62324 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Substance Abuse and Mental Health 

Services Administration 

Notice of Publication of SAMHSA’s 

Revised Standard Grant 

Announcements 

Authority: Sections 509, 516, and 520A of 

the Public Health Service Act. 

AGENCY: Substance Abuse and Mental 

Health Services Administration, HHS. 

ACTION: Notice of publication of 

samhsa’s revised standard grant 

announcements. 

SUMMARY: This is a publication of the 

Substance Abuse and Mental Health 

Services Administration’s revised 

standard grant announcements for 

Services Grants, Infrastructure Grants, 

Best Practices Planning and 

Implementation Grants, and Service to 

Science Grants. These announcements 

were previously published on March 8, 

2004. The purpose of these revisions is 

to make minor technical changes to 

enhance the readability and use of the 

standard grant announcements, and to 

make the following more significant 

changes: (1) The address and telephone 

numbers of SAMHSA’s offices have 

changed, since the agency recently 

moved into a new building in Rockville, 

Maryland. Grant applications and 

correspondence from the State Single 

Points of Contact (SPOCs) and Single 

State Agencies (SSAs) should be sent to 

this new address, which can be found 

in Section IV, Intergovernmental Review 

(E.O. 12372) Requirements, and Other 

Submission Requirements. Updated 

agency contact information for grants 

management issues can be found in 

Section VII; (2) Section IV, Submission 

Dates and Times, has been revised to 

identify specific carriers for shipment of 

applications and to change the 

requirements for proof of timely 

submission of applications; (3) in the 

Services Grants Announcement, 

Appendix 1 is required, indicating that 

applicants must meet certain 

experience, licensing, accreditation, and 

certification requirements, but 

applications that fail to provide this 

information will no longer be screened 

out. This change can be found in 

Section III, Evidence of Experience and 

Credentials; (4) a change in Section IV, 

Content and Form of Application 

Submission, indicates that applications 

will not be screened out if Appendices 

exceed the page limitation, and that 

reviewers will not consider Appendices 

that are not required; (5) an additional 

requirement can be found in Section IV, 

Funding Limitations/Restrictions, 

indicating that SAMHSA will not accept 

a ‘‘research’’ indirect cost rate and that 

grantees must use the ‘‘other sponsored 

program rate’’ or the lowest rate 

available. 

DATES: Use of these revised standard 

grant announcements will be effective 

October 25, 2004. The standard grant 

announcements must be used in 

conjunction with separate Notices of 

Funding Availability (NOFAs) that will 

provide application due dates and other 

key dates for specific SAMHSA grant 

funding opportunities. 

ADDRESSES: Questions about SAMHSA’s 

standard grant announcements may be 

directed to Cathy Friedman, M.A., 

SAMHSA, Office of Policy, Planning 

and Budget, 1 Choke Cherry Road, 

Room 8–1097, Rockville, Maryland, 

20857. Fax: (240–276–2220). E-mail: 

cathy.friedman@samhsa.hhs.gov. 

FOR FURTHER INFORMATION CONTACT: 

Cathy Friedman, M.A., SAMHSA, Office 

of Policy, Planning and Budget, 1 Choke 

Cherry Road, Room 8–1097, Rockville, 

Maryland, 20857. Fax: (240–276–2220). 

E-mail: 

cathy.friedman@samhsa.hhs.gov. 

Phone: (240) 276–2316. 

SUPPLEMENTARY INFORMATION: Starting in 

FY 2004, SAMHSA changed its 

approach to announcing and soliciting 

applications for its discretionary grants. 

SAMHSA publishes four standard grant 

announcements that describe the 

general program design and provide 

application instructions for four types of 

grants—Services Grants, Infrastructure 

Grants, Best Practices Planning and 

Implementation Grants, and Service-toScience Grants. These standard grant 

announcements are posted on 

SAMHSA’s web page and are available 

from SAMHSA’s clearinghouses on an 

ongoing basis. The standard 

announcements are used in conjunction 

with brief Notices of Funding 

Availability (NOFAs) that announce the 

availability of funds for specific grant 

funding opportunities within each of 

the standard grant programs (e.g., 

Homeless Treatment grants, Targeted 

Capacity Expansion grants, Youth 

Violence Prevention grants, etc.). 

The Notices of Funding Availability 

(NOFAs) announcing the availability of 

funds for specific grant funding 

opportunities are published separately 

in the Federal Register, and are posted 

on the Federal grants Web site (http:// 

www.grants.gov) and on the SAMHSA 

Web site (http://www.samhsa.gov). The 

NOFAs: 

• Identify any specific target 

population or issue for the specific grant 

funding opportunity, 

• Identify which of the four standard 

announcements applicants must use to 

prepare their applications, 

• Specify total funding available for 

the first year of the grants and the 

expected size and number of awards, 

• Specify the application deadline, 

• Note any specific program 

requirements for each funding 

opportunity, and 

• Include any limitations or 

exceptions to the general provisions in 

the standard announcement. 

Applicants need to have both the 

NOFA and the appropriate standard 

announcement to prepare their 

applications. Both documents will be 

provided, along with application 

materials, in the application kits 

available from SAMHSA’s 

clearinghouses as well as on SAMHSA’s 

web site. SAMHSA’s clearinghouse for 

the Center for Mental Health Services 

(CMHS) is the National Mental Health 

Information Center, which can be 

reached at 1–800–789–2647. The 

clearinghouse for the Center for 

Substance Abuse Treatment (CSAT) and 

Center for Substance Abuse Prevention 

(CSAP) is the National Clearinghouse 

for Alcohol and Drug Information 

(NCADI), which can be reached at 

1–800–729–6686. 

