Foa_Content_of_HHS-2022-ACL-AOD-DDMH-0084.pdf

Administration for Community Living

Administration on Disabilities

PNS: Co-Occurring Resource Center for Individuals with ID/DD

HHS-2022-ACL-AOD-DDMH-0084

06/21/2022

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

I. Funding Opportunity Description

II. Award Information

III. Eligibility Information

1. Eligible Applicants

2. Cost Sharing or Matching

3. Responsiveness and Screening Criteria

IV. Application and Submission Information

1. Address to Request Application Package

2. Content and Form of Application Submission

Letter of Intent

Project Narrative

SUMMARY/ABSTRACT

STATEMENT OF NEED

GOALS AND OBJECTIVES

PROPOSED APPROACH

OUTCOMES

ORGANIZATIONAL CAPABILITY & PROJECT MANAGEMENT

PROJECT WORK PLAN

LETTERS OF COMMITMENT FROM KEY PARTICIPATING ORGANIZATIONS AND

AGENCIES

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

4. Submission Dates and Times

5. Intergovernmental Review

6. Funding Restrictions

7. Other Submission Requirements

V. Application Review Information

1. Criteria

2. Review and Selection Process

3. Anticipated Announcement Award Date

VI. Award Administration Information

1. Award Notices

2. Administrative and National Policy Requirements

3. Reporting

4. FFATA and FSRS Reporting

VII. Agency Contacts

VIII. Other Information

The Paperwork Reduction Act of 1995 (P.L. 104-13)

Appendix

Instructions for Completing Required Forms

Budget Narrative/Justification- Sample Format

Instructions for Completing the Project Summary/ Abstract

ACL Center:

Administration on Disabilities Funding Opportunity Title:

PNS: Co-Occurring Resource Center for Individuals with ID/DD Funding Opportunity Number:

HHS-2022-ACL-AOD-DDMH-0084

Primary CFDA Number:

93.631 Due Date for Letter of Intent:

05/10/2022 Due Date for Applications:

06/21/2022 Date for Informational Conference Call:

05/18/2022 Applications that fail to meet the application due date will not be reviewed and will receive no further consideration. You are strongly encouraged to submit your application a minimum of 3-5 days prior to the application closing date. Do not wait until the last day in the event you encounter technical difficulties, either on your end or, with https://www.grants.gov. Grants.gov can take up to 48 hours to notify you of a successful submission.

Executive Summary Additional Overview Content/Executive Summary The Administration for Community Living’s (ACL) mission is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, their families, and their support networks. ACL was created around the fundamental principle that older adults and people of all ages with disabilities should be able to live where they choose, with the people they choose, and with the ability to participate fully in their communities.

ACL’s Administration on Disabilities (AoD) will award under the Projects of National Significance (PNS) program one competitive, five-year cooperative agreement to establish a https://www.grants.gov/ national, person-centered, culturally competent training center for building capacity in state and local service systems to support individuals with co-occurring intellectual and developmental disabilities (ID/DD) and mental health disabilities living well. The Center will be guided by people with lived experience, including those from underserved communities, and will provide training, peer-to-peer learning, and resources to individuals, family members, and professionals working with people with ID/DD and mental health disabilities, including mental health professionals and direct support professionals. The National Resource and Technical Assistance Center (Center) will also support state agencies by providing resources related to policy development, service design, and service coordination across agencies.

I. Funding Opportunity Description

A. STATEMENT OF NEED

According to a report on home and community-based services for people with co-occurring ID/DD and mental health needs “people with IDD who have dual diagnosis or who present behavioral ‘challenges’ are more likely to be institutionalized and are often the last to get out of institutions.[1] Often this exclusion from community living begins when youth with ID/DD are still in school. Research suggests that punitive measures that occur throughout school systems such as zero tolerance policies, restraint and seclusion practices, and unnecessary referrals to law enforcement, including school resource officers, result in the School-to-Prison Pipeline for youth with disabilities. A 2015 report from the National Council on Disability found that “among incarcerated youth, 85 percent have learning and/or emotional disabilities, yet only 37 percent receive special education in school. Most were either undiagnosed or not properly served in school.”[2] This initiative aims to support individuals with ID/DD and mental health disabilities to live well in the community, including through diversion and re-entry practices.

Even when not institutionalized, individuals with ID/DD who have co-occurring mental health disabilities often experience inequities to living well in the community[3]. The 2008-2009 National Core Indicators Consumer Survey Report[4] found significant differences in outcomes between individuals with and without co-occurring mental health disabilities. The data showed that individuals with co-occurring ID/DD and mental health disabilities were more likely to live in a group home than an independent living setting. Additionally, those with co-occurring ID/DD and mental health disabilities were somewhat less likely to be in excellent or very good health.

