Department of Health and Human Services

**Substance Abuse and Mental Health Services Administration**

**Service-to-Science Grants - STS 05 PA**

**(Initial Announcement)**

**Catalogue of Federal Domestic Assistance (CFDA) No.:** 93.243 (unless
otherwise specified in a NOFA in the Federal Register and on
[www.grants.gov](http://www.grants.gov/))

**Key Dates:**

+----------------------+-----------------------------------------------+
| **Application        | **This Program Announcement provides          |
| Deadline**           | instructions and guidelines for multiple      |
|                      | funding opportunities. Application deadlines  |
|                      | for specific funding opportunities will be    |
|                      | published in Notices of Funding Availability  |
|                      | (NOFAs) in the Federal Register and on        |
|                      | [www.grants.gov](http://www.grants.gov/).**   |
+----------------------+-----------------------------------------------+
| **Intergovernmental  | **Letters from State Single Point of Contact  |
| Review**             | (SPOC) are due 60 days after application      |
|                      | deadline**                                    |
| **(E.O. 12372)**     |                                               |
+----------------------+-----------------------------------------------+
| **Public Health      | **Applicants must send the PHSIS to           |
| System Impact        | appropriate State and local health agencies   |
| Statement (PHSIS)/   | by application deadline. Comments from Single |
| Single State Agency  | State Agency are due 60 days after            |
| Coordination**       | application deadline.**                       |
+----------------------+-----------------------------------------------+

Table of Contents

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

[1. INTRODUCTION 3](#introduction)

[2. EXPECTATIONS 4](#expectations)

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

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

[2. FUNDING MECHANISM 9](#funding-mechanism)

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

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

[2. COST SHARING 10](#cost-sharing)

[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 18](#submission-dates-and-times)

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

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

[6. OTHER SUBMISSION REQUIREMENTS 22](#other-submission-requirements)

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

[1. EVALUATION CRITERIA 23](#evaluation-criteria)

[2. REVIEW AND SELECTION PROCESS 28](#review-and-selection-process)

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

[1. AWARD NOTICES 29](#award-notices)

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

[3. REPORTING REQUIREMENTS 30](#reporting-requirements)

[VII. AGENCY CONTACTS 31](#agency-contacts)

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

[Appendix B - Glossary 34](#appendix-b---glossary)

[Appendix C -- Logic Model Resources
36](#appendix-c-logic-model-resources)

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

#   {#section .unnumbered}

# I. FUNDING OPPORTUNITY DESCRIPTION

## 1. INTRODUCTION

The Substance Abuse and Mental Health Services Administration (SAMHSA)
announces its intent to solicit applications for Service-to-Science
grants. This program announcement [must]{.underline} be considered in
conjunction with a full Notice of Funding Availability (NOFA), which
specifies the grant program's purpose, target population, and other
requirements of the program. These grants will document and evaluate
innovative practices that address critical substance abuse and mental
health service gaps but have not yet been formally evaluated. Applicants
who seek to stabilize, document, and evaluate promising practices for
mental health and/or substance abuse treatment, prevention, and support
services should apply for awards under this announcement.

SAMHSA also funds grants under three other standard grant announcements:

-   [Services Grants]{.underline} provide funding to implement substance
    abuse and mental health services.

-   [Infrastructure Grants]{.underline} support identification and
    implementation of systems changes but are not designed to fund
    services.

-   [Best Practices Planning and Implementation Grants]{.underline} help
    communities and providers identify practices to effectively meet
    local needs, develop strategic plans for implementing/adapting those
    practices and pilot-test practices prior to full-scale
    implementation.

This announcement describes the general program design and provides
application instructions for all SAMHSA Service-to-Science Grants. The
availability of funds for specific Service-to-Science Grants will be
announced in supplementary Notices of Funding Availability (NOFAs) in
the Federal Register and at [www.grants.gov]{.underline} - the Federal
grant announcement web page.

SAMHSA's Service-to-Science Grants are authorized under Section 509, 516
and/or 520A of the Public Health Service Act, unless otherwise specified
in a NOFA in the Federal Register and on
[www.grants.gov](http://www.grants.gov/).

**Typically, funding for Service-to-Science Grants will be targeted to
specific populations and/or issue areas, which will be specified in the
NOFAs. The NOFAs will also:**

-   **Specify total funding available for the first year of the grants
    and the expected size and number of awards;**

-   **Provide the application deadline;**

-   **Note any specific program requirements for each funding
    opportunity; and**

-   **Include any limitations or exceptions to the general provisions in
    this announcement (e.g., eligibility, award size, allowable
    activities).**

**It is, therefore, critical that you consult the NOFA as well as this
announcement in developing your grant application**.

## 2. EXPECTATIONS

While there is a well-established evidence base for many behavioral
health practices, critical service gaps exist for which there is no
formal evidence base. Stakeholders have developed many innovative
practices to fill these gaps, but they may lack the expertise and/or
resources to formally document and evaluate their practices.
Consequently, it is not clear whether these innovative practices are
effective, and they are not disseminated widely. SAMHSA seeks to
encourage continued development of evidence-based practices to fill
service gaps by documenting and evaluating promising
stakeholder-initiated practices. This program will help organizations
that have identified promising new practices to evaluate and package
those innovations for review and inclusion in the National Registry of
Effective Programs and Practices (NREPP) as well as for further
research.

**2.1 Program Design**

SAMHSA will fund Service-to-Science grants in two phases. You may apply
for Phase I and II combined or for Phase II alone. **Applications for
Phase I alone will not be accepted**. The program design requirements
for Phase I and Phase II are described below. Applicants
[must]{.underline}, however, consult the NOFA for any program design
requirements (e.g., required activities) specific to the funding
opportunity.

