PKG00263682-instructions.pdf

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Bureau of Health Workforce Division of Nursing and Public Health

Behavioral Health Workforce Education and Training (BHWET)

Program for Professionals

Funding Opportunity Number: HRSA-21-089 Funding Opportunity Type(s): New and Competing Continuation

Assistance Listings (CFDA) Number: 93.732

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2021

Application Due Date: January 21, 2021

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: October 7, 2020

Isabel Nieto Project Officer, Behavioral and Public Health Branch Telephone: (301) 443-2351 Email: BHWET@hrsa.gov

Authority: 42 U.S.C. § 294e–1(a)(1)-(3) (Section 756(a)(1)-(3) of the Public Health Service Act) mailto:BHWET@hrsa.gov

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for Fiscal Year (FY) 2021 for the Behavioral Health Workforce Education and Training (BHWET) Program for Professionals.

The purpose of the BHWET Program for Professionals is to develop and expand experiential training opportunities, such as field placements and internships, to improve the distribution and supply of the behavioral health workforce. The BHWET Program for Professionals emphasizes relationships with community-based partners (e.g., hospitals, crisis centers, state and local health departments, emergency departments, faith-based organizations, first responders, and judicial systems) to increase access to quality behavioral health services for populations across the lifespan in high need and high demand areas.1 A special focus is placed on demonstrating knowledge and understanding of the specific concerns for children, adolescents, and transitional-aged youth who are at risk for behavioral health disorders. Additionally, the BHWET Program for Professionals emphasizes interdisciplinary collaboration by utilizing team-based care in integrated behavioral health and primary care settings and recruiting a workforce that reflects 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, interested in serving high need and high demand areas.

Under this Notice of Funding Opportunity (NOFO), an eligible institution may submit a maximum of one application for the BHWET Program for Professionals. Collaboration within the institution is encouraged to ensure only one application is submitted.

Funding Opportunity Title: Behavioral Health Workforce and

Education Training (BHWET) for Professionals

Funding Opportunity Number: HRSA-21-089 Due Date for Applications: January 21, 2021 Anticipated Total Annual Available FY 2021 Funding:

Approximately $44,200,000

Estimated Number and Type of Award(s): Up to 92 grants Estimated Award Amount: Up to $480,000 per year

Awards are subject to the availability of appropriated funds.

1 For purposes of this NOFO high need and high demand areas are identified as sites located within Mental Health Professional Shortage Areas (HPSAs) and/or a Facility Mental HPSA with a score of 16 or above, or within a geographical area considered rural as defined by the HRSA Federal Office of Rural Health Policy (FORHP).

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Cost Sharing Required: Cost sharing is only required for doctoral-level Psychology, Psychiatry, Behavioral Pediatrics and Psychiatric Nursing Internships, where applicable, to cover any student stipend costs beyond $28,352 per geographic reimbursement requirements set by the applicable association (42 U.S.C. § 797(b) of the Public Health Service Act).

Period of Performance: July 1, 2021 through June 30, 2025 (4 years)

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Eligible Applicants Accredited institutions of higher education or accredited professional training programs that are establishing or expanding internships or other field placement programs in mental health in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing (which may include master’s and doctoral level programs), social work, school social work, substance use disorder prevention and treatment, marriage and family therapy, occupational therapy, school counseling, or professional counseling, including such programs with a focus on child and adolescent mental health, trauma, and transitional-age youth.

Accredited doctoral, internship, and post-doctoral programs of health service psychology (including clinical psychology, counseling, and school psychology) for the development and implementation of interdisciplinary training of psychology graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, as well as the development of faculty in health service psychology.

Accredited master’s and doctoral degree programs of social work for the development and implementation of interdisciplinary training of social work graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, and the development of faculty in social work.

Individuals are not eligible to apply under this NOFO.

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All current grant recipients funded under the FY 2017 BHWET Program for Professionals are eligible to apply and grant recipients will need to distinguish how proposed activities under this NOFO differ from other currently awarded BHW grants.

See Section III.1 of this notice of funding opportunity 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

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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

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

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

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Behavioral Health Workforce Education and Training (BHWET) Program for Professionals.

