FINAL_FORHP HRSA-22-163 (U2S) NBRC Health Workforce.pdf

U.S. Department of Health and Human Services

Federal Office of Rural Health Policy

Rural Strategic Initiatives Division

Rural Behavioral Health Workforce Centers – Northern Border Region Funding Opportunity Number: HRSA-22-163

Funding Opportunity Type: New

Assistance Listings (AL/CFDA) Number: 93.912

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

MODIFIED on June 13, 2022 to extend the Application Due Date

Application Due Date: July 13, 2022 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: April 22, 2022

Sarah O’Donnell Team Lead, Rural Strategic Initiatives Division Telephone: (240) 485-8285 Email: ruralopioidresponse@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: Section 711(b)(5) of the Social Security Act (42 U.S.C. 912(b)(5)) mailto:ruralopioidresponse@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 listed in Section VII.

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Rural Behavioral Health Workforce Centers – Northern Border Region (“RBHWCs”). The purpose of this program is to improve behavioral health care services in rural areas through educating and training future and current health professionals in treatment and interventions for behavioral health disorders, including substance use disorder (SUD).

Funding Opportunity Title: Rural Behavioral Health Workforce Centers – Northern Border Region

Funding Opportunity Number: HRSA-22-163

Due Date for Applications: July 13, 2022

Anticipated Total Annual Available FY 2022 Funding:

$625,000

Estimated Number and Type of Award: Up to one cooperative agreement

Estimated Annual Award Amount: Up to $625,000 per award

Cost Sharing/Match Required: No

Period of Performance: September 1, 2022 through August 31, 2025 (3 years)

Eligible Applicants: Eligible applicants include all domestic public or private, non-profit or for-profit entities. Eligible entities must be physically located in the state of New York.

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

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Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online, except where instructed in this NOFO to do otherwise.

Technical Assistance

HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Tuesday, May 10, 2022 Time: 2 – 3 p.m. ET Call-In Number: 1-833-568-8864 Participant Code: 161 901 1957 Weblink: https://hrsa-gov.zoomgov.com/j/1619011957

Following the webinar, please email Sarah O’Donnell (sodonnell@hrsa.gov) for a link to the recording.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa-gov.zoomgov.com/j/1619011957 mailto:sodonnell@hrsa.gov

HRSA-22-163 iii

Table of Contents

EXECUTIVE SUMMARY ..................................................................................................I TABLE OF CONTENTS ........................................................................................................ III

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

PROGRAM-SPECIFIC INSTRUCTIONS

i. Project Abstract

NARRATIVE GUIDANCE

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

3. Unique Entity Identifier (UEI) and System for Award Management (SAM) ……………………………………………………………………………………….22

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: ELIGIBLE RURAL NBRC COUNTIES AND CENSUS TRACTS IN NEW

YORK

APPENDIX B: EXAMPLES OF POTENTIAL STRATEGIC NETWORK MEMBERS . 40

APPENDIX C: RESOURCES FOR APPLICANTS

HRSA-22-163 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Rural Behavioral Health Workforce Centers – Northern Border Region (“RBHWCs”). The RBHWCs are a part of the Rural Communities Opioid Response Program, a multi-year HRSA initiative with the goal of reducing morbidity and mortality resulting from substance use disorder (SUD), including opioid use disorder (OUD), in high risk rural communities.

The RBHWCs will advance RCORP’s overall goal by improving behavioral health care services in rural areas through educating and training health professionals and community members to care for individuals with behavioral health disorders, including

SUD.

This program supports HRSA’s collaboration with the Northern Border Regional Commission (NBRC) to provide career and workforce training activities within the four-state NBRC region, in order to assist individuals with behavioral health needs, particularly SUD.

To this end, the RBHWCs will utilize a multi-sectoral, collaborative approach to enhance behavioral health care delivery within eligible rural NBRC counties and census tracts (see Appendix A) by developing and implementing training and mentorship programs focused on building the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health care needs.

In support of this goal, the RBHWCs will work towards achieving the following five objectives:

Objective 1: Form and sustain a multi-sectoral strategic network of key behavioral health and community services partners from across the target rural service area, to support the development and implementation of training and mentorship programs as well as recruitment of participants.

Objective 2: Assess resources, needs, and opportunities in the target rural service area as they relate to the program goal to inform future activities of the program, including an initial assessment in year one and ongoing updates in years two through three.

