BHW HRSA-22-043 (D40) GPE_Final.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Graduate Psychology Education Program

Funding Opportunity Number: HRSA-22-043

Funding Opportunity Type(s): Competing Continuation and New

Assistance Listings (AL/CFDA) Number: 93.191

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: December 9, 2021

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: September 24, 2021

LCDR Candice T. Karber, LICSW, BCD Project Officer, DNPH Telephone: (301) 443-2785 Email: GPE@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: Section 756(a)(2) of the Public Health Service Act (U.S.C. 42 U.S.C. § 294e–1(a)(2)) mailto:GPE@hrsa.gov

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508 COMPLIANCE DISCLAIMER

Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, please email or call one of the HRSA staff above in Section VII.

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Graduate Psychology Education (GPE) Program. The purpose of this program is to train doctoral health service psychology students, interns, and post-doctoral residents to provide quality interdisciplinary, integrated behavioral health including but not limited to Opioid Use Disorder (OUD) and other Substance Use Disorders (SUD) into community-based primary care settings in high need and high demand areas.1 The program also supports faculty development of health service psychologists.

Through these efforts, the GPE Program transforms clinical training environments and is aligned with HRSA’s mission to improve health and achieve health equity through access to quality services, a skilled workforce, and innovative programs.

Funding Opportunity Title: Graduate Psychology Education Program Funding Opportunity Number: HRSA-22-043 Due Date for Applications: December 9, 2021 Anticipated Total Annual Available FY 2022 Funding:

$25,000,000

Estimated Number and Type of Award(s): Approximately 55 grants Estimated Annual Award Amount: Up to $450,000 per award Cost Sharing/Match Required: No Period of Performance: July 1, 2022 through June 30, 2025

(3 years)

1 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition DSM-5.

Washington, DC and London, England: American Psychiatric Publishing.

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Eligible Applicants: Eligible applicants are American Psychological Association (APA)-accredited doctoral level schools and programs of health service psychology, APA-accredited doctoral internships in professional psychology, APA-accredited post-doctoral residency programs in practice psychology and Psychological Clinical Science Accreditation System (PCSAS)-accredited doctoral level schools of psychology.

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance

HRSA will hold a pre-application technical assistance (TA) webinar(s) for applicants seeking funding through this opportunity. The webinar(s) will provide an overview of pertinent information in the NOFO and an opportunity for applicants to ask questions.

Visit the HRSA Bureau of Health Workforce’s open opportunities website at https://bhw.hrsa.gov/fundingopportunities/default.aspx to learn more about the resources available for this funding opportunity.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://bhw.hrsa.gov/fundingopportunities/default.aspx

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Justification Narrative

v. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER TRANSITION

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

(REQUIRED)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Graduate Psychology Education (GPE) Program.

Program Purpose

The purpose of this program is to train doctoral health service psychology students, interns, and post-doctoral residents in integrated, interdisciplinary behavioral health for placement into community-based primary care settings in high need and high demand areas. The program also supports faculty development in health service psychology.

Program Goal

Goal: To increase the number of trained doctoral health service psychology students, interns, and post-doctoral residents providing quality interdisciplinary, integrated behavioral health for placement into community-based primary care settings.

Program Objectives

The GPE Program objectives are to:

• Improve access to quality behavioral health, including trauma-informed care, by increasing the number of doctoral health service psychology graduates;

Demonstrate an ability to recruit and place the doctoral health service psychology students, interns, and post-doctoral residents in experiential training sites that provide integrated, interdisciplinary behavioral health for placement into community-based primary care settings in high need and high demand areas2 with two (2) or more health disciplines other than psychology, and also ensure at least twenty-five (25) percent of the time in the experiential training site(s) is in the delivery of OUD and other SUD prevention, treatment, and recovery services;

• Demonstrate enhanced didactic and experiential training activities to develop competencies of doctoral health service psychology students, interns, and post-doctoral residents in integrated, interdisciplinary (in collaboration with two (2) or more health disciplines) team based care to address the social determinants of health (SDOH), provider resiliency, trauma-informed care, OUD and other SUD, and other behavioral health concerns;

• Establish or enhance academic and community partnerships for the development of experiential training sites, settings may include but are not limited to academic, K-12 schools, gerontology, criminal justice, and community health

2 For purposes of this NOFO, high need and high demand areas are identified experiential training sites that are:

• Located in a county that has less than 10 licensed psychologists per 100,000 population (APA County Level Analysis of US Licensed Psychologists);

• Located in a Mental Health Professional Shortage Area (HPSAs) or that are Facility Mental HPSAs with a score of 16 or above as found in the HPSA Find Tool; or

• Located within a geographical area considered rural as defined by the HRSA Federal Office of Rural Health Policy (FORHP).

