Department of Health and Human Services

**Substance Abuse and Mental Health Services Administration**

**Circles of Care IV: Infrastructure Development for Children's Mental
Health Systems in American Indian/Alaska Native Communities**

**(Short Title: Circles of Care)**

**(Initial Announcement)**

**Request for Applications (RFA) No. SM-08-012**

**Catalogue of Federal Domestic Assistance (CFDA) No**.: 92.243

**Key Date:**

  ----------------------- -----------------------------------------------
  **Application           **Applications are due by May 09, 2008.**
  Deadline**              

  ----------------------- -----------------------------------------------

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

A. Kathryn Power, M.Ed. Terry L. Cline, Ph.D.

Director Administrator

Center for Mental Health Services Substance Abuse and Mental Health

Substance Abuse and Mental Health Services Administration

Services Administration

**Table of Contents**

[I. FUNDING OPPORTUNITY DESCRIPTION
5](#i.-funding-opportunity-description)

[1. INTRODUCTION 5](#introduction)

[2. EXPECTATIONS 6](#expectations)

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

[III. ELIGIBILITY INFORMATION 10](#iii.-eligibility-information)

[1. ELIGIBLE APPLICANTS 10](#eligible-applicants)

[2. COST SHARING and MATCH REQUIREMENTS
10](#cost-sharing-and-match-requirements)

[3. OTHER 10](#other)

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

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

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

[3. SUBMISSION DATES AND TIMES 13](#submission-dates-and-times)

[4. FUNDING LIMITATIONS/RESTRICTIONS
14](#funding-limitationsrestrictions)

[5. OTHER SUBMISSION REQUIREMENTS 14](#other-submission-requirements)

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

[1. EVALUATION CRITERIA 15](#evaluation-criteria)

[2. REVIEW AND SELECTION PROCESS 21](#review-and-selection-process)

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

[1. AWARD NOTICES 21](#award-notices)

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

[3. REPORTING REQUIREMENTS 22](#reporting-requirements)

[VII. AGENCY CONTACTS 23](#vii.-agency-contacts)

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

[Appendix B -- Guidance for Electronic Submission of Applications
27](#appendix-b-guidance-for-electronic-submission-of-applications)

[Appendix C -- Sample Logic Model 30](#appendix-c-sample-logic-model)

[Appendix D -- Logic Model Resources
33](#appendix-d-logic-model-resources)

[Appendix E -- Confidentiality and Participant Protection
34](#appendix-e-confidentiality-and-participant-protection)

[Appendix F -- Sample Budget and Justification
38](#appendix-f-sample-budget-and-justification)

[Appendix G- References 43](#appendix-g--references)

[Appendix H- Prior Circles of Care Grantees
49](#appendix-h--prior-circles-of-care-grantees)

[Appendix I - Definition of Family-Driven Care
50](#appendix-i---definition-of-family-driven-care)

[Appendix J -- Definition of Youth-Guided Care
52](#appendix-j-definition-of-youth-guided-care)

**Executive Summary:**

The Substance Abuse and Mental Health Services Administration, Center
for Mental Health Services is accepting applications for fiscal year
(FY) 2008 for Circles of Care IV: Infrastructure Development for
Children's Mental Health Systems in American Indian/Alaska Native
Communities (Short Title: Circles of Care) grants. The purpose of this
program is to provide tribal and urban Indian communities with tools and
resources to plan and design a holistic, community-based *system of
care* to support mental health and wellness for their children, youth
and families. These grants will increase the capacity and effectiveness
of behavioral health systems serving AI/AN communities. As a result,
Circles of Care grantees will be equipped to reduce the gap between the
need for behavioral health services and the availability and
coordination of services for children and families in AI/AN communities.
In FY 2008, SAMHSA/CMHS is especially interested in projects that focus
on improving the linkages between primary care and behavioral health.

**Funding Opportunity Title:** Circles of Care

**Funding Opportunity Number:** SM-08-012

**Due Date for Applications:** May 09, 2008

**Anticipated Total Available Funding:** \$2,141,000

**Estimated Number of Awards:** 7

**Estimated Award Amount:** Up to \$305,875 per year

**Length of Project Period:** Up to 3 years

**Eligible Applicants:** State and federally recognized Tribes and
tribal organizations including urban Indian organizations and Tribal
colleges and universities

\[See Section III-1 of this RFA for complete eligibility information.\]

# I. FUNDING OPPORTUNITY DESCRIPTION

## INTRODUCTION

The Substance Abuse and Mental Health Services Administration, Center
for Mental Health Services is accepting applications for fiscal year
(FY) 2008 for Circles of Care IV: Infrastructure Development for
Children's Mental Health Systems in American Indian/Alaska Native
Communities (Short Title: Circles of Care) grants. The purpose of this
program is to provide tribal and urban Indian communities with tools and
resources to plan and design a holistic, community-based *system of
care* to support mental health and wellness for their children, youth,
and families. These grants will increase the capacity and effectiveness
of behavioral health systems serving AI/AN communities. As a result,
Circles of Care grantees will be equipped to reduce the gap between the
need for behavioral health services and the availability and
coordination of services for children and families in AI/AN communities.
In FY 2008, SAMHSA/CMHS is especially interested in projects that focus
on improving the linkages between primary care and behavioral health.

# 

The Circles of Care grant program draws on the *system of care*
philosophy and principles that are implemented in the SAMHSA Cooperative
Agreements for Comprehensive Community Mental Health Services for
Children and Their Families Program (CMHI). In this grant, a *system of
care* is defined as a coordinated network of community-based services
and supports that are organized to meet the challenges of children and
youth with serious mental health needs and their families. In a model
system of care, families and youth work in partnership with public and
private organizations to design mental health services and supports that
are effective, that build on the strengths of individuals and that
address each person\'s cultural and linguistic needs. A system of care
helps children, youth and families function better at home, in school,
in the community and throughout life. Community leaders and community
members work in partnership with child serving agency directors and
staff members to formulate methods to reduce stigma, improve
relationships between provider groups, address service capacity issues
and increase cultural competence in the overall system: tribal, county,
State and federal.

###### 

Tribal colleges and universities (TCUs) have been instrumental in some
tribal systems of care projects, conducting needs assessments,
facilitating strategic planning, and developing and presenting
culturally specific wraparound training curricula for providers and
community members. Tribal colleges often utilize distance-learning
technology to partner with full universities, to enable students to stay
in the community and pursue advanced degrees. Post-secondary student
populations often face emotional/behavioral barriers to course
completion such as substance abuse, suicidal behaviors and competing
family responsibilities. These students represent important sources of
future providers to their own communities.

**Circles of Care** is one of SAMHSA's infrastructure grant programs.
SAMHSA's infrastructure grants support an array of activities to help
the grantee build a solid foundation for delivering and sustaining
effective mental health services through a system of care approach.
SAMHSA recognizes that each applicant will start from a unique point in
developing infrastructure and will serve populations/communities with
specific needs. Awardees may pursue diverse strategies and methods to
achieve their infrastructure development and capacity expansion goals.
Successful applicants will provide a coherent and detailed conceptual
"roadmap" of the process by which they have assessed or intend to assess
service system needs and plan/implement infrastructure development
strategies that meet those needs. The plan put forward in the grant
application must show the linkages among needs, the proposed
infrastructure development strategy, and increased system capacity that
will implement, enhance and sustain effective programs and services.

Circles of Care grants are authorized under 520 of the Public Health
Service Act, as amended. This announcement addresses Healthy People 2010
focus area 18 (Mental Health and Mental Disorders).

## 2. EXPECTATIONS

Circles of Care grant funds must be used primarily to support
infrastructure development, including the following types of activities:

-   Develop a holistic local system of care model that is designed by
    American Indian/Alaska Native community members, in partnership with
    program and evaluation staff, to develop the integration of
    behavioral health and primary healthcare systems and strengthen
    infrastructure towards this goal.

-   Actively engage a wide range of AI/AN community members (including
    youth and family members representative of the population of focus)
    in assessing service system needs, gaps and potential resources, and
    plan infrastructure development strategies that meet those needs and
    promote wellness among children and their families.

-   Place special emphasis on developing infrastructure to address
    co-occurring issues of mental health and substance abuse, suicide
    and other problems of high concern to AI/AN communities.

-   Increase the participation of families, tribal leaders and spiritual
    advisors in planning and developing service systems and treatment
    options based on the values and principles of the AI/AN community
    served by the project.

-   Evaluate the feasibility of the proposed community service system
    model, in terms of potential resources for implementation beyond the
    life of this grant.

-   Serve as a catalyst for broad-based, systemic change in the
    community including policy reform and infrastructure development
    that results in a holistic model system of care that is
    community-based, family-driven, youth-guided, culturally competent
    and collaborative across multiple agencies.

