PKG00257877-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Opioid-Impacted Family Support Program

Funding Opportunity Number: HRSA-20-014 Funding Opportunity Type: New

Assistance Listings (CFDA) Number: 93.732

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2020

Application Due Date: April 13, 2020

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: January 21, 2020

Andrea L. Knox, MS Public Health Analyst, DNPH Telephone: (301) 443-4170 Email: OIFSP@hrsa.gov

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

HRSA-20-014 i

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2020 Opioid-Impacted Family Support Program. The purpose of this program is to support training programs that expand the number of peer support specialists and other behavioral health-related paraprofessionals who are trained to work in integrated, interprofessional teams in providing services to children whose parents are impacted by opioid use disorders (OUD) and other substance use disorders (SUD), and their family members who are in guardianship roles. Additionally, a special focus is on demonstrating knowledge and understanding of the specific concerns for children, adolescents and transitional aged youth in high need and high demand areas who are at risk for mental health disorders and SUDs. For the purpose of this NOFO, the term “paraprofessional” refers specifically to those working in the behavioral health-related field. Additionally, this program will provide developmental opportunities and educational support to increase the number of paraprofessional trainees receiving a certificate upon completion of pre-service training (Level I training which includes didactic and experiential field training) and entering into in-service training (Level II training which includes training at a registered Department of Labor apprenticeship site).

Funding Opportunity Title: Opioid-Impacted Family Support Program Funding Opportunity Number: HRSA-20-014 Due Date for Applications: April 13, 2020 Anticipated Total Annual Available FY 2020 Funding:

$11,500,000

Estimated Number and Type of Award(s): Approximately 19 grants Estimated Award Amount: Up to $600,000 per year subject to the availability of appropriated funds Cost Sharing/Match Required: No Period of Performance: September 1, 2020 through

August 31, 2024 (4 years)

HRSA-20-014 ii

Eligible Applicants: State-licensed mental health nonprofit and for-profit organizations (see Definition in Section VIII). 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. Domestic faith-based and community-based organizations, tribes, and tribal organizations may apply for these funds, if otherwise eligible. Individuals are not eligible to apply.

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/default.aspx 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/default.aspx

HRSA-20-014 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/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 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

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Opioid-Impacted Family Support Program (OIFSP).

Program Purpose The purpose of this program is to support training programs that enhance and expand paraprofessionals1 knowledge, skills and expertise, and to increase the number of peer support specialists and other behavioral health-related paraprofessionals who work on integrated, interprofessional teams in providing services to children whose parents are impacted by opioid use disorders (OUD) and other substance use disorders (SUD), and their family members who are in guardianship roles. Additionally, a special focus is on demonstrating knowledge and understanding of the specific concerns for children, adolescents and transitional aged youth in high need and high demand areas2 who are at risk for mental health disorders and SUDs.

Program Goal The program goal is to increase the number of peer support specialists and other behavioral health-related paraprofessionals who are prepared to work with families who are impacted by OUD and other SUDs in high need and high demand areas.

Program Objectives The program objectives are to:

1) Enhance and expand, didactic educational support and experiential field training opportunities for OIFSP paraprofessional trainees that target children, adolescents and transitional age youth whose parents are impacted by OUD and other SUDs, and their family members who are in guardianship roles. These two components (didactic and experiential field training) comprise Level I training and are further explained in the Background section.

2) Develop, or establish a partnership with, registered apprenticeship programs to provide in-service training that places paraprofessional trainees in behavioral health-related positions addressing OUD and other SUDs. The apprenticeship program constitutes Level II training and is also further explained in the Background section.

3) Reduce financial barriers by providing financial support to trainees in the form of tuition/fees, supplies, and stipend support.

4) Create additional training positions beyond current program capacity to increase the number of paraprofessionals trained by a minimum of 10 percent in year one and maintain that level each year of the 4-year project period, with a focus on working with families who are impacted by OUD and other SUDs.

1 For the purpose of this NOFO, the term “paraprofessional” refers specifically to those working in the behavioral health-related field

HHS and HRSA Priorities You are encouraged to address HHS’s and HRSA’s clinical priority: Combatting the opioid crisis. https://www.hhs.gov/about/leadership/secretary/priorities/index.html

2. Background

The OIFSP is authorized by Section 756(a)(4) of the Public Health Service (PHS) Act, as amended (42 U.S.C. § 294e–1(a)(4)) and builds upon existing HRSA paraprofessional programs. Increased levels of individual substance use, including but not limited to opioids, have devastated many American families, and impacted the child welfare system. Child welfare caseloads nationally increased by 10 percent from 397,600 to 437,500 between fiscal years 2012 and 2016.3 Child welfare agencies and their community partners are struggling to meet families’ needs due to shortages of trained staff, which can undermine the efforts of family reunification.

