Department of Health and Human Services

**Substance Abuse and Mental Health Services Administration**

**National Child Traumatic Stress Initiative-- (Category I)**

**National Center for Child Traumatic Stress**

**(Initial Announcement)**

**Request for Applications (RFA) NO. SM-05-004**

**Catalogue of Federal Domestic Assistance (CFDA) No.:** 93.243

**Key Dates:**

+---------------------+------------------------------------------------+
| **Application       | **May 6, 2005**                                |
| Deadline**          |                                                |
+---------------------+------------------------------------------------+
| **Intergovernmental | **Letters from State Single Point of Contact   |
| Review**            | (SPOC) are due no later than 60 days after     |
|                     | application deadline.**                        |
| **(E.O. 12372)**    |                                                |
+---------------------+------------------------------------------------+
| **SSA               | **Comments from Single State Agency are due no |
| Coordination**      | later than 60 days after application           |
|                     | deadline.**                                    |
+---------------------+------------------------------------------------+

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

A.Kathryn Power, M.Ed. Charles G. Curie, M.A., A.C.S.W.

Director Administrator

Center for Mental Health Services Substance Abuse and Mental Health

Services Administration

> **Table of Contents**
>
> [I. FUNDING OPPORTUNITY DESCRIPTION
> 3](#i.-funding-opportunity-description)

[1. INTRODUCTION 3](#introduction)

[2. EXPECTATIONS 3](#expectations)

[II. AWARD INFORMATION 9](#ii.-award-information)

[1. AWARD AMOUNT 9](#award-amount)

[2. FUNDING MECHANISM 10](#funding-mechanism)

[III. ELIGIBILITY INFORMATION 11](#iii.-eligibility-information)

[1. ELIGIBLE APPLICANTS 11](#eligible-applicants)

[2. COST SHARING 12](#cost-sharing)

[IV. APPLICATION AND SUBMISSION INFORMATION
12](#iv.-application-and-submission-information)

[1. ADDRESS TO REQUEST APPLICATION PACKAGE
12](#address-to-request-application-package)

[2. CONTENT AND FORM OF APPLICATION SUBMISSION
12](#content-and-form-of-application-submission)

[3. SUBMISSION DATES AND TIMES 22](#submission-dates-and-times)

[4. INTERGOVERNMENTAL REVIEW (E.O. 12372) REQUIREMENTS
23](#intergovernmental-review-e.o.-12372-requirements)

[5. FUNDING LIMITATIONS/RESTRICTIONS
24](#funding-limitationsrestrictions)

[6. OTHER SUBMISSION REQUIREMENTS 24](#other-submission-requirements)

[V. APPLICATION REVIEW INFORMATION
25](#v.-application-review-information)

[1. EVALUATION CRITERIA 25](#evaluation-criteria)

[2. REVIEW AND SELECTION PROCESS 31](#review-and-selection-process)

[VI. AWARD ADMINISTRATION INFORMATION
31](#vi.-award-administration-information)

[1. AWARD NOTICES 31](#award-notices)

[2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS
31](#administrative-and-national-policy-requirements)

[3. REPORTING REQUIREMENTS 32](#reporting-requirements)

[VII. AGENCY CONTACTS 33](#vii.-agency-contacts)

[Appendix A -- Checklist for Formatting Requirements and Screenout
Criteria for SAMHSA Grant Applications
35](#appendix-a-checklist-for-formatting-requirements-and-screenout-criteria-for-samhsa-grant-applications)

[Appendix B - Glossary 38](#appendix-b---glossary)

[Appendix C -- Areas of Budget Consideration
40](#appendix-c-areas-of-budget-consideration)

[Appendix D- Sample Budget and Justification
41](#appendix-d--sample-budget-and-justification)

# I. FUNDING OPPORTUNITY DESCRIPTION

## 1. INTRODUCTION

> The Substance Abuse and Mental Health Services Administration (SAMHSA)
> announces available funding for a National Center for Child Traumatic
> Stress grant through the National Child Traumatic Stress Initiative.
> TNumber range CHAPTERhe purpose of the National Child Traumatic Stress
> Initiative (NCTSI) is to improve treatment and services for all
> children and adolescents in the United States who have experienced
> traumatic events. The initiative is designed to address child trauma
> issues by creating a national Network of grantees---the National Child
> Traumatic Stress Network---that work collaboratively to develop and
> promote effective community practices for children and adolescents
> exposed to a wide array of traumatic events. The role of the National
> Center for Child Traumatic Stress (NCCTS) is to provide leadership,
> infrastructure, and support for the Network to achieve its goals
> ofNumber range CHAPTER increasing access and raising the standard of
> care for traumatized children, adolescents, and their families.

The Network is composed of three types of centers:

1.  The [National Center for Child Traumatic Stress]{.underline} (NCCTS)
    works with SAMHSA to develop and maintain the Network structure,
    provide technical assistance to grantees within the Network, oversee
    resource development and dissemination, and coordinate national
    education and training efforts;

2.  The [Treatment and Services Adaptation (TSA) Centers]{.underline}
    provide national expertise on specific types of traumatic events,
    population groups, and service systems and support the specialized
    adaptation of effective treatment and service approaches for
    communities across the country; and

3.  The [Community Treatment and Services (CTS) Centers]{.underline}
    implement and evaluate effective treatment and services in community
    settings and youth serving service systems and collaborate with
    other Network Centers on clinical issues, service approaches,
    policy, financing, and training issues.

## 2. EXPECTATIONS

> In providing leadership for the National Child Traumatic Stress
> Network, the NCCTS will be expected to perform the following
> functions:

-   [Identify National Unmet Needs and Emerging Issues in Child
    Trauma]{.underline}

> The National Center will collaborate with SAMHSA, the Treatment and
> Services Adaptation Centers, and Community Treatment and Services
> Centers in identifying child trauma intervention needs, and gaps and
> fragmentation in services. In conducting analyses of emerging issues
> or unmet needs related to child trauma, the National Center will
> further develop and support the Network's collaborative approach to
> identifying, improving, developing, disseminating, and/or evaluating
> child trauma treatment and services.

-   [Develop and Maintain Collaborative Network Structure]{.underline}

> The National Center will continue to develop and maintain a framework
> and organizational procedures for collaborative National Child
> Traumatic Stress Network functioning. This framework will include
> procedures to coordinate and integrate new Centers into the Network.
> The National Center will identify and use existing resources of
> Network Centers in all areas of Network activity and promote increased
> participation of Centers in Network activity, communication, and
> collaboration among Centers.

-   [Expand the National Reach of the Network]{.underline}

    The National Center will collaborate with SAMHSA staff in developing
    plans to expand the reach of the National Child Traumatic Stress
    Network. In part, this effort will include an expanded "vision" of
    Network membership that is not dependent solely upon Federal
    funding. As part of this expanded vision, the National Center will
    develop a process and expectations for "affiliate" membership, which
    may be available to a wide array of potential organizational
    partners. Affiliate membership may entitle organizations that do not
    currently receive SAMHSA grant support to participate in workgroups,
    training, and product development and dissemination. Through this
    process, new stakeholders can be engaged in the process of
    transforming child trauma services, and current grantees that do not
    receive Federal funds in future years may still participate in
    collaborative activities of the Network. Affiliate members that
    contribute productively to Network activities may potentially
    receive Federal logistical support to attend workgroup meetings and
    events.

-   [Facilitate Network Communications]{.underline}

    The National Center will develop Network communication systems to
    promote effective routine and emergency linkage among Network
    members. Ideally, this communication structure will facilitate
    access for all grantees to up-to-date information on collaborative
    activities within the Network. Plans to mobilize specialized Network
    child trauma expertise in times of national emergency need should be
    developed and tested. While a new Treatment and Services Adaptation
    Center focused on disaster and terrorism will be created, the
    National Center will maintain a leadership role in mobilizing
    Network resources to assist SAMHSA and its Federal, State, and local
    partners during times of crisis.

-   [Strengthen the Process for Developing and Disseminating Network
    Products]{.underline}

The National Center will continue to work with other National Child
Traumatic Stress Network Centers to develop and disseminate information
on evidence-based practices, policy and funding opportunities,
educational materials, and other information on child and adolescent
traumatic stress vital to professionals, policy makers and the public.
The National Center will further develop the Network's national capacity
for training Network and non-Network providers in implementing
evidence-based treatment and service delivery approaches. As part of
this effort, the National Center will support Network activities to
assess the effectiveness and applicability of Network-developed
intervention products in community and service settings, submit
information on effective intervention approaches for review by SAMHSA's
National Registry of Effective Programs and Practices (NREPP), and
develop and use other approaches for promoting the dissemination of
evidence-based interventions.

-   [Promote Sustainability Planning]{.underline}

> In order to be successful in its nationwide goals, the intervention
> and service approaches developed through the National Child Traumatic
> Stress Network must "take root" in communities independent of Federal
> grant funding. All grantees in the National Child Traumatic Stress
> Network will be expected to develop a sustainability plan and model an
> infrastructure for sustainability of Network activities that have
> improved or have the potential to improve outcomes for traumatized
> children and families. The National Center, with assistance from
> Network Centers and SAMHSA, will provide an inventory of successful
> models and strategies for addressing sustainability to members of the
> Network and provide technical assistance to Network programs to
> implement these sustainability models and strategies. Results of
> sustainability planning should include development, implementation,
> and training on various techniques for sustainability of Network
> programs and services that are strategically designed for long-term
> impact.

-   [Participate in Performance Monitoring and Cross-Site Evaluation
    Efforts]{.underline}

    The National Center will collaborate with SAMHSA, an evaluation
    contractor, and Network grantees in the design and implementation of
    cross-site evaluation plans, which will include attention to SAMHSA
    Government Performance and Results Act (GPRA) goals, National Child
    Traumatic Stress Network operation goals, and program-specific
    goals. The National Center will maintain a lead role in providing
    expertise to Network members on clinical data issues. In this role,
    the National Center will support the development of Network-wide
    protocols, clinical assessment measures, and screening instruments
    for the collection and analysis of clinical treatment and service
    data. The National Center will also provide technical assistance to
    grantees on clinical use and analysis of this information.

