in the amount of $221,000, to the following eleven states:

  • Guam - Self-Directed Care, Mental Health First Aid, Suicide and Trauma Informed Care
  • Idaho - Statewide Recovery Infrastructure and Empowerment (MH & SA)
  • Illinois - Creating an Integrated Database for Mental Health, Drug and Veterans' Courts
  • Indiana - Behavioral and Primary Health Integration
  • Kentucky - Expanding Access to Evidence-Based Practices for Kentucky’s Young Children in Child Care
  • Louisiana - Criminal Justice Collaborative Demonstration
  • Massachusetts - Building Capacity for Peer Support in Deaf Communities
  • Minnesota - Veteran Certified Peer Support and Specialists
  • Nebraska - Trauma Informed Peer Support within Family Systems
  • Tennessee - Expanding Screening and Referral to Community Services for Youth in Juvenile Courts
  • Virginia - Cross Systems Education and Statewide Advance Directives Project

Summaries of FY 2012-13 projects are located here



In FY 2011-2012, CMHS awarded TTI grants, all in the amount of $221,000 to the following eleven states: 

  • Alabama – Leadership Forums and other activities to prepare for healthcare reform
  • Arizona – Training trainers to teach peer-support specialists about chronic disease self-management planning
  • Arkansas – Consumer empowerment through strengthening of a statewide consumer network and statewide outreach 
  • Colorado – Supported Employment
  • Georgia – Peer supported whole health and wellness coaching
  • Kentucky – Trauma Informed Care (TIC) Forums and Statewide Implementation Efforts
  • Michigan – Certified Peer Support Specialists in Federally Qualified Health Centers
  • Montana – Criminal Justice, Corrections and Courts Collaboration
  • New Jersey – Peer Wellness Coaches
  • Pennsylvania – Peer Wellness Coaches
  • Wisconsin – Trauma, Parent Peer Specialists and Juvenile Justice

Summaries of FY 2011-2012 projects can be found here.

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 – Building a statewide consumer network through peer support
  • Idaho – Data collection
  • Kansas – Health and wellness initiative through whole health campaigns within communities
  • Kentucky*** – Healthcare reform implementation
  • Minnesota*** – Integration of primary care into ACT teams
  • New Hampshire – Statewide implementation of ANSA and CANS
  • Pennsylvania*** – Older Adult Peer Support Services
  • Rhode Island – Peer support services and recovery training at CMHCs
  • South Carolina – Health integration
  • Tennessee*** – Family support providers within juvenile courts
  • Vermont – Statewide EBP cooperative
  • Virginia – Consumer and family integration into statewide and local CIT teams

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.