As of the fall 2007, approximately 1.4 million men and women have been
deployed to serve in Operation Enduring Freedom (OEF) and Operation
Iraqi Freedom (OIF) in support of the Global War on Terror.  Department
of Defense data indicate that over 24,000 active duty service members
are American Indian (not including those who are Indian and another
race). Individuals returning from Iraq and Afghanistan are at increased
risk for suffering post traumatic stress and other related disorders. 
Experts estimate that up to one-third of returning veterans will need
mental health and/or substance abuse treatment and related services.  In
addition, the family members of returning veterans have an increased
need for related support services.  To address these concerns, SAMHSA
strongly encourages all applicants to consider the unique needs of
returning veterans and their families in developing their proposed
project.

**2.1 Required Activities**

During the first year of the project:

-   conduct an in-depth analysis of the existing infrastructure of the
    local child serving system to identify policy, service gaps and
    potential resources;

-   facilitate culturally respectful strategic planning activities
    engaging community members, key stakeholders, youth, elders,
    spiritual advisors and tribal leaders to identify outcome
    expectations and measures;

-   implement consensus building to develop a culturally relevant logic
    model for an integrated system of care through family-driven and
    youth-guided approaches (see definitions in Appendices I and J);

-   utilize culturally appropriate social marketing techniques to
    broaden the awareness of behavioral health throughout the population
    of focus and reinforce commitments from system partners.

During years two and three of the project:

-   formalize interagency commitments;

-   reinforce the role of community leaders, members, youth and families
    in decision-making;

-   develop policies, corresponding funding streams and other strategies
    for implementation and sustainability of the model system of care;

-   identify evidence-based practices that may be culturally relevant in
    the community;

-   identify the role of traditional healing practices (practice-based
    evidence) in the community, especially if there are indications that
    such integration will reduce disparities in mental health care;

-   conduct trainings to expand service capacity;

-   confirm performance measures for system assessment;

-   complete the feasibility assessment and process evaluation, leading
    to adoption of the model.

**2.2 Data Collection and Performance Measures**

All SAMHSA grantees are required to collect and report certain data so
that SAMHSA can meet its obligations under the Government Performance
and Results Act (GPRA).  You must document your ability to collect and
report the required data in "Section D: Performance Assessment and Data"
of your application. Grantees will be required to report performance
measures on infrastructure development. These measures are currently
under development, but will most likely be derived from the following
domains: policy development; workforce development; financing;
organizational restructuring; accountability; types/targets of
practices; and cost efficiency. Data will be collected via the cross
site evaluation until the measures are completed and data collection
instruments are implemented in FY 2009. Performance information may be
gathered from administrative data and/or from data the grantee will be
required to collect. Data collected will be entered into the CMHS
Transformation Accountability (TRAC) Web-based system on an annual basis
on data collection forms which are also under development. Initial
training and ongoing technical assistance on the use of the TRAC system
will be provided.

[]{.mark}

Performance data will be reported to the public, the Office of
Management and Budget (OMB) and Congress as part of SAMHSA's budget
request.

**2.3 Performance Assessment**

Grantees must assess their projects, addressing the performance measures
described in Section I-2.2. The assessment should be designed to help
you determine whether you are achieving the goals, objectives and
outcomes you intend to achieve and whether adjustments need to be made
to your project. You will be required to report on your progress
achieved, barriers encountered and efforts to overcome these barriers in
a performance assessment report to be submitted twice per year. A
suggested reporting format will be provided after the award**.**

In addition to assessing progress against the performance measures
required for this program, your performance assessment must also
consider local outcome and process questions, such as the following
examples:

*Outcome Questions:*

-   Have changes been made through program activities to support
    appropriate training, credentialing and/or certification that
    promote local AI/AN workforce development?

-   What program or tribal government policies have been instituted to
    promote ongoing family-driven and youth-guided participation in
    formulating and implementing behavioral health/primary care-related
    policies, practices and evaluations?

-   What amount and type of collaborative funding across program
    partners has been initiated as a result of program activities?

-   How many and which organizations have initiated collaboration
    activities to promote program goals?

-   How has the community's capacity to provide access to integrated
    behavioral health and primary care services been increased as a
    result of funded program activities?

*Process Questions:*

-   What challenges were encountered in implementing program goals and
    objectives?

-   What community resources were identified for training and
    educational opportunities around culturally based behavioral health
    service delivery for youth?

-   How many people have been trained in specific mental health related
    practices/activities targeted by the program, and what was their
    role or profession?

-   How many and what type of collaborations have been established
    between behavioral health representatives and primary care
    representatives?

-   What strategies have been implemented to promote the ongoing
    family-driven and youth guided efforts in administration and other
    aspects of program development?

-   How were new practices and strategies identified to fund and/or
    improve practices/activities targeted by the program?

-   How were youth, families and community members (including
    traditional healers) involved in the program goal setting and
    planning/evaluation process?

**No more than 20% of the total grant award may be used for data
collection, performance measurement, and performance assessment, e.g.,
activities required in Sections I-2.2 and 2.3 above.**

**2.4 Grantee Meetings**

At least two mandatory grantee meetings will be scheduled each year,
which will likely alternate between Portland, Oregon and Denver,
Colorado. Grantee meetings are a primary resource for training,
technical assistance, peer-to-peer consensus development and negotiation
of desired project outcomes. Teams attending the grantee meeting should
include a minimum of 6 members (the project director, evaluator, family
representative, youth representative, cultural broker/community leader,
and a behavioral health and/or primary care provider.) Additional key
community members, such as tribal council representatives may also be
appropriate to attend meetings. The anticipated annual cost for the
local and grantee meeting travel is \$21,000. Travel cost estimates
include increased rates for local rural travel, small rural airports and
support for consumer/community/board participation. Applications must
include funding for travel to grantee meetings in the budget. Attendance
is required and failure to do so may result in the reduction or
elimination of continuation funds.

# II. AWARD INFORMATION

**Funding Mechanism:** Grant

**Anticipated Total Available Funding:** \$2,141,000

**Estimated Number of Awards:** 7

**Estimated Award Amount:** Up to \$305,875 per year

**Length of Project Period:** Up to 3 years

**Proposed budgets cannot exceed \$305,857 in total costs (direct and
indirect) in any year of the proposed project.** Annual continuation
awards will depend on the availability of funds, grantee progress in
meeting project goals and objectives, timely submission of required data
and reports, and compliance with all terms and conditions. **Applicants
should be aware that funding for this program is not included in the FY
2009 President's budget request, and funding beyond FY 2008 is not
guaranteed. SAMHSA is allowing applicants to submit proposals for 2
additional budget years for planning purposes and for technical
assistance in sustainability activities.**

# III. ELIGIBILITY INFORMATION 

## ELIGIBLE APPLICANTS

Eligible applicants are State and federally recognized American
Indian/Alaska Native (AI/AN) Tribes, tribal organizations and Tribal
colleges and universities. Tribal organization means the recognized body
of any AI/AN Tribe; any legally established organization of American
Indians/Alaska Natives which is controlled, sanctioned, or chartered by
such governing body or which is democratically elected by the adult
members of the Indian community to be served by such organization and
which includes the maximum participation of American Indians/Alaska
Natives in all phases of its activities. Consortia of tribal
organizations are eligible to apply, but each participating entity must
indicate its approval.

Prior Circles of Care grantees are ineligible to apply (See Appendix H).

## 2. COST SHARING and MATCH REQUIREMENTS

Cost sharing match are not required in this program.

## 3. OTHER

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

# IV. APPLICATION AND SUBMISSION INFORMATION 

## 1. ADDRESS TO REQUEST APPLICATION PACKAGE 

You may request a complete application kit from the SAMHSA Information
Line at 1-877-SAMHSA7 \[TDD: 1-800-487-4889\].

You also may download the required documents from the SAMHSA Web site at
[www.samhsa.gov/grants/apply.aspx](http://www.samhsa.gov/grants/apply.aspx)

Additional materials available on the SAMHSA web site include:

-   a grant writing technical assistance manual for potential
    applicants;

-   standard terms and conditions for SAMHSA grants;

-   information on technical assistance Webinars for perspective
    applicants on March 31, and April 1, 2008;

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

-   list of certifications and assurances referenced in item 21 of the
    SF 424 v2.

## 2. CONTENT AND FORM OF APPLICATION SUBMISSION

1.  **Application Kit**

SAMHSA application kits include the following documents:

-   PHS 5161-1 (revised July 2000) -- Includes the face page (SF 424
    v2), 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**.

