BHW HRSA-23-131 (M01) BHWET-CAY_FINAL.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2023

Bureau of Health Workforce

Division of Nursing and Public Health

Behavioral Health Workforce Education and Training- Children, Adolescents, and Young Adults (BHWET-CAY) Program for

Professionals Funding Opportunity Number: HRSA-23-131

Funding Opportunity Type(s): New

Assistance Listings Number: 93.732

Application Due Date: July 14, 2023 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 may take up to 1 month to complete.

Issuance Date: June 12, 2023

India Johns, DrPH, LCSW-C, BCD, PMH-C Project Officer, Division of Nursing and Public Health Email: BHWET-CAY@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 294e–1(a)(1)-(3) (Section 756(a)(1)-(3) of the Public Health Service Act) mailto:BHWET-CAY@hrsa.gov

HRSA-23-131 i

508 COMPLIANCE DISCLAIMER

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

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2023 Behavioral Health Workforce Education and Training-Children, Adolescents, and Young Adults (BHWET-CAY) Program for Professionals. The purpose of the BHWET-CAY Program for Professionals is to increase the supply and distribution of behavioral health professionals providing behavioral health services to children, adolescents, and young adults (CAY), and thereby increase access to behavioral health providers and services in rural1 and underserved communities. It also invests in the supply and training for clinical supervisors.

Funding Opportunity Title: Behavioral Health Workforce Education and Training- Children, Adolescents, and Young Adults (BHWET- CAY) Program for Professionals

Funding Opportunity Number:

HRSA-23-131

Due Date for Applications: July 14, 2023

Anticipated FY 2023 Total Available Funding:

$9,700,000

Estimated Number and Type of Award(s):

Up to 18 grants

Estimated Annual Award Amount:

Up to $530,000 per award

Cost Sharing/Match Required:

Not Required.

Period of Performance: September 30, 2023, through September 29, 2025 (2 years)

1 Rural, as def ined by HRSA’s Federal Office of Rural Health Policy.

https://www.hhs.gov/guidance/document/defining-rural-population#:%7E:text=The%20FORHP%20accepts%20all%20non-Metro%20counties%20as%20rural,counties%20with%20the%20codes%204-10%20are%20considered%20rural.

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Eligible Applicants: Accredited institutions of higher education or accredited professional training programs that are establishing or expanding internships or other field placement programs in mental health including in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing (which may include master’s and doctoral level programs), social work, school social work, substance use disorder prevention and treatment, marriage and family therapy, occupational therapy (which may include master’s and doctoral level programs), school counseling, or professional counseling, including such programs with a focus on child and adolescent mental health, trauma, and transitional-age youth;

Accredited doctoral, internship, and post-doctoral residency programs of health service psychology (including clinical psychology, counseling, and school psychology) for the development and implementation of interdisciplinary training of psychology graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, as well as the development of faculty in health service psychology; and

Accredited master’s and doctoral degree programs of social work for the development and implementation of interdisciplinary training of social work graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, and the development of faculty in social work.

Individuals are not eligible to apply under this NOFO.

Domestic community-based organizations, tribes and tribal organizations may also apply for these funds, if otherwise eligible.

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

HRSA-23-131 iii

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, except where instructed in this NOFO to do otherwise. Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

HRSA will hold a pre-application technical assistance (TA) webinar for applicants seeking funding through this opportunity. The webinar 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 to learn more about the resources available for this funding opportunity.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application 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

2. COST SHARING/MATCHING

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 Justif ication Narrative

v. Standardized Work Plan (SWP) Form,

vi. Program-Specific Forms

vii. Attachments

3. UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

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

APPENDIX A: PAGE LIMIT WORKSHEET

APPENDIX B – INSTRUCTIONS TO COMPLETE BHW PROGRAM SPECIFIC DATA FORM43

HRSA-23-131 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Behavioral Health Workforce Education and Training - Children, Adolescents, and Young Adult (BHWET-CAY) Program for Professionals.