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centers to create a pipeline of well-trained, culturally responsive health service psychologists, who are committed to working in high need and high demand areas following graduation;

• Promote technology integration in the provision of psychological services and training programs, including utilizing tele-behavioral health services, offering options for distance learning to improve access to health services and improved patient outcomes; and

• Enhance faculty development and training program content that includes incorporating a holistic review strategy that assesses an individual’s SDOH health factors alongside traditional mechanisms of providing behavior health services in the provision of OUD and other SUD prevention, treatment, and recovery tele-behavioral health services, and other relevant trainings such as provider resiliency, culturally appropriate service delivery, and trauma informed care.

HHS and HRSA Priorities

Ending the crisis of opioid addiction and overdose in America, improving mental health access and care, and strengthening health care access through telehealth are HHS’s and HRSA’s clinical priorities. The GPE program seeks to address these priorities by increasing the number of psychologists trained in the provision of OUD and other SUD prevention, treatment, and recovery services and the collaborations with community-based partnership in high need and high demand areas.

Promoting equity is essential to the Department’s mission of protecting the health of Americans and providing essential human services. This view is reflected in Executive Order (E.O.) 13985 entitled Advancing Racial Equity and Support for Underserved Communities Through the Federal Government (Jan. 20, 2021).

The Health Resources and Services Administration (HRSA), Bureau of Health Workforce (BHW), is committed to increasing diversity in health professions programs and the health workforce across the Nation. This commitment extends to ensuring that the U.S. has the right clinicians, with the right skills, working where they are needed.

General Emergency Preparedness Statement

Eligible entities must be ready to continue programmatic activities in the event of a public health emergency – both those that are expected and unexpected.

A training-focused emergency preparedness plan is critical for HRSA-funded projects and helps ensure that grantees are able to continue programmatic activities, can coordinate effectively, and can implement recovery plans when emergencies disrupt project activities. Applicants must develop and maintain a flexible training-focused emergency preparedness plan in case of public health emergencies to ensure continuation of programmatic and training activities, including but not limited to graduate psychology training.

2. Background

The GPE Program is authorized by Title VII, Section 756(a)(2) of the Public Health Service Act (U.S.C. 42 U.S.C. § 294e–1(a)(2)). The program was established to assist

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American Psychological Association (APA) accredited doctoral programs and internships in meeting the costs to plan, develop, operate, or maintain graduate psychology education programs to train health service psychologists to work with high need and high demand populations.

The focus of the FY 2022 GPE Program is to provide quality training to doctoral health service psychology students, interns, and post-doctoral residents in integrated, interdisciplinary behavioral health for placement into community-based primary care settings in high need and high demand areas. In 2017, the U.S. Department of Health and Human Services (HHS) declared a public health emergency and announced a five point strategy to combat the opioid crisis.3 Access to better prevention, treatment, and recovery services is one of the strategies and a priority for improvement of behavioral health workforce programs.

In 2019, an estimated 51.5 million adults (20.6 percent of the population) aged 18 or older were diagnosed with any mental illness (AMI) in the past year. Among the 20.4 million people aged 12 or older with a past year SUD in 2019, 71.1 percent (or 14.5 million people) had a past year alcohol use disorder, 40.7 percent (or 8.3 million people) had a past year illicit drug use disorder, and 11.8 percent (or 2.4 million people) had both an alcohol use disorder and an illicit drug use disorder, 10.1 million people misused opioids in the past year, including 9.7 million pain reliever misusers and 745,000 heroin users.

