Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

***Center for Substance Abuse Treatment***

**Grant Program to Provide Substance Abuse Treatment and Reentry
Services to Sentenced Juveniles and Young Adult Offenders Returning to
the Community from the Correctional System**

**Short Title: Young Offender Reentry Program (YORP)**

***(Initial Announcement)***

**Request for Applications (RFA) No. TI 04- 002**

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

**Key Dates:**

+----------------------+-----------------------------------------------+
| **Application        | **June 15, 2004**                             |
| 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**       |                                               |
+----------------------+-----------------------------------------------+

Date of Issuance: April 2004

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM Charles G. Curie, M.A.,
A.C.S.W.

Director, Center for Substance Abuse Treatment Administrator

Substance Abuse and Mental Health Substance Abuse and Mental Health

Services Administration Services Administration

**Table of Contents**

[I. FUNDING OPPORTUNITY DESCRIPTION 3](#__RefHeading___Toc67274367)

[1. INTRODUCTION 3](#introduction)

[2. EXPECTATIONS 3](#expectations)

[II. AWARD INFORMATION 10](#ii.-award-information)

[1. AWARD AMOUNT 10](#award-amount)

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

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

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

[2. COST-SHARING 11](#cost-sharing)

[3. OTHER 11](#other)

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

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

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

[3. SUBMISSION DATES AND TIMES 16](#submission-dates-and-times)

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

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

[6. OTHER SUBMISSION REQUIREMENTS 16](#other-submission-requirements)

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

[1. EVALUATION CRITERIA 16](#evaluation-criteria)

[2. REVIEW AND SELECTION PROCESS 16](#review-and-selection-process)

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

[1. AWARD NOTICES 16](#award-notices)

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

[3. REPORTING REQUIREMENTS 16](#reporting-requirements)

[VII. AGENCY CONTACTS 16](#vii.-agency-contacts)

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

[Appendix B - Glossary 16](#appendix-b---glossary)

[Appendix C - Statement Of Assurance
16](#appendix-c---statement-of-assurance)

[]{#__RefHeading___Toc67274367 .anchor}I. FUNDING OPPORTUNITY
DESCRIPTION

## 1. INTRODUCTION {#introduction .unnumbered}

As authorized under Section 509 of the Public Health Service Act, the
Substance Abuse and Mental Health Services Administration (SAMHSA),
Center for Substance Abuse Treatment (CSAT), announces the availability
of Fiscal Year 2004 grants to expand and/or enhance substance abuse
treatment and related reentry services in agencies currently providing
supervision of and services to **sentenced** juvenile and young adult
offenders returning to the community from **incarceration** for
criminal/juvenile offenses. Applicants are expected to form stakeholder
partnerships that will plan, develop and provide community-based
substance abuse treatment and related reentry services for the targeted
populations. Because reentry transition must begin in the correctional
or juvenile facility before release, funding may be used for limited
activities in institutional correctional settings in addition to the
expected community-based services. (**Note**: see **Expectations**
section below for allowable services in incarcerated settings.)

##  {#section .unnumbered}

## 2. EXPECTATIONS {#expectations .unnumbered}

### 2.1 Target Population

> This program addresses the needs of **[sentenced]{.underline}**
> substance-abusing juveniles and young adult offenders returning to
> their families and community from adult or juvenile incarceration in
> facilities including prisons, jails, or juvenile detention centers.
> This grant program is not designed to address the needs of individuals
> in custody or detention settings awaiting adjudication, or sentenced
> to residential treatment facilities, or school-based programs.

SAMHSA/CSAT will award grants to applicants proposing to serve one of
two specific young offender population categories:

**Juveniles**: Those sentenced offenders 14 years up to 18 years old
under the jurisdiction of the juvenile justice system. (In those State
jurisdictions where juvenile justice supervision extends up past 18
years of age, those "juveniles" are eligible to be served.)

**Young Adult Offenders:** Those sentenced offenders up to 24 years of
age under the supervision of the adult criminal justice system.

The applicant organization must clearly state in the application
**Abstract** and in the **Project Narrative** which population is to be
served and the number of clients to be served each year.

In addition to qualifying as either a "juvenile offender" or a "young
adult offender" as defined above, individuals must meet the following
qualifications to receive services funded under this grant program. They
must:

-   Be assessed as substance-abusing or diagnosed as having a substance
    abuse disorder;

-   Have been **[sentenced]{.underline}** by the criminal or juvenile
    justice system to incarceration;

-   If incarcerated, be within one year of scheduled release to the
    community in order to receive services in the correctional/detention
    setting (including limited assessment, transition planning, and
    systems coordination). -- \[Note: see Section I-2.4 Expectations,
    Required Systems Linkages and Services/Treatment of this Request for
    Applications (RFA)\]; and

-   If already released to the community from incarceration, be within
    60 days of release from incarceration and under some form of
    juvenile/criminal supervision.

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

###### **2.2 Background**  {#background .unnumbered}

Statistics regarding juvenile offenders indicate that "juveniles were
involved in 16 percent of all violent crime arrests and 32 percent of
all property crimes in 1999..." As the trend toward confining greater
numbers of juveniles and young offenders continues, so does the growing
number of young offenders reentering our communities. An estimated
100,000 youth are released from secure and residential facilities and
returned to the community each year. Research also shows that a small
percentage of juveniles commit an overwhelming majority of juvenile
crime, and that a substantial number of these juvenile and young adult
offenders are substance-involved or have substance abuse disorders.