**Phase I** provides support for up to 2 years to stabilize and document
an existing practice that fills an identified gap. During Phase I, you
may:

-   further develop or refine the promising practice;

-   develop training and practice manuals;

-   train persons who are implementing the practice;

-   more systematically implement the practice;

-   develop measurement instruments; and

-   ensure that the intended target population (see Glossary) is being
    reached by the practice.

The desired endpoint of Phase I is readiness to conduct a high-quality,
systematic evaluation.

**Phase II** provides support for 1-3 years to evaluate the success of
the practice. The purpose of Phase II is to conduct a high-quality,
systematic evaluation to document short-term outcomes and demonstrate
that the practice is worthy of an experimental study. On the basis of
the evaluation, you may need to further refine the practice and further
refine the practice manual. The evaluation may use a pre-post approach,
an open trial model, other quasi or non-experimental model, or an
experimental model.

The desired endpoint for Phase II is readiness to submit the practice
for inclusion in SAMHSA's NREPP and/or to submit applications to various
research institutions for additional research.

SAMHSA's Service-to-Science grants will provide support to stabilize
practices so that they may be documented and evaluated. However, **these
grants are not intended to support development of entirely new
practices**. The practices must be in place and operational for at least
one year prior to application, and you must have at least anecdotal
evidence that the practice is effective.

You may apply for a combination of Phases I and II in a single grant
application if you have identified a priority gap for which a fully
developed and documented practice currently does not exist.

-   During Phase I, you will further develop and document the practice.

-   During Phase II, you will evaluate the practice.

At the conclusion of Phase I, SAMHSA staff will review your progress to
determine whether Phase II is warranted. This decision will be based on
review of the documentation required by the end of Phase I, as described
under the Performance Expectations section below. You must provide
compelling evidence that the practice has been sufficiently developed
and documented to be evaluated and has produced positive results.

For practices that are already fully developed, implemented, stabilized,
and documented but that have not yet been formally evaluated, you may
apply for Phase II only. **Applications for Phase I alone will not be
accepted.**

Depending on your readiness, you may receive a combination of Phases I
and II for a period of up to, but not more than, 5 years. You may apply
for a shorter grant period than the maximum, and SAMHSA may award a
grant for a shorter time period than you request.

**2.2 Establishing Need**

Service-to-Science grants are intended to develop solutions to
widespread needs. This grant program is *not* intended to address a
local community's need for funds to solve a local problem. Therefore,
you must demonstrate that the broader substance abuse and/or mental
health field---not just your local community---has a need for the
practice. You must also show that no well-documented solution to the
problem exists, and that your local community can support an evaluation
that will increase the knowledge base of the field.

**2.3 Allowable Activities**

**Phase I: Practice Development and Documentation**

In Phase I, you will further develop and document the practice. The
types of activities that may be needed and that are allowable include,
but are not limited to, the following:

-   Strategic planning

-   Convening stakeholder meetings

-   Training of practitioners

-   Efforts to overcome policy and funding barriers to practice
    stability

-   Development of an action plan for systematizing and stabilizing the
    practice

-   Development of a practice support system

-   Developing needed partnerships for ongoing implementation

-   Logic model development

-   Documentation of core elements of the practice

-   Practice manual development

-   Measurement instrument development/selection

-   Participant recruitment

-   Development of quality assurance and accountability mechanisms

-   Implementation and refinement of the practice

-   Implementation process evaluation

-   Management information system development

-   Collection of pilot outcome data

**Phase II: Practice Evaluation**

During Phase II, SAMHSA will (if necessary) continue to fund
implementation of the practice being evaluated. Other types of allowable
activities include, but are not limited to, the following:

-   Convening relevant stakeholder meetings

-   Alignment of management information systems with data collection
    needs

-   Training evaluators

-   Measurement instrument development/selection

-   Data collection

-   Database management

-   Data and cost analysis

-   Dissemination of results

-   Refinement of logic model and practice manual based on evaluation
    results

**2.4 Performance Expectations**

All grantees will be expected to meet the following performance
requirements by the end of their grant projects.

**Phase I**

By the end of Phase I, documentation for the practice must include:

-   A logic model depicting the principles and concepts underlying the
    practice.

-   A manual describing the practice in detail that would allow others
    to replicate the practice.

-   Documentation of how critical stakeholders were included in the
    development of the practice.

-   A detailed description of the population that the practice is
    designed to serve, and demographic characteristics of the people
    served by the practice over the past year.

-   Documentation that the number of people being served by the practice
    has been stabilized.

-   Documentation of the number and percentage of staff trained in the
    practice, and a mechanism for ongoing training for any new staff.

-   A process evaluation demonstrating that the practice is in full
    operation and that a routine service delivery process is in place.

-   Pilot outcome results. (Note: Collection of these data need not
    include an extensive set of outcomes systematically collected on all
    participants, but quantitative project data should provide some
    indication that key outcomes are being achieved.)

**Phase II**

By the end of Phase II, the evaluation of the practice must have
demonstrated that:

-   Key outcome measures have been clearly identified and defined.

-   Participant data collection systems are in place that include:

    -   Demographic characteristics

    -   Practice outcomes

    -   Service utilization

    -   Service delivery costs

    -   Satisfaction with services

-   Demographic characteristics of participants, as well as the types of
    services that participants have received, are consistent with
    expectations based on the logic model for the practice.

-   Service delivery patterns are stable.

-   A fidelity scale has been developed for assessing the integrity of
    the practice, and the practice has been implemented with fidelity
    according to the scale.

-   Systematically collected short-term outcome measures indicate
    meaningful results.

-   Consumers, family members, and other critical stakeholders are
    satisfied with the practice.

In addition, at the end of Phase II, grantees must:

-   Demonstrate how consumers, family members, and other critical
    stakeholders participated in the evaluation of the practice.

-   Demonstrate how the practice will be sustained over the 5 years
    following the end of the grant period.