Paraprofessionals, including behavioral specialists, peer support specialists and community health workers, continue to represent an under-utilized segment of the behavioral health workforce.4 The role of behavioral health-related paraprofessionals and the unique skills and abilities they bring to the behavioral health workforce is increasingly being recognized as a critical component of coordinated care teams.5 In addition, there is increasing federal support for utilizing an integrated care model for addressing the behavioral health needs of children and youth.6 Paraprofessionals and other behavioral health technicians have also been increasingly recognized for their key role in mitigating provider shortages and increasing behavioral health care access to underserved youth and minority populations.7 8 A number of studies in the literature provide evidence that families fare better when their children are provided with services that support their developmental, behavioral, and social-emotional needs to help mitigate the long-term impacts of OUD and SUD. 9

3 Laura Radel, Melinda Baldwin, Ph.D., Gilbert Crouse, Ph.D., Robin Ghertner and Annette Waters, Ph.D. Substance Use, the Opioid Epidemic, and the Child Welfare System: Key Findings from a Mixed Methods Study. ASPE Research Brief, HHS. March 2018. Available at https://aspe.hhs.gov/system/files/pdf/258836/SubstanceUseChildWelfareOverview.pdf 4 Scope of Practice Alignment with Job Tasks for Paraprofessionals and Addiction Counselors. University of Michigan Behavioral Health Workforce Research Center. Available at: http://www.behavioralhealthworkforce.org/wp-content/uploads/2017/05/FA3P3_SOP- Parapro_Addiction-Couns_Full-Report_v2.pdf 5 Ibid 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 David Newlin et al, “Environmental Transmission of DSM‐IV Substance Use Disorders in Adoptive and Step Families,” Alcoholism: Clinical and Experimental Research, 24 (April 2006): 1785-1794, https://doi.org/10.1111/j.1530-0277.2000.tb01982.x.

8 The Annapolis Coalition on the Behavioral Health Workforce. An Action Plan for Behavioral Health Workforce Development. Cincinnati, OH:

Annapolis Coalition 2007.

9 Calhoun S, Conner E, Miller M, Messina N. Improving the outcomes of children affected by parental substance abuse: a review of randomized controlled trials. Subst Abuse Rehabil. 2015 Jan 28;6:15-24. doi: 10.2147/SAR.S46439.

https://www.hhs.gov/about/leadership/secretary/priorities/index.html https://aspe.hhs.gov/system/files/pdf/258836/SubstanceUseChildWelfareOverview.pdf http://www.behavioralhealthworkforce.org/wp-content/uploads/2017/05/FA3P3_SOP-Parapro_Addiction-Couns_Full-Report_v2.pdf http://www.behavioralhealthworkforce.org/wp-content/uploads/2017/05/FA3P3_SOP-Parapro_Addiction-Couns_Full-Report_v2.pdf 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

The diagram below represents the idealistic training flow for funded OIFSP recipients.

OIFSP Training (Level I Pre-service training)

Recipients will recruit peer support specialists and other behavioral health-related paraprofessional trainees into their program. Trainees must be enrolled full- or part-time in the school or program receiving the grant award in order to receive tuition and stipend support in the OIFSP. Level I pre-service training consists of two components – the first part is didactic training and the second part is hands-on learning in the form of experiential field placements to understand specific concerns of the targeted population in OUD and other SUD prevention treatment and recovery services. Recipients will identify these field placement sites and match trainees to those sites. Trainees may participate in didactic and experiential field placement training simultaneously, or complete the didactic portion first and then move on to experiential field placements portion. Both the didactic and experiential curriculum will help trainees develop competencies in integrated and interprofessional teams focusing on children, adolescents and transitional age youth. Depending on whether students are full-time or part-time, Level I pre-service training can take up to 6-12 months. Full time trainees

DIDACTIC TRAINING

(up to 6 months)

REGISTERED

APPRENTICESHIP

(Minimum 12 months)

PRE-SERVICE (Level I) (All Trainees)

Educational Program

IN-SERVICE

(Level II)

(At least 50% of Level 1 program completers)

RECEIVE CERTIFICATE

OIFSP Training Diagram

RECIPIENT

TRAINEE RECRUITMENT

EXPERIENTIAL FIELD TRAINING

(6-12 months) who successfully complete Level I pre-service training will receive the full tuition/fees and supplies (maximum $3,000) and stipend ($5,000) support for no more than 12 consecutive months. Part-time trainees are allowed to receive a stipend prorated at one-half of the fixed amount per budget year for no more than twenty-four (24) consecutive months. Throughout the training period, the trainee will receive portions of their stipend to help defray the cost of living expenses. The recipient organization determines how often the stipends will be disbursed based on their institution policies.