Objective 3: In collaboration with the strategic network, develop and implement training and mentorship programs that address identified gaps in the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health needs.

https://www.hrsa.gov/rural-health/rcorp/rural-behavioral-health-northern-border-region https://www.hrsa.gov/rural-health/rcorp https://www.nbrc.gov/

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Objective 4: In collaboration with the strategic network, develop and implement training and mentorship programs that address health equity and stigma as it relates to behavioral health.

Objective 5: Ensure that trainings and mentorship programs are available, accessible, and well-known throughout the entire target rural service area.

For more details, see Program Requirements and Expectations

Target Rural Service Area

Note that funding may only support activities and services in eligible rural NBRC counties and census tracts within the state of New York. Additionally, applicants must include in their target rural service area all eligible rural NBRC counties and census tracts for the state of New York (see Appendix A).

Services and resources supported by this funding must be available and easily accessible throughout the entire target rural service area. However, it is acceptable to more actively focus on communities with disproportionate levels of need within the target rural service area.

Applicants are encouraged to give special consideration to populations that have historically suffered from poorer health outcomes or health disparities, as compared to the rest of the rural population. Examples of these populations include, but are not limited to, homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.

2. Background

This program is authorized by Section 711(b)(5) of the Social Security Act (42 U.S.C.

912(b)(5)). HRSA’s Federal Office of Rural Health Policy (FORHP) is the focal point for rural health activities within the U.S. Department of Health and Human Services.

FORHP programs provide technical assistance and other activities as necessary to support improving health care in rural areas. For additional information about FORHP, please see https://www.hrsa.gov/rural-health/index.html.

The Northern Border Regional Commission (NBRC) is a federal-state partnership for economic and community development in Maine, New Hampshire, Vermont, and New York (for a list of counties included in the NBRC service area, https://www.nbrc.gov/).

The NBRC was formed by Congress in 2008, and each year the NBRC provides federal funds for critical economic and community development projects. Their mission is to catalyze regional, collaborative, and transformative community economic development approaches that alleviate economic distress and position the region for economic growth. The states of Maine, New Hampshire, Vermont, and New York partner with the NBRC to focus funding strategies and help prioritize investment applications.

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

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In FY 2021, HRSA awarded three cooperative agreements under the RBHWC program.

The recipients are located in Vermont, New Hampshire, and Maine. There is currently not a RBHWC recipient located in New York.

In 2020, 21 percent of individuals in rural areas with any mental illness and almost half of those with significant functional impairments resulting from their mental illness reported unmet need for mental health services.1 Some studies suggest that rural residents may not receive certain treatments for mental or behavioral health issues at the same rate as urban counterparts.2 Moreover, of the 5,733 mental health, health professional shortage areas (HPSAs) in the U.S., 3,363 (58.66 percent) are in rural areas, representing 25,327,659 people who do not have adequate access to mental health care providers. Additionally, more than half of rural counties still lack physicians with a waiver to prescribe buprenorphine.3 In the Northern Border Region, a total of 4,456,730 individuals live in a mental health HPSA in this area of the country, and only 33 percent of the need is met for mental health care providers.4

According to the 2019 National Survey on Drug Use and Health, adults aged 18 or older who experience mental illness are more likely to be users of illicit drugs, marijuana, misusers of opioids, or binge alcohol users.5

Nationally, drug overdose deaths have increased in both rural and urban counties over the past two decades. A March 2021 Data Brief from the National Center for Health Statistics (NCHS) reports that in rural counties, the age-adjusted rate of drug overdose deaths increased from 4.0 per 100,000 in 1999 to 19.6 in 2019 (urban counties increased from 6.4 to 22.0).6 Moreover, the states in the Northern Border Region experience some of the highest opioid-involved overdose death rates in the country.7

According to the provisional drug overdose death counts from NCHS, from August 2019 to August 2020, the number of drug overdose deaths is estimated to have increased by

36.3 percent in Maine, 23.3 percent in New York, 7.5 percent in New Hampshire, and

7.2 percent in Vermont.8

1 SAMHSA. (2020). Results from the 2020 National Survey on Drug Use and Health: Detailed Tables.

https://w ww.samhsa.gov/data/report/2020-nsduh-detailed-tables 2 Terlizzi EP, Zablotsky B.Mental health treatment among adults: United States, 2019. NCHS Data Brief, no 380. Hyattsvil le, MD:

National Center for Health Statistics. 2020.