The purpose of the BHWET-CAY Program is to increase the supply and distribution of behavioral health providers in rural and underserved communities to address the behavioral health needs of children, adolescents, and young adults (ages 16-25). The BHWET-CAY Program aims to address specific bottlenecks in recruiting and training behavioral health professionals including by providing stipends to support trainees during their clinical/experiential training and by increasing the supply of and training for clinical supervisors overseeing trainees.

Program Goals:

1. Establishing training opportunities (i.e., field placements, internships, etc.) for trainees in community-based settings serving children, adolescents, and young adults, prioritizing settings in underserved and rural communities.

2. Increasing the number of clinical supervisors for behavioral health professional trainees working with children, adolescents, and young adults and enhancing training opportunities for new and existing faculty and clinical supervisors focused on the behavioral health needs of children, adolescents, and young adults.

3. Providing assistance and supports to connect graduates with employment opportunities.

2. Background

The BHWET-CAY program seeks to increase the behavioral health workforce across disciplines, in rural and underserved areas, through collaboration with traditional and non-traditional community partners to provide experiential training sites and assist in connecting graduates with potential employment opportunities. Studies have shown that providing didactic and experiential training opportunities in underserved communities can influence providers to practice in those communities, as well as educating and engaging students who are from rural and

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underserved can increase the chances that they will practice in those settings.2

The prevalence of anxiety, depression, and other behavioral health challenges has increased for children, adolescents and young adults over the past decade. Additionally, pre-existing mental health challenges and substance use disorders for children and youth were exacerbated during the COVID-19 pandemic. From February to March 2021, emergency department visits in the United States for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same period in 2019.3 Suicide rates among Black children younger than age 13 have rapidly increased, with Black children being twice as likely to die by suicide than White children.4 In 2022, 45% of lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) youth seriously considered suicide over the past year. Socioeconomically disadvantaged children and adolescents are two to three times more likely to develop mental health conditions than peers with higher socioeconomic status.5 Given the increasing rates of behavioral health conditions and their disproportionate impacts among diverse populations of young people, the workforce would benefit from additional providers trained in providing developmentally appropriate behavioral health care for CAY.

The BHWET-CAY Program will support training that focuses on providing identification, assessment and treatment of behavioral health conditions for these vulnerable populations. It will support psychoeducation training to trainees, clinical supervisors, and staff to reduce barriers to behavioral health care for CAY, including stigma and inequity.

Program Definitions A glossary containing general definitions for terms used

2 Baum, N., King, J. (2020). The Behavioral Health Workforce in Rural America: Developing a National Recruitment Strategy, (February 2022). https://www.behavioralhealthworkforce.org/wp-content/uploads/2020/02/Recruitment-and-Retention-of-BH-Providers-Full-Report-2.2020.pdf 3 Yard, E., Radhakrishnan, L., Ballesteros, M. F., Sheppard, M., Gates, A., Stein, Z., Hartnett, K., Kite-Powell, A., Rodgers, L., Adjemian, J., Ehlman, D. C., Holland, K., Idaikkadar, N., Ivey- Stephenson, A., Martinez, P., Law, R., & Stone, D. M. (2021). Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12-25 Years Before and During the COVID-19 Pandemic - United States, January 2019-May 2021. MMWR. Morbidity and Mortality Weekly Report, 70(24), 888–894. https://doi.org/10.15585/mmwr.mm7024e1.

4 Bridge JA, Horowitz LM, Fontanella CA, et al. (2018). Age-Related Racial Disparity in Suicide Rates Among US Youths From 2001 Through 2015. JAMA Pediatrics, 172(7):697–699.

doi:10.1001/jamapediatrics.2018.0399.

5 National Center for Health Statistics. Health, United States, 2020–2021: Annual Perspective.

Hyattsville, MD. 2023. DOI: https://dx.doi.org/10.15620/cdc:122044.

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throughout the Bureau of Health Workforce NOFOs can be found at the Health Workforce Glossary. Additional definitions specific to the FY 2023 BHWET-CAY Program for Professionals can be found in Section VIII.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New.

