FORHP HRSA-22-064 (U6B) RCORPT TA_v2.FINAL.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Office of Rural Health Policy Rural Strategic Initiatives Division

Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance

Funding Opportunity Number: HRSA-22-064

Funding Opportunity Type: New and Competing Continuation Assistance Listings (CFDA) Number: 93.912

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: March 9, 2022

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

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: December 8, 2021

Marcia Colburn Public Health Analyst, Federal Office of Rural Health Policy Telephone: (301) 443-3261 Email: mcolburn@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: Section 711(b)(5) of the Social Security Act (42 U.S.C. 912(b)(5)).

mailto:mcolburn@hrsa.gov

HRSA-22-064 i

508 COMPLIANCE DISCLAIMER

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

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Rural Communities Opioid Response Program- Behavioral Health Care Technical Assistance (RCORP-BHCTA). The purpose of this program is to provide TA to rural consortiums engaging in activities to address behavioral health care issues, including substance use disorders (SUD). The TA will strengthen rural organizations’ capacity to develop multi-sector consortia that can plan, implement, and sustain programs that improve access to and quality of behavioral health care services, including substance use disorder (SUD)/opioid use disorder (OUD) services, in rural areas.

Funding Opportunity Title: Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance

Funding Opportunity Number: HRSA-22-064 Due Date for Applications: March 9, 2022 Anticipated Total Annual Available FY 2022 Funding:

$10,000,000

Estimated Number and Type of Award: One (1) cooperative agreement

Estimated Annual Award Amount: Up to $10,000,000 per year for 4 years, subject to the availability of appropriated funds

Cost Sharing/Match Required: No Period of Performance: September 1, 2022 through August 31, 2026 (4 years) Eligible Applicants: Eligible applicants include domestic public or private, non-profit and for-profit, entities. Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply.

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

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Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf, except where instructed in this NOFO to do otherwise.

Webinar

Day and Date: Tuesday, January 11, 2022 Time: 2 – 3 p.m. ET Call-In Number: 1-833-568-8864 Webinar ID: 160 416 9399 Weblink: https://hrsa-gov.zoomgov.com/j/1604169399

Following the webinar, please email Marcia Colburn (mcolburn@hrsa.gov) for a link to the recording.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa-gov.zoomgov.com/j/1604169399

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AW ARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Attachments

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

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

MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AW ARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice solicits applications for the Rural Communities Opioid Response Program-Behavioral Health Care Technical Assistance (RCORP-BHCTA). The purpose of this cooperative agreement is to strengthen, through technical assistance (TA), rural organizations’ capacity to develop multi-sector consortia that can plan, implement, and sustain programs that improve access to and quality of behavioral health care services, including substance use disorder (SUD)/opioid use disorder (OUD) services.

For the purposes of this cooperative agreement, improving rural behavioral health care service delivery includes increasing access to and utilization of prevention, treatment, and recovery services to improve health care for those affected by behavioral health conditions, which may include substance use and mental health disorders. Evidence-based prevention strategies improve health care in rural communities by reducing the strain on the rural health care system while also providing a cost-effective way of addressing and minimizing the individual and societal costs of behavioral health disorders.

This cooperative agreement will continue and enhance the TA efforts that began in 2018 for the Rural Communities Opioid Response Program (RCORP), a multi-year HRSA initiative aimed at reducing the morbidity and mortality of SUD, including OUD, in high-risk rural communities through the provision of prevention, treatment, and recovery services1.

The cooperative agreement recipient will provide TA to current and future RCORP award recipients, as well as other, non-RCORP award recipients, as determined by HRSA. For more information on RCORP, including a list of current programs and award recipients, visit here: https://www.hrsa.gov/rural-health/rcorp

The goals of RCORP-BHCTA, in collaboration with HRSA, are to:

1. Provide TA to RCORP award recipients2 and other rural stakeholders seeking guidance on how to improve access to and quality of behavioral health care services, including SUD/OUD services;

1 https://w ww.govinfo.gov/content/pkg/CREC-2018-03-22/html/CREC-2018-03-22-pt3-PgH2697.htm