Program Purpose The purpose of the BHWET Program for Professionals is to increase the supply of behavioral health professionals while also improving distribution of a quality behavioral health workforce and thereby increasing access to behavioral health services. A special focus is placed on the knowledge and understanding of children, adolescents, and transitional-aged youth at risk for behavioral health disorders.

Program Goals

1. Establish relationships with community-based partners (e.g. hospitals, crisis centers, state and local health departments, emergency departments, faith-based organizations, first responders, and judicial systems) to increase access to quality behavioral health services in high need and high demand areas for populations across the lifespan;

2. Promote collaborative training by utilizing team-based models of care in integrated, interdisciplinary behavioral and primary care settings; and

3. Recruit a workforce that reflects 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, interested in serving high need and high demand areas interested in serving high need and high demand areas.

Program Objectives

1. Increase the number of experiential training sites to promote the integration of behavioral health into primary care settings in high need and high demand areas.

Experiential placements must include interdisciplinary training of two or more health disciplines using a team based care approach to provide quality behavioral health services;

2. Enhance didactic and experiential training activities through the development of competencies in primary and behavioral integrated, interprofessional team-based trauma informed care, for trainees, faculty, and staff;

3. Establish community partnerships to ensure 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, opportunities for field placements, community education, career development, and provide job placement services, to increase access to behavioral health services;

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4. Promote technology integration in the provision of services and training programs, including utilizing telehealth services, implementing strategies to increase digital health literacy, and offering options for distance learning; and

5. Reduce financial barriers by providing financial support to trainees in the form of stipends and other participant support costs.

HHS and HRSA Priorities Improving mental health care and access to quality services is a HHS and HRSA clinical priority. The BHWET program seeks to address this priority by increasing the behavioral health workforce across disciplines, in high need and high demand areas, and through the collaboration with community-based partnerships.

2. Background

This program is authorized by 42 U.S.C. § 294e–1. The BHWET Program was established in 2014 to expand the behavioral health workforce by supporting professionals and paraprofessionals to: increase access to behavioral health care services in mental health and substance abuse; develop interprofessional training and behavioral health integration; and implement experiential training serving child, adolescent, and transitional aged youth. Over the years, its purpose has expanded to serve rural, vulnerable, and medically underserved areas; as well as individuals across the lifespan, including those with substance use disorders; and to demonstrate enhanced didactic and experiential training. Starting in Fiscal Year 2021, the BHWET program will have: separate NOFOs for professionals and paraprofessionals; a focus on serving high need and high demand areas; and technology integration through the use of telehealth, digital health literacy, and distance learning. More information regarding the history of the BHWET Program and BHW’s investments in behavioral health can be found at: https://bhw.hrsa.gov/grants/behavioral-health.

Mental health disorders are associated with high levels of disability, high mortality rates, and lost health.2 In 2018, 1 in 5 U.S. adults reported having any mental illness and 1 in 25 U.S. adults reported having a serious mental illness. Almost 10 million adults experiencing a mental illness also report having a substance use disorder (SUD) and while about half of U.S. adults with co-occurring disorders received care for their mental illness or SUD, only 7% of U.S. adults received treatment for both. In 2018, 1 in 7 U.S.

adolescents reported having a major depressive episode within the past year, a steady increase since 2004, and adolescents with any mental illness were twice more likely to engage in substance use than those without.3 Between 2017 and 2018, 8 of the 12 most frequently reported conditions among children 0-17 years of age were mental, behavioral, and developmental conditions and 1 in 3 had experienced at least one adverse childhood experience (ACE), which is strongly related to health problems.

2 Pan American Health Organization. The Burden of Mental Health Disorders in the Region of the Americas, 2018. Washington, D.C.: PAHO; 2018. https://iris.paho.org/bitstream/handle/10665.2/49578/9789275120286_eng.pdf?sequence=10&isAllowed=y 3 Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54).

Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.

2019. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf.

https://bhw.hrsa.gov/grants/behavioral-health https://iris.paho.org/bitstream/handle/10665.2/49578/9789275120286_eng.pdf?sequence=10&isAllowed=y https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

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Children of racial minorities and low socioeconomic status were at higher risk of experiencing 2 or more ACEs.4

Youth involvement in and exposure to violence are related to important psychosocial and behavioral outcomes, including substance use. Survivors of violence are more likely to become victims of other forms of violence and are at higher risk of behaving violently.

