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The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency within the U.S. Department of Health and Human Services. With a vision to create "a life in the community for everyone," the National Outcome Measures (NOMs) were developed by SAMHSA in partnership with states and jurisdictions as the data strategy for measuring the success of the agency's block grant programs and key initiatives. In addition, NOMs were designed to meet the various reporting requirements of the federal government.

There are two primary federal activities that are concerned with the effectiveness and accountability of federal programs: the Government Performance and Results Act of 1993 and the Performance Assessment Rating Tool (PART) administered by the White House Office of Management and Budget. While each has its own distinct purpose and reporting requirements, NOMs are an attempt to create a single mechanism for meeting a variety of reporting requirements. As of September 2007, all grantees from any of SAMHSA s centers currently report, or will be required to report, relevant NOMs data.

SAMHSA administers grants and programs through its three centers: the Center for Mental Health Services, the Center for Substance Abuse Treatment, and the Center for Substance Abuse Prevention. Each center is obligated to develop and maintain systems for collecting NOMs data in order to measure outcomes and maintain accountability for the centers' unique missions.

Federal Performance Activities

Government Performance and Results Act

Established in 1993, the Government Performance and Results Act was designed to improve efficiency and effectiveness among federal agencies and to hold these agencies accountable for setting and achieving outcomes. The act details requirements of federal agencies for developing strategic plans that outline goals and objectives and a plan for achieving desired outcomes. This act mandates measurable performance objectives along with regular reporting procedures and timelines.

Performance Assessment Rating Tool

The Office of Management and Budget is responsible for the administration of the PART. This tool serves as a mechanism for measuring the performance of federal agencies and is conducted separate from Government Performance and Results measures. The PART guides the budgetary and management process of the federal government and is intended to provide an assessment of the strengths and weaknesses of the various federal agencies and their respective programs. Fifty percent of the total PART score is an assessment of outcomes. In addition to outcome assessment, the PART allows the Office of Management and Budget to monitor federal programs and track action taken in identified areas of need. The PART is consistent across all programs, allowing for comparison among similar programs while providing a system for measuring progress over time. PART scores are available to the public on the Internet at http://expectmore.gov.

Overview of National Outcome Measures

In response to these federal performance mandates, SAMHSA developed the NOMs. The NOMs consist of a set of 10 domains that reflect SAMHSAs vision. Within each domain are respective outcomes and measures organized according to the three primary activities within SAMHSA (mental health, substance abuse treatment, and substance abuse prevention). See Table 1 for a complete matrix of these domains, outcomes, and measures. Updated versions of the matrix can be viewed on SAMHSAs Web site at http://www.nationaloutcomemeasures.samhsa.gov.

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