2 Note that the cooperative agreement recipient may be asked to provide TA to other, non-RCORP aw ard recipients, as determined by HRSA. Non-RCORP aw ard recipients may include entities such as those funded through other FORHP programs that are focused on behavioral health, including SUD/OUD.

https://www.hrsa.gov/rural-health/rcorp

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2. Identify and/or develop, promote, and maintain tools and resources that support rural communities’ efforts to improve and sustain access to quality, equitable behavioral health care services, including SUD/OUD services;

3. Develop and enhance meaningful partnerships with relevant stakeholders at the local, state, regional, and national level to promote exchange of information and promising practices that improve and sustain behavioral health care, including SUD/OUD services, in rural communities; and

4. Identify and strengthen rural communities’ capacity to anticipate, prepare for, and respond to emerging behavioral health care issues, including SUD/OUD-related issues that would further negatively affect rural communities.

See the Project Specific Instructions section for information on HRSA and the cooperative agreement recipient’s respective responsibilities under each goal.

2. Background

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

912(b)(5)), which grants HRSA’s Federal Office of Rural Health Policy (FORHP) authority to “administer grants, cooperative agreements, and contracts to provide TA and other activities as necessary to support activities related to improving health care in rural areas.”

HRSA developed RCORP in 2018 to reduce the morbidity and mortality of SUD, including OUD, in high-risk rural communities. Since its inception, RCORP has invested over $400 million in community-based grants and technical assistance to support rural communities across 47 states and 2 territories.

The cooperative agreement recipient will provide intensive TA to active RCORP award recipients (and potentially non-RCORP award recipients as well, as determined by HRSA) to assist them with establishing and expanding behavioral health services, including for SUD/OUD, in their rural communities in addition to reducing behavioral health disparities. This program will expand upon the previous TA provided to RCORP award recipients under the RCORP-TA NOFO HRSA-18- 124.

Recent data suggest that SUD/OUD remains a significant challenge in rural communities. From 1999 through 2019, the rate of drug overdose deaths increased from 4.0 per 100,000 to 19.6 in rural counties. In the wake of the COVID-19 pandemic, preliminary data from the Centers for Disease Control and Prevention (CDC) indicates that there were over 100,000 overdose deaths in the 12-month period ending April 2021. In 2017, the rate of drug overdose deaths involving natural and semisynthetic opioids and psychostimulants was higher in rural than in urban counties. Additional data suggest that substances beyond opioids are of growing https://www.hrsa.gov/grants/find-funding/hrsa-18-124 https://www.hrsa.gov/grants/find-funding/hrsa-18-124 https://www.cdc.gov/nchs/products/databriefs/db403.htm https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm https://www.cdc.gov/nchs/data/databriefs/db345-h.pdf https://www.cdc.gov/nchs/data/databriefs/db345-h.pdf

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concern in rural communities. Overdose death rates from psychostimulants with abuse potential are higher in rural counties than urban ones, and alcohol-induced death rates increased at a greater rate in rural vs. urban between 2000 and 2018.

At the same time, behavioral health challenges more broadly continue to affect rural communities. For example, over half of Mental Health Professional Shortage Areas are located in rural communities and rural suicide rates were higher than urban rates in 2018 for both males and females. In 2019, nearly 20 percent of individuals in rural areas with any mental illness and almost half of those with significant functional impairments resulting from their mental illness reported unmet need for mental health services.

Compounding these behavioral health and substance use issues is the fact that significant behavioral health disparities persist in rural communities. In addition to having a higher prevalence of self-reported fair or poor health (compared to non- Hispanic whites), non-Hispanic blacks and American Indian/Alaska Natives (AI/ANs) living in rural communities report higher rates of frequent mental distress. Rural disparities in access to care also exist: in rural communities, fewer non-Hispanic blacks and Hispanics have insurance compared to non-Hispanic whites, and more non-Hispanic blacks, Hispanics, and AI/ANs report not being able to see a physician because of cost. Many individuals in rural communities also face cultural barriers that discourage them from seeking care, including the lack of culturally and linguistically sensitive providers.

