Foa_Content_of_HHS-2023-ACF-ORR-ZQ-0062.pdf

Administration for Children and Families

Office of Refugee Resettlement

Support for Trauma-Affected Refugees (STAR)

HHS-2023-ACF-ORR-ZQ-0062

Application Due Date: 10/02/2023

Table of Contents Executive Summary

I. Program Description

II. Federal Award Information

III. Eligibility Information

III.1. Eligible Applicants

III.2. Cost Sharing or Matching

III.3. Other

IV. Application and Submission Information

IV.1. Address to Request Application Package

IV.2. Content and Form of Application Submission

Required Forms, Assurances, and Certifications

The Project Description

The Project Budget and Budget Justification

Application Submission Options

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

IV.4. Submission Dates and Times

Explanation of Due Dates

Acknowledgement of Received Application

IV.5. Intergovernmental Review

IV.6. Funding Restrictions

IV.7. Other Submission Requirements

V. Application Review Information

V.1. Criteria

V.2. Review and Selection Process

V.3. Anticipated Announcement and Federal Award Dates

VI. Federal Award Administration Information

VI.1. Federal Award Notices

VI.2. Administrative and National Policy Requirements

VI.3. Reporting

VII. HHS Award Agency Contact(s)

VIII. Other Information

Reference Websites

Application Checklist

Appendix

Funding Opportunity Title:

Support for Trauma-Affected Refugees (STAR) Announcement Type:

Initial Funding Opportunity Number:

HHS-2023-ACF-ORR-ZQ-0062

Primary CFDA Number:

93.576 Due Date for Applications:

10/02/2023 Executive Summary

Notice:

Applicants are strongly encouraged to read the entire notice of funding opportunity (NOFO) carefully and observe the application formatting requirements listed in Section IV.2. Content and Form of Application Submission. For more information on applying for grants, please visit "How to Apply for a Grant" on the ACF Grants & Funding Page at https://www.acf.hhs.gov/grants/how-apply-grant.

The Office of Refugee Resettlement (ORR) within the Administration for Children and Families (ACF) invites eligible entities to submit competitive grant applications under the new Support for Trauma-Affected Refugees (STAR) Program for fiscal year 2023. The goals of the STAR Program are the integration and successful achievement of sustained physical, social, emotional, and economic well-being of underserved refugees and other newcomers eligible for ORR services (hereafter referred to as “newcomers” for simplicity) whose experience of trauma is impeding their ability to function effectively at home, school, work or in social settings. For further details including newcomer eligibility criteria, please see Section I. Program Requirements, Enrollment Criteria.

ORR intends to achieve these goals through the following two objectives:

1. To increase underserved newcomers’ access to appropriate and effective trauma assistance services at both the individual and family level.

2. To fund and foster the development of a network of culturally responsive providers (recipients) that can deliver holistic services to address the psychosocial needs of trauma-affected newcomers and to facilitate their successful integration and well-being.

In support of the two objectives above, the STAR Program requires recipients to encompass a comprehensive approach to serve newcomers displaying symptoms of trauma that impede their ability to function effectively at home, school, work or in social settings. Using STAR funds, recipients will provide eligible newcomers with holistic and integrated case management services, including health, psychological, and social adjustment services directly. Through project-related activities, recipients will simultaneously enhance their capacity to serve these populations.

https://www.acf.hhs.gov/grants/how-apply-grant

I. Program Description

Statutory Authority Section 412(c)(1)(A) of the Immigration and Nationality Act (INA), 8 U.S.C. § 1522(c)(1)(A)

Description

BACKGROUND

ORR provides newly arriving refugees and other eligible populations with the opportunity to maximize their well-being and potential in the United States. Through INA, ORR is authorized to provide resettlement assistance and other benefits available to specific eligible refugee populations in response to their displacement overseas and subsequent resettlement in the United States. Recognizing the unique experiences and needs of this population, ORR is issuing this new NOFO to support the successful and meaningful resettlement of underserved newcomers whose experience of trauma impedes their ability to function effectively at home, school, work or in social settings.

For the purposes of this NOFO, individual trauma is defined as an event or circumstance resulting in physical harm, emotional harm, and/or life-threatening harm and has lasting adverse effects on an individual’s mental health, emotional health, physical health, social well-being, and/or spiritual well-being. Traumatic events increase the risk for mental health conditions such as post-traumatic stress disorder (PTSD), depression, and anxiety. Among refugee populations, the prevalence of PTSD, depression, and anxiety has been reported to be 31 percent, 32 percent, and 11 percent, respectively. Furthermore, refugees and asylum-seekers are 10 times more likely to experience PTSD compared to host populations. While most resettled refugees successfully carve out new lives without visible adverse mental health effects, at least 5-15 percent of newcomers may require intensive support services due to the psychosocial and health repercussions of their traumatic displacement-related experiences.