If a full time trainee completes didactic as well as experiential training in 6 months, they will receive the full amount for tuition/supplies (maximum $3000) and stipend ($5000).

This will ensure trainees will receive support during their training period. The maximum stipend amount is awarded to those trainees who complete both the didactic and experiential trainings (Level I pre-service). Once a trainee completes the didactic and experiential training and receives a certificate, these trained paraprofessionals are known as Level I pre-service program completers.

The recipient will aim for at least 50 percent of the Level I pre-service program completers to enter into a registered apprenticeship program (Level II in-service training). Level I pre-service program completers that agree to enter into a registered apprenticeship program will sign a commitment letter that describes the training relationship, including the expectations of the registered apprenticeship site and the role of the apprentice. The award recipient will manage and serve as the conduit between the Level I pre-service program completer and the registered apprenticeship training program.

Level I pre-service program completers may be referred by the recipient to receive in-service training by entering into a registered apprenticeship (Level II in-service training).

Registered Apprenticeship (Level II In-service training) The Department of Labor describes an apprenticeship as a proven approach for preparing workers for jobs while meeting the needs of business for a highly-skilled workforce. It is an employer-driven, “learn-while-you-earn” model that combines on-the-job training, provided by the employer that hires the apprentice, with job-related instruction in curricula tied to the attainment of national skills standards. The model also involves progressive increases in an apprentice’s skills and wages. For the purposes of this NOFO, a registered apprenticeship is described as a system of training behavioral health-related paraprofessional trainees that receive on-the-job training once they have completed didactic and experiential field training (Level I pre-service training) and attained the required Level I pre-service certificate. An apprentice is a paraprofessional who is enrolled into the registered apprenticeship training program, receiving paid on-the-job training, working with a skilled professional. The recipient may provide a stipend in the amount of $7,500 per year for Level II in-service fulltime trainees during their apprenticeship. Each full-time trainee may receive $7,500 per year and $3,750 per year for part time trainees, for each level of training attained, up to a maximum of four (4) years.

The recipient can develop their own registered apprenticeship program or they can establish a partnership with an existing registered apprenticeship program that has registered with the Department of Labor or with a State Apprenticeship Agency.

Additionally, the duration of a Level II in-service training will be for a minimum of 12 months and the recipient will track the apprenticeship status of the apprentice.

Information about the Level II in-service training must be included in APPENDIX B Table 2. You must provide data for each Level II in-service trainee placed in the registered apprenticeship program, the location(s) of your apprenticeship site(s) and other pertinent information. All data provided is subject to verification.

To become a Registered Apprenticeship program or partner with one, please refer to the Department of Labor’s apprenticeship toolkit.

https://www.doleta.gov/oa/employers/apprenticeship_toolkit.pdf.

This toolkit provides helpful steps and resources to start and register an apprenticeship program.

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. Additional definitions specific to this NOFO can be found in Section VIII below.

II. Award Information

1. Type of Application and Award

Type of applications sought: New

HRSA will provide funding in the form of a grant.

https://www.doleta.gov/oa/employers/apprenticeship_toolkit.pdf https://bhw.hrsa.gov/grants/resourcecenter/glossary

2. Summary of Funding

HRSA expects approximately $11,500,000 to be available annually to fund approximately 19 recipients. You may apply for a ceiling amount of up to $600,000 total cost (includes both direct and indirect, facilities and administrative costs) per year. The period of performance is September 1, 2020 through August 31, 2024 (4 years). The actual amount available will not be determined until enactment of the final FY 2020 federal appropriation. 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 in a timely manner. Funding beyond the first year is subject to the availability of appropriated funds for the Opioid- Impacted Family Support Program 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.