Furthermore, people who behave violently are more likely to commit other forms of violence (i.e. youth who bully are more likely to bring guns to school). Intimate partner violence (IPV) is another byproduct of early violence. Conflict at home is linked to almost all forms of violence perpetration like child maltreatment, teen dating violence, IPV, sexual violence, youth violence, and bullying. However, access to mental health and substance use services is one protective measure that lessens the likelihood of experiencing violence and increasing resilience when a youth is exposed to violence.

Additionally, resources and services among community agencies as well as connectedness to one’s community have been demonstrated to increase community resilience.5

Despite population growth for minority racial and ethnic groups in the U.S. and increasing levels of diversity in the nation as a whole, representation levels of minority groups within the health workforce remains disproportionately low overall.6 Additionally, life expectancy is lower among racial and ethnic minorities, as well as in rural areas of the U.S. Much of rural America lacks access to health care, has a higher rate of chronic health conditions, and poorer quality of life compared with non-rural areas. In rural communities on average there is a 45 percent higher rate of opioid overdose than in urban areas. Additionally, rural America has a greater shortage of mental health providers, a smaller number of comprehensive treatment facilities, and fewer detox services per county in contrast to non-rural areas.7

The primary care setting is the common point of entry to healthcare, and for patients in medically underserved communities it provides an opportunity for diagnosing new, untreated, and previously unrecognized behavioral health disorders as well as connecting patients to needed care. Making behavioral health services directly available within the same settings as routine primary care services increases the likelihood that individuals will take advantage of them. 8 For example, health centers deliver high quality, culturally competent, and comprehensive primary care, including services for mental health and substance use disorders to high need and high demand communities.9 Collaborating with community-based partners such as public health

4 Health Resources and Services Administration: Maternal and Child Health. National Survey of Children’s Health Data Brief.

Rockville, MD. 2019. https://mchb.hrsa.gov/sites/default/files/mchb/Data/NSCH/NSCH-2018-factsheet.pdf 5 Centers for Disease Control and Prevention. National Center for Injury Prevention and Control. Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence. 2014. https://www.cdc.gov/violenceprevention/pdf/connecting_the_dots-a.pdf 6 Health Resources and Services Administration. National Center for Workforce Analysis. Sex, Race, and Ethnic Diversity of U.S.

Health Occupations (2011-2015). 2017.

https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/diversityushealthoccupations.pdf.

7 Health Resources and Services Administration, Office of Health Equity. Health Equity Report 2017. Rockville, Maryland: U.S.

Department of Health and Human Services; 2018.https://www.hrsa.gov/sites/default/files/hrsa/health-equity/2017-HRSA-health-equity-report.pdf 8 National Rural Health Association. The Future of Rural Health. 2013.

https://www.ruralhealthweb.org/getattachment/Advocate/Policy-Documents/FutureofRuralHealthFeb-2013.pdf.aspx 9 Health Resources and Services Administration, Bureau of Primary Health Care. What Is a Health Center? Updated 2018.

https://bphc.hrsa.gov/about/what-is-a-health-center/index.html https://mchb.hrsa.gov/sites/default/files/mchb/Data/NSCH/NSCH-2018-factsheet.pdf https://www.cdc.gov/violenceprevention/pdf/connecting_the_dots-a.pdf https://www.cdc.gov/violenceprevention/pdf/connecting_the_dots-a.pdf https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/diversityushealthoccupations.pdf https://www.hrsa.gov/sites/default/files/hrsa/health-equity/2017-HRSA-health-equity-report.pdf https://www.hrsa.gov/sites/default/files/hrsa/health-equity/2017-HRSA-health-equity-report.pdf https://www.ruralhealthweb.org/getattachment/Advocate/Policy-Documents/FutureofRuralHealthFeb-2013.pdf.aspx https://bphc.hrsa.gov/about/what-is-a-health-center/index.html

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organizations, hospitals, law enforcement agencies, schools, and juvenile justice agencies present an opportunity to further reduce disparities in access to behavioral and public health services. The BHWET program encourages applicants to collaborate with health centers and non-traditional community partnerships to provide experiential training sites and assist in connecting graduates with potential employment opportunities.