Newcomers may experience traumatic events before, during, and/or after their migration journeys. Following resettlement, risk of or progression of mental health conditions is compounded by the acculturative stress of finding employment and reaching self-sufficiency, maintaining housing, learning a new language, navigating complex healthcare systems, having lower levels of social support, living in poverty, and/or experiencing discrimination.

The inter-generational effects of trauma have also been documented in refugee families. Children who have experienced trauma and other adverse childhood events are at increased risk for long-term developmental, physical, and mental health risks from their own exposures and when their family members experience suffering from trauma-related psychological disorders.

The STAR Program aims to support the healing and recovery of trauma among these underserved newcomers by funding recipients that offer mental health care and case management services through developmentally, culturally, and linguistically appropriate, trauma-informed interventions at the individual, group, and family levels.

STAR PROGRAM OVERVIEW

GOALS, OBJECTIVES, AND SCOPE OF THE STAR PROGRAM

The goal of the STAR Program is the successful achievement of sustained physical, social, emotional, and economic well-being of newcomers whose experience of trauma is impeding their ability to function effectively at home, school, work or in social settings.

ORR intends to achieve these goals through the following objectives:

1. To increase eligible and underserved newcomers’ access to appropriate, effective, and holistic trauma assistance and mental health services at the individual, group, and family levels, taking into account considerations of age and gender.

2. To fund and foster the development of a network of culturally responsive providers (recipients) with the capacity for delivering holistic services to address the psychosocial needs of trauma-affected refugees and to facilitate their successful integration and well-being.

Objective-Centered Program Activities and Relevant Assessment Areas

Recipient activities must align with STAR Program objectives as outlined above. ORR will assess recipient activities under the following two main programmatic requirements: core service delivery and capacity building. Note: An activity may fall under more than one programmatic requirement; for example, telehealth options for core services fall under both core service delivery and capacity building and will be assessed as such.

ASSESSMENT AREA I: CORE SERVICE DELIVERY

Required activities in support of this objective include:

Offering mental health services such as individual and group therapy, to trauma-affected newcomers, including vulnerable or marginalized groups such as survivors of domestic violence (DV), intimate partner violence (IPV) and gender-based violence (GBV);

children and adolescents; and lesbian, gay, bisexual, transgender, queer or questioning, and intersex (LGBTQI+) individuals who may be experiencing social, mental, emotional, and familial challenges.

Providing evidence-based family-strengthening interventions that promote healthy family dynamics.

Holding culturally sensitive training for parents to regain or strengthen their parenting competencies as they encounter unfamiliar cultural norms in education, parenting, and family life.

Providing emergency assistance in situations where program beneficiaries (clients) are at risk of homelessness or food insecurity.

Assisting with interpretation and transportation needs for mental health services.

Working with culturally and linguistically appropriate community health workers to conduct home visits.

Offering options for onsite and telehealth platforms for individual, group, and family therapy or counseling.

Offering clients holistic therapeutic programs that foster recovery, resiliency, and creativity.

ASSESSMENT AREA II: CAPACITY BUILDING

Required activities in support of this objective include the following:

Partnering with ethnic community and/or faith-based organizations to develop, deliver, and/or promote culturally and linguistically appropriate services for survivors from those newcomer communities.

Fostering partnerships with mainstream providers to enhance community capacity to respond to the needs of underserved newcomers impacted by trauma.

Developing organizational capacity to offer appropriate bi/multilingual interventions and easily applicable screening instruments for trauma, depression, anxiety, suicidality, and/or substance abuse.

Recruiting from newcomer communities and/or former clients at both operational and leadership levels, ensuring client-centered programming to evaluate project effectiveness, improve service delivery, and promote equity.

Integrating newcomer survivors/clients within organizational and programmatic structures through establishing advisory boards comprised of former clients and community members, especially through encouraging the participation of minority sub-groups such as LGBTQI+ individuals, youth, and female clients to ensure organizational diversity and equity.

Encouraging and promoting the professional development of bi/multilingual and bi/multicultural staff from newcomer communities to promote healthcare equity through increased representation and visibility of such communities in those professions.

Ensuring peer support and adequate supervision of client-facing staff with particular attention to client-case worker ratios to ensure workforce sustainability.

Engaging in rigorous project monitoring and performance evaluation through collection, reporting, and analysis of project data to improve service delivery, outcomes, processes, and systems.

Identifying sustainable sources of funding to continue the project after the grant has ended.

Communicating and coordinating at least quarterly with local refugee service providers, State Refugee Coordinators, and State Refugee Health Coordinators to facilitate timely and relevant exchange of information regarding service needs and resettlement trends that may affect service delivery and referral systems.

NOTE: Fundraising and solicitation of funds are not allowable activities under this grant (45 CFR§75.442). Please see Section IV.6. Funding Restrictions for further information.

Eligible Populations for STAR Program Services

Through section 412(c)(1)(A) of the INA (8 U.S.C. 1522(c)(1)(A)), Congress authorized ORR to provide funding for resettlement assistance and other benefits available for refugees and other eligible newcomer populations. ORR Policy Letters 16-01, 22-01, 22-02, and 22-13 delineate populations eligible for ORR services and programs, including STAR.