**2.1 Allowable Activities**

> In close partnership with SAMHSA's Center for Mental Health Services,
> the National Center will provide the vision, leadership, and overall
> organization and coordination to move the National Child Traumatic
> Stress Network toward achieving its goals. Allowable activities to be
> carried out by the National Center are as follows:
>
> [Administration of National Child Traumatic Stress Network
> Structure]{.underline}

-   Oversight and support for the organization of the Network to support
    collaborative adaptation of treatment and service approaches,
    evaluation, and dissemination; clinical data collection and
    analysis; resource development; knowledge dissemination; and
    collaboration and coordination with consumer and service provider
    constituencies.

-   Development of collaborative management structures that make it
    easier for Network members to work with one another.

-   Coordination of a Steering Committee for the Network consisting of
    grantee representatives from all levels of the Network.

-   Coordination of an Advisory Committee for the Network consisting of
    selected experts in child trauma, consumer and family involvement,
    and related areas.

> [Collaborative Product Development and Dissemination]{.underline}

-   Development of a comprehensive marketing plan for product
    development and dissemination.

-   Development of customized training materials.

-   Organization of training events.

-   Dissemination of training curricula developed by Network members.

-   Communication and marketing of Network activities and products
    through the use of multiple media, including Web-based technology.

-   Development of a national public education strategy and global
    marketing plan that reaches out to professional, government,
    consumers and families, and other stakeholder groups.

> [Consultation and Technical Assistance]{.underline}

-   Technical assistance to Network members, policy makers, and the
    public utilizing expertise from within the Network as well as from
    external consultants.

-   Consultation and liaison activities to foster opportunities for
    grantee sites to partner with state/local mental health systems,
    major child serving agencies, and other local stakeholders to
    address community needs related to transforming systems to address
    the challenges of child and adolescent trauma.

-   Consultation and technical assistance on clinical data issues,
    including consultation on instruments for assessment of clinical and
    behavioral issues related to child traumatic stress.

-   Consultation and technical assistance to Network members on the
    development and implementation of strategies for disseminating
    promising practices in child and adolescent trauma, with specific
    consultation and technical assistance to grantees around the
    submission of these practices and interventions to the National
    Registry of Effective Programs and Practices (NREPP). The National
    Center will consult with SAMHSA staff responsible for NREPP to
    ensure the development and implementation of appropriate NREPP
    technical assistance efforts.

> [Performance Monitoring]{.underline}

-   Development of internal performance monitoring systems.

-   Consultation and direct assistance to CMHS and an evaluation
    contractor to monitor and evaluate all internal and external Network
    collaborative activities for relevance, efficiency, effectiveness,
    and impact on the main goals of the Initiative.

**2.2 Data and Performance Measurement**

The National Center for Child Traumatic Stress will be required to
assist SAMHSA and an evaluation contractor in reporting on the
performance of the National Child Traumatic Stress Network in
accomplishing the following Government Performance and Results Act
(GPRA) goals:

1)  increasing the number of children and adolescents reached by
    improved services; and

2)  improving children\'s outcomes.

    Specific indicators and expected outcomes for the National Center
    for Child Traumatic Stress include the following:

-   Increased percentage of grantees contributing to cross-Network
    initiatives (i.e. task forces, working groups, cross-site
    evaluations, product development, etc.); and increased number and
    quality of Network products that result from cross-Network
    initiatives (i.e., training manuals, policy briefs, publications,
    multimedia products, toolkits, etc).

-   Increased number of grantees and other treatment and service
    providers across the country trained in implementing effective child
    trauma treatment and service delivery.

-   Increased percentage of grantees showing evidence of involving
    clients served and/or their families/partners/guardians in: (a)
    planning; (b) policy development; and (c) treatment planning
    implementation.

-   Increased number and quality of informational resources and other
    products available on child and adolescent traumatic stress.

-   Increased number and quality of established partnerships with
    professionals groups, policy makers, community-based organizations,
    child serving agencies and systems, and other key stakeholders to
    support dissemination efforts.

Grantees will utilize standard NCTSI-wide instruments to report on these
indicators. These instruments are currently under development.
Applicants must explicitly state in their application that they will use
these instruments to collect and report on the required data. Applicants
must document their ability to collect and report the required data in
"Section D: Evaluation" of their applications.

**2.3 Grantee Meetings**

The National Center for Child Traumatic Stress (NCCTS) must coordinate
with SAMHSA in planning and conducting an annual national grantee
meeting for the National Child Traumatic Stress Network as a whole and
must budget for travel for at least ten (10) staff to attend this annual
meeting. At these meetings, grantees will collaborate on cross-Network
working groups, present the results of their projects, and discuss
project requirements with Federal staff. Each meeting will be three
days. These meetings will usually be held in the Washington, D.C. area
and attendance is mandatory for all Network Centers.

**2.4 Evaluation**

The National Center for Child Traumatic Stress (NCCTS) must evaluate its
project, and applicants are required to describe a proposed evaluation
plans in their applications. The evaluation should be designed to
provide regular feedback to the project to improve program operations
and, ultimately, the outcomes that will result from implementation of
the project. The successful grantee will be expected to submit an annual
internal evaluation report to SAMHSA.

As the lead grantee working in partnership with SAMHSA to coordinate the
activities of the National Child Traumatic Stress Network, NCCTS plays a
pivotal role in ensuring that the Network meets the overall goals of
this initiative. Therefore, the National Center for Child Traumatic
Stress must address the following in its evaluation:

-   Demonstrating effectiveness and leadership for managing activities
    that require coordination and integration across funded Centers;

-   Enhancing the national-level impact of the Network through strategic
    information dissemination activities and external Network
    partnerships.

Data collected for GPRA purposes should be used in conducting the
evaluation. Applicants must also commit the proposed Center to
participate in a national evaluation of the National Child Traumatic
Stress Initiative and in cross-site evaluations of Network intervention
products and services. In October of 2004, an evaluation firm was
contracted to design and implement a national cross-site evaluation of
the NCTSI. The goals of the evaluation are to:

-   describe the children and families served by the Network and their
    outcomes;

-   assess the development and dissemination of effective treatments and
    services;

-   evaluate intra-Network collaboration; and

-   assess the Network's impact beyond the Network.

    All Centers funded through the National Child Traumatic Stress
    Initiative (NCTSI) (including NCCTS) will be required to cooperate
    with the evaluation contractor and participate in the cross-site
    evaluation. The evaluation design consists of a core descriptive and
    outcome study and a study evaluating collaboration and Network
    participation. In addition there will be several targeted areas for
    in-depth study, each addressing specified aspects of the evaluation
    goals described above. At a minimum, NCCTS will participate in the
    core descriptive and outcome study and the collaboration and Network
    participation study. Examples of required cross-site evaluation
    participation by the lead grantee may include: involvement in
    collaboration and dissemination studies; Network analysis/national
    impact studies conducted by the evaluation contractor; and sharing
    information and data collected through already established National
    Center reporting mechanisms.

    All NCTSI grantees (including NCCTS) must provide sufficient
    evaluation staff with associated support in order to comply with
    reporting requirements, and cooperate fully with cross-site
    evaluation activities. Costs associated with employing and
    supporting evaluation staff must be reflected in the proposal
    budget. The evaluation contractor will provide ongoing training and
    technical assistance to all awarded Centers participating in the
    evaluation to ensure the timely submission of data and overall
    compliance with the evaluation protocol.

    Process evaluations must measure change relating to project goals
    and objectives over time compared to baseline information. You must
    consider your evaluation plan when preparing the project budget,
    including necessary staff time to consult on the cross site
    evaluation efforts, the implementation of collect clinical data
    using the core data set, and compile and submit data to a national
    evaluation contractor. It is estimated that evaluation and data
    collection activities will average 10-15% of most grantee budgets.
    No more than 20% of the grant award may be used for evaluation and
    data collection.

# II. AWARD INFORMATION

## 1. AWARD AMOUNT

> It is expected that up to \$5 million will be available to fund one
> award in FY 2005. The maximum allowable award is \$5 million in total
> costs (direct and indirect) per year for up to four years. Proposed
> budgets cannot exceed the allowable amount in any year of the proposed
> project. The actual amount available for award may vary depending on
> unanticipated program requirements and the availability of funds.

## 2. FUNDING MECHANISM

Because of the strong expectation of collaboration within the National
Child Traumatic Stress Network, independent evaluation, and nationwide
product development and dissemination, all of the grants within the
National Child Traumatic Stress Network will be Cooperative Agreements.

The specific roles for grantees of the National Center for Child
Traumatic Stress and the Federal government are outlined below.

> **Role of Federal Staff:**

-   Consult with the National Center Directors on all phases of the
    project to ensure accomplishment of the goals of the Initiative;

-   Review critical project activities for conformity to the mission of
    the NCTSI;

-   Assume overall responsibility for monitoring the conduct and
    progress of the NCTSI programs;

-   Make recommendations regarding continued funding;

-   Provide guidance on project design and components;

-   Participate in policy and steering groups or related work groups;

-   Review quarterly reports and conduct site visits, if warranted;

-   Oversee development and implementation of a multi-site evaluation in
    partnership with evaluation contractors, NCCTS staff and other NCTSI
    grantees;

-   Approve data collection plans and institute policies regarding data
    collection;

-   Submit required clearance packages to the U.S. Office of Management
    and Budget (OMB) using information and materials provided by the
    grantee and evaluation contractor;

-   Recommend outside consultants for training, site-specific
    evaluation, and data collection, if needed;

-   Author or co-author publications on program findings; and

-   Provide technical assistance on ways to help disseminate and apply
    study results.

> **Role of Awardee:**

-   Comply with the terms of the award and satisfactorily perform
    activities to achieve the NCTSI goals;

-   Consult with and accept guidance from CMHS staff on performance of
    activities to achieve NCTSI goals;

-   Consult with SAMHSA staff and an outside cross-site evaluation
    contractor on evaluation plans. Assist in cross-site evaluation of
    Network activities and program outcome evaluation;

-   Provide SAMHSA and a cross-site evaluation contractor with
    justifications and materials for clearance of data collection and
    analysis activities by the U.S. Office of Management and Budget
    (OMB);

-   Support and participate in Network meetings;

-   Respond to requests for information from CMHS;

-   Agree to provide SAMHSA with data required for the Government
    Performance and Results Act (GPRA);

-   As appropriate, support and disseminate intervention products,
    training materials, and other publications developed by the Network
    for use by the field; and

-   Produce required SAMHSA reports.