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-   Request for Applications (RFA) -- Provides a description of the
    program, specific information about the availability of funds, and
    instructions for completing the grant application. This document is
    the RFA. The RFA will be available on the SAMHSA Web site
    ([[www.samhsa.gov/grants/index.aspx]{.underline}](../www.samhsa.gov/grants/index.aspx))
    and a synopsis of the RFA is available on the Federal grants Web
    site ([www.Grants.gov](http://www.Grants.gov/)).

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

**2.2 Required Application Components**

Applications 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** -- SF 424 v2 is the Face Page. This form is part of
    the PHS 5161-1. \[Note: Applicants must provide a Dun and Bradstreet
    (DUNS) number to apply for a grant or cooperative agreement from the
    Federal Government. SAMHSA applicants are required to provide their
    DUNS number on the face page of the application. Obtaining a DUNS
    number is easy and there is no charge. To obtain a DUNS number,
    access the Dun and Bradstreet Web site at
    [www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or call
    1-866-705-5711. To expedite the process, let Dun and Bradstreet know
    that you are a public/private nonprofit organization getting ready
    to submit a Federal grant application.\]

-   **Abstract** -- Your total abstract should not be longer than 35
    lines. It should include the project name, population of focus,
    proposed catchment area, proposed strategies/methods, project goals
    and measurable objectives to achieve infrastructure development and
    capacity expansion. 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 F of this document.

-   **Project Narrative and Supporting Documentation** -- The Project
    Narrative describes your project. It consists of Sections A
    through D. Sections A-D together may not be longer than 25 pages.
    (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. Additional instructions for completing these sections
    are included in Section V under "Supporting Documentation."
    Supporting documentation should be submitted in black and white (no
    color).

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-   **Appendices 1 through 4** -- Use only the appendices listed below.
    If your application includes any appendices not required in this
    document, they will be disregarded. Do not use more than a total of
    30 pages for Appendices 1, 3 and 4 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. Please label the appendices as:
    Appendix 1, Appendix 2, etc.

    -   *Appendix 1*: Letters of Support

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

    -   *Appendix 3*: Sample Consent Forms

    -   *Appendix 4*: Tribal resolution or letter of commitment from
        governing body of the tribal organization indicating that the
        proposed project addresses an identified tribal or tribal
        organization priority.

-   **Assurances** -- Non-Construction Programs. You must read the list
    of assurances provided on the SAMHSA Web site or in the application
    kit before signing the face page (SF 424 v2) of the application. You
    are also required to complete the Assurance of Compliance with
    SAMHSA Charitable Choice Statutes and Regulations Form SMA 170. This
    form will be posted on SAMHSA's Web site with the RFA and provided
    in the application kits.

-   **Certifications** - You must read the list of certifications
    provided on the SAMHSA Web site or in the application kit before
    signing the face page (SF 424 v2) of the application.

-   **Disclosure of Lobbying Activities** -- You must submit 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. If no lobbying is to be disclosed, mark
    N/A on the form.

-   **Checklist** -- Use the Checklist found in the PHS 5161-1. The
    Checklist ensures that you have obtained the proper signatures,
    assurances and certifications. If you are submitting a paper
    application, the Checklist should be the last page.

**2.3 Application Formatting Requirements**

**Please refer to Appendix A, *Checklist for Formatting Requirements and
Screenout Criteria for SAMHSA Grant Applications*, for SAMHSA's basic
application formatting requirements. Applications that do not comply
with these requirements will be screened out and will not be reviewed.**

## 3. SUBMISSION DATES AND TIMES 

Applications are due by close of business on May 9, 2008. Hard copy
applications are due by 5:00 PM (EST). Electronic applications are due
by 11:59 P.M. (EST). **Hand carried applications will not be accepted.
Applications may be shipped using only DHL, Federal Express (FedEx),
United Parcel Service (UPS), or the United States Postal Service
(USPS).**

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

**Your application must be received by the application deadline or it
will not be considered for review.** Please remember that mail sent to
Federal facilities undergoes a security screening prior to delivery. You
are responsible for ensuring that you submit your application so that it
will arrive by the application due date and time.

If an application is mailed to a location or office (including room
number) that is not designated for receipt of the application and, as a
result, the designated office does not receive your application by the
deadline, your application will be considered late and ineligible for
review.

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

SAMHSA accepts electronic submission of applications through
[www.Grants.gov](http://www.Grants.gov/). Please refer to Appendix B for
"Guidance for Electronic Submission of Applications."

## 4. FUNDING LIMITATIONS/RESTRICTIONS 

Cost principles describing allowable and unallowable expenditures for
Federal grantees, including SAMHSA grantees, are provided in the
following documents, which are available at
[www.samhsa.gov/grants/management.aspx](http://www.samhsa.gov/grants/management.aspx):

-   Institutions of Higher Education: OMB Circular A-21

-   State and Local Governments and Federally Recognized Indian Tribal
    Governments: OMB Circular A-87

-   Nonprofit Organizations: OMB Circular A-122

-   Hospitals: 45 CFR Part 74, Appendix E

In addition, SAMHSA's **Circles of Care** grant recipients must comply
with the following funding restrictions:

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

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

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-   Grant 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.
    (Applicants may request up to \$75,000 for renovations and
    alterations of existing facilities, if necessary and appropriate to
    the project.)

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

## 5. OTHER SUBMISSION REQUIREMENTS

You may submit your application in either electronic or paper format:

**[Submission of Electronic Applications]{.underline}**

SAMHSA accepts electronic submission of applications through
[www.Grants.gov](http://www.Grants.gov/). 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.

**Please refer to Appendix B for detailed instructions on submitting
your application electronically.**

**[Submission of Paper Applications]{.underline}**

You must submit an original application and 2 copies (including
appendices). The original and copies must not be bound. Do not use
staples, paper clips, or fasteners. Nothing should be attached, stapled,
folded, or pasted.

Send applications to the address below:

**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**

Change the zip code to **20850** if you are using another delivery
service.

Do not send applications to other agency contacts, as this could delay
receipt. Be sure to include **"Circles of Care SM 08-012"** in item
number 12 on the face page (SF 424 v2) of any paper applications. If you
require a phone number for delivery, you may use (240) 276-1199.

**Hand carried applications will not be accepted. Applications may be
shipped using only DHL, 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 

The Project Narrative describes what you intend to do with your project
and includes the Evaluation Criteria in Sections A-D below. Your
application will be reviewed and scored according to the
[quality]{.underline} of your response to the requirements in Sections
A-D.

-   In developing the Project Narrative section of your application, use
    these instructions which have been tailored to this program. **These
    are to be used instead of the "Program Narrative" instructions found
    in the PHS 5161-1**.

-   The Project Narrative (Sections A-D) together may be no longer than
    25 pages.

-   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 of the Project Narrative.

-   Reviewers will be looking for evidence of cultural competence in
    each section of the Project Narrative, and will consider how well
    you address the cultural competence aspects of the evaluation
    criteria when scoring your application. 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/Applying
    for a New SAMHSA Grant/Guidelines for Assessing Cultural
    Competence."

    -   The Supporting Documentation you provide in Sections E-H and
        Appendices 1-4 will be considered by reviewers in assessing your
        response, along with the material in the Project Narrative.

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-   The number of points after each heading is the maximum number of
    points a review committee may assign to that section of your Project
    Narrative. Although scoring weights are not assigned to individual
    bullets, applicants are encouraged to respond to each bulleted
    statement.

**Section A: Statement of Need (10 points)**

-   Describe the proposed catchment area and the individuals who will
    receive services through the targeted systems or agencies.

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-   Document the need for an enhanced infrastructure to increase the
    capacity to implement, sustain and improve effective integration of
    behavioral health and primary care services for the proposed
    population of focus in the proposed catchment area. Documentation of
    need may come from local data or trend analyses, State data (e.g.,
    from State Needs Assessments), and/or national data (e.g., from
    SAMHSA's National Survey on Drug Use and Health or from National
    Center for Health Statistics/Centers for Disease Control reports).
    For data sources that are not well known, provide sufficient
    information on how the data were collected so reviewers can assess
    the reliability and validity of the data.

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-   Describe the service gaps, barriers and other problems related to
    the need for infrastructure development and integration of
    behavioral health and primary care systems. Describe the community
    partner agencies, community leaders and other resources in the
    catchment area that can help implement the needed infrastructure
    development. Applicants should include whether the applicant
    receives funds from other related Federal or State grant programs,
    including the Department of Justice's Tribal Youth Program or other
    SAMHSA grants. The applicant must describe how the proposed project
    will be coordinated with any existing Indian Health Service or
    Bureau of Indian Affairs services in the community along with any
    projects funded through other grant resources.