While no significant statistical difference was found among rates of employment between these groups, people with co-occurring ID/DD and mental health disabilities earned less income than individuals with ID/DD only. Individuals with co-occurring ID/DD and mental health disabilities also were less likely to report having friends and were significantly more likely to report feeling lonely. ACL seeks to improve these circumstances and quality of life for people with ID/DD and mental health disabilities through this initiative.

Prevalence of co-occurring ID/DD and mental health disabilities is difficult to attain due to lack of reporting across siloed service systems, variance in the way these disabilities are defined, and diagnostic overshadowing, in which a mental health disability might go undiagnosed as behaviors or symptoms are misattributed to the developmental disability diagnosis.[5] Despite this, several sources suggest that individuals with ID/DD experience a higher rate of mental health conditions across the lifespan. According to the National Association of Dual Diagnosis, most professionals currently accept that roughly 35% of people with intellectual disabilities also experience mental health disabilities. The National Core Indicators survey data from 2017-2018 of over 22,500 individuals with ID/DD found that approximately 48% have one of four diagnoses: mood disorder, anxiety disorder, psychotic disorder, or other mental health diagnosis, with a range of 34% to 64% across 35 states and the District of Columbia[6]. A study conducted by the Boston Children’s Hospital and Harvard Medical School found the prevalence of ID/DD and co-occurring mental illness to be around 40%, with “persistent mental ill-health” around 30%.[7]

In 2003, the National Association of State Mental Health Program Directors (NASMHPD) hosted a meeting on co-occurring mental illness and developmental disabilities with a focus on systems barriers and strategies for reform. The report from this meeting identified the following values that meeting participants agreed should drive the vision for a coordinated service delivery system:

Plans of care should be driven by the needs of each individual.

Self-advocates should be involved at all levels of decision-making.

Community integration and reducing stigma should be principal goals.

Coordinated service delivery systems should be culturally informed and responsive.

Coercion and violence should be eliminated in all setting in which services, supports, or treatment are provided. [8]

ACL seeks to support these values through the work of this national resource and technical assistance center. ACL also aims to advance trauma-informed practices and services through this center. According to the National Child Traumatic Stress Network, youth with ID/DD are at increased risk for physical and sexual abuse, restraint, seclusion, and emotional neglect, all of which can result in trauma. Additionally, people with ID/DD may experience trauma because of chronic medical conditions that result in invasive procedures.[9] Applicants should describe how they will promote and educate about trauma-informed practices in the work of this center.

Given that individuals with co-occurring intellectual and developmental disabilities and mental health disabilities have historically been marginalized and left out of efforts to increase equity and be included in the community, authentic engagement and a high level of participation of people with these disabilities will be critical to the success of this project.[10] Applicants should describe how people with ID/DD and mental health disabilities will be meaningfully included at all stages of planning and implementing this project, including those who are from underserved communities, as defined in the Administration’s Executive Order on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government (E.O.

13985)[11] and referenced in Subsection I.F. below. The Center will also be guided by principles of equity, community living, and self-determination (These definitions are included in Subsection I.F.).

B. PROGRAM HISTORY AND BACKGROUND

The U.S. Department of Health and Human Services (HHS) has made a significant investment in the expansion of mental and behavioral health services. In FY2022, HHS, through the Substance Abuse and Mental Health Services Administration (SAMHSA):

Expanded the Community Mental Health Block Grant;

Funded the Mental Health Awareness Training program;

Increased mental health supports for youth through funding the National Child Traumatic

Stress Network;

Expanded SAMHSA’s Criminal and Juvenile Justice programs to address the mental health needs of people involved in the criminal justice system;

Funded the Certified Community Behavioral Health Clinics Expansion Program; and, Funded SAMHSA’s Minority Fellowship Programs to improve behavioral health care outcomes for diverse populations.

HHS will also be transitioning to the 988 code to access the National Suicide Prevention Lifeline July 2022. In addition, HHS, through the Centers for Medicare and Medicaid Services (CMS), has begun implementing two provisions of the American Rescue Plan that allow states to expand behavioral health services: Section 9817 that provides states an enhanced federal match for certain home and community-based services, including behavioral health services, and a new mobile crisis services option authorized under section 9813.

ACL anticipates that the grantee will work with recipients of these and other HHS mental or behavioral health programs and funding to increase their competencies to better serve people with ID/DD and mental health disabilities.