Additionally, an estimated 9.5 million adults, aged 18 or older, had both AMI and SUD in the past year. Of the 9.5 million adults with co-occurring AMI and SUD, 48.6 percent received either substance use treatment at a specialty facility or mental health services Of the 397,000 adolescents in 2019 who had a major depressive episode (MDE) and SUD co-occurring disorder, 66.3 percent received either substance use treatment at a specialty facility or mental health services.4

Drug overdose death rates increased from 1999 to 2019 for all age groups. In 2019, there were 70,630 drug overdose deaths in the United States. The age-adjusted rate of drug overdose deaths in 2019 (21.6 per 100,000) was higher than in 2018 (20.7).5 Moreover, according to the National Center for Health Statistics, the number of fatal overdoses involving psychostimulants, such as methamphetamine, amphetamine, and methylphenidate is on the rise. There has been a yearly significant increase by 30 percent (0.8 to 3.9) from 2012-2018.6 The opioid crisis and its effect is especially evident in geographical areas with large rural concentrations, where nonmedical prescription opioid misuse continues to remain a growing public problem.7

3 U.S. Department of Health and Human Services (HHS). (2021). 5-Point Strategy to Combat the Opioid Crisis.

https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html 4 Substance Abuse and Mental Health Services Administration. (2020). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.

https://www.samhsa.gov/data/report/2019-nsduh-annual-national-report 5 Centers for Disease Control and Prevention (CDC). (2020, December). Drug Overdose Deaths in the United States, 1999–2019. https://www.cdc.gov/nchs/data/databriefs/db394-H.pdf 6 Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/databriefs/db356-h.pdf 7 Pear, V. A., Ponicki, W. R., Gaidus, A., Keyes, K. M., Martins, S. S., Fink, D. S., ... & Cerdá, M. (2019). Urban-rural variation in the socioeconomic determinants of opioid overdose. Drug and alcohol dependence, 195, 66-73.

https://dx.doi.org/10.1016%2Fj.drugalcdep.2018.11.024 https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html https://www.samhsa.gov/data/report/2019-nsduh-annual-national-report https://www.cdc.gov/nchs/data/databriefs/db394-H.pdf https://www.cdc.gov/nchs/data/databriefs/db356-h.pdf https://dx.doi.org/10.1016%2Fj.drugalcdep.2018.11.024

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Across the United States, these behavioral health and substance use issues highlight the significant disparities in underserved communities. Such disparities may be attributed to lack of access to health care, need for a diverse health care workforce, a lack of information, and the need for culturally and linguistically responsive care and programs.8 Research has shown that health care profession students who are exposed to training in rural and/or medically underserved communities are more likely to care for similar populations once employed.9

SDOH affects behavioral and physical health, individually and in combination with each other. Exposure to adverse SDOH factors can increase the level of stress experienced by individuals, which then can raise the risk for experiencing mental health issues and substance use problems.10 The implementation of resilience training aims to provide faculty and trainees with basic psychological skills to improve mental health outcomes for the individuals for whom they provide care. In learning these skills, resiliency training is essential for enhancing provider resiliency. Improving the wellbeing of current and future providers can be beneficial for both patients and providers, as poor wellbeing is associated with reduced clinical care capacity and is a risk factor for developing mental illness in the short and long-term.11

Tele-behavioral health is an important tool for delivering services and resources to HRSA’s target populations in underserved communities. The use of tele-behavioral health can serve to reduce barriers that connect patients and providers to a wider network, regardless of location, making it easier to match patients with specialists and providers, engage in unique treatments, and unite patient communities who speak their native language or share a similar cultural background. Tele-behavioral health also offers more privacy than face-to-face care, often making patients more willing to seek behavioral health treatment via online counseling.12

In 2020, the nation was impacted by the Novel Coronavirus (2019-nCOV), also referred to as COVID-19. Although COVID-19 is a respiratory illness that easily spreads from person to person, this virus also had implications on other aspects of individual’s lives and exacerbated existing public health crises. A public health crisis that COVID-19 exacerbated is opioid use and other substance use, which sometimes result in overdose.12 CDC preliminary data show that 81,230 overdose deaths occurred in the United States from June 2019 through May 2020, which is the highest number of overdose deaths ever recorded in a 12-month period. Overdose deaths involving

8 Substance Abuse and Mental Health Services Administration (SAMHSA). (2021). Behavioral Health Equity.

https://www.samhsa.gov/behavioral-health-equity 9 VanderWielen, L. M., Vanderbilt, A. A., Crossman, S. H., Mayer, S. D., Enurah, A. S., Gordon, S. S, & Bradner, M.