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $9,700,000 to be available annually to fund up to 18 recipients. You may apply for a ceiling amount of up to $530,000 annually (reflecting direct and indirect costs) per year. At least 50 percent of the total requested budget per year must be dedicated to stipends only for BHWET-CAY trainees who are in their final year of experiential training (internship or field placement). All other costs, including indirect costs, must be budgeted out of the remaining 50 percent. Your request for each subsequent year of the period of performance cannot exceed your year 1 request.

The period of performance is September 30, 2023, through September 29, 2025 (2 years). Funding beyond the first year is subject to the availability of appropriated funds in subsequent fiscal years, satisfactory 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.

Limitations on Indirect Cost Rates

Indirect costs under training awards to organizations other than state or local governments or federally recognized Indian tribes, will be budgeted and reimbursed at 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 subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

https://bhw.hrsa.gov/grants/resourcecenter/glossary https://bhw.hrsa.gov/grants/resourcecenter/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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III. Eligibility Information

1. Eligible Applicants

For the purposes of this program, eligible applicants include:

• Accredited institutions of higher education or accredited professional training programs that are establishing or expanding internships or other field placement programs in mental health in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing (which may include master’s and doctoral level programs), social work, school social work, substance use disorder prevention and treatment, marriage and family therapy, occupational therapy (which may include master’s and doctoral level programs), school counseling, or professional counseling, including such programs with a focus on child and adolescent mental health, trauma, and transitional-age youth;

• Accredited doctoral, internship, and post-doctoral residency programs of health service psychology (including clinical psychology, counseling, and school psychology) for the development and implementation of interdisciplinary training of psychology graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, as well as the development of faculty in health service psychology; and

• Accredited master’s and doctoral degree programs of social work for the development and implementation of interdisciplinary training of social work graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, and the development of faculty in social work.

In addition to entities in the 50 states, eligible entities may be located in 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 community-based organizations, tribes, and tribal organizations may also apply for these funds, if otherwise eligible.

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

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Accreditation/Approval Documentation

Entities must be accredited by a nationally recognized accrediting body, as specified by the U.S. Department of Education. Applicants must provide a copy of their accreditation documentation, specifying the dates covered by the active accreditation, including expiration date, as Attachment 5. Doctoral-level schools and programs of health service psychology, professional psychology internships, and post-doctoral psychology residencies must provide documentation of their institution’s American Psychological Association (APA) or Psychological Clinical Science Accreditation System (PCSAS) accreditation.

All applicants must provide proof of accreditation. HRSA will consider any application that fails to submit Attachment 5 nonresponsive and will 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

Not required

3. Other

HRSA stipends are capped and anything above the cap has to be paid for by the grantee only for doctoral-level participants and only for students, interns, and doctoral residents/fellows where stipends exceed the BHWET allowable threshold.

This is required only for doctoral- level students where applicable, to cover any BHWET-CAY trainee stipend costs beyond $25,000, as well as doctoral-level interns, where applicable to cover any BHWET-CAY trainee stipend costs beyond $28,352, and doctoral-level residents/fellows, where applicable to cover any BHWET-CAY trainee stipend costs beyond $48,804 per geographic reimbursement requirements set by association requirements in order to ensure all interns/residents in a program are treated the same (e.g. equal stipends) whether supported by HRSA or not.

Clearly outline the difference between the doctoral-level student, doctoral-level intern, and post-doctoral resident/fellow stipend maximum amounts.

Any regional standard above the stipend maximum amount must be covered by the grant recipient using non-federal funding. Each applicant must include a written statement in the budget narrative justification that addresses the regional requirements for interns’ stipends set by the American Psychology Association.

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

• Exceeds the ceiling amount of $530,000 per year

• Fails to satisfy the deadline requirements referenced in Section

VII.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(b), §797(b) of the Public Health Service Act. Such federal funds are intended to supplement, not supplant, existing non-federal expenditures for such activities. Complete the Maintenance of Effort (MOE) information and submit as Attachment 4.

HRSA will enforce statutory MOE requirements through all available mechanisms.