The four standard grant 

announcements are used for many of 

SAMHSA’s grant funding opportunities. 

However, there are some funding 

opportunities that do not fit the 

standard announcements. In those 

instances, separate stand-alone grant 

announcements will be published and 

provided to applicants in the Federal 

Register, on the SAMHSA Web site, on 

the Federal grants Web site, and through 

SAMHSA’s clearinghouses. 

Services Grants—SVC 05 PA (Initial 

Announcement) 

Catalogue of Federal Domestic 

Assistance (CFDA) No.: 93.243 (unless 

otherwise specified in a NOFA in the 

Federal Register and on http:// 

www.grants.gov) 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62325 

KEY DATES

Application Deadline ........................................... This Program Announcement provides general instructions and guidelines for multiple funding 

opportunities. Application deadlines for specific funding opportunities will be published in Notices of Funding Availability (NOFAs) in the Federal Register and on http://www.grants.gov. 

Intergovernmental Review (E.O. 12372) ............ Letters from State Single Point of Contact (SPOC) are due no later than 60 days after application deadline. 

Public Health System Impact Statement 

(PHSIS)/Single State Agency Coordination.

Applicants must send the PHSIS to appropriate State and local health agencies by application 

deadline. Comments from Single State Agency are due no later than 60 days after application deadline. 

Table of Contents 

I. Funding Opportunity Description 

1. Introduction 

2. Expectations 

II. Award Information 

1. Award Amount 

2. Funding Mechanism 

III. Eligibility Information 

1. Eligible Applicants 

2. Cost Sharing 

3. Other 

IV. Application and Submission Information 

1. Address to Request Application Package 

2. Content and Form of Application 

Submission 

3. Submission Dates and Times 

4. Intergovernmental Review (E.O. 12372) 

Requirements 

5. Funding Limitations/Restrictions 

6. Other Submission Requirements 

V. Application Review Information 

1. Evaluation Criteria 

2. Review and Selection Process 

VI. Award Administration Information 

1. Award Notices 

2. Administrative and National Policy 

Requirements 

3. Reporting Requirements 

VII. Agency Contacts 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria for 

SAMHSA 

Grant Applications 

Appendix B—Glossary 

Appendix C—National Registry of Effective 

Programs and Practices 

Appendix D—Center for Mental Health 

Services Evidence-Based Practice 

Toolkits 

Appendix E—Effective Substance Abuse 

Treatment Practices 

Appendix F—Statement Of Assurance 

Appendix G—Logic Model Resources 

Appendix H—Sample Budget and 

Justification 

I. Funding Opportunity Description 

1. Introduction 

The Substance Abuse and Mental 

Health Services Administration 

(SAMHSA) announces its intent to 

solicit applications for Services Grants. 

This program announcement must be 

considered in conjunction with a full 

Notice of Funding Availability (NOFA), 

which specifies the grant program’s 

purpose, target population, and other 

requirements of the program. These 

grants will expand and strengthen 

effective, culturally appropriate 

substance abuse and mental health 

services at the State and local levels. 

The services implemented through 

SAMHSA’s Services Grants must 

incorporate the best objective 

information available regarding 

effectiveness and acceptability. In 

general, the services implemented 

through SAMHSA’s Services Grants will 

have strong evidence of effectiveness. 

However, because the evidence base is 

limited in some areas, SAMHSA may 

fund some services for which the 

evidence base, while limited, is sound. 

SAMHSA expects that the services 

funded through these grants will be 

sustained by the grantee beyond the 

term of the grant. 

SAMHSA also funds grants under 

three other standard grant 

announcements: 

fi Infrastructure Grants support 

identification and implementation of 

systems changes but are not designed to 

fund services. 

fi Best Practices Planning and 

Implementation Grants help 

communities and providers identify 

practices to effectively meet local needs, 

develop strategic plans for 

implementing/adapting those practices 

and pilot-test practices prior to fullscale implementation. 

fi Service to Science Grants 

document and evaluate innovative 

practices that address critical substance 

abuse and mental health service gaps 

but that have not yet been formally 

evaluated. 

This announcement describes the 

general program design and provides 

application instructions for all 

SAMHSA Services Grants. The 

availability of funds for specific 

Services Grants will be announced in 

supplementary Notices of Funding 

Availability (NOFAs) in the Federal 

Register and at http://www.grants.gov—

the Federal grant announcement web 

page. 

SAMHSA’s Services Grants are 

authorized under Section 509, 516 and/ 

or 520A of the Public Health Service 

Act, unless otherwise specified in a 

NOFA in the Federal Register and on 

http://www.grants.gov. 

Typically, funding for Services Grants 

will be targeted to specific populations 

and/or issue areas, which will be 

specified in the NOFAs. The NOFAs 

will also: 

fi Specify total funding available for 

the first year of the grants and the 

expected size and number of awards; 

fi Provide the application deadline; 

fi Note any specific program 

requirements for each funding 

opportunity; and 

fi Include any limitations or 

exceptions to the general provisions in 

this announcement (e.g., eligibility, 

allowable activities). 

It is, therefore, critical that you 

consult the NOFA as well as this 

announcement in developing your grant 

application. 

