PKG00248943-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Opioid Workforce Expansion Program (OWEP) Paraprofessionals

Funding Opportunity Number: HRSA-19-089 Funding Opportunity Type: New

Catalog of Federal Domestic Assistance (CFDA) Number 93.732

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2019

Application Due Date: May 7, 2019

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, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: March 8, 2019

Nicole M. Wilkerson Project Officer, Behavioral and Public Health Branch Division of Nursing and Public Health Email: OWEP-para@hrsa.gov

Authority: Sections 756(a)(4) of the Public Health Service (PHS) Act, as amended (42 U.S.C. § 294 e–1) mailto:OWEP-para@hrsa.gov i

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for fiscal year (FY) 2019 for the Opioid Workforce Expansion Program (OWEP) Paraprofessionals program.

The purpose of this Notice of Funding Opportunity (NOFO) is to build upon existing HRSA investments to enhance community-based experiential training focused on Opioid Use Disorder (OUD)1 and other Substance Use Disorders (SUD) for students preparing to become peer support specialists and other types of behavioral health-related paraprofessionals. The Opioid Workforce Expansion Program Paraprofessionals program will train behavioral health-related paraprofessionals in the provision of OUD and other SUD prevention, treatment, and recovery services in high need and high demand areas.2 Special focus is on demonstrating knowledge and understanding of the specific concerns of children, adolescents, and transitional-age youth in high need and high demand areas who are at risk for behavioral health disorders.

The OWEP Paraprofessionals program is designed to expand and improve direct access to quality treatment and foster an integrated and/or interprofessional approach to address OUD and other SUD treatment emphasizing the role of the family and lived experience of the consumer through academic, community and non-traditional community organization partnerships.

Funding Opportunity Title: Opioid Workforce Expansion Program

(OWEP) Paraprofessionals

Funding Opportunity Number: HRSA-19-089 Due Date for Applications: May 7, 2019

Anticipated Total Available FY19 Funding:

$29,800,000

Estimated Number and Type of Award(s): Approximately 33 Estimated Award Amount: Up to $900,000 (fully funded at the outset for use over the period of performance) Cost Sharing/Match Required: No

Period of Performance: September 1, 2019 thru August 31, 2022

(3 years)

1 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition DSM-5. Washington, DC and London, England: American Psychiatric Publishing.

2 For purposes of this NOFO high need areas are identified on as sites located within Mental Health Professional Shortage Areas

(HPSAs) or Facility Mental HPSAs with a score of 16 or above, and/or that have a County overdose rate that is higher than the national average of 21.7per 100,000 population (2017 CDC).

ii

Eligible Applicants

State-licensed mental health nonprofit and for-profit organizations (see Definition in section VIII).

Eligible entities, including academic institutions (i.e., universities, community colleges or technical schools), must be accredited by a nationally recognized accrediting agency, as specified by the U.S. Department of Education.

Tribal Organizations may apply for these funds, if otherwise eligible.

Individuals are not eligible to apply under this NOFO.

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

Application Guide You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance HRSA will hold a pre-application technical assistance (TA) webinar(s) for applicants seeking funding through this opportunity. The webinar(s) will provide an overview of pertinent information in the NOFO and an opportunity for applicants to ask questions.

Visit the HRSA Bureau of Health Workforce’s open opportunities website at https://bhw.hrsa.gov/fundingopportunities/ to learn more about the resources available for this funding opportunity.

http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf https://bhw.hrsa.gov/fundingopportunities/ iii

Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING

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 Justification Narrative

v. Attachments

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

SYSTEM FOR AWARD MANAGEMENT

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 AND OTHER PRE-AWARD ACTIVITIES

4. ANTICIPATED ANNOUNCEMENT AND AWARD DATES

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

IX. TIPS FOR WRITING A STRONG APPLICATION

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Opioid Workforce Expansion Program (OWEP) Paraprofessionals program.

The purpose of this program is to enhance community-based experiential training for students preparing to become peer support specialists and other types of behavioral health-related paraprofessionals with a focus on Opioid Use Disorder (OUD) and other Substance Use Disorders (SUD) prevention, treatment and recovery services.

Consistent with the statutory authority, applicants must also demonstrate a special focus on preservice or in-service training of paraprofessional child and adolescent mental health workers to understand the specific concerns of children, adolescents, and transitional-age youth in high need and high demand areas who are at risk for behavioral health disorders.