3 Andril la, C. H. A., Coulthard, C., & Larson, E. H. (2017). Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder. The Annals of Family Medicine, 15(4), 359–362. https://doi.org/10.1370/afm.2099 4 Bureau of Health Workforce, HRSA, HHS. (2020, December). Designated Health Professional Shortage Areas Statistics.

https://data.hrsa.gov/Default/GenerateHPSAQuarterlyReport 5 SAMHSA. (2019a). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.

https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf 6 Hedegaard H, Spencer MR. Urban–rural differences in drug overdose death rates, 1999–2019. NCHS Data Brief, no 403.

Hyattsvil le, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi. org/10.15620/cdc:102891.

7 Opioid Summaries by State. (2020, July 15). National Institute on Drug Abuse. https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state 88 Ahmad FB, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2021.

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II. Award Information

1. Type of Application and Award

Type of applications sought: New

HRSA will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where HRSA anticipates substantial involvement with the recipient during performance of the contemplated project.

HRSA program involvement will include:

Providing input and guidance

• Providing guidance and assistance in identifying key organizations and stakeholders with which to share information on program activities, resources, and emerging needs and trends in the region;

• Providing guidance and assistance in identifying key organizations with whom to partner and collaborate (to include the facilitation of collaboration with other HRSA/federal partners);

• As appropriate, providing guidance, assistance, and participating in the planning of any meetings, educational/training/mentorship activities, or workgroups conducted during the period of the cooperative agreement;

• Identifying opportunities and providing guidance on strategies for disseminating information about activities and resources;

• Reviewing and providing input on activities, findings, resources, trainings, and other products developed under this award prior to public dissemination; and

• Providing input, guidance, and reviewing measures for monitoring program progress and outcomes.

Coordinating and Collaborating

• Coordinating with NBRC and RBHWC award recipients to prioritize activities and assess progress made in achieving the goals of this cooperative agreement;

• Collaborating with NBRC and RBHWC award recipients to address shifts in rural health care needs or HRSA priorities; and

• Collaborating with NBRC and RBHWC award recipients to identify opportunities for joint, coordinated projects that cover the entire NBRC rural service area.

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Sharing Information

• Sharing relevant FORHP and HRSA program data, as appropriate, to inform the efforts of the RBHWCs within the target rural service area.

The RBHWC cooperative agreement recipient’s responsibilities will include:

Coordinating and Collaborating

• Collaborating across all funded Northern Border Region RBHWCs;

• Coordinating and collaborating across all funded Northern Border Region RBHWCs on special, joint projects covering the entire rural NBRC service area, on topics which may include (but are not limited to) sustainability, data collection, and piloting new training approaches for health support workers;

• Directly engaging impacted populations within the target rural service area, including rural health care providers, health support workers, non-clinical staff, community members, and individuals with behavioral health disorders;

• Identifying and engaging key stakeholders from across a variety of sectors to create a sustainable, collaborative strategic network of key partners that will work in coordination with HRSA, NBRC, and the Northern Border Region RBHWCs to address the behavioral health care needs of the target rural service area;

• Building and maintaining a direct relationship with stakeholders and entities in the eligible rural NBRC counties and census tracts;

• Collaborating with HRSA and NBRC to address shifts in HRSA priorities or the needs of the target rural service area;

• Coordinating with HRSA and NBRC in the planning of any meetings, educational/training/mentorship activities, or workgroups conducted during the period of the cooperative agreement; and

• Coordinating with HRSA and NBRC to develop and maintain process and outcome measures to monitor project progress and impact.

Achieving Program Goals

• Ensuring all activities and resources directly benefit and address the behavioral health care needs of eligible rural NBRC counties and census tracts;

• Ensuring all activities and resources directly align with the stated program goals and objectives;

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• Ensuring all activities and resources are made easily accessible to eligible rural NBRC counties and census tracts, accounting for unique rural challenges such as lack of internet bandwidth, increased stigma, transportation, staffing shortages, etc.;

• Completing all program objectives and activities as proposed by the applicant, except as modified in consultation with HRSA through the appropriate prior approval processes; and

• Planning timelines to allow sufficient time for HRSA to review and provide input on activities, findings, resources, trainings, and other products developed under this award prior to public dissemination.

Sharing Information

• Informing HRSA and NBRC partners of emerging needs and trends in the region;

• Providing input to HRSA on the future direction of rural behavioral health care programs based on identified needs;

• Sharing information with HRSA, NBRC, and the Northern Border Region RBHWCs on methods and processes for collecting data and monitoring project progress and outcomes; and

• Sharing any data collected with HRSA, NBRC, and the Northern Border Region RBHWCs, as needed.