Recognizing the significant needs faced by people with co-occurring intellectual and developmental disabilities and mental health disabilities and the systemic changes needed to support better community living, ACL’s Administration on Disabilities (AoD) funded the development of the Mental Health and Developmental Disabilities (MHDD) National Training Center from Fiscal Year 2018-2021. Functioning as a collaboration between the University Centers for Excellence in Developmental Disabilities (UCEDD) at the University of Kentucky, University of Alaska Anchorage, and Utah State University, the MHDD Center continues to serve as a clearinghouse, providing access to current evidence-based, trauma-informed, culturally responsive practices that address the mental health needs of individuals with developmental disabilities.

In March 2020, the MHDD National Training Center published “National Needs Assessment:

Mental Health Services for People with Intellectual and Developmental Disabilities.”[12] This survey of 877 individuals from 49 states identified current gaps and needs in mental health services for the ID/DD community, particularly to inform training efforts to increase capacity in the workforce to serve this community. Findings in the study identify several barriers to mental health services for people with developmental disabilities, including a shortage of mental health providers, lack of expertise on serving people with ID/DD among mental health providers, long wait times for preventative or routine mental health services, and cost. These barriers have only been exacerbated by the increased need for mental health services and supports for youth and adults of all ages during the COVID-19 pandemic. ACL anticipates that applicants will use the findings of this needs assessment and other relevant resources provided by the MHDD National Training Center to inform the work of this national resource and technical assistance center.

Building on the work of the National Training Center, in September of 2021, ACL awarded 5 UCEDD National Training Initiative Grants to Support People with ID/DD with Co-Occurring

Mental or Behavioral Health Disabilities to the UCEDDs at University of Alaska Anchorage, University of Illinois Chicago, University of Kentucky, The Ohio State University, and Utah State University. These grants are supporting collaboration between state mental health and developmental disability service agencies to create more integrated services and supports for this community. Individuals with these co-occurring disabilities have reported a significant lack of coordination and collaboration across the service systems. At the same time, service providers and administrators have reported that they do not have the resources available to serve this population.[13] Applicants should describe how they will leverage these existing ACL efforts, as well as others in planning and implementing this project.

This new center will be a critical activity as part of AoD’s strategic priority to promote equity, including health equity of individuals with disabilities. ACL recognizes that a leading contributor to the inequities individuals with ID/DD and co-occurring mental health disabilities experience is a lack of access to a comprehensive, coordinated, and integrated system of mental health and home and community-based services. This investment will support Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government which directed the Federal Government to develop a “comprehensive approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.”[14] It will also support the Administration’s priorities to address the COVID-19 pandemic.

The center will promote community living, stressing the importance of empowering individuals with disabilities to exercise full choice and control over their lives and to live independently in their communities with the appropriate services and supports. It is expected that applicants will demonstrate how these aims will be advanced particularly through active, meaningful collaborations with a diverse array of stakeholders vested in community living, self-advocacy, health, and wellness. Applicant(s) should provide evidence that individuals with disabilities, including those from culturally and linguistically diverse backgrounds will be actively and meaningfully engaged throughout all funded activities, including staffing, administration, and governance.

C. PROGRAM GOALS

AoD seeks to fund one (1) five-year cooperative agreement to create and maintain a National Resource and Technical Assistance Center: Increasing Capacity to Support Individuals with Co-occurring Intellectual and Developmental Disabilities and Mental Health Disabilities. This Center will respond to the need for:

Systems change that improves policies, service design, and service coordination.

Building the capacity of the workforce to support individuals with co-occurring ID/DD and mental health disabilities.

Improving access to person-centered, culturally competent mental health services and community supports for individuals with co-occurring ID/DD and mental health disabilities.

By targeting efforts in each of these areas, ACL aims to improve services and supports that will support individuals with ID/DD and co-occurring mental health conditions to live well in the community

Outcomes:

Improved coordination between mental health, DD, and Medicaid service systems to develop and/or amend policies and practices that fill service gaps, recruit and train competent staff, and assure equitable access to quality services.*

Increased number of mental health professionals and paraprofessionals, including community-based mobile crisis intervention service personnel, peer support workers, and service providers for the 988 Dialing Code for National Suicide Prevention Lifeline, with the competencies needed to provide effective and culturally competent supports to individuals with co-occurring ID/DD and mental health disabilities.*

Increased number of community service providers, who have the capacity to support individuals with ID/DD and co-occurring mental health disabilities.

More streamlined access for all people with ID/DD to competent mental health services.* Improved awareness and knowledge of the strengths, needs, challenges, and systemic barriers experienced by people with co-occurring ID/DD and mental health disabilities.

Improved ability to deliver responsive and equitable programming, training, and technical assistance.

Increased self-determination, empowerment, and quality of life for people with co-occurring ID/DD and mental health disabilities.

Enhanced service delivery infrastructure, including mechanisms for ongoing and sustained engagement of individuals with lived experience.

