Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

**Prevention of Methamphetamine Abuse**

**(Initial Announcement)**

**SP-06-005**

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

**Key Dates:**

+----------------------+-----------------------------------------------+
| **Application        | **Applications are due by May 16, 2006.**     |
| Deadline**           |                                               |
+----------------------+-----------------------------------------------+
| **Intergovernmental  | **Letters from State Single Point of Contact  |
| Review**             | (SPOC) are due no later than 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            | by application deadline. Comments from Single |
| (PHSIS)/Single State | State Agency are due no later than 60 days    |
| Agency               | after application deadline.**                 |
| Coordination**       |                                               |
+----------------------+-----------------------------------------------+

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

Dennis O. Romero, M.A. Charles G. Curie, M.A., A.C.S.W.

Acting Director Administrator

Center for Substance Abuse Prevention Substance Abuse and Mental Health

Substance Abuse and Mental Health Services Administration

Services Administration

**Table of Contents**

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

[1. INTRODUCTION 3](#introduction)

[2. EXPECTATIONS 3](#expectations)

[II. AWARD INFORMATION 7](#ii.-award-information)

[1. AWARD AMOUNT 7](#award-amount)

[2. FUNDING MECHANISM 7](#funding-mechanism)

[III. ELIGIBILITY INFORMATION 7](#iii.-eligibility-information)

[1. ELIGIBLE APPLICANTS 7](#eligible-applicants)

[2. COST SHARING 8](#cost-sharing)

[3. OTHER 8](#other)

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

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

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

[3. SUBMISSION DATES AND TIMES 14](#submission-dates-and-times)

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

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

[6. OTHER SUBMISSION REQUIREMENTS 18](#other-submission-requirements)

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

[1. EVALUATION CRITERIA 19](#evaluation-criteria)

[2. REVIEW AND SELECTION PROCESS 27](#review-and-selection-process)

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

[1. AWARD NOTICES 28](#award-notices)

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

[3. REPORTING REQUIREMENTS 29](#reporting-requirements)

[VII. AGENCY CONTACTS 30](#vii.-agency-contacts)

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

[Appendix B -- Glossary 33](#appendix-b-glossary)

[Appendix C -- Overview of SAMHSA's National Registry of Evidence-based
Programs and Practices
(NREPP)............................................................\..........................35](#appendix-c-overview-of-samhsas-national-registry-of-evidence-based-programs-and-practices-nrepp)

Appendix D -- Logic Model Resources
............................................................36

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

Appendix F - Cost Band
Description................................................................41

Appendix G --National Outcomes Measures
Tools.............................................\...42

# I. FUNDING OPPORTUNITY DESCRIPTION {#i.-funding-opportunity-description .unnumbered}

## 1. INTRODUCTION {#introduction .unnumbered}

###### []{.mark} {#section .unnumbered}

The Substance Abuse and Mental Health Services Administration (SAMHSA),
Center for Substance Abuse Prevention is accepting applications for
fiscal year 2006 for grants to support expansion of methamphetamine
prevention interventions and/or infrastructure development. This program
addresses the growing problem of methamphetamine abuse and addiction by
assisting localities to expand prevention interventions that are
effective and evidence-based and/or to increase capacity through
infrastructure development. The goal is to intervene effectively to
prevent, reduce or delay the use and/or spread of methamphetamine abuse.

Prevention of Methamphetamine Abuse grants are authorized under Section
519E of the Public Health Service Act, as amended. This announcement
addresses Healthy People 2010 focus area 26 (Substance Abuse).

## 2. EXPECTATIONS {#expectations .unnumbered}

Proposed projects for Prevention of Methamphetamine Abuse grants may be
used for:

-   conducting community-based prevention programs focused on those
    populations within the community that are most at risk for
    methamphetamine abuse and addiction.

-   assisting local government entities to conduct appropriate
    methamphetamine prevention activities in rural and urban areas that
    are experiencing increases in methamphetamine abuse and addiction.
    This can documented by local and specific epidemiological, health
    service use, judicial and/or environmental data;

-   training and educating State and local law enforcement officials,
    prevention and education officials, members of community anti-drug
    coalitions and parents on the signs of methamphetamine abuse and
    addiction and the options for prevention;

-   planning, administration, and educational activities related to the
    prevention of methamphetamine abuse and addiction;

-   monitoring and evaluation of methamphetamine prevention activities,
    and reporting and disseminating resulting information to the public;

-   conducting targeted pilot programs with evaluation components to
    encourage innovative methodologies with drug-endangered children.

Applicants proposing to implement services interventions must document
how the intervention will be implemented as soon as possible and [no
later than 4 months]{.underline} after award.

######## **2.1 Documenting the Evidence Base for Interventions to be implemented** {#documenting-the-evidence-base-for-interventions-to-be-implemented .unnumbered}

Applicants proposing prevention interventions must document in their
applications that the interventions they propose to implement are
evidence-based interventions. In addition, applicants must justify use
of the proposed intervention(s) for the target population along with any
adaptations or modifications necessary to meet the unique needs of the
target population or otherwise increase the likelihood of achieving
positive outcomes. Further guidance on each of these requirements is
provided below.

*Documenting the Evidence-Based Intervention*

SAMHSA has already determined that certain interventions have a
documented evidence base, and encourages applicants to select
interventions from SAMHSA's National Registry of Evidence-based Programs
and Practices (NREPP) (see Appendix C), although this is not required.

Applicants proposing interventions that are not included in NREPP must
provide a narrative justification that summarizes the evidence for
effectiveness and acceptability of the proposed intervention. The
preferred evidence of effectiveness and acceptability will include the
findings from clinical trials, efficacy and/or effectiveness studies
published in the peer-reviewed literature.

In areas where little or no research has been published in the
peer-reviewed scientific literature, the applicant may present evidence
involving studies that have not been published in the peer-reviewed
research literature and/or documents describing formal consensus among
recognized experts. If consensus documents are presented, they must
describe consensus among multiple experts whose work is recognized and
respected by others in the field. Local recognition of an individual as
a respected or influential person at the community level is not
considered a "recognized expert" for this purpose.

*Justifying Selection of the Intervention for the Target Population*

All applicants must show that any proposed intervention is appropriate
for the proposed target population. Ideally, this evidence will include
research findings on effectiveness and acceptability specific to the
proposed target population. However, if such evidence is not available,
the applicant should provide a justification for using the proposed
intervention with the target population. This justification might
involve, for example, a description of adaptations to the proposed
intervention based on other research involving the target population.