Over the past decade, awareness of the issue of the need for a
continuing care system for juvenile and young adult offenders has grown
as States and local communities have struggled with the increasing
number of these individuals returning to the community after release
from correctional confinement. Often the juvenile or adult criminal
justice system has services and structures in place for these offenders
at entry into the system (i.e., at pre-trial or adjudication), but there
are few and fragmented services in place for these young offenders as
they are released from correctional settings. Reentry into the community
and reintegration into the family are risky times for these offenders
and their families. The U.S. Department of Justice's Office of Juvenile
Justice and Delinquency Prevention (OJJDP) indicates that in the first
year following release, young offenders re-offend at a rate of
sixty-three (63) percent. Substance abuse treatment for offenders in
prison and in the community has been extensively studied and evaluated
over the past several years, and the results are consistent and clear --
treatment works, reducing crime and recidivism. SAMHSA/CSAT recognizes
the need to successfully return and reintegrate these youths into the
community by providing substance abuse treatment and other related
reentry services while also ensuring public safety for the community and
family. This program builds on previous and ongoing SAMHSA/CSAT criminal
and juvenile justice program initiatives, and builds on learning gained
from these previous initiatives.

######## **2.3 Required Letters of Support from Proposed Key Stakeholders** {#required-letters-of-support-from-proposed-key-stakeholders .unnumbered}

SAMHSA/CSAT is seeking applications from individual organizations that
have or will form partnerships with key stakeholders such as
criminal/juvenile agencies (as appropriate to the juvenile or young
adult population specified in your application), alcohol and drug abuse
agencies, substance abuse treatment providers and community-based
organizations providing treatment-related wrap around services for
family and community reintegration. Therefore, all eligible entities
that apply are required to provide in Appendix 2 of the application,
"Letters of Support and Commitment," (as appropriate to the proposed
approach) from key partners. Examples of key partners include:

-   The State or local Department of Corrections;

-   The State or local Alcohol and Drug Abuse Agency;

-   The State or local Mental Health Agency;

-   The State or local juvenile/criminal justice agency responsible for
    community supervision upon release from incarceration (such as
    parole authority, after release judicial or probation agency,
    reentry court, community corrections supervision authority, youth
    release authority);

-   Community-based substance abuse treatment agencies whose services
    will be used (Note: see Section III-3.2 Eligibility
    Information/Other/Evidence of Experience and Credentials); and

-   Other Federal, State, or local government agencies and
    community-based organizations including faith-based organizations,
    whose services will be used for ancillary reentry services,
    including housing assistance, job skills development, employment
    assistance, educational and vocational assistance, and family
    counseling, among other services.

Applications submitted by Indian Tribes and tribal organizations for
juveniles and young adults returning from Tribal or Federal facilities
must include the appropriate Tribal or Federal stakeholder
agencies/organizations in lieu of State or local governmental entities,
as appropriate.

Letters of support and commitment must include:

-   The agency/organization's commitment to participate;

-   The proposed role and level of support of the stakeholder
    agency/organization; and

-   The signature of the head of the agency/organization.

Because SAMHSA/CSAT recognizes that each State, Tribe, and local
community differs in its ability to immediately implement the proposed
services, awarded grantees will be allowed **up to 6 months of the first
year of the grant** to develop any appropriate systems coordination
among governmental agencies and community-based organizations, and to
start the implementation of the proposed services expansion and/or
enhancement. Applicants should clearly indicate the period of time, up
to 6 months, needed in year one to develop a systems coordination plan
and implement proposed services to the target population.

### 2.4 Required Systems Linkages and Services/Treatment {#required-systems-linkages-and-servicestreatment .unnumbered}

Offender reentry, often called reintegration or continuing care, is the
process an offender in a juvenile or adult correctional facility goes
through as he/she transitions from the institution to the community.

SAMHSA/CSAT has a substantial interest in funding projects that provide
**both systems linkages and services/treatment** for the reentering
young offender. Applications must propose to address [both]{.underline}
of these areas, and funds must be used to support the following
activities:

**SYSTEMS LINKAGES**: Activities that support communities in their
development of a comprehensive, multi-agency approach to expanding
and/or enhancing substance abuse treatment in addition to
juvenile/criminal justice supervision to targeted juveniles and young
adults leaving incarceration and returning to the community and to their
families (**No more than 15% of the total grant award may be used for
Systems Linkages activities).**

Upon release of the offender to the community, funds should be used to
provide effective, comprehensive substance abuse and related reentry
services to the target population. The following represents a
comprehensive but not inclusive range of **systems linkage**
coordination activities to be provided, and for which funds may be used.

1.  Systems coordination planning and developmental activities that
    bring all the key stakeholder agencies/organizations together.

2.  The development of systems linkages and referral sources in the
    community.

3.  Efforts to increase treatment capacity to provide immediate entry
    into substance abuse treatment.

4.  Assistance in paying for Department of Labor Bonding for employment
    of the substance-abusing offender.

**SERVICES/TREATMENT**: Activities that improve the health of the
targeted clients by:

-   providing comprehensive substance abuse treatment for the client
    diagnosed as having a substance abuse disorder;

-   improving family functioning;

-   helping clients develop job skills and find jobs;

-   reducing the likelihood the client will be re-arrested; and

-   reducing the crime rate and the number of victims.