II. Award Information

1. Type of Application and Award

Types of applications sought: New and Competing Continuation

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

HRSA Responsibilities

• Provide monitoring and ongoing support to individual RCORP award recipients to ensure that they adhere to program requirements, that project goals and objectives are achieved, and that activities and efforts can be sustained after the period of federal funding ends;

• Provide support in the identification and selection of TA focus areas and effective methods for delivering TA;

https://www.cdc.gov/nchs/products/databriefs/db345.htm https://www.cdc.gov/nchs/data/databriefs/db383-H.pdf https://data.hrsa.gov/Default/GenerateHPSAQuarterlyReport https://data.hrsa.gov/Default/GenerateHPSAQuarterlyReport https://www.cdc.gov/nchs/products/databriefs/db373.htm https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/NSDUHDetailedTabs2019/NSDUHDetailedTabs2019.pdf https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/NSDUHDetailedTabs2019/NSDUHDetailedTabs2019.pdf https://rupri.org/wp-content/uploads/Behavioral-Health-in-Rural-America-Challenges-and-Opportunities.pdf https://rupri.org/wp-content/uploads/Behavioral-Health-in-Rural-America-Challenges-and-Opportunities.pdf https://rupri.org/wp-content/uploads/Behavioral-Health-in-Rural-America-Challenges-and-Opportunities.pdf https://rupri.org/wp-content/uploads/Behavioral-Health-in-Rural-America-Challenges-and-Opportunities.pdf https://rupri.org/wp-content/uploads/Behavioral-Health-in-Rural-America-Challenges-and-Opportunities.pdf

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• Provide support in the identification and selection of focus areas and methods for developing evidence-based resources, tools, program-specific deliverables, and trainings focused on improving behavioral health care in rural communities;

• Review the TA approach and any modifications to the approach during the period of performance;

• Review TA materials and resources developed under the cooperative agreement for format, tone, and expected impact;

• Participate, as appropriate, in the planning of any meetings, educational activities, or workgroups conducted during the period of performance, including selecting dates, developing the agenda, inviting speakers, etc.;

• Identify opportunities and provide guidance on strategies for disseminating information about programs, activities, and resources, including key organizations through which to share information;

• Provide guidance and assistance in identifying emerging behavioral and public health care needs and priorities in rural communities that negatively impact pre-existing OUD/SUD health care problems;

• Identify and suggest special projects, products, resources, and/or technical assistance focused on improving health care in rural communities, including responding to identified emerging behavioral and public health care issues; and

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

Cooperative Agreement Recipient Responsibilities

• Collaborate with HRSA, the RCORP-Evaluation recipient, the RCORP Centers of Excellence recipients, and other rural stakeholders in the planning, execution and assessment of TA activities, including the identification of technical assistance and educational/developmental needs and the selection of mechanisms for implementation;

• Provide specific clinical, organizational and behavioral health care expertise to RCORP award recipients to help them achieve project and program goals;

• Provide customized TA to RCORP award recipients that includes, but is not limited to:

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o Regular 1:1 TA calls with award recipients;

o In-person and/or virtual site visits as needed;

o Learning opportunities such as Learning Collaboratives, Peer-to-Peer Networking, Policy Academies, etc.;

o In-person or virtual meetings, webinars, workgroups, town halls and/or trainings;

o Targeted TA, specific to regions and states; and o Other innovative TA methods as recommended by HRSA, RCORP- Evaluation findings, and/or award recipients;

• Provide ongoing learning opportunities to update RCORP award recipients and rural communities on key behavioral health care issues, considerations, trends, and available resources related to their projects;

• In collaboration with HRSA and the RCORP-Evaluation recipient, continuously adapt TA approaches and offerings to align with HRSA priorities, and the needs and feedback of RCORP award recipients and rural communities;

• In collaboration with HRSA and the RCORP-Evaluation recipient, provide guidance to RCORP award recipients on data collection best practices and use RCORP award recipients’ performance data to inform TA approaches and offerings;