*Justifying Adaptations/Modifications of the Proposed Intervention*

SAMHSA has found that a high degree of faithfulness or "fidelity" (see
Glossary) to the original model for an evidence-based intervention
increases the likelihood that positive outcomes will be achieved when
the model is used by others. Therefore, SAMHSA encourages fidelity to
the original evidence-based intervention to be implemented. However,
SAMHSA recognizes that adaptations or modifications to the original
model may be necessary for a variety of reasons:

-   To allow implementers to use resources efficiently

-   To adjust for specific needs of the target population

-   To address unique characteristics of the local community where the
    intervention will be implemented

All applicants must describe and justify any adaptations or
modifications to the proposed intervention that will be made.

2.  **Data and Performance Measurement**

SAMHSA will assess outcomes for the Methamphetamine Prevention Program
through the National Outcomes Measures (NOMs) for substance abuse
prevention that SAMHSA has developed in partnership with the States.

  --------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ --
  **PREVENTION NATIONAL OUTCOME                                                                                                                                                                                                                                                            
  MEASURES**                                                                                                                                                                                                                                                                               

  ** **                             **PREVENTION**                                                                                                                                                                                                                                         

  **OUTCOME**                       **Substance Abuse**                                                                                                                                                                                                                                    

  **Abstinence from Drug/ Alcohol   [30 day Use](../../../../../../../../C:%5CDocuments%20and%20Settings%5Ccholden%5CLocal%20Settings%5CTemporary%20Internet%20Files%5COLK11B%5CNOMs%20Attachment%202%20-%20Prevention%20ONLY%20fINAL%2011-17-05.xls#RANGE!_ftn4%23RANGE!_ftn4)            
  Abuse**                                                                                                                                                                                                                                                                                  

                                    [Age of First Use](../../../../../../../../C:%5CDocuments%20and%20Settings%5Ccholden%5CLocal%20Settings%5CTemporary%20Internet%20Files%5COLK11B%5CNOMs%20Attachment%202%20-%20Prevention%20ONLY%20fINAL%2011-17-05.xls#RANGE!_ftn5%23RANGE!_ftn5)      

                                    [Perception of                                                                                                                                                                                                                                         
                                    Disapproval/Attitude](../../../../../../../../C:%5CDocuments%20and%20Settings%5Ccholden%5CLocal%20Settings%5CTemporary%20Internet%20Files%5COLK11B%5CNOMs%20Attachment%202%20-%20Prevention%20ONLY%20fINAL%2011-17-05.xls#RANGE!_ftn6%23RANGE!_ftn6)   

                                    Perceived Risk/Harm of Use                                                                                                                                                                                                                             

  **Decreased Mental Illness**      NOT APPLICABLE                                                                                                                                                                                                                                         

  **Symptomatology/Functioning**                                                                                                                                                                                                                                                           

  **Increased/Retained Employment   Perception of Workplace Policy/ Workplace AOD Use/ ATOD Related suspensions and expulsions/Attendance and Enrollment.                                                                                                                                  
  or Return to/Stay in School**                                                                                                                                                                                                                                                            

  **Decreased Criminal Justice      Alcohol-Related Car Crashes and Injuries/Alcohol and Drug Related Crime                                                                                                                                                                                
  Involvement**                                                                                                                                                                                                                                                                            

  **Increased Stability in          NOT APPLICABLE                                                                                                                                                                                                                                         
  Housing**                                                                                                                                                                                                                                                                                

  **Increased Access to Services    Number of persons served by age, gender, race and ethnicity                                                                                                                                                                                            
  (Service Capacity)**                                                                                                                                                                                                                                                                     

  **Increased retention in          Total number of evidence-based programs and strategies/Percentage youth seeing, reading, watching, or listening to a prevention message                                                                                                                
  treatment -- substance abuse**                                                                                                                                                                                                                                                           

                                                                                                                                                                                                                                                                                           

  **Reduced utilization of          NOT APPLICABLE                                                                                                                                                                                                                                         
  psychiatric inpatient beds --                                                                                                                                                                                                                                                            
  mental health**                                                                                                                                                                                                                                                                          

  **Increased Social                Family Communication Around Drug Use                                                                                                                                                                                                                   
  Supports/Social Connectedness**                                                                                                                                                                                                                                                          

  **Client Perception of Care**     NOT APPLICABLE                                                                                                                                                                                                                                         

  **Cost Effectiveness (Average     Services provided within cost bands                                                                                                                                                                                                                    
  Cost)**                                                                                                                                                                                                                                                                                  

  **Use of Evidence-Based           Total number of evidence-based programs and strategies                                                                                                                                                                                                 
  Practices**                                                                                                                                                                                                                                                                              

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

NOMs will be assessed at the community level as appropriate to each
grantee's project. Baseline data at the community level must be included
in the application. You will be required to report on all your NOMs
including cost bands, i.e., the average cost per person served by
program type. This can be determined by dividing the numbers of persons
served by the total grant program costs. For more information on cost
effectiveness and cost bands, please refer to Appendix F.

The instrument for collecting and reporting the NOMs has been approved
by the Office of Management and Budget, please see Appendix G. Grantees
will be required to use this data collection instrument for collecting
and reporting data at the community level, as appropriate to their
project. Applicants must describe their current capacity for collecting
and reporting the NOMs at the community level as well as plans for
ensuring that the NOMs can be collected and reported at the community
level within the three-year timeframe of this program.

######## **2.3 Evaluation** {#evaluation .unnumbered}

Grantees must evaluate their projects, and applicants are required to
describe their evaluation plans in their applications. The evaluation
should be designed to provide regular feedback to the project to improve
the project. The evaluation must include both process and outcome
components. Process and outcome evaluations must measure change relating
to project goals and objectives over time compared to baseline
information. Control or comparison groups are not required. Applicants
must consider their evaluation plans when preparing the project budget.

**Process components** should address issues such as:

-   How closely did the implementation match the plan?

-   What types of deviation from the plan occurred?

-   What led to the deviations?

-   What effect did the deviations have on the planned intervention and
    evaluation?

-   Who (program, staff) provided what services (modality, type,
    intensity, duration), to whom (individual characteristics), in what
    context (system, community), and at what cost (facilities,
    personnel, dollars)?

#######  {#section-1 .unnumbered}

**Outcome components** should address issues such as:

-   What was the effect of the intervention on participants? (for
    intervention projects only)

-   What was the effect of infrastructure development on service
    capacity and other system outcomes? (for infrastructure projects
    only)

-   What program/contextual factors were associated with outcomes?