Limitations on indirect cost rates

Indirect costs under training awards to organizations other than state, local or Indian tribal governments will be budgeted and reimbursed at 8 percent of modified total direct costs rather than on the basis of a negotiated rate agreement, and are not subject to upward or downward adjustment. Direct cost amounts for equipment, tuition and fees, and subawards and subcontracts 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:

State-licensed mental health nonprofit and for-profit organizations (see definition in Section VIII). These organizations must be able to support programs for pre-service or in-service training of paraprofessional child, adolescent and transitional aged youth mental health workers. These training programs can include behavioral health-related paraprofessional occupations such as peer support specialist, peer support counselor, community health worker, outreach worker, behavioral health aide, social services aide, substance abuse/addictions worker, youth worker, and promotor/a (for full list of occupations see the Paraprofessional definition in section VIII). 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. Domestic faith-based and community-based http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75 organizations, tribes, and tribal organizations may apply for these funds, if otherwise eligible. Individuals are not eligible to apply under this NOFO.

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, and the Republic of Palau.

PHS Act section 756(b) outlines several requirements for these awards, including:

(1) the requirement that to be eligible for a grant, an institution shall demonstrate an ability to recruit and place the students in areas with a high need and high demand population.

For purposes of this NOFO, an area will be deemed to be in high need and high demand if it satisfies one of the two criteria below:

i. Mental Health Professional Shortage Areas (HPSAs) or Facility Mental HPSAs with a score of 16 or above as found in the HPSA Find tool https://data.hrsa.gov/tools/shortage-area/hpsa-find); or a

ii. County with a drug overdose rate that is higher than the national average of 21.7 per 100,000 population (2017

CDC)

(2) knowledge and understanding of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations;

(3) knowledge and understanding of the concerns of the individuals and groups described in bullet (2) listed above, especially individuals with mental disorder symptoms or diagnoses, particularly children, adolescents and transitional aged youth;

(4) any apprenticeship or other field placement program assisted under the award will prioritize cultural and linguistic competency; and

(5) the recipient will provide to HRSA such data, assurances, and information as HRSA may require.

Paraprofessional Trainee Eligibility Level I pre-service trainees must be enrolled full- or part-time in the school or program receiving the grant award in order to receive tuition and stipend support in the OIFSP.

Level II in-service trainees must have completed Level I pre-service training. A 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 Applicants must be accredited by a nationally recognized accrediting agency, and provide a copy of their active accreditation or active approval from state government as Attachment 6, as specified by the U.S. Department of Education, or must be approved https://data.hrsa.gov/tools/shortage-area/hpsa-find by the state government to provide a behavioral health-related paraprofessional certificate training program.

HRSA may consider any application that fails to attach a copy of the required accreditation or related documentation as Attachment 6 to be non-responsive and may not consider it for funding under this notice. Applicants are required to maintain their accreditation or state approval status throughout the period of performance and notify HRSA of change in status.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

Ceiling Amount HRSA will consider any application that exceeds the ceiling amount of $600,000 per year non-responsive and will not be considered for funding under this notice.

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

Maintenance of Effort The recipient must agree to maintain non-federal funding for award activities at a level that is not less than expenditures for such activities maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives the award. Complete the Maintenance of Effort information and submit as Attachment 5.

Multiple Applications All eligible applicants can submit only one application. Multiple applications from an organization with the same DUNS number are not allowed.

For eligible colleges and universities, only one application per campus will be accepted;

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 sites must participate in integrated, interprofessional team based practices with a special focus on Level I pre-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.

Registered Apprenticeship Sites Registered apprenticeship sites will also participate in integrated, interprofessional team based practices, and can be run either directly through the recipient’s organization or through a documented partnership with an outside site. All registered apprenticeship sites will provide preceptors/mentors to provide guidance to trainees. You must submit a Memorandum of understanding/Memorandum of agreement with the registered apprenticeship site(s) that meet the criteria in Attachment 12 within 12 months of receiving the OIFSP award if not already provided in your application.

If your entity is an already established apprenticeship site, you must submit official documentation (e.g., certificate of approved registration) from the Department of Labor in Attachment 12.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) 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 may 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 http://www.grants.gov/applicants/apply-for-grants.html.

The NOFO is also known as “Instructions” on Grants.gov. You must provide your email address when reviewing or preparing the workspace application package in order to receive notifications including modifications and/or republications of the NOFO on Grants.gov before its closing date. You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. 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.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html

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. 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 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 workspace application package do not count in the page limit. Biographical sketches do count in the page limitation.

Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count 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

1) You, on behalf of the applicant organization certify, 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) Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 14: Other Relevant Documents.