Technology can play a major role in how individuals seek, find, and understand health information. The BHWET program aims to promote technology integration in the training programs it supports. Strategies to improve digital health literacy and the uptake of health technology increase availability and access to health information, as well as patient engagement, leading to improved health outcomes.10 Additionally, offering options for distance learning can allow students who may face barriers to receiving in person didactic training continued learning. Telehealth services can be leveraged to connect patients and providers when geographical, social, and other barriers prevent in-person visits. Applicants are strongly encouraged to use telehealth in their proposed service delivery plans when feasible or appropriate. Additional information on telehealth can be found at https://telehealth.hhs.gov/. In addition, if you use broadband or telecommunications services for the provision of health care, HRSA strongly encourages you to seek discounts through the Federal Communication Commission’s Universal Service Program. For information about such discounts, see https://www.usac.org/rural-health-care/. Patients may also be eligible for free or low cost mobile or broadband services through the Universal Service Lifeline program at https://www.lifelinesupport.org/.

The behavioral health workforce has a role in addressing mental health needs and ensuring that populations across the lifespan have access to essential health care services. Over the next decade, it’s projected that the demand for behavioral health professionals will continue to increase; this will necessitate a workforce trained and prepared to meet these needs, which the workforce supply is overall on track to meet.11 However, sustained investments in support of up-to-date, evidence-based training opportunities in high need high demand areas will be required to keep up with the dynamic nature of the behavioral health landscape.

HRSA has a number of investments targeting opioid use disorder (OUD) and SUD across its Bureaus and Offices. To leverage HRSA-supported resources, technical assistance, and training, visit: https://www.hrsa.gov/opioids.

Program Definitions A glossary containing general definitions for terms used throughout the Bureau of Health Workforce NOFOs can be found at the Health Workforce Glossary. Additional definitions specific to the FY 2021 BHWET Program for Professionals can be found in Section VIII.

10 Health Resources and Services Administration, Bureau of Health Workforce. Behavioral Health Workforce Projections, 2017- 2030. 2018. https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/bh-workforce-projections-fact-sheet.pdf 11In It Together: Improving Health Literacy for All. Health Literacy Research Guide. 2017. https://targethiv.org/library/health-literacy-resource-guide https://telehealth.hhs.gov/ https://telehealth.hhs.gov/ https://www.usac.org/rural-health-care/ https://www.lifelinesupport.org/ https://www.hrsa.gov/opioids https://bhw.hrsa.gov/grants/resourcecenter/glossary https://bhw.hrsa.gov/grants/resourcecenter/glossary https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/bh-workforce-projections-fact-sheet.pdf https://targethiv.org/library/health-literacy-resource-guide https://targethiv.org/library/health-literacy-resource-guide

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II. Award Information

1. Type of Application and Award

Type(s) of applications sought: New and Competing Continuations.

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $44,200,000 to be available annually to fund 92 recipients. The actual amount available will not be determined until enactment of the final FY 2021 federal appropriation.

You may apply for a ceiling amount of up to $480,000 total cost (includes both direct and indirect) per year.

This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

The period of performance is July 1, 2021 through June 30, 2025 (4 years). Funding beyond the first year is subject to the availability of appropriated funds for the BHWET Program in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government. HRSA may reduce recipient funding levels beyond the first year if you are unable to fully succeed in achieving the goals listed in application.

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

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

For the purposes of this program, eligible applicants include:

• Accredited institutions of higher education or accredited professional training programs that are establishing or expanding internships or other field placement programs in mental health in psychiatry, psychology, school psychology, http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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behavioral pediatrics, psychiatric nursing (which may include master’s and doctoral level programs), social work, school social work, SUD prevention and treatment, marriage and family therapy, occupational therapy, school counseling, or professional counseling, including such programs with a focus on child and adolescent mental health, trauma, and transitional-age youth;

• Accredited doctoral, internship, and post-doctoral residency programs of health service psychology (including clinical psychology, counseling, and school psychology); and

• Accredited master’s and doctoral degree programs of social work for the development and implementation of interdisciplinary training of social work graduate students for providing behavioral health services, including trauma-informed care and substance use disorder prevention and treatment services, and the development of faculty in social work

Note: 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.