-   What individual factors were associated with outcomes?

-   How durable were the effects?

No more than 20% of the total grant award may be used for evaluation and
data collection, including the NOMs.

######## **2.4 Grantee Meetings** {#grantee-meetings .unnumbered}

You must plan to send the Program Director and the Evaluator 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 last 2-3 days.
These meetings are usually held in the Washington, D.C., area and
attendance is mandatory.

# II. AWARD INFORMATION {#ii.-award-information .unnumbered}

## 1. AWARD AMOUNT {#award-amount .unnumbered}

It is expected that up to \$3.3 million will be available to fund 9-11
awards in FY 2006. Annual awards are expected to be from \$300,000 to
\$350,000 per year in total costs (direct and indirect) for up to 3
years.

**Proposed budgets cannot exceed \$350,000 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.

## 2. FUNDING MECHANISM {#funding-mechanism .unnumbered}

Awards will be made as grants.

# III. ELIGIBILITY INFORMATION {#iii.-eligibility-information .unnumbered}

## ELIGIBLE APPLICANTS

Eligible applicants are domestic public and private nonprofit entities.
For example, State and local governments; federally recognized tribes;
State recognized tribes, urban Indian organizations (as defined in P.L.
94-437, as amended); public or private universities and colleges;
community- and faith-based organizations; and tribal organizations may
apply. The statutory authority for this program prohibits grants to
for-profit organizations. No more than one application may be submitted
from one organization.

## 2. COST SHARING  {#cost-sharing .unnumbered}

Cost sharing is not required in this program, and applications will not
be screened out on the basis of cost sharing.

## 3. OTHER {#other .unnumbered}

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

# IV. APPLICATION AND SUBMISSION INFORMATION  {#iv.-application-and-submission-information .unnumbered}

**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  {#address-to-request-application-package .unnumbered}

You may request a complete application kit from the National
Clearinghouse for Alcohol and Drug Information (NCADI) at
1-800-729-6686.

You also may download the required documents from the SAMHSA web site at
[[www.samhsa.gov/grants/index.aspx]{.underline}](../www.samhsa.gov/grants/index.aspx)

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 {#content-and-form-of-application-submission .unnumbered}

**2.1 Application Kit**

SAMHSA application kits include the following documents:

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

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

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

**2.2 Required Application Components**

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

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

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

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

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

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

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

-   *Appendix* 1**:** Data Collection Instruments/Interview Protocols

-   *Appendix 2*: Sample Consent Forms (Intervention Projects) or
    Letters of Commitment (Infrastructure Projects)

-   *Appendix 3*: 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. You are also required to complete the
        Assurance of Compliance with SAMHSA Charitable Choice Statutes
        and Regulations Form SMA 170. This form will be posted on
        SAMHSA's web site with the RFA and provided in the application
        kits available at SAMHSA's clearinghouse (NCADI).

```{=html}
<!-- -->
```
-   **Certifications** -- Use the "Certifications" forms found in PHS
    5161-1.

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

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

2.3 Application Formatting Requirements

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

-   Information provided must be sufficient for review.

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

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

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

footnotes will not be considered in determining compliance.)

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

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

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

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

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

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

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

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

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

-   The page limit of a total of 30 pages for Appendices 2 and 3
    combined should not be exceeded.

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

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

SAMHSA offers the opportunity for you to submit your application to us
either in electronic or paper format. Register one time, and Grants.gov
will generate your information for future applications so you don't have
to re-enter it. Built-in error-checking increases the completeness and
accuracy of your application. Electronic submission is voluntary. No
review points will be added or deducted, regardless of whether you use
the electronic or paper format.

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

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

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

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

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

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

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

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

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

-   *Amount of space allowed for Project Narrative:* The Project
    Narrative for an electronic submission may not exceed 12,875 words.
    If the Project Narrative for an electronic submission exceeds the
    word limit and exceeds the allowed space as defined in Appendix A,
    then **any part of the Project Narrative in excess of these limits
    will not be submitted to review**. To determine the number of words
    in your Project Narrative document in Microsoft Word, select
    file/properties/statistics.

While keeping the Project Narrative as a separate document, please
consolidate all other materials in your application to ensure the fewest
possible number of attachments. Ensure all pages in your application are
numbered consecutively, with the exception of the standard forms in the
PHS-5161 application package. Please name and number your attachments,
indicating the order in which they should be assembled. Failure to
comply with these requirements may affect the successful transmission
and consideration of your application.

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

After you electronically submit your application, you will receive an
automatic acknowledgement from Grants.gov that contains a Grants.gov
tracking number. It is important that you retain this number. **Include
the Grants.gov tracking number in the top right corner of the face page
for any paper submission.**

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

**For United States Postal Service:**

Crystal Saunders, Director of Grant Review

Office of Program Services

Substance Abuse and Mental Health Services Administration

Room 3-1044

1 Choke Cherry Road

Rockville, MD **20857**

ATTN: Electronic Applications

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

Crystal Saunders, Director of Grant Review

Office of Program Services

Substance Abuse and Mental Health Services Administration

Room 3-1044

1 Choke Cherry Road

Rockville, MD **20850**

ATTN: Electronic Applications

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

## 3. SUBMISSION DATES AND TIMES  {#submission-dates-and-times .unnumbered}

Applications are due by close of business on **May 16, 2006**. **Hand
carried applications will not be accepted. Applications may be shipped
using only DHL, Federal Express (FedEx), United Parcel Service (UPS), or
the United States Postal Service (USPS).**

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, Federal Express (FedEx), or United
    Parcel Service (UPS), proof of timely submission shall be the date
    on the tracking label affixed to the package by the carrier upon
    receipt by the carrier. That date must be at least 24 hours prior to
    the application deadline. The date affixed to the package by the
    applicant will not be sufficient evidence of timely submission.**

-   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. Please refer to Section
IV-2.3 above for "Guidance for Electronic Submission of Applications."

## 4. INTERGOVERNMENTAL REVIEW (E.O. 12372) REQUIREMENTS {#intergovernmental-review-e.o.-12372-requirements .unnumbered}

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 tribe.

    -   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. SP-06-005
>
> **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. SP-06-005

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 federally recognized tribal 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 3, "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. SP-06-005
>
> **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. SP-06-005

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 {#funding-limitationsrestrictions .unnumbered}

Cost principles describing allowable and unallowable expenditures for
Federal grantees, including SAMHSA grantees, are provided in the
following documents, which are available at
<http://www.hhs.gov/grantsnet/roadmap/index.html>:

-   Institutions of Higher Education: OMB Circular A-21

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

-   Nonprofit Organizations: OMB Circular A-122

-   Hospitals: 45 CFR Part 74, Appendix E

In addition, SAMHSA's Prevention of Methamphetamine Abuse grant
recipients must comply with the following funding restriction:

-   No more than 20% of the total grant award may be used for evaluation
    and data collection, including NOMs.