The program is designed to expand and improve direct access to quality treatment and foster an integrated and/or interprofessional approach to address OUD and other SUD treatment emphasizing the role of the family and lived experience of the consumer through academic, community and non-traditional community organization partnerships.

The program also supports career development in behavioral health for paraprofessional career progression as well as the development of skills and expertise of staff, facilitators, and training instructors in prevention, treatment, and recovery services of OUD and other SUDs.

Award recipients will impact the behavioral health workforce by increasing the number of behavioral health-related paraprofessionals and transforming integrated and interprofessional teams to effectively prevent and treat OUD and other SUDs in community-based practices.

Program Goal and Objectives

Goal: To increase the number of peer support specialists and other behavioral health-related paraprofessionals trained in the provision of OUD and other SUD prevention, treatment, and recovery services to serve in high need and high demand areas.

The OWEP Paraprofessionals Program objectives are to:

• Enhance the existing paraprofessional certificate program(s) through curriculum development or enhancement and inclusion of hands-on learning in the form of field placements or internships including preservice or in-service training to understand the specific concerns of the targeted population in OUD and other SUD prevention, treatment and recovery services;

HRSA-19-089

• Create additional slots beyond current program capacity to increase the number of students trained in high need and high demand areas with a focus on working with persons who are at risk for behavioral health disorders, including children, adolescents, and transitional-aged youth;

• Support career development and job readiness that will prepare trainees to participate in collaborating programs to create an infrastructure of skills, expertise, and support of a behavioral health team, which provides support and services to Drug Addiction Treatment Act (DATA-waived) Medication Assisted Treatment (MAT) prescribers as part of coordinated care teams;

• Provide job placement services to assist students in obtaining employment in high need and high demand areas. Implement integrated and/or interprofessional training in community-based experiential training sites, including community-based and non-traditional community partners and organizations (e.g., emergency departments, first responders, judicial systems) to serve high need and high demand areas;

• Establish or leverage partnerships with community-based and non-traditional community organizations to serve high need and high demand areas and populations;

• Develop or enhance student/trainee competencies around evidence-supported prevention and treatment modalities used in integrated and/or interprofessional team-based practices for OUD and other SUD prevention, treatment, and recovery services; and

• Ensure a culturally competent workforce by recruiting and providing financial support to students who are committed to serving high need and high demand areas after program completion.

Please note: HRSA aims to provide technical assistance and evaluation support to OWEP Paraprofessionals program recipients and other HRSA behavioral and mental health recipients. It is required that all applicants who are awarded under the OWEP Paraprofessionals program Notice of Funding Opportunity (NOFO) will work collaboratively with the technical assistance providers (to be determined) as well as other OWEP Professionals and Paraprofessionals recipients throughout the duration of the period of performance regarding technical assistance and evaluation issues.

Refer to Section V.2 of this funding opportunity for detailed information on qualifying for a funding priority or preference.

2. Background

The OWEP Paraprofessionals program is authorized by Section 756(a)(4) of the Public Health Service (PHS) Act, as amended (42 U.S.C. § 294e–1). Section 756 states that applicants must also demonstrate a special focus on preservice or in-service training of paraprofessional child and adolescent mental health workers to understand the specific concerns of children, adolescents, and transitional-age youth in high need and high demand areas who are at risk for behavioral health disorders. Collaborative models focusing on both pediatric mental health and primary care are increasingly recognized as optimal for meeting the needs of children with behavioral health issues.3,4,5

Additionally, there is increasing federal support for utilizing an integrated care model for addressing the behavioral health needs of children and youth.6

The opioid crisis is a multigenerational problem affecting individuals throughout the lifespan from infants to seniors, and will have resounding repercussions for many years to come.7 Opioid use and its resulting deaths have impacted the lives of individuals and families, weakened communities, and depleted limited resources.8 The effect is especially evident in states with large rural populations, where nonmedical prescription opioid misuse remains a growing public problem.9

In 2017, there were 70,237 drug overdose deaths in the United States.10 Drug overdose death rates increased from 1999 to 2017 for all age groups.10 The age-adjusted rate of drug overdose deaths increased from 6.1 per 100,000 standard population in 1999 to 21.7 in 2017.10 Emergency department visits for opioid overdoses rose 30 percent in all parts of the United States from July 2016 through September 2017.11

In 2017, an estimated 46.6 million adults (18.9 percent of the population), aged 18 or older, were diagnosed with any mental illness (AMI) in the past year.12 Similarly, in this same year, 19.7 million people aged 12 or older had a SUD.12 Moreover, an estimated

8.5 million adults, aged 18 or older (3.4 percent of all adults), had both AMI and SUD in the past year.12 Among the 8.5 million adults with co-occurring AMI and SUD, 51 percent received either substance use treatment at a specialty facility or mental health

3 Greene, C.A., Ford, J.D., Ward-Zimmerman, B., Honigfeld, L., Pidano, A.E. Strengthening the Coordination of Pediatric Mental

Health and Medical Care: Piloting a Collaborative Model for Freestanding Practices. Child Care Youth Forum 2016; 45(5):

729-744. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098813/.