*Tracking with performance measures for the Projects of National Significance program

D. MAJOR ACTIVITIES:

Applicant(s) should respond to this funding announcement by submitting proposals that describe a well-designed, strategic approach they will take, if funded, to create, maintain, and sustain a National Resource and Technical Assistance Center that builds the capacity of our communities across the nation to better serve people with co-occurring ID/DD and mental health disabilities living well in the community. Applicant(s) should explain how they plan to implement the required activities outlined in this subsection below along with any other activities they deem necessary to achieve the outcomes listed in Subsection I.C above.

1. Collaboration with stakeholders:

ACL expects that no single organization will be able to completely fulfill the priority areas addressed in this project. Therefore, applicants should describe how they plan to partner with other organizations, particularly those representing the needs of traditionally unserved and underserved people with ID/DD and co-occurring mental health disabilities, including those from racially and ethnically diverse populations, with intersectional identities, who use augmentative and alternative communication, and/or who are disconnected from ongoing supports and systems (such as youth transitioning out of the juvenile justice or foster care systems). While the applicant organization must be the fiscal and programmatic lead, applicants should clearly define their key partners’ roles throughout the application materials (e.g., work plan, budget, project narrative). Applicants should include letters of commitment from initial partners in this application. Applicants should also describe how they will engage with external stakeholders such as those on the non-exhaustive list below:

Individuals with co-occurring ID/DD and mental health disabilities National agencies representing state developmental disabilities, mental health, and

Medicaid program directors Organizations representing community services providers and mental health providers Disability-led organizations, including those that provide training, technical assistance, and peer to peer support The National Suicide Prevention Lifeline crisis centers ACL Aging and Disability network organizations and Projects of National Significance grantees Other national organizations representing individuals with disabilities, families, and advocates, including those focused on health equity Key researchers and subject matter experts Key federal partners including Substance Abuse and Mental Health Services

Administration (SAMHSA) and Centers for Medicare and Medicaid Services (CMS)

2. Steering Committee

The applicant should describe how they will develop a steering committee comprised entirely of people with co-occurring ID/DD and mental health disabilities to guide the development and dissemination of resources and other activities of the Center. Applicants should describe their plan for developing this steering committee and ensuring the group is inclusive of people with ID/DD and mental health disabilities from underserved communities, as described in subsection I.F. Applicants should ensure they budget appropriately for every individual to fully participate in the steering committee, including the cost of reasonable accommodations, virtual meeting platforms, and potentially stipends for the individuals’ time. Applicants should describe how they will recruit, support, and engage with this steering committee.

3. Resource Development and Dissemination

Information dissemination, direct technical assistance, and capacity building to improve community living support for individuals with ID/DD and co-occurring mental health disabilities will be a central component of this five-year initiative. Applicants should describe a resource development and dissemination plan that includes input from the steering committee for identifying and developing a variety of multi-modal resources tailored to the information needs of state systems, mental health and ID/DD professionals including direct support professionals, mobile crisis unit staff, staff of the National Suicide Prevention Lifeline Crisis Centers, individuals with co-occurring ID/DD and mental health disabilities, families, and other support networks. This plan may include conducting an environmental scan and/or gap analysis to identify what resources are in greatest need. Applicants should describe how they will ensure that the resources will be cognitively accessible, culturally and linguistically competent, and evidence-informed. Applicants should identify a sampling of potential resources and describe a dissemination plan for these resources, including dissemination to individuals from underserved communities as defined in Section I.F. The dissemination plan should include strategies that support:

State systems in developing system policies, program and services design, payment practices, and for developing interagency collaboration;

Mental health and ID/DD professionals and paraprofessionals, including community-based mobile crisis professionals, 988 responders, peer support workers, and substance use reduction personnel in providing effective mental health crisis services, referrals, and interventions for individuals with ID/DD and mental health disabilities, home and community-based services (HCBS), and integrated mental health treatment strategies into daily HCBS services and support; and

Individuals to live well in the community.

4. Website

A website on supporting individuals with ID/DD and co-occurring mental health disabilities will be the central structure for disseminating information. ACL will develop and make available the necessary pages on the ACL.gov website for all materials, products and other information related to the project. In this regard, a new dedicated page on the ACL website will be the primary web presence for this project. Applicants should describe how the information and materials provided by the grantee and partners for dissemination, regardless of method, will be fully accessible (i.e., 508-compliant), and meet the accessibility and cultural and linguistic needs of the intended audience.

With an ACL.gov webpage as the primary vehicle for presenting and organizing public-facing information, ACL anticipates that the successful applicant will develop and employ a robust and far-reaching dissemination strategy designed to ensure that project information, best practices, and other information are available and shared broadly. Applicants should describe their dissemination plans and articulate the methods (e.g., electronic/web-based, in-person, print, etc.) by which such activities will occur.