2. Expectations 

The Services Grant program is 

designed to address gaps in substance 

abuse and mental health services and/or 

to increase the ability of States, units of 

local government, Indian tribes, tribal 

organizations and governments, and 

community- and faith-based 

organizations to help specific 

populations or geographic areas with 

serious, emerging mental health and 

substance abuse problems. SAMHSA 

intends that its Services Grants result in 

the delivery of services as soon as 

possible and no later than 4 months 

after award. SAMHSA’s Services Grants 

may include substance abuse 

prevention, substance abuse treatment 

and/or mental health services. 

Throughout this announcement, 

SAMHSA will use the term ‘‘services’’ to 

refer to all three types of services. The 

NOFA will provide guidance on the 

particular type of service to be provided 

through each funding opportunity. 

Applicants must refer to the NOFA for 

required activities and exceptions to 

allowable activities. 

2.1 Documenting the Evidence-Base 

for Services to be Implemented 

The services implemented through 

SAMHSA’s Services Grants must 

incorporate the best objective 

information available regarding the 

effectiveness and acceptability of the 

services to be implemented. In general, 

the services implemented through 

62326 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

SAMHSA’s Services Grants will have 

strong evidence of effectiveness. 

However, because the evidence base is 

limited in some areas, SAMHSA may 

fund some services for which the 

evidence of effectiveness is based on 

formal consensus among recognized 

experts in the field and/or evaluation 

studies that have not been published in 

the peer reviewed literature. 

Applicants must document in their 

applications that the services/practices 

they propose to implement are 

evidence-based services/practices. In 

addition, applicants must justify use of 

the proposed services/practices for the 

target population along with any 

adaptations or modifications necessary 

to meet the unique needs of the target 

population or otherwise increase the 

likelihood of achieving positive 

outcomes. Further guidance on each of 

these requirements is provided below. 

Documenting the Evidence-Based 

Practice/Service 

SAMHSA has already determined that 

certain services/practices are solidly 

evidence-based services/practices and 

encourages applicants to select services/ 

practices from the following sources 

(though this is not required): 

fi SAMHSA’s National Registry of 

Effective Programs and Practices 

(NREPP) (see Appendix C). 

fi Center for Mental Health Services 

(CMHS) Evidence Based Practice Tool 

Kits (see Appendix D). 

fi List of Effective Substance Abuse 

Treatment Practices (see Appendix E). 

fi Additional practices identified in 

the NOFA for a specific funding 

opportunity, if applicable. 

Applicants proposing services/ 

practices that are not included in the 

above-referenced sources must provide 

a narrative justification that summarizes 

the evidence for effectiveness and 

acceptability of the proposed service/ 

practice. The preferred evidence of 

effectiveness and acceptability will 

include the findings from clinical trials, 

efficacy and/or effectiveness studies 

published in the peer-reviewed 

literature. 

In areas where little or no research 

has been published in the peer-reviewed 

scientific literature, the applicant may 

present evidence involving studies that 

have not been published in the peerreviewed research literature and/or 

documents describing formal consensus 

among recognized experts. If consensus 

documents are presented, they must 

describe consensus among multiple 

experts whose work is recognized and 

respected by others in the field. Local 

recognition of an individual as a 

respected or influential person at the 

community level is not considered a 

‘‘recognized expert’’ for this purpose. 

In presenting evidence in support of 

the proposed service/practice, 

applicants must show that the evidence 

presented is the best objective 

information available. 

Justifying Selection of the Service/ 

Practice for the Target Population 

Regardless of the strength of the 

evidence-base for the service/practice, 

all applicants must show that the 

proposed service/practice is appropriate 

for the proposed target population. 

Ideally, this evidence will include 

research findings on effectiveness and 

acceptability specific to the proposed 

target population. However, if such 

evidence is not available, the applicant 

should provide a justification for using 

the proposed service/practice with the 

target population. This justification 

might involve, for example, a 

description of adaptations to the 

proposed service/practice based on 

other research involving the target 

population. 

Justifying Adaptations/Modifications of 

the Proposed Service/Practice 

SAMHSA has found that a high 

degree of faithfulness or ‘‘fidelity’’ (see 

Glossary) to the original model for an 

evidence-based service/practice 

increases the likelihood that positive 

outcomes will be achieved when the 

model is used by others. Therefore, 

SAMHSA encourages fidelity to the 

original evidence-based service/practice 

to be implemented. However, SAMHSA 

recognizes that adaptations or 

modifications to the original model may 

be necessary for a variety of reasons: 

• To allow implementers to use 

resources efficiently, 

• To adjust for specific needs of the 

client population, 

• To address unique characteristics of 

the local community where the service/ 

practice will be implemented. 

All applicants must describe and 

justify any adaptations or modifications 

to the proposed service/practice that 

will be made. 

2.2 Services Delivery 

SAMHSA’s Services Grant funds must 

be used primarily to support direct 

services, including the following types 

of activities: 

fi Conducting outreach and preservice strategies to expand access to 

treatment or prevention services to 

underserved populations. If you propose 

to provide only outreach and pre-service 

strategies, you must show that your 

organization is an effective and integral 

part of a network of service providers. 

fi Purchasing or providing direct 

treatment (including screening, 

assessment, and care management) or 

prevention services for populations at 

risk. Treatment must be provided in 

outpatient, day treatment or intensive 

outpatient, or residential programs. 

fi Purchasing or providing ‘‘wraparound’’ services (see Glossary) (e.g., 

child care, vocational, educational and 

transportation services) designed to 

improve access and retention. 

fi Collecting data using specified 

tools and standards to measure and 

monitor treatment or prevention 

services and costs. (No more than 20% 

of the total grant award may be used for 

data collection and evaluation.) 