-   As appropriate, submit the practice to the SAMHSA National Registry
    of Effective Programs and Practices (NREPP).

-   Demonstrate the willingness of those who initiated the practice to
    participate in rigorous research over the next 5 years (e.g.,
    through submission of grant applications to the National Institutes
    of Health, private foundations, or other research funding sources;
    through formal agreements between practice initiators and
    researchers; etc.)

    5.  **Data and Performance Measurement**

The Government Performance and Results Act of 1993 (P.L.103-62, or
"GPRA") requires all Federal agencies to set program performance targets
and report annually on the degree to which the previous year's targets
were met.

Agencies are expected to evaluate their programs regularly and to use
results of these evaluations to explain their successes and failures and
justify requests for funding.

To meet the GPRA requirements, SAMHSA must collect performance data
(i.e., "GPRA data") from grantees. Grantees are required to report these
GPRA data to SAMHSA on a timely basis.

Specifically, grantees will be required to provide data on a set of
required measures, as specified in the NOFA. The data collection tools
to be used for reporting the required data will be provided in the
application kits distributed by SAMHSA's clearinghouses and posted on
SAMHSA's website along with each NOFA. In your application, you must
demonstrate your ability to collect and report on these measures, and
you may be required to provide some baseline data.

The terms and conditions of the grant award also will specify the data
to be submitted and the schedule for submission. Grantees will be
required to adhere to these terms and conditions of award.

Applicants should be aware that SAMHSA is working to develop a set of
required core performance measures for each of SAMHSA's standard grants
(i.e., Services Grants, Infrastructure Grants, Best Practices Planning
and Implementation Grants, and Service-to-Science Grants). As this
effort proceeds, some of the data collection and reporting requirements
included in SAMHSA's NOFAs may change. All grantees will be expected to
comply with any changes in data collection requirements that occur
during the grantee's project period.

**2.6 Grantee Meetings**

You must plan to send a minimum of two people (including the Project
Director) to at least one joint grantee meeting in each year of the
grant, and you must include funding for this travel in your budget. At
these meetings, grantees will present the results of their projects and
Federal staff will provide technical assistance. Each meeting will be 3
days. These meetings will usually be held in the Washington, D.C., area
and attendance is mandatory.

# II. AWARD INFORMATION

## 1. AWARD AMOUNT

The NOFA will specify the expected award amount for each funding
opportunity. Regardless of the amount specified in the NOFA, the actual
award amount will depend on the availability of funds.

You may apply for either a *combined* Phase I & II grant or for a *Phase
II only* grant.

-   Awards for Phase I of the combined grants are for up to \$150,000
    (direct and indirect costs) per year for up to 2 years.

-   Awards for Phase II are \$300,000-\$500,000 (direct and indirect
    costs) per year for 1-3 years.

-   Awards for combined Phase I and II grants may not exceed 5 years.

Phase II funding will be approved only if you provide compelling
evidence that the practice has been sufficiently developed and
documented to be evaluated and has produced positive results.

Proposed budgets cannot exceed the allowable amount as specified in the
NOFA 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, and timely submission of required data and
reports.

Summary Table:

+------+--------------------+-------------+-------------+-------------+
| #    | ####               | #           | *           | ####### Fu  |
| #### | ### Activity Focus | ##### Years | Application | nding Level |
| ## P |                    |  of Support | R           |             |
| hase |                    |             | equirement* | *(direct    |
|      |                    |             |             | and         |
|      |                    |             |             | indirect    |
|      |                    |             |             | costs)*     |
+------+--------------------+-------------+-------------+-------------+
| I    | Practice           | 0-2         | Optional    | Up to       |
|      | Development and    |             |             | \$150,000   |
|      | Documentation      |             |             | per year    |
+------+--------------------+-------------+-------------+-------------+
| II   | Practice           | 1-3         | Required    | \$300,00    |
|      | Evaluation         |             |             | 0-\$500,000 |
|      |                    |             |             | per year    |
+------+--------------------+-------------+-------------+-------------+
|      | ######## Total     | 1-5         |             |             |
+------+--------------------+-------------+-------------+-------------+

## 2. FUNDING MECHANISM

The NOFA will indicate whether awards for each funding opportunity will
be made as grants or cooperative agreements (see the Glossary in
Appendix B for further explanation of these funding mechanisms). For
cooperative agreements, the NOFA will describe the nature of Federal
involvement in project performance and specify roles and
responsibilities of grantees and Federal staff.

# 

# III. ELIGIBILITY INFORMATION

## 1. ELIGIBLE APPLICANTS

Eligible applicants are domestic public and private
[nonprofit]{.underline} entities. For example, State, local or tribal
governments; public or private universities and colleges; community- and
faith-based organizations; and tribal organizations may apply. The
statutory authority for this program precludes grants to for-profit
organizations. The NOFA will indicate any limitations on eligibility.

Though not required, SAMHSA encourages community-based providers and
independent researchers to partner when applying for Service-to-Science
grants. Such partnerships will use the expertise of each partner to
ensure sound service delivery, high-quality evaluation, independent
results, and relevance of the evaluation design to service delivery
outcomes.

## 2. COST SHARING

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

## 3. OTHER

**Applications must comply with the following requirements, or they will
be screened out and will not be reviewed:** use of the PHS 5161-1
application; application submission requirements in Section IV-3 of this
document; and formatting requirements provided in Section IV-2.3 of this
document. Applicants should be aware that the NOFA may include
additional requirements that, if not met, will result in applications
being screened out and returned without review. These requirements will
be specified in Section III-3 of the NOFA.

You also must comply with any additional program requirements specified
in the NOFA, such as the required signature of certain officials on the
face page of the application and/or required memoranda of understanding
with certain signatories.