Domestic faith-based and community-based organizations, tribes, and tribal organizations may also apply for these funds, if otherwise eligible.

Current BHWET award recipients whose grants are scheduled to end on August 31, 2021 are eligible to apply for this funding opportunity and should apply as “Competing Continuations.”

If funded, for-profit organizations are prohibited from earning profit from the federal award (45 CFR part 75.216(b)).

Accreditation/Approval Documentation

Entities must be accredited by a nationally recognized accrediting body, as specified by the U.S. Department of Education. Applicants must provide a copy of their accreditation documentation, specifying the dates covered by the active accreditation, including expiration date, as Attachment 6.

Applicants applying for doctoral-level schools and programs of health service psychology, professional psychology internships, and post-doctoral psychology residencies must provide documentation of their institution’s APA accreditation, specifying the dates covered by the active accreditation, including expiration date, letter as Attachment 6.

Failure to submit Attachment 6 may be considered by HRSA as non-responsive and ineligible for consideration. Applicants are required to maintain their accreditation or https://www.law.cornell.edu/definitions/uscode.php?width=840&height=800&iframe=true&def_id=42-USC-1391568762-1327066157&term_occur=999&term_src= https://www.law.cornell.edu/definitions/uscode.php?width=840&height=800&iframe=true&def_id=42-USC-646160747-1342391136&term_occur=999&term_src= https://www.law.cornell.edu/definitions/uscode.php?width=840&height=800&iframe=true&def_id=42-USC-646160747-1342391136&term_occur=999&term_src=

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state approval status throughout the period of performance and notify HRSA of change in status.

2. Cost Sharing

Cost Sharing is required only for doctoral-level psychiatry, psychology, school psychology, psychiatric nursing or behavioral pediatrics internships, to cover any trainee stipend costs beyond $28,352 per geographic reimbursement requirements set by association requirements. The difference between the doctoral-levels intern stipend maximum amount and any regional standard above the stipend maximum must be covered by the grant recipient using non-federal funding and must include a written statement in the budget narrative justification. If applicable, HRSA will deem ineligible all applications that fail to address cost matching requirements (42 U.S.C. § 797(b) of the Public Health Service Act).

3. Other

Ceiling Amount HRSA will consider any application that exceeds the ceiling amount of $480,000 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 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, as required by 42 U.S.C. § 295n-2. Complete the Maintenance of Effort information and submit as Attachment 5.

Multiple Applications Multiple applications from an organization are not allowable. An organization is defined by having a valid Data Universal Numbering System (DUNS) number or Unique Entity Identifier (UEI).

Where multiple programs within your organization are interested in applying under this funding announcement, you may collaborate across programs to submit a single application.

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.

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Experiential Training Sites HRSA will consider any application that fails to include Attachment 4 non-responsive and will not consider it for funding under this notice.

Beneficiary Eligibility Trainees must be enrolled full or part time in the school or program receiving the grant award in order to receive stipend support. In addition, trainees must be eligible to work in the United States. A trainee receiving support from grant funds under this program must be a citizen, national, or permanent resident of the United States. Individuals on temporary or student visas are not eligible to participate.

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

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

2. Content and Form of Application Submission

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 HRSA’s 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 75 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.

https://www.grants.gov/ http://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

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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.

Please note: If you use an OMB-approved form that is not included in the workspace application package for HRSA-21-089, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important 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.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

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

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

3. Where you are unable to attest to the statements in this certification, an explanation shall be included in Attachment 13: Other Relevant Documents.