The following represents a comprehensive but not inclusive range of
**treatment services** to be provided, and for which funds may be used.

1.  Alcohol and drug (substance abuse) treatment.

2.  Wrap around services supporting the access to and retention in
    substance abuse treatment or to address the treatment-specific needs
    of clients during or following a substance abuse treatment episode.

3.  Screening, assessment, case management, program management and
    referrals related to substance abuse treatment for clients.

4.  Comprehensive individual assessment for alcohol and drug abuse.

5.  Individualized services planning.

6.  Case management, using a team approach that includes juvenile or
    adult criminal justice supervising authorities, substance abuse
    treatment professionals, existing treatment alternatives
    organizations such as TASC or similar treatment referral and case
    management models, and law enforcement as appropriate to the
    community setting.

7.  Drug testing as required for supervision, treatment compliance, and
    therapeutic intervention.

8.  Support in obtaining a GED and/or other necessary education.

9.  Relapse prevention and long-term management support.

10. As appropriate for juvenile populations, continuing care
    programming, including peer support groups and mentoring services.

Because CSAT's focus is on the return of the young offender to the
community, the expectation is that most proposed treatment and related
reentry services will be provided in the community. However, recognizing
that effective offender reentry requires assessment and release planning
while the offender is incarcerated, limited funds (**no more than 15% of
the total grant award**) may be used for certain activities inside
juvenile or adult institutional correctional settings for:

1.  Systems coordination planning and developmental activities that
    bring together all the key stakeholder agencies/organizations
    identified in the Letters of Support and Commitment to form
    partnerships that will plan, develop, and provide substance abuse
    treatment and related reentry services in the community.

2.  The development of systems linkages and referral processes in both
    institutional and communities settings.

3.  Purchase and/or administration of brief diagnostic and screening
    tools for identification of substance abuse issues for the targeted
    offender population.

4.  Purchase and/or administration of substance abuse instruments for
    the targeted offender population.

5.  Intake and/or case management staff with substance abuse treatment
    expertise to administer assessment instruments and to assist
    correctional staff in developing the individual offender transition
    plans for reentry into the community.

6.  Community-based organizations, including faith-based groups, to go
    inside the correctional institution to begin wrap around transition
    planning activities such as, but not limited to, jobs skills
    planning or educational program planning for community follow up
    upon release.

### 2.5 Recommended Treatment Models for Youth {#recommended-treatment-models-for-youth .unnumbered}

> Applicants are encouraged, when appropriate for their setting and
> population, to choose the assessment instrument and one of the
> treatment protocols listed below. The assessment instrument, the
> treatment protocols, and other supporting materials are available at
> <http://www.chestnut.org/LI/APSS/CSAT/protocols/>. If you experience
> any difficulty accessing this site, please contact Dan Foust at
> 309-820-3543, ext. 8-3421 or by email at <Dfoust@chestnut.org>.
>
> The majority of CSAT's grantees providing services to youth are using
> a standardized comprehensive bio-psycho-social assessment: The Global
> Appraisal of Individual Needs. The cost for licensing, software,
> training, and certification will be borne by CSAT for successful
> applicants who choose to use this assessment instrument. Successful
> applicants who use this instrument will also have the opportunity to
> participate with other grantees in ongoing studies on youth treatment
> outcomes.
>
> Two of CSAT's earlier grant programs: Cannabis Youth Treatment (CYT),
> and Adolescent Treatment Models (ATM) tested and manualized a number
> of effective treatment interventions for youth with substance use
> disorders. The Assertive Continuing Care (ACC) intervention has also
> been used successfully by CSAT grantees. These adolescent treatment
> services interventions range from brief outpatient through long-term
> residential models. Applicants are encouraged to adopt/adapt one of
> these protocols as their treatment intervention. Training and
> technical assistance for implementation of these treatment protocols
> will be available for successful applicants.

**As indicated previously, applicants may propose a planning phase of up
to six months of the first year of funding for systems linkages
activities. However, even with unexpected delays that may occur,
grantees must begin delivery of treatment and reentry services by the
end of the first year in order to receive continuation funding for
additional years.**

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

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

**2.7 Data and Performance Measurement**

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

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

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

Specifically, grantees will be required to provide data on a set of
required measures explained below.

**For adults receiving services**, GPRA indicators include changes in a
positive direction or stability over time on each of five measures,
showing that adults receiving your services:

-   are currently employed or engaged in productive activities;

-   have a permanent place to live in the community;

-   have reduced their involvement with the criminal justice system;

-   have not used illegal drugs or misused alcohol or prescription drugs
    during the past month; and

-   have experienced reduced health, behavior, or social consequences
    related to abuse of alcohol or illegal drugs or misuse of
    prescription drugs.

**For youth/adolescents under age 18 receiving services**, GPRA
indicators include changes in a positive direction or stability over
time on five measures, showing that youth/adolescents receiving your
services:

-   are attending school;

-   are residing in a stable living environment;

-   have no involvement in the juvenile justice system;

-   have not used alcohol or illegal drugs or misused prescription drugs
    during the previous month; and

-   have experienced reduced health, behavior, or social consequences
    related to use of alcohol, abuse of illegal drugs, or misuse of
    prescription drugs.

GPRA data must be collected at baseline (i.e., the client's entry into
the project), 6 months after the baseline, and 12 months after the
baseline. Projects serving adolescents also must collect 3 month
post-baseline data to capture the nuances of change particular to this
population. GPRA data must be entered into the GPRA web system within 7
business days of the forms being completed. In addition, 80% of the
participants must be followed up.