-   Applicants must show that developing infrastructure to meet
    identified needs is consistent with priorities of the Tribe or
    tribal organization.

**Section B: Proposed Approach (35 points)**

-   Clearly state the purpose of the proposed project, with goals and
    objectives. Describe how achievement of goals will increase system
    capacity to support effective mental health services.

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-   Describe the proposed project. Provide evidence that the proposed
    activities meet the infrastructure needs and show how your proposed
    infrastructure development strategy will meet the goals and
    objectives.

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-   Discuss the population of focus language, beliefs, norms and values,
    as well as socioeconomic factors that must be considered in
    delivering programs to this population, and how the proposed
    approach addresses these issues.

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-   Provide a logic model (see Appendix C) that demonstrates the linkage
    between the identified need, the proposed approach and outcomes.

-   If you plan to include an advisory body in your project, describe
    its membership, roles and functions, frequency of meetings and how
    it will relate to the elected governing body of the Tribe or tribal
    organization.

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-   Describe any other organizations that will participate in the
    proposed project and their roles and responsibilities. Include
    letters of commitment/coordination/support from these community
    organizations in **Appendix 1** of your application.

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-   Describe how the proposed project will address issues of age, race,
    ethnicity, culture, language, sexual orientation, disability,
    literacy and gender in the population of focus.

-   Describe how members of the population of focus were involved in the
    preparation of the application, and how they will be involved in the
    planning, implementation, and performance assessment of the project
    to promote family-driven and youth-guided policy development and
    services (see Appendices I and J) and a sense of community ownership
    of the project.

-   Describe the potential barriers to successful conduct of the
    proposed project and how you will overcome them.

-   Describe how your activities will improve the capacity for a
    coordinated and collaborative mental health service system for
    children and families in your community []{.mark}and improve the
    integration of behavioral health and primary care systems.

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-   Describe your plan to continue the project after the funding period
    ends. Also describe how program continuity will be maintained when
    there is a change in the operational environment (e.g., staff
    turnover, change in project leadership) to ensure stability over
    time.

**Section C: Staff, Management, and Relevant Experience (25 points)**

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

-   Discuss the capability and experience of the applicant organization
    and other participating organizations with similar projects and
    populations, including experience in providing culturally
    appropriate/competent services.

-   Provide a complete list of staff positions for the project, showing
    the role of each and their level of effort and qualifications.
    Include the Project Director and other key personnel, such as the
    evaluator, treatment/prevention personnel, community coordinators or
    youth/family representatives.

-   Discuss how key staff have demonstrated experience in serving the
    population of focus and are familiar with the culture and language
    of the population. If the population of focus is multicultural and
    multilinguistic, describe how the staff are qualified to serve this
    population.

**Section D: Performance Assessment and Data (30 points)**

-   Document your ability to collect and report on the required
    performance measures as specified in Section I-2.2 of this document,
    including data required by SAMHSA to meet GPRA requirements. Specify
    and justify any additional measures you plan to use for your grant
    project and how additional measures will be reviewed or adapted for
    cultural relevance in the community.

-   Describe how data will be used to manage the project and assure
    continuous quality improvement.

-   Describe how family-driven and youth-guided principles will be
    incorporated throughout each step of the performance assessment
    process (see Appendices I and J for definitions).

-   Describe your plan for conducting the performance assessment as
    specified in Section I-2.3 of this RFA and document your ability to
    conduct the assessment.

NOTE: Although the budget for the proposed project is not a scored
review criterion, the Review Group will be asked to comment on the
appropriateness of the budget after the merits of the application have
been considered.

**SUPPORTING DOCUMENTATION**

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

**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 performance assessment. An illustration of a budget
and narrative justification is included in Appendix F of this document.

**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.

-   Information on what should be included in biographical sketches and
    job descriptions can be found on page 22, Item 6, in the Program
    Narrative section of the PHS 5161-1 instruction page, available at
    [www.hhs.gov/forms/PHS-5161-1.doc](http://www.hhs.gov/forms/PHS-5161-1.doc).

    **Section H:** Confidentiality and SAMHSA Participant
    Protection/Human Subjects: You 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. More detailed guidance for completing
    this section can be found in Appendix E of this RFA.

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

Because of the confidential nature of the work in which many SAMHSA
grantees are involved, it is important to have safeguards protecting
individuals from risks associated with their participation in SAMHSA
projects. All applicants must address the eight bullets below. If some
are not applicable or relevant to the proposed project, simply state
that they are not applicable and indicate why. In addition to addressing
these eight bullets, read the section that follows entitled Protection
of Human Subjects Regulations to determine if the regulations may apply
to your project. If so, you are required to describe the process you
will follow for obtaining Institutional Review Board (IRB) approval.
While we encourage you to keep your responses brief, there are no page
limits for this section and no points will be assigned by the Review
Committee. Problems with confidentiality, participant protection, and
the protection of human subjects identified during peer review of the
application must be resolved prior to funding.

-   Identify foreseeable risks or adverse effects due to participation
    in the project and/or in the data collection (performance
    assessment) activities (including physical, medical, psychological,
    social, legal, and confidentiality) and provide your procedures for
    minimizing or protecting participants from these risks.

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

-   Describe the population of focus and explain why you are including
    or excluding certain subgroups. Explain how and who will recruit and
    select participants.

-   State whether participation in the project is voluntary or required.
    If you plan to provide incentives/compensate participants, specify
    the type (e.g., money, gifts, coupons), and the value of any such
    incentives. Provide justification that the use of incentives is
    appropriate, judicious, and conservative and that incentives do not
    provide an "undue inducement" which removes the voluntary nature of
    participation. Incentives should be the minimum amount necessary to
    meet the programmatic and performance assessment goals of the grant.
    Applicants should determine the minimum amount that is proven to be
    effective by consulting with existing local programs and reviewing
    the relevant literature. In no case may the value of an incentive
    paid for with SAMHSA discretionary grant funds exceed \$20. (See
    Appendix E: Confidentiality and Participant Protection.)

-   Describe data collection procedures, including sources (e.g.,
    participants, school records) and the data collecting setting (e.g.,
    clinic, school). Provide copies of proposed data collection
    instruments and interview protocols in **Appendix 2** of your
    application, "Data Collection Instruments/Interview Protocols."
    State whether specimens such as urine and/or blood will be obtained
    and the purpose for collecting the specimens. If applicable,
    describe how the specimens and process will be monitored to ensure
    both the safety of participants and the integrity of the specimens.

-   Explain how you will ensure privacy and confidentiality of
    participants' records, data collected, interviews, and group
    discussions. Describe where the data will be stored, safeguards
    (e.g., locked, coding systems, storing identifiers separate from
    data), and who will have access to the information.

-   Describe the process for obtaining and documenting consent from
    adult participants and assent from minors along with consent from
    their parents or legal guardians. Provide copies of all consent
    forms in **Appendix 3** of your application, "Sample Consent Forms."
    If needed, give English translations.

-   Discuss why the risks are reasonable compared to expected benefits
    from the project.

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

SAMHSA expects that most grantees funded under this announcement will
not have to comply with the Protection of Human Subjects Regulations (45
CFR 46), which requires Institutional Review Board (IRB) approval.
However, in some instances, the applicant's proposed performance
assessment design may meet the regulation's criteria of research
involving human subjects. For assistance in determining if your proposed
performance assessment meets the criteria in 45 CFR 46, Protection of
Human Subjects Regulations, refer to the SAMHSA decision tree on the
SAMHSA Web site, under "Applying for a New SAMHSA Grant,"
<http://www.samhsa.gov/grants/apply.aspx>.

Applicants whose projects must comply with the Human Subjects
Regulations must, in addition to the bullets above, fully describe the
process for obtaining IRB approval. While IRB approval is not required
at the time of grant award, these grantees will be required, as a
condition of award, to provide documentation that an Assurance of
Compliance is on file with the Office for Human Research Protections
(OHRP). IRB approval must be received in these cases prior to enrolling
clients in the project. General information about Human Subjects
Regulations can be obtained through OHRP at <http://www.hhs.gov/ohrp>,
or <ohrp@osophs.dhhs.gov>, or (240) 453-6900. SAMHSA--specific questions
should be directed to the program contact listed in Section VII of this
announcement.

## 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 also must 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 applicable, approved by the Center for
    Mental Health Services' National Advisory Council;

-   availability of funds; and

-   equitable distribution of awards in terms of geography (including
    urban, rural and remote settings) and balance among populations of
    focus and program size.

# 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 through postal mail, 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.

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

## 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS 

[]{.mark}

-   If your application is funded, 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
    http://[www.samhsa.gov/grants/management.aspx](http://www.samhsa.gov/grants/management.aspx).