2.3 Infrastructure Development 

(Maximum 15% of Total Grant Award) 

Although SAMHSA expects that its 

Services Grant funds will be used 

primarily for direct services, SAMHSA 

recognizes that infrastructure changes 

may be needed to support service 

delivery expansion in some instances. 

You may use up to 15% of the total 

Services Grant award for the following 

types of infrastructure development, if 

necessary to support the direct service 

expansion of the grant project. 

fi Building partnerships to ensure 

the success of the project and entering 

into service delivery and other 

agreements. 

fi Developing or changing the 

infrastructure to expand treatment or 

prevention services. 

fi Training to assist treatment or 

prevention providers and community 

support systems to identify and address 

mental health or substance abuse issues. 

2.4 Data and Performance 

Measurement 

The Government Performance and 

Results Act of 1993 (Pub. L.103–62, or 

‘‘GPRA’’) requires all Federal agencies to 

set program performance targets and 

report annually on the degree to which 

the previous year’s targets were met. 

Agencies are expected to evaluate 

their programs regularly and to use 

results of these evaluations to explain 

their successes and failures and justify 

requests for funding. 

To meet the GPRA requirements, 

SAMHSA must collect performance data 

(i.e., ‘‘GPRA data’’) from grantees. 

Grantees are required to report these 

GPRA data to SAMHSA on a timely 

basis. 

Specifically, grantees will be required 

to provide data on a set of required 

measures, as specified in the NOFA. 

The data collection tools to be used for 

reporting the required data will be 

provided in the application kits 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62327 

distributed by SAMHSA’s 

clearinghouses and posted on 

SAMHSA’s website along with each 

NOFA. In your application, you must 

demonstrate your ability to collect and 

report on these measures, and you may 

be required to provide some baseline 

data. 

The terms and conditions of the grant 

award also will specify the data to be 

submitted and the schedule for 

submission. Grantees will be required to 

adhere to these terms and conditions of 

award. 

Applicants should be aware that 

SAMHSA is working to develop a set of 

required core performance measures for 

each of SAMHSA’s standard grants (i.e., 

Services Grants, Infrastructure Grants, 

Best Practices Planning and 

Implementation Grants, and Service-toScience Grants). As this effort proceeds, 

some of the data collection and 

reporting requirements included in 

SAMHSA’s NOFAs may change. All 

grantees will be expected to comply 

with any changes in data collection 

requirements that occur during the 

grantee’s project period. 

2.5 Grantee Meetings 

You must plan to send a minimum of 

two people (including the Project 

Director) to at least one joint grantee 

meeting in each year of the grant, and 

you must include funding for this travel 

in your budget. At these meetings, 

grantees will present the results of their 

projects and Federal staff will provide 

technical assistance. Each meeting will 

be 3 days. These meetings will usually 

be held in the Washington, DC, area and 

attendance is mandatory. 

2.6 Evaluation 

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: 

fi How closely did implementation 

match the plan? 

fi What types of deviation from the 

plan occurred? 

fi What led to the deviations? 

fi What effect did the deviations 

have on the planned intervention and 

evaluation? 

fi 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: 

fi What was the effect of treatment 

on participants? 

fi What program/contextual factors 

were associated with outcomes? 

fi What individual factors were 

associated with outcomes? 

fi How durable were the effects? 

No more than 20% of the total grant 

award may be used for evaluation and 

data collection, including GPRA and 

incentives for completing the 

evaluation. 

II. Award Information 

1. Award Amount 

The expected award amount for each 

funding opportunity will be specified in 

the NOFA. Typically, SAMHSA’s 

Services Grant awards are expected to 

be about $500,000 per year in total costs 

(direct and indirect) for up to 5 years. 

Awards may range as high as $3.0 

million per year in total costs (direct 

and indirect) for up to 5 years. 

Regardless of the award amount 

specified in the NOFA, the actual award 

amount will depend on the availability 

of funds. 

Proposed budgets cannot exceed the 

allowable amount specified in the 

NOFA in any year of the proposed 

project. Annual continuation awards 

will depend on the availability of funds, 

grantee progress in meeting project goals 

and objectives, and timely submission 

of required data and reports. 

2. Funding Mechanism 

The NOFA will indicate whether 

awards for each funding opportunity 

will be made as grants or cooperative 

agreements (see the Glossary in 

Appendix B for further explanation of 

these funding mechanisms). For 

cooperative agreements, the NOFA will 

describe the nature of Federal 

involvement in project performance and 

specify roles and responsibilities of 

grantees and Federal staff. 

III. Eligibility Information 

1. Eligible Applicants 

Eligible applicants are domestic 

public and private nonprofit entities. 

For example, State, local or tribal 

governments; public or private 

universities and colleges; communityand faith-based organizations; and tribal 

organizations may apply. The statutory 

authority for this program prohibits 

grants to for-profit organizations. The 

NOFA will indicate any limitations on 

eligibility. 

2. Cost Sharing 

Cost sharing (see Glossary) is not 

required in this program, and 

applications will not be screened out on 

the basis of cost sharing. However, you 

may include cash or in-kind 

contributions (see Glossary) in your 

proposal as evidence of commitment to 

the proposed project. 

3. Other 

3.1 Additional Eligibility 

Requirements 

Applications must comply with the 

following requirements, or they will be 

screened out and will not be reviewed: 

use of the PHS 5161–1 application; 

application submission requirements in 

Section IV–3 of this document; and 

formatting requirements provided in 

Section IV–2.3 of this document. 