The data collection tool, Targeted Capacity Expansion Client Level GPRA
Tool, to be used for reporting the required data will be provided in the
application kits distributed by the National Clearinghouse for Alcohol
and Drug Information (NCADI) and can be found at
www.csat-gpra.samhsa.gov. (Click on "Data Collection
Tools/Instructions." Then click on "Targeted Capacity Expansion
Program," then "GPRA Tool.")

In your application, you must demonstrate your ability to collect and
report on these measures. GPRA data are to be collected and then entered
into CSAT's GPRA Data Entry and Reporting System
(www.csat-gpra.samhsa.gov). Training and technical assistance on data
collecting, tracking, and follow-up, as well as data entry, will be
provided by CSAT.

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

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

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

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

Grantees must evaluate their projects, and you are required to describe
your evaluation plans in your application. The evaluation should be
designed to provide regular feedback to the project to improve services.
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. You must consider your evaluation
plan when preparing the project budget.

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

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

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

-   What was the effect of treatment on participants?

-   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 GPRA.

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

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

It is expected that \$6 million will be available to fund up to 12-14
awards in FY 2004. The average annual award will range from \$300,000 to
\$500,000 in total costs (direct and indirect). **Applicants may request
up to but no more than \$500,000 in total costs (direct and indirect)
per year in any year of the grant project**. The actual amount available
for the awards may vary, depending on unanticipated program requirements
and the number and quality of the applications received.

Awards may be requested for up to 4 years. Applicants may request up to
six months of the first year for systems coordination planning and
development. The planning phase is to be followed by the implementation
of the reentry work plan including the delivery of treatment and other
reentry services.

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 for this funding opportunity will be made as grants (see the
Glossary in Appendix B for further explanation of this funding
mechanism).

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

## 1. ELIGIBLE APPLICANTS {#eligible-applicants .unnumbered}

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

While units of government may apply, they may not submit "pass through,"
"umbrella," or "cover letter" applications. This means that as the
applicant, a unit of government, must take an active role in the
oversight of the project, coordinate with the treatment services
providers, and be legally, fiscally, and administratively responsible
for the grant.

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

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

## 3. OTHER {#other .unnumbered}

**3.1 Additional Eligibility Requirements**

Applicants 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.

**3.2 Evidence of Experience and Credentials**

> SAMHSA believes that only existing, experienced, and appropriately
> credentialed organizations with demonstrated infrastructure and
> expertise will be able to provide required services quickly and
> effectively. Therefore, in addition to the basic eligibility
> requirements specified in this announcement, applicants must meet
> three additional requirements related to the provision of treatment or
> prevention services.
>
> The three requirements are:

-   A provider organization for direct client substance abuse treatment
    services appropriate to the grant must be involved in each
    application. The provider may be the applicant or another
    organization committed to the project. More than one provider
    organization may be involved;

-   Each direct service provider organization must have at least 2 years
    experience providing services in the geographic area(s) covered by
    the application, as of the due date of the application; and

-   Each direct service provider organization must comply with all
    applicable local (city, county) and State/tribal licensing,
    accreditation, and certification requirements, as of the due date of
    the application.

> \[Note: The above requirements apply to all service provider
> organizations. A license from an individual clinician will not be
> accepted in lieu of a provider organization's license.\]

In **Appendix 1** of the application, you must: (1) identify at least
one experienced, licensed service provider organization; (2) include a
list of all direct service provider organizations that have agreed to
participate in the proposed project, including the applicant agency if
the applicant is a treatment service provider organization; and (3)
include the Statement of Assurance (provided in Appendix C of this
announcement), signed by the authorized representative of the applicant
organization identified on the face-page of the application, that all
participating service provider organizations:

-   meet the 2-year experience requirement

```{=html}
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```
-   meet applicable licensing, accreditation, and certification
    requirements, and,

-   if the application is within the funding range, will provide the
    Government Project Officer (GPO) with the required documentation
    within the time specified.

> **If Appendix 1 of the application does not contain items (1)-(3), the
> application will be considered ineligible and will not be reviewed.**

In addition, if, following application review, an application's score is
within the fundable range for a grant award, the GPO will call the
applicant and request that the following documentation be sent by
overnight mail:

-   a letter of commitment that specifies the nature of the
    participation and what service(s) will be provided from every
    service provider organization that has agreed to participate in the
    project;

-   official documentation that all participating organizations have
    been providing relevant services for a minimum of 2 years before the
    date of the application in the area(s) in which the services are to
    be provided; and

-   official documentation that all participating service provider
    organizations comply with all applicable local (city, county) and
    State/tribal requirements for licensing, accreditation, and
    certification or official documentation from the appropriate agency
    of the applicable State/tribal, county, or other governmental unit
    that licensing, accreditation, and certification requirements do not
    exist.

If the GPO does not receive this documentation within the time
specified, the application will be removed from consideration for an
award and the funds will be provided to another applicant meeting these
requirements.

# 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 by calling SAMHSA's 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](http://www.samhsa.gov/). Click on "grant
opportunities."

Additional materials available on this web site include:

-   a technical assistance manual for potential applicants;

-   standard terms and conditions for SAMHSA grants;

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

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

## 2. CONTENT AND FORM OF APPLICATION SUBMISSION {#content-and-form-of-application-submission .unnumbered}

**2.1 Required Documents**

SAMHSA application kits include the following documents:

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

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

You must use the above documents in completing your application.

**2.2 Required Application Components**

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

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

-   **Abstract** -- Your total abstract should not be longer than 35
    lines. In the first five lines or less of your abstract, write a
    summary of your project that can be used, if your project is funded,
    in publications, reporting to Congress, or press releases. Indicate
    the total number of clients to be treated in each year of the grant,
    and which population (juveniles or young adult offenders) will be
    served.

-   **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.

-   **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.
    More detailed instructions for completing each section of the
    Project Narrative are provided in "Section V -- Application Review
    Information" of this document.

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

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

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-   *Section F* **-** Budget Justification, Existing Resources, Other
    Support. You must provide a narrative justification of the items
    included in your proposed budget, as well as a description of
    existing resources and other support you expect to receive for the
    proposed project. Be sure to show that no more than 15% of the total
    grant award will be used for certain activities inside juvenile or
    adult institutional correctional settings and for systems linkages
    activities, respectively, and that no more than 20% of the total
    grant award will be used for data collection and evaluation,
    including GPRA.

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

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

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

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

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

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

####### Appendices 1 through 5 -- Use only the appendices listed below. Do not use more than 30 pages for Appendices 1, 4 and 5. There are no page limitations for Appendices 2 and 3. Do not use appendices to extend or replace any of the sections of the Project Narrative. Reviewers will not consider them if you do.

-   *Appendix 1*: Evidence of Experience and Credentials. Identification
    of at least one experienced, licensed service provider organization.
    A list of all direct service provider organizations that have agreed
    to participate in the proposed project, including the applicant
    agency, if it is a treatment service provider organization. The
    Statement of Assurance (provided in Appendix C of this announcement)
    signed by the authorized representative of the applicant
    organization identified on the face page of the application, that
    assures SAMHSA that all listed providers meet the 2-year experience
    requirement, are appropriately licensed, accredited, and certified,
    and that if the application is within the funding range for an
    award, the applicant will send the GPO the required documentation
    within the specified time.

-   *Appendix 2*: Letters of Support and Commitment from stakeholders
    and project participants. (As indicated in Section I-2.3,
    Expectations, Required Letters of Support from Proposed Key
    Stakeholders.)

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

-   *Appendix 4:* Sample Consent Forms

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

-   **Assurances** -- Non-Construction Programs. Use Standard Form 424B
    found in PHS 5161-1. Because grantees in the YORP program will use
    grant funds to provide direct substance abuse services, applicants
    are 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 NCADI.

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-   **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.

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

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

footnotes will not be considered in determining compliance.)

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

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

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

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

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

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

-   The 30-page limit for Appendices 1, 4 and 5 cannot be exceeded.

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 with one column per page.

-   Pages should not have printing on both sides.

-   Please use black ink and 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.

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

2.4 SAMHSA Confidentiality and Participant Protection Requirements and
Protection of Human Subjects Regulations

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

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

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

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

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

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

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

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

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

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

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

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

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

3.  [Absence of Coercion]{.underline}

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

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

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

4.  [Data Collection]{.underline}

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

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

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

5.  [Privacy and Confidentiality:]{.underline}

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

-   Describe:

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-   How you will use data collection instruments.

-   Where data will be stored.

-   Who will or will not have access to information.

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