ORR assistance and services must be provided to eligible newcomers without regard to race, religion, nationality, sex, or political opinion.

Persons deemed eligible for Refugee Resettlement Program benefits (see 45 CFR § 400.43(a) (1)-(6) or statutory provisions cited below) include the following:

https://www.acf.hhs.gov/orr/policy-guidance/policy-letters

1. Individuals paroled as refugees or asylees under § 212(d)(5) of INA.

2. Refugees admitted under § 207 of INA.

3. Asylees whose status was granted under § 208 of INA.

4. Cuban and Haitian entrants, in accordance with the requirements in 45 CFR § 401.2.

a. Any individual granted parole status as a Cuban/Haitian Entrant (status pending) or granted any other special status subsequently established under the immigration laws for nationals of Cuba or Haiti, regardless of the status of the individual at the time assistance or services are provided;

b. A national of Cuba or Haiti who was paroled into the United States and has not acquired any other status under the INA and with respect to whom a final, non-appealable, and legally enforceable order of removal, deportation, or exclusion has not been entered;

c. A national of Cuba or Haiti who is the subject of removal, deportation, or exclusion proceedings under the INA and with respect to whom a final, non-appealable, and legally enforceable order of removal, deportation, or exclusion has not been entered; or

d. A national of Cuba or Haiti who has an application for asylum pending with the Department of Homeland Security/United States Citizenship and Immigration Services (USCIS) or Department of Justice/ Executive Office for Immigration Review and with respect to whom a final, non-appealable, and legally enforceable order of removal, deportation or exclusion has not been entered.

5. Lawful permanent residents provided the individuals previously held one of the statuses identified above. (Note that this does not refer to Amerasians and Special Immigrant Visa holders from Iraq and Afghanistan who are admitted as lawful permanent residents. See #6 and #7 below.)

6. Certain Amerasians from Vietnam who are admitted to the United States as immigrants pursuant to § 584 of the Foreign Operations, Export Financing, and Related Programs.

Appropriations Act, 1988 (as contained in § 101(e) of Public Law 100-202), as amended (8 U.S.C. 1101 note).

7. Iraqi and Afghan Special Immigrants per section 1244(g) of Div. A of Public Law 110-181, as amended (8 U.S.C. 1157 note) and section 602(b)(8) of Div. F of Public Law 111-8 as amended (8 U.S.C. 1101 note).

8. Victims of a severe form of trafficking in persons per the Victims of Trafficking and Violence Protection Act of 2000, Public Law No. 106-386, as amended, 22 U.S.C. 7105(b)(1) (A) and (C).

9. Afghan populations authorized to receive ORR services by the Afghanistan Supplemental Appropriations Act, 2022 including:

a. Citizens or nationals of Afghanistan (including unaccompanied minors) paroled into the United States under section 212(d)(5) of the Immigration and Nationality Act between July 31, 2021, and September 30, 2023. This group is eligible for benefits and services from their eligibility date until March 31, 2023, or until the end of the individual’s parole term, whichever is later, unless otherwise amended by law or the individual gains another ORR-eligible category or status;

b. A spouse or child of any individual described above, who is paroled into the United States after September 30, 2022. This group is eligible for benefits and services from their eligibility date until March 31, 2023, or the end of the individual’s parole term, whichever is later, unless otherwise amended by law or the individual gains another ORR-eligible category or status; or

c. A parent or legal guardian of any individual described above in (a) who is determined to be an unaccompanied child as defined by 6 U.S.C. 279(g)(2) or who is paroled into the United States after September 30, 2022. This group is eligible for benefits and services from their eligibility date until March 31, 2023, or the end of the individual’s parole term, whichever is later, unless otherwise amended by law or the individual gains another ORR-eligible category or status.

10. Displaced populations from Ukraine per the Additional Ukraine Supplemental Appropriations Act, 2022 including:

a. Citizens or nationals of Ukraine who the Department of Homeland Security (DHS) has paroled into the United States between February 24, 2022, and September 30, 2023. This group is eligible for benefits and services until their parole terminates, unless otherwise amended by law or the individual gains another ORR-eligible category or status;

b. Non-Ukrainian individuals who last habitually resided in Ukraine, who DHS has paroled into the United States between February 24, 2022, and September 30, 2023. This group is eligible for benefits and services until their parole terminates, unless otherwise amended by law or the individual gains another ORR-eligible category or status;

c. A spouse or child of an individual described in sections (a) or (b) who is paroled into the United States after September 30, 2023. This group is eligible for benefits and services until their parole terminates, unless otherwise amended by law or the individual gains another ORR-eligible category or status; or

d. A parent, legal guardian, or primary caregiver of an unaccompanied refugee minor or an unaccompanied child described in sections (a) or (b) who is paroled into the United States after September 30, 2023. This group is eligible for benefits and services until their parole terminates, unless otherwise amended by law or the individual gains another ORR-eligible category or status.