K. (2015). Health Disparities and Underserved Populations: A Potential Solution, Medical School Partnerships with Free Clinics to Improve Curriculum. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408316/#CIT0013 10 Center for Health Policy, Indiana University. (2020). Social Determinants of Health and Their Impact on Mental Health and Substance Misuse. https://fsph.iupui.edu/doc/research-centers/Social-Determinants-of-Health-and-Their- Impact2.pdf 11 van Agteren, J., Iasiello, M. & Lo, L. (2018). Improving the Wellbeing and Resilience of Health Services Staff via Psychological Skills Training. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303850/ 12 U.S. Department of Health and Human Services (HHS). (2021). Telehealth for behavioral health care.

https://telehealth.hhs.gov/providers/telehealth-for-behavioral-health/getting-started/ 12 Centers for Disease Control and Prevention (CDC). (2021). Drug Overdose Deaths Increased During the COVID- 19 Pandemic. https://www.cdc.gov/drugoverdose/featured-topics/save-lives-now.html https://telehealth.hhs.gov/ https://www.samhsa.gov/behavioral-health-equity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408316/#CIT0013 https://fsph.iupui.edu/doc/research-centers/Social-Determinants-of-Health-and-Their-Impact2.pdf https://fsph.iupui.edu/doc/research-centers/Social-Determinants-of-Health-and-Their-Impact2.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303850/ https://telehealth.hhs.gov/providers/telehealth-for-behavioral-health/getting-started/ https://www.cdc.gov/drugoverdose/featured-topics/save-lives-now.html

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cocaine increased by 26.5 percent. These deaths are likely linked to co-use of cocaine with illicitly manufactured fentanyl or heroin. Overdose deaths involving psychostimulants, such as methamphetamine, increased by 34.8 percent.13 As a result, training in OUD and other SUD prevention, treatment, and recovery services continue to be vital for behavioral health professionals.

HRSA has a number of investments targeting OUD and other SUD resources across its Bureaus and Offices that applicants may be able to leverage. For information on HRSA-supported resources, technical assistance, and training, visit here:

https://www.hrsa.gov/opioids.

Program Definitions: A glossary containing general definitions for terms used throughout the Bureau of Health Workforce NOFOs can be located at the Health Workforce Glossary. A listing of other key terms relevant to this announcement can be found in Section VIII Other Information.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New and Competing Continuation. HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA expects approximately $25,000,000 to be available annually to fund approximately 55 award recipients. The actual amount available will not be determined until enactment of the final FY 2022 federal appropriation. You may apply for a ceiling amount of up to $450,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

The period of performance is July 1, 2022 through June 30, 2025, three (3) years.

Funding beyond the first year is dependent on the availability of appropriated funds for the GPE Program in subsequent fiscal years, satisfactory recipient progress, and a decision that continued funding is in the best interest of the Federal Government.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles and Audit Requirements at 45 CFR part 75.

Indirect costs under training awards to organizations other than state, local, or Indian tribal governments will be budgeted and reimbursed at eight (8) percent of modified total direct costs rather than on the basis of a negotiated rate agreement, and are not subject to upward or downward adjustment. Direct cost amounts for equipment, tuition and fees, as otherwise allowable, and sub-awards and subcontracts in excess of $25,000 are

13 Ibid.

https://www.hrsa.gov/opioids https://bhw.hrsa.gov/glossary https://bhw.hrsa.gov/glossary http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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excluded from the direct cost base for purposes of this calculation.

III. Eligibility Information

1. Eligible Applicants

Eligible entities are APA-accredited doctoral, internship, and post-doctoral residency programs of health service psychology (including clinical psychology, counseling, and school psychology) and Psychological Clinical Science Accreditation System (PCSAS)-accredited doctoral level schools of psychology.

Note: Individuals are not eligible to apply under this NOFO.

In addition to the fifty (50) states, eligible entities include the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. Domestic faith-based and community-based organizations, and tribal organizations are also eligible to apply, if otherwise eligible.

Current GPE award recipients whose grants are scheduled to end on August 31, 2022 are eligible to apply for this funding opportunity and should apply as “Competing Continuations.” All other applicants should apply as “New.” If funded, for-profit organizations are prohibited from earning profit from the federal award (45 CFR part 75.216(b)).