Prevention of Methamphetamine Abuse grant funds must be used for
purposes supported by the program and may not be used to:

-   Pay for any lease beyond the project period.

```{=html}
<!-- -->
```
-   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.)

-   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 (STD)/sexually transmitted illnesses (STI), TB,
    and hepatitis B and C, or for psychotropic drugs.

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 {#other-submission-requirements .unnumbered}

1.  **Where to Send Applications**

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

Send applications to the following address:

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

Do not send applications to other agency contacts, as this could delay
receipt. Be sure to include "**Prevention of Methamphetamine Abuse --
SM-06-005**" in item number 10 on the face page of any paper
applications. If you require a phone number for delivery, you may use
(240) 276-1199.

**6.2 How to Send Applications**

SAMHSA is collaborating with [www.Grants.gov](http://www.Grants.gov/) to
accept electronic submission of applications. Please refer to Section
IV-2.3 of this announcement for "Guidance for Electronic Submission of
Applications."

Following are instructions for submission of paper applications.

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

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

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

# V. APPLICATION REVIEW INFORMATION {#v.-application-review-information .unnumbered}

## EVALUATION CRITERIA

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

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

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

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

```{=html}
<!-- -->
```
-   Reviewers will be looking for evidence of cultural competence in
    each section of the Project Narrative. Points will be assigned based
    on how well you address the cultural competence aspects of the
    evaluation criteria. SAMHSA's guidelines for cultural competence can
    be found on the SAMHSA web site at
    [www.samhsa.gov](http://www.samhsa.gov/). Click on "Grants/SAMHSA's
    Supporting Grant Information/Useful Information for
    Applicants/Guidelines and Resources for Grant Applicants."

```{=html}
<!-- -->
```
-   The Supporting Documentation you provide in Sections E-H and
    Appendices 1-3 will be considered by reviewers in assessing your
    response, along with the material in the Project Narrative.

-   The number of points after each heading 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 the criterion.

**Section A: Statement of Need (20 points)**

-   Describe the target population (see Glossary) as well as the
    geographic area to be served, and justify the selection of both. The
    target population should include persons at high risk for
    methamphetamine abuse and addiction Include the numbers to be served
    and demographic information. Discuss the target population's
    language, beliefs, norms and values, as well as socioeconomic
    factors that must be considered in services to this population

```{=html}
<!-- -->
```
-   Document the need for a methamphetamine prevention project in the
    rural or urban area selected which is experiencing increases in
    methamphetamine abuse and addiction. This documentation of need may
    come from a variety of qualitative and quantitative sources,
    including local and specific baseline epidemiological, health
    service use, judicial and/or environmental data. The epidemiological
    and health service use data could come from local data or trend
    analyses, State data (e.g., from State Needs Assessments), and/or
    national data (e.g., from SAMHSA's National Household Survey on Drug
    Use and Health or from the National Center for Health
    Statistics/Centers for Disease Control reports). Judicial data could
    come from state and local police reports on methamphetamine arrests
    and laboratory incidents, and environmental damage data can be
    obtained from the Environmental Protection Agency. For data sources
    that are not well known, provide sufficient information on how the
    data were collected so reviewers can assess the reliability and
    validity of the data.

-   If proposing infrastructure development, document the need for an
    enhanced infrastructure to increase the capacity to implement,
    sustain, and improve effective methamphetamine abuse prevention
    services for the proposed target population in the proposed
    catchment area.

• Show that identified needs are consistent with priorities of the
State, county or tribe that has primary responsibility for the service
delivery system.

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

-   Clearly state the purpose, goals and objectives of your proposed
    project and how it addresses the target population and the
    geographic area being served. Describe how achievement of the goals
    will produce meaningful and relevant results (e.g., increase access,
    availability, prevention, outreach, pre-services, treatment, and/or
    intervention).

```{=html}
<!-- -->
```
-   If proposing to implement a prevention intervention, describe the
    evidence base for the proposed intervention (See Section I-2.1,
    documenting the Evidence-Base for Services to be Implemented.)

> \[Note: If you are proposing to implement an intervention included in
> NREPP (see Appendix C), you may simply identify the intervention and
> state the source from which it was selected. You do not need to
> provide further evidence of effectiveness. If you are proposing an
> intervention that is not included in NREPP, you must provide a
> narrative justification that summarizes the evidence of effectiveness
> and acceptability of the proposed intervention. The preferred evidence
> of effectiveness and acceptability will be findings published in the
> peer-reviewed literature. However, in areas where little or no
> research has been published in the peer-reviewed scientific
> literature, you may present evidence involving studies that have not
> been published in the peer-reviewed research literature and/or
> documents describing formal consensus among recognized experts.\]
>
> \- Describe and justify any adaptations necessary to meet the needs of
> the target population as well as evidence that such adaptations will
> be effective for the target population.

-   If proposing infrastructure development, provide evidence that the
    proposed activities meet the infrastructure needs and show how your
    proposed infrastructure development strategy will meet the goals and
    objectives.

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

```{=html}
<!-- -->
```
-   Describe how the proposed project will address issues of age, race,
    ethnicity, culture, language, sexual orientation, disability,
    literacy, and gender in the target population, while retaining
    fidelity to the chosen practice.

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

```{=html}
<!-- -->
```
-   If you plan to include an advisory body in your project, describe
    its membership, roles and functions, and frequency of meetings.

```{=html}
<!-- -->
```
-   Describe how members of the target population helped prepare the
    application and how they will help plan, implement, and evaluate the
    project.

```{=html}
<!-- -->
```
-   Identify any other organizations that will participate in the
    proposed project. Describe their roles and responsibilities and
    demonstrate their commitment to the project. Include letters of
    commitment from community organizations supporting the project in
    **Appendix 2.**

```{=html}
<!-- -->
```
-   Show that the necessary groundwork (e.g., planning, consensus
    development, development of memoranda of agreement, identification
    of potential facilities) has been completed or is near completion so
    that the project can be implemented and any prevention intervention
    can begin as soon as possible and no later than 4 months after grant
    award.

```{=html}
<!-- -->
```
-   Describe any potential barriers to successful conduct of the
    proposed project and how you will overcome them.