2. Summary of Funding

HRSA estimates approximately $625,000 to be available annually to fund one recipient.

You may apply for a ceiling amount of up to $625,000 total cost (includes both direct and indirect, facilities and administrative costs) per year.

The period of performance is September 1, 2022 through August 31, 2025 (3 years).

Funding beyond the first year is subject to the availability of appropriated funds for RBHWC in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

HRSA may reduce or take other enforcement actions regarding recipient funding levels beyond the first year if they are unable to fully succeed in achieving the goals listed in the application.

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

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

Eligible applicants include all domestic public or private, non-profit or for-profit entities.

Eligible entities must be physically located in New York.

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

• Proposes a service area that does not include all HRSA-designated rural counties and rural census tracts within the New York NBRC service area, as listed in Appendix A.

• Proposes a service area that includes counties or census tracts that are not within in the rural New York NBRC service area, as listed in Appendix A.

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

NOTE: Multiple applications from an organization are not allowable.

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.

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 workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at Grants.gov: HOW TO

APPLY FOR GRANTS.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html 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-22-163 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 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 the HRSA SF-424 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 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 Application Guide for the Application Completeness Checklist.

Application Page Limitation The total size of all uploaded files included in the page limit shall be no more than the equivalent of 50 pages when printed by HRSA. The page limit includes the project and budget narratives, and attachments required in the 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 (SF) "Project_Abstract Summary.” Standard OMB-approved forms included in the workspace application package do not count in the page limit. If you use an OMB-approved form that is not included in the workspace application package for HRSA-22-163, 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. Additionally, Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count 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 50 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 HRSA-22-163 before the deadline.

https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.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. § 3354).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachment 6-15: Other Relevant Documents.

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

Program Requirements and Expectations

Applicants must have demonstrated experience serving HRSA-designated rural counties and rural census tracts within the NBRC service area in New York, as listed in Appendix A.

All planned activities supported by this program must exclusively target the HRSA-designated rural counties and rural census tracts within the NBRC service area in New York, as listed in Appendix A. Within partially rural counties, only HRSA-designated rural census tracts are eligible to receive activities and services supported by this award. For your reference, a list of HRSA-designated rural census tracts is available here.

Services and resources supported by this funding must be available and easily accessible throughout the entire target rural service area of all eligible rural NBRC counties and census tracts in New York, as listed in Appendix A. However, it is acceptable to more actively focus on communities with disproportionate levels of need within the target rural service area.

Additionally, all funded activities must support the program goal and five objectives:

Goal: Utilize a multi-sectoral, collaborative approach to enhance behavioral health care delivery within eligible rural NBRC counties and census tracts (see Appendix A) by developing and implementing training and mentorship programs focused on building the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health care needs.

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 https://data.hrsa.gov/Content/Documents/tools/rural-health/forhpeligibleareas.pdf

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• Objective 1: Form and sustain a multi-sectoral strategic network of key behavioral health and community services partners from across the target rural service area, to support the development and implementation of training and mentorship programs as well as recruitment of participants.

• Objective 2: Assess resources, needs, and opportunities in the target rural service area as they relate to the program goal to inform future activities of the program, including an initial assessment in year one and ongoing updates in years two through three.

• Objective 3: In collaboration with the strategic network, develop and implement training and mentorship programs that address identified gaps in the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health needs.

• Objective 4: In collaboration with the strategic network, develop and implement training and mentorship programs that address health equity and stigma as it relates to behavioral health.

• Objective 5: Ensure that trainings and mentorship programs are available, accessible, and well-known throughout the entire target rural service area.

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

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 limitation. For information required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 Application Guide.

Please also include the following information in addition to the required information requested in the Project Abstract Summary Form:

• Applicant organization facility type (e.g., critical access hospital, State Office of Rural Health (SORH), tribal organization, federally qualified health center, rural health clinic, institution of higher learning, public health department, etc.).

• Identify how the applicant learned about this funding opportunity (e.g., State Office of Rural Health (SORH), Grants.gov, HRSA news release, etc.).

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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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.