Accreditation

Doctoral-level schools and programs of health service psychology, professional psychology internships, and post-doctoral psychology residencies must provide documentation of their institution’s APA or PCSAS accreditation, specifying the dates covered by the active accreditation, including expiration date letter as Attachment 6.

All applicants must provide proof of accreditation. HRSA may consider any application that fails to attach a copy of the required accreditation or certification documentation nonresponsive, and may not consider it for funding under this notice. Applicants are required to maintain their accreditation throughout the period of performance and notify HRSA of change in status.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA may not consider an application for funding if it contains any of the non-responsive criteria below:

• Exceeds the ceiling amount https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75#se45.1.75_1216 https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75#se45.1.75_1216

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• Fails to satisfy the deadline requirements referenced in Section IV.4

Maintenance of Effort The recipient must agree to maintain non-federal funding for award activities at a level that is not less than expenditures for such activities maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award, as required by 42 U.S.C. § 295n-2 (PHS Act section 797(b)). Such federal funds are intended to supplement, not supplant, existing non-Federal expenditures for such activities.

Complete the Maintenance of Effort information and submit as Attachment 5.

HRSA will enforce statutory MOE requirements through all available mechanisms.

Multiple Applications Multiple applications from an organization are not allowable. An institution must select and submit an application for only one (1) of either a:

• Doctoral school or program of health service psychology or

• Doctoral internship in professional psychology or

• Post-doctoral residency program in practice psychology.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates), an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, before the Grants.gov application due date as the final and only acceptable application.

Failure to include all required documents as part of the application may result in an application being considered incomplete or non-responsive. Applications received without the appropriate tables will be deemed non-responsive to the NOFO and will not be considered for funding under this notice.

Beneficiary eligibility requirements – Trainee Eligibility Doctoral students, doctoral interns, and post-doctoral residents receiving a stipend or other funds in the GPE Program must be a citizen, national, or permanent resident of the United States. Individuals on temporary or student visas are not eligible participants.

In addition, trainees must be enrolled full or part- time in the school or program receiving the award in order to receive stipend support.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 Research and Related (R&R) workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html

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The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-22-043 in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov.

You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this

NOFO.

2. Content and Form of Application Submission

Application Format Requirements

Section 4 of HRSA’s SF-424 R&R Application Guide provides general instructions for the budget, budget justification, staffing plan and personnel requirements, assurances, certifications, etc. You must submit the information outlined in the SF-424 R&R Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

See Section 8.5 of the HRSA SF-424 R&R Application Guide for the Application Completeness Checklist.

Application Page Limitation The total size of all uploaded files may not exceed the equivalent of 75 pages, when printed by HRSA.

The page limit includes the project narrative, budget justification narrative, attachments including biographical sketches (biosketches), and letters of commitment and support required in HRSA’s SF-424 R&R Application Guide and this NOFO.

Please note: Effective April 22, 2021, the abstract is no longer an attachment that counts in the page limit. The abstract is the standard form “Project Abstract Summary.”

Standard OMB-approved forms that are included in the workspace application package do NOT count in the page limitation. Biographical sketches do count in the page limitation. Note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-22-043, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) will not be counted in the page limit. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit of 75 pages will not be read, evaluated, or considered for funding.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline.

https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3321).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachment 12: Other Relevant Documents.

See Section 4.1 viii of HRSA’s SF-424 R&R Application Guide for additional information on all certifications.

Temporary Reassignment of State and Local Personnel during a Public Health Emergency

Section 319(e) of the Public Health Service (PHS) Act provides the Secretary of the Department of Health and Human Services (HHS) with discretion upon request by a state or tribal organization to authorize the temporary reassignment of state, tribal, and local personnel during a declared federal public health emergency. The temporary reassignment provision is applicable to state, tribal, and local public health department or agency personnel whose positions are funded, in full or part, under PHS programs and allows such personnel to immediately respond to the public health emergency in the affected jurisdiction. Funds provided under the award may be used to support personnel who are temporarily reassigned in accordance with § 319(e). Please reference detailed information available on the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) website via http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx.