• In collaboration with HRSA, provide or develop evidence-based resources, tools, and trainings on topics focused on improving and increasing access to behavioral health care in rural communities including, but not limited to:

o Substance use disorder prevention, treatment, and recovery in rural communities;

o Behavioral health care and workforce policies and service delivery in rural communities;

o Sustainability;

o Harm reduction;

o Developing, strengthening, and sustaining rural consortia;

o Innovative service delivery models;

o Health equity;

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o Addressing stigma in rural communities;

o Behavioral health care integration; and o Other emerging behavioral health care needs in rural communities;

• Develop a communications strategy that ensures resources, program updates, and other information can be easily shared between HRSA, RCORP award recipients, and other relevant stakeholders;

• Utilize various platforms, including a website, to provide RCORP award recipients and rural communities with regularly updated information, resources, and examples of promising/innovative practices related to behavioral health care policies, service delivery, sustainability strategies, and other pertinent topics;

• Highlight and share examples of promising and innovative rural behavioral health care initiatives and practices through various platforms;

• Disseminate evidence-based resources, tools, information, and trainings through multiple mediums and in a culturally and linguistically appropriate manner;

• In collaboration with HRSA, facilitate connections between rural communities and local/state/national resources and organizations to build capacity and infrastructure for behavioral health care services in rural areas. Examples include, but are not limited to:

o Telehealth Resource Centers; State Offices of Rural Health; RCORP- Rural Centers of Excellence on Substance Use Disorders cooperative agreement recipients; RCORP-Evaluation cooperative agreement recipient, Bureau of Health Workforce’s Behavioral and Public Health Programs and National Health Service Corps; and Rural Health Information Hub;

• Establish referral systems with stakeholders and entities who can help strengthen rural communities’ capacity to deliver mental/behavioral care services;

• In collaboration with HRSA, serve as a central organizing body for TA-related partnership convening, educational activities, and/or workgroups conducted during the period of the cooperative agreement;

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• Coordinate and collaborate regularly with the RCORP-Evaluation recipient and the RCORP-Rural Centers of Excellence on Substance Use Disorders recipients to ensure no duplication of effort;

• Provide guidance and assistance in identifying key organizations and stakeholders with which to share information on mental/behavioral health care activities, resources, and emerging needs and trends;

• Provide input to HRSA on the future direction of rural behavioral health care programs based on identified SUD/OUD needs of rural communities; and

• Collaborate with HRSA to ensure that TA provided and resources developed are responsive to shifts in HRSA priorities and the health care needs of rural communities.

2. Summary of Funding

HRSA estimates approximately $10,000,000 to be available annually to fund one recipient. The actual amount available will not be determined until enactment of the final FY 2022 federal appropriation. You may apply for a ceiling amount of up to $10,000,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

The period of performance is September 1, 2022 through August 31, 2026 (4 years).

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

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

III. Eligibility Information

1. Eligible Applicants

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

Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply.

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

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In addition to the 50 U.S. states, only organizations in the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated State of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau may apply. If you are located outside the 50 states, you must still meet the eligibility requirements.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

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

• Exceeds the ceiling amount

• Exceeds the application page limitations referenced in Section IV.2

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

• Because the cooperative agreement recipient will be expected to provide technical assistance to RCORP award recipients across the 50 U.S. states as well as in the U.S. territories/freely associated states, applications that are not nationwide in scope may be considered non-responsive, and may not be considered for funding. Applicants must submit an attestation in Attachment 6 which affirms that the proposed project is nationwide in scope, inclusive of all 50 states, the District of Columbia, and the U.S.

territories and freely associated states.

NOTE: Multiple applications from an organization are not allowable.

HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, before the Grants.gov application due date as the final and only acceptable application.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 workspace application package associated with this https://www.grants.gov/

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notice of funding opportunity (NOFO) following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-22-064 in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov. You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this NOFO.

2. Content and Form of Application Submission

Application Format Requirements

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

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

Application Page Limitation

The total size of all uploaded files included in the page limit shall be no more than the equivalent of 80 pages when printed by HRSA. The page limit includes the project and budget narratives, and attachments required in the Application Guide and this

NOFO.