When fully operational, ACL envisions the website for the center will become a hub for federal, state, and all other entities engaged in the delivery of mental health and DD services as well as for people with ID/DD and co-occurring mental health disabilities, their families, mental health and ID/DD professionals and paraprofessionals including direct support professionals, peer support workers, community-based mobile crisis professionals, and 988 responders to access an array of model policies, promising practices, training materials, technical assistance, payment strategies, and service designs and learning collaboratives.

The materials to be catalogued on the site should include:

Research studies Training curricula and platforms Assessments and planning processes Effective mental health and substance use disorder treatment interventions Information and interventions on trauma and developmental trauma

Information and resources to support cultural competency for providers serving individuals with ID/DD and mental health disabilities, particularly those from underserved communities

Models of home and community-based services and supports for people with ID/DD and mental health disabilities including staff training and support

Models for educating and supporting families and individuals with lived experience, including self-advocacy training and peer supports

Models of system collaboration and integrated approaches including between Mental Health, ID/DD, Education, Justice, and Child Welfare systems

Guidance regarding leveraging resources to increase the use of community-based mobile crisis intervention services

Protocols for staff of 988 Dialing Code for National Suicide Prevention Lifeline Crisis Centers

Plain language materials and materials for people with limited English proficiency

Applicants should consider and develop a multi-modal approach for effectively disseminating the information developed and catalogued via this initiative. In developing their proposals, applicants should describe the approaches they will employ to help realize ACL’s vision.

Applicants should describe how the website and the resources they will develop as the grantee will be branded so that it is clear to the public and others that they were developed with the support of ACL. The grantee will also use social media to promote the website and the overall project. Applicants should describe how they will enable requests for technical assistance from subject matter experts, including those with lived experience, through the website.

5. Communities of Practice

To generate change and create more integrated mental health and home and community-based services, the grantee will develop communities of practice (CoPs) for at minimum, the following communities:

State system leaders including state disability, mental health, and Medicaid agencies, and ACL aging and disability network organizations

Mental health and ID/DD professionals and paraprofessionals including direct support professionals and peer support workers

Individuals with co-occurring ID/DD and mental health disabilities, including training on topics such as peer mentoring or using storytelling as an advocacy tool

Families and others in support networks

Applicants should describe how they will develop the CoPs and provide targeted technical assistance to the CoPs through an accessible virtual platform not less than quarterly.

Applicants should describe how they will ensure these groups are inclusive of underserved communities. Applicants should describe how they will recruit, structure, and engage with the communities of practice.

6. National Conference

Applicants should describe the approach they will take in hosting a conference in year five of this grant for a variety of stakeholders focused on better serving people with ID/DD and mental health disabilities. The goal of the conference is to share promising practices that emerge from the work of the Center and disseminate the information to individuals with lived experience and other stakeholders, including service professionals and state and local agency personnel. The conference may occur virtually, in-person, or as a hybrid event.

Budgeting should be appropriate to ensure people with ID/DD, including those from underserved communities are able to fully participate in this conference.

7. Evaluation

Applicants should describe how they will use process evaluation techniques to analyze delivery of project activities to determine the extent to which the project is implemented as planned; how the project activities are being received by the collaborative partners and other stakeholders (particularly those from underserved communities); the barriers to implementation; and areas for project improvements.

Please see Subsection I.C, Program Goals above and link the evaluation activities to the intended outcomes.

Evaluation should at a minimum include:

The quality and perceived usefulness of the training materials and resources Increased knowledge, awareness, and/or skills among communities of practice.

The extent to which participants receiving training make practice or policy changes as a result of their participation

8. Sustainability

Through this funding opportunity, ACL expects to realize tangible, measurable, and sustainable advancements for people with co-occurring ID/DD and mental health disabilities An expected outcome of this project will be sustainability of a national resource center on co-occurring ID/DD and mental health disabilities. During the course of the project, efforts should be made to generate sufficient resources and strategies for organizational sustainability, financial sustainability and/or community sustainability to continue and to refine the work of the center. Applicants should propose a range of potential approaches for ensuring the sustainability of project efforts after federal funding has ended.

E. OPTIONAL ACTIVITIES

Applicants may undertake any other training activities in order to accomplish the outcomes listed in Subsection I.C.

F. DEFINITIONS

Equity - Executive Order 13985[15] defines equity as “the consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and

Native American persons, Asian Americans and Pacific Islanders and other persons of color;

members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.”