Narrative Section Review Criteria

Introduction (1) Need

Needs Assessment (1) Need

Methodology (2) Response and (4) Impact

Work Plan (2) Response

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures

Organizational Information (5) Resources/Capabilities

Budget Narrative (6) Support Requested

ii. Project Narrative

This section provides a comprehensive description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and organized in alignment with the sections and format below so that reviewers can understand the proposed project.

Use the following section headers for the narrative:

INTRODUCTION -- Corresponds to Section V’s Review Criterion #1: Need

The Introduction section should:

• Clearly and succinctly summarize the key strategies and activities of the proposed project, and how they will support the program goals and objectives.

• Briefly summarize the characteristics and needs of the proposed target population and target rural service area.

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NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion #1: Need

The Needs Assessment section should:

• Describe the needs of the target population, as they relate to the program goals. Include information on any impacted subpopulations who have historically suffered from health disparities. These populations may include, but are not limited to, homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.

• Provide supporting data and statistics derived from appropriate, reliable sources that reflect the most recent timeframe available.

• Where possible, compare local data to state and federal data to highlight the need of the target rural service area.

METHODOLOGY -- Corresponds to Section V’s Review Criteria #2: Response and #4: Impact

The Methodology Section should provide clear, actionable strategies and activities for how you will achieve each of the program objectives. All proposed strategies and activities should directly support the program goal as stated below, with an emphasis on substance use disorder:

Enhance behavioral healthcare delivery within eligible rural NBRC counties and census tracts (see Appendix A) by developing and implementing training and mentorship programs focused on building the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health care needs.

NOTE: While the RBHWCs may define behavioral health care services broadly, applicants must also demonstrate a specific focus on substance use disorder, in line with the RCORP initiative.

To that end, the Methodology section should include the following for each objective:

• Objective 1: Form and sustain a multi-sectoral strategic network of key behavioral health and community services partners from across the target rural service area, to support the development and implementation of training and mentorship programs as well as recruitment of participants.

o Describe in detail how you will identify and engage key stakeholders and partners from a variety of sectors to create a formal strategic network that will work collaboratively to coordinate the project’s activities in support of the program goal.

o Describe how the strategic network will be structured, managed, and maintained. Appendix B contains examples of organizations that may be included in the strategic network.

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o Detail how the strategic network will be sustained after the period of performance ends.

o Detail how the strategic network will address the unique needs of underserved sub-populations within the target population (such as homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.).

o Describe how the strategic network will collaborate with HRSA, NBRC, the Northern Border Region RBHWCs, and other key stakeholders and partners to identify and share information on emerging priorities and community needs.

o Detail the strategic network’s approach to flexibly adapting to any changes that might be required as a result of shifting priorities and needs.

NOTE: The strategic network must plan to work collaboratively with HRSA, the NBRC, and other RBHWCs throughout the period of performance. Additionally, a majority of members in each strategic network must be located within the eligible rural NBRC counties and census tracts (see Appendix A).

• Objective 2: Assess resources, needs, and opportunities in the target rural service area as they relate to the program goal to inform future activities of the program, including an initial assessment in year one and ongoing updates in years two through three.

o Describe how, within in the first six months of the project, the strategic network will conduct an initial assessment and analysis of existing resources, needs, and opportunities in the target rural service area as they relate to the program goal.

o Describe how, after the initial assessment, the strategic network will continually assess progress, successes, challenges, and evolving community health care needs throughout the project, in support of the program goal.

o Describe how the initial and ongoing assessments will address issues pertinent to the program goal, including the behavioral health training needs of rural health care providers, health support workers, non-clinical staff, and community members.

o Detail how the strategic network will directly engage impacted populations in the initial and ongoing assessments, including rural health care providers, health support workers, non-clinical staff, and individuals and families impacted by behavioral health disorders.

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o Describe how the strategic network will coordinate with HRSA, NBRC, other Northern Border Region RBHWCs, and key rural partners and stakeholders in conducting the initial and ongoing assessments. A full (non-exhaustive) list of potential stakeholders and partners is available in Appendix B.

o Detail how the results of the initial and ongoing assessments will be used to inform future project activities.

• Objective 3: In collaboration with the strategic network, develop and implement training and mentorship programs that address identified gaps in the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health needs.

o Detail how the strategic network will use the results of the assessment to develop training and mentorship programs that address gaps in the skills and capacity of rural health care providers, health support workers, non-clinical staff, and community members to care for individuals with behavioral health needs.

o Explain how the strategic network will ensure that trainings account for the unique needs of vulnerable sub-populations within the target population (such as homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.).

o Provide detailed, specific, and actionable strategies for how the strategic network will implement training and mentorship programs in the target rural service area to address identified needs.

o Detail how the strategic network will leverage existing resources at the federal, state, and local levels and avoid duplication in the creation of training and mentorship programs.

o Describe in detail how the strategic network will measure the impact of training and mentorship programs and use that information to inform future programming.