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

Program-Specific Instructions

Program Requirements:

1. Provide stipend support to students who are in their final experiential training (internship or field placement) prior to graduation for no less than six consecutive months and no more than 12 consecutive months;

2. Establish or expand the number of partnerships with experiential training sites in high need and high demand areas in order to recruit and place trainees in these areas;

3. Advance the integration of behavioral health training into primary care settings to improve access to quality behavioral health services;

4. Recruit a workforce that reflects 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, interested in serving high need and high demand areas;

5. Enhance didactic and experiential training activities that develop trainee competencies in behavioral health as well as its integration into primary care for the development and implementation of interdisciplinary training (i.e. two or more health disciplines);

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6. Create or enhance current, evidence-based interprofessional training programs for faculty and field site supervisors;

7. Demonstrate knowledge and understanding of the concerns of the population served, especially individuals with mental disorder symptoms or diagnoses, particularly children and adolescents, and transitional-age youth;

8. Include technology integration by providing options for distance learning and developing didactic and experiential training activities that address strategies for providing telehealth services and increasing digital health literacy;

9. Establish relationships with community-based partners (e.g. hospitals, crisis centers, state and local health departments, emergency departments, faith-based organizations, first responders, and judicial systems) to provide experiential training, career development, and job placement services that assist students in obtaining employment following graduation from the program;

10. Demonstrate any internship or other field placement program assisted under the grant prioritizes cultural and linguistic competency;

11. Use an evidence based continuous monitoring tool to evaluate program objectives and make adjustments as needed to improve program outputs and outcomes over the four-year project period;

12. Collect specified program and performance data, and disseminate findings to appropriate audiences. Participate in program evaluations during and upon completion of the project period; and

13. Collaborate regularly during the project period with other BHWET Program for Professionals grant recipients (e.g. the grantee engagement platform, consortium developed by recipients in state or nearby states, etc.) to leverage resources, enhance interdisciplinary training, and collaborate across regions.

Additional Program Areas of Focus:

Additionally, the BHWET program welcomes applications that intend to incorporate the following areas of focus into their programs. Please note that that these are not program requirements, but are encouraged activities, and all applications will be given fair and equitable consideration.

Health Center Collaboration – HRSA-Supported Health Centers provide culturally competent, comprehensive primary care services in an integrated setting to communities in high need and high demand areas. Applicants can collaborate with these centers to develop experiential training opportunities and leverage partnerships for future employment opportunities for graduates.

Violence Prevention –Applications can address the role that intimate partner violence and youth violence play in the behavioral health outcomes of individuals in high need and high demand areas by incorporating plans for didactic and experiential training that recognizes and supports victims through an understanding of trauma-informed care.

Behavioral health service delivery will ideally also include the provision of culturally and linguistically appropriate care for racial and ethnic minority populations within the community.

Loan Repayment Programs – To reduce financial burdens that students and trainees may face, applicants can connect graduates with HRSA-sponsored loan repayment

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programs such as the National Health Service Corps (NHSC) SUD Workforce Loan Repayment Program or the NHSC Rural Community Loan Repayment Program.

Additional information regarding the programs and eligibility can be found at https://nhsc.hrsa.gov/loan-repayment/index.html.

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

The Abstract must include:

1. The discipline(s) for which you are applying;

2. The requested funding amount;

3. A brief overview of the project as a whole (i.e. proposed services, needs address, target population(s), etc.);

4. A summary of the proposed project goals for which funding is requested;

5. How the proposed project will be accomplished (i.e., the “who, what, when, where, why, and how” of the project;

6. Specific, measurable objectives that the project will accomplish; and

7. If applicable, a statement indicating eligibility for funding preference and/or funding priority.

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

Briefly describe the purpose of the proposed project and outline the needs of the training program or institution. Discuss the target population(s) served by the behavioral health workforce of focus, as well as the social determinants of health and the health disparities impacting the population or communities served. Use and cite demographic data whenever possible to support the information provided.

This section will help reviewers understand the organization that would receive funding for training, as well as the needs of the communities that trainees would ultimately serve.

Please include the following:

• Describe the unmet need for the behavioral health service area of focus;

• Describe the need for evidence-based behavioral health workforce training, particularly as it pertains to integrated, interdisciplinary team-based care in the behavioral health discipline of focus;

• Discuss the current scope of representation of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, class https://nhsc.hrsa.gov/loan-repayment/index.html

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backgrounds, different genders, and sexual orientations in the behavioral health field;

• Discuss the current capacity of the local community to meet the needs of populations in high need and high demand areas and how the proposed project activities will strengthen partnerships with traditional and non-traditional community-based organizations to improve health outcomes;

• Describe the health needs of the target population(s) served by the proposed experiential training site(s);

• Detail the information regarding experiential training sites shown in Table 1 and submit as Attachment 4;

• Discuss the need and plan to provide evidence based trainings for faculty and staff in interprofessional settings;

• Describe the current implementation technology integration, including telehealth services, initiatives to address digital health literacy, and options for distance learning, how it supports the needs of the trainees and the target population(s) they serve; and

• As applicable, describe any current innovative models of care that deliver integrated and coordinated behavioral health and primary care services, incorporate trauma-informed care, and address intimate partner violence and youth violence. In particular, describe how this service delivery focuses on culturally appropriate care for racial and ethnic minority populations within the community.