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

6.  [Adequate Consent Procedures:]{.underline}

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

-   State:

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-   Whether or not their participation is voluntary.

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

-   Possible risks from participation in the project.

-   Plans to protect clients from these risks.

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

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

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

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

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

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

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

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

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

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

Depending on the evaluation and data collection requirements of the
particular funding opportunity for which you are applying or the
evaluation design you propose in your application, you may have to
comply with the Protection of Human Subjects Regulations (45 CFR 46).

Applicants must be aware that even if the Protection of Human Subjects
Regulations do not apply to all projects funded under a given funding
opportunity, 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 the IRB approval has been
received prior to enrolling any clients in the proposed project.

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

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

The deadline for submission of applications for YORP is June 15,
2004**.**

Your application must be received by the application deadline.
Applications received after this date must have a proof-of-mailing date
from the carrier dated at least 1 week prior to the due date. Private
metered postmarks are not acceptable as proof of timely mailing.

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

Applications not received by the application deadline or not postmarked
by a week prior to the application deadline will be screened out and
will not be reviewed.

## 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 Indian tribal government.

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

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

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

Substance Abuse and Mental Health Services Administration

Office of Program Services, Review Branch

5600 Fishers Lane, Room 17-89

Rockville, Maryland, 20857

ATTN: SPOC -- Funding Announcement No. TI 04-002

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

This 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 5, "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:

> Substance Abuse and Mental Health Services Administration
>
> Office of Program Services, Review Branch
>
> 5600 Fishers Lane, Room 17-89
>
> Rockville, Maryland, 20857
>
> ATTN: SSA -- Funding Announcement No. TI 04-002

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:

-   Institutions of Higher Education: OMB Circular A-21

-   State and Local Governments: OMB Circular A-87

-   Nonprofit Organizations: OMB Circular A-122

-   Appendix E Hospitals: 45 CFR Part 74

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

-   No more than 15% of the total grant award may be used for systems
    linkages activities.

-   No more than 15% of the total grant award may be used for activities
    inside juvenile or adult correctional facilities.

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

YORP 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.

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-   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), except as noted
    in the **Expectations Section** of this RFA.

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

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

-   Pay for housing other than residential substance abuse treatment.

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

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

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

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

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-   Provide any services in a program implementing stated "harm
    reduction" philosophy or practice.

## 6. OTHER SUBMISSION REQUIREMENTS {#other-submission-requirements .unnumbered}

**6.1 Where to Send Applications**

Send applications to the following address:

Substance Abuse and Mental Health Services Administration

Office of Program Services, Review Branch

5600 Fishers Lane, Room 17-89

Rockville, Maryland, 20857

Be sure to include "YORP, TI 04-002" in item number 10 on the face page
of the application. If you require a phone number for delivery, you may
use (301) 443-4266.

**6.2 How to Send Applications**

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

You must use a recognized commercial or governmental carrier. **Hand
carried applications will not be accepted. Faxed or e-mailed
applications will not be accepted.**

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

## 1. EVALUATION CRITERIA {#evaluation-criteria .unnumbered}

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

-   In developing the Project Narrative section of your application, use
    these instructions, 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.

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

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

-   The number of points after each heading is the maximum number of
    points a review committee may assign to that section of your Project
    Narrative. Except as provided in Section B below, 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: Understanding the Problem, Justification of Need, and
    Project Description**

    **20 points**

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-   For the proposed project, discuss offender reentry, showing an
    understanding of the substance abuse relationship to crime, the
    obstacles to effective reentry, and solutions to the obstacles.
    Review recent literature and other information that demonstrates a
    thorough understanding of the substance abuse issues in the proposed
    target population.

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-   Describe the problem the project will address in terms of unmet
    treatment need for the target population, using local data to the
    extent possible.

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-   Clearly indicate which one of the target populations (sentenced
    juveniles or young adults) are to be served, and provide the
    rationale for selecting the target population.

-   Describe the target population in terms of demographics, and
    demonstrate that the target population meets the qualifications
    listed in Section I-2.1, Target Population in this RFA.

-   Describe the geographic area that will have access to expanded or
    enhanced services and provide recent population numbers for the
    area.

-   Fully describe existing services, including the number and type of
    current treatment services/slots/beds available and the number of
    people [currently]{.underline} being served.

    **Section B: Project Plan**

    **35 points**

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-   Describe the proposed project for meeting the needs you described
    above in Section A: Understanding the Problem, Justification of
    Need, and Project Description, making sure that the design is
    consistent with Section I-2, Expectations, in this RFA.

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-   Demonstrate an understanding of key stakeholder partnerships needed
    to plan, develop, and provide substance abuse treatment and related
    reentry services. Applicants must show evidence of stakeholder
    partnership by including Letters of Support and Commitment, signed
    by the head of the agency/organization, from key partners critical
    to the success of the proposed project in **Appendix 2** of the
    application. (Note: For purposes of rating the understanding of key
    stakeholder partnerships needed, and the presence of signed Letters
    of Support and Commitment from key partners in Appendix 2, reviewers
    will be instructed to use 9 of the total 35 points allowed for
    Section B for this single critical requirement).

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-   Describe the systems linkages component of the project design, and
    define the role and responsibility of each stakeholder. Identify any
    cash or in-kind contributions that will be made to the project by
    the applicant or other partnering organizations.

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-   By grant year, fully describe the number of additional people to be
    served each year with the grant funds, and the four-year total.