# III. ELIGIBILITY INFORMATION 

## 1. ELIGIBLE APPLICANTS

This is a competitive grant award open to Number range CHAPTERdomestic
public and private nonprofit entities. For example, the following are
eligible to apply: community-based organizations, out-patient clinics,
faith-based organizations, public or private universities, psychiatric
or general hospitals, units of State or local governments, and
partnerships of multiple clinical centers, programs and/or community
service providers applying as a single center. Eligible are federally
recognized tribes, and tribal organizations. "Tribal organization" means
the recognized governing body of any American Indian or Alaska Native
tribe, or any legally established organization of American Indians and
Alaska Natives---such as urban Indian health programs, inter-tribal
councils, and regional Indian health boards---which is controlled,
sanctioned, or chartered by such governing body or which is
democratically elected by the adult members of the AI/AN community to be
served by such an organization. The statutory authority for this program
precludes grants to for- profit organizations. Existing Network grantees
whose funding ends in FY 2005 are also eligible to apply for this
competitive grant award. All applicants will be evaluated by the same
criteria outlined in the evaluation criteria section.

## 2. COST SHARING

Cost sharing (see Appendix B: Glossary) is not required in this program,
and applications will not be screened out on the basis of cost sharing.
However, you may include cash or in-kind (see Appendix B: Glossary)
contributions in your proposal as evidence of commitment to the proposed
project.

**3. OTHER**

**Applications must comply with the following requirements, or they will
be screened out and will not be reviewed:** use of the PHS 5161-1
application; application submission requirements in Section IV-3 of this
document; and formatting requirements provided in Section IV-2.3 of this
document.

# IV. APPLICATION AND SUBMISSION INFORMATION 

**(To ensure that you have met all submission requirements, a checklist
is provided for your use in Appendix A of this document.)**

## 1. ADDRESS TO REQUEST APPLICATION PACKAGE 

You may request a complete application kit by calling SAMHSA's National
Mental Health Information Center at 1-800-789-CMHS (2647).

You also may download the required documents from the SAMHSA web site at
[www.samhsa.gov](http://www.samhsa.gov/). Click on "Grants."

Additional materials available on this web site include:

-   a technical assistance manual for potential applicants;

-   standard terms and conditions for SAMHSA grants;

-   guidelines and policies that relate to SAMHSA grants (e.g.,
    guidelines on cultural competence, consumer and family
    participation, and evaluation); and

-   enhanced instructions for completing the PHS 5161-1 application.

## 2. CONTENT AND FORM OF APPLICATION SUBMISSION

**2.1 Application Kit**

SAMHSA application kits include the following documents:

-   PHS 5161-1 (revised July 2000) -- Includes the face page, budget
    forms, assurances, certification, and checklist. You must use the
    PHS 5161-1. **Applications that are not submitted on the required
    application form will be screened out and will not be reviewed**.

    -   Request for Applications (RFA) -- Includes instructions for the
        grant application. This document is the RFA.

You must use all of the above documents in completing your application.

**2.2 Required Application Components**

To ensure equitable treatment of all applications, applications must be
complete. In order for your application to be complete, it must include
the required ten application components (Face Page, Abstract, Table of
Contents, Budget Form, Project Narrative and Supporting Documentation,
Appendices, Assurances, Certifications, Disclosure of Lobbying
Activities, and Checklist).

-   **Face Page** -- Use Standard Form (SF) 424, which is part of the
    PHS 5161-1. \[Note: Beginning October 1, 2003, applicants will need
    to provide a Dun and Bradstreet (DUNS) number to apply for a grant
    or cooperative agreement from the Federal Government. SAMHSA
    applicants will be required to provide their DUNS number on the face
    page of the application. Obtaining a DUNS number is easy and there
    is no charge. To obtain a DUNS number, access the Dun and Bradstreet
    web site at
    [www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or call
    1-866-705-5711. To expedite the process, let Dun and Bradstreet know
    that you are a public/private nonprofit organization getting ready
    to submit a Federal grant application.\]

-   **Abstract** -- Your total abstract should not be longer than 35
    lines. In the first five lines or less of your abstract, write a
    summary of your project that can be used, if your project is funded,
    in publications, reporting to Congress, or press releases.

-   **Table of Contents** -- Include page numbers for each of the major
    sections of your application and for each appendix.

-   **Budget Form** -- Use SF 424A, which is part of the 5161-1. Fill
    out Sections B, C, and E of the SF 424A. A sample budget and
    justification is included in Appendix D of this Request for
    Applications.

-   **Project Narrative and Supporting Documentation** -- The Project
    Narrative describes your project. It consists of Sections A
    through D. These sections in total may not be longer than 25 pages.
    (For example, remember that if your Project Narrative starts on page
    5 and ends on page 30, it is 26 pages long, not 25 pages.) More
    detailed instructions for completing each section of the Project
    Narrative are provided in "Section V---Application Review
    Information" of this document.

    The Supporting Documentation provides additional information
    necessary for the review of your application. This supporting
    documentation should be provided immediately following your Project
    Narrative in Sections E through H. There are no page limits for
    these sections, except for Section G, Biographical Sketches/Job
    Descriptions.

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-   *Section E* - Literature Citations. This section must contain
    complete citations, including titles and all authors, for any
    literature you cite in your application.

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-   *Section F* - Budget Justification, Existing Resources, Other
    Support. You must provide a narrative justification of the items
    included in your proposed budget, as well as a description of
    existing resources and other support you expect to receive for the
    proposed project. Be sure to show that no more than 20% of the total
    grant award will be used for data collection and evaluation.

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-   *Section G* - Biographical Sketches and Job Descriptions.

    -   Include a biographical sketch for the Project Director and other
        key positions. Each sketch should be 2 pages or less. If the
        person has not been hired, include a position description and/or
        letter of commitment with a current biographical sketch from the
        individual.

    -   Include job descriptions for key personnel. Job descriptions
        should be no longer than 1 page each.

    -   Sample sketches and job descriptions are listed on page 22, Item
        6 in the Program Narrative section of the PHS 5161-1.

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    -   *Section H* - Confidentiality and SAMHSA Participant
        Protection/Human Subjects. Section IV-2.4 of this document
        describes requirements for the protection of the
        confidentiality, rights and safety of participants in
        SAMHSA-funded activities. This section also includes guidelines
        for completing this part of your application.

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    -   **Appendices 1 through 3** -- Use only the appendices listed
        below. If your application includes any appendices not required
        in the grant announcement, they will be disregarded. Do not use
        more than a total of 30 pages for Appendices 1 and 3 combined.
        There are no page limitations for Appendices 2. Do not use
        appendices to extend or replace any of the sections of the
        Project Narrative. Reviewers will not consider them if you do.

        -   *Appendix 1*: Letters of Support, Memoranda of Understanding
            or other documentation of collaboration with other potential
            centers of programs.

        -   *Appendix 2*: Data Collection Instruments/Interview
            Protocols

        -   *Appendix 3*: Sample Consent Forms

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    -   **Assurances** -- Non-Construction Programs. Use Standard Form
        424B found in PHS 5161-1. Applicants will be required to
        complete the Assurance of Compliance with SAMHSA Charitable
        Choice Statutes and Regulations Form SMA 170.

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-   **Certifications** -- Use the "Certifications" forms found in PHS
    5161-1.

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-   **Disclosure of Lobbying Activities** -- Use Standard Form LLL found
    in the PHS 5161-1. Federal law prohibits the use of appropriated
    funds for publicity or propaganda purposes, or for the preparation,
    distribution, or use of the information designed to support or
    defeat legislation pending before the Congress or State
    legislatures. This includes "grass roots" lobbying, which consists
    of appeals to members of the public suggesting that they contact
    their elected representatives to indicate their support for or
    opposition to pending legislation or to urge those representatives
    to vote in a particular way.

-   **Checklist** -- Use the Checklist found in PHS 5161-1. The
    Checklist ensures that you have obtained the proper signatures,
    assurances and certifications and is the last page of your
    application.

**2.3 Application Formatting Requirements**

Applicants also must comply with the following basic application
requirements. Applications that do not comply with these requirements
will be screened out and will not be reviewed.

-   Information provided must be sufficient for review.

-   Text must be legible. (For Project Narratives submitted
    electronically in Microsoft Word, see separate requirements below
    under "Guidance for Electronic Submission of Applications.")

• Type size in the Project Narrative cannot exceed an average of 15
characters per

inch, as measured on the physical page. (Type size in charts, tables,
graphs, and

footnotes will not be considered in determining compliance.)

• Text in the Project Narrative cannot exceed 6 lines per vertical inch.

-   Paper must be white paper and 8.5 inches by 11.0 inches in size.

-   To ensure equity among applications, the amount of space allowed for
    the Project Narrative cannot be exceeded. (For Project Narratives
    submitted electronically in Microsoft Word, see separate
    requirements below under "Guidance for Electronic Submission of
    Applications.")

• Applications would meet this requirement by using all margins (left,
right, top, bottom) of at least one inch each, and adhering to the
25-page limit for the Project Narrative.

• Should an application not conform to these margin or page limits,
SAMHSA will use the following method to determine compliance: The total
area of the Project Narrative (excluding margins, but including charts,
tables, graphs and footnotes) cannot exceed 58.5 square inches
multiplied by 25. This number represents the full page less margins,
multiplied by the total number of allowed pages.

• Space will be measured on the physical page. Space left blank within
the Project Narrative (excluding margins) is considered part of the
Project Narrative, in determining compliance.

To facilitate review of your application, follow these additional
guidelines. Failure to adhere to the following guidelines will not, in
itself, result in your application being screened out and returned
without review. However, following these guidelines will help reviewers
to consider your application.

-   Pages should be typed single-spaced in black ink, with one column
    per page. Pages should not have printing on both sides.

-   Please number pages consecutively from beginning to end so that
    information can be located easily during review of the application.
    The cover page should be page 1, the abstract page should be page 2,
    and the table of contents page should be page 3. Appendices should
    be labeled and separated from the Project Narrative and budget
    section, and the pages should be numbered to continue the sequence.

-   The page limit of a total of 30 pages for Appendices 1 and 3
    combined should not be exceeded.

-   Send the original application and two copies to the mailing address
    in Section IV-6.1 of this document. Please do not use staples, paper
    clips, and fasteners. Nothing should be attached, stapled, folded,
    or pasted. Do not use heavy or lightweight paper or any material
    that cannot be copied using automatic copying machines. Odd-sized
    and oversized attachments such as posters will not be copied or sent
    to reviewers. Do not include videotapes, audiotapes, or CD-ROMs.