Detailed information on eligibility, including documenting the date of eligibility, for ORR-funded projects is available at 45 CFR § 400.43 and ORR Policy Letters 16-01, 22-01, 22-02, and 22-13.

Documentation of Eligibility

To ensure eligibility, all individuals wishing to enroll in STAR Program services are required to provide recipients with documentary proof of one of the statuses included in the list above.

Recipients must include that documentation in the client's case file upon enrollment.

Enrollment Criteria for STAR Services

To qualify for STAR Program-funded services, individuals must meet three essential criteria.

They must: (1) hold eligible newcomer status as defined in Eligible Populations for STAR Program Services; (2) have a history of trauma that impedes their functioning at home, work, school, or in social settings; and (3) have been eligible for ORR services for no longer than 5 years. Documentation of all three criteria must be included in client case files upon enrollment in STAR services.

While referral to the program does not require a formal assessment by a mental health professional, enrollment requires a determination by licensed clinical intake staff regarding a client’s impaired ability to function effectively at home, school, work, or in social settings due to their trauma exposure.

PROGRAMMATIC REQUIREMENTS

CORE SERVICE DELIVERY

Each recipient must provide case management of core services for adult, adolescent, and pediatric clients, allowing options for telehealth and remote delivery, especially in locations where diaspora groups have not traditionally resettled. In such instances, recipients must offer telehealth platforms for access to developmentally, culturally and linguistically appropriate mental health services, and case management.

Core services must include:

1. Conducting comprehensive, family-centered (if applicable) intake assessments of clients’ trauma-induced impairment or mental health needs.

2. Establishing personal and family wellness plans to help survivors identify and advance toward goals for healing and recovery. See details of such plans below this list of core services.

3. Designing and providing, directly and/or in partnership, a holistic package of psychological, and social services to address the physical, psychological, and social effects of trauma upon survivors and their families, with the option of telehealth for all core services.

4. Documenting the provision of a reasonable number of individual and/or group core services each month, after consultation with clients, in order to address client mental health needs and updating client case files quarterly.

5. Implementing specific and developmentally appropriate interventions for vulnerable subgroups such as women, LGBTQI+ individuals, children, and youth.

6. Offering individual and group therapy for clients and their families, including family-strengthening interventions.

7. Providing strengths-based, trauma-informed case management to coordinate care and connect clients to other services and community resources as needed.

8. Facilitating support groups and providing referrals and linkages to help survivors build a sustainable social support network.

9. Conducting quarterly outcome assessments each federal fiscal year for each client that align with client-identified goals and ensuring that personal and family wellness plans contain specific, measurable, attainable, realistic, and time-bound (SMART) goals for clients and, if applicable, their family members.

10. Assessing clients at the end of each federal fiscal year and informing them of their eligibility for case closure based on their achievement of goals outlined in their wellness plans.

11. Meeting with continuing clients at the start of each federal fiscal year to inform them of their service options and to identify client goals to work toward during that period.

12. Issuing closeout letters informing clients of the successful achievement of their self-identified wellness goals and connecting them to relevant ORR and community resources.

Individual and Family Wellness Plans

Once an individual (client) has been assessed and determined to be eligible for trauma-assistance services and interventions, the case manager must establish a wellness plan with that individual or the parent or legal guardian in the case of a minor.

The plan must include the following:

1. An identification of the specific area/s of vulnerability that merit a client’s enrollment in

STAR;

2. The specific mental health services that the client will receive;

3. The self-sufficiency or age/developmentally appropriate goal(s) toward which the client and the agency (and, where applicable, family members) will work; and

4. A description of any training or counseling that the client, or parent/legal guardian on behalf of the client, agrees to attend, including the type, intended duration, expected outcomes, and the provider of the program.

CLAS Standards

ORR requires the use of evidence-based case management activities that are rooted in effective best practices for serving underserved minority populations. Additionally, due to the diverse backgrounds of newcomers, mainstream local health and mental health providers must implement the National CLAS Standards. The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. More information on the National CLAS Standards can be found at:

https://minorityhealth.hhs.gov/Default.aspx.

THE STAR PROGRAM APPROACH: Holistic, Strengths-Based, and Trauma-Informed Service Delivery Model

The STAR Program requires that any service model for newcomer survivors of trauma and their eligible family members include the following:

Direct provision of core services by the recipient with the option for indirect provision of some services through partner organizations and/or affiliates under a memorandum of understanding (MOU) that mandates administrative oversight and care coordination by the primary recipient.

Culturally and linguistically appropriate core services for the client population.

Holistic service delivery using a multidisciplinary team with shared systems and regular communication to coordinate provision of behavioral health, primary care, and social services across implementing partners.

Recognition of the client and family’s strengths and promotion of resiliency.

Comprehensive assessment at intake of the clients' medical, psychological, and social needs.

https://minorityhealth.hhs.gov/Default.aspx

A family-focused service plan that includes services for eligible family members who may experience the effects of trauma in their relationships.