    State the types of services you will provide these individuals.

-   Explain the time frame for year one planning of systems coordination
    and development; indicate the proposed number of months of planning
    before actual services provision. (Make sure to comply with the RFA
    requirement that only up to six months of year one may be used for
    this purpose.)

-   Explain how you propose to provide services to the target population
    in the correctional or detention facility and which services will be
    provided there. Discuss how these services are consistent with the
    limitations on funding within correctional settings specified under
    Section I-2, Expectations**,** in this RFA.

-   Explain how you propose to provide services to the target population
    after return to the community, which treatment and related reentry
    services will be provided, who will provide these services, and how
    the stakeholders' partnership will coordinate the services and
    supervision.

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-   Demonstrate how the proposed project will have a significant impact
    on the described need during the four years of funding. Demonstrate
    that the number of persons to be served and the anticipated outcomes
    of service represent an effective use of funds requested.

-   Discuss how the project will address age, race/ethnic, cultural,
    language, sexual orientation, disability, literacy, and gender
    issues relative to the target population.

**Section C: Evaluation/GPRA**

**15 points**

-   Describe plans to comply with GPRA requirements, including the
    collection of CSAT's GPRA Core Client Outcomes, and tracking and
    follow-up procedures to meet the 80% follow-up standard.

-   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 GPRA
    requirements.

-   Discuss instruments to be used, including their reliability,
    validity, and cultural appropriateness. Document the appropriateness
    of the proposed approaches to gathering quantitative and qualitative
    data for the target population. Address not only traditional
    reliability and validity but also sensitivity to age, gender,
    language, sexual orientation, culture, literacy, disability and
    racial/ethnic characteristics of the target population.

-   Provide examples of forms that will be signed by clients that permit
    the appropriate exchange of treatment and other information between
    the named agencies (i.e., confidentiality waiver forms). Further,
    provide any data sharing agreements that the key stakeholders will
    use. Place all of this documentation in **Appendices 3 (Data
    Collection Instruments/Interview Protocols) and 4** **(Sample
    Consent Forms)** of your application.

    **Section D: Project Management**

    **30 points**

####### [Implementation and Operation Plan]{.underline} {#implementation-and-operation-plan .unnumbered}

-   Present a plan for the implementation and operation of the project
    to achieve the intended results. Include a schedule and timeline of
    activities and products, target dates and person(s) responsible; and
    how multi-agency and/or system arrangements will be implemented and
    managed.

-   Describe how the applicant will provide effective management,
    fiscal, and administrative monitoring and oversight of the grant
    including the treatment providers and other contractors (including
    evaluators).

-   Demonstrate that the project will be fully operational within six
    months and providing treatment and related reentry services to the
    target population within the first year.

######## [Organization Capability]{.underline} {#organization-capability .unnumbered}

-   Describe your experience with the implementation of multi-agency
    systems partnerships and multi-system programs. Discuss how this
    experience will contribute to the success of your project.

-   If subcontractors are involved, describe their organizational
    capabilities, and what they will contribute to the project.

######## [Staff and Staffing Plans]{.underline} {#staff-and-staffing-plans .unnumbered}

-   Provide a staffing plan, showing an organizational chart. Include
    staff, consultants, subcontractors, and collaborating agencies.

-   Provide the level of effort and qualifications of the Project
    Director and other key personnel.

-   Provide evidence that the proposed staff have requisite training,
    experience, and cultural sensitivity to provide services to the
    target population. Show evidence of the appropriateness of the
    proposed staff to the language, age, gender, sexual orientation,
    disability, literacy, and ethnic, racial, and cultural factors of
    the target population.

######## [Equipment and Facilities]{.underline} {#equipment-and-facilities .unnumbered}

########  {#section-4 .unnumbered}

-   Describe facilities and equipment available to the project, and any
    equipment that will have to be procured for the project. Equipment
    and facilities must be shown to be adequate for the proposed project
    activities; accessible to the target population; and American
    Disabilities Act compliant.

######## [Budget, Sustainability and Other Support]{.underline} {#budget-sustainability-and-other-support .unnumbered}

-   Provide a per-person or unit cost of the project to be implemented,
    based on the applicant's actual costs and projected costs over the
    life of the project. Applicants must state whether or not the per
    person costs are within the following reasonable ranges by treatment
    modality. Applicants must also discuss the reasonableness of the per
    person costs. If proposed costs exceed reasonable ranges, a detailed
    justification must be provided.

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-   Program costs. The following are considered reasonable ranges by
    treatment modality:

> Residential: \$3,000 to \$10,000
>
> Outpatient (Non-Methadone): \$1,000 to \$5,000
>
> Outpatient (Methadone): \$1,500 to \$8,000
>
> Intensive Outpatient: \$1,500 to \$7,500
>
> Screen/Brief Intervention/Brief Treatment/Outreach/Pretreatment
>
> Services: \$200 to \$1,200
>
> SAMHSA/CSAT computes per person costs as follows. The total support
> requested for the life of the project is multiplied by .8 (.2 will be
> the allowance for GPRA reporting requirements). The resulting amount
> is then divided by the number of persons the applicant proposes to
> serve over the life of the project.

The outreach and pretreatment services cost band only applies to
outreach and pretreatment programs that do not also offer treatment
services but operate within a network of substance abuse treatment
facilities. Treatment programs that add outreach and pretreatment
services to a treatment modality or modalities are expected to fall
within the cost band for that treatment modality.

-   Provide a plan to secure resources or obtain support to continue
    activities funded by this program at the end of the period of
    Federal funding.

    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.

In submitting the line item budgets for each year of the proposed grant,
the applicant is to use annualized budgets that are the same each year.
This means that the amount requested in the first year (for example,
\$300,000 in total costs) should be the amount requested for each of the
remaining three years (\$300,000). Applicants should request a full
year's funding in the first year although there is recognition that most
projects will not begin operating and serving clients immediately.

######## Applicants may build in cost-of-living increases for the second, third, and fourth years, but the costs must come from within the other budget lines. For example, an applicant may increase salaries by 3% in accordance with cost of living increases, but the total amount of the budget request must remain at the year one level (using the above indicated example, \$300,000 for each year). {#applicants-may-build-in-cost-of-living-increases-for-the-second-third-and-fourth-years-but-the-costs-must-come-from-within-the-other-budget-lines.-for-example-an-applicant-may-increase-salaries-by-3-in-accordance-with-cost-of-living-increases-but-the-total-amount-of-the-budget-request-must-remain-at-the-year-one-level-using-the-above-indicated-example-300000-for-each-year. .unnumbered}

##  {#section-5 .unnumbered}

## 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 appropriate
    National Advisory Council;

-   availability of funds;

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

-   after applying the aforementioned criteria, the following method for
    breaking ties: When funds are not available to fund all applications
    with identical scores, SAMHSA will make award decisions based on the
    application(s) that received the greatest number of points by peer
    reviewers on the evaluation criterion in Section V-1 with the
    highest number of possible points (Section B: Project Plan -- 35
    points). Should a tie still exist, the evaluation criterion with the