Program Requirements

1. Recruit and train doctoral health service psychology students, interns, and post-doctoral residents in experiential training sites that provide integrated, interdisciplinary behavioral health for placement into community-based primary care settings in high need and high demand areas with two (2) or more health disciplines other than psychology, and also ensure at least twenty-five (25) percent of the time in the experiential training site(s) is in the delivery of OUD and other SUD prevention, treatment, and recovery services;

2. Provide stipend support to GPE doctoral health service psychology students, interns, and post-doctoral residents who are in their final experiential training and are committed to working in high need and high demand areas following graduation;

3. Establish or enhance academic and community-based partnerships to expand experiential site settings including academic institutions, K-12 schools, gerontology, criminal justice and community health centers to create a pipeline of well-trained, culturally responsive health service psychologists;

http://www.phe.gov/Preparedness/legal/pahpa/section201/Pages/default.aspx

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4. Enhance didactic and experiential training activities to develop competencies of doctoral health service psychology students, interns, and post-doctoral residents in integrated, interdisciplinary (in collaboration with two (2) or more health disciplines) team based care to address SDOH, teach strategies for providing tele-behavioral health, provider resiliency, trauma-informed care, OUD and other SUD, and other behavioral health concerns;

5. Enhance faculty development training and program content to include a holistic review strategy that assesses an individual’s SDOH factors alongside traditional mechanisms of providing behavioral health services in the provision of OUD and other SUD prevention, treatment, and recovery, tele-behavioral health services, and other relevant trainings such as provider resiliency, trauma-informed care;

6. Develop or enhance training that focuses on site supervisors and faculty from collaborating programs to create an infrastructure of skills and expertise, to support Drug Addiction Treatment Act (DATA-waived) Medication Assisted Treatment (MAT) prescribers as part of coordinated care teams;

7. Collaborate regularly during the period of performance with other GPE grant recipients (e.g. the grantee engagement platform, consortium developed by recipients in state or nearby states, etc.) to leverage resources, enhance integrated training, and collaborate across regions;

8. Recruit a workforce of health service psychologists to participate in the institutions’ programs of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, class backgrounds, and different genders and sexual orientations, interested in serving high need and high demand areas;

9. Follow-up with graduates to collect post-graduation employment demographics for at least one (1) year after program completion. Awardees should encourage doctoral psychology trainees to apply for a National Provider Identifier (NPI) number, and must collect the NPI numbers of doctoral psychology trainees who receive HRSA funds, where available;

10. Inform GPE students, interns, and post-doctoral residents of HRSA-sponsored loan repayment options such as the National Health Service Corps (NHSC) SUD Workforce Loan Repayment Program, the NHSC Rural Community Loan Repayment Program and the HRSA-sponsored SUD Treatment and Recovery (STAR) Loan Repayment Program. Additional information regarding the programs and eligibility can be found at https://nhsc.hrsa.gov/loan-repayment/index.html.

11. Inform GPE students, interns, and post-doctoral residents of the NHSC plan to provide psychologists who have completed the HRSA-22-043 GPE program with priority status when applying for NHSC LRP awards.

12. Use an evidence based continuous monitoring tool to evaluate program objectives and make adjustments as needed to improve program outputs and outcomes over the three (3) year project period;

13. Collect specified program and performance data, and disseminate findings to appropriate audiences; and

14. Collaborate regularly with the identified HRSA technical assistance provider, University of Wisconsin System, Madison throughout the duration and upon completion of the period of performance regarding technical assistance and evaluation of activities taking place under the grant as well as program impact.

HRSA-22-043 11

Program-Specific Instructions

Loan Repayment Programs – The NHSC is committed to strengthening the behavioral health workforce through the recruitment and retention of high quality behavioral health providers at NHSC-approved sites. The NHSC Loan Repayment Program (LRP) provides loan repayment assistance to behavioral health professionals in exchange for a commitment to serve in a Health Professional Shortage Area (HPSA). The NHSC plans to provide fully licensed psychologists who have completed the HRSA-22-043 GPE program with priority status when applying for NHSC LRP awards. Details concerning the priority status for fully licensed psychologists who have completed the HRSA-22-043 GPE Program will be announced in NHSC Application and Program Guidance (APG) beginning 2024.

In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 R&R Application Guide (including the budget, budget justification, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment. For information required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 R&R Application Guide.