Assessment and mitigation of the effects of trauma through family-strengthening interventions and conflict transformation.

Regular quarterly assessment of outcomes aligned with client-identified goals in the individual and family service plans.

Linkages and referrals to trauma-informed social support, such as housing, child-care, employment, educational or vocational assistance, that may preclude or reduce the need for more specialized mental health and case management services.

Note: Implementation of evidence-based promising trauma healing methodologies is encouraged.

Examples include mind-body interventions, creative arts and story-telling activities, sports, play therapy, and parenting training for caregivers, and leadership and empowerment initiatives for youth.

Maintenance of Case Files and Documentation of Services

STAR Program service providers are required to create and maintain confidential case files for each client. Upon enrollment, recipients will provide a form to each client or their parent/legal guardian regarding protection of their identity and privacy. The recipient must obtain the client or parent/legal guardian signature on the form and retain the form on file, as well as provide a copy to the client.

Providers must ensure compliance with 45 CFR § 75.303(e) to take reasonable measures to safeguard protected personally identifiable information. Files should be stored in a filing cabinet or other records storage areas, locked at all times when not in use, and accessible only to appropriate program personnel. If a service provider uses an electronic case file system, then it must establish safeguards such as limiting data access and encryption to protect participant information. The case file will, at minimum, include copies of documents that show client eligibility for trauma assistance services under the STAR Program, records of expenditures made on behalf of the client (where relevant, as in emergency funds), consent form for minor clients signed by parent/legal guardian, case notes, and related documents.

Intake information must include the client's name, date of birth, status under which the client arrived in the United States, date of enrollment, date of projected program service termination, and documentation of eligibility for STAR Program services. If a client is enrolled in other service programs, including ORR-funded programs, or is referred to another agency for service, documentation of the program and services provided under that program must be included in the case file.

ORR will seek approval from OMB for collection of case file information under the Paperwork Reduction Act (PRA).

NOTE: Consistent with the PRA of 1995, (44 U.S.C. 3501-3521), under this NOFO, ORR will not conduct or sponsor – and a person is not required to respond to a collection of information covered by such Act, unless it displays a currently valid OMB control number. ORR will obtain OMB approval for a federal study of the funded grant activities, as appropriate.

Confidentiality Forms

Upon enrollment, recipients will provide a form to each client or their parent/legal guardian regarding protection of their identity and privacy. The recipient must obtain the client or parent/legal guardian signature on the form and retain the form on file, as well as provide a copy to the client.

Release of Information Form

Upon enrollment, each client or the parent/legal guardian will receive a signed form from the agency regarding release of private information instituted by the STAR Program service provider and/or ORR.

Service Period and Term Limits

Once enrolled, individuals are eligible for 1 year of STAR services. If at the end of 1 year of services a client has not achieved the desired outcomes identified in their Individual and Family Wellness Plan and requires further services, the recipient may choose to enroll the client for a second term to provide ongoing support. The recipient must create a new Individual Self- Sufficiency and Wellness Plan for that client to ensure new SMART wellness goals for the second term of service. Clients will receive STAR services for a maximum of 2 consecutive periods. If at the end of 2 terms, a client has not reached therapeutic goals specified in the Wellness Plan, recipients must request ORR approval for enrolling the client in a third term of service.

Case Closure and Service-Closure Letter

Upon completion of the STAR service term, clients or the parent/legal guardian must receive a document indicating the closure of their case. The document will contain, at minimum, the following items:

1. A description of the specific mental health and other services provided and the relevant outcome/s;

2. A reminder to adjust immigration status to that of Lawful Permanent Resident (LPR) at the appropriate time frame from grant of the immigration status that made the individual eligible for ORR Services (if applicable), and resources or referrals to support the client’s adjustment to

LPR;

3. A reminder that failure to naturalize will result in the loss of Supplemental Security Income (SSI) benefits (where applicable);

4. A reminder that upon moving to a new address, the client must complete and submit a Change of Address Form AR-11 to USCIS and a Change of Address Form with the United States Postal Service (USPS);

5. A list of ORR-funded and mainstream resources and services available in the respective community. STAR Program clients must be advised that they are eligible for ORR state-administered Social Services for up to 5 years from their date of eligibility;

6. Contact information of a representative of the implementing partner as a reference point for subsequent service provider/s; and

7. Documentation of the completion of a “warm hand-off” to ensure continuity of care and to connect the client or their parent/legal guardian to any necessary ongoing services.

Non-Duplicative Services

Funding for STAR may not be used to duplicate and/or supplant activities and services offered through any ORR-funded program, including the Services for Survivors of Torture (SOT), Services for Afghan Survivors Impacted by Combat (SASIC), Refugee Health Promotion (RHP), Preferred Communities (PC) Programs within the state(s) of operation. Client case files must indicate clearly the discrete and specific scope of STAR activities to address and alleviate the impact of trauma for the intended service population. STAR clients may not be enrolled simultaneously in the PC Program, nor should recipients engage in capacity development for trauma interventions for clients under the STAR Program, using funds from other ORR grants only allocable costs are permitted per 45 CFR 75.405(c).