Please note: Effective April 22, 2021, the abstract is no longer an attachment that counts in the page limit. The abstract is the standard form (SF) "Project Abstract Summary.” Standard OMB-approved forms included in the workspace application package do not count in the page limit. If you use an OMB-approved form that is not included in the workspace application package for HRSA-22-064, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit.

Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit.

http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit of 80 will not be read, evaluated, or considered for funding.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under HRSA-22-064 before the deadline.

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Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

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

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

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

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

Program-Specific Instructions

Required activities for each program goal are as follows:

Program Goal 1: Provide TA to RCORP award recipients3 and other rural stakeholders seeking guidance on how to improve access to and quality of behavioral health care services, including SUD/OUD services.

• Collaborate with HRSA, the RCORP-Evaluation award recipient, RCORP Centers of Excellence recipients, and other rural stakeholders in the planning, execution and assessment of TA activities, including the identification of technical assistance and educational/development needs and the selection of mechanisms for implementation;

• Provide specific clinical, organizational and behavioral health care expertise to award recipients to help them achieve project and program goals;

• Provide customized TA to RCORP award recipients that includes, but is not limited to:

o Regular 1:1 TA calls with award recipients;

o In-person and/or virtual site visits as needed;

3 Note that the cooperative agreement recipient may be asked to provide TA to other, non-RCORP aw ard recipients, as determined by HRSA. Non-RCORP aw ard recipients may include entities such as those funded through other FORHP programs that are focused on behavioral health, including SUD/OUD.

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o Learning opportunities such as Learning Collaboratives, Peer-to-Peer Networking, Policy Academies, etc.;

o In-person or virtual meetings, webinars, workgroups, town halls and/or trainings;

o Targeted TA, specific to regions and states; and o Other innovative TA methods as recommended by HRSA, evaluation reports, and/or award recipients;

• Provide ongoing learning opportunities to update RCORP award recipients and rural communities on key behavioral health care issues, considerations, trends, and available resources related to their projects;

• In collaboration with HRSA and RCORP-Evaluation, continuously adapt TA approach and offerings to align with HRSA priorities and the needs and feedback of RCORP award recipients and rural communities; and

• In collaboration with HRSA and the RCORP-Evaluation recipient, provide guidance to RCORP award recipients on data collection best practices and use RCORP award recipients’ performance data to inform TA approaches and offerings.

Program Goal 2: Identify and/or develop, promote, and maintain tools and resources that support rural communities’ efforts to improve and sustain access to quality, equitable behavioral health care services, including SUD/OUD services.

• In collaboration with HRSA, provide or develop evidence-based resources, tools, and trainings on topics focused on improving and increasing access to behavioral health care in rural communities including, but not limited to:

o Substance use disorder prevention, treatment, and recovery in rural communities (NOTE: Evidence-based prevention strategies improve health care in rural communities by reducing the strain on the rural health care system while also providing a cost-effective way of addressing and minimizing the individual and societal costs of behavioral health disorders);

o Behavioral health care and workforce policies and service delivery in rural communities;

o Sustainability;

o Harm reduction;

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o Developing, strengthening, and sustaining rural consortia;

o Innovative service delivery models;

o Health equity;

o Addressing stigma in rural communities;

o Behavioral health integration; and o Other emerging mental/behavioral health needs in rural communities;

• Highlight and share examples of promising and innovative rural behavioral health care initiatives and practices through various platforms;

• Develop a communications strategy that ensures resources, program updates, and other information can be easily shared between HRSA, RCORP award recipients, and other relevant stakeholders;

• Utilize various platforms, including a website, to provide RCORP award recipients and rural communities with regularly updated information, resources, and examples of promising/innovative practices related to behavioral health care policies, service delivery, sustainability strategies, and other pertinent topics; and,

• Disseminate evidence-based resources, tools, and trainings through multiple mediums and in a culturally and linguistically appropriate manner.

Program Goal 3: Develop and enhance meaningful partnerships with relevant stakeholders at the local, state, regional, and national level to promote exchange of information and promising practices that improve and sustain behavioral health care, including SUD/OUD services, in rural communities.