4 Gooding, H.C., Ziniel, S., Touloumtzis, C., Pitts, S., Goncalves, A., Emans, J., Burke, P. Case-Based Teaching for Interprofessional Postgraduate Trainees in Adolescent Health. Journal of Adolescent Health 2016; 58: 567-572. Available at:

https://www.jahonline.org/article/S1054-139X(16)00043-4/pdf.

5Wolraich, M.L., Drotar, D.>, Perrin, E.C. Developmental-Behavioral Pediatrics Evidence and Practice 2008. Available at:

https://www.sciencedirect.com/book/9780323040259/developmental-behavioral-pediatrics.

6 Briggs, H.E., Miller, S.E, Briggs, A.C. Enhancing Behavioral Health Workforce in Youth Mental Health through Grand Challenges in Social Work. Journal of Child and Adolescent Behavior 2016; 4(1): 270. Available at: https://www.omicsonline.org/open-access/enhancing-behavioral-health-workforce-in-youth-mental-health-throughgrand-challenges-in-social-work-2375-4494- 1000270.php?aid=69568.

7 Committee on Education and Workforce, U.S. House of Representatives, November 2017. Available at:

https://edworkforce.house.gov/news/documentsingle.aspx?DocumentID=402081.

8 Johns Hopkins Bloomberg School of Public Health, and the Clinton Foundation, Clinton Health Matters Initiative. The Opioid Epidemic From Evidence to Impact. (2017, October). Available at https://www.jhsph.edu/events/2017/americas-opioid-epidemic/report/2017-JohnsHopkins-Opioid-digital.pdf.

9 Keyes, K.M., Cerda, M., Brady, J.E., Havens, J.R., Galea, S. Understanding the Rural-Urban Differences in Nonmedical Prescription Opioid Use and Abuse in the United States. American Journal of Public Health 2014; 104(2): e52-e59. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935688/.

10Centers for Disease Control and Prevention. Hedegaard H, Miniño AM, Warner M. Drug overdose deaths in the United States, 1999–2017. NCHS Data Brief, no 329. Hyattsville, MD: National Center for Health Statistics. (2018, November). Available at https://www.cdc.gov/nchs/data/databriefs/db329-h.pdf.

11 Vital Signs. Opioid Overdoses Treated in Emergency Departments. Available at https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html.

12 Substance Abuse and Mental Health Services Administration. (2018, September). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Retrieved February 21, 2019, from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098813/ https://www.jahonline.org/article/S1054-139X(16)00043-4/pdf https://www.sciencedirect.com/book/9780323040259/developmental-behavioral-pediatrics https://www.omicsonline.org/open-access/enhancing-behavioral-health-workforce-in-youth-mental-health-throughgrand-challenges-in-social-work-2375-4494-1000270.php?aid=69568 https://www.omicsonline.org/open-access/enhancing-behavioral-health-workforce-in-youth-mental-health-throughgrand-challenges-in-social-work-2375-4494-1000270.php?aid=69568 https://www.omicsonline.org/open-access/enhancing-behavioral-health-workforce-in-youth-mental-health-throughgrand-challenges-in-social-work-2375-4494-1000270.php?aid=69568 https://edworkforce.house.gov/news/documentsingle.aspx?DocumentID=402081 https://www.jhsph.edu/events/2017/americas-opioid-epidemic/report/2017-JohnsHopkins-Opioid-digital.pdf https://www.jhsph.edu/events/2017/americas-opioid-epidemic/report/2017-JohnsHopkins-Opioid-digital.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935688/ https://www.cdc.gov/nchs/data/databriefs/db329-h.pdf https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report care.12 Also in 2017, 13.3 percent of adolescents aged 12 to 17 (3.2 million adolescents) and 13.1 percent of young adults aged 18 to 25 (4.4 million) had a major depressive episode.12

Compounding these behavioral health challenges is the fact that significant behavioral health disparities persist in underserved communities across the United States. These disparities may be due to a number of different factors, including a lack of access to health care, a need for a health care workforce that reflects the population served, a lack of information, and the need for culturally and linguistically competent care and programs.13

