NASW SOW-0292.docm

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

Title: NASW HIV/AIDS Spectrum: HIV/AIDS Education and Training of Social Workers

I. Background Information and Objectives

A. History and Background

SAMHSA is committed to achieving the nation’s goals to combat HIV and AIDS and to disseminate knowledge about the mental health aspects of HIV/AIDS and the ethical issues of providing services to people living with or affected by HIV/AIDS.

According to the Centers for Disease Control and Prevention (CDC) [1] at the end of 2003, the latest date for which these data are available, an estimated 1,039,000 to 1,185,000 persons in the United States were living with HIV/AIDS [2]. In 2006, in the 33 states with long-term, confidential name-based HIV reporting, 35,314 new cases of HIV/AIDS in adults, adolescents, and children were diagnosed [3]. Using a new and innovative system designed to estimate the number of new HIV infections for the United States in a given year, CDC estimated 56,300 new HIV infections occurred in 2006 [4]. Almost half of new HIV infections were among African Americans -- only 13% of the over-all population in the 33 states. By age, persons aged 25-34 and 35-44 accounted for the largest proportion of those newly diagnosed, 26% and 32% respectively.

During the 1990s, advances in HIV treatments slowed the progression of HIV infection to AIDS and led to decreases in deaths across the nation, 50 states and the District of Columbia. Similarly to the period from 2002 through 2005, estimates in 2006 suggest the number of AIDS cases remained stable and that deaths decreased but it is too early to determine whether this trend will hold. Advances in care and treatment have led to increasing numbers of persons who are living with AIDS and HIV. With longer life expectancies, the treatment and management of mental health becomes progressively more relevant. Conversely, the presence of mental illness and substance abuse are associated with higher rates of HIV [5].

Since the early 1980s, first the National Institute of Mental Health, and then the Center for Mental Health Services (CMHS), have provided support for a program to develop model educational approaches to train traditional and non-traditional mental health care providers in neuropsychiatric and psychosocial aspects of HIV/AIDS (i.e., the CMHS Mental Health Care Provider Education (MHCPE) Program).

Given the fact that the effects of the illness and the physical and psychological ramifications of the medical regimen for treatment are constantly changing, relatively frequent updates and continuing education of mental health service providers are crucial.

Further, individuals with HIV/AIDS are asked to make life altering decisions in view of ever changing options for medical treatment, such as beginning Highly Active Anti-Retroviral Therapy (HAART), a multi-drug treatment for HIV/AIDS, or the use of protease inhibitors. Thus, in addition to coping with the psychosocial impact of the physical illness, the neuropsychiatric sequella of the disease, and the treatment adherence/compliance aspects of chronic care, HIV/AIDS infected individuals and their mental health care providers need to be much more involved in their health care decision making process. This includes quality of life issues (e.g., the consequences of having a chronic and debilitating illness, as opposed to a disease that was once considered to be an automatic death sentence) as well as financial issues.

The widely accepted biopsychosocial model of care is increasingly important to meet the medical, mental health, and psychosocial needs of HIV/AIDS patients.

The social work perspective includes drawing upon client and community strengths, as seen in the clinical skill of enhancing personal strengths and resources, helping clients solve both interpersonal and environmental problems, and helping clients mobilize for change. Historically, social workers are the only mental health care providers who work across the full range of health, mental health, and social service settings and are in a position to recognize, refer and/or treat the emotional and mental health manifestations of HIV/AIDS. Because social workers in health and mental health settings are frequently the ‘first point of contact’ with the health care system for families as well as individuals, there is a critical need for CMHS to respond by providing social workers in all settings with comprehensive education and training in the care and support for people living with or affected by HIV/AIDS. It is recognized that social workers are part of and collaborate with a larger community promoting HIV/AIDS services, prevention and mental health related issues, and adherence to complex medication regiments. Given the high interest and need for HIV/AIDS education, it is important that we both provide training for social workers and work to engage in innovative collaborative projects to meet the mental health challenges posed by the HIV/AIDS epidemic.

The National Association of Social Workers (NASW) is the largest single provider of social work continuing education in the country. NASW is experienced in developing and conducting a full range of traditional and technology based education programs at the national and state/local levels, NASW is also the lead organization in establishing professional practice standards and practice certification for social workers. NASW sets national standards of practice for social workers (be they members or not), and NASW sets national credentials used by public and private agencies and entities.

This is of paramount importance for the success of this project and its long-term goal of continuing education and training among this group of mental health care providers. The expansion and enhancement of the Spectrum Project will increase the workforce of social workers who are capable of providing HIV-related mental health services across the full range of health, mental health, and social service settings.