• In collaboration with HRSA, facilitate connections between rural communities and local/state/national resources and organizations to build capacity and infrastructure for behavioral health care services in rural areas. Examples include, but are not limited to:

o Telehealth Resource Centers;

o State Offices of Rural Health; RCORP-Rural Centers of Excellence on Substance Use Disorders cooperative agreement recipients;

o RCORP-Evaluation cooperative agreement recipient;

HRSA-22-064 14

o Bureau of Health Workforce’s Behavioral and Public Health Programs and National Health Service Corps;

o and Rural Health Information Hub;

• Establish referral systems with stakeholders and entities who can help strengthen rural communities’ capacity to deliver mental/behavioral care services;

• In collaboration with HRSA, serve as a central organizing body for TA-related partnership convening, educational activities, and/or workgroups conducted during the period of the cooperative agreement;

• Coordinate and collaborate regularly with the RCORP-Evaluation recipient and the RCORP-Rural Centers of Excellence on Substance Use Disorders recipients to ensure no duplication of effort; and

• Provide guidance and assistance in identifying key organizations and stakeholders with which to share information on mental/behavioral health care activities, resources, and emerging needs and trends.

Program Goal 4: Identify and strengthen rural communities’ capacity to anticipate, prepare for, and respond to emerging behavioral health care issues, including SUD/OUD-related issues that would further negatively affect rural communities.

• Provide input to HRSA on the future direction of rural mental/behavioral health care programs based on identified SUD/OUD needs of rural communities; and

• Collaborate with HRSA to ensure that TA provided and resources developed are responsive to shifts in HRSA priorities and the health care needs of rural communities.

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

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment or it will count toward the page limitation. Please use the guidance below.

It is most current and differs slightly from that in Section 4.1.ix of HRSA’s SF-424 Application Guide.

Provide a summary of the application in the Project Abstract box of the Project http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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Abstract Summary Form using 4,000 characters or less.

Address Project Director Name Contact Phone Numbers (Voice, Fax) Email Address Website Address, if applicable List all grant program funds requested in the application, if applicable

Because the abstract is often distributed to provide information to the public and Congress, prepare this so that it is clear, accurate, concise, and without reference to other parts of the application. It must include a brief description of the proposed project including the needs to be addressed, the proposed services, and the population group(s) to be served. If the application is funded, your project abstract information (as submitted) will be made available to public websites and/or databases including USAspending.gov.

NARRATIVE GUIDANCE

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

Narrative Section Review Criteria

Introduction (1) Need

Needs Assessment (1) Need

Methodology (2) Response and (4) Impact

Work Plan (2) Response and (4) Impact

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures, (4) Impact and

(5) Resources/Capabilities

Organizational Information (5) Resources/Capabilities

Budget Narrative (6) Support Requested http://www.usaspending.gov/

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ii. Project Narrative

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

Use the following section headers for the narrative:

INTRODUCTION -- Corresponds to Section V’s Review Criterion(a) #1---Need

This section should briefly describe how the applicant will advance the stated goals of RCORP-BHCTA and the applicant’s experience and expertise working with rural communities to improve behavioral health care services, including SUD/OUD services.

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

The needs assessment should help reviewers understand the behavioral health care needs, including SUD/OUD, to be fulfilled by this TA cooperative agreement and provide the context and rationale for the proposed work plan and budget.

Using quantitative and qualitative data and information from relevant and appropriate sources, you should demonstrate comprehensive knowledge and understanding of the access to behavioral health care, workforce, and policy barriers facing rural communities that affect their ability to implement and sustain behavioral health care services, including SUD/OUD, services.

This section should also demonstrate an understanding of the distinct health care delivery system and social service needs of providers and communities in rural America and the gaps that exist within the current infrastructure for support of behavioral health care services, including SUD/OUD prevention, treatment, and recovery services, for this population.

Finally, you should include demographic and health outcomes data that depict the target population and their unmet behavioral health care needs, including information on any affected subpopulations who have historically suffered from health disparities.