To help address these issues, there has been a dramatic rise in the adoption of alternative forms of peer support services in the behavioral health service arena to assist recovery, particularly for those with co-occurring psychiatric and SUDs.14 Peer support workers encompass a range of activities and interactions between people who share similar experiences of being diagnosed with mental health conditions, SUD, or both.15 Peer support workers use their lived experience of recovery from mental illness and/or SUD as well as skills learned in formal training that include evidence-based interventions to deliver services in behavioral health settings that promote mind– body recovery and resilience.16 Peer support workers offer a level of acceptance, understanding, and validation not found in many other professional relationships. By sharing their own lived experience and practical guidance, peer support workers help people to develop their own goals, create strategies for self-empowerment, and take concrete steps towards building fulfilling, self-determined lives for themselves.17

For example, parent peer support, also commonly called family peer support or family support services, offers hope, guidance, advocacy, and camaraderie for parents and caregivers of children and youth receiving services from mental health, substance use, and related service systems.17 Parent support providers deliver peer support through face-to-face support groups, phone calls, or individual meetings.17 They bring expertise based on their own experience parenting children or youth with social, emotional, behavioral, or substance use challenges, as well as specialized training, to support other parents and caregivers.17 Protective factors such as family stability, supportive and nurturing relationships, a strong community, and faith organizations can help prevent certain kinds of problems from developing in children and adolescents and can

13 Substance Abuse and Mental Health Services Administration. Health Disparities. Available at: https://www.samhsa.gov/health-disparities.

14 Tracy, K. Wallace, S. Benefits of peer support groups in treatment of addiction 2016. Available at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047716/#b11-sar-7-143.

15 Substance Abuse and Mental Health Services Administration. Value of Peers 2017. Available at:

https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/value-of-peers-2017.pdf 16 Center for Substance Abuse Treatment. What are peer recovery support services? Substance Abuse an.d Mental Health Services

Administration, HHS, Rockville, MD (2009).HHS Publication No. SMA 09-4454.

17 Substance Abuse and Mental Health Services Administration. Value of Peers 2017. Available at:

https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/value-of-peers-2017.pdf.

https://www.sciencedirect.com/topics/medicine-and-dentistry/substance-use-disorder https://www.sciencedirect.com/topics/medicine-and-dentistry/bodymind https://www.sciencedirect.com/topics/medicine-and-dentistry/bodymind https://www.samhsa.gov/health-disparities https://www.samhsa.gov/health-disparities https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047716/#b11-sar-7-143 https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/value-of-peers-2017.pdf https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/value-of-peers-2017.pdf also be a source of support that will help them cope with mental health and substance use problems.18

Integrated health care is also an emerging key role for behavioral health-related paraprofessionals. Integrated care involves a patient-centered care team such as psychologists, social workers, psychiatric nurses and peer support specialists who provide evidence-based treatments for a defined population using a measurement-based treat-to-target approach.19 Integrating mental health, substance abuse, and primary care services produces the best outcomes and proves the most effective approach to caring for people with multiple healthcare needs.20

For example, a number of emergency departments are utilizing peer support services (recovery coaches, peer counselors) to assist OUD and other SUD patients as part of the treatment plan to avoid additional overdoses. AnchorED was launched in an attempt to reduce the instance of accidental opioid overdose by connecting overdose patients with Certified Recovery Coaches in emergency departments.21 In its first year of operation, between 2014 and 2015, recovery coaches saw 230 survivors, and only 12 of these survivors (5 percent) have been seen in the emergency room multiple times.

The state of Massachusetts has implemented a new program that will expand residential recovery services, increase access to MAT, add new recovery coaches, and implement a consistent clinical assessment tool throughout the treatment system.22

The need for behavioral health-related paraprofessionals with expertise and skills to provide OUD and other SUD prevention, treatment and recovery services in creative and innovative ways is evident. HRSA is seeking applicants to train behavioral health-related paraprofessionals who are committed to serving individuals in high need and high demand areas in need of OUD and other SUD prevention, treatment and recovery services with a focus on the special concerns of children and adolescents during their training and following program completion. As holistic review and social determinants of health indicate that outcomes are more positive when more than just “the addiction” is treated, you are encouraged to consider the utilization of integrated and/or interprofessional training teams and environments that include both paraprofessional and professional team members.