-   If your application is funded, you must also comply with the
    administrative requirements outlined in 45 CFR Part 74 or 45 CFR
    Part 92, as appropriate. For more information see the SAMHSA Web
    site
    (http://[www.samhsa.gov/grants/management.aspx](http://www.samhsa.gov/grants/management.aspx)).

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-   Depending on the nature of the specific funding opportunity and/or
    your proposed project as identified during review, SAMHSA may
    negotiate additional terms and conditions with you prior to grant
    award. These may include, for example:

    -   actions required to be in compliance with confidentiality and
        participant protection/human subjects requirements;

    -   requirements relating to additional data collection and
        reporting;

    -   requirements relating to participation in a cross-site
        evaluation; or

    -   requirements to address problems identified in review of the
        application.

-   If your application is funded, 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.

-   Grant funds cannot be used to supplant current funding of existing
    activities. "Supplant" is defined as replacing funding of a
    recipient's existing program with funds from a Federal grant.

-   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 and is posted on the SAMHSA Web site. You are
    encouraged to complete the survey and return it, using the
    instructions provided on the survey form.

## 3. REPORTING REQUIREMENTS

In addition to the data reporting requirements listed in Section I-2.2,
you must comply with the following reporting requirements:

## 

1.  **Progress and Financial Reports**

-   You will be required to submit bi-annual and final progress reports.

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-   Because SAMHSA is extremely interested in ensuring that treatment
    and prevention services can be sustained, your progress reports
    should explain plans to ensure the sustainability of efforts
    initiated under this grant.

-   If your application is funded, SAMHSA will provide you with
    guidelines and requirements for these reports 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
    your 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. The performance requirements for SAMHSA's
**Circles of Care** grant program are described in Section I-2.2 of this
document under "Data Collection and Performance Measurement."

**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 about program issues contact:

> R. Andrew Hunt, MSW, LICSW
>
> Child Adolescent and Family Branch
>
> Center for Mental Health Services
>
> Substance Abuse and Mental Health Services Administration
>
> 1 Choke Cherry Road
>
> Room 6-1054
>
> Rockville, Maryland 20857
>
> \(240\) 276-1926
>
> <Andrew.hunt@samhsa.hhs.gov>

For questions on grants management issues, contact:

Gwendolyn Simpson

Office of Program Services, Division of Grants Management

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Room 7-1085

Rockville, Maryland 20857

\(240\) 276-1408

<gwendolyn.simpson@samhsa.hhs.gov>

**Technical Assistance Webinars**

### 

### There will be a series of two Webinars (seminars via the internet) providing technical assistance for potential applicants of *Circles of Care*.  Part one will be held on March 31, 2008 from 4:00-5:30 PM EST and part two will be held on April 1, 2008 from 4:00-5:30 PM EST.  Applicants interested in participating in the Webinars should contact Dolores Jimerson (phone: 503-222-4044 ext 122. E-mail: [**dolores@nicwa.org**](mailto:dolores@nicwa.org)) at the National Indian Child Welfare Association for details or questions about how to register for the Webinar.  Registration and log-on information for the Webinars can also be found directly at [**https://nicwa.on.intercall.com**](https://nicwa.on.intercall.com/) . 

### 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 form.

-   Applications must be received by the application due date and time,
    as detailed in Section IV-3 of this grant announcement.

-   Information provided must be sufficient for review.

-   Text must be legible. Pages must be typed in black ink,
    single-spaced, using a font of Times New Roman 12, with all margins
    (left, right, top, bottom) at least one inch each. (For Project
    Narratives submitted electronically, see separate requirements in
    Section IV-6 of this announcement under "Submission of Electronic
    Applications.")

-   To ensure equity among applications, page limits for the Project
    Narrative cannot be exceeded.

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

*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 and submitted in the following order:

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-   Face Page (Standard Form 424 v2, 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

-   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 and participant protection
    specified in Section V-1 of this announcement.

-   Budgetary limitations as specified in Sections I, II, and IV-5 of
    this announcement.

-   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.

-   Pages should be numbered consecutively from beginning to end so that
    information can be located easily during review of the application.
    The abstract page should be page 1, the table of contents should be
    page 2, etc. The four pages of Standard form 424 v2 are not to be
    numbered. 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 Section IV-2.2 of this
    announcement should not be exceeded.

-   Send the original application and two copies to the mailing address
    in Section IV-6 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.

###  

### Appendix B -- Guidance for Electronic Submission of Applications

If you would like to submit your application electronically, you may
search [www.Grants.gov](http://www.Grants.gov/) for the downloadable
application package by the funding announcement number (called the
opportunity number) or 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 the
[www.Grants.gov](http://www.Grants.gov/) apply site, on the Help page.
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, excluding Federal holidays.

**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: 1) DUNS Number registration; 2)
Central Contractor Registry (CCR) registration; 3) Credential Provider
registration; and 4) Grants.gov registration.

**It is strongly recommended that you submit your grant application
using Microsoft Office 2003 products (e.g., Microsoft Word 2003,
Microsoft Excel, etc.).** The new Microsoft Vista operating system and
Microsoft Word 2007 products are not currently accepted by Grants.gov.
If you do not have access to Microsoft Office products, you may submit
PDF files. 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 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 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 at least
    one inch each. Adhering to these standards will help to ensure the
    accurate transmission of your document.

-   *Amount of space allowed for Project Narrative*: The Project
    Narrative for an electronic submission may not exceed **12,875**
    words. **If the Project Narrative for an electronic submission
    exceeds the word limit, the application will be screened out and
    will not be reviewed**. To determine the number of words in your
    Project Narrative document in Microsoft Word, select
    file/properties/statistics.

**Keep the Project Narrative as a separate document. Please consolidate
all other materials in your application to ensure the fewest possible
number of attachments. Be sure to label each file according to its
contents, e.g., "Appendices 1-3", "Appendices 4-5." **

Ensure all pages in your application are numbered consecutively, with
the exception of the standard forms in the PHS-5161 application package.
**Documents containing scanned images must also contain page numbers to
continue the sequence.** Failure to comply with these requirements may
affect the successful transmission and consideration of your
application.

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. **Include
the Grants.gov tracking number in the top right corner of the face page
(SF 424 v2)** **for any paper submission. Receipt of the tracking number
is the only indication that Grants.gov has successfully received and
validated your application. If you do not receive a Grants.gov tracking
number, you may want to contact the Grants.gov help desk for
assistance.**

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 v2), the assurances (SF 424B), and hard copy of any other
required documentation that cannot be submitted electronically. **You
must include the Grants.gov tracking number for your application on
these documents with original signatures, on the top right corner of the
face page, and send the documents to the following address. The
documents must be received at the following address within 5 business
days after 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 services, change the zip code to 20850.**

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

### 

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### Appendix C -- Sample Logic Model 

A Logic Model is a tool to show how your proposed project links the
purpose, goals, objectives, and tasks stated with the activities and
expected outcomes or "change" and can help to plan, implement, and
assess your project. The model also links the purpose, goals,
objectives, and activities back into planning and evaluation. A Logic
Model is a *picture* of your project. It graphically shows the
activities and progression of the project. It should also describe the
relationships among what resources you put in (inputs), the strategies
you use, the infrastructure changes that occur, what takes place
(outputs), and what happens or results (outcomes). Based on both your
planning and evaluating activities, you can then make a "logical" chain
of "if-then" relationships.

Look at the graphics on the following pages to see the chain of events
that links the inputs to strategies, the strategies to infrastructure
changes, the infrastructure changes to outputs, and the outputs to
outcomes (goals).

The framework you set up to build your model is based on a review of
your Statement of Need, in which you state the conditions that gave rise
to the project with your targeted systems or agencies. Then you look at
the **Inputs,** which are the resources you will invest to change these
conditions. These inputs then are organized into the **Strategies** you
will use and the **Infrastructure Changes** that will result. These
changes then are intended to create **Outputs** such as increased
numbers of people served or numbers of providers trained. **Outcomes**
are the intended consequences of the program or activity, such as
changes in behavior or rates of substance abuse or mental illness.

### 

### 

\*The logic models presented are not a required format and SAMHSA does
not expect strict adherence to this format. They are presented only as
samples of how you can present a logic model in your application.

![](media/image1.wmf){width="9.65in" height="6.404861111111111in"}

### Appendix D -- Logic Model Resources

Chen, W.W., Cato, B.M., & Rainford, N. (1998-9). Using a logic model to

plan and evaluate a community intervention program: A case study.
*International Quarterly of Community Health Education*, *18*(4),
449-458.