Applicants should be aware that the 

NOFA may include additional 

requirements that, if not met, will result 

in applications being screened out and 

returned without review. These 

requirements will be specified in 

Section III–3 of the NOFA. 

You also must comply with any 

additional program requirements 

specified in the NOFA, such as 

signature of certain officials on the face 

page of the application and/or required 

memoranda of understanding with 

certain signatories. 

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 services (e.g., substance abuse 

treatment, substance abuse prevention, 

mental health 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 

62328 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

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 or prevention service provider 

organization; and (3) include the 

Statement of Assurance (provided in 

Appendix F 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 

• 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. 

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 

To ensure that you have met all 

submission requirements, a checklist is 

provided for your use in Appendix A of 

this document. 

1. Address to Request Application 

Package 

You may request a complete 

application kit by calling one of 

SAMHSA’s national clearinghouses: 

fi For substance abuse prevention or 

treatment grants, call the National 

Clearinghouse for Alcohol and Drug 

Information (NCADI) at 1–800–729–

6686. 

fi For mental health grants, call the 

National Mental Health Information 

Center at 1–800–789-CMHS (2647). 

You also may download the required 

documents from the SAMHSA Web site 

at http://www.samhsa.gov. Click on 

‘‘Grant Opportunities.’’

Additional materials available on this 

Web site include: 

fi A technical assistance manual for 

potential applicants; 

fi Standard terms and conditions for 

SAMHSA grants; 

fi Guidelines and policies that relate 

to SAMHSA grants (e.g., guidelines on 

cultural competence, consumer and 

family participation, and evaluation); 

and 

fi Enhanced instructions for 

completing the PHS 5161–1 applicatiod. 

2. Content and Form of Application 

Submission 

2.1 Application Kit 

SAMHSA application kits include the 

following documents: 

fi PHS 5161–1 (revised July 2000)—

Includes the face page, budget forms, 

assurances, certification, and checklist. 

Use the PHS 5161–1, unless otherwise 

specified in the NOFA. Applications 

that are not submitted on the required 

application form will be screened out 

and will not be reviewed. 

fi Program Announcement (PA)—

Includes instructions for the grant 

application. This document is the PA. 

fi Notice of Funding Availability 

(NOFA)—Provides specific information 

about availability of funds, as well as 

any exceptions or limitations to 

provisions in the PA. The NOFAs will 

be published in the Federal Register, as 

well as on the Federal grants Web site 

(http://www.grants.gov). It is very 

important that you read the entire 

NOFA before beginning to write your 

application. 

You must use all of the above 

documents in completing your 

application. 

2.2 Required Application Components 

To ensure equitable treatment of all 

applications, applications must be 

complete. In order for your application 

to be complete, it must include the 

required ten application components 

(Face Page, Abstract, Table of Contents, 

Budget Form, Project Narrative and 

Supporting Documentation, 

Appendices, Assurances, Certifications, 

Disclosure of Lobbying Activities, and 

Checklist). 

b 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 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.] 

b 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. 

b Table of Contents—Include page 

numbers for each of the major sections 

of your application and for each 

appendix. 

b Budget Form—Use SF 424A, 

which is part of the PHS 5161–1. Fill 

out Sections B, C, and E of the SF 424A. 

A sample budget and justification is 

included in Appendix H of this Program 

Announcement. 

b Project Narrative and Supporting 

Documentation—The Project Narrative 

describes your project. It consists of 

Sections A through E. Sections A–E 

together may not be longer than 30 

pages. For example, remember that if 

your Project Narrative starts on page 5 

and ends on page 35, it is 31 pages long, 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62329 

not 30 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 F through I. There 

are no page limits for these sections, 

except for Section H, the Biographical 

Sketches/Job Descriptions. 

• Section F—Literature Citations. 

This section must contain complete 

citations, including titles and all 

authors, for any literature you cite in 

your application. 

fi Section G—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 infrastructure development 

and that no more than 20% of the total 

grant award will be used for data 

collection and evaluation, including 

GPRA. 

fi Section H—Biographical Sketches 

and Job Descriptions. 

Include a biographical sketch for the 

Project Director and other key positions. 

Each sketch should be 2 pages or less. 

If the person has not been hired, include 

a position description and/or a letter of 

commitment with a current biographical 

sketch from the individual. 

Include job descriptions for key 

personnel. Job descriptions should be 

no longer than 1 page each. 

Sample sketches and job 

descriptions are listed on page 22, Item 

6 in the Program Narrative section of the 

PHS 5161–1. 

fi Section I—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. 

b Appendices 1 through 5—Use only 

the appendices listed below. If your 

application includes any appendices not 

required in the grant announcement or 

NOFA, they will be disregarded. Do not 

use more than a total of 30 pages for 

Appendices 1, 3 and 4 combined. There 

are no page limitations for Appendices 

2 and 5. Do not use appendices to 

extend or replace any of the sections of 

the Project Narrative unless specifically 

required in the NOFA. Reviewers will 

not consider them if you do. 

fi Appendix 1: (1) Identification of at 

least one experienced, licensed service 

provider organization; (2) 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 or 

prevention service provider 

organization; (3) the Statement of 

Assurance (provided in Appendix F 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; (4) letters of 

commitment/support. 