HRSA has a number of investments targeting OUD and other SUD across its bureaus and offices that applicants may be able to leverage. For information on HRSA-

18 Substance Abuse and Mental Health Services Administration. Identifying Mental Health and Substance Use Problems of Children and Adolescents: A Guide for Child-Serving Organizations. Available at: https://store.samhsa.gov/shin/content/SMA12- 4700/SMA12-4700.pdf.

19SAMSHA-HRSA Center for Integrated Health Solutions https://www.integration.samhsa.gov/integrated-care-models/CIHS_quickStart_decisiontree_with_links_as.pdf

20 SAMSHA-HRSA Center for Integrated Health Solutions. Available at: https://www.integration.samhsa.gov/about-us/what-is-integrated-care

21 Substance Abuse and Mental Health Services Administration. Supporting recovery in acute care and emergency settings.

Available at: https://www.samhsa.gov/sites/default/files/programs_campaigns/recovery_to_practice/supporting-recovery-in-acute-care-emergency-settings.pdf

22 Office of Governor Charlie Baker and Lt. Governor Karyn Polito. Press Release: Governor Baker Highlights Role of Recovery Coaches During Visit to Beverly Hospital. Available at: https://www.mass.gov/news/governor-baker-highlights-role-of-recovery-coaches-during-visit-to-beverly-hospital https://store.samhsa.gov/shin/content/SMA12-4700/SMA12-4700.pdf https://store.samhsa.gov/shin/content/SMA12-4700/SMA12-4700.pdf https://www.integration.samhsa.gov/integrated-care-models/CIHS_quickStart_decisiontree_with_links_as.pdf https://www.integration.samhsa.gov/integrated-care-models/CIHS_quickStart_decisiontree_with_links_as.pdf https://www.integration.samhsa.gov/about-us/what-is-integrated-care https://www.integration.samhsa.gov/about-us/what-is-integrated-care https://www.samhsa.gov/sites/default/files/programs_campaigns/recovery_to_practice/supporting-recovery-in-acute-care-emergency-settings.pdf https://www.samhsa.gov/sites/default/files/programs_campaigns/recovery_to_practice/supporting-recovery-in-acute-care-emergency-settings.pdf https://www.mass.gov/news/governor-baker-highlights-role-of-recovery-coaches-during-visit-to-beverly-hospital https://www.mass.gov/news/governor-baker-highlights-role-of-recovery-coaches-during-visit-to-beverly-hospital supported resources, technical assistance, and training, visit here:

https://www.hrsa.gov/opioids.

Program Definitions

A glossary containing general definitions for terms used throughout the Bureau of Health Workforce NOFOs can be located at the Health Workforce Glossary. A listing of other key terms relevant to this notice can be found in Section VIII Other Information.

II. Award Information

1. Type of Application and Award

Types of applications sought: New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA expects approximately $29,800,000 to be available to fund approximately 33 recipients. You may apply for a ceiling amount of up to $900,000 total cumulative cost, or a ceiling amount of $300,000 per year (includes both direct and indirect/facilities and administrative costs). The budget period and period of performance are from September 1, 2019 through August 31, 2022. Awards are fully funded at the outset for use over the period of performance.

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

Indirect costs under training grants to organizations other than federally recognized Native American or American Indian tribes, state, or local governments will be budgeted and reimbursed at eight (8) percent of modified total direct costs rather than on the basis of a negotiated cost agreement, and are not subject to upward or downward adjustment. Direct cost amounts for equipment, tuition and fees, and sub-awards and contracts in excess of $25,000 are excluded from the direct cost base for purposes of this calculation.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include the following:

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

• State-licensed mental health nonprofit and for-profit organizations. These organizations must be able to carry out programs for pre-service or in-service training of paraprofessional child and adolescent mental health workers. These programs can include occupations such as peer support specialist, peer support counselor, community health worker, outreach worker, social services aide, substance abuse/addictions worker, youth worker, and promotor/a (for full list of occupations see the definitions section). For the purpose of this NOFO, these organizations may include academic institutions, including universities, community colleges and technical schools, which must be accredited by a nationally recognized accrediting agency, as specified by the U.S. Department of Education.

Tribal Organizations may apply for this these funds, if otherwise eligible.

In addition to the 50 states, eligible entities include the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau.

Trainee Eligibility

Students must be enrolled full or part time in the school or program receiving the grant award in order to receive tuition support in the OWEP Paraprofessionals program. In addition, students must be eligible to work in the United States. A student/trainee receiving support from grant funds must be a citizen of the United States or a foreign national having in his/her possession a visa permitting permanent residence in the United States.