# IV. APPLICATION AND SUBMISSION INFORMATION 

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

## 1. ADDRESS TO REQUEST APPLICATION PACKAGE 

You may request a complete application kit by calling one of SAMHSA's
national clearinghouses:

-   For substance abuse prevention or treatment grants, call the
    National Clearinghouse for Alcohol and Drug Information (NCADI) at
    1-800-729-6686.

-   For mental health grants, call the National Mental Health
    Information Center at 1-800-789-CMHS (2647).

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

Additional materials available on this web site include:

-   a technical assistance manual for potential applicants;

-   standard terms and conditions for SAMHSA grants;

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

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

## 2. CONTENT AND FORM OF APPLICATION SUBMISSION

**2.1 Application Kit**

SAMHSA application kits include the following documents:

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

-   Program Announcement (PA) -- Includes instructions for the grant
    application. This document is the PA.

-   Notice of Funding Availability (NOFA) -- Provides specific
    information about availability of funds, as well as any exceptions
    or limitations to provisions in the PA. The NOFAs will be published
    in the Federal Register as well as on the Federal grants web site
    ([www.grants.gov](http://www.fedgrants.gov/)). It is very important
    that you read the entire NOFA before beginning to write your
    application.

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

**2.2 Required Application Components**

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

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

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-   **Abstract** -- Your total abstract should be no longer than 35
    lines. In the first five lines or less of your abstract, write a
    summary of your project that can be used, if your project is funded,
    in publications, reporting to Congress, or press releases.

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-   **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 PHS 5161-1.
    Fill out Sections B, C, and E of the SF 424A. A sample budget and
    justification is included in Appendix D of this Program
    Announcement.

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-   **Project Narrative and Supporting Documentation** -- The Project
    Narrative describes your project. It consists of Sections A
    through D. These sections in total may be no longer than 25 pages.
    (For example, remember that if your Project Narrative starts on page
    5 and ends on page 30, it is 26 pages long, not 25 pages.) More
    detailed instructions for completing each section of the Project
    Narrative are provided in "Section V -- Application Review
    Information" of this document.

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

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

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-   *Section F* - Budget Justification, Existing Resources, Other
    Support. You must provide a narrative justification of the items
    included in your proposed budget, as well as a description of
    existing resources and other support you expect to receive for the
    proposed project.

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

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-   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 a letter of
    commitment with a current biographical sketch from the individual.

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

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

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

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-   **Appendices 1 through 5** - Use only the appendices listed below.
    If your application includes any appendices not required in the
    grant announcement or NOFA, they will be disregarded. Do not use
    more than a total of 30 pages for Appendices 1, 4, and 5 combined.
    There are no page limitations for Appendices 2 and 3. Do not use
    appendices to extend or replace any of the sections of the Project
    Narrative unless specifically required in the NOFA. Reviewers will
    not consider them if you do.

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-   *Appendix 1*: Letters of Support

-   *Appendix 2*: Documentation of the Practice (*Phase II only*
    applicants)

-   *Appendix 3*: Data Collection Instruments/Interview Protocols

-   *Appendix 4*: Sample Consent Forms

-   *Appendix 5*: Letter to the SSA (if applicable; see Section IV-4 of
    this document)

    -   **Assurances** -- Non-Construction Programs. Use Standard Form
        424B found in PHS 5161-1. Some applicants will be required to
        complete the Assurance of Compliance with SAMHSA Charitable
        Choice Statutes and Regulations Form SMA 170. If this assurance
        applies to a specific funding opportunity, it will be posted on
        SAMHSA's web site with the NOFA and provided in the application
        kits available at SAMHSA's clearinghouse (NCADI).

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

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

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

**2.3 Application Formatting Requirements**

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

-   Information provided must be sufficient for review.

-   Text must be legible.

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

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

footnotes will not be considered in determining compliance.)

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

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

-   To ensure equity among applications, the amount of space allowed for
    the Project Narrative cannot be exceeded.

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

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

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

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

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

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

-   The page limit of a total of 30 pages for Appendices 1, 4 and 5
    combined should not be exceeded.

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

**2.4 Confidentiality and Human Subjects Protection**

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

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

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

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

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

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

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

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

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

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

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

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

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

3.  [Absence of Coercion]{.underline}

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

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

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

4.  [Data Collection]{.underline}

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

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

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-   Provide in **Appendix 3: Data Collection Instruments/Interview
    Protocols**, copies of [all]{.underline} available data collection
    instruments and interview protocols that you plan to use.

5.  [Privacy and Confidentiality]{.underline}

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

-   Describe:

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-   How you will use data collection instruments.

-   Where data will be stored.

-   Who will or will not have access to information.

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

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

6.  [Adequate Consent Procedures]{.underline}

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

-   State:

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-   Whether or not their participation is voluntary.

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

-   Possible risks from participation in the project.

-   Plans to protect clients from these risks.

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

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

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

-   Include, as appropriate, sample consent forms that provide for: (1)
    informed consent for participation in service intervention; (2)
    informed consent for participation in the data collection component
    of the project; and (3) informed consent for the exchange (releasing
    or requesting) of confidential information. The sample forms must be
    included in **Appendix 4, "Sample Consent Forms"**, of your
    application. If needed, give English translations.

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

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

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

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

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

#### Protection of Human Subjects Regulations

All applicants for Service-to-Science grants must comply with the
Protection of Human Subjects Regulations (45 CFR 46).

Applicants 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, you 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
participants 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 (301-496-7005). SAMHSA-specific questions related to Protection of
Human Subjects Regulations should be directed to the program contact
listed in Section VII of the NOFA.

## 3. SUBMISSION DATES AND TIMES 

Deadlines for submission of applications for specific funding
opportunities will be published in the NOFAs in the Federal Register and
posted on the Federal grants web site
([www.grants.gov](http://www.grants.gov/)).