These populations may include, but are not limited to, homeless populations, racial and ethnic minorities, people who are pregnant, adolescents and youth, LGBTQ individuals, the elderly, individuals with disabilities, etc.

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

Using data and information provided in the “Needs Assessment” section of the application, please include the following in this section:

• Outline your proposed approach to fulfilling each of the project goals and corresponding cooperative agreement responsibilities outlined in the Program Specific Instructions section. It is strongly encouraged that you use the subheadings “Project Goal 1,” “Project Goal 2,” “Project Goal 3,” and “Project Goal 4.”

• Describe the methods by which the TA cooperative agreement will address the behavioral health care access and outcome disparities experienced by vulnerable populations within rural communities. You are encouraged to utilize the methods outlined in the National Culturally and Linguistically Appropriate Services Standards (CLAS), among other sources.

• Detail how the cooperative agreement will be complementary, versus duplicative, of other HHS and HRSA-funded activities.

• Describe the methods by which you will collaborate and communicate with HRSA and other relevant partners to implement and meet project goals.

• Describe how the strategies implemented during the period of performance will continue to have an impact after federal funding ends, including how they will enable RCORP and non-RCORP award recipients to sustain behavioral health care services, including SUD/OUD.

Note that while the Work Plan section of the application will identify discrete inputs, activities, timelines, and responsible individuals/organizations, the Methodology section of the application focuses more on the overarching strategy for fulfilling the project goals.

WORK PLAN -- Corresponds to Section V’s Review Criteria #2---Response and

#4---Impact

This section describes the processes that you will use to achieve the strategies in the “Methodology” section. It is strongly recommended that you provide your work plan in a table format and clearly link activities to the project goals outlined in the Program- Specific Instructions section of the NOFO. The work plan should reflect a four-year period of performance.

Your work plan should include the following:

https://thinkculturalhealth.hhs.gov/clas/standards https://thinkculturalhealth.hhs.gov/clas/standards

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• Activities/tasks associated with each of the cooperative recipient responsibilities enumerated in the Program Specific Instructions section of the

NOFO.

• Activities/tasks associated with addressing behavioral health care access and outcome disparities experienced by vulnerable populations within rural communities.

• Activities/tasks to ensure that strategies implemented during the period of performance will continue to have an impact after federal funding ends and enable RCORP award recipients to sustain behavioral health care services, including SUD/OUD.

• Activities/tasks associated with ensuring a smooth transition to the next RCORP four-year period of performance.

• Timeline for completing each activity/task (note that timelines should be clear and specific; “ongoing” is not an acceptable timeline).

• Individual or partner organization responsible for each activity/task.

The work plan should be included in the application as Attachment 1. It is appropriate to simply refer reviewers to Attachment 1 in the Project Narrative section of the application instead of including the work plan twice.

RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion

#2---Response

Discuss specific challenges expected pertaining to the development and implementation of the activities described in the work plan, and detailed approaches to resolve such challenges. You should describe anticipated internal challenges as well as challenges associated with working with HRSA, other relevant partners, and rural communities (including vulnerable populations within those communities). Also describe anticipated challenges related to state and regional-specific issues, including, but not limited to, policy barriers. In discussing solutions, identify any infrastructure in place and/or resources that will assist in overcoming potential barriers.

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EVALUATION AND TECHNICAL SUPPORT CAPACITY -- CORRESPONDS TO

SECTION V’S REVIEW CRITERIA #3---Evaluative Measures, (4) Impact and #5--- Resources and Capabilities.

Describe the plan for the program performance evaluation that will contribute to continuous quality improvement. The program performance evaluation should monitor ongoing processes and the progress towards the goals and objectives of the project. Include descriptions of the inputs (e.g., organizational assets, collaborative partners, key personnel, budget, and other resources), key processes, and expected outcomes of the funded activities. You should detail how you will designate at least one individual to work directly with the RCORP-Evaluation cooperative agreement recipient to ensure that technical assistance is continually monitored, assessed, and improved to maximize the impact on health care in rural communities.

Additionally, clearly describe how evaluation results and lessons learned will be communicated to HRSA, RCORP award recipients and other relevant stakeholders.