    next highest possible point value will be used, continuing
    sequentially to the evaluation criterion with the lowest possible
    point value, should that be necessary to break all ties. If an
    evaluation criterion to be used for this purpose has the same number
    of possible points as another evaluation criterion, the criterion
    listed first in Section V-1 will be used first.

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

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

#######  {#section-6 .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.

## 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS  {#administrative-and-national-policy-requirements .unnumbered}

[]{.mark}

-   You must comply with all terms and conditions of the grant award.
    SAMHSA's standard terms and conditions are available on the SAMHSA
    web site
    [www.samhsa.gov/grants/2004/useful_info.asp](http://www.samhsa.gov/grants/2004/useful_info.asp).

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-   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 human subjects
        requirements;

    -   requirements relating to additional data collection and
        reporting;

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

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

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

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

#######  {#section-7 .unnumbered}

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

**3.1 Progress and Financial Reports**

-   Grantees must provide semi-annual (6 months) and final progress
    reports. The final report must summarize information from the
    semi-annual reports, describe the accomplishments of the project,
    and describe next steps for implementing plans developed during the
    grant period.

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-   Grantees must provide annual and final financial status reports.
    These reports may be included as separate sections of semi-annual
    and final progress reports or can be separate documents. Because
    SAMHSA is extremely interested in ensuring that treatment services
    can be sustained, your financial reports should explain plans to
    ensure the sustainability (see Glossary) of efforts initiated under
    this grant. Initial plans for sustainability should be described in
    year 01. In each subsequent year, you should describe the status of
    your project, as well as the successes achieved and obstacles
    encountered in that year.

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

3.2 Government Performance and Results Act (GPRA)

The Government Performance and Results Act (GPRA) mandates
accountability and performance-based management by Federal agencies. To
meet the GPRA requirements, SAMHSA must collect performance data (i.e.,
"GPRA data") from grantees. These requirements are specified in Section
I-2.7, Expectations, Data and Performance Measurement, in this RFA.

**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 (301-443-8596) 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.

### 

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

For questions on program issues, contact:

Kenneth W. Robertson

Team Leader

Systems Improvement Branch, Division of Services Improvement

CSAT/SAMHSA

Rockwall II/Suite 740

5600 Fishers Lane

Rockville, MD 20857

\(301\) 443-7612

E-Mail: kroberts@samhsa.gov

For questions on grants management issues, contact:

> Kathleen Sample
>
> SAMHSA, Division of Grants Management
>
> 5600 Fishers Lane
>
> Rockwall II 6^th^ Floor
>
> Rockville, MD 20857
>
> \(301\) 443-9667
>
> E-Mail: <ksample@samhsa.gov>

# Appendix A - Checklist for Formatting Requirements and Screenout Criteria for SAMHSA Grant Applications {#appendix-a---checklist-for-formatting-requirements-and-screenout-criteria-for-samhsa-grant-applications .unnumbered}

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

-   Use the PHS 5161-1 application.

-   Applications must be received by the application deadline.
    Applications received after this date must have a proof of mailing
    date from the carrier dated at least 1 week prior to the due date.
    Private metered postmarks are not acceptable as proof of timely
    mailing. Applications not received by the application deadline or
    not postmarked at least 1 week prior to the application deadline
    will not be reviewed.

-   Information provided must be sufficient for review.

-   Text must be legible.

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-   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.

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

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

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

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

-   The page limit for Appendices stated in the specific funding
    announcement cannot be exceeded.

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

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

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

-   Abstract

-   Table of Contents

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

-   Project Narrative and Supporting Documentation

-   Appendices

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

-   Certifications (a form within PHS 5161-1)

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

-   Checklist (a form in PHS 5161-1)

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-   Applications should comply with the following requirements:

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-   Provisions relating to confidentiality, participant protection and
    the protection of human subjects specified in Section IV-2.4 of the
    specific funding announcement.

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

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

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-   Pages should be typed single-spaced with one column per page.

-   Pages should not have printing on both sides.

-   Please use black ink and 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.

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

# Appendix B - Glossary {#appendix-b---glossary .unnumbered}

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

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

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

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

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

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

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

**[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 - Statement Of Assurance {#appendix-c---statement-of-assurance .unnumbered}

As the authorized representative of the applicant organization, I assure
SAMHSA that if *{insert name of organization}* application is within the
funding range for a grant award, the organization will provide the
SAMHSA Government Project Officer (GPO) with the following documents. I
understand that if this documentation is not received by the GPO within
the specified timeframe, the application will be removed from
consideration for an award and the funds will be provided to another
applicant meeting these requirements.

-   a letter of commitment that specifies the nature of the
    participation and what service(s) will be provided from every
    service provider organization, listed in Appendix 1 of the
    application, that has agreed to participate in the project;

-   official documentation that all service provider organizations
    participating in the project have been providing relevant services
    for a minimum of 2 years prior to the date of the application in the
    area(s) in which services are to be provided. Official documents
    must definitively establish that the organization has provided
    relevant services for the last 2 years; and

-   official documentation that all participating service provider
    organizations are in compliance with all local (city, county) and
    State/tribal requirements for licensing, accreditation, and
    certification or official documentation from the appropriate agency
    of the applicable State/tribal, county, or other governmental unit
    that licensing, accreditation, and certification requirements do not
    exist. (Official documentation is a copy of each service provider
    organization's license, accreditation, and certification.
    Documentation of accreditation will not be accepted in lieu of an
    organization's license. A statement by, or letter from, the
    applicant organization or from a provider organization attesting to
    compliance with licensing, accreditation and certification or that
    no licensing, accreditation, certification requirements exist [does
    not]{.underline} constitute adequate documentation.)

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

Signature of Authorized Representative Date

###