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

    **Section C: Staff and Organizational Experience (15 points)**

```{=html}
<!-- -->
```
-   Discuss the capability and experience of the applicant organization
    and other participating organizations with similar projects and
    populations. Demonstrate that the applicant organization and other
    participating organizations have linkages to the target population
    and ties to grassroots/community-based organizations that are rooted
    in the culture of the target population.

-   Provide a list of staff who will participate in the project, showing
    the role of each and their level of effort and qualifications.
    Include the Project Director and other key personnel, such as the
    evaluator and prevention personnel.

-   Describe the cultural 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.

-   Describe the resources available for the proposed project (e.g.,
    facilities, equipment), and provide evidence that services will be
    provided in a location that is adequate, accessible, compliant with
    the Americans with Disabilities Act (ADA), and amenable to the
    target population.

    **Section D: Evaluation and Data (30 points)**

```{=html}
<!-- -->
```
-   Document your ability to collect and report on the required
    performance measures as specified in Section I-2.2 of this RFA.
    Specify and justify any additional measures you plan to use for your
    grant project. These could include but are not limited to: Changes
    in methamphetamine use in the community, changes in perception of
    risk/harm associated with methamphetamine in the community,
    reduction in the number of illegal sales and thefts of
    methamphetamine supplies, changes in policies regarding the
    placement/storage of methamphetamine supplies/products in retail
    outlets, increases in the number of retail outlets storing certain
    supplies/products behind the counter, and changes in the number of
    closures in methamphetamine laboratories.

    -   Describe plans for data collection, management, analysis,
        interpretation and reporting. Describe the existing approach to
        the collection of data, along with any necessary modifications.
        Be sure to include data collection instruments/interview
        protocols in **Appendix 1**.

```{=html}
<!-- -->
```
-   Discuss the reliability and validity of evaluation methods and
    instrument(s) in terms of the gender/age/culture of the target
    population.

-   Describe the process and outcome evaluation, including assessments
    of implementation and individual outcomes. Show how the evaluation
    will be integrated with requirements for collection and reporting of
    performance data, including data required by SAMHSA to meet NOMs
    requirements.

-   For prevention intervention projects, describe how the evaluation
    will be used to ensure fidelity to the prevention intervention.

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.

**SUPPORTING DOCUMENTATION**

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

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

####### Section G: Biographical Sketches and Job Descriptions.  {#section-g-biographical-sketches-and-job-descriptions. .unnumbered}

####### 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.

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

    **Section H:** Confidentiality and SAMHSA Participant
    Protection/Human Subjects: Applicants must describe procedures
    relating to Confidentiality, Participant Protection and the
    Protection of Human Subjects Regulations in Section H of the
    application, using the guidelines provided below. Number range
    CHAPTER

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

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

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.

```{=html}
<!-- -->
```
-   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.

```{=html}
<!-- -->
```
-   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.

```{=html}
<!-- -->
```
-   Provide in **Appendix 1, "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:

```{=html}
<!-- -->
```
-   How you will use data collection instruments.

-   Where data will be stored.

-   Who will or will not have access to information.

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

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

6.  [Adequate Consent Procedures]{.underline}

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

-   State:

```{=html}
<!-- -->
```
-   Whether or not their participation is voluntary.

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

-   Possible risks from participation in the project.

-   Plans to protect clients from these risks.

```{=html}
<!-- -->
```
-   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.

```{=html}
<!-- -->
```
-   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 2, "Sample Consent Forms,"** of your
    application. If needed, give English translations.

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

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

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

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

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

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

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

Applicants must be aware that even if the Protection of Human Subjects
Regulations does not apply to all projects funded, the specific
evaluation design proposed by the applicant may require compliance with
these regulations.

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

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

## 2. REVIEW AND SELECTION PROCESS {#review-and-selection-process .unnumbered}

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

Decisions to fund a grant are based on:

-   the strengths and weaknesses of the application as identified by
    peer reviewers and when applicable, approved by the Center for
    Substance Abuse Prevention's National Advisory Council;

```{=html}
<!-- -->
```
-   availability of funds; and

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

# VI. AWARD ADMINISTRATION INFORMATION {#vi.-award-administration-information .unnumbered}

## 1. AWARD NOTICES  {#award-notices .unnumbered}

#######  {#section-2 .unnumbered}

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  {#administrative-and-national-policy-requirements .unnumbered}

[]{.mark}

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

-   Successful applicants must also comply with the administrative
    requirements outlined in 45 CFR Part 74 or 45 CFR Part 92, as
    appropriate. For more information see the SAMHSA web site
    (<http://www.samhsa.gov/Grants/generalinfo/grant_reqs.aspx> ).

```{=html}
<!-- -->
```
-   Depending on the nature of the specific funding opportunity and/or
    the proposed project as identified during review, additional terms
    and conditions may be negotiated with the grantee prior to grant
    award. These may include, for example:

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

    -   requirements relating to additional data collection and
        reporting;

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

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

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

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

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

#######  {#section-3 .unnumbered}

## 3. REPORTING REQUIREMENTS {#reporting-requirements .unnumbered}

1.  **Progress and Financial Reports**

-   Grant performance will require the submission of annual, biannual
    and final progress reports, as well as annual and final financial
    status reports.

```{=html}
<!-- -->
```
-   Because SAMHSA is extremely interested in ensuring that treatment
    and prevention services can be sustained, your progress reports
    should explain plans to ensure the sustainability (see Glossary) of
    efforts initiated under this grant.

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

3.2 Government Performance and Results Act

The Government Performance and Results Act (GPRA) mandate accountability
and performance-based management by Federal agencies. To meet the GPRA
requirements, SAMHSA must collect NOMs performance data from grantees.
The instrument for collecting and reporting the NOMs has been approved
by the Office of Management and Budget. The performance requirements for
SAMHSA's Prevention of Methamphetamine Abuse grant program are described
in Section I-2.2 of this document under "Data and Performance
Measurement."

**3.3 Publications**

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

#  {#section-4 .unnumbered}

# VII. AGENCY CONTACTS {#vii.-agency-contacts .unnumbered}

For questions about program issues contact:

Wilma Pinnock

Center for Substance Abuse Prevention

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Room 4-1012

Rockville, Maryland 20857

\(240\) 276-2421 wilma.pinnock@samhsa.hhs.gov

For questions on grants management issues contact:

Kimberly Pendleton

Office of Program Services, Division of Grants Management

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Room 7-1097

Rockville, Maryland 20857

\(240\) 276-1421

<kimberly.pendleton@samhsa.hhs.gov>

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

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

-   Use the PHS 5161-1 application.