Underserved Communities - Executive Order 13985 defines underserved communities as populations sharing a particular characteristic, as well as geographic communities, that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life, as exemplified by the list in the preceding definition of “equity.”

Self-Determination Activities - The Developmental Disabilities Assistance and Bill of Rights Act[16] defines self-determination activities as “activities that result in individuals with developmental disabilities, with appropriate assistance, having:

o the ability and opportunity to communicate and make personal decisions;

o the ability and opportunity to communicate choices and exercise control over the type and intensity of services, supports, and other assistance the individual receives;

o the authority to control resources to obtain needed services, supports, and other assistance;

o opportunities to participate in, and contribute to their communities; and support, including financial support, to advocate for themselves and others, to develop leadership skills, through training in self-advocacy, to participate in coalitions, to educate policymakers, and to play a role in the development of public policies that affect individuals with developmental disabilities.”

Community Living - Community Living stresses the importance of empowering individuals with disabilities to exercise full choice and control over their lives and to live independently in their communities with the appropriate services and supports.

[1] Friedman, Carli & Lulinski, Amie & Rizzolo, Mary. (2015). Mental/Behavioral Health Services: Medicaid Home and Community-Based Services 1915(c) Waiver Allocation for People With Intellectual and Developmental Disabilities. Intellectual and developmental disabilities. 53.

257-270. 10.1352/1934-9556-53.4.257.

[2] “Breaking the School-to-Prison Pipeline for Students with Disabilities.” NCD.gov, National Council on Disability , 5 May 2016, https://www.ncd.gov/publications/2015/06182015.

[3] “Reconciling the Past & Changing the Future.” Center for START Services, 28 Jan. 2022, https://centerforstartservices.org/Truth-and-Reconciliation-Project.

[4] Human Services Research Institute, National Association of State Directors of Developmental Disabilities Services, NCI Data Brief, Issue 2, April, 2011.

www.nationalcoreindicators.org/upload/core-indicators/Data_Brief_--_dual_dx_--_Issue_2_-- _April_4_2011_1.pdf.

[5] National Association of State Mental Health Program Directors (NASMHPD). 2004, Serving Individuals with Co-Occurring Developmental Disabilities and Mental Illnesses: Systems Barriers and Strategies for Reform. Alexandria, VA.

[6] Bradley, V., Hiersteiner, D. Maloney, J, Vegas, L and Bourne, M.L. 2019, What Do NCI

Data Reveal About People Who Are Dual Diagnosed with ID and Mental Illness? Alexandria, VA.

[7] Division of Developmental Medicine, University Center for Excellence in Developmental Disabilities (UCEDD), Boston Children’s Hospital, Boston, Massachusetts, USA’ Department of Psychiatry, Boston Children’s Hospital, Boston, Massachusetts, USA; Oliver Wendell Holmes Society, Harvard Medical School, Boston, Massachusetts, USA https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814928/ [8] National Association of State Mental Health Program Directors (NASMHPD). 2004, Serving Individuals with Co-Occurring Developmental Disabilities and Mental Illnesses: Systems Barriers and Strategies for Reform. Alexandria, VA.

[9] Horton, C., Evans, N., Charkowski, R., D’Amico, P., Gomez, M., R., Henderson Bethel, T., Kraps, J., Vogel, J., and Youde, J. (2021) Children with intellectual and developmental disabilities can experience traumatic stress: A fact sheet for parents and caregivers. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.

[10] “Reconciling the Past & Changing the Future.” Center for START Services, 28 Jan. 2022, https://centerforstartservices.org/Truth-and-Reconciliation-Project.

[11] “Executive Order on Advancing Racial Equity and Support for Underserved Communities through the Federal Government.” The White House, The United States Government, 21 Jan.

2021, https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government/.

[12] “MHDD National Needs Assessment 2020.” MHDD National Training Center, 13 May 2020, https://www.mhddcenter.org/mhdd-national-needs-assessment-2020-2/.

[13] National Association of State Mental Health Program Directors (NASMHPD). 2004, Serving Individuals with Co-Occurring Developmental Disabilities and Mental Illnesses:

Systems Barriers and Strategies for Reform. Alexandria, VA., [14] Executive Order on Advancing Racial Equity and Support for Underserved Communities through the Federal Government.” The White House, The United States Government, 21 Jan.

2021, https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government/.

[15] Executive Order on Advancing Racial Equity and Support for Underserved Communities through the Federal Government.” The White House, The United States Government, 21 Jan.

2021, https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government/.

[16] An Act to Improve Service Systems for Individuals with Developmental Disabilities, and for Other Purposes. (PL 106-442) U.S. G.P.O., 2000.