Accreditation/Approval Documentation

Entities must be accredited by a nationally recognized accrediting agency, as specified by the U.S. Department of Education or must be approved by the state government to provide a behavioral health-related paraprofessional certificate program. Applicants must provide a copy of their active accreditation or active approval from the state government as Attachment 6.

All applicants must provide proof of accreditation or state government approval documentation in the form of a letter on state government letterhead. HRSA may consider any application that fails to attach a copy of the required accreditation or certification documentation as Attachment 6 non-responsive and may not consider it for funding under this notice. Applicants are required to maintain their accreditation throughout the period of performance and notify HRSA of change in status.

2. Cost Sharing

Cost Sharing is not required for this program.

3. Other

Ceiling Amount HRSA will consider any application that exceeds the ceiling amount of $900,000 for the entire 3-year period, or $300,000 per year, non-responsive and will not consider it for funding under this notice.

Deadline

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 non-responsive and will not consider it for funding under this notice.

Maintenance of Effort (MoE) The recipient must agree to maintain non-federal funding for award activities at a level that is not less than expenditures for such activities during the fiscal year prior to receiving the award. Complete the MoE document and submit it as Attachment 5 in your application.

Multiple Applications Multiple applications from an organization with the same DUNS number are not allowed.

Eligible applicants can submit only one application per campus; multiple applications from a single campus are not allowable. A campus is defined as a division of a university that has its own grounds, buildings and faculty. Where multiple programs from an institution are interested in applying under this funding notice, you may collaborate across programs to submit a single application.

Experiential Training Sites Experiential training or internship sites must participate in integrated and/or interprofessional team based practices with a special focus on preservice or in-service training in a behavioral health-related paraprofessional field.

You must submit agreements and/or contracts with the experiential training sites that meet these criteria in Attachment 2.

If for any reason (including submitting to the wrong funding opportunity number, making corrections/updates, or multiple applications from the same institution), an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

Failure to include all required documents as part of the application will result in an application being considered incomplete or non-responsive.

IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 Research and Related (R&R) workspace application package associated with this NOFO following the directions provided at https://www.grants.gov/applicants/apply-for-grants.html.

If you are reading NOFO (also known as “Instructions” on Grants.gov) and reviewing or preparing the workspace application package, you will automatically be notified in the event HRSA changes and/or republishes the NOFO on Grants.gov before its closing date. Responding to an earlier version of a modified notice may result in a less competitive or ineligible application. Please note, you are ultimately responsible for reviewing the For Applicants page for all information relevant to desired opportunities.

2. Content and Form of Application Submission

Section 4 of HRSA’s SF-424 R&R Application Guide provides instructions for the budget, budget justification, staffing plan and personnel requirements, assurances, certifications, and abstract. You must submit the information outlined in the SF-424 R&R Application Guide in addition to the program specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 R&R Application Guide except where instructed in the NOFO to do otherwise.

Applications must be submitted in the English language and must be in terms of U.S.

dollars (45 CFR § 75.111(a)).

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

Application Page Limit The total size of all uploaded files may not exceed the equivalent of 70 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments including biographical sketches (biosketches), and letters of commitment and support required in HRSA’s SF-424 R&R Application Guide and this NOFO.

Standard OMB-approved forms that are included in the application package do NOT count in the page limitation. Biographical Sketches do count in the page limitation.

Indirect Cost Rate Agreement and proof of non-profit status (if applicable) will not be counted in the page limit. We strongly urge you to take appropriate measures to ensure your application does not exceed the specified page limit.

Applications must be complete, within the specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline to be considered under this notice.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification https://www.grants.gov/ https://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf

1) The prospective recipient certifies, by submission of this proposal, that neither it nor its principals is 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) Where the prospective recipient is unable to attest to any of the statements in this certification, an explanation shall be included in Attachment 12 Other Relevant Documents.

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

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

i. Project Abstract See Section 4.1.ix of HRSA’s SF-424 R&R Application Guide.

In addition to the requirements listed in the SF-424 R&R Application Guide, you must include the following information in the abstract:

1. Project Title;

2. A brief overview of the project as a whole;

3. Specific, measurable objectives that the project will accomplish;

4. How the proposed project will be accomplished, i.e., the "who, what, when, where, why and how" of a project; and

5. Statement indicating eligibility for funding preference and/or funding priority (if applicable).

The project abstract must be single-spaced and is limited to one page in length.

ii. Project Narrative

This section provides a comprehensive framework and description of all aspects of the proposed project. The Project Narrative should be succinct, self-explanatory and well organized so that reviewers can understand the proposed project. It must address the goals and purpose of the NOFO and the strategies to be used in attaining the goals and meeting the funding opportunity’s purpose.