Further, this contract addresses several of the goals in The President’s New Freedom Commission on Mental Health report. For example, Goal 1 (1.1): The project will provide national education that addresses the misconceptions about mental illness (and HIV/AIDS). Goal 3: The contractor will train social workers in the provision of culturally competent HIV related mental health services and will reach providers in rural and geographically remote areas. Goal 5 (5.2): The contractor provides a bridge between research and evidence practices and services by offering social workers up-to-date state-of-the-science training in HIV-related mental health service provision; in addition (5.3) the contractor activities develop the workforce to become more willing and more capable of providing evidence based treatment.

B. Goals and Objectives

The activities outlined in this contract represent a key component in SAMHSA’s commitment to expand the knowledge and capacity of mental health service providers, particularly, social workers as they struggle to address the mental health and psychosocial issues confronting people infected and affected by HIV disease.

The primary goals of this initiative are:

· To increase the number of social workers with the knowledge and skills needed to provide a range of psychosocial and mental health interventions, from prevention to treatment, for persons affected by and living with HIV/AIDS regardless of geographical locations of the participant;

· To expand the number of expert trainers available to provide social workers with state-of-the-science knowledge of HIV-related mental health service provision, and to provide technical assistance to trainers on an ongoing basis;

· To update existing training materials and develop new resources;

· To provide education/training opportunities to social workers utilizing new and emerging technologies;

· To provide oversight of the Project Spectrum Advisory Committee;

· To utilize the CMHS Ethics and HIV/AIDS Curricula when conducting ethics workshops, and

· To participate in the evaluation component of the MHCPE Program.

II. Services to be Performed

The Contractor shall develop and deliver educational programs and materials that will provide training to an increasing cadre of psychiatrists.

General Requirements

1. Independently, and not as an agent of the Government, the Contractor shall furnish all necessary labor, materials, supplies, equipment, and services (except as otherwise specified herein) and perform the work described below.

2. All work under the Contract shall be monitored by the Government Project Officer (GPO).

Specific Requirements

Task I - Plan of Performance

HHSS280200900005C

Reference No. 280-09-0292 Attachment I

The Contractor shall meet with the GPO, in person or by telephone, within 7 days after the contract effective date (CED) to review the scope of work, and discuss and clarify the plan of performance submitted with the proposal. The Contractor shall incorporate the GPO’s comments and submit a final plan within 14 days of receiving the GPO’s comments. A revised final plan of performance and timetable for conducting the tasks and requirements shall provide to the GPO no later than 30 days after the CED.

Task II - Provide Training to Social Workers Serving Populations Increasingly Affected by HIV/AIDS

The Contractor shall provide training to social workers serving populations increasingly affected by HIV/AIDS. In delivering the curriculum to trainers and other social workers, existing training structures should be used whenever possible. The Contractor will be required to train an estimated one thousand social workers annually. Special emphasis should be placed on providing training in rural and underserved areas.

Attention should be paid to current and emerging treatment options (e.g., issues related to drug interactions and patient compliance/adherence). In addition, trainers should be sensitive to cultural differences in the presentation of psychosocial and neurological symptoms and the cultural barriers to treatment. Moreover, the prevention and treatment strategies suggested need to incorporate the special cultural and treatment related issues for older adults, women and lesbian, gay, bisexual, and transgender (LGBT) people, and youth.

Task III - Expand the Number of Expert Trainers Available

The Contractor shall expand the number of expert trainers available to present content and ensure the quality of the content of new and existing trainers. The Contractor shall continue to provide technical assistance to Project Spectrum trainers as they work to implement their training initiatives in their respective areas. This assistance will be most important in rural and underserved areas.

Technical assistance should also include keeping social workers apprized of developments in the field. Available technology shall be used as often and effectively as possible in outreach efforts.

Task IV –Update /Expand/Use Current NASW Curricula Materials

The Contractor shall develop training tools and materials that are tailored to individual needs and keep pace with emerging issues (e.g., HIV and dementia among the elderly, drug interactions and drug resistance).

The Contractor shall pay particular attention to issues of national significance including HIV among increasing numbers of minorities, older adults, youth, and women. Curricula are to continue to be culturally relevant and meet the needs of diverse populations, including ethnic and cultural minorities; children, adolescents and their families; women; LGBT individuals; men who have sex with men; people with serious mental illness and/or substance abuse and other co-occurring problems; older adults; homeless persons and persons who are incarcerated. Because of the importance of understanding consumer perspectives, it is expected that people living with and/or affected by HIV/AIDS will be involved in the development/modification of curricula.

The Contractor shall also explore the possibility of developing brief and easily accessible print materials for use by social workers in diverse areas of the workforce. For example, practice updates designed specifically for use by social workers who work with older adults, persons with serious mental illness or other disabilities, or survivors of trauma.