The Abstract must include:

1. Project Title;

2. Program Type Applying for - indicate only one (1):

a. Doctoral Psychology School or Program or

b. Internship Program or

c. Post-Doctoral Residency Program;

3. A brief overview of the project as a whole;

4. Specific, measurable objectives that the project will accomplish;

5. Which of the clinical priorities will be addressed by the project, if applicable;

6. How the proposed project for which funding is requested will be accomplished

(e.g., the "who, what, when, where, why, and how" of a project); and

7. Statement indicating eligibility for funding preference (if applicable).

The project abstract must be single-spaced and is limited to one (1) page in length.

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria.

Any forms and attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria

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Purpose and Need (1) Purpose and Need

Response to Program Purpose:

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

(2) Response to Program Purpose

(a) Work Plan

(b) Methodology/Approach

(c) Resolution of Challenges

Impact:

(a) Evaluation and Technical Support Capacity

(b) Project Sustainability

(3) Impact:

(a) Evaluation and Technical Support Capacity

(b) Project Sustainability

Organizational Information, Resources, and Capabilities

(4) Organizational Information, Resources, and Capabilities

Budget and Budget Justification

Narrative

(5) Support Requested – the budget section should include sufficient justification to allow reviewers to determine the reasonableness of the support requested.

ii. Project Narrative

This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and well-organized so that reviewers can understand the proposed project. It must address the goals and purpose of the NOFO and the strategies to be used in attaining the goals and meeting the funding opportunity’s purpose.

Applicants who propose a tele-behavioral health component to their work plan are encouraged to reach out to one of the 12 HRSA-supported Regional Telehealth Resource Centers located at https://www.hrsa.gov/rural-health/telehealth/index.html, which provide technical assistance to organizations and individuals who are actively providing or interested in providing telehealth services to rural and/or underserved communities.

Please use the following section headers for the narrative:

PURPOSE AND NEED -- Corresponds to Section V’s Review Criterion #1

Briefly describe the purpose of the proposed project. Outline the needs of the training program or institution. Describe and document the targeted discipline and its training needs. Include a discussion of the target population served by this segment of the health workforce, as well as the SDOHs and health disparities impacting the population or communities served and/or unmet. Use and cite demographic data whenever possible to support the information provided.

This section will help reviewers understand the organization that would receive funding for training, as well as the needs of the communities that trainees would ultimately serve.

Please include the following:

https://www.hrsa.gov/rural-health/telehealth/index.html

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• The state and local health status indicators related to behavioral health, including overdose rate, and morbidity and mortality statistics of behavioral health and OUD and other SUD in the community;

• The demographics of the community and the experiential training site(s) population that trainees will serve, and their SDOH, behavioral health disparities, and access to behavioral health and substance use services, including trauma-informed care, that will be addressed through the proposed project;

• Existing or developing tele-behavioral health services at the experiential training sites and how tele-behavioral health will be used to improve access to care and training if applicable;

• The needs of the behavioral health workforce in the community, including recruitment and retention efforts of doctoral health service psychology students, interns, and post-doctoral residents, and how the community from the academic and community partnerships in the proposed project will benefit;

• The need for development or enhancement of the applicant training program and description of training models, curriculum, courses, rotations, seminars, tracks, and other innovative methods that prepares health service psychologists to practice in the provision of OUD and other SUD prevention, treatment, and recovery services;

• The need to provide integrated, interdisciplinary behavioral health for placement into community-based primary care settings with two (2) or more health disciplines;

• The institution’s experience increasing diversity of psychologists in the health workforce including participation in the institutions’ programs of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations. Include data on enrollment and graduation rates by gender, minority status and whether the trainees were from a disadvantaged background.

• The need for faculty development in behavioral health services including but not limited to OUD and other SUD prevention, treatment and, recovery services, and other relevant trainings such as provider resiliency, culturally appropriate service delivery, and trauma-informed care; and

• A description of the experiential training site(s) where the trainees will train and include the following information depicted in the Table 1 example as Attachment 4.