[Guidance for Electronic Submission of Applications]{.underline}

SAMHSA is now offering the opportunity for you to submit your
application to us either in electronic or paper format. Electronic
submission is voluntary. No review points will be added or deducted,
regardless of whether you use the electronic or paper format.

To submit an application electronically, you must use the
[www.Grants.gov](http://www.Grants.gov/) apply site. You will be able to
download a copy of the application package from
[www.Grants.gov](http://www.Grants.gov/), complete it off-line, and then
upload and submit the application via the Grants.gov site. E-mail
submissions will not be accepted.

You must search the Grants.gov site for the downloadable application
package, by the Catalogue of Federal Domestic Assistance (CFDA) number.
You can find the CFDA number on the first page of the funding
announcement.

You must follow the instructions in the User Guide available at:
[www.Grants.gov](http://www.Grants.gov/) apply site, on the Customer
Support tab. In addition to the User Guide, you may wish to use the
following sources for help:

-   By e-mail: <support@Grants.gov>

-   By phone: 1-800-518-4726 (1-800-518-GRANTS). The Customer Support
    Center is open from 7:00 a.m. to 9:00 p.m. Eastern Time, Monday
    through Friday.

If this is the first time you have submitted an application through
Grants.gov, you must complete four separate registration processes
before you can submit your application. Allow at least **two weeks** (10
business days) for these registration processes, prior to submitting
your application. The processes are: DUNS Number registration, Central
Contractor Registry (CCR) registration, Credential Provider
registration, and Grants.gov registration.

**It is strongly recommended that you submit your grant application
using Microsoft Office products (e.g., Microsoft Word, Microsoft Excel,
etc.).** If you do not have access to Microsoft Office products, you may
submit a PDF file. Directions for creating PDF files can be found on the
Grants.gov Web site. Use of file formats other than Microsoft Office or
PDF may result in your file being unreadable by our staff.

The Project Narrative must be a separate document in the electronic
submission. Formatting requirements for SAMHSA grant applications are
described above, and in Appendix A of this announcement. These
requirements also apply to applications submitted electronically, with
the following exceptions only for Project Narratives submitted
electronically in Microsoft Word. These requirements help to ensure the
accurate transmission and equitable treatment of applications.

-   *Text legibility:* Use a font of Times New Roman 12, line spacing of
    single space, and all margins (left, right, top, bottom) of one inch
    each. Adhering to these standards will help to ensure the accurate
    transmission of your document. If the type size in the Project
    Narrative of an electronic submission exceeds 15 characters per
    inch, or the text exceeds 6 lines per vertical inch, SAMHSA will
    reformat the document to Times New Roman 12, with line spacing of
    single space. Please note that this may alter the formatting of your
    document, especially for charts, tables, graphs, and footnotes.

-   *Amount of space allowed for Project Narrative:* The Project
    Narrative for an electronic submission may not exceed 12,875 words.
    **Any part of the Project Narrative in excess of the word limit will
    not be submitted to review.** To determine the number of words in
    your Project Narrative document in Microsoft Word, select
    file/properties/statistics.

Applicants are strongly encouraged to submit their applications to
Grants.gov early enough to resolve any unanticipated difficulties prior
to the deadline. You may also submit a back-up paper submission of your
application. Any such paper submission must be received in accordance
with the requirements for timely submission detailed in Section IV-3 of
this announcement. The paper submission must be clearly marked: "Back-up
for electronic submission." The paper submission must conform with all
requirements for non-electronic submissions. If both electronic and
back-up paper submissions are received by the deadline, the electronic
version will be considered the official submission.

After you electronically submit your application, you will receive an
automatic acknowledgement from Grants.gov that contains a Grants.gov
tracking number. It is important that you retain this number.

The Grants.gov Web site does not accept electronic signatures at this
time. Therefore, you must submit a signed paper original of the face
page (SF 424), the assurances (SF 424B), and the certifications, and
hard copy of any other required documentation that cannot be submitted
electronically. **You must reference the Grants.gov tracking number for
your application, on these documents with original signatures, and send
the documents to the following address. The documents must be received
at the following address within 5 business days of your electronic
submission.** Delays in receipt of these documents may impact the score
your application receives or the ability of your application to be
funded.

**For United States Postal Service:**

Crystal Saunders, Director of Grant Review

Office of Program Services

Substance Abuse and Mental Health Services Administration

Room 3-1044

1 Choke Cherry Road

Rockville, MD **20857**

ATTN: Electronic Applications

**For other delivery service (DHL, Falcon Carrier, Federal Express,
United Parcel Service):**

Crystal Saunders, Director of Grant Review

Office of Program Services

Substance Abuse and Mental Health Services Administration

Room 3-1044

1 Choke Cherry Road

Rockville, MD **20850**

ATTN: Electronic Applications

If you require a phone number for delivery, you may use (240) 276-1199.

4.  **SAMHSA Confidentiality and Participant Protection Requirements
    and**

**Protection of Human Subjects Regulations**

Applicants must describe procedures relating to Confidentiality,
Participant Protection and the Protection of Human Subjects Regulations
in Section H of the application, using the guidelines provided below.
Number range CHAPTERProblems with confidentiality, participant
protection, and protection of human subjects identified during peer
review of the application may result in the delay of funding.

**[Confidentiality and Participant Protection:]{.underline}**

All applicants [must]{.underline} describe how they will address the
requirements for each of the following elements relating to
confidentiality and participant protection.

1.  [Protect Clients and Staff from Potential Risks]{.underline}

-   Identify and describe any foreseeable physical, medical,
    psychological, social, and legal risks or potential adverse effects
    as a result of the project itself or any data collection activity.

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-   Describe the procedures you will follow to minimize or protect
    participants against potential risks, **including risks to
    confidentiality**.

-   Identify plans to provide guidance and assistance in the event there
    are adverse effects to participants.

-   Where appropriate, describe alternative treatments and procedures
    that may be beneficial to the participants. If you choose not to use
    these other beneficial treatments, provide the reasons for not using
    them.

2.  [Fair Selection of Participants]{.underline}

-   Describe the target population(s) for the proposed project. Include
    age, gender, and racial/ethnic background and note if the population
    includes homeless youth, foster children, children of substance
    abusers, pregnant women, or other targeted groups.

-   Explain the reasons for including groups of pregnant women,
    children, people with mental disabilities, people in institutions,
    prisoners, and individuals who are likely to be particularly
    vulnerable to HIV/AIDS.

-   Explain the reasons for [including or excluding]{.underline}
    participants.

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-   Explain how you will recruit and select participants. Identify who
    will select participants.

3.  [Absence of Coercion]{.underline}

-   Explain if participation in the project is voluntary or required.
    Identify possible reasons why participation is required, for
    example, court orders requiring people to participate in a program.

-   If you plan to compensate participants, state how participants will
    be awarded incentives (e.g., money, gifts, etc.).

-   State how volunteer participants will be told that they may receive
    services intervention even if they do not participate in or complete
    the data collection component of the project.

4.  [Data Collection]{.underline}

-   Identify from whom you will collect data (e.g., from participants
    themselves, family members, teachers, others). Describe the data
    collection procedures and specify the sources for obtaining data
    (e.g., school records, interviews, psychological assessments,
    questionnaires, observation, or other sources). Where data are to be
    collected through observational techniques, questionnaires,
    interviews, or other direct means, describe the data collection
    setting.

-   Identify what type of specimens (e.g., urine, blood) will be used,
    if any. State if the material will be used just for evaluation or if
    other use(s) will be made. Also, if needed, describe how the
    material will be monitored to ensure the safety of participants.

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-   Provide in **Appendix 2, "Data Collection Instruments/Interview
    Protocols,"** copies of [all]{.underline} available data collection
    instruments and interview protocols that you plan to use.

5.  [Privacy and Confidentiality]{.underline}

-   Explain how you will ensure privacy and confidentiality. Include who
    will collect data and how it will be collected.

-   Describe:

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-   How you will use data collection instruments.

-   Where data will be stored.

-   Who will or will not have access to information.

-   How the identity of participants will be kept private, for example,
    through the use of a coding system on data records, limiting access
    to records, or storing identifiers separately from data.

    **NOTE:** If applicable, grantees must agree to maintain the
    confidentiality of alcohol and drug abuse client records according
    to the provisions of **Title 42 of the Code of Federal Regulations,
    Part 2.**

6.  [Adequate Consent Procedures]{.underline}

-   List what information will be given to people who participate in the
    project. Include the type and purpose of their participation.
    Identify the data that will be collected, how the data will be used
    and how you will keep the data private.

-   State:

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-   Whether or not their participation is voluntary.

-   Their right to leave the project at any time without problems.

-   Possible risks from participation in the project.

-   Plans to protect clients from these risks.

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-   Explain how you will get consent for youth, the elderly, people with
    limited reading skills, and people who do not use English as their
    first language.

    **NOTE:** If the project poses potential physical, medical,
    psychological, legal, social or other risks, you **must** obtain
    [written]{.underline} informed consent.

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-   Indicate if you will obtain informed consent from participants or
    assent from minors along with consent from their parents or legal
    guardians. Describe how the consent will be documented. For example:
    Will you read the consent forms? Will you ask prospective
    participants questions to be sure they understand the forms? Will
    you give them copies of what they sign?

-   Include, as appropriate, sample consent forms that provide for: (1)
    informed consent for participation in service intervention; (2)
    informed consent for participation in the data collection component
    of the project; and (3) informed consent for the exchange (releasing
    or requesting) of confidential information. The sample forms must be
    included in **Appendix 3, "Sample Consent Forms"**, of your
    application. If needed, give English translations.

    **NOTE:** Never imply that the participant waives or appears to
    waive any legal rights, may not end involvement with the project, or
    releases your project or its agents from liability for negligence.

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-   Describe if separate consents will be obtained for different stages
    or parts of the project. For example, will they be needed for both
    participant protection in treatment intervention and for the
    collection and use of data?

-   Additionally, if other consents (e.g., consents to release
    information to others or gather information from others) will be
    used in your project, provide a description of the consents. Will
    individuals who do not consent to having individually identifiable
    data collected for evaluation purposes be allowed to participate in
    the project?

7.  [Risk/Benefit Discussion]{.underline}

    Discuss why the risks are reasonable compared to expected benefits
    and importance of the knowledge from the project.