Beneficiary Eligibility Requirement

A trainee receiving support from grant funds under this program must be a citizen, non-citizen national of the United States, an individual lawfully admitted for permanent residence to the United States, or any other “qualified alien” under section 431(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. 104-193, as amended. Individuals on temporary or student visas are not eligible to participate.

Multiple Applications

Multiple applications from an organization with the same Unique Entity Identifier (UEI) are not allowable.

HRSA will only accept your last validated electronic submission 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.

https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-information-kit/unique-entity-identifier-update https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-information-kit/unique-entity-identifier-update

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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 Grants.gov: HOW TO APPLY FOR GRANTS. If you use an alternative electronic submission, see Grants.gov: APPLICANT SYSTEM-TO-SYSTEM.

Form Alert: For the Project Abstract Summary, applicants using the SF- 424 R&R Application Package are encountering a “Cross-Form Error” associated with the Project Summary/Abstract field in the “Research and Related Other Project Information” form, Box 7. To avoid the “Cross-Form Error,” you must attach a blank document in Box 7 of the “Research and Related Other Project Information” form and use the Project Abstract Summary Form in workspace to complete the Project Abstract Summary.

See Section IV.2.i Project Abstract for content information.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-23-131 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 narrative, staffing plan and personnel requirements, assurances, certifications, etc. You must submit the information outlined in HRSA’s 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 budget figures expressed in 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 to assist you in completing your application.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/s2s/applicant-system-to-system.html https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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Application Page Limit

The total number of pages that count toward the page limit shall be no more than 50 pages when we print them. HRSA will not review any pages that exceed the page limit. Using the pages within the page limit, HRSA will determine eligibility using Section III. Eligibility Information of the

NOFO.

These items don’t count toward the page limit:

• Standard OMB-approved forms you find in the NOFO’s workspace application package

• Abstract (standard form (SF) "Project_Abstract Summary”)

• Indirect Cost Rate Agreement

• Proof of non-profit status (if it applies)

If there are other items that don’t count toward the page limit, we’ll make this clear in Section IV.2.vii Attachments.

If you use an OMB-approved form that isn’t in the HRSA-23-131 workspace application package, it may count toward the page limit. We recommend you only use Grants.gov workspace forms related with this NOFO to avoid going over the page limit.

Applications must be complete and validated by Grants.gov under HRSA-23-131 before the deadline.

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. § 3354).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachment 13: Other Relevant Documents.

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

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371

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Program Requirements

Successful recipients must address the following:

1. Provide stipend support to BHWET-CAY trainees who are in their final year of experiential training (internship or field placement) prior to graduation for no less than 6 consecutive months and no more than 12 consecutive months for full-time trainees. Part-time BHWET-CAY trainees are allowed to receive a stipend prorated at one-half of the fixed amount for no more than 24 consecutive months.

2. Develop or expand the number of experiential trainings sites (traditional, non-traditional, and community-based settings which could include tribal locations) in rural6 and underserved communities that prioritize cultural and linguistic competencies.

3. Recruit current students and clinical supervisors from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations into the BHWET-CAY Program.

4. Provide training to faculty, clinical supervisors, and BHWET-CAY trainees to increase the knowledge and understanding of the concerns of children and adolescents, and young adults exhibiting risk factors for or diagnosed with mental health or substance use disorders.

5. Recruit, develop, retain, and, when not otherwise funded, compensate clinical supervisors supporting field placements, internships, practicums, etc. for BHWET-CAY trainees.

6. Provide resources and support to BHWET-CAY trainees in securing employment post-graduation in in rural and underserved communities that provide behavioral health services to CAY.

Program-Specific Instructions

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

6 Rural, as def ined by HRSA’s Federal Office of Rural Health Policy.

https://www.hhs.gov/guidance/document/defining-rural-population#:%7E:text=The%20FORHP%20accepts%20all%20non-Metro%20counties%20as%20rural,counties%20with%20the%20codes%204-10%20are%20considered%20rural.

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Applicants are required to develop and upload (in Attachment 11) a disparities impact statement.