fi Appendix 2: Data Collection 

Instruments/Interview Protocols 

fi Appendix 3: Sample Consent 

Forms 

fi Appendix 4: Letter to the SSA (if 

applicable; see Section IV–4 of this 

document) 

fi Appendix 5: A copy of the State or 

County Strategic Plan, a State or county 

needs assessment, or a letter from the 

State or county indicating that the 

proposed project addresses a State-or 

county-identified priority. 

b Assurances—Non-Construction 

Programs. Use Standard Form 424B 

found in PHS 5161–1. Some applicants 

will be required to complete the 

Assurance of Compliance with 

SAMHSA Charitable Choice Statutes 

and Regulations Form SMA 170. If this 

assurance applies to a specific funding 

opportunity, it will be posted on 

SAMHSA’s web site with the NOFA and 

provided in the application kits 

available at SAMHSA’s clearinghouse 

(NCADI). 

b Certifications—Use the 

‘‘Certifications’’ forms found in PHS 

5161–1. 

b 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. 

b 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. 

b Information provided must be 

sufficient for review. 

b 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. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

b 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 30-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 30. 

This number represents the full page 

less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the 

physical page. Space left blank within 

the Project Narrative (excluding 

margins) is considered part of the 

Project Narrative, in determining 

compliance. 

To facilitate review of your 

application, follow these additional 

guidelines. Failure to adhere to the 

following guidelines will not, in itself, 

result in your application being 

screened out and returned without 

review. However, following these 

guidelines will help reviewers to 

consider your application. 

b Pages should be typed singlespaced in black ink, with one column 

per page. Pages should not have printing 

on both sides. 

62330 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

b Please number pages consecutively 

from beginning to end so that 

information can be located easily during 

review of the application. The cover 

page should be page 1, the abstract page 

should be page 2, and the table of 

contents page should be page 3. 

Appendices should be labeled and 

separated from the Project Narrative and 

budget section, and the pages should be 

numbered to continue the sequence. 

b The page limit of a total of 30 pages 

for Appendices 1, 3 and 4 combined 

should not be exceeded. 

b 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 

Applicants must describe procedures 

relating to Confidentiality, Participant 

Protection and the Protection of Human 

Subjects Regulations in Section I of the 

application, using the guidelines 

provided below. Problems with 

confidentiality, participant protection, 

and protection of human subjects 

identified during peer review of the 

application may result in the delay of 

funding. 

Confidentiality and Participant 

Protection 

All applicants must describe how 

they will address requirements for each 

of the following elements relating to 

confidentiality and participant 

protection. 

1. Protect Clients and Staff from 

Potential Risks: 

fi 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. 

fi Describe the procedures you will 

follow to minimize or protect 

participants against potential risks, 

including risks to confidentiality. 

fi Identify plans to provide guidance 

and assistance in the event there are 

adverse effects to participants. 

fi 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: 

fi 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. 

fi 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. 

fi Explain the reasons for including 

or excluding participants. 

fi Explain how you will recruit and 

select participants. Identify who will 

select participants. 

3. Absence of Coercion: 

fi 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. 

fi If you plan to compensate 

participants, state how participants will 

be awarded incentives (e.g., money, 

gifts, etc.). 

fi 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: 

fi 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. 

fi 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. 

fi Provide in Appendix 2, ‘‘Data 

Collection Instruments/Interview 

Protocols,’’ copies of all available data 

collection instruments and interview 

protocols that you plan to use. 

5. Privacy and Confidentiality: 

fi Explain how you will ensure 

privacy and confidentiality. Include 

who will collect data and how it will be 

collected. 

fi Describe: 

Æ How you will use data collection 

instruments. 

Æ Where data will be stored. 

Æ Who will or will not have access to 

information. 

Æ How the identity of participants 

will be kept private, for example, 

through the use of a coding system on 

data records, limiting access to records, 

or storing identifiers separately from 

data. 

Note: If applicable, grantees must agree to 

maintain the confidentiality of alcohol and 

drug abuse client records according to the 

provisions of Title 42 of the Code of Federal 

Regulations, Part 2. 

6. Adequate Consent Procedures: 

fi 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. 

fi State: 

Æ Whether or not their participation 

is voluntary. 

Æ Their right to leave the project at 

any time without problems. 

Æ Possible risks from participation in 

the project. 

Æ Plans to protect clients from these 

risks. 

fi 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 

informed consent. 

fi 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? 

fi Include, as appropriate, sample 

consent forms that provide for: (1) 

Informed consent for participation in 

service intervention; (2) informed 

consent for participation in the data 

collection component of the project; and 

(3) informed consent for the exchange 

(releasing or requesting) of confidential 

information. The sample forms must be 

included in Appendix 3, ‘‘Sample 

Consent Forms’’, of your application. If 

needed, give English translations. 

Note: Never imply that the participant 

waives or appears to waive any legal rights, 

may not end involvement with the project, or 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62331 

releases your project or its agents from 

liability for negligence. 

fi 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? 

fi 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: 

Discuss why the risks are reasonable 

compared to expected benefits and 

importance of the knowledge from the 

project. 

Protection of Human Subjects 

Regulations 

SAMHSA expects that most grantees 

funded under Services Grant programs 

will not be required to comply with the 

Protection of Human Subjects 

Regulations (45 CFR part 46). However, 

in some instances, special evaluation 

and data collection requirements for a 

particular funding opportunity may 

necessitate that all grantees comply with 

these regulations. In such instances, the 

NOFA will explicitly state that grantees 

must comply with the regulations. 