    **[Protection of Human Subjects Regulations]{.underline}**

    SAMHSA expects that the grantees funded under this announcement may
    be required to comply with the Protection of Human Subjects
    Regulations (45 CFR 46). The grantee will be required to comply with
    the regulations only if the project-specific evaluation design
    proposed by the grantee requires compliance with the regulations.

    Applicants whose projects must comply with the Protection of Human
    Subjects Regulations must describe the process for obtaining
    Institutional Review Board (IRB) approval fully in their
    applications. While IRB approval is not required at the time of
    grant award, these applicants will be required, as a condition of
    award, to provide the documentation that an Assurance of Compliance
    is on file with the Office for Human Research Protections (OHRP) and
    that IRB approval has been received prior to enrolling any clients
    in the proposed project.

    General information about Protection of Human Subjects Regulations
    can be obtained on the web at <http://hhs.gov/ohrp>. You may also
    contact OHRP by e-mail (<ohrp@osophs.dhhs.gov>[)]{.underline} or by
    phone (301-496-7005). []{.mark}

## 3. SUBMISSION DATES AND TIMES 

The deadline for submission of applications for the National Center for
Child Traumatic Stress is May 6, 2005.

**Hand carried applications will not be accepted. Applications may be
shipped using only DHL, Falcon Carrier, Federal Express (FedEx), United
Parcel Service (UPS), or the United States Postal Service (USPS).**

Your application must be received by the application deadline, or you
must have proof of its timely submission as specified below.

-   For packages submitted via DHL, Falcon Carrier, Federal Express
    (FedEx), or United Parcel Service (UPS), timely submission shall be
    evidenced by a delivery service receipt indicating the application
    was delivered to a carrier service at least 24 hours prior to the
    application deadline.

-   For packages submitted via the United States Postal Service (USPS),
    proof of timely submission shall be a postmark not later than 1 week
    prior to the application deadline, and the following upon request by
    SAMHSA:

    -   proof of mailing using USPS Form 3817 (Certificate of Mailing),
        or

    -   a receipt from the Post Office containing the post office name,
        location, and date and time of mailing.

You will be notified by postal mail that your application has been
received.

**Applications not meeting the timely submission requirements above will
not be considered for review.** Please remember that mail sent to
Federal facilities undergoes a security screening prior to delivery.
Allow sufficient time for your package to be delivered.

If an application is mailed to a location or office (including room
number) that is not designated for receipt of the application, and that
results in the designated office not receiving your application in
accordance with the requirements for timely submission, it will cause
the application to be considered late and ineligible for review.

SAMHSA will not accept or consider any applications sent by facsimile.

SAMHSA is collaborating with [www.grants.gov](http://www.grants.gov/) to
accept electronic submission of applications for this grant program.
Guidance for electronic submission of applications is provided in
Section IV-2.3 of this announcement.

## 4. INTERGOVERNMENTAL REVIEW (E.O. 12372) REQUIREMENTS

Executive Order 12372, as implemented through Department of Health and
Human Services (DHHS) regulation at 45 CFR Part 100, sets up a system
for State and local review of applications for Federal financial
assistance. A current listing of State Single Points of Contact (SPOCs)
is included in the application kit and can be downloaded from the U.S.
Office of Management and Budget (OMB) web site at
[www.whitehouse.gov/omb/grants/spoc.html](http://www.whitehouse.gov/omb/grants/spoc.html).

-   Check the list to determine whether your State participates in this
    program. You **do not** need to do this if you are a federally
    recognized Indian tribal government.

    -   If your State participates, contact your SPOC as early as
        possible to alert him/her to the prospective application(s) and
        to receive any necessary instructions on the State's review
        process.

    -   For proposed projects serving more than one State, you are
        advised to contact the SPOC of each affiliated State.

    -   The SPOC should send any State review process recommendations to
        the following address within 60 days of the application
        deadline:

> **For United States Postal Service:**
>
> Crystal Saunders, Director of Grant Review
>
> Office of Program Services
>
> Substance Abuse and Mental Health Services Administration
>
> Room 3-1044
>
> 1 Choke Cherry Road
>
> Rockville, MD **20857**

ATTN: SPOC -- Funding Announcement No. SM-05-004

> **For other delivery service:**
>
> Crystal Saunders, Director of Grant Review
>
> Office of Program Services
>
> Substance Abuse and Mental Health Services Administration
>
> Room 3-1044
>
> 1 Choke Cherry Road
>
> Rockville, MD **20850**
>
> ATTN: SPOC -- Funding Announcement No. SM-05-004

## 5. FUNDING LIMITATIONS/RESTRICTIONS 

Cost principles describing allowable and unallowable expenditures for
Federal grantees, including SAMHSA grantees, are provided in the
following documents:

-   Institutions of Higher Education: OMB Circular A-21

-   State and Local Governments: OMB Circular A-87

-   Nonprofit Organizations: OMB Circular A-122

-   Appendix E Hospitals: 45 CFR Part 74

In addition, the grant recipient must comply with the following funding
restrictions:

-   Grant funds must be used for only purposes supported by the program.

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-   No more than 20% of the grant award may be used for evaluation and
    data collection expenses.

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-   Funds may not be used to pay for the purchase or construction of any
    building or structure to house any part of the grant project.
    Applications may request up to \$75,000 for renovations and
    alterations of existing facilities.

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-   SAMHSA will not accept a "research" indirect cost rate. The grantee
    must use the "other sponsored program rate" or the lowest rate
    available.

## 6. OTHER SUBMISSION REQUIREMENTS

1.  **Where to Send Applications**

(Guidance for Electronic Submission of Applications is provided in
Section IV-2.3 of this announcement. Following are instructions for
submission of paper applications.)

Send applications to the following address:

> **For United States Postal Service:**
>
> Crystal Saunders, Director of Grant Review
>
> Office of Program Services
>
> Substance Abuse and Mental Health Services Administration
>
> Room 3-1044
>
> 1 Choke Cherry Road
>
> Rockville, MD **20857**
>
> **For other delivery service:**
>
> Crystal Saunders, Director of Grant Review
>
> Office of Program Services
>
> Substance Abuse and Mental Health Services Administration
>
> Room 3-1044
>
> 1 Choke Cherry Road
>
> Rockville, MD **20850**

Do not send applications to other agency contacts, as this could delay
receipt. Be sure to include the funding announcement number on the face
page of the application. If you require a phone number for delivery, you
may use (240) 276-1199.

**6.2 How to Send Applications**

(Guidance for Electronic Submission of Applications is provided in
Section IV-2.3 of this announcement. Following are instructions for
submission of paper applications.)

Mail or deliver an original application and 2 copies (including
appendices) to the mailing address provided above, according to the
instructions in Section IV-3. The original and copies must not be bound.
Do not use staples, paper clips, or fasteners. Nothing should be
attached, stapled, folded, or pasted.

**Hand carried applications will not be accepted. Applications may be
shipped using only DHL, Falcon Carrier, Federal Express (FedEx), United
Parcel Service (UPS), or the United States Postal Service (USPS).**

**SAMHSA will not accept or consider any applications sent by
facsimile.**

# V. APPLICATION REVIEW INFORMATION

## 1. EVALUATION CRITERIA 

Your application will be reviewed and scored according to the
[quality]{.underline} of your response to the requirements listed below
for developing the Project Narrative (Sections A-D). These sections
describe what you intend to do with your project.

-   You must use the four sections/headings listed below in developing
    your Project Narrative. Be sure to place the required information in
    the correct section, **or it will not be considered**. Your
    application will be scored according to how well you address the
    requirements for each section.

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-   Reviewers will be looking for evidence of cultural competence in
    each section of the Project Narrative. Points will be assigned based
    on how well you address the cultural competence aspects of the
    evaluation criteria. SAMHSA's guidelines for cultural competence can
    be found on the SAMHSA web site at
    [www.samhsa.gov](http://www.samhsa.gov/). Click on "Grants."

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-   The Supporting Documentation you provide in Sections E-H and
    Appendices 1-3 will be considered by reviewers in assessing your
    response, along with the material in the Project Narrative.

-   The number of points after each heading below is the maximum number
    of points a review committee may assign to that section of your
    Project Narrative. Bullet statements in each section do not have
    points assigned to them. They are provided to invite the attention
    of applicants and reviewers to important areas within each section.

-   Applicants must be familiar with, or familiarize themselves with,
    the current structure and operation of the NCTSN and commit to
    working within this collaborative framework. To adequately address
    some of the requirements in this section it would be helpful to be
    familiar with current NETWORK Centers and collaborative activities.
    This information is available in the application kit and can be
    accessed electronically at the National Child Traumatic Stress
    Initiative website ([www.nctsnet.org](http://www.nctsnet.org/)).

**A. Understanding of National Needs Related to Child Traumatic Stress
(25 Points)**

-   Describe the major issues involved in: (1) improving treatment and
    services for children and adolescents who experience traumatic
    events throughout the country, and (2) increasing access to such
    improved treatment and services.

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-   Describe the capacity and experience of the proposed Center
    Director(s) in providing national leadership focused on child
    traumatic stress, and the expertise of other proposed key staff in
    child/adolescent trauma interventions and service delivery, clinical
    data collection and use, measurement and evaluation, and policy
    issues relevant to child/adolescent trauma.

-   Based on the concepts and goals outlined in the President's New
    Freedom Commission Report for mental health ([Achieving the Promise:
    Transforming Mental Health Care in America]{.underline}, July 2003),
    briefly describe potential areas in which the National Center for
    Child Traumatic Stress can provide leadership to help accomplish the
    major goals of the report. The applicant should also outline general
    issues and concerns related to the necessary transformation of
    service systems for children and adolescents who have experienced
    trauma.

**B. Proposed Approach (45 Points Total)**

-   Describe how you will perform the following functions of the
    > National Center for Child Traumatic Stress. Propose a set of plans
    > to develop Network activities, resources, and products within the
    > existing framework of the National Child Traumatic Stress Network.
    > This framework requires collaboration of Network Centers through
    > the Network's organization of committees in all phases of Network
    > operations. Applicants must be familiar with, or familiarize
    > themselves with, the current structure and operation of the
    > Network, and commit to operating within this collaborative
    > framework. The plans must state specific goals that can be
    > assessed to indicate success in accomplishing the objectives of
    > each of the required sections, and strategies and procedures that
    > will be used to adequately achieve the proposed performance goals
    > stated for each required area.