Award recipients must adhere to HHS Evaluation Policy and evaluation standards and best practices described in OMB Memorandum M-20-12 when evaluating their program. Award recipients are required to participate in federally designed evaluations to assess program effectiveness and efficiency upon request.

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form that is included in the workspace application package. Do not upload the abstract as an attachment or it may count toward the page limit. See Form Alert in Section IV.1 Application Package. For information required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 R&R Application Guide. When applicable, identify if a funding priority and/or preference is being requested.

The Abstract must include:

1. The discipline(s) for which you are applying

2. The requested funding amount

3. A brief overview of the project as a whole (i.e., proposed services, needs addressed, target population(s), etc.)

4. A summary of the proposed project goals for which funding is requested

5. How the proposed project will be accomplished (i.e., the “who, what, when, where, why, and how” of the project

6. Specific, measurable objectives that the project will accomplish (e.g., total number of new behavioral health professionals in training; total number graduated; total number employed in underserved or rural communities)

7. If applicable, a statement indicating eligibility for funding preference and/or funding priority

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NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, the table below provides a crosswalk between the narrative language and where each section falls within the review criteria. Any forms or attachments referenced in a narrative section may be considered during the objective review.

ii. Project Narrative Successful applications will contain the information below. Please use the following section headers for the narrative:

PURPOSE AND NEED -- Corresponds to Section V’s Review Criterion(a) 1

• Describe the need for behavioral health services for children, adolescents and young adults in the community-based settings your proposal seeks to address.

• Include a Disparities Impact Statement (DIS) in Attachment 11. The DIS is an instrument used to measure and describe how training will support trainees’ capacity to meet the needs of underserved populations.

Narrative Section Review Criteria

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

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• Include the BHW Program Specific Data Form. Applicants must complete the BHW Program Specific Data Form located in Appendix B and include it in Attachment 10.

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(a) 2 (a)

Provide a detailed work plan that demonstrates your ability to implement the project. 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 program goal. The Project Director must register in the HRSA electronic handbook (EHB) once an award is made, in order to review and finalize the completed SWP

In addition to completing the SWP, applicants should include a brief narrative of the elements outlined below:

• Explain how the work plan is appropriate for the BHWET-CAY Program for professionals.

• Describe the activities or steps you will use to achieve each of the proposed SWP objectives as described in the methodology section.

• Describe tools and strategies for ongoing training, outreach, collaborations, communication, and information sharing/dissemination with efforts to target communities.

• Describe the timeframes, deliverables, and key partners required to address each of the needs described in the Purpose and Need section.

• Identify the number, by discipline, of full-time and part-time BHWET- CAY trainees you expect to train in each year of the performance period.

• Identify, by discipline, where you intend to conduct community-based clinical training.

• Identify how you intend to deliver the proposed training. Describe strategies, tools and/or activities to address the health equity needs of CAY in rural and underserved communities.

• Describe how you intend to support graduates in securing employment in underserved and rural communities.

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(b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion 2 (b) In your application, and consistent with the Program Requirements and Expectations in this NOFO:

• Concisely describe your Standardized Work Plan objectives and proposed activities and how they link to the project purpose and stated needs.

• Describe methods that you will use to train students to address the stated needs of CAY in rural and underserved communities.

• Describe methods to develop tools and strategies for ongoing staff training, outreach, collaborations, clear communication, and information sharing/dissemination.

• Identify strategies, tools and/or activities to ensure that graduates are trained to meet the needs of the target population to be served.

• Identify meaningful support and collaboration with strategic partners and key stakeholders in planning, designing, and implementing all activities, including development of the application.

(c) RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion 2 (c)

• Describe plans to address challenges related to recruitment, retention, education, training, job placement, and career development of BHWET-CAY trainees in rural and underserved communities.

• Describe plans to resolve challenges related to partnering with experiential training sites and recruiting, supporting, and training supervisors to ensure BHWET-CAY trainees receive appropriate clinical supervision.