If the NOFA does not explicitly state 

that grantees must comply with the 

Protection of Human Subjects 

Regulations (45 CFR 46), grantees will 

be required to comply with the 

regulations only if the project-specific 

evaluation design proposed by the 

grantee requires compliance with the 

regulations. 

Applicants whose projects must 

comply with the Protection of Human 

Subjects Regulations must describe the 

process for obtaining Institutional 

Review Board (IRB) approval fully in 

their applications. While IRB approval 

is not required at the time of grant 

award, these applicants will be 

required, as a condition of award, to 

provide the documentation that an 

Assurance of Compliance is on file with 

the Office for Human Research 

Protections (OHRP) and the IRB 

approval has been received prior to 

enrolling any clients in the proposed 

project. 

General information about Protection 

of Human Subjects Regulations can be 

obtained on the web at http:// 

www.hhs.gov/ohrp. You may also 

contact OHRP by e-mail 

(ohrp@osophs.dhhs.gov) or by phone 

(301/496–7005). SAMHSA-specific 

questions related to Protection of 

Human Subjects Regulations should be 

directed to the program contact listed in 

Section VII of the NOFA. 

3. Submission Dates and Times 

Deadlines for submission of 

applications for specific funding 

opportunities will be published in the 

NOFAs in the Federal Register and 

posted on the Federal grants Web site 

(http://www.grants.gov). 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

Your application must be received by 

the application deadline, or you must 

have proof of its timely submission as 

specified below. 

• For packages submitted via DHL, 

Falcon Carrier, Federal Express (FedEx), 

or United Parcel Service (UPS), timely 

submission shall be evidenced by a 

delivery service receipt indicating the 

application was delivered to a carrier 

service at least 24 hours prior to the 

application deadline. 

• For packages submitted via the 

United States Postal Service (USPS), 

proof of timely submission shall be a 

postmark not later than 1 week prior to 

the application deadline, and the 

following upon request by SAMHSA: 

Æ proof of mailing using USPS Form 

3817 (Certificate of Mailing), or 

Æ a receipt from the Post Office 

containing the post office name, 

location, and date and time of mailing. 

You will be notified by postal mail 

that your application has been received. 

Applications not meeting the timely 

submission requirements above will not 

be considered for review. Please 

remember that mail sent to Federal 

facilities undergoes a security screening 

prior to delivery. Allow sufficient time 

for your package to be delivered. 

If an application is mailed to a 

location or office (including room 

number) that is not designated for 

receipt of the application, and that 

results in the designated office not 

receiving your application in 

accordance with the requirements for 

timely submission, it will cause the 

application to be considered late and 

ineligible for review. 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

SAMHSA is collaborating with 

http://www.grants.gov to accept 

electronic submission of applications 

only for select funding opportunities. 

Unless specifically indicated in the 

NOFA, electronic submission of 

applications will not be accepted. 

4. Intergovernmental Review (E.O. 

12372) Requirements 

Executive Order 12372, as 

implemented through Department of 

Health and Human Services (DHHS) 

regulation at 45 CFR Part 100, sets up 

a system for State and local review of 

applications for Federal financial 

assistance. A current listing of State 

Single Points of Contact (SPOCs) is 

included in the application kit and can 

be downloaded from the Office of 

Management and Budget (OMB) Web 

site at http://www.whitehouse.gov/omb/ 

grants/spoc.html. 

fi 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. 

fi 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. 

fi For proposed projects serving 

more than one State, you are advised to 

contact the SPOC of each affiliated 

State. 

fi The SPOC should send any State 

review process recommendations to the 

following address within 60 days of the 

application deadline: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857, ATTN: SPOC—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SPOC—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition, community-based, nongovernmental service providers who are 

not transmitting their applications 

through the State must submit a Public 

Health System Impact Statement 

(PHSIS) (approved by OMB under 

control no. 0920–0428; see burden 

statement below) to the head(s) of 

appropriate State or local health 

agencies in the area(s) to be affected no 

later than the pertinent receipt date for 

applications. The PHSIS is intended to 

keep State and local health officials 

informed of proposed health services 

grant applications submitted by 

62332 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

community-based, non-governmental 

organizations within their jurisdictions. 

State and local governments and Indian 

tribal government applicants are not 

subject to these requirements. 

The PHSIS consists of the following 

information: 

fi A copy of the face page of the 

application (SF 424); and 

fi 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 

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 

include a copy of a letter transmitting 

the PHSIS to the SSA in Appendix 4, 

‘‘Letter to the SSA.’’ The letter must 

notify the State that, if it wishes to 

comment on the proposal, its comments 

should be sent not later than 60 days 

after the application deadline to: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857,ATTN: SSA—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SSA—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition: 

fi Applicants may request that the 

SSA send them a copy of any State 

comments. 

fi The applicant must notify the SSA 

within 30 days of receipt of an award. 

[Public reporting burden for the 

Public Health System Reporting 

Requirement is estimated to average 10 

minutes per response, including the 

time for copying the face page of SF 424 

and the abstract and preparing the letter 

for mailing. An agency may not conduct 

or sponsor, and a person is not required 

to respond to, a collection of 

information unless it displays a 

currently valid OMB control number. 

The OMB control number for this 

project is 0920–0428. Send comments 

regarding this burden to CDC Clearance 

Officer, 1600 Clifton Road, MS D–24, 

Atlanta, GA 30333, ATTN: PRA (0920–

0428).] 