Statutory Authority This project is funded under the Projects of National Significance (PNS) within the Developmental Disabilities Assistance and Bill of Rights Act, which defines the purpose of PNS as a program to "create opportunities for individuals with developmental disabilities to directly and fully contribute to, and participate in, all facets of community life; and support the development of national and State policies that reinforce and promote, with the support of families, guardians, advocates, and communities, of individuals with developmental disabilities, the self-determination, independence, productivity, and integration and inclusion in all facets of community life of such individuals."[1]

[1] An Act to Improve Service Systems for Individuals with Developmental Disabilities, and for Other Purposes. (PL 106-442) U.S. G.P.O., 2000.

II. Award Information Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$650,000 Expected Number of Awards:

Award Ceiling:

$650,000 Per Budget Period

Award Floor:

$600,000 Per Budget Period

Length of Project Period:

60-month project period with five 12-month budget periods Additional Information on Project Periods and Explanation of 'Other' Once a cooperative agreement is in place, requests to modify or amend it or the work plan may be made by ACL or the awardee at any time if it stays within the original scope of the proposed project description. Major changes may affect the integrity of the competitive review process.

Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the execution of an award notice. When an award is issued, the cooperative agreement terms and conditions from the program announcement are incorporated by reference unless ACL is authorized under the Terms and Conditions of award, 45 CFR Part 75, or other applicable regulation or statute to make unilateral amendments.

The ACL project officer agrees to execute the responsibilities of the cooperative agreement outlined below:

Perform the day-to-day Federal responsibilities of grants management while working with the grantee to ensure that the minimum requirements for the grant are met.

Assist the grantee project leadership in understanding the policy concerns and/or priorities of ACL by conducting periodic briefings and by carrying out ongoing consultations.

Work cooperatively with the grantee to clarify the programmatic and budgetary issues to be addressed by the project.

Within 30 days post-award, meet with the grantee to finalize the workplan to the mutual agreement of all parties to this cooperative agreement

Provide guidance to the grantee, as necessary, in making sub-awards (i.e., sub-grants/contracts) as permitted in this funding opportunity announcement.

Provide guidance to the grantee on the provision of technical support and associated tasks related to the fulfillment of the goals and objectives of this grant.

Establish and maintain the primary website/webpage for this project on the ACL.gov website.

Review and provide technical advice to the grantee on all work products and other project deliverables and processes.

Provide consultation to the grantee in identifying emerging issues as they relate to the goals and objectives of this grant program.

Work with the grantee on the development and implementation of evaluation and quality assurance systems to ensure that performance is measured, and continuous improvement occurs.

Attend and participate in major project events as appropriate.

The grantee will execute the responsibilities of the cooperative agreement, as listed below:

Immediately inform, and collaborate with, the ACL on any in-scope modification of the work plan.

Within 30 days post award, meet with ACL to finalize the project work plan to the mutual satisfaction of all parties to this agreement.

Participate in monthly check-in calls with the ACL Program Officer;

Provide drafts of all press releases and social media announcements

Provide preliminary and other working drafts of all products and deliverables to the ACL Program Officer for review;

Prior to dissemination, provide final drafts of all products and deliverables to the ACL Project Officer for accessibility and 508-compliance review;

Ensure that all materials and products as well as all aspects of the website, are fully accessible and developed in accordance with 508 compliance standards.

Use the ACL-established website/webpage for this project as the primary location for all web-based materials.

Collaborate with ACL on the identification and selection of steering committee (if established) members and any subject matter experts/advisory consultants to the project;

Evaluate the impact of overall project activities and ensure quality assurance systems are in place.

Share information with ACL, national and local organizations, and other entities as appropriate.

Fulfill all requirements of the grant initiative as detailed in this program announcement.

Report semi-annually on project accomplishments, challenges, and progress towards measurable objectives.

Work with the ACL Program Officer to evaluate performance results reported semiannually and jointly develop strategies to address those areas requiring improvement.

III. Eligibility Information

1. Eligible Applicants For FY 2022 the below guidance is provided to advance the Administration’s policy, as stated in E.O. 13985, to “pursue a comprehensive approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.” This guidance is intended to begin to address inequities in HHS programs, processes, and policies that may serve as barriers to equal opportunity. By advancing equity in our NOFOs, we can “create opportunities for the improvement of communities that have been historically underserved, which benefits everyone.”

Domestic public or private non-profit entities including state and local governments, Indian tribal governments and organizations (American Indian/Alaskan Native/Native American), faith-based organizations, community-based organizations, hospitals, and institutions of higher education.

SEC. 162. <<NOTE: 42 USC 15082.>> GRANT AUTHORITY. (a) In General. --The Secretary shall award grants, contracts, or cooperative agreements to public or private nonprofit entities for projects of national significance relating to individuals with developmental disabilities to carry out activities described in section 161(2).