IMPACT -- This section includes two sub-sections— (a) Evaluation and Technical Support Capacity; and (b) Project Sustainability—both of which correspond to Section V’s Review Criteria 3 (a) and (b).

(a) EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion) 3 (a)

• Describe the plan for the program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation should monitor ongoing processes and the progress towards meeting the goals and objectives of the project.

Include descriptions of the inputs (e.g., organizational profile, collaborative partners, key personnel, budget, and other

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resources), key processes, variables to be measured, and expected outcomes of the funded activities. Evaluations must adhere to HHS Evaluation Policy and evaluation standards and best practices described in OMB Memorandum M-20-12.

• Describe the systems and processes that will enable you to meet HRSA’s performance measurement requirements for the BHWET-CAY Program. This should include your strategy for collecting, managing, and reporting required performance data in an accurate and timely manner. At the following link you will find examples of reporting forms required for other BHW nursing workforce development grants that include data elements that you may be required to collect:

http://bhw.hrsa.gov/grants/reporting/index.html. Note: Performance measures and data forms are subject to change each academic year.

• Describe how the trainings provided are routinely assessed and improved to meet the behavioral health needs of CAY.

• Describe your process to track BHWET-CAY trainees after graduation for up to 1 year. Note: BHWET-CAY trainees who receive HRSA funds as a result of this award are encouraged to apply for an NPI for the purpose of collecting post-graduation employment demographics.

(b) PROJECT SUSTAINABILITY -- Corresponds to Section V’s Review Criterion 3 (b)

• Propose a plan for project sustainability after the period of federal funding ends. Recipients are expected to sustain key elements of their projects that have been effective in improving practices and that have led to improved outcomes for the target population.

• Include a description of specific actions you will take to (a) highlight key elements of your grant projects, e.g., training methods or strategies (b) obtain future sources of potential funding; and (c) provide a timetable for becoming self-sufficient.

• Discuss challenges that are likely to be encountered in sustaining the program and approaches that will be used to resolve them.

• ORGANIZATIONAL INFORMATION, RESOURCES, AND CAPABILITIES --

Corresponds to Section V’s Review Criterion(a) 4

• Describe your organization’s current mission, structure, and scope of current activities and how these elements all contribute to the organization’s ability to achieve program goals.

• Discuss how the organization will properly account for the federal funds and document all costs to avoid audit findings.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Faspe.hhs.gov%2Fsites%2Fdefault%2Ffiles%2Fmigrated_legacy_files%2F200386%2Fhhs-evaluation-policy.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7Ca124bcd0f48f49734a0108db15bc1e92%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638127670798899539%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=8ueiCkmhVkYaEwk1haAQRR6UB0IB7m3eQjv0%2B2RKtiQ%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Faspe.hhs.gov%2Fsites%2Fdefault%2Ffiles%2Fmigrated_legacy_files%2F200386%2Fhhs-evaluation-policy.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7Ca124bcd0f48f49734a0108db15bc1e92%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638127670798899539%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=8ueiCkmhVkYaEwk1haAQRR6UB0IB7m3eQjv0%2B2RKtiQ%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.whitehouse.gov%2Fwp-content%2Fuploads%2F2020%2F03%2FM-20-12.pdf&data=05%7C01%7CSLevant%40hrsa.gov%7Ca124bcd0f48f49734a0108db15bc1e92%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638127670798899539%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=qATMeAfSr2NAO1sOf33W4zfnTuRU6iuGR1bs9i0X9PM%3D&reserved=0 http://bhw.hrsa.gov/grants/reporting/index.html

HRSA-23-131 15

• Include the staffing plan and job descriptions for key faculty/staff in Attachment 1. Describe the minimum qualifications for each faculty position in the job description. Functional and program responsibilities should be specified in the narrative and position descriptions. A position description should not exceed one page in length but can be as short as one paragraph in length due to page limits.

• Include an organizational chart for the proposed project. (Attachment 3)

• Include biographical sketches for key personnel in the SF-424 RESEARCH & RELATED Senior Key Person Profile (Expanded) form that can be accessed in the Application Package under “Mandatory.”