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Table 1

Site Name

Experiential Site Address

(EXAMPLE:

## Main Street, Town, State, Zip code)

Number of

GPE

Trainees

Number of trainee hours and weeks/ months at training site

Experiential training site offers OUD and other

SUD

prevention, treatment, and/or recovery services (yes/no)

Experiential training site offers tele-behavioral health services (yes/no)

Experiential training site integrates behavioral health into primary care (yes/no)

Experiential training site has interdisciplin ary training with two (2) or more disciplines (yes/no)

Number of psychologist s in the county of experiential training site location using the APA County Level Analysis of US Licensed Psychologist s

Mental Health or Facility

HPSA

score of the experiential using

Geographica l area considered Rural as defined by the HRSA Federal Office of Rural Health Policy

(FORHP)

as found in the Am I Rural tool https://www.apa.org/workforce/publications/15-county-analysis/report.pdf https://www.apa.org/workforce/publications/15-county-analysis/report.pdf https://www.apa.org/workforce/publications/15-county-analysis/report.pdf https://www.apa.org/workforce/publications/15-county-analysis/report.pdf https://www.apa.org/workforce/publications/15-county-analysis/report.pdf

HRSA-22-043 15

RESPONSE TO PROGRAM PURPOSE -- This section includes three sub-sections

— (a) Work Plan; (b) Methodology/Approach; and (c) Resolution of Challenges—all of which correspond to Section V’s Review Criteria #2 (a), (b), and (c).

(a) WORK PLAN -- Corresponds to Section V’s Review Criterion #2 (a).

Provide a detailed work plan that demonstrates your experience implementing a project of the proposed scope. Your work plan must be submitted through the Standardized Work Plan (SWP) Form located in the Grants.gov workspace. The SWP form is organized by budget period and must include all activities and deliverables for each objective and program goal. The program goals for this NOFO must be entered in the Program Goals section of the SWP form. For example, Goal 1 in the Purpose section of the NOFO will need to be entered as Goal 1 in the SWP form. Objectives and sub-objectives can be tailored to your project needs. Objectives may be tagged with organizational priorities by selecting applicable priorities on the SWP form. For the purpose of this NOFO, please write in COVID-19 or Health Equity in the “Other Priority Linkage” if your objective or sub-objectives align with those priorities. Form instructions are provided along with the SWP form, and are included in the application package found on Grants.gov.

You must complete the Standardized Work Plan (SWP) mandatory form in the Application Package.

The work plan must drive and align with the methodology and include the following:

• Description of the activities or steps, key partners, and staff responsible for achieving each of the objectives proposed during the entire period of performance identified in the Methodology section. Goals and objectives must be specific, measurable, achievable, realistic, and time framed. A sample tool to apply SMART goals can be found here;

• Description of the timeframes, deliverables, and key partners required during the grant period of performance to address each of the needs described in the Purpose and Need section;

• Explanation of how the work plan is appropriate for the program design and how the targets fit into the overall timeline of grant implementation and three (3) year period of performance;

• Identification of meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities, including the development of the application, and the extent to which these contributors address the cultural, racial, linguistic and/or geographic diversity of the populations and communities served; and

• If funds will be sub-awarded or expended on contracts, description of how your organization will ensure the funds are properly documented.

(b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion #2

(b).

Describe your objectives and proposed activities, and provide evidence for how they link to the project purpose and stated needs. Propose methods that you will use to address https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html

HRSA-22-043 16

the stated needs and meet each of the previously described program requirements and expectations in this NOFO.

Please include the methodologies, strategies, and approaches for the following:

• Building or enhancing academic and community partnerships that provide opportunity for doctoral health service psychology students, interns, and postdoctoral residents to train in an integrated, interdisciplinary, team-based care setting, in high need and high demand areas with two (2) or more health disciplines other than psychology;

• Improving access to behavioral health and substance use services in your community, particularly in the provision of OUD and other SUD prevention, treatment, and recovery services, along with the use of tele-behavioral health;

• Demonstrating that trainees will receive at least twenty-five (25) percent of the time in experiential training site(s) in the delivery of OUD and other SUD prevention, treatment, and recovery services;

• Training in tele-behavioral health in the experiential training site(s) and an estimate of the number of tele-behavioral health patient contacts per trainee during each year of the grant, if applicable;

• Creating a pipeline of well-trained, culturally responsive health service psychologists, addressing needs of the population served in the community, and committed to working in high need and high demand areas following graduation;

• Implementing experiential and didactic training, including the development or enhancement of curriculum that models and develops competencies in integrated, interdisciplinary behavioral health for placement into…