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

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

Program-Specific Instructions

Program Requirements The program will be required to facilitate the following program requirements:

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

2) Establish or leverage partnerships with community-based, non-traditional community organizations and tribal colleges to serve high need and high demand areas and populations.

3) Provide “on-the-job training”, through a registered apprenticeship program to assist paraprofessional trainees in gaining career ladder opportunities, earning stackable credits, and enhancing their skills that lead to obtaining meaningful employment in high need and high demand areas.

4) Create additional training positions beyond current program capacity by a minimum of 10 percent in year one and maintain that level each year over the 4-year project period to increase the number of paraprofessionals trained with a focus on working with families impacted by OUD and other SUD. For example, a program with a baseline of 10 trainees will increase the capacity to 11 thus training at least 11 trainees annually for the 4-year project period.

5) Provide support up to $8,000 (maximum $3,000 tuition/fees and supplies and $5,000 stipend) to Level I pre-service behavioral health-related paraprofessional trainees to help defray the cost of living while in the training program, as detailed in Section IV.2.iv Budget, not to exceed twelve months. In addition, provide stipend support $7,500 to Level II in-service trainees during the apprenticeship period. Each full-time trainee may receive a stipend of $7,500 per year, for up to four (4) years, for each level of training attained.

6) Identify experienced preceptors/mentors to provide assistance to trainees at experiential placement and registered apprenticeship sites.

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.

The Abstract must include:

1. A brief overview of the project as a whole

2. Specific, measurable objectives that the project will accomplish

3. Which of the clinical priorities will be addressed by the project, if applicable;

and

4. How the proposed project for which funding is requested will be accomplished, i.e., the "who, what, when, where, why and how" of a project.

ii. Project Narrative

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

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:

• Focus on target population and its unmet health needs, specifically describing the lack of access to health care, with an emphasis on children, adolescents and transitional aged youth whose parents are impacted by OUD and other SUDs, and their family members who are in guardianship roles. Specifically applicant should include a robust discussion (using current, well-cited available data) of poverty, unemployment, and OUD and other SUD in the target service areas;

• Describe the participation of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations, and your knowledge and understanding of the concerns of those individuals, especially individuals with behavioral health disorder symptoms or diagnoses, particularly children, adolescents and transitional aged youth;

• The needs of the behavioral health workforce in the local community including the Level I pre-service and Level II in-service training sites’ patient populations, and a description of the services that paraprofessional trainees will provide to address these needs;

• Your relationship with the experiential training site(s) that provide care through integrated, interprofessional teams to children, adolescents and transitional aged youth whose parents are impacted by OUD and other SUDs, and their family members who are in guardianship roles;

• Your relationships with the academic, community and non-traditional community organization partnerships (e.g., social services, faith-based services, judicial systems) that foster integrated, interprofessional training experiences for the trainees and impact the quality of and access to OUD and other SUD prevention, treatment, and recovery services in the community;

• Your ability to identify two or more health disciplines or service providers that will be collaborating and training with the trainees supported under this NOFO in integrated, interprofessional team based care of OUD and other SUD services; and

• As applicable, your ability to describe how telehealth will be utilized to meet health and treatment needs of the target population.

Table 1. Experiential Field Training Sites (Attachment 4)

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 to complete all programmatic activities. Timeframes include Level I pre-service (up to 12 months) and Level II in-service (up to 12 months), during the four (4) year period of performance. Work plan must include baseline positions (start point used for comparisons) and planned number of new trainees’ positions. Goals and objectives must be specific, measurable, achievable, realistic, and time framed. A sample tool to understand SMART goals can be found here

Site Name Experiential Site Address

(EXAMPLE:

XX Main Street, Town, State, Zip code)

Number of

OIFSP

Trainees Trained

Number of trainee hours or hours in rotation

Mental Health HPSA score using the HPSA Find Tool

County Overdos e Rate

(Provide Rate per 100,000

Population)

Name and Link of Site from which County

Overdose Rates were obtained https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.

html;

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 four (4) 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 at http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx.

Documentation of work plan must be submitted as Attachment 10.

(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 to prepare them in their future careers to work on integrated, interprofessional teams and provide services to children, adolescents and transitional aged youth and their family members who are in guardianship roles;

• 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 develops competencies in integrated and/or interprofessional teams focusing on children, adolescents and transitional aged youth;

• Create additional training positions beyond current program capacity by a minimum of 10 percent in year one and maintain that level each year over the 4-year project period to increase the number of trainees trained in high need and high demand areas with a focus on working with families who are impacted by OUD and other SUDs;

• Implement a disbursement plan for the provision of stipend support for paraprofessional trainees for the required Level I pre-service training experiential field placement, and for Level II in-service training support (if applicable), which includes the disbursement schedule/rate of that support , and is consistent with your institution’s policies and procedures.