To identify best or promising practices in effectively integrating your proposed grant project into your existing health care practice, you are encouraged to work with your Regional Telehealth Resource Center (http://www.telehealthresourcecenter.org/who-your-trc). You may wish to review the Agency for Healthcare Research and Quality’s http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424rrguidev2.pdf http://www.telehealthresourcecenter.org/who-your-trc http://www.telehealthresourcecenter.org/who-your-trc technical brief, MAT Models of Care for OUD in Primary Care Settings (http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=2350) or the Rural Health Information Hub’s Community Health Gateway (https://www.ruralhealthinfo.org/community-health) for models that specifically incorporate telehealth or could be modified to include a telehealth component.

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

PURPOSE AND NEED -- Corresponds to Section V’s Review Criterion #1

You must describe the purpose and need for the proposed project, including:

• Your relationship with experiential training sites in the community and ability to place trainees;

• Your relationships with community-based organizations and non-traditional partners (e.g., emergency departments, first responders, judicial systems) to address OUD and other SUD prevention, treatment and recovery services, with emphasis on the knowledge and understanding of the specific concerns of children, adolescents and transitional-age youth who are at risk for behavioral health disorders;

• Describe the participation in the institutions’ programs of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations, and the concerns of individuals with behavioral health disorder symptoms or diagnoses, particularly children and adolescents and transitional-age youth;

• The needs of the behavioral health workforce in the local community including the training site’s patient population, and a description of the expertise and training that OWEP Paraprofessional recipients will provide to address these needs;

• The behavioral health, and OUD and other SUD prevention, treatment, and recovery service needs of the community where trainees will practice. Include the information shown in Table 1 as Attachment 4. You must provide the source from which you obtain the county overdose rate for the location(s) of your training site(s). All data provided is subject to verification;

• The target population served in the experiential training sites described in Attachment 4, the community served, social determinants of health, behavioral health disparities, and how they will be addressed through the training grant;

• The needs of the applicant training program including description of the experiential training sites and pertinent didactics/courses related to OUD and other SUD prevention, treatment and recovery services;

• If applicable, your existing or developing telehealth network, its members and plans for addressing the health care service needs of at-risk populations in high need and high demand areas;

http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=2350 http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=2350 https://www.ruralhealthinfo.org/community-health

• Gaps and barriers in preparing trainees to provide integrated and/or interprofessional team based care with a focus on the OUD and other SUD population and at-risk populations; and

• The benefit to the community from the collaborative partnerships in the proposed project.

Table 1 Site Name

Experiential Site Address

(EXAMPLE:

XX Main Street, Town, State, Zip code)

Number of

OWEP

Students Trained

Number of trainee hours or hours in rotation

Mental Health HPSA score using the HPSA Find Too

County Overdose

Rate (Provide Rate per 100,000

Population)

Name and Link of Site from which County

Overdose Rates were obtained

RESPONSE TO PROGRAM PURPOSE -- This section includes three sub-sections —

(a) Work Plan; (b) Methodology/Approach; and (c) Resolution of Challenges—all of which correspond to Section V’s Review Criteria #2 (a), (b), and (c).

(a) WORK PLAN -- Corresponds to Section V’s Review Criterion #2 (a).

Provide a comprehensive, detailed work plan that addresses how, through concrete steps, you plan to implement the proposed project in order to achieve the goals of the NOFO and successfully implement the proposed activities identified in the Methodology/Approach section. The work plan must drive and align with the methodology and include the following:

1. Description of the activities or steps, key partners, staff responsible, and timeframes during the three (3) year period of performance. Goals and objectives must be specific, measurable, achievable, realistic, and time framed;

2. Explanation of how the work plan is appropriate for the program design and how the targets for key activities fit into the overall grant implementation timeline and three (3) year period of performance; and

3. Identification of meaningful support and collaboration with key stakeholders in planning, designing and implementing all activities, including development of the application and, further, the extent to which these contributors reflect the populations and communities served.

A sample work plan can be found in at http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx.

Documentation of work plan must be submitted as Attachment 10.

http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx

(b) METHODOLOGY/APPROACH -- Corresponds to Section V’s Review Criterion #2

Describe your objectives and proposed activities, and provide evidence for how they link to the project purpose and stated needs. Propose methods that you will use to address the stated needs and meet each of the previously described program objectives in this

NOFO.