Equity Considerations

ORR stresses the importance of advancing equity consistent with the Executive Order on Advancing Racial Equity and Support for Underserved Communities (E.O. 13985) in all of its programming. ORR urges all recipients to ensure that all ORR-eligible populations, regardless of race, religion, gender identity, sexual orientation, disability, or other characteristic(s), receive fair treatment, access, and opportunity. ORR also strongly encourages recipients to practice inclusion, through purposeful collaboration and engagement with ethnic communities with lived experience to inform culturally and linguistically appropriate service design and delivery.

POST AWARD REQUIREMENTS

STAR Program Recipient Meetings

ORR will conduct an annual meeting of STAR recipients in person in Washington, DC, (conditions permitting) or remotely via teleconference. Recipients must send at least one key representative. The meeting will be designed to foster a community of practice through ORR and recipients sharing lessons learned, identifying notable practices, reporting trends, and disseminating knowledge of effective trauma-related interventions and case management.

Program Performance Monitoring and Evaluation

ORR will seek approval from OMB for information collection under the Paperwork Reduction Act (PRA) on collecting STAR client level data by utilizing the Refugee Arrival Data System (RADS) database.

NOTE: Consistent with the PRA of 1995 (44 U.S.C. 3501-3521), under this NOFO, ORR will not conduct or sponsor, and a person is not required to respond to, a collection of information covered by such Act, unless it displays a currently valid OMB control number. ORR is seeking approval of its STAR Program data indicators through the OMB Office of Information and Regulatory Affairs. ORR will not request this information if these forms are not approved at the time that reports are due. Please see Section VI.3. Reporting for more information.

Recipients must summarize and include monitoring reports of implementing partner sites in their semi-annual program progress reports provided to ORR to the extent authorized by OMB.

Following OMB approval, STAR recipients must report client progress using the STAR Mental Health and Case Management Client Assessment Indicators framework. Program indicators are currently under development and will be shared with grant recipients when complete. For https://www.acf.hhs.gov/orr/programs/refugees/services-survivors-torture https://www.acf.hhs.gov/orr/programs/refugees/sasic https://www.acf.hhs.gov/orr/programs/refugees/preventive-health https://www.acf.hhs.gov/orr/programs/refugees/pc#:~:text=The%20Preferred%20Communities%20(PC)%20program,at%20risk%2C%20and%20elderly%20refugees.

subsequent years, ORR will utilize achieved outcomes against those proposed in recipients’ non-competing applications to assess the need to award continued STAR funding.

As required by PRA, ORR will obtain approval from the OMB on data indicators for post-award reporting. Grant recipients will be required to report data points collected on an OMB-approved form on an annual basis.

STAR Program Performance Monitoring and Assessment

ORR Program staff and/or contract monitors may undertake periodic site visits as well as remote desk audits to monitor recipients’ performance and to assess their service delivery model, including through meeting community stakeholders. Areas of assessment have been described earlier in this section under Objective-Centered Program Activities and Relevant Assessment Areas. Following the visit, ORR will issue an official monitoring report to which recipients must respond.

A recipient that posts consistently low outcomes in one or both assessment areas and is found to be in non-compliance with one or more STAR program requirements and ORR/HHS policy guidelines will be placed under a Program Improvement Plan (PIP). Such a recipient must comply with training and technical assistance as required under the terms of PIP. Upon the recipient’s completion of and compliance with PIP, ORR will conduct a follow-up monitoring review to assess the effectiveness of PIP. If the recipient does not improve, ORR will follow customary procedures regarding suspension and/or termination of the cooperative agreement.

Staffing Requirements

ORR requires that recipients' Key Personnel possess appropriate professional credentials and licensures to address the mental health and case management needs of their client populations.

Additionally, where recipients are unable to engage bi/multilingual staff, staff from mainstream communities must demonstrate cultural awareness of, and sensitivity to, the ethnic and cultural groups represented in their service population. Onsite interpretation is a key requirement where staff do not possess proficiency in the languages represented in their client caseload. Adequate and effective Client-Case Staff ratios aligned with professional standards for the type of service provided (such as case management and mental health counseling) are also an essential staffing requirement to ensure workforce sustainability and well-being. Recipients must inform ORR of Key Personnel changes per 45 CFR 75.308(c)(1)(ii). Approval will be accomplished by a Notice of Award amendment issued by the ACF Office of Grants Management.

Key Personnel

Key personnel are salaried individuals (or volunteer professionals) whose contributions are essential for project implementation. They include, but are not limited to, the following:

Behavioral Health Services Director - This individual, who must be a licensed behavioral health expert in trauma-informed care, will oversee service design and delivery.