    1.  **Leadership of National Network**

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-   Describe how the National Center for Child Traumatic Stress will
    work collaboratively with SAMHSA and Network grantees to promote the
    transformation of services for children and adolescents who have
    experienced trauma in order to promote improved access to effective
    services. National leadership activities focused on transforming
    service systems may include promoting national attention to child
    trauma, promoting policy initiatives, and collaborating with
    national consumer and professional organizations. The applicant must
    describe how it will provide leadership and support for
    collaborative activities of Network Centers.

-   Describe how the National Center for Child Traumatic Stress will
    refine and maintain a framework and organizational procedures for
    collaborative National Child Traumatic Stress Network functioning.
    The applicant must describe a process through which it will identify
    and use existing resources of Network Centers in all areas of
    Network activity, and promote increased participation of Centers in
    Network activity, and communication and collaboration among Centers.
    Describe procedures to identify and recruit staff and other
    resources from Network Centers for Network activities. This
    framework must include procedures to coordinate and integrate new
    Centers into the Network. Describe mechanisms to improve
    communication among Network Centers and involvement of Centers in
    collaborative Network activities. The applicant must demonstrate an
    understanding of the current structure of the Network, and outline
    areas for potential improvement and suggestions for potential
    modifications to the current structure.

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-   Describe the composition and activities of a Steering Committee
    representative of Network Centers to provide guidance on general
    policies for operation of the Network, and an Advisory Board of
    constituency representatives to provide input on how the Network can
    achieve the national goals of NCTSI, including membership, roles,
    functions, and frequency of meetings.

-   Describe a planning process to expand the reach of the National
    Child Traumatic Stress Network by developing formalized procedures
    for collaboration with organizations that do not receive direct
    grant funding from SAMHSA. This process should include plans to
    develop an approach to "affiliate" membership, which may be
    available to a wide array of potential organizational partners. A
    selective process of affiliate membership may entitle organizations
    that do not currently receive SAMHSA grant support (e.g., prior
    grantees, community organizations) to participate in workgroups,
    training, and product development and dissemination.

-   Describe plans for any policy-related projects and activities (such
    as development of analytical materials related to the adoption of
    evidence-based practices within a variety of service systems). The
    rationale, purpose, and guidelines for any policy-related projects
    and activities must be clearly described. In keeping with Federal
    law, applicants must state explicitly that grant funds will not be
    used for the preparation, distribution, or use of information
    designed to support or defeat legislation pending before Congress or
    State legislatures.

-   Describe procedures to include input from consumer constituency
    groups, especially children/adolescents, families, and community
    service providers, in all aspects of Center and Network activities,
    including, but not limited to, representation on the Advisory Board.

-   Describe procedures to ensure consideration of cultural and other
    types of diversity in the activities of the Network and in the
    development of interventions and intervention products.

    1.  **Collaborative Resource Development and Dissemination**

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-   Describe how Network Centers will be engaged in public,
    professional, and policy maker resource development, and how the
    resource needs of the Centers will be solicited and met. Describe a
    process to obtain input from key consumers, service providers, and
    policy makers on information and other resource needs. Describe a
    process, including staffing needs, to produce a range of materials
    to address the public, consumer, service provider, and policy maker
    needs. Indicate how the adequacy of resources developed to meet
    resource needs will be assessed. Discuss how considerations of
    cultural and other types of diversity will be incorporated into
    information and resource development.

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-   Describe processes to support development and dissemination of
    effective clinical and service intervention products through
    collaborative Network activity.

-   Describe how the National Center will further develop the Network's
    national capacity for training Network and non-Network providers in
    implementing evidence-based treatment and service delivery
    approaches. As part of this effort, describe how the National Center
    will support Network activities to assess the effectiveness and
    applicability of Network-developed intervention products in
    community and service settings, and assist grantees in submitting
    information on effective intervention approaches for review by
    SAMHSA's National Registry of Effective Programs and Practices
    (NREPP), and developing and using other approaches for promoting the
    dissemination of evidence-based interventions.

-   Describe strategies for establishing and maintaining partnerships
    with professional groups, policy makers, community-based
    organizations, child serving agencies and systems, and other key
    stakeholders to support dissemination efforts.

-   Describe how needs of diverse cultural and linguistic communities
    will be addressed in Network-developed products.

-   Describe a plan for developing a national media strategy and
    marketing plan for the National Child Traumatic Stress Network that
    reaches professional and government organizations.

    1.  **Consultation and Technical Assistance**

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```
-   Describe how the National Center for Child Traumatic Stress will
    support a Network capacity to collect clinical and service data
    across Network Centers that provide treatment and services,
    including support for procedures for collecting such data, with
    attention to issues of clinical feasibility, the uses of such data,
    and how such data can promote knowledge to improve treatment and
    services for children/adolescents/families exposed to traumatic
    events. The applicant should describe plans to provide technical
    assistance and consultation to grantees on the effective use and
    analysis of clinical and service data.

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```
-   Describe a plan to identify effective models of sustainability from
    within the National Child Traumatic Stress Network and elsewhere in
    the fields of mental health, substance abuse, and co‑occurring
    disorders, and a plan to facilitate the transfer of executable
    knowledge and methods for sustainability plan development and
    implementation to sites in the Network. The plan must describe how
    the applicant will: (a) establish and operate a planning group
    representative of the Network, (b) stimulate and support Network
    sites in developing multifaceted sustainability plans that extend
    beyond traditional fund raising to include community collaboration
    and support, outcomes evaluation, social marketing, and diverse
    strategies for funding and other supportive resources, (c) provide
    outreach and training to Network sites using a variety of methods,
    and (d) evaluate the process and products/outputs/outcomes of these
    activities.

**C. Staff, Management, and Relevant Experience (20 points)**

-   Provide a realistic time line for the project (chart or graph)
    showing key activities, milestones, and responsible staff. (Note:
    The time line should be part of the Project Narrative. It should not
    be placed in an appendix.)

-   Describe a staffing plan adequate to accomplish the function and
    goals specified above in "Proposed Approach," including a
    description of staff positions with expected qualifications, or
    identification of existing staff with background and experience
    capable of performing required staff roles.

-   Describe the experience and expertise of the applicant organization
    in managing a complex, national network of collaborative projects.

-   Indicate how the applicant organization will support and promote
    cultural competence in the Center's activities through staffing
    and/or training.

D.  **Evaluation (10 points)**

-   Describe the applicant organization's commitment and plan for
    collaborating with SAMHSA staff, an evaluation contractor, and
    Network grantees in providing available data and reports for
    evaluation purposes, and for contributing to the development of a
    data collection package and supporting materials for approval by the
    U.S. Office of Management and Budget (OMB).

-   Describe an internal performance evaluation plan to assess and
    report annually on the performance of the National Center for Child
    Traumatic Stress in achieving the function and goals specified in
    "Proposed Approach" above. This internal evaluation plan should
    identify indicators of goal achievement, some benchmarks to assess
    progress in goal achievement, data collection methods, discussion of
    potential barriers/issues/problems, and proposed strategies for
    correction of these issues.

-   Discuss coordination with a cross-site evaluation contract overseen
    by the Center for Mental Health Services. For example, the National
    Center for Child Traumatic Stress may provide consultation regarding
    the clinical data routinely collected by trauma programs, and
    consult with CMHS and its evaluation contractor regarding
    appropriate data to be included in the cross-site evaluation of
    Community Treatment and Services Centers. The National Center for
    Child Traumatic Stress may also provide technical assistance to
    other Network grantees regarding the clinical use of data. The
    application must discuss preliminary plans to collaborate with the
    evaluation contractor in the implementation of the cross-site
    evaluation of Network activities and Network-produced intervention
    products. These plans must include attention to NCTSI and SAMHSA
    GPRA goals. Plans should also discuss technological capabilities and
    potential processes for data collection and data sharing.

-   Describe other planned activities in the areas of data collection,
    analysis, evaluation, and reporting of findings to promote the goals
    of the National Child Traumatic Stress Initiative.

## 2. REVIEW AND SELECTION PROCESS 

SAMHSA applications are peer-reviewed according to the review criteria
listed above. For those programs where the individual award is over
\$100,000, applications must also be reviewed by the appropriate
National Advisory Council.

Decisions to fund a grant are based on:

-   the strengths and weaknesses of the application as identified by
    peer reviewers and, when appropriate, approved by the appropriate
    National Advisory Council;

-   availability of funds; and

-   after applying the aforementioned criteria, the following method for
    breaking ties: When funds are not available to fund all applications
    with identical scores, SAMHSA will make award decisions based on the
    application that received the greatest number of points by peer
    reviewers on the evaluation criterion in Section V-1 with the
    highest number of possible points (Proposed Approach - 45 points).
    Should a tie still exist, the evaluation criterion with the next
    highest possible point value will be used, continuing sequentially
    to the evaluation criterion with the lowest possible point value,
    should that be necessary to break all ties. If an evaluation
    criterion to be used for this purpose has the same number of
    possible points as another evaluation criterion, the criterion
    listed first in Section V-1 will be used first.

# VI. AWARD ADMINISTRATION INFORMATION

## 1. AWARD NOTICES

After your application has been reviewed, you will receive a letter from
SAMHSA through postal mail that describes the general results of the
review, including the score that your application received.

If you are approved for funding, you will receive an **additional**
notice, the Notice of Grant Award, signed by SAMHSA's Grants Management
Officer. The Notice of Grant Award is the sole obligating document that
allows the grantee to receive Federal funding for work on the grant
project. It is sent by postal mail and is addressed to the contact
person listed on the face page of the application.

If you are not funded, you can re-apply if there is another receipt date
for the program.

## 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS 

[]{.mark}

**2.1 General Requirements**

-   You must comply with all terms and conditions of the grant award.
    SAMHSA's standard terms and conditions are available on the SAMHSA
    web site at
    [www.samhsa.gov/grants/generalinfo/grants_management.aspx](http://www.samhsa.gov/grants/generalinfo/grants_management.aspx).

[]{.mark}

-   You will be held accountable for the information provided in the
    application relating to performance targets. SAMHSA program
    officials will consider your progress in meeting goals and
    objectives, as well as your failures and strategies for overcoming
    them, when making an annual recommendation to continue the grant and
    the amount of any continuation award. Failure to meet stated goals
    and objectives may result in suspension or termination of the grant
    award, or in reduction or withholding of continuation awards.

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-   In an effort to improve access to funding opportunities for
    applicants, SAMHSA is participating in the U.S. Department of Health
    and Human Services "Survey on Ensuring Equal Opportunity for
    Applicants." This survey is included in the application kit for
    SAMHSA grants. Applicants are encouraged to complete the survey and
    return it, using the instructions provided on the survey form.