You must present a clear plan to:

• Recruit and train behavioral health paraprofessional trainees with a focus on OUD and other SUD prevention, treatment and recovery services, as well as demonstrate knowledge and understanding of the specific concerns of children, adolescents, and transitional-age youth in high need and high demand areas who are at risk for behavioral health disorders;

• Identify the number of trainees that will be trained focusing on OUD and other SUD prevention, treatment and recovery services;

• Develop and deliver experiential and didactic curriculum that models and develops competencies in integrated and/or interprofessional teams focusing on at risk populations in OUD and other SUD prevention, treatment and recovery services;

• Create additional slots beyond current program capacity to increase the number of students trained in high need and high demand areas with a focus on working with persons who are at risk for behavioral health disorders, including children, adolescents, and transitional-aged youth;

• Support career development, and job readiness that will prepare trainees to participate in collaborating programs to create an infrastructure of skills, expertise, and support of a behavioral health team, including how they will provide behavioral health support and services to Drug Addiction Treatment Act (DATA-waived) MAT Prescribers as part of coordinated care teams;

• Describe how you will assist students with job placement services to attain employment in facilities in high need and high demand areas; ensure there is a mechanism to provide and track trainee supervision with the evidence-supported prevention and treatment modalities used in the delivery of integrated and/or interprofessional team based practices for OUD and other SUD prevention, treatment and recovery services;

• Establish or leverage partnerships with community-based and non-traditional community organizations that serve high need and high demand areas and populations;

• Participate in training for staff, field supervisors, facilitators and training instructors to create an infrastructure of skills, expertise, and support of interprofessional teams;

• List the health care and community support services, with an emphasis on OUD and other SUD prevention, treatment, and recovery services, that will be provided via telehealth when applicable, and provide well-reasoned estimates of the number of patients that will receive care for each service during each year of the grant;

• Discuss the strategies for coordinating the integration and/or interprofessional training in community based experiential training sites, including community-based and non-traditional community partners and organizations (e.g., emergency departments, first responders, judicial systems) that serve high need and high demand areas;

• Discuss the strategies for training staff, field supervisors, facilitators and training instructors to create an infrastructure of skills, expertise, and support of a interprofessional team;

• Demonstrate a holistic approach to health care that incorporates social determinants of health; and

• Develop a logic model for designing and managing their project as Attachment

9. A logic model is a one-page diagram that presents the conceptual framework for a proposed project and explains the links among program elements to achieve the relevant outcomes. While there are many versions of logic models, for the purposes of this notice the logic model should summarize the connections between the:

• Goals of the project (e.g., objectives, reasons for proposing the intervention, if applicable);

• Assumptions (e.g., beliefs about how the program will work and support resources. Base assumptions on research, best practices, and experience);

• Inputs (e.g., organizational profile, collaborative partners, key staff, budget, other resources);

• Target population (e.g., the individuals to be served);

• Activities (e.g., approach, listing key intervention, if applicable);

• Outputs (i.e., the direct products or deliverables of program activities); and

• Outcomes (i.e., the results of a program, typically describing a change in people or systems).

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

Discuss challenges that they are likely to encounter in designing and implementing the activities described in the work plan, and approaches to resolve such challenges. This section must include:

1. Challenges related to program objectives, work plan, project implementation, and achievement of the proposed goals and objectives (e.g., program performance evaluation and performance measurement requirements);

2. Challenges related to the workforce development, such as recruitment and retention and education and training of paraprofessionals in high need and high demand areas;

3. Obstacles to obtaining experiential training sites with the principal focus on OUD and other SUD prevention, treatment and recovery services; and

4. Resources and plans to resolve and overcome these challenges and obstacles.

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

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

Describe how you plan to monitor, evaluate, and document your project’s performance.

Performance Evaluation Plan: The applicant must provide a Performance Evaluation Plan that will contribute to continuous quality improvement. The plan must include:

1. How the applicant will monitor ongoing processes and progress toward meeting goals and objectives of the project;

2. An approach for utilizing both quantitative and qualitative data efforts to quarterly review program outcomes;

3. Descriptions of the inputs (e.g., key evaluation staff and organizational support, collaborative partners, budget, and other resources), key processes, and variables to be measured;

4. Expected outcomes of the funded activities; and

5. Description of how all key evaluative measures will be reported and disseminated.

You must submit as Attachment 1 a complete staffing plan and job descriptions for…