Differentiation between Level I pre-service disbursement and Level II in-service (if applicable) disbursement should be clear;

• Assist trainees who complete Level I pre-service training to transition into a Level II in-service registered apprenticeship program or job placement services to attain employment in high need and high demand areas;

https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html http://bhw.hrsa.gov/grants/technicalassistance/workplantemplate.docx

• Discuss the strategies for how you will aim for at least 50 percent of the Level I pre-service program completers to enter into a registered apprenticeship program (Level II in-service training);

• Ensure there is a mechanism to track trainee supervision used in the delivery of integrated and/or interprofessional team based practices for OUD and other SUD prevention, treatment and recovery services;

Additionally, the plan should:

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

• The implementation of telehealth solutions, as applicable;

• 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. Collaboration among traditional and non-traditional experiential training sites is highly encouraged for coordination of integration and/or interprofessional training;

• Discuss strategies for identifying registered apprenticeship sites or creating new registered apprenticeship sites, placing trainees in those sites and identifying preceptors/mentors/liaisons to provide assistance to trainees;

• Describe career ladder opportunities offered to trainees during Level I Pre-service and Level II In-service training (e.g. college credits, stackable credits, additional credentials beyond entry level, job promotions);

• Include a logic model for designing and managing the project as Attachment 8. 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).

• Strong, pre-existing relationships with external partners, such as non-profit and public organizations focused on health care, social services, and behavioral health needs of these at-risk populations, and how these organizations will host trainee field placements and apprenticeship sites and assist with career placements for program graduates;

• Direct connection between the certificate offered and the support needed within the population served, including future career ladder opportunities stemming from the proposed program (i.e., how the certificate can lead to an associate or bachelor’s degree); and

• Provide “on-the-job training” through a registered apprenticeship program to assist paraprofessional trainees in obtaining employment after completing experiential field placements in high need and high demand areas.

(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 identifying and collaborating with experiential training sites with the principal focus on OUD and other SUD prevention, treatment and recovery services;

4. Challenges related to identifying and managing preceptors/mentors for experiential field training sites and apprenticeship sites; and

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

1. How you 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 key personnel. Bio sketches of Key Personnel should be uploaded in the SF-424 R&R Senior/Key Person Profile form. You must demonstrate evidence that the evaluative measures selected will be able to assess: 1) the extent to which the program objectives have been met, and 2) the extent to which these can be attributed to the project.

It is required that all recipients will work collaboratively with HRSA’s technical assistance provider (to be determined) for technical assistance and evaluation needs.

Performance Reporting Plan: You must describe the systems and processes that will support your organization's collection of HRSA’s performance measurement requirements for this program. The following link includes examples of the required data forms for this program: http://bhw.hrsa.gov/grants/reporting/index.html.

Describe the data collection strategy to collect, manage, analyze and track data to measure the impact/outcomes, of the work plan in a way that allows for accurate and timely reporting of performance outcomes.

Describe potential obstacles for implementing the program performance evaluation and meeting HRSA’s performance measurement requirements and your plan to address those obstacles. The evaluation and reporting plan also should indicate the feasibility and effectiveness of plans for dissemination of project results, the extent to which project results may be national in scope, and the degree to which the project activities are replicable.

Describe your capacity to collect, validate, and report required data measures:

• Ability to provide trainee support for experiential training;

• Ability to increase the number of paraprofessional trainee program slots capacity by a minimum of 10 percent in year one and maintain that level each year over the 4-year project period;

• Ability to identify registered apprenticeship sites or create new registered apprenticeship sites and recruit trainees into those sites;

• Ability to identify preceptors/mentors for assisting trainees;

• Ability to recruit trainees interested in behavioral health with a focus on improving trainee’s knowledge and understanding of the specific concerns http://bhw.hrsa.gov/grants/reporting/index.html of children, adolescents and transitional aged youth whose parents are impacted by OUD and other SUDs, and their family members who are in guardianship roles;

• Ability to recruit and place the trainees in areas with a high need and high demand population;

• Ability to develop and implement training in integrated and/or interprofessional team based practice settings;

• Ability to develop and implement experiential field placements;

• Number of trainees trained in behavioral health care and the number of available experiential field…