## 3. REPORTING REQUIREMENTS 

## 

**3.1 Progress and Financial Reports**

-   Grantees must provide quarterly and final progress reports. The
    final progress report must summarize information from the annual
    reports, describe the accomplishments of the project, and describe
    next steps for implementing plans developed during the grant period.

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-   Grantees must provide annual and final financial status reports.
    These reports may be included as separate sections of annual and
    final progress reports or can be separate documents. Because SAMHSA
    is extremely interested in ensuring that infrastructure development
    and enhancement efforts can be sustained, your financial reports
    must explain plans to ensure the sustainability (see Appendix B:
    Glossary) of efforts initiated under this grant. Initial plans for
    sustainability should be described in year 1 of the grant. In each
    subsequent year, you should describe the status of the project,
    successes achieved and obstacles encountered in that year.

-   SAMHSA will provide guidelines and requirements for these reports to
    grantees at the time of award and at the initial grantee orientation
    meeting after award. SAMHSA staff will use the information contained
    in the reports to determine the grantee's progress toward meeting
    its goals.

**3.2 Government Performance and Results Act**

The Government Performance and Results Act (GPRA) mandates
accountability and performance-based management by Federal agencies. To
meet the GPRA requirements, SAMHSA must collect performance data (i.e.,
"GPRA data") from grantees as outlined in the performance expectations
section, Section 2.2, of this announcement.

CMHS is currently in the initial planning stages of implementing a
web-based GPRA data collection and reporting system. Grantees may be
asked in the future to submit their GPRA data electronically using this
web-based system. All applicants must agree to comply with the web-based
submission of performance data in their application. When development of
the system is complete, grantees will be provided initial training and
ongoing technical assistance in order to ensure a smooth transition to
the electronic system and continued user support.

**3.3 Publications**

If you are funded under this grant program, you are required to notify
the Government Project Officer (GPO) and SAMHSA's Publications Clearance
Officer (240-276-2130) of any materials based on the SAMHSA-funded
project that are accepted for publication.

In addition, SAMHSA requests that grantees:

-   Provide the GPO and SAMHSA Publications Clearance Officer with
    advance copies of publications.

-   Include acknowledgment of the SAMHSA grant program as the source of
    funding for the project.

-   Include a disclaimer stating that the views and opinions contained
    in the publication do not necessarily reflect those of SAMHSA or the
    U.S. Department of Health and Human Services, and should not be
    construed as such.

SAMHSA reserves the right to issue a press release about any publication
deemed by SAMHSA to contain information of program or policy
significance to the substance abuse treatment/substance abuse
prevention/mental health services community.

# VII. AGENCY CONTACTS

For questions concerning program issues contact:

Cecilia Rivera-Casale, Ph.D.

> Division of Prevention, Traumatic Stress, and Special Programs
>
> SAMHSA/Center for Mental Health Services

1 Choke Cherry Road, Room 6-1003

> Rockville, MD 20857
>
> 240-276-1880
>
> E-mail: <cecilia.casale@samhsa.hhs.gov>

For questions on grants management issues, contact:

Kimberly Pendleton

Office of Program Services, Division of Grants Management

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Room 7-1097

Rockville, Maryland 20857

\(240\) 276-1421

<kimberly.pendleton@samhsa.hhs.gov>

### Appendix A -- Checklist for Formatting Requirements and Screenout Criteria for SAMHSA Grant Applications

*SAMHSA's goal is to review all applications submitted for grant
funding. However, this goal must be balanced against SAMHSA's obligation
to ensure equitable treatment of applications. For this reason, SAMHSA
has established certain formatting requirements for its applications.
**If you do not adhere to these requirements, your application will be
screened out and returned to you without review.***

-   Use the PHS 5161-1 application.

-   Applications must be received by the application deadline or have
    proof of timely submission, as detailed in Section IV-3 of the grant
    announcement.

-   Information provided must be sufficient for review.

-   Text must be legible. (For Project Narratives submitted
    electronically in Microsoft Word, see separate requirements in
    Section IV-2.3 of this announcement under "Guidance for Electronic
    Submission of Applications.")

• Type size in the Project Narrative cannot exceed an average of 15
characters per

inch, as measured on the physical page. (Type size in charts, tables,
graphs, and

footnotes will not be considered in determining compliance.)

• Text in the Project Narrative cannot exceed 6 lines per vertical inch.

-   Paper must be white paper and 8.5 inches by 11.0 inches in size.

-   To ensure equity among applications, the amount of space allowed for
    the Project Narrative cannot be exceeded. (For Project Narratives
    submitted electronically in Microsoft Word, see separate
    requirements in Section IV-2.3 of this announcement under "Guidance
    for Electronic Submission of Applications.")

• Applications would meet this requirement by using all margins (left,
right, top, bottom) of at least one inch each, and adhering to the page
limit for the Project Narrative stated in the specific funding
announcement.

• Should an application not conform to these margin or page limits,
SAMHSA will use the following method to determine compliance: The total
area of the Project Narrative (excluding margins, but including charts,
tables, graphs and footnotes) cannot exceed 58.5 square inches
multiplied by the page limit. This number represents the full page less
margins, multiplied by the total number of allowed pages.

• Space will be measured on the physical page. Space left blank within
the Project Narrative (excluding margins) is considered part of the
Project Narrative, in determining compliance.

*To facilitate review of your application, follow these additional
guidelines. Failure to adhere to the following guidelines will not, in
itself, result in your application being screened out and returned
without review. However, the information provided in your application
must be sufficient for review. Following these guidelines will help
ensure your application is complete, and will help reviewers to consider
your application.*

-   The 10 application components required for SAMHSA applications
    should be included. These are:

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-   Face Page (Standard Form 424, which is in PHS 5161-1)

-   Abstract

-   Table of Contents

-   Budget Form (Standard Form 424A, which is in PHS 5161-1)

-   Project Narrative and Supporting Documentation

-   Appendices

-   Assurances (Standard Form 424B, which is in PHS 5161-1)

-   Certifications (a form within PHS 5161-1)

-   Disclosure of Lobbying Activities (Standard Form LLL, which is in
    PHS 5161-1)

-   Checklist (a form in PHS 5161-1)

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-   Applications should comply with the following requirements:

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-   Provisions relating to confidentiality, participant protection and
    the protection of human subjects specified in Section IV-2.4 of the
    FY 2005 standard funding announcements.

-   Budgetary limitations as specified in Section I, II, and IV-5 of the
    FY 2005 standard funding announcements.

-   Documentation of nonprofit status as required in the PHS 5161-1.

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-   Pages should be typed single-spaced in black ink, with one column
    per page. Pages should not have printing on both sides.

-   Please number pages consecutively from beginning to end so that
    information can be located easily during review of the application.
    The cover page should be page 1, the abstract page should be page 2,
    and the table of contents page should be page 3. Appendices should
    be labeled and separated from the Project Narrative and budget
    section, and the pages should be numbered to continue the sequence.

-   The page limits for Appendices stated in the specific funding
    announcement should not be exceeded.

-   Send the original application and two copies to the mailing address
    in the funding announcement. Please do not use staples, paper clips,
    and fasteners. Nothing should be attached, stapled, folded, or
    pasted. Do not use heavy or lightweight paper or any material that
    cannot be copied using automatic copying machines. Odd-sized and
    oversized attachments such as posters will not be copied or sent to
    reviewers. Do not include videotapes, audiotapes, or CD-ROMs.

### Appendix B - Glossary

+-----------------------------------------------------------------------+
| **Best Practice:** Best practices are practices that incorporate the  |
| best objective information currently available regarding              |
| effectiveness and acceptability.                                      |
|                                                                       |
| **Catchment Area:** A catchment area is the geographic area from      |
| which the target population to be served by a program will be drawn.  |
|                                                                       |
| **Cooperative Agreement:** A cooperative agreement is a form of       |
| Federal grant. Cooperative agreements are distinguished from other    |
| grants in that, under a cooperative agreement, substantial            |
| involvement is anticipated between the awarding office and the        |
| recipient during performance of the funded activity. This involvement |
| may include collaboration, participation, or intervention in the      |
| activity. HHS awarding offices use grants or cooperative agreements   |
| (rather than contracts) when the principal purpose of the transaction |
| is the transfer of money, property, services, or anything of value to |
| accomplish a public purpose of support or stimulation authorized by   |
| Federal statute. The primary beneficiary under a grant or cooperative |
| agreement is the public, as opposed to the Federal Government.        |
|                                                                       |
| **Cost Sharing or Matching:** Cost sharing refers to the value of     |
| allowable non-Federal contributions toward the allowable costs of a   |
| Federal grant project or program. Such contributions may be cash or   |
| in-kind contributions. For SAMHSA grants, cost sharing or matching is |
| not required, and applications will not be screened out on the basis  |
| of cost sharing.  However, applicants often include cash or in-kind   |
| contributions in their proposals as evidence of commitment to the     |
| proposed project. This is allowed, and this information may be        |
| considered by reviewers in evaluating the quality of the application. |
|                                                                       |
| **Fidelity:** Fidelity is the degree to which a specific              |
| implementation of a program or practice resembles, adheres to, or is  |
| faithful to the evidence-based model on which it is based. Fidelity   |
| is formally assessed using rating scales of the major elements of the |
| evidence-based model. A toolkit on how to develop and use fidelity    |
| instruments is available from the SAMHSA-funded Evaluation Technical  |
| Assistance Center at [http://tecathsri.org](http://tecathsri.org/) or |
| by calling (617) 876-0426.                                            |
|                                                                       |
| **Grant:** A grant is the funding mechanism used by the Federal       |
| Government when the principal purpose of the transaction is the       |
| transfer of money, property, services, or anything of value to        |
| accomplish a public purpose of support or stimulation authorized by   |
| Federal statute. The primary beneficiary under a grant or cooperative |
| agreement is the public, as opposed to the Federal Government.        |
|                                                                       |
| **In-Kind Contribution**: In-kind contributions toward a grant        |
| project are non-cash contributions (e.g., facilities, space,          |
| services) that are derived from non-Federal sources, such as State or |
| sub-State non-Federal revenues, foundation grants, or contributions   |
| from other non-Federal public or private entities.                    |
|                                                                       |
| **Logic Model:** A logic model is a diagrammatic representation of a  |
| theoretical framework. A logic model describes the logical linkages   |
| among program resources, conditions, strategies, short-term outcomes, |
| and long-term impact. More information on how to develop logics       |
| models and examples can be found through the resources listed in      |
| Appendix G.                                                           |
|                                                                       |
| **Practice:** A practice is any activity, or collective set of        |
| activities, intended to improve outcomes for people with or at risk   |
| for substance abuse and/or mental illness. Such activities may        |
| include direct service provision, or they may be supportive           |
| activities, such as efforts to improve access to and retention in     |
| services, organizational efficiency or effectiveness, community       |
| readiness, collaboration among stakeholder groups, education,         |
| awareness, training, or any other activity that is designed to        |
| improve outcomes for people with or at risk for substance abuse or    |
| mental illness.                                                       |
|                                                                       |
| **Practice Support System:** This term refers to contextual factors   |
| that affect practice delivery and effectiveness in the pre-adoption   |
| phase, delivery phase, and post-delivery phase, such as a) community  |
| collaboration and consensus building, b) training and overall         |
| readiness of those implementing the practice, and c) sufficient       |
| ongoing supervision for those implementing the practice.              |
|                                                                       |
| **Stakeholder**: A stakeholder is an individual, organization,        |
| constituent group, or other entity that has an interest in and will   |
| be affected by a proposed grant project.                              |
|                                                                       |
| **Sustainability:** Sustainability is the ability to continue a       |
| program or practice after SAMHSA grant funding has ended.             |
|                                                                       |
| **Target Population:** The target population is the specific          |
| population of people whom a particular program or practice is         |
| designed to serve or reach.                                           |
|                                                                       |
| **Wraparound Service:** Wraparound services are non-clinical          |
| supportive services---such as child care, vocational, educational,    |
| and transportation services---that are designed to improve the        |
| individual's access to and retention in the proposed project.         |
+-----------------------------------------------------------------------+