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

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

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

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

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

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

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

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

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

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

SAMHSA is collaborating with [www.grants.gov](http://www.grants.gov/) to
accept electronic submission of applications only for select funding
opportunities. Unless specifically indicated in the NOFA, electronic
submission of applications will not be accepted.

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

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

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

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

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

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

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

ATTN: SPOC -- Funding Announcement No. \[fill in pertinent funding
opportunity number from NOFA\]

> **For other delivery service:**
>
> Crystal Saunders, Director of Grant Review
>
> Office of Program Services
>
> Substance Abuse and Mental Health Services Administration
>
> Room 3-1044
>
> 1 Choke Cherry Road
>
> Rockville, MD **20850**
>
> ATTN: SPOC -- Funding Announcement No. \[fill in pertinent funding
> opportunity number from NOFA\]

In addition, community-based, non-governmental service providers who are
not transmitting their applications through the State must submit a
Public Health System Impact Statement (PHSIS) (approved by OMB under
control no. 0920-0428; see burden statement below) to the head(s) of
appropriate State or local health agencies in the area(s) to be affected
no later than the pertinent receipt date for applications. The PHSIS is
intended to keep State and local health officials informed of proposed
health services grant applications submitted by community-based,
non-governmental organizations within their jurisdictions. [State and
local governments and Indian tribal government applicants are not
subject to these requirements]{.underline}.

The PHSIS consists of the following information:

-   a copy of the face page of the application (SF 424); and

-   a summary of the project, no longer than one page in length, that
    provides: 1) a description of the population to be served, 2) a
    summary of the services to be provided, and 3) a description of the
    coordination planned with appropriate State or local health
    agencies.

For SAMHSA grants, the appropriate State agencies are the Single State
Agencies (SSAs) for substance abuse and mental health. A listing of the
SSAs can be found on SAMHSA's web site at
[www.samhsa.gov](http://www.samhsa.gov/). If the proposed project falls
within the jurisdiction of more than one State, you should notify all
representative SSAs.

Applicants who are not the SSA [must]{.underline} include a copy of a
letter transmitting the PHSIS to the SSA in **Appendix 4, "Letter to the
SSA**." The letter must notify the State that, if it wishes to comment
on the proposal, its comments should be sent not later than 60 days
after the application deadline to:

> **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: SSA -- Funding Announcement No. \[fill in pertinent funding
> opportunity number from NOFA\]
>
> **For other delivery service:**
>
> Crystal Saunders, Director of Grant Review
>
> Office of Program Services
>
> Substance Abuse and Mental Health Services Administration
>
> Room 3-1044
>
> 1 Choke Cherry Road
>
> Rockville, MD **20850**
>
> ATTN: SSA -- Funding Announcement No. \[fill in pertinent funding
> opportunity number from NOFA\]

In addition:

-   Applicants may request that the SSA send them a copy of any State
    comments.

-   The applicant must notify the SSA within 30 days of receipt of an
    award.

*\[Public reporting burden for the Public Health System Reporting
Requirement is estimated to average 10 minutes per response, including
the time for copying the face page of SF 424 and the abstract and
preparing the letter for mailing. An agency may not conduct or sponsor,
and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB control
number for this project is 0920-0428. Send comments regarding this
burden to CDC Clearance Officer, 1600 Clifton Road, MS D-24, Atlanta, GA
30333, ATTN: PRA (0920-0428).\]*

## 5. FUNDING LIMITATIONS/RESTRICTIONS

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

-   Institutions of Higher Education: OMB Circular A-21

-   State and Local Governments: OMB Circular A-87

-   Nonprofit Organizations: OMB Circular A-122

-   Appendix E Hospitals: 45 CFR Part 74

In addition, SAMHSA Service-to-Science grant funds *may not be used* to:

-   Pay for any lease beyond the project period.

-   Provide services to incarcerated populations (defined as those
    persons in jail, prison, detention facilities, or in custody where
    they are not free to move about in the community).

-   Pay for the purchase or construction of any building or structure to
    house any part of the program. (Applicants may request up to
    \$75,000 for renovations and alterations of existing facilities, if
    necessary and appropriate to the project.)

-   Provide residential or outpatient treatment services when the
    facility has not yet been acquired, sited, approved, and met all
    requirements for human habitation and services provision. (Expansion
    or enhancement of existing residential services is permissible.)

-   Pay for housing other than residential mental health and/or
    substance abuse treatment.

-   Provide inpatient treatment or hospital-based detoxification
    services. Residential services are not considered to be inpatient or
    hospital-based services.

-   Pay for incentives to induce clients to enter treatment. However, a
    grantee or treatment provider may provide up to \$20 or equivalent
    (coupons, bus tokens, gifts, childcare, and vouchers) to clients as
    incentives to participate in required data collection follow-up.
    This amount may be paid for participation in each required
    interview.

-   Implement syringe exchange programs, such as the purchase and
    distribution of syringes and/or needles.

-   Pay for pharmacologies for HIV antiretroviral therapy, sexually
    transmitted diseases (STDs)/sexually transmitted illnesses (STI),
    TB, and hepatitis B and C, or for psychotropic drugs.

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

## 6. OTHER SUBMISSION REQUIREMENTS

##### 6.1 Where to Send Applications

Send applications to the following address:

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

Do not send applications to other agency contacts, as this could delay
receipt. Be sure to include the funding announcement number from the
NOFA in item number 10 on the face page of the application. If you
require a phone number for delivery, you may use (240) 276-1199.

##### 6.2 How to Send Applications

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

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

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

**Unless specifically indicated in the NOFA, electronic submission of
applications will not be accepted.**

# V. APPLICATION REVIEW INFORMATION

## 1. EVALUATION CRITERIA

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

-   In developing the Project Narrative section of your application, use
    these instructions along with any additional instructions found in
    the NOFA. **These are to be used instead of the "Program Narrative"
    instructions found in the PHS 5161-1**.