Pediatric Mental Health Advisor - This individual, who must possess child and adolescent wellness, health, and mental health training and expertise, will ensure availability and appropriateness of services for children and adolescents.

Case Management Coordinator - This individual, who must possess at minimum a master’s degree in social work, will be responsible for (1) coordination with, at a minimum, psychosocial, educational, and housing services; (2) supervision of referrals and follow up to ensure timely and appropriate service delivery; and (3) collection of outcome information.

Cultural and Community Liaison - This individual, who must possess in-depth and preferably lived experience with local newcomer communities, will facilitate the delivery of culturally appropriate services.

Community Health Workers—These individuals, who must be trained in outreach and basic health literacy/mental health first aid, may be employed as necessary to enhance the effectiveness of services to the intended population/s.

Note: One individual may fulfill several of the roles described above, provided that they meet requirements and can perform requisite duties. Positions can be full-time or part-time to ensure project flexibility and cost-effectiveness.

Subawards

Recipients under this program may opt to transfer a portion of substantive programmatic work to other organizations through subaward(s). The prime recipient must maintain a substantive role in the project. ACF defines a substantive role as conducting activities and/or providing services funded under the award that are necessary and integral to the completion of the project.

Subrecipient monitoring activities alone, as specified in 45 CFR § 75.352, do not constitute a substantive role. Furthermore, ACF does not fund awards where the role of the applicant is primarily to serve as a conduit for passing funds to other organizations unless that arrangement is authorized by statute.

Subrecipient(s) must meet the eligibility requirements identified in the NOFO, Section III.1.

Eligible Applicants. Additionally, all subrecipient(s) must obtain a Unique Entity Identifier (UEI) number assigned by the System for Award Management (SAM), if they do not already have one. Prime recipients are required to check SAM to verify that the subrecipient(s) is/are not debarred, suspended, or ineligible.

Please reference the Award Term and Condition on Subawards on the ACF Administrative and National Policy Requirements website for further requirements involving subawards.

If, during the project period, ORR and/or recipients are required to adjust program and/or recipient requirements due to a nationally declared emergency, ORR will exercise maximum flexibilities as needed. Requirements may be conducted virtually and/or timelines modified in consultation with ORR.

STAR Federal Program Evaluation

If ACF identifies resources to fund a federal study of STAR Program activities, then the recipient must participate in that study. Such a study will utilize a non-recipient evaluation team and will focus on the processes, implementation, progress indicators, and quality improvement of ACF-funded activities.

NOTE: Consistent with the PRA of 1995 (44 U.S.C. 3501-3521), under this NOFO, ORR will not conduct or sponsor, and a person is not required to respond to, a collection of information covered by such Act, unless it displays a currently valid OMB control number. ORR will obtain OMB approval for a federal study of the funded grant activities, as appropriate.

https://www.acf.hhs.gov/administrative-and-national-policy-requirements#book_content_14 https://www.acf.hhs.gov/administrative-and-national-policy-requirements https://www.acf.hhs.gov/administrative-and-national-policy-requirements

Bibliography

1. Refugee Health Technical Assistance Center. https://www.refugeehealthta.org/physical-mental-health/index.html Accessed February 17, 2023.

2. Trauma and Violence. The Substance Abuse and Mental Health Services Administration.

https://www.samhsa.gov/trauma-violence. Accessed January 23, 2023.

3. Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005; 365:1309–14.

4. Birman, D., & Tran, N. (2008). Psychological distress and adjustment of Vietnamese refugees in the United States: Association with pre- and postmigration factors. The American Journal of Orthopsychiatry, 78(1), 109–120. https://doi.org/10.1037/0002- 9432.78.1.109

5. Nose M, Ballette F, Bighelli I, Turrini G, Purgato M, Tol W, et al. (2017). Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis. PLoS One, 12(2), e0171030.

6. Sangalang CC, Vang C. Intergenerational trauma in refugee families: a systematic review. J Immigrant Minority Health. 2017;19(3):745-754.

7. Kutlesic V, Brewinski Isaacs M, Freund L, Hazra R, Raiten D. Executive Summary:

Research Gaps at the Intersection of Pediatric Neurodevelopment, Nutrition, and Inflammation in Low-Resource Settings. Pediatrics. (2017) 139 (Supplement_1): S1– S11.

8. Neuner F, Schauer M, Karunakara U, Klaschik C, Robert C, Elbert T. Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry. 2004; 4:34.

II. Federal Award Information

Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$14,000,000 Expected Number of Awards:

Award Ceiling:

$600,000 Per Budget Period

Award Floor:

$400,000 Per Budget Period

Average Projected Award Amount:

$500,000 Per Budget Period https://www.refugeehealthta.org/physical-mental-health/index.html https://www.refugeehealthta.org/physical-mental-health/index.html https://www.samhsa.gov/trauma-violence https://doi.org/10.1037/0002-9432.78.1.109 https://doi.org/10.1037/0002-9432.78.1.109 https://doi.org/10.1007/s10903-016-0499-7 https://doi.org/10.1007/s10903-016-0499-7

Anticipated Project Start Date:

01/15/2024 Length of Project Periods:

48-month project period with four 12-month budget periods

Additional Information on Project Periods and Explanation of 'Other' Additional Information on Awards:

Awards made under this funding opportunity are subject to the availability of federal funds.