+-----------------------------------------------------------------------+
| #                                                                     |
+-----------------------------------------------------------------------+

###  Appendix C -- Areas of Budget Consideration

[Note:]{.underline} Information in this appendix is provided for
planning purposes. Unless otherwise referenced in the RFA, budget
percentages and dollar ranges are approximate amounts for consideration
when developing program plans.

  ------------------ ---------------------------- -------------- -------------
  **Budget           **Allowable Activities**     **Percentage   **Dollar
  Category**                                      Range of       Range of
                                                  Budget**       Budget (TC)**

  *Administration*   Center director(s),          15-20%         \$750,000 to
                     administrative staff,                       \$1,000,000
                     support for Advisory Board                  
                     and Steering Committee,                     
                     other administrative                        
                     activities                                  

  *Support for       Support for Network          20-30%         \$1,000,000
  Network            organizational structure,                   to
  Collaboration*     Network committees, Network                 \$1,500,000
                     meetings and communication                  

  *Support for       Staff dedicated to regular   A minimum of   \$500,000
  Liaison with       communication with Network   10%            
  Network Centers*   centers, travel to Network                  
                     sites                                       

  *Evaluation/Data   Participation in cross-site  10-20%         \$500,000 to
  Collection*        evaluation and performance                  \$1,000,000
                     monitoring activities,                      
                     Network clinical data                       
                     collection, implementation                  
                     of the core data set,                       
                     center-specific evaluation                  
                     activities                                  

  *Resource          Development of resources for 20-40%         \$1,000,000
  Development and    public, professionals, and                  to
  Dissemination*     policy makers, support for                  \$2,000,000
                     Network intervention product                
                     development, dissemination                  
                     of Network educational and                  
                     intervention products                       
  ------------------ ---------------------------- -------------- -------------

### Appendix D- Sample Budget and Justification

**ILLUSTRATION OF A SAMPLE DETAILED BUDGET AND**

**NARRATIVE JUSTIFICATION TO ACCOMPANY**

**SF 424A: SECTION B FOR 01 BUDGET PERIOD**

**[OBJECT CLASS CATEGORIES]{.underline}**

**[Personnel]{.underline}**

**Job Annual Level of Salary being**

**Title** **Name Salary Effort Requested**

Project

Director J. Doe \$30,000 1.0 \$30,000

Secretary Unnamed \$18,000 0.5 \$ 9,000

Counselor R. Down \$25,000 1.0 \$25,000

> **Enter Personnel subtotal on 424A, Section B, 6.a. \$64,000**

**[Fringe Benefits]{.underline}** (24%) \$15,360

> **Enter Fringe Benefits subtotal on 424A, Section B, 6.b. \$15,360**

**[Travel]{.underline}**

2 trips for SAMHSA Meetings for 2 Attendees

(Airfare @ \$600 x 4 = \$2,400) + (per diem

@ \$120 x 4 x 6 days = \$2,880) \$5,280

Local Travel (500 miles x .24 per mile) 120

> **Enter Travel subtotal on 424A, Section B, 6.c. \$ 5,400**

**[Equipment]{.underline}** (List Individually)

> \"Equipment\" means an article of nonexpendable, tangible personal
> property having a useful life of more than one year and an acquisition
> cost which equals the lesser of (a) the capitalization level
> established by the governmental unit or nongovernmental applicant for
> financial statement purposes, or (b) \$5000.

**Enter Equipment subtotal on 424A, Section B, 6.d.**

**[Supplies]{.underline}**

Office Supplies \$500

Computer Software - 1 WordPerfect 500

**Enter Supplies subtotal on 424A, Section B, 6.e. \$1,000**

ILLUSTRATION OF DETAILED BUDGET AND NARRATIVE JUSTIFICATION (cont'd.)

**[Contractual Costs]{.underline}**

**Evaluation**

Job Name Annual Salary being Level of

Title Salary Requested Effort

Evaluator J. Wilson \$48,000 \$24,000 0.5

Other Staff \$18,000 \$18,000 1.0

Fringe Benefits (25%) \$10,500

**Travel**

2 trips x 1 Evaluator

(\$600 x 2) \$ 1,200

per diem @ \$120 x 6 720

Supplies (General Office) 500

Evaluation Direct \$54,920

Evaluation Indirect Costs (19%) \$10,435

Evaluation Subtotal \$65,355

**Training**

Job Name Level of Salary being

Title Effort Requested

Coordinator M. Smith 0.5 \$ 12,000

Admin. Asst. N. Jones 0.5 \$ 9,000

Fringe Benefits (25%) \$ 5,250

**Travel**

2 Trips for Training

Airfare @ \$600 x 2 \$ 1,200

Per Diem \$120 x 2 x 2 days 480

Local (500 miles x .24/mile) 120

**Supplies**

Office Supplies \$ 500

Software (WordPerfect) 500

**Other**

Rent (500 Sq. Ft. x \$9.95) \$ 4,975

Telephone 500

Maintenance (e.g., van) \$ 2,500

Audit \$ 3,000

Training Direct \$ 40,025

Training Indirect \$ -0-

**Enter Contractual subtotal on 424A, Section B, 6.f. \$105,380**

ILLUSTRATION OF DETAILED BUDGET AND NARRATIVE JUSTIFICATION (cont'd.)

**[Other]{.underline}**

Consultants = Expert @ \$250/day X 6 day \$ 1,500

(If expert is known, should list by name)

**Enter Other subtotal on 424A, Section B, 6.h. \$ 1,500**

**Total Direct Charges (sum of 6.a-6.h)**

**Enter Total Direct on 424A, Section B, 6.i. \$192,640**

**[Indirect Costs]{.underline}**

15% of Salary and Wages (copy of negotiated

indirect cost rate agreement attached)

**Enter Indirect subtotal of 424A, Section B, 6.j. \$ 9,600**

**[TOTALS]{.underline}**

**Enter TOTAL on 424A, Section B, 6.k. \$202,240**

**[JUSTIFICATION]{.underline}**

PERSONNEL - Describe the role and responsibilities of each position.

FRINGE BENEFITS - List all components of the fringe benefit rate.

EQUIPMENT - List equipment and describe the need and the purpose of the
equipment in relation to the proposed project.

SUPPLIES - Generally self-explanatory; however, if not, describe need.
Include explanation of how the cost has been estimated.

TRAVEL - Explain need for all travel other than that required by SAMHSA.

CONTRACTUAL COSTS - Explain the need for each contractual arrangement
and how these components relate to the overall project.

OTHER - Generally self-explanatory. If consultants are included in this
category, explain the need and how the consultant's rate has been
determined.

INDIRECT COST RATE - If your organization has no indirect cost rate,
please indicate whether your organization plans to a) waive indirect
costs if an award is issued, or b) negotiate and establish an indirect
cost rate with DHHS within 90 days of award issuance.

[CALCULATION OF FUTURE BUDGET PERIODS]{.underline}

[(based on first 12-month budget period)]{.underline}

Review and verify the accuracy of future year budget estimates.
Increases or decreases in the future years must be explained and
justified and no cost of living increases will be honored. (NOTE: new
salary cap of \$180,100 is effective for all FY 2005 awards.) \*

First Second Third

12-month 12-month 12-month

Period Period Period

Personnel

Project Director 30,000 30,000 30,000

Secretary\*\* 9,000 18,000 18,000

Counselor 25,000 25,000 25,000

TOTAL PERSONNEL 64,000 73,000 73,000

\*Consistent with the requirement in the Consolidated Appropriations
Act, Public Law 108-199.

\*\*Increased from 50% to 100% effort in 02 through 03 budget periods.

Fringe Benefits (24%) 15,360 17,520 17,520

Travel 5,400 5,400 5,400

Equipment -0- -0- -0-

Supplies\*\*\* 1,000 520 520

\*\*\*Increased amount in 01 year represents costs for software.

Contractual

Evaluation\*\*\*\* 65,355 67,969 70,688

Training 40,025 40,025 40,025

\*\*\*\*Increased amounts in 02 and 03 years are reflected of the
increase in client data collection.

Other 1,500 1,500 1,500

Total Direct Costs 192,640 205,934 208,653

Indirect Costs 9,600 9,600 9,600

(15% S&W)

TOTAL COSTS 202,240 216,884 219,603

The Federal dollars requested for all object class categories for the
first 12-month budget period are entered on Form 424A, Section B, Column
(1), lines 6a-6i. The [total]{.underline} Federal dollars requested for
the second through the fifth 12-month budget periods are entered on Form
424A, Section E, Columns (b) -- (e), line 20. The RFA will specify the
maximum number of years of support that may be requested.