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

-   Information provided must be sufficient for review.

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

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

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

footnotes will not be considered in determining compliance.)

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

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

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

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

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

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

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

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

```{=html}
<!-- -->
```
-   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)

```{=html}
<!-- -->
```
-   Applications should comply with the following requirements:

```{=html}
<!-- -->
```
-   Provisions relating to confidentiality and participant protection
    specified in Section V-1 of this announcement.

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

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

```{=html}
<!-- -->
```
-   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 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.

###  

### 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.

**[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.

**[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 D.

**[NOMs:]{.underline}** The National Outcomes Measures for substance
abuse prevention that SAMHSA has developed in partnership with the
States.

**[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:]{.underline} 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. {#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. .unnumbered}

**[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 -- Overview of SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP)

The National Registry of Evidence-based Programs and Practices (NREPP --
formerly the National Registry of Effective Prevention Programs) is a
voluntary rating and classification system for mental health and
substance abuse prevention and treatment interventions. The system is
designed to categorize and disseminate information about programs and
practices that meet established evidence rating criteria. SAMHSA is
committed to making NREPP a leading national resource for contemporary
and reliable information on the scientific basis and practicality of
interventions to prevent and/or treat mental and addictive disorders.

The system began in 1998 in SAMHSA\'s Center for Substance Abuse
Prevention (CSAP), and is being revised and expanded to include all
interventions to prevent and/or treat mental and addictive disorders.
SAMHSA\'s Center for Substance Abuse Treatment (CSAT) and Center for
Mental Health Services (CMHS) are participating in this expansion.
SAMHSA will launch the expanded system in Spring 2006.

However, approximately 160 programs are on the current Registry as
either Model, Effective, or Promising Programs. Information on these
programs is available through the current Model Programs web site at
[www.modelprograms.samhsa.gov](http://www.modelprograms.samhsa.gov/)

### Appendix D -- Logic Model Resources

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

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

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

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

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

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

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

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

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

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

241\. Thousand Oaks, CA: Sage.

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

### 

###  Appendix E -- 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

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

> **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 \$183,500 is effective for all FY 2006 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 108-447.

\*\*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 PA will specify the
maximum number of years of support that may be requested.

Appendix F \-- Cost Bands

CSAP COST BANDS: SUMMARY

Background

The Center for Substance Abuse Prevention has supported a multistage
initiative to develop cost bands for substance abuse prevention
programs. The development of cost bands and the collection of data
relating to the cost of substance abuse prevention services will allow
CSAP to meet its PART and NOMS reporting requirements. It will also
assist the agency in resource allocation decisions.

The development of the CSAP cost bands evolved through three distinct
phases of analyses and trials. Phase one involved a thorough review of
published literature reflecting costs for providing prevention services.
During Phase Two, cost data from CSAP programs were incorporated into
the estimates. Phase Three involved the development of a template with
State representatives and solicitation of comments on the draft plans.

Regionally Adjusted Provisional Cost Bands from Literature, SIG Grants,
and Other CSAP Discretionary Grants in 2005 Dollars\*

+------------+--------------+--------------+--------------+----------+
| 2005       | IOM Program  |              |              |          |
| P          | Category     |              |              |          |
| ercentiles |              |              |              |          |
+------------+--------------+--------------+--------------+----------+
|            | Universal    | Universal    | Selected     | I        |
|            |              | Indirect     |              | ndicated |
|            | Direct       |              |              |          |
+------------+--------------+--------------+--------------+----------+
| 25^th^     | \$58.01      | \$1.05       | \$151.88     | \$510.47 |
| Percentile |              |              |              |          |
+------------+--------------+--------------+--------------+----------+
| 75^th^     | \$693.98     | \$82.26      | \$6,409.29   | \$       |
| Percentile |              |              |              | 4,888.44 |
+------------+--------------+--------------+--------------+----------+

\*Sources for CPI:

<http://www.whitehouse.gov/cea/20041217-econ-forecast.pdf>

<http://www.whitehouse.gov/cea/cea-wp-20050809.html>

2005 Baseline

As part of its reporting requirements under PART and NOMs, CSAP is
required to document the increase in the number of services provided
within cost bands. The provisional 2005 baseline is that the cost of 50%
of services provided fall within the 2005 cost bands established for
each program type.

**Previous Cost Band Reports (available upon request)**

Cost Bands Stage 2: Combining Information on Prevention Intervention
Costs from Literature with CSAP State Incentive Grants and Other
Selected CSAP Grants Information. August 22, 2005. Report Prepared by
CSAP Data Coordinating Center Contract No. 277-00-6112.

# Recommended Cost Bands for Substance Abuse Prevention. (Final Report). May 20, 2005. Report Prepared by CSAP Data Coordinating Center Contract No. 277-00-6112. {#recommended-cost-bands-for-substance-abuse-prevention.-final-report.-may-20-2005.-report-prepared-by-csap-data-coordinating-center-contract-no.-277-00-6112. .unnumbered}

Appendix G -- National Outcome Measures Tools

**CSAP NOMS tool**

**Adults**

**RECORD MANAGEMENT**

**Participant ID**
\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

**Contract/Grant ID**
\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\|**

**Grant Year** \|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**\_\_\_\_\|**

**Year**

**Interview Date** \|\_\_\_\_\|\_\_\_\_\| / \|\_\_\_\_\|\_\_\_\_\| /
\|\_\_\_\_\|\_\_\_\_\|

**A. DEMOGRAPHICS:** Questions A1-4 asked only at baseline from
individuals in direct services programs.

**1. Gender**

**\_\_\_ Male**

**\_\_\_ Female**

**\_\_\_ Transgender**

**2. Are you Hispanic or Latino?**

**\_\_\_ Hispanic**

**\_\_\_ Latino**

**\_\_\_ Neither**

**3. What is your race? (Select one or more)**

**\_\_\_ Black or African American**

**\_\_\_ Asian**

**\_\_\_ American Indian**

**\_\_\_ Native Hawaiian or Other**

**\_\_\_ Alaska Native**

**\_\_\_ White**

**4. What is your date of birth? \|\_\_\_\_\|\_\_\_\_\| /
\|\_\_\_\_\|\_\_\_\_\| / \|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

**Month / Day / Year**

**B. DRUG AND ALCOHOL USE**

**Domain: Abstinence**

1.  **During the past 30 days, that is, since \_\_\_ \_\_\_ / \_\_\_
    \_\_\_ on how many days did you smoke part or all of a cigarette?**