Applications requesting an award amount that exceeds the Award Ceiling per budget period, or per project period, as stated in this section, will be disqualified from competitive review and funding under this funding opportunity. This disqualification applies only to the Award Ceiling listed for the first 12-month budget period for projects with multiple budget periods. If the project and budget period are the same, the disqualification applies to the Award Ceiling listed for the project period. Please see Section III.3. Other, Application Disqualification Factors.

Note: For those programs that require matching or cost sharing, recipients will be held accountable for projected commitments of non-federal resources in their application budgets and budget justifications by budget period or by project period for fully funded awards, even if the projected commitment exceeds the required amount of match or cost share. A recipient's failure to provide the required matching amount may result in the disallowance of federal funds.

For more information on these requirements, see Section III.2. Cost Sharing or Matching.

Non-competing continuation awards will be offered for the second, third, and fourth budget periods of the project based on the availability of funds, satisfactory progress of the recipient, and review and approval of the continuation application. The Grants Project Team (Grants Management Specialist, Federal Project Officer, and technical assistance provider) will use the recipient’s semi-annual performance progress and financial reports, site visits, audit reports and other supporting documentation to determine, in accordance with the requirements in the Competitive STAR NOFO and statute, if satisfactory progress is being made. ORR will factor in the recipient’s ability to meet the dues dates as identified in the NOFO. The Grants Project Team’s review of reports and other documentation will be used to assess progress in (1) accomplishing the project goals, objectives, and activities; (2) completing proposed activities;

and (3) documenting allowable expenses that support project goals, objectives, and the approved budget. Please refer to Section VI.3. Reporting Requirements for more information on required reports.

Description of ACF's Anticipated Substantial Involvement Under the Cooperative Agreement Award

The following is a description of ORR's anticipated substantial involvement under the cooperative agreement. ORR will:

• Approve the project work plan on an annual basis.

• Confer with the recipient on project activities throughout the year and recommend modification of the work plan, particularly with regard to shifts in eligible populations or to project sites, as necessary and appropriate.

• Consider, as necessary, enrollment exception requests and interventions to address gaps in services to vulnerable trauma-affected refugees as proposed by recipients.

• Monitor and provide written reports on the implementation, compliance, and outcomes of services and/or resources provided to refugees under the cooperative agreement. Such monitoring may include site visits, meetings, conference calls, review of reports and data, and requests for access to information associated with the implementation of the STAR Program, to the extent authorized by OMB.

• Convene, at a minimum, quarterly meetings with STAR Program recipients to discuss goals, objectives, outcomes, challenges, and other matters relating to the program.

III. Eligibility Information

III.1. Eligible Applicants

Eligibility is limited to public and private non-profit agencies.

Eligibility is open to the following types of entities: state governments; county governments; city or township governments; special district governments; independent school districts; public- and state-controlled institutions of higher education; Native American tribal governments (federally recognized); public housing authorities/Indian housing authorities; Native American tribal organizations (other than federally recognized tribal governments); non-profits having a 501(c)(3) status with the IRS other than institutions of higher education; non-profits without 501(c)(3) status with the IRS other than institutions of higher education; and private institutions of higher education.

Applications from individuals (including sole proprietorships) and foreign entities are not eligible and will be disqualified from competitive review and funding under this funding opportunity. See Section III.3. Other, Application Disqualification Factors.

Faith-based and community organizations that meet the eligibility requirements are eligible to receive awards under this funding opportunity. Faith-based organizations may apply for this award on the same basis as any other organization, as set forth at and, subject to the protections and requirements of 45 CFR Part 87 and 42 U.S.C. 2000bb et seq., ACF will not, in the selection of recipients, discriminate against an organization on the basis of the organization's religious character, affiliation, or exercise.

Reference to Legal Status See Section IV.2. Legal Status of Applicant Entity for documentation required to support eligibility.

III.2. Cost Sharing or Matching

Cost Sharing / Matching Requirement:

No For all federal awards, any shared costs or matching funds and all contributions, including cash and third-party in-kind contributions, must be accepted as part of the recipient’s cost sharing or matching when such contributions meet all criteria listed in 45 CFR § 75.306.

For awards that require matching by statute, recipients will be held accountable for projected commitments of non-federal resources in their application budgets and budget justifications by budget period, or by project period for fully funded awards, even if the projected commitment exceeds the amount required by the statutory match. A recipient’s failure to provide the statutorily required matching amount 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, where “cost sharing” refers to any situation in which the recipient voluntarily shares in the costs of a project other than as statutorily required matching, recipients will be held accountable for projected commitments of non-federal resources in their application budgets and budget justifications by budget period, or by project period for fully funded awards.