Table 1: Experiential Training Sites Site Name Experiential site address (Example: XX Main Street, Town, State, Zip Code)

Number and discipline of proposed BHWET trainees at experiential site

Number of trainee hours or hours in rotation

Mental Health HPSA Score using the HPSA Find Tool

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 work plan that demonstrates through concrete steps how you will implement the proposed project to meet the goals of this NOFO. A sample work plan can be found here.

Please include the following:

• Describe the program goals and objectives, elaborate on key partners, list deliverables, and assign staff and timeframes to complete programmatic activities within the four year performance period. Goals and objectives must be specific, measurable, achievable, realistic, and time framed. A sample tool to apply SMART goals can be found here;

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

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• Explain how the work plan is appropriate for the program design and how the targets fit into the overall timeline of grant implementation;

• Identify meaningful collaboration with key stakeholders who will support planning, designing, and implementing all activities, and describe the extent to which these contributors reflect the populations and communities served; and

• Describe how your organization will ensure any subawarded funds or funds expended on contracts are properly documented.

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

#2 (b).

Describe the objectives, proposed activities, and strategies and provide evidence for how they (1) align with and drive the work plan, (2) incorporate each of the program requirements and expectations of the NOFO; and (3) address the needs in the Purpose and Need section.

Please include the following:

• A plan to develop or enhance didactic and experiential training by utilizing evidence-based behavioral health modalities to prepare trainees to serve populations in high need and high demand areas;

• The number of training slots that will be established to accommodate trainees in the behavioral health discipline(s) of focus and increase the training capacity of the organization/institution;

• A plan to ensure participation of trainees from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations;

• A plan to increase the number of experiential training slots within integrated, interprofessional settings that utilize team-based models of care;

• A description of how the experiential training assisted under the grant will prioritize cultural and linguistic competencies;

• A plan to develop evidence-based interprofessional training for faculty and staff;

• A disbursement plan for the provision of stipend support to trainees during the required experiential training;

• A plan to collaborate on projects, leverage resources, and expand opportunities for trainees with at least one other BHWET grant recipient during the period of performance; and

• A description of how the project and training components are connected to the public systems of health and behavioral health care in the communities or areas of focus, including how the applicant will collaborate with these public organizations during the project.

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You must also submit a logic model for designing and managing the project. 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., 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 personnel, 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).

NOTE: Although there are similarities, a logic model is not a work plan. A work plan is an “action” guide with a timeline used during program implementation; the work plan provides the “how to” steps. A logic model is a visual diagram that demonstrates an overview of the relationships between the 1) resources and inputs, 2) implementation strategies and activities, and 3) desired outputs and outcomes in a project. Find additional information on developing logic models here.

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

#2 (c)

Discuss challenges likely to be encountered in designing and implementing the activities described in the work plan and their resolutions.

• Challenges and resolutions related to the work plan, implementation of the project, and achievement of the proposed goals and objectives (e.g.

program performance evaluation, and performance measurement requirements);

• Challenges and resolutions related to workforce development, such as recruitment, retention, education, training, job placement, and career development of behavioral health professionals in high need and high demand areas;

• Challenges and resolutions related to ensuring participation in the institutions’ programs of individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and http://www.acf.hhs.gov/sites/default/files/fysb/prep-logic-model-ts.pdf http://www.acf.hhs.gov/sites/default/files/fysb/prep-logic-model-ts.pdf

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different genders and sexual orientations that represent the population served;

• Obstacles and approaches to ensuring experiential training sites offer integrated, interprofessional behavioral health services, include technology implementation, and…