**NUMBER OF DAYS: \[RANGE: 1 - 30\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

2.  **During the past 30 days, that is, since \_\_\_ \_\_\_ / \_\_\_
    \_\_\_ on how many days did you use other tobacco products?**

**NUMBER OF DAYS: \[RANGE: 1 - 30\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

3.  **Think specifically about the past 30 days, that is from \_\_\_
    \_\_\_ / \_\_\_ \_\_\_ through today. During the past 30 days, on
    how many days did you drink one or more drinks of an alcoholic
    beverage?**

**NUMBER OF DAYS: \[RANGE: 0 -30\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

4.  **Think specifically about the past 30 days, from \_\_\_ \_\_\_ /
    \_\_\_ \_\_\_ up to and including today. During the past 30 days, on
    how many days did you use marijuana or hashish?**

**NUMBER OF DAYS: \[RANGE: 0 - 30\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

5.  **Think specifically about the past 30 days, from \_\_\_ \_\_\_ /
    \_\_\_ \_\_\_ up to and including today. During the past 30 days, on
    how many days did you use any other illegal drug?**

**NUMBER OF DAYS: \[RANGE: 0 - 30\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

6.  **How old were you the FIRST TIME you smoked part or all of a
    cigarette?**

**AGE: \[(RANGE: 1 - 110\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

7.  **How old were you the FIRST TIME you used any other tobacco
    product?**

**AGE: \[RANGE: 1 - 110\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

8.  **Think about the FIRST TIME you had a drink of an alcoholic
    beverage. How old were you the FIRST TIME you had a drink of an
    alcoholic beverage? Please do not include any time when you only had
    a sip or two from a drink.**

**AGE: \[RANGE: 1 - 110\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

9.  **How old were you the FIRST TIME you used marijuana or hashish?**

**AGE: \[RANGE: 1 - 110\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

10. **How old were you the FIRST TIME you used any other illegal drug?**

**AGE: \[RANGE: 1 - 110\] \_\_\_\_**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

11. **How much do people risk harming themselves physically and in other
    ways when they smoke ONE OR MORE PACKS OF CIGARETTES PER DAY?**

```{=html}
<!-- -->
```
1.  **\_\_\_\_No risk**

2.  **\_\_\_\_Slight risk**

3.  **\_\_\_\_Moderate risk**

4.  **\_\_\_\_Great risk**

> \_\_\_\_ **Don't Know**
>
> **\_\_\_\_ Refuse to Answer**

12. **How much do people risk harming themselves physically and in other
    ways when they smoke MARIJUANA ONCE OR TWICE A WEEK?**

```{=html}
<!-- -->
```
1.  **\_\_\_\_\_No risk**

2.  **\_\_\_\_\_Slight risk**

3.  **\_\_\_\_\_Moderate risk**

4.  **\_\_\_\_\_Great risk**

> **\_\_\_\_ Don't Know**
>
> **\_\_\_\_ Refuse to Answer**

13. **How much do people risk harming themselves physically and in other
    ways when they have FIVE OR MORE DRINKS OF AN ALCOHOLIC BEVERAGE
    ONCE OR TWICE A WEEK?**

```{=html}
<!-- -->
```
1.  **\_\_\_\_\_No risk**

2.  **\_\_\_\_\_Slight risk**

```{=html}
<!-- -->
```
3.  **\_\_\_\_\_Moderate risk**

4.  **\_\_\_\_\_Great risk**

> **\_\_\_\_ Don't Know**
>
> **\_\_\_\_ Refuse to Answer**

**C. EMPLOYMENT/EDUCATION**

1.  **Would you be more or less likely to want to work for an employer
    that tests its**

**employees for drug or alcohol use on a random basis? Would you say
more likely, less likely, or would it make no difference to you?**

1.  **\_\_\_\_\_More likely**

2.  **\_\_\_\_\_Less likely**

3.  **\_\_\_\_\_Would make no difference**

**\_\_\_\_ Don't Know**

**\_\_\_\_ Refuse to Answer**

**D. CRIME AND CRIMINAL JUSTICE**

1.  **DURING THE PAST 12 MONTHS, have you driven a vehicle while you
    were under the influence of alcohol only?**

```{=html}
<!-- -->
```
1.  **\_\_\_\_\_Yes**

2.  **\_\_\_\_\_No**

> **\_\_\_\_ Don't Know**
>
> **\_\_\_\_ Refuse to Answer**

**E. SOCIAL SUPPORT/SOCIAL CONNECTEDNESS**

1.  **DURING THE PAST 12 MONTHS, how many times have you talked with
    your child about the dangers or problems associated with the use of
    tobacco, alcohol, or other drugs?**

```{=html}
<!-- -->
```
1.  **\_\_\_\_\_0 times**

2.  **\_\_\_\_\_1 to 2 times**

3.  **\_\_\_\_\_A few times**

4.  **\_\_\_\_\_Many times**

> **\_\_\_\_ Don't Know**
>
> **\_\_\_\_ Refuse to Answer**
>
> **CSAP NOMS TOOL**
>
> **YOUTH**

**RECORD MANAGEMENT**

**Participant ID
\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

**Contract/Grant ID
\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

**Grant Year \|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|\_\_\_\_\|**

> **Year**

**Interview Date \|\_\_\_\_\|\_\_\_\_\| / \|\_\_\_\_\|\_\_\_\_\| /
\|\_\_\_\_\|\_\_\_\_\|**

A.  **DEMOGRAPHICS: Questions A1-4 asked only at baseline from
    individuals in direct service programs.**

```{=html}
<!-- -->
```
1.  **Gender**

**\_\_\_\_ Male**

**\_\_\_\_ Female**

**\_\_\_\_ Transgender**

2.  **Are you Hispanic or Latino?**

**\_\_\_\_ Hispanic**

**\_\_\_\_ Latino**

**\_\_\_\_ Neither**

3.  **What is your race? (Select one or more)**

**\_\_\_\_ Black or African American**

**\_\_\_\_ Asian**

**\_\_\_\_ American Indian**

**\_\_\_\_ Native Hawaiian or Other Pacific Islander**

**\_\_\_\_ Alaskan Native**

**\_\_\_\_ White**

4.  **What is your date of birth? \| \_\_ \| \_\_ \| / \| \_\_ \| \_\_
    \| / \| \_\_ \| \_\_ \| \_\_ \| \_\_ \|**

> **Month / Day / Year**

**B: DRUG AND ALCOHOL USE**

**Domain: Abstinence**

Measure: 30 day use

**1.** **During the past 30 days, that is, since \_\_ \_\_ / \_\_ \_\_,
on how many days did you smoke part or all of a cigarette?**