Even though the document has an OMB clearance number, it is not a standard form but a format, and so biographical sketches do count against the page limit. (See details below)

• Describe organizations who will partner with yours to fulfill the goals of the program and meet the training objectives.

• Include, noting overall page limits, select copies of agreements, letters of support or similar documents from key organizations/individuals of their willingness to perform in accordance with the plan presented in the application. (Attachments 3 and/or 8)

Biographical Sketches

Provide a biographical sketch for key faculty/staff contributing to the project. The information must be current, indicating the individual’s position and sufficient detail to assess the individual’s qualifications for the position being sought and consistent with the position description. Each biographical sketch should be limited to one page as they count toward the overall page limit. Include all degrees and certificates.

Biographical sketches should include the following information:

• Senior/key personnel name

• Position Title

• Education/Training - beginning with baccalaureate or other initial professional education, such as nursing, including postdoctoral training and residency training if applicable:

o Institution and location o Degree (if applicable) o Date of degree (MM/YY) o Field of study

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• Section A (required) Personal Statement. Briefly describe why the individual’s experience and qualifications make them particularly well-suited for their role (e.g., PD/PI) in the project that is the subject of the award.

• Section B (required) Positions and Honors. List in chronological order previous positions, concluding with the present position. List any honors.

Include present membership on any Federal Government public advisory committee.

• Section C (optional) Other Support. List both selected ongoing and completed (during the last 3 years) projects (federal or non-federal support). Begin with any projects relevant to the project proposed in this application. Briefly indicate the overall goals of the projects and responsibilities of the Senior/Key Person identified on the Biographical Sketch.

• When applicable, biographical sketches must include training, language fluency, and experience working with populations that are culturally and linguistically different from their own.

iii. Budget The directions offered in the SF-424 R&R Application Guide may differ from those offered by Grants.gov. Follow the instructions in Section 4.1.iv of HRSA’s SF-424 R&R Application Guide and any additional budget instructions provided below. A budget that follows the Application Guide will ensure that, if HRSA selects your application for funding, you will have a well-organized plan and, by carefully following the approved plan, may avoid audit issues during the implementation phase.

Refer to Section 4.1.iv of HRSA’s SF-424 R&R Application Guide for more details.

At least 50 percent of the total requested budget per year must be dedicated to stipends. Only BHWET-CAY trainees who are in their final year of experiential training (internship or field placement) are eligible for stipends. All other costs, including indirect costs, must be budgeted out of the remaining 50 percent.

Additional Budget Instructions:

Subawards/subcontracts

A detailed line-item budget form is required for each subaward and should be uploaded to the Subaward Budget Attachment(s) Form.

The R&R Subaward Budget Attachment Form limits the number of attachments for subawards to 10. If you need to include additional line-item budget forms, upload the attachment in R&R Other Project Information Form, block 12 “Other http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

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Attachments.” These additional line-item budget forms for subawards will not count against the page limit. Note that any additional budget justifications (i.e., back-up information) are included in the page limit.

Reminder: The Total Project or Program Costs are the total allowable costs (inclusive of direct and indirect costs) you incur to carry out a HRSA-supported project or activity. Total project or program costs include costs charged to the award and costs borne by you to satisfy a matching or cost-sharing requirement, as applicable.

As required by the Consolidated Appropriations Act, 2023 (P.L. 117-328), Division H, § 202, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II.” Effective January 2023, the salary rate limitation is $212,100. Note that these or other salary rate limitations may apply in the following fiscal years, as required by law.

Indirect costs under training awards to organizations other than state or local governments, or federally recognized Indian tribes, will be budgeted and reimbursed at 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, and subawards and subcontracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

Your request for each subsequent year of the period of performance cannot exceed your year 1 request.

iv. Budget Justification Narrative See Section 4.1.v. of HRSA’s SF-424 R&R Application Guide.

All budgets must provide sufficient details to fully explain and justify the resources needed to accomplish all program objectives.

In your application:

• Describe all line-item federal funds (including subawards) and matching non-federal funds proposed for this project. Please note: all budget justification narratives count against the page limit.