• Objective 4: In collaboration with the strategic network, develop and implement training and mentorship programs that address health equity and stigma it relates to behavioral health.

o Detail how the strategic network will use the results of the assessment to develop training and mentorship programs that address stigma and health equity among rural health care providers, health support workers, non-clinical staff, and community members that care for and interface with individuals with behavioral health needs.

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o Explain how the strategic network will ensure that trainings account for the unique needs of vulnerable sub-populations within the target population (such as homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.).

o Provide detailed, specific, and actionable strategies for how the strategic network will implement training and mentorship programs in the target rural service area to address identified needs.

o Describe how the strategic network will use trainings and mentorship programs to build connections between rural behavioral health care providers and community services such as job readiness programs, transportation services, etc.

o Detail how the strategic network will leverage existing resources at the federal, state, and local levels and avoid duplication in the creation of training and mentorship programs.

o Describe in detail how the strategic network will measure the impact of training and mentorship programs and use that information to inform future programming.

• Objective 5: Ensure that trainings and mentorship programs are available, accessible, and well known throughout the entire target rural service area.

o Describe in detail how the strategic network will ensure that rural health care providers, health support workers, non-clinical staff, and community members will be able to both access and participate in relevant training and mentorship programs.

o Describe in detail how the strategic network will actively and directly engage rural health care providers, health support workers, non-clinical staff, and community members to recruit participants for training and mentorship programs.

o Explain how the strategic network will account for the unique challenges of rural areas when ensuring access to and participation in training and mentorship programs, such as lack of internet bandwidth, increased stigma, transportation issues, staffing shortages, and others.

o Explain how the strategic network will ensure that vulnerable sub-populations within the target rural service area (such as homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.) are able to access and participate in trainings and mentorship programs.

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WORK PLAN -- Corresponds to Section V’s Review Criterion #2: Response

Provide a clear and coherent work plan in Attachment 1. It is recommended that you provide your work plan in table format. The work plan activities should align with the activities proposed throughout your methodology section, and should include the following:

• Specific activities that you will undertake to achieve project objectives and goals;

• Responsible individual for each activity;

• Timeline for completion of each activity.

NOTE: Applicants should plan to complete the initial assessment of needs, resources, and opportunities within the first 6 months of the project.

RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion #2: Response

The Resolution of Challenges Section should:

• Describe challenges that you are likely to encounter in carrying out the activities described in the work plan. Specifically, consider any challenges that are unique to working with rural communities within the target service area, forming and maintaining a strategic network, and addressing the needs of vulnerable populations within the target rural service area.

• Identify specific, actionable approaches that you will use to resolve each challenge.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion #3: Evaluative Measures

The Evaluation and Technical Support Capacity Section should:

• Describe how the strategic network will track progress towards completing the project’s objectives and activities as outlined in the work plan. Include specific, measurable, time-bound process measures where applicable.

• Propose five to seven outcome measures and describe how these measures could be used to assess the project’s progress towards achieving the program goals.

• Describe how the strategic network will coordinate with HRSA and the NBRC to refine a unified set of outcome measures across the RBHWCs program.

• Provide a specific and actionable plan for how your strategic network will collect, monitor, and analyze process and outcome measures to determine if the project is proceeding as anticipated and achieving the desired outcomes.

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• Describe how you will use information from the process and outcome measures to inform and adjust project activities, as necessary and in collaboration with HRSA.

ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion #5: Resources/Capabilities

The Organizational Information Section should:

• Describe the following about your organization, with a particular focus on your organization’s experience with and knowledge of rural behavioral health care workforce, particularly SUD:

o Current mission, structure, and scope of current activities;

o Clear, specific, demonstrated ability to meet program requirements and achieve program goals and objectives;

i. Include specific examples of your previous experience working to enhance behavioral healthcare delivery in rural areas.

ii. Include specific examples of your previous experience developing and delivering trainings to rural health care providers, health support workers, non-clinical staff, and community members.

iii. NOTE: If your organization does not have direct, specific experience in either of the above areas, explain how this experience will be consistently and robustly represented in the strategic network.