2. Cost Sharing or Matching Cost Sharing / Matching Requirement:

No For awards that require matching or cost sharing by statute, recipients will be held accountable for projected commitments of non-federal resources (at or above the statutory requirement) in their application budgets and budget justifications by budget period, or by project period for fully funded awards. The applicant will be held accountable for all proposed non-federal resources as shown in the Notice of Award (NOA). A recipient's failure to provide the statutorily required matching or cost sharing amount (and any voluntary committed amount in excess) may result in the disallowance of federal funds. Recipients will be required to report these funds in the Federal Financial Reports.

For awards that do not require matching or cost sharing by statute, recipients are not expected to provide cost sharing or matching. However, recipients are allowed to voluntarily propose a commitment of non-federal resources. If an applicant decides to voluntarily contribute non-federal resources towards project costs and the costs are accepted by ACL, the non-federal resources will be included in the approved project budget. The applicant will be held accountable for all proposed non-federal resources as shown in the Notice of Award (NOA). A recipient's failure to meet the voluntary amount of non-federal resources that was accepted by ACL as part of the approved project costs and that was identified in the approved budget in the NOA, may result in the disallowance of federal funds. Recipients will be required to report these funds in the Federal Financial Reports.

3. Responsiveness and Screening Criteria Application Responsiveness Criteria Applications that fail to meet the responsiveness criteria described below will not be reviewed and will receive no further consideration.

Application Screening Criteria All applications will be screened to assure a level playing field for all applicants. Applications that fail to meet the four screening criteria described below will not be reviewed and will receive no further consideration. For an application to be reviewed, it must meet the following screening requirements:

Applications must be submitted electronically via https://www.grants.gov by 11:59 p.m., Eastern Time, by the due date listed in section IV.3 Submission Dates and Times.

The Project Narrative section of the Application must be double-spaced, on 8.5” x 11” plain white paper with 1” margins on all sides, and a standard font size of no less than 11 point, preferably Calibri or Arial.

The Project Narrative must not exceed 25 pages. Project Narratives that exceed 25 pages will have the additional pages removed and only the first 25 pages of the Project Narrative will be provided to the merit reviewers for funding consideration. NOTE: The Project Work Plan, Letters of Commitment, Organizational Charts, Résumés/Vitae of Key Project Personnel, and Logic Model are not counted as part of the Project Narrative for purposes of the 25-page limit.

Applications must contain a budget request that is equal to or more than the “Award Floor” amount and not more than the “Award Ceiling” amount as found in Section II of this funding opportunity announcement.

Unsuccessful submissions will require authenticated verification from https://www.grants.gov indicating system problems existed at the time of your submission.

For example, you will be required to provide an https://www.grants.gov submission error notification and/or tracking number to substantiate missing the application deadline.

IV. Application and Submission Information

1. Address to Request Application Package Application materials can be obtained from https://www.grants.gov or https://www.acl.gov/grants/applying-grants.

Please note, ACL requires applications for all announcements to be submitted electronically through http://www.grants.gov in Workspace. Grants.gov Workspace is the standard way for organizations and individuals to apply for federal grants in Grants.gov. An overview and training on Grants.gov Workspace can be found here at:

https://www.grants.gov/web/grants/applicants/workspace-overview.html http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ https://www.grants.gov/ https://www.acl.gov/grants/applying-grants http://www.grants.gov/ https://www.grants.gov/web/grants/applicants/workspace-overview.html

The Grants.gov registration process can take several days. If your organization is not currently registered, please begin this process immediately. For assistance with https://www.grants.gov, please contact them at support@grants.gov or 800-518-4726 between 7:00 a.m. and 9:00 p.m.

Eastern Time.

At the https://www.grants.gov website, you will find information about submitting an application electronically through the site, including the hours of operation. ACL strongly recommends that you do not wait until the application due date to begin the application process because of the time involved to complete the registration process.

All applicants must have a UEI and be registered with the System for Award Management (SAM, www.sam.gov) and maintain an active SAM registration until the application process is complete, and should a grant be made, throughout the life of the award. Effective June 11, 2018, when registering or renewing your registration, you must submit a notarized letter appointing the authorized Entity Administrator. Please be sure to read the FAQs located at www.sam.gov to learn more. Applicants should allot sufficient time prior to the application deadline to finalize a new, or renew an existing registration. This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award. Maintain documentation (with dates) of your efforts to register or renew at least two weeks before the deadline. See the SAM Quick Guide for Grantees at:

https://www.sam.gov/SAM/pages/public/help/samQUserGuides.jsf.

Note: Once your SAM registration is active, allow 24 to 48 hours for the information to be available in…