• Include an itemized budget and budget justification for each subaward and contract.

In addition, the BHWET-CAY Program for Professionals requires the following:

Participant/Trainee Support Costs: List stipends, and other trainee support costs, as applicable such as tuition/fees/health insurance, travel, subsistence, other, and the number of participants/trainees. Ensure that https://www.congress.gov/bill/117th-congress/house-bill/2617/text

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your budget breakdown separates these trainee costs, and includes a separate sub-total entitled “total Participant/Trainee Support Costs” which includes the summation of all trainee costs.

HRSA stipends are capped and anything above the cap has to be paid for by the grantee only for doctoral-level participants and only for students, interns, and doctoral residents/fellows where stipends exceed the BHWET allowable threshold. This is required for

• Doctoral- level Psychology, Occupational Therapy, and Psychiatric Nursing Internships, where applicable, to cover any student stipend costs beyond $28,352, as well as post-doctoral level Psychology residencies in practice psychology;

• Psychiatry residencies, and Developmental-Behavioral Pediatrics residencies, where applicable to cover any student stipend costs beyond $48,804 per geographic reimbursement requirements set by the applicable association (42 U.S.C. §295o; Section 798 of the Public Health Service Act).

• Any regional standard above the fixed stipend amount must be covered by the grant recipient using non-federal funding and must include a written statement in the budget narrative justification. Other federal funds cannot be used to fund the remainder of the stipend amount.

Please Note: 50 percent of the total funding requested per year is for stipends ONLY. All other requested participant support costs must be budgeted out of administration and program management.

Consultant Services: If you are using consultant services, list the total costs for all consultant services. In the budget justification, identify each consultant, the services they will perform, the cost per day/hour, total number of days and hours devoted to this project travel costs, and the total estimated costs.

Clinical Supervisor Support Costs: List support costs for clinical supervisors providing supervision to BHWET–CAY trainees. Ensure that your budget breakdown separates the number of support costs for each clinical supervisor, and includes a separate sub-total entitled “total Experiential Setting Supervision Support Costs” which includes the summation of all clinical supervisor costs.

HRSA-23-131 19

v. Standardized Work Plan (SWP) Form, As part of the application package submitted through Grants.gov, you must complete and electronically submit the SWP Form by the application due date. Ensure it includes all the information detailed in Section IV.2.ii. Project Narrative.

vi. Program-Specific Forms The BHW Program Specific Form is found in Appendix B of this NOFO for your reference. The form must be completed electronically and submitted as part of the official electronic application package.

vii. Attachments

Provide the following items in the order specified below to complete the content of the application. Unless otherwise noted, attachments count toward the application page limit. Your indirect cost rate agreement and proof of non-profit status (if applicable) will not count toward the page limit.

Clearly label each attachment. You must upload attachments into the application. HRSA and the objective review committee will not open/review any hyperlinked attachments.

Attachment 1: Staffing Plan and Job Descriptions for Key Personnel (Required)

See Section 4.1.vi. of HRSA’s SF-424 R&R Application Guide. Keep each job description to one page in length as much as is possible. Include the role, responsibilities, and qualifications of proposed project staff. Also, please include a description of your organization’s time keeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 2: Letters of Agreement, Memoranda of Understanding, and/or contracts (Required)

Provide any documents that describe working relationships between your organization and other entities and programs cited in the proposal.

Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and any deliverable. Make sure any letters of agreement are signed and dated. It is not necessary to include the entire contents of lengthy agreements, as the included document provides the information that relates to the requirements of the NOFO.

Attachment 3: Project Organizational Chart (Required) Provide a one-page figure that depicts the organizational structure of the project (not the applicant organization).

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Attachment 4: Maintenance of Effort (MoE) Documentation (Required) Provide a baseline aggregate expenditure for the prior fiscal year and an estimate for the next fiscal year using a chart similar to the one below. HRSA will enforce statutory MOE requirements through all available mechanisms.

The goal of the MOE documentation is to verify that federal…