-   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.

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

-   The Supporting Documentation you provide in Sections E-H and
    Appendices 1 through 5 will be considered by reviewers in assessing
    your response, along with the material in the Project Narrative.

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

**Section A: Statement of Need (15 points)**

-   Describe the problem the project will address. Describe the national
    significance of the problem. Documentation of need may come from a
    variety of qualitative and quantitative sources in the professional
    literature. The quantitative data could also come from national data
    available regarding mental health and substance use needs, gaps, and
    priorities. For example:

    -   Applications focusing on substance abuse might draw from
        SAMHSA's National Household Survey on Drug Use and Health
        (NHSDUH); Drug Abuse Warning Network (DAWN); and Drug and
        Alcohol Services Information System (DASIS), which includes the
        Treatment Episode Data Set (TEDS).

    -   Applications focusing on mental health might draw on data
        available from the National Association of State Mental Health
        Program Directors (NASMHPD), SAMHSA
        ([www.samhsa.gov/cmhs/MentalHealthStatistics](http://www.samhsa.gov/cmhs/MentalHealthStatistics)),
        or other sources.

> Qualitative sources may also include conclusions of conferences and
> events of national significance.

-   Describe the target population for the practice, including
    demographic information. Be sure to check the NOFA for any specific
    requirements regarding the target population and catchment area.
    Discuss the target population's language, beliefs, norms and values,
    as well as socioeconomic factors that must be considered in
    delivering programs to this population.

-   Review the literature that demonstrates a need to develop or adapt
    an effective practice for the target population. Demonstrate through
    the literature review that current evidence-based approaches to the
    problem do not exist or have not been evaluated for the specific
    target populations, or that approaches of greater clinical or cost
    effectiveness are needed.

-   Demonstrate that the need in the community in which the project will
    be carried out is of sufficient magnitude that an adequate
    evaluation of the practice can be conducted. To the extent possible,
    use locally generated data or State data such as that available
    through State needs assessments.

-   Check the NOFA for any additional requirements.

**Section B: Proposed Approach (30 points)**

-   Describe the practice proposed for evaluation. Document that the
    practice has been in place and operational for at least one year
    prior to the application due date.

-   Describe how the proposed practice will respond to the needs
    described in Section A of your Project Narrative and is consistent
    with the program purpose described in the NOFA. Address any and all
    program requirements specified in the NOFA.

-   Discuss the potential effectiveness of the practice proposed for
    evaluation. Why has this practice been selected? Present the
    theoretical underpinnings, core principles, and major assumptions of
    the proposed practice. Outline the key operational elements of the
    practice and summarize any relevant literature.

-   Identify any necessary collaborators on the project, including their
    roles and responsibilities. Demonstrate their commitment to the
    project. Include letters of support in **Appendix 1: Letters of
    Support**. Identify any cash or in-kind contributions that will be
    made to the project by the applicant or other partnering
    organizations.

-   Describe your experience with similar collaborative projects, and
    explain why you believe you will be able to sustain this
    collaboration throughout the project period.

-   **If applying for combined Phase I and II,** describe the extent to
    which the practice has been previously developed, implemented,
    stabilized, and documented. Include a description of the extent to
    which the support system needed for full implementation of the
    proposed practice is in place -- e.g., community collaboration and
    consensus building; alignment of management information systems,
    policies, and funding mechanisms; documentation of core elements of
    the practice; reliable recruitment and intake procedures; quality
    assurance and accountability mechanisms; training and overall
    readiness of those implementing the practice; and involvement of
    families and consumers in the project.

-   **If applying for Phase II only,** show that the practice is ready
    for systematic evaluation by providing documentation, in **Appendix
    2,** that includes all of the following:

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-   A logic model depicting the principles and concepts underlying the
    practice.

-   A copy of the Title Page and Table of Contents for a manual
    describing the practice in detail that would allow others to
    replicate the practice, and details on how the manual can be
    acquired.

-   Documentation of how critical stakeholders were included in the
    development of the practice.

-   A detailed description of the population that the practice is
    designed to serve, and demographic characteristics of the people
    served by the practice over the past year.

-   Demonstration of stability in the number of people being served by
    the practice.

-   Documentation that staff are trained in the practice (via the number
    and percentage of staff trained), and a mechanism for ongoing
    training for any new staff.

-   Evidence demonstrating that the practice is in full operation and
    that a routine service delivery process is in place.

-   Pilot outcome results. (Note: Collection of these data need not
    include an extensive set of outcomes systematically collected on all
    participants, but quantitative project data should provide some
    indication that key outcomes are being achieved.)

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-   Present the goals and measurable objectives of the project. Describe
    why the practice can better be evaluated for effectiveness following
    completion of the grant activities. For applications that include
    Phase I, include in your description how achievement of your goals
    will fulfill the Performance Expectations cited in Section I-2 of
    this document.

-   Describe the action steps to accomplish the goals and objectives.
    Demonstrate that the action steps will lead to successful
    accomplishment of the goals and objectives.

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

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

-   Check the NOFA for any additional requirements.

    **Section C: Evaluation Design and Analysis (40 points)**

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-   Describe in detail your evaluation design for determining the
    effectiveness of the practice. **For applications that include Phase
    I**, describe your process evaluation to determine that the practice
    is in full operation, as well as how you will track the number and
    percentage of staff fully trained in the practice.

-   Describe the process and outcome evaluation protocols you intend to
    use. Include in **Appendix 3** evaluation instruments to be used.
    Describe any literature or pilot testing done to verify the validity
    and reliability of the instruments to be used or how you plan to
    develop the instruments during the grant period.

-   Discuss the reliability and validity of evaluation methods and
    instrument(s) in terms of the gender/age/culture of the target
    population.