Edwards, E.D., Seaman, J.R., Drews, J., & Edwards, M.E. (1995). A
community approach for Native American drug and alcohol prevention
programs: A logic model framework. *Alcoholism Treatment Quarterly*,
*13*(2), 43-62.

Hernandez, M. & Hodges, S. (2003). *Crafting Logic Models for Systems of
Care: Ideas into Action*. \[Making children's mental health services
successful series, volume 1\]. Tampa, FL: University of South Florida,
The Louis de la Parte Florida Mental Health Institute, Department of
Child & Family Studies.
[http://cfs.fmhi.usf.edu](http://cfs.fmhi.usf.edu/) or phone (813)
974-4651

Hernandez, M. & Hodges, S. (2001). Theory-based accountability. In M.
Hernandez & S. Hodges (Eds.), *Developing Outcome Strategies in
Children\'s Mental Health*, pp. 21-40. Baltimore: Brookes.

Julian, D.A. (l997). Utilization of the logic model as a system level
planning and evaluation device. *Evaluation and Planning,* *20*(3),
251-257.

Julian, D.A., Jones, A., & Deyo, D. (1995). Open systems evaluation and
the

logic model: Program planning and evaluation tools. *Evaluation and
Program*

*Planning,* *18*(4), 333-341.

Patton, M.Q. (1997). *Utilization-Focused Evaluation* (3^rd^ Ed.), pp.
19, 22,

241\. Thousand Oaks, CA: Sage.

Wholey, J.S., Hatry, H.P., Newcome, K.E. (Eds.) (1994). *Handbook of
Practical Program Evaluation.* San Francisco, CA: Jossey-Bass Inc.

### Appendix E -- 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 population(s) of focus 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.). Provide
    justification that the use of incentives is appropriate, judicious,
    and conservative and that incentives do not provide an "undue
    inducement" which removes the voluntary nature of participation.
    Incentives should be the minimum amount necessary to meet the
    programmatic and performance assessment goals of the grant.
    Applicants should determine the minimum amount that is proven
    effective by consulting with existing local programs and reviewing
    the relevant literature. In no case may the value if an incentive
    paid for with SAMHSA discretionary grant funds exceed \$20.

-   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 II.**

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.

```{=html}
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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.

```{=html}
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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}**

Applicants may also have to comply with the Protection of Human Subjects
Regulations (45 CFR 46), depending on the evaluation and data collection
procedures proposed and the population to be served.

Applicants must be aware that even if the Protection of Human Subjects
Regulations do not apply to all projects funded, the specific
performance assessment design proposed by the applicant may require
compliance with these regulations. For assistance in determining if your
proposed performance assessment meets the criteria in 45 CFR 46,
Protection of Human Subjects Regulations, refer to the SAMHSA decision
tree on the SAMHSA Web site, under "Applying for a New SAMHSA Grant,"
<http://www.samhsa.gov/grants/apply.aspx>.

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://www.hhs.gov/ohrp>. You may also
contact OHRP by e-mail (<ohrp@osophs.dhhs.gov>[)]{.underline} or by
phone (240/453-6900). SAMHSA-specific questions related to Protection of
Human Subjects Regulations should be directed to the program contact
listed in Section VII of this RFA.

### 

###  

### Appendix F -- 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 SAMHSA Non-Federal TOTAL**

**Title** **Name Salary Effort Funded Sources**

Project

> Director J. Doe \$30,000 1.0 \$30,000 \$-0-
>
> Clinical
>
> Director J. Doe \$-0- In-Kind

Secretary Unnamed \$18,000 0.5 \$-0- \$ 9,000

Counselor R. Down \$25,000 1.0 \$25,000 \$-0-

**SUBTOTAL \$55,000 \$9,000**

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

**[Fringe Benefits]{.underline}** (24%) \$15,360 \$-0-

**SUBTOTAL \$15,360 \$-0-**

**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 \$-0-

Local Travel (500 miles x .24 per mile) \$-0- \$120

\[Note: Current Federal Government per diem rates are available at
[www.gsa.gov](http://www.gsa.gov/).\]

**SUBTOTAL \$5,280 \$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.

**SUBTOTAL \$-0- \$-0-**

**Enter Equipment subtotal on 424A, Section B, 6.d. \$-0-**

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

**[Supplies]{.underline}**

Office Supplies \$500 \$-0-

Computer Software -- Microsoft Word \$-0- 500

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

**[CONTRACTUAL COSTS]{.underline}**

**[Evaluation]{.underline}**

**Job Annual Level of SAMHSA Non-Federal TOTAL**

**Title** **Name Salary Effort Funded Sources**

Evaluator J. Wilson \$48,000 .05 \$24,000 \$-0-

Other Staff \$18,000 1.0 \$18,000 \$-0-

Fringe Benefits (25%) \$10,500 \$-0-

**Travel**

2 trips x 1 Evaluator

(\$600 x 2) \$ 1,200 \$-0-

Per Diem @ \$120 x 6 720 \$-0-

Supplies (General Office) 500 \$-0-

Evaluation Contractual Direct Costs \$54,920 \$-0-

Evaluation Contractual Indirect Costs (19%) \$10,435 \$-0-

Evaluation Contract Subtotal **\$65,355**

**SUBTOTAL \$65,355** **\$-0- \$65,355**

**[Training]{.underline}**

**Job Annual Level of SAMHSA Non-Federal TOTAL**

**Title** **Name Salary Effort Funded Sources**

Coordinator M. Smith \$ 12,000 0.5 \$12,000 \$-0-

Admin. Asst. N. Jones 9,000 0.5 9,000 \$-0-

Fringe Benefits (25%) 5,250 \$-0-

**Travel**

2 Trips for Training

Airfare @ \$600 x 2 \$1,200 \$-0-

Per Diem \$120 x 2 x 2 days 480 \$-0-

Local (500 miles x .24/mile) 120 \$-0-

**Supplies**

Office Supplies \$500 \$-0-

Software (Microsoft Word) \$500 \$-0-

Training Contractual Direct Costs Subtotal \$40,025 \$-0- **\$40,025**

Training Contractual Indirect Costs Subtotal \$-0- \$-0- **\$-0-**

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

**SUBTOTAL \$105,380 \$-0-** **\$105,380**

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

**SAMHSA Non-Federal TOTAL**

**Funded Sources**

**[OTHER]{.underline}**

Rent (500 Sq. Ft. x \$9.95) \$ 4,975 \$-0-

Telephone \$ 500 \$-0-

Maintenance (e.g., van) \$-0- \$ 2,500

Audit \$-0- \$ 3,000

Consultants = Expert @ \$250/day X 6 day \$ 1,500 \$-0-

(If expert is known, should list by name)

**SUBTOTAL \$6,957 \$5,500**

**Enter Other subtotal on 424A, Section B, 6.h. \$12,475**

**[TOTAL DIRECT CHARGES]{.underline} (sum of 6.a-6.h)**

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

**[INDIRECT CHARGES]{.underline}**

15% of Salary and Wages (copy of negotiated

Indirect Cost Rate Agreement attached) \[\$64,000 X 15% = \$9,600\]

> **Enter Indirect Costs subtotal of 424A, Section B, 6.j. \$9,600**
>
> **Enter TOTALS on 424A, Section B, 6.k. (sum of 6i and 6j) \$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. If rent is requested, provide the name of the owner of the
building/facility. If anyone related to the project owns the building
which is a less than arms length arrangement, provide cost of
ownership/use allowance.

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.

OTHER SOURCES -- If other non-Federal sources of funding, including
match or cost sharing as a total operating budget is included, provide
the name of the source, e.g., in-kind, foundation, program income,
Medicaid, State funds, applicant organization, etc., and explain its
use.

[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. (NOTE: salary cap of \$191,300 is effective for all FY 2008
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

\*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 reflect 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.

### Appendix G- References

**American Indian and Alaska Native Youth Behavioral Health**

Abbott, P.J. (1998). Traditional and western healing practices for
alcoholism in American Indians and Alaska Natives. *Substance Abuse and
Misuse.* 33(13), 2605-2646. Brodeur, Pl (2002). Programs to improve the
health of Native Americans. In S. Issacs and J. Knickman (eds.), *To
improve health and health care* (pp. 53-74). San Francisco: Jossey-Bass.