Task V – Provide Education/Training Opportunities to Social Workers Utilizing New and Emerging Technologies

The Contractor shall use the NASW website, to promote web-based continuing education content addressing HIV/AIDS, mental health, and related issues. The Contractor should consider the expansion of the Spectrum Project’s web-based capacity by creating a Project specific page on the NASW website. The Contractor shall also explore, and implement if feasible, the development of content that will provide web-based on-line continuing education using video and voice streaming/audio presentations. All of the above products should conform to the specifications in Task III.

Task VI - Oversight of Project by Advisory Committee

The Contractor shall have an Advisory Committee that will provide expertise on an on-going basis throughout the duration of the contract. Advisory Committee members should be actively involved in curricula development, review, and evaluation, and in all subject matter related aspects of the Project. Because of the importance of understanding the issues from a consumer perspective, it is expected that people living with and/or affected by HIV/AIDS will be included as members of the Advisory Committee.

Task VII - Use of the CMHS Ethics and HIV/AIDS Curricula

The Contractor shall use the CMHS MHCPE Ethics and HIV/AIDS Curricula for all ethics training workshops that are supported under this contract (a copy of the new materials will be distributed by the government as they are updated and revised). If new trainers, or advanced training, are needed, the Contractor will need to provide this training.

Task VIII - Participate in the Evaluation Component of the MHCPE Program

The Contractor shall use the CMHS OMB-approved Participant Feedback Forms to evaluate CMHS-funded trainings conducted by Spectrum Project trainers. The Contractor shall work with the CMHS GPO and the Data/Coordinating Center on the evaluation component.

Task IX - Association Contractor Meetings

At the GPO’s request, the Contractor shall attend up to three (3) local HIV/AIDS education contractor meetings (i.e., the three mental health provider professional associations: American Psychiatric Institute for Research and Education (APIRE), American Psychological Association (APA), and NASW.

Task X - Preparation of Reports

The Contractor shall prepare and submit the following reports to the GPO in the quantities and at the times indicated in the Delivery Schedule.

a. Quarterly Progress Reports

The Contractor shall submit one (1) hard copy and one (1) disk copy or copy via e-mail (exclusive of items unsuitable for this format), of a progress report for each quarter during the life of the contract. The report shall: (1) detail activities which involve expenditures and obligations; (2) address problems encountered and how they were (or will be) resolved; (3) address planned activities for the upcoming reporting period; and (4) contain a statement that the contract will (or will not) be completed in accordance with the time frame specified in the delivery schedule and will (or will not) be completed within the budget amount. The quarterly time frame will be determined with GPO.

The Contractor shall add an annual summary report to the fourth quarter progress report. The report shall: (1) summarize activities which involved expenditures and obligations; (2) address planned activities for the upcoming year; and (3) contain a statement that the contract will (or will not) be completed in accordance with the time frame specified in the delivery schedule and will (or will not) be completed within the budget amount.

c. Draft Final Report

Six (6) weeks prior to the contract expiration date, the Contractor shall submit to the GPO for review and approval one hard copy of a draft final report that summarizes the results of the activities conducted during the performance of the contract, including problems encountered and their solutions. The Contractor shall incorporate any comments or suggestions received from the GPO into the final report.

d. Final Report

The Contractor shall submit one (1) hard copy and one (1) disk copy or copy via e-mail (exclusive of items unsuitable for this format), of the final report to the GPO, as approved above, and one (1) hard copy to the Contracting Officer by the contract expiration date.

Task XI – Transfer of Activities

Turnover at End of Contract

(1) The Contractor shall provide, by no later than the eighth month of the final performance period, three (3) copies of plans for transfer of the project to either the government or a new contractor (as applicable). If necessary, the Contractor shall initiate transition activities sixty (60) calendar days prior to the expiration of the contract. These activities include:

(a) continued full service to the customers of HIV/AIDS Education and Training;

(b) at the Contracting Officer’s discretion, participating in five (5) or more meetings with the new contractor to effect a smooth transition and to receive detailed information on the operation of the project.

(c) providing complete documentation and all hardware, software, materials and data produced or acquired with contract funds, or under the Contractor’s control as Government Furnished Property or Materials, and turn them over to SAMHSA or the new contractor in good condition; and, during a three (3)-week transition period, assure that the Contractor’s senior personnel train the new personnel (contractor or government) in all system operation and maintenance functions; and,

(d) performing appropriate close-out of all outstanding technical and related work.

(2) Unless the underlying data used in the selected study analysis are leased or proprietary, analytic files (where source files are reduced in volume and tailored to specific analyses), or data analytic programs, then the results produced under the auspices of this project shall be property of the federal government. If State data are used, the federal government shall collaborate with the participating States in planning, carrying out and disseminating the results of such analyses.

All information and materials, including data developed under this contract, are the property of the government and shall be delivered as part of the turnover at the end of the contract. No information developed under this contract shall be released by the Contractor without the written permission of the government.