-   Describe how you will develop and manage a database management
    system to record participant demographic characteristics, practice
    outcomes, service utilization, practice costs, and satisfaction of
    stakeholders with the practice.

-   Describe how the integrity of the practice will be assessed using a
    fidelity (see Glossary) scale. If no fidelity scale currently exists
    for the practice, describe the process by which you will develop one
    during the grant period. Describe how you will document and assess
    changes to the model that occur throughout the project.

-   Document your ability to collect and report on the required
    performance measures as specified in the NOFA, including data
    required by SAMHSA to meet GPRA requirements. Specify and justify
    any additional measures you plan to use for your grant project.

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-   Describe how you will analyze the data collected. Include any
    analyses that will be done to determine the effectiveness of the
    practice for diverse subgroups, as well as the satisfaction of
    various stakeholder groups with the practice.

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-   Describe how your process evaluation will document the role of
    critical stakeholders in the development and/or evaluation of the
    practice.

-   Check the NOFA for any additional requirements.

**Section D: Management Plan and Staffing (15 points)**

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

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-   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 list of staff members who will conduct the project,
    showing the role of each and their level of effort and
    qualifications. Include the Project Director and other key
    personnel, such as evaluators and database management personnel.

-   Describe the racial/ethnic characteristics of key staff and indicate
    if any are members of the target population/community. If the target
    population is multi-linguistic, indicate if the staffing pattern
    includes bilingual and bicultural individuals.

-   If you plan to include an advisory body in your project, describe
    its membership, roles and functions, and frequency of meetings.

-   Describe the resources available for the proposed project (e.g.,
    facilities, equipment), and provide evidence that resources are
    adequate for conducting a high-quality evaluation of the identified
    practice.

-   Check the NOFA for any additional requirements.

NOTE: Although the budget for the proposed project is not a 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.

## 2. REVIEW AND SELECTION PROCESS

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

Decisions to fund a grant are based on:

-   the strengths and weaknesses of the application as identified by the
    peer review committee and approved by the appropriate National
    Advisory Council;

-   availability of funds; and

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-   after applying the aforementioned criteria, the following method for
    breaking ties: When funds are not available to fund all applications
    with identical scores, SAMHSA will make award decisions based on the
    application(s) that received the greatest number of points by peer
    reviewers on the evaluation criterion in Section V-1 with the
    highest number of possible points (Evaluation Design and
    Analysis---40 points). Should a tie still exist, the evaluation
    criterion with the next highest possible point value will be used,
    continuing sequentially to the evaluation criterion with the lowest
    possible point value, should that be necessary to break all ties. If
    an evaluation criterion to be used for this purpose has the same
    number of possible points as another evaluation criterion, the
    criterion listed first in Section V-1 will be used first.

# VI. AWARD ADMINISTRATION INFORMATION

## 1. AWARD NOTICES

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

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

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

## 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS 

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

-   Depending on the nature of the specific funding opportunity and/or
    the proposed project as identified during review, additional terms
    and conditions may be identified in the NOFA or negotiated with the
    grantee prior to grant award. These may include, for example:

    -   actions required to be in compliance with 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.

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

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

## 3. REPORTING REQUIREMENTS

**3.1 Progress and Financial Reports**

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

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

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

**3.2 Government Performance and Results Act (GPRA)**

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. These requirements will be specified in the
NOFA for each funding opportunity.

**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.

# AGENCY CONTACTS

The NOFAs provide contact information for questions about program
issues.

For questions on grants management issues, contact:

Kimberly Pendleton

Office of Program Services, Division of Grants Management

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Room 7-1097

Rockville, Maryland 20857

\(240\) 276-1421

<kimberly.pendleton@samhsa.hhs.gov>

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

*SAMHSA's goal is to review all applications submitted for grant
funding. However, this goal must be balanced against SAMHSA's obligation
to ensure equitable treatment of applications. For this reason, SAMHSA
has established certain formatting requirements for its applications.
**If you do not adhere to these requirements, your application will be
screened out and returned to you without review.** In addition to these
formatting requirements, programmatic requirements (e.g., relating to
eligibility) may be stated in the specific NOFA and in Section III of
the standard grant announcement. Please check the entire NOFA and
Section III of the standard grant announcement before preparing your
application.*

-   Use the PHS 5161-1 application.

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

-   Information provided must be sufficient for review.

-   Text must be legible.

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

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

footnotes will not be considered in determining compliance.)

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

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

-   To ensure equity among applications, the amount of space allowed for
    the Project Narrative cannot be exceeded.

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

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

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

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

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

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

-   Abstract

-   Table of Contents

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

-   Project Narrative and Supporting Documentation

-   Appendices

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

-   Certifications (a form within PHS 5161-1)

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

-   Checklist (a form in PHS 5161-1)

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-   Applications should comply with the following requirements:

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

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

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

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

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

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

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

### Appendix B - Glossary

**[Best Practice:]{.underline}** Best practices are practices that
incorporate the best objective information currently available regarding
effectiveness and acceptability.

**[Catchment Area:]{.underline}** A catchment area is the geographic
area from which the target population to be served by a program will be
drawn.

**[Cooperative Agreement:]{.underline}** A cooperative agreement is a
form of Federal grant. Cooperative agreements are distinguished from
other grants in that, under a cooperative agreement, substantial
involvement is anticipated between the awarding office and the recipient
during performance of the funded activity. This involvement may include
collaboration, participation, or intervention in the activity. HHS
awarding offices use grants or cooperative agreements (rather than
contracts) when the principal purpose of the transaction is the transfer
of money, property, services, or anything of value to accomplish a
public purpose of support or stimulation authorized by Federal statute.
The primary beneficiary under a grant or cooperative agreement is the
public, as opposed to the Federal Government.