> **NUMBER OF DAYS: \[Range: 0 - 30\] \_\_\_\_\_**

**\_\_\_\_ Don't know**

**\_\_\_\_ Refuse to answer**

**2. During the past 30 days, that is since \_\_ \_\_ / \_\_ \_\_, on
how many days did you use other tobacco products?**

> **NUMBER OF DAYS: \[Range: 0 - 30\] \_\_\_\_\_**

**\_\_\_\_ Don't know**

**\_\_\_\_ Refuse to answer**

**3. Think specifically about the past 30 days, that is from \_\_ \_\_ /
\_\_ \_\_ through today. During the past 30 days, on how many days did
you drink one or more drinks of an alcoholic beverage?**

**NUMBER OF DAYS: \[Range: 0 - 30\] \_\_\_\_\_**

**\_\_\_\_ Don't know**

> **\_\_\_\_ Refuse to answer**

**4. Think specifically about the past 30 days, from \_\_ \_\_ / \_\_
\_\_ up to and including today. During the past 30 days, on how many
days did you use marijuana or hashish?**

> **NUMBER OF DAYS: \[Range: 0 - 30\] \_\_\_\_\_**

**\_\_\_\_ Don't know**

**\_\_\_\_ Refuse to answer**

**5. Think specifically about the past 30 days, from \_\_ \_\_ / \_\_
\_\_ up to and including today. During the past 30 days, on how many
days did you use any other illegal drug?**

**NUMBER OF DAYS: \[Range: 0 -- 30\] \_\_\_\_\_**

> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

Measure: Age of First Use

**6. How old were you the *first time* you smoked part or all of a
cigarette?**

> **AGE: \[Range: 1-110\] \_\_\_\_\_**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**7. How old were you the *first time* you used any other tobacco
product?**

> **AGE: \[Range: 1-110\] \_\_\_\_\_**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**8. Think about the *first time* you had a drink of an alcoholic
beverage. How old were the *first time* you had a drink of an alcoholic
beverage? Please do not include any time when you had only a sip or two
from a drink.**

> **AGE: \[Range: 1-110\] \_\_\_\_\_**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**9. How old were you *the first time* you used marijuana or hashish?**

> **AGE: \[Range: 1-110\] \_\_\_\_\_**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**10.** **How old were you the *first time* you used any other illegal
drug?**

> **AGE: \[Range: 1-110\] \_\_\_\_\_**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

Measure: Perception of Disapproval/Attitude

**11.** **How do you feel about someone your age smoking one more packs
of cigarettes a day?**

> **1. \_\_\_\_\_ Neither approve nor disapprove**

**2. \_\_\_\_\_ Somewhat disapprove**

> **3. \_\_\_\_\_ Strongly disapprove**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**12. How do you think your close friends would feel about *you* smoking
one or more packs of cigarettes a day?**

> **1. \_\_\_\_\_ Neither approve nor disapprove**
>
> **2. \_\_\_\_\_ Somewhat disapprove**
>
> **3. \_\_\_\_\_ Strongly disapprove**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**13. How do you feel about someone your age trying marijuana or hashish
once or twice?**

> **1. \_\_\_\_\_ Neither approve nor disapprove**
>
> **2. \_\_\_\_\_ Somewhat disapprove**
>
> **3. \_\_\_\_\_ Strongly disapprove**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**14. How do you feel about someone your age using marijuana once a
month or more?**

> **1. \_\_\_\_\_ Neither approve nor disapprove**
>
> **2. \_\_\_\_\_ Somewhat disapprove**
>
> **3. \_\_\_\_\_ Strongly disapprove**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**15. How do you feel about someone your age having one or two more
drinks of an alcoholic beverage nearly every day?**

> **1. \_\_\_\_\_ Neither approve nor disapprove**
>
> **2. \_\_\_\_\_ Somewhat disapprove**
>
> **3. \_\_\_\_\_ Strongly disapprove**
>
> **\_\_\_\_ Don't know**

**\_\_\_\_ Refuse to answer**

Measure: Perceived Risk/Harm of Use

**16. How much do people risk harming themselves physically and in other
ways when they smoke *one or more packs of cigarettes per day*?**

> **1. \_\_\_\_\_ No risk**
>
> **2. \_\_\_\_\_ Slight risk**
>
> **3. \_\_\_\_\_ Moderate risk**
>
> **4. \_\_\_\_\_ Great risk**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**17. How much do people risk harming themselves physically and in other
ways when they smoke *marijuana once or twice a week*?**

> **1. \_\_\_\_\_ No risk**
>
> **2. \_\_\_\_\_ Slight risk**
>
> **3. \_\_\_\_\_ Moderate risk**
>
> **4. \_\_\_\_\_ Great risk**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**18. How much do people risk harming themselves physically and in other
ways when they have *five or more drinks of an alcoholic beverage once
or twice a week*?**

> **1. \_\_\_\_\_ No risk**
>
> **2. \_\_\_\_\_ Slight risk**
>
> **3. \_\_\_\_\_ Moderate risk**
>
> **4. \_\_\_\_\_ Great risk**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**Domain: Employment / Education**

Measure: Perception of Workplace Policy

**19. Would you be more or less likely to want to work for an employer
that tests its employees for drug or alcohol use on a random basis?
Would you say more likely, less likely, or would it make no difference
for you?**

> **1. \_\_\_\_\_ More likely**
>
> **2. \_\_\_\_\_ Less likely**
>
> **3. \_\_\_\_\_ Would make no difference**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**Domain: Crime and Criminal Justice**

Measure: Alcohol Related Car Crashes and Injuries

**20. *During the past 12 months*, have you driven a vehicle while you
were under the influence of alcohol only?**

> **1. \_\_\_\_\_ Yes**
>
> **2. \_\_\_\_\_ No**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**

**Domain: Social Support/Social Connectedness**

Measure: Family Communications around Drug Use

**21. Now think about the past 12 months, that is, from \_\_ \_\_ / \_\_
\_\_ through today. *During the past 12 months*, have you talked with at
least one of your parents about the dangers of tobacco, alcohol, or drug
use? By *parents*, we mean your biological parents, adoptive parents,
stepparents, or adult guardians- whether or not they live with you.**

> **1. \_\_\_\_\_ Yes**
>
> **2. \_\_\_\_\_ No**
>
> **\_\_\_\_ Don't know**
>
> **\_\_\_\_ Refuse to answer**