Allen, J., LeMaster, P., Deters, P.B. (2004). Mapping pathways to
services: Description of local services for American Indian and Alaska
Native children by Circles of Care. *American Indian and Alaska Native
Mental Health Research: the Journal of the National Center,* 11(2),
65-87. Available at
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Beals, J., Novins, D., Mitchell, C., Shore, J., Manson, S. (2002).
Comorbidity between alcohol abuse/dependence and psychiatric disorders:
Prevalence, treatment implications, and new directions for research
among American Indian populations. *NIAA Research Monograph Series,* 37,
371-41. Available at:
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Bess, G., King, M., LeMaster, P.L. (2004). Process evaluation: How it
works; *American Indian and Alaska Native Mental Health Research: The
Journal of the National Center,* 11(2), 109-120. Available at:
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Borowsky, I.W., Resnick, M.D., Ireland,M., Blum, R.W. (1999). Suicide
attempts among American Indian and Alaska Native youth, protective
factors. *Archives of Pediatric and Adolescent Medicine*, 153, 573-580.

Center for Mental Health Services. *Mental Health, United States, 2002.*
Manderscheid, R. W., Henderson, M.J., eds.DHHS Pub No. (SMA) 3938.
Rockville, MD: Substance Abuse and Mental Health Services
Administration, 2004.

Coll, K.M., Mohatt, G., LeMaster, P.L. (2004). Feasibility assessment of
the service delivery model. *American Indian and Alaska Native Mental
Health Research: The Journal of the National Center,* 11(2), 99-108.
Available at:
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Costello, E.J., Compton, S.N., Keller, Gl, and Angold, A., (2003).
Relationships between poverty and psychopathology: a natural experiment.
*JAMA.*290. 2023-9

Crofoot, Graham T.L., Corcoran, K., Mental health screening results for
Native American and Euro-American youth in Oregon juvenile justice
settings. *Psychological Reports.* 92(3 Pt 2):1053-60, 2003 June.

Cross, T., Deserly, K., (1996). *American Indian Children's Mental
Health Services, an* . *Assessment of Tribal Access to Children's Mental
Health Funding and a Review of Tribal Mental Health Programs,* National
Indian Child Welfare Association.

Cross, T., Earle, K., Echo-Hawk Solie, Mannes, K. (200). Cultural
strengths and challenges in implementing a system of care model in
American Indian communities. *Systems of Care: Promising Practices in
Children\'s Mental Health, 2000 Series, Volume I.* Washington D.C.:
Center for Effective Collaboration and Practice, American Institutes for
Research.

Davis, J.D., Erickson, J.S., Johnson, S.R., Marshall, C.A., Running
Wolf, P., Santiago, R.L., (Eds.). (2002). *Work Group on American Indian
Research and Program Evaluation Methodology (AIRPEM), Symposium on
Research and Evaluation Methodology: Lifespan Issues Related to American
Indians/Alaska Natives with Disabilities.* Flagstaff: Northern Arizona
University, Institute for Human Development, Arizona University Center
on Disabilities, American Indian Rehabilitation Research and Training
Center.

Drummond, M.F., Stoddart, G.L., Torrance, G.W. (1987). *Methods for the
Economic Evaluation of Health Care Programmes.* Oxford University Press,
Oxford.

Duclos, C., Phillips, M., & LeMaster, P.L. (2004). Ourcomes and
accomplishments of the Circles of Care planning efforts. *American
Indian and Alaska Native Mental Health Research: The Journal of the
National Center,* 11(2), 121-138. Available at:
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Duran, B, Malco, L.H., Sanders, M., Waitzkin, H., Skipper, Bl, Yager, J.
Child maltreatment prevalence and mental disorders outcomes among
American Indian women in primary care. *Child Abuse &Neglect.* 28(2):
131-45, 2004 Feb.

Executive Order 13270 (2002) *White House Initiative on Tribal Colleges
and Universities.*

Fickenscher, A., Novins, D. K. (2003). Conduct disorder among American
Indian Adolescents in residential, substance abuse treatment. *Journal
of Psychoactive Drugs,* 35:79-84.

Freeman, B., Iron Cloud-Two Dogs, E., Novins, D.K., LeMaster, P.L.
(2004). Contextual issues for strategic planning and evaliuation of
systems of care for American Indian and Alaska Native communities: An
introduction to Circles of Care. *American Indian and Alaska Native
Mental Health Research: The Journal of the National Center,* 11(2),
1-29. Available at
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Garroutte, E.M., Goldberg, J., Beals, J., Herrell, R., Manson, S.M.,
AI-SUPERPFP TEAM. Spirituality and attempted suicide among American
Indians. *Social Science & Medicine.* 56(7):1571-9, 2003 April.

Gilder, D.A., Wall, T.L., Ehlers, C.L., Psychiatric diagnoses among
Mission Indian children with and without a parental history of alcohol
dependence. *Journal of Studies on Alcohol,* 63(1):18-23, 2002 January.

Jumper-Thurman, P., Allen, J., Deters, P.B. (2004). The Circles of Care
evaluation: Doing participatory evaluation with American Indian and
Alaska Native communities. *American Indian and Alaska Native Mental
Health Research: The Journal of the National Center,*11(2), 139-154.
Available at:
<http://aianp.uchsc.edu/ncaianmhr/journal/pdf_files/11(2).pdf>.

Koss, M.P., Yuan, N.P., Dightman, D., Prince, R.J., Polacca, M.
Sanderson, B., Goldman, D., Adverse childhood exposures and alcohol
dependence among seven Native American Tribes *American Journal of
Preventive Medicine.* 25(3):238-44, 2003 October.

LeMaster, P.L., Beals, J., Novins, D.K., Manson, S.M. (2004). The
prevalence of suicidal behaviors among Northern Plains American Indians.
*Suicide and Life-Threatening Behavior,* 34:242-54.

[]{.mark}

Levin, J.M., McEwan, P.J., (2001)*. Cost-Effectiveness Analysis: 2^nd^
Edition*. Sage Publications, Inc., Thousand Oaks.

Libby, A.M., Orton, H.D., Novins, D.K., Spicer, P., Buchwald, D.,
Manson, S.M. (2004). Childhood physical abuse and lifetime alcohol and
drug disorders for two American Indian tribes. *Journal of Applied
Developmental Sciences.* 1:135-144.

Manson, S.M., Bechtold, D.W., Novins, D.K., Beals, J. (1997). Assessing
psychopathology among American Indian and Alaska Native children and
adolescents. *Journal of Applied Developmental Sciences.* 1:135-144.

Manson, S., ed. (1982). *New Directions in Prevention among American
Indian and Alaska Native Communities,* National Center for American
Indian and Alaska Native Mental Health Research, Oregon Health Sciences
University.

May, P.A., Van Winkle, N.W.. Indian adolescent suicide: The
epidemiologic picture in New Mexico. In Duclos, C.W., Manson, S.M., eds.
*Calling from the Rim: Suicidal Behavior among American Indian and
Alaska Native Adolescents.* Boulder, CO: University of Colorado Press,
1994:2-23.

McCubbin, H., Thompson, E., Thompson, E., Fromer, J., *Resiliency in
Native American and Immigrant Families,* Sage Publications, 1998.

Middlebrook, D.L., LeMaster, P.L., Beals, J., Novins, D.K., Manson, S.M.
(2001). Suicide prevention in American Indian and Alaska Native: A
critical review of programs. *Suicide and Life Threatening Behavior,* 31
(Supplement): 132-149.

Mitchell, C.M., Beals, N., Novins, D.K., Spicer, P. AI-SUPERPFP team
(2003). Drug use among two American Indian populations: Prevalence of
lifetime use and DSM-IV substance abuse disorders. *Drug and Alcohol
Dependence.* 69:29-41.

Nebelkopf, E., Phillips, M., Ed. *Healing and Mental Health for Native
Americans, Speaking in Red,* Altamire Press, 2004.

Nitzkin, J., Smith, S.A. *Clinical preventive services in substance
abuse and mental health update: From science to services.* (2004). DHHS
Pub. No. (SMA) 04-3906. Rockville, M.D.: Center for Mental Health
Services, Substance Abuse and Mental Health Services Administration.

Novins, D.K., Beals, J., Moore, L., Spicer, P., Manson, S.M. (2004). Use
of biomedical services and traditional healing options among American
Indians: socio-demographic correlates, spirituality and ethnic identity.
*Medical Care,* 42:670-679.

Novins, D.K., Bechtold, D.W., Sack, W.H., Thompson, J., Carter, D.R.,
Manson, S.M. (1997). The DSM-IV outline for cultural formulation: A
critical demonstration with American Indian children. *Journal of the
American Academy of Child and Adolescent Psychiatry.* 36:1244-1251.

Novins, D.K., Spicer, P., Beals, J., Manson, S.M. (2004). Preventing
underage drinking in American Indian and Alaska Native communities:
contexts, epidemiology, and culture. In National Research Council and
Institute of Medicine, *Reducing Underage Drinking: A Collective
Responsibility.* Committee on developing a strategy to reduce and
prevent underage drinking, Bonnie, R.J., O'Connell, M.E., Editors.
Washington D.C.: The National Academies Press, pp. 678-696.