**[Cost Sharing or Matching:]{.underline}** Cost sharing refers to the
value of allowable non-Federal contributions toward the allowable costs
of a Federal grant project or program. Such contributions may be cash or
in-kind contributions. For SAMHSA grants, cost sharing or matching is
not required, and applications will not be screened out on the basis of
cost sharing.  However, applicants often include cash or in-kind
contributions in their proposals as evidence of commitment to the
proposed project. This is allowed, and this information may be
considered by reviewers in evaluating the quality of the application.

**[Fidelity:]{.underline}** Fidelity is the degree to which a specific
implementation of a program or practice resembles, adheres to, or is
faithful to the evidence-based model on which it is based. Fidelity is
formally assessed using rating scales of the major elements of the
evidence-based model. A toolkit on how to develop and use fidelity
instruments is available from the SAMHSA-funded Evaluation Technical
Assistance Center at [http://tecathsri.org](http://tecathsri.org/) or by
calling (617) 876-0426.

**[Grant:]{.underline}** A grant is the funding mechanism used by the
Federal Government when the principal purpose of the transaction is the
transfer of money, property, services, or anything of value to
accomplish a public purpose of support or stimulation authorized by
Federal statute. The primary beneficiary under a grant or cooperative
agreement is the public, as opposed to the Federal Government.

**[In-Kind Contribution]{.underline}**: In-kind contributions toward a
grant project are non-cash contributions (e.g., facilities, space,
services) that are derived from non-Federal sources, such as State or
sub-State non-Federal revenues, foundation grants, or contributions from
other non-Federal public or private entities.

**[Logic Model:]{.underline}** A logic model is a diagrammatic
representation of a theoretical framework. A logic model describes the
logical linkages among program resources, conditions, strategies,
short-term outcomes, and long-term impact. More information on how to
develop logics models and examples can be found through the resources
listed in Appendix C.

**[Practice]{.underline}:** A practice is any activity, or collective
set of activities, intended to improve outcomes for people with or at
risk for substance abuse and/or mental illness. Such activities may
include direct service provision, or they may be supportive activities,
such as efforts to improve access to and retention in services,
organizational efficiency or effectiveness, community readiness,
collaboration among stakeholder groups, education, awareness, training,
or any other activity that is designed to improve outcomes for people
with or at risk for substance abuse or mental illness.

**[Practice Support System]{.underline}:** This term refers to
contextual factors that affect practice delivery and effectiveness in
the pre-adoption phase, delivery phase, and post-delivery phase, such as
a) community collaboration and consensus building, b) training and
overall readiness of those implementing the practice, and c) sufficient
ongoing supervision for those implementing the practice.

#### Stakeholder: A stakeholder is an individual, organization, constituent group, or other entity that has an interest in and will be affected by a proposed grant project.

**[Sustainability:]{.underline}** Sustainability is the ability to
continue a program or practice after SAMHSA grant funding has ended.

**[Target Population:]{.underline}** The target population is the
specific population of people whom a particular program or practice is
designed to serve or reach.

**[Wraparound Service:]{.underline}** Wraparound services are
non-clinical supportive services---such as child care, vocational,
educational, and transportation services---that are designed to improve
the individual's access to and retention in the proposed project.

### Appendix C -- 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 D -- Sample Budget and Justification

**ILLUSTRATION OF A SAMPLE DETAILED BUDGET AND**

**NARRATIVE JUSTIFICATION TO ACCOMPANY**

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

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

**[Personnel]{.underline}**

**Job Annual Level of Salary being**

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

Project

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

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

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

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

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

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

**[Travel]{.underline}**

2 trips for SAMHSA Meetings for 2 Attendees

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

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

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

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

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

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

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

**[Supplies]{.underline}**

Office Supplies \$500

Computer Software - 1 WordPerfect 500

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

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

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

**Evaluation**

Job Name Annual Salary being Level of

Title Salary Requested Effort

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

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

Fringe Benefits (25%) \$10,500

**Travel**

2 trips x 1 Evaluator

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

per diem @ \$120 x 6 720

Supplies (General Office) 500

Evaluation Direct \$54,920

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

Evaluation Subtotal \$65,355

**Training**

Job Name Level of Salary being

Title Effort Requested

Coordinator M. Smith 0.5 \$ 12,000

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

Fringe Benefits (25%) \$ 5,250

**Travel**

2 Trips for Training

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

Per Diem \$120 x 2 x 2 days 480

Local (500 miles x .24/mile) 120

**Supplies**

Office Supplies \$ 500

Software (WordPerfect) 500

**Other**

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

Telephone 500

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

Audit \$ 3,000

Training Direct \$ 40,025

Training Indirect \$ -0-

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

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

**[Other]{.underline}**

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

(If expert is known, should list by name)

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

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

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

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

15% of Salary and Wages (copy of negotiated

indirect cost rate agreement attached)

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

**[TOTALS]{.underline}**

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

**[JUSTIFICATION]{.underline}**

PERSONNEL - Describe the role and responsibilities of each position.

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

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

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

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

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

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

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

[CALCULATION OF FUTURE BUDGET PERIODS]{.underline}

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

Review and verify the accuracy of future year budget estimates.
Increases or decreases in the future years must be explained and
justified and no cost of living increases will be honored. (NOTE: new
salary cap of \$175,700 is effective for all FY 2005 awards.) \*

First Second Third

12-month 12-month 12-month

Period Period Period

Personnel

Project Director 30,000 30,000 30,000

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

Counselor 25,000 25,000 25,000

TOTAL PERSONNEL 64,000 73,000 73,000

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

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

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

Travel 5,400 5,400 5,400

Equipment -0- -0- -0-

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

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

Contractual

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

Training 40,025 40,025 40,025

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

Other 1,500 1,500 1,500

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

Indirect Costs 9,600 9,600 9,600

(15% S&W)

TOTAL COSTS 202,240 216,884 219,603

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