o Clear, specific, demonstrated ability to implement activities and strategies as proposed in the methodology and work plan;

o Experience with directly engaging impacted populations within New York’s eligible rural NBRC counties and census tracts, including rural health care providers, health support workers, non-clinical staff, and community members caring for individuals with behavioral health care needs, as well as individuals with behavioral health disorders;

o Experience with identifying, engaging and collaborating with other federal, state, and local entities and programs to achieve project goals;

i. Include specific examples of your previous experience that demonstrates your ability to engage and collaborate with HRSA, the NBRC, and your proposed strategic network partners.

o Ability to form and maintain a strategic network of key local, state, and regional partners and stakeholders; and o Ability to properly account for the federal funds and document all costs to avoid audit findings.

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• In Attachment 2, include a one-page organizational chart that clearly depicts the location of the project management and oversight within the applicant organization.

• In Attachment 3, include dated letters of support from any partners/stakeholders that will have a significant impact on the ability of the applicant organization to execute the proposed project methodology. While there is no minimum required number of letters of support, you must provide letters from any organization or entity that will have a key role in the project.

At least 50 percent of the letters of support should be from organizations located within the target rural service area. The letter of support may be in any format, including email, and must include the following:

o The organization’s anticipated roles and responsibilities in the project, o How the organization’s expertise is relevant to the project, o The organization’s address, including city, state, and ZIP code, and o Whether the organization is located in the target rural service area.

• In Attachment 4, provide a staffing plan that directly links to the methodology and activities proposed in the work plan. In the staffing plan, include the following information for each proposed project staff member o Name o Title o Organizational affiliation o Full-time equivalent (FTE) devoted to the project o List of roles/responsibilities on the project o NOTE: The staffing plan must identify a Project Director with a minimum time commitment of .25 FTE, who will manage the project and engage both the community and key stakeholders to fulfill the proposed project activities in the work plan. The Project Director is typically the primary point of contact and leadership for the award, directs project activities, and makes staffing, financial, or other adjustments to align project activities with the project outcomes. You should clearly demonstrate that the Project Director has appropriate and applicable experience for leading the project. If the Project Director serves as a Project Director for other federal awards, please list the other federal awards in the staffing plan, as well as the percent FTE for the respective federal award(s). Project Directors cannot bill more than 1.0 FTE across federal awards. Ensure that you list the designated Project Director in Box 8f of the SF-424 Application Page.

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o NOTE: You are expected to immediately operationalize the proposed approach upon receipt of the award. To this end, if there are any positions that are vacant at the time of application include in the staffing plan a timeline and process for rapidly filling these positions, as well as a projected start date.

• In Attachment 5, provide a resume and/or biographical sketch for each proposed project staff member, which describes their qualifications and relevant experience for fulfilling their designated role in the project. If a position is vacant at the time of application, provide the position description you will use in the hiring process.

iii. Budget

The directions offered in the SF-424 Application Guide may differ from those offered by Grants.gov. Follow the instructions in Section 4.1.iv of HRSA’s SF-424 Application Guide and the 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.

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.

In addition, RBHWC requires the following:

Travel

You are expected to budget for the following trips:

• A three-day program meeting in Washington, DC, once in every project year.

• A two-day regional program meeting, two times during the period of performance. For budgeting purposes, you can assume that this will take place within the Northern Border Regional Commission region.

HRSA will work with award recipients to make any budget adjustments, once the details of these meetings are finalized.

Note that you may also propose additional meetings and conferences to attend, which are directly related to the purpose of the program and will support achievement of project goals and objectives.

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As required by the Consolidated Appropriations Act, 2022 (P.L. 117-103), 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.” See Section 4.1.iv Budget – Salary Limitation of HRSA’s SF-424 Application Guide for additional information. Note that these or other salary limitations may apply in the following fiscal years, as required by law.

iv. Budget Narrative

See Section 4.1.v. of HRSA’s SF-424 Application Guide.

In addition, RBHWC requires the following:

Applicants must provide a budget and budget narrative for each year of the three-year period of performance.

v. 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 limitation. Your indirect cost rate agreement and proof of non-profit status (if applicable) will not count toward the page limitation. Clearly label each attachment.

You must upload attachments into the application. Any hyperlinked attachments will not be reviewed/opened by HRSA.

Attachment 1: Work Plan

Attach a clear and coherent work plan. It is recommended that you provide your work plan in table format.