Novins, D.K., King, M., Stone, L.S. (2004). Developing a plan for
outcomes in model systems of care for American Indian and Alaska Native
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Spicer, P., Beals, J., Mitchell, C.M., Novins, D.K., Manson S.M. (2003).
The prevalence of alcohol dependence in two American Indian reservation
communities. *Alcoholism: Clinical and Experimental Research,*
27:1785-1797.

Spicer, P., Novins, D.K., Mitchell, D.M., Beals, J. (2003). Aboriginal
social organization, contemporary experience and American Indian
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*Alcohol,* 64:450-457.

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01-3549. Rockville, M.D., 2001.

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*Trends in Indian Health,* (2000-2001).

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Culture, Race and Ethnicity-A Supplement to Mental Health: A Report of
the Surgeon General.* U.S. Department of Health and Human Services,
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Mental Health.

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Health Administration, Center for Substance Abuse Prevention, and Indian
Health Services, *Gathering of Native Americans (GONA) Facilitator
Guide, Substance Abuse Prevention Curriculum,* Condensed version, 2000,
original release, 1992 by Substance Abuse and Mental Health
Administration, Center for Substance Abuse Prevention, Kauffman and
Associates, Inc.

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Health Administration. (1998). *Substance Abuse and Mental Health
Statistics Source Book,* "Suicide, Homicide, and Total Death Rates by
Race/Ethnicity", pp. 228-237.

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Abuse among Racial/Ethnic Subgroups in the United States, 1991-1993\".

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Health Administration, Center for Substance Abuse Prevention, *Substance
Abuse Resource Guide: American Indians and Native Alaskans,* (1998)

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Justice Statistics, *American Indians and Crime,* (1999).

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September 30, 1976.

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Education Assistance Act Amendments,* June 24, 1996.

### Appendix H- Prior Circles of Care Grantees

1998-2001:

-   Cheyenne River Sioux Tribe, South Dakota

-   Choctaw Nation, Oklahoma

-   Fairbanks Native Association, Alaska

-   Feather River Tribal Health Association, Oroville, California

-   First Nations Clinic, Albuquerque, New Mexico

-   In-Care Network, Billings, Montana

-   Intertribal Council of Michigan

-   Native American Health Center, Oakland, California

-   Oglala Sioux Tribe, South Dakota

2001-2004:

-   Blackfeet Nation, Montana

-   Central Council Tlingit and Haida Indian Tribes of Alaska

-   Pascua Yaqui Tribe of Arizona

-   Puyallup Tribal Health Authority, Washington

-   Salt River Pima-Maricopa Indian Community, Arizona

-   United Indian Involvement, Los Angeles, California

-   Ute Indian Tribe, Utah

2005-2008

-   Cook Inlet Tribal Council, Alaska

-   Denver Indian Family Resource Center, Colorado

-   Muscogee (Creek) Nation, Oklahoma

-   Native American Rehabilitation Association, Portland, Oregon

-   Quileute Tribe, Washington

-   Sinte Gleska University, South Dakota

-   Tulsa Indian Health Care Resource Center, Oklahoma

### Appendix I - Definition of Family-Driven Care

Definition of Family-Driven Care

Family-driven means families have a primary decision making role in the
care of their own children as well as the policies and procedures
governing care for all children in their community, State, Tribe,
territory and nation. This includes:

-   choosing supports, services, and providers;

-   setting goals;

-   designing and implementing programs;

-   monitoring outcomes; and

-   determining the effectiveness of all efforts to promote the mental
    health of children and youth.

Guiding Principles of Family-Driven Care

1.  Families and youth are given accurate, understandable and complete
    information necessary to make choices for improved planning for
    individual children and their families.

2.  Families and youth are organized to collectively use their knowledge
    and skills as a force for systems transformation.

3.  Families and youth embrace the concept of sharing decision-making
    and responsibility for outcomes with providers.

4.  Providers embrace the concept of sharing decision-making authority
    and responsibility for outcomes with families and youth.

5.  Providers take the initiative to change practice from
    provider-driven to family-driven.

6.  Administrators allocate staff, training and support resources to
    make family-driven practice work at the point where services and
    supports are delivered to children, youth and families.

7.  Families and family-run organizations engage in peer support
    activities to reduce isolation and strengthen the family voice.

8.  Community attitude change efforts focus on removing barriers created
    by stigma.

9.  Communities embrace and value the diverse cultures of their
    children, youth and families.

10. Everyone who connects with children, youth and families continually
    advance their cultural and linguistic responsiveness as the
    population served changes.

Characteristics of Family-Driven Care

1.  Family and youth experiences, their visions and goals, their
    perceptions of strengths and needs and their guidance about what
    will make them comfortable steer decision making about all aspects
    of service and system design, operation, and evaluation.

2.  Family-run organizations receive resources and funds to support and
    sustain the infrastructure that is essential to insure an
    independent family voice in their communities, States, Tribes,
    territories and the nation.

3.  Meetings and service provision happen in culturally and
    linguistically competent environments where family and youth voices
    are heard and valued, everyone is respected and trusted and it is
    safe for everyone to speak honestly.

4.  Administrators and staff actively demonstrate their partnerships
    with all families and youth by sharing power, resources, authority
    and control with them.

5.  Families and youth have access to useful, usable and understandable
    information and data, as well as sound professional expertise so
    they have good information to make decisions.

6.  All children, youth and families have a biological, adoptive, foster
    or surrogate family voice advocating on their behalf.

### Appendix J -- Definition of Youth-Guided Care

+-----------+----------------------------------------------------------+
| **[You    | -   Youth is engaged in the idea that change is possible |
| th-Guided |     in his or her life and the systems that serve them.  |
| Individ   |                                                          |
| ual]{.und | -   Youth need to feel safe, cared for, valued, useful   |
| erline}** |     and spiritually grounded.                            |
|           |                                                          |
|           | -   The program needs to enable youth to learn and build |
|           |     skills that allow them to function and give back in  |
|           |     their daily lives                                    |
|           |                                                          |
|           | -   There is a development and practice of leadership    |
|           |     and advocacy skills, and a place where equal         |
|           |     partnership is valued.                               |
|           |                                                          |
|           | -   Youth are empowered in their planning process from   |
|           |     the beginning and have a voice in what will work for |
|           |     them.                                                |
|           |                                                          |
|           | -   Youth receive training on how systems operate, their |
|           |     rights, purpose of the system and youth involvement  |
|           |     and development opportunities.                       |
+-----------+----------------------------------------------------------+
| **[You    | Community partners and stakeholders have:                |
| th-Guided |                                                          |
| Commun    | -   An open minded viewpoint and there are decreased     |
| ity]{.und |     stereotypes about youth.                             |
| erline}** |                                                          |
|           | -   Prioritized youth involvement and input during       |
|           |     planning and/or meetings.                            |
|           |                                                          |
|           | -   A desire to involve youth                            |
|           |                                                          |
|           | -   Begun stages of partnership with youth.              |
|           |                                                          |
|           | -   Begun to use language supporting youth engagement.   |
|           |                                                          |
|           | -   Taken the youth view and opinion into account.       |
|           |                                                          |
|           | -   A minimum of one youth partner with experience       |
|           |     and/or expertise in the systems represented.         |
|           |                                                          |
|           | -   Begun to encourage and listen to the views and       |
|           |     opinions of the involved youth, rather than minimize |
|           |     their importance.                                    |
|           |                                                          |
|           | -   Created open and safe spaces for youth               |
|           |                                                          |
|           | -   Appropriate incentives are provided to youth. This   |
|           |     includes youth participation in the program as well  |
|           |     as those who serve on boards or provide training.    |
+-----------+----------------------------------------------------------+
| **[You    | -   Youth are invited to meetings                        |
| th-Guided |                                                          |
| Pol       | -   Training and support is provided for youth on what   |
| icy]{.und |     the meeting is about                                 |
| erline}** |                                                          |
|           | -   Youth and board are beginning to understand the role |
|           |     of youth at the policy-making level                  |
|           |                                                          |
|           | -   Youth can speak on their experiences (even if it is  |
|           |     not in perfect form) and talk about what's really    |
|           |     going on with young people.                          |
|           |                                                          |
|           | -   Adults value what youth have to say in an advisory   |
|           |     capacity.                                            |
|           |                                                          |
|           | -   Youth have a role in decision making.                |
|           |                                                          |
|           | -   Youth have an appointed mentor who is a regular      |
|           |     attendee of the meetings and makes sure that the     |
|           |     youth feels comfortable to express his or herself    |
|           |     and clearly understands the process.                 |
+-----------+----------------------------------------------------------+