Please include examples of mediums/platforms for disseminating this information and experience using these such platforms.

ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review

Criterion 5 Resources and Capabilities

Please provide the following information in this section:

• Information on your organization’s current mission and structure, and scope of current activities.

• Description of your organization’s experience and expertise in working with diverse stakeholders within rural communities to implement and sustain behavioral health care services including SUD/OUD. Include relevant individuals on staff, materials published, and previous work of a similar nature.

• Description of your organization’s ability to implement a project that is responsive to the technical assistance behavioral health care needs, including SUD/OUD, of rural communities across the country.

• Description of your organization’s ability to provide overall project management and serve as the fiscal agent for this cooperative agreement.

• Description of your organization’s knowledge of, as well as successful experience working with, entities including, but not limited to, HHS agencies, Regional Telehealth Resource Center(s), Primary Care Organizations, quality improvement organizations, national, state, and local rural health and social service organizations, rural health care providers and systems of care, etc.

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• An organizational chart (Attachment 5) that clearly shows the internal hierarchy among project staff at the applicant organization as well as the applicant organization’s relationship to any partner organizations that will be involved in the project.

• Clear designation of a Project Director who is employed by the applicant organization and who will devote a minimum of 0.50 FTE on this cooperative agreement. The Project Director is the point person on the award and makes staffing, financial, and other decisions to align project activities with project outcomes. You should detail how the Project Director will facilitate collaborative input and engagement with HRSA, other partner organizations, and rural communities to complete the proposed work plan during the period of performance.

• Staffing plan and job descriptions for key personnel as Attachment 2. NOTE: If a staff member has yet to be hired (TBH), please put “TBH” in lieu of a name and detail the process and timeline for hiring and onboarding the new staff, as well as the qualifications and expertise required by the position. At a minimum, the staffing plan should include a Project Director and an individual who will be responsible for coordinating with the RCORP- Evaluation cooperative agreement recipient as detailed in the “Evaluative Measures and Technical Capacity” section of this NOFO.

o The staffing plan should at a minimum contain the following information and clearly link to the activities in the work plan:

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Name Title Organizational affiliation Relevant certifications and degrees Full-time Equivalent (FTE) dedicated to this project Roles/responsibilities on the project Timeline and process for hiring or onboarding, if applicable

• Biosketches for all key personnel in Attachment 3. The biosketches should demonstrate that staff have the necessary expertise and qualifications for executing their designated roles and responsibilities on the project.

• Signed and dated letter(s) of commitment from any partner organizations formally collaborating (i.e., through a subcontractual agreement) on this project in Attachment 4. The letter(s) should include the following:

o Commitment to working with the applicant organization on the project;

o Anticipated time commitment and duration of involvement on the project;

o Anticipated roles/responsibilities on the project; and o Relevant experience, qualifications, and/or expertise that align with their roles and responsibilities on the project.

iii. Budget

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

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

Applicant organizations are strongly encouraged to demonstrate how their budget will maximize their capacity to implement the proposed project and improve the health care delivery in rural communities (e.g., by limiting indirect costs).

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As required by the Consolidated Appropriations Act, 2021 (P.L. 116-260), Division H, § 202 and Division A of the Further Continuing Appropriations Act, 2022 (P.L. 117- 70), “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II.” See Section 4.1.iv Budget – Salary Limitation of HRSA’s SF-424 Application Guide for additional information. Note that these or other salary limitations may apply in the following fiscal years, as required by law.

iv. Budget Narrative

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

v. Attachments

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

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

Attachment 1: Work Plan

Attach the work plan for the project that includes all information detailed in Section IV.

Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (see Section

4.1. of HRSA’s SF-424 Application Guide)

Keep each job description to one page in length as much as is possible. Include the role, responsibilities, and qualifications of proposed project staff. Also include a description of your organization’s time keeping process to ensure that you will comply with the federal standards related to documenting personnel costs.

Attachment 3: Biographical Sketches of Key Personnel

Include biographical sketches for persons occupying the key positions described in Attachment 2, not to exceed two pages in length per person.