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 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. 

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.