5. Funding Limitations/Restrictions 

Cost principles describing allowable 

and unallowable expenditures for 

Federal grantees, including SAMHSA 

grantees, are provided in the following 

documents: 

fi Institutions of Higher Education: 

OMB Circular A–21. 

fi State and Local Governments: 

OMB Circular A–87. 

fi Nonprofit Organizations: OMB 

Circular A–122. 

fi Appendix E Hospitals: 45 CFR Part 

74. 

In addition, SAMHSA Services Grant 

recipients must comply with the 

following funding restrictions: 

fi No more than 15% of the total 

grant award may be used for developing 

the infrastructure necessary for 

expansion of services. 

fi No more than 20% of the total 

grant award may be used for evaluation 

and data collection, including GPRA 

and incentives for completing the 

evaluation. 

Service Grant funds must be used for 

purposes supported by the program and 

may not be used to: 

fi Pay for any lease beyond the 

project period. 

fi 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). 

fi 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.) 

fi 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.) 

fi Pay for housing other than 

residential mental health and/or 

substance abuse treatment. 

fi Provide inpatient treatment or 

hospital-based detoxification services. 

Residential services are not considered 

to be inpatient or hospital-based 

services. 

fi 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. 

fi Implement syringe exchange 

programs, such as the purchase and 

distribution of syringes and/or needles. 

fi 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. 

fi SAMHSA will not accept a 

‘‘research’’ indirect cost rate. The 

grantee must use the ‘‘other sponsored 

program rate’’ or the lowest rate 

available. 

6. Other Submission Requirements 

6.1 Where To Send Applications 

Send applications to the following 

address: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850. 

Do not send applications to other 

agency contacts, as this could delay 

receipt. Be sure to include the funding 

announcement number from the NOFA 

in item number 10 on the face page of 

the application. If you require a phone 

number for delivery, you may use (240) 

276–1199. 

6.2 How To Send Applications 

Mail or deliver an original application 

and 2 copies (including appendices) to 

the mailing address provided above, 

according to the instructions in Section 

IV–3. The original and copies must not 

be bound. Do not use staples, paper 

clips, or fasteners. Nothing should be 

attached, stapled, folded, or pasted. 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

Unless specifically indicated in the 

NOFA, electronic submission of 

applications will not be accepted. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62333 

V. Application Review Information 

1. Evaluation Criteria 

Your application will be reviewed 

and scored according to the quality of 

your response to the requirements listed 

below for developing the Project 

Narrative (Sections A–E). These sections 

describe what you intend to do with 

your project. 

fi In developing the Project Narrative 

section of your application, use these 

instructions along with any additional 

instructions found in the NOFA. These 

are to be used instead of the ‘‘Program 

Narrative’’ instructions found in the 

PHS 5161–1. 

fi The Project Narrative (Sections A–

E) together may be no longer than 30 

pages. 

fi You must use the five 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. 

fi 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 

http://www.samhsa.gov. Click on ‘‘Grant 

Opportunities.’’

fi The Supporting Documentation 

you provide in Sections F–I and 

Appendices 1–5 will be considered by 

reviewers in assessing your response, 

along with the material in the Project 

Narrative. 

fi The number of points after each 

heading is the maximum number of 

points a review committee may assign to 

that section of your Project Narrative. 

Bullet statements in each section do not 

have points assigned to them. They are 

provided to invite the attention of 

applicants and reviewers to important 

areas within the criterion. 

Section A: Statement of Need (10 

Points) 

fi Describe the target population (see 

Glossary) as well as the geographic area 

to be served, and justify the selection of 

both. Be sure to check the NOFA for any 

specific requirements regarding the 

target population and/or catchment 

area. Include the numbers to be served 

and demographic information. Discuss 

the target population’s language, beliefs, 

norms and values, as well as 

socioeconomic factors that must be 

considered in delivering programs to 

this population. 

fi Describe the nature of the problem 

and extent of the need for the target 

population based on data. The statement 

of need should include a clearly 

established baseline for the project. 

Documentation of need may come from 

a variety of qualitative and quantitative 

sources. The quantitative data could 

come from local data or trend analyses, 

State data (e.g., from State Needs 

Assessments), and/or national data (e.g., 

from SAMHSA’s National Household 

Survey on Drug Abuse and Health or 

from National Center for Health 

Statistics/Centers for Disease Control 

reports). For data sources that are not 

well known, provide sufficient 

information on how the data were 

collected so reviewers can assess the 

reliability and validity of the data. 

fi Non-tribal applicants must show 

that identified needs are consistent with 

priorities of the State or county that has 

primary responsibility for the service 

delivery system. Include, in Appendix 

5, a copy of the State or County Strategic 

Plan, a State or county needs 

assessment, or a letter from the State or 

county indicating that the proposed 

project addresses a State-or countyidentified priority. Tribal applicants 

must provide similar documentation 

relating to tribal priorities. 

fi Check the NOFA for any 

additional requirements. 

Section B: Proposed Evidence-Based 

Service/Practice (30 Points) 

fi Clearly state the purpose, goals 

and objectives of your proposed project. 

Describe how achievement of the goals 

will address the overall program 

purpose specified in the NOFA and 

produce meaningful and relevant results 

(e.g., increase access, availability, 

prevention, outreach, pre-services, 

treatment, and/or intervention). 

fi Identify the evidenced based 

service/practice that you propose to 

implement. Describe the evidence-base 

for the proposed service/practice and 

show that it incorporates the best 

objective information available 

regarding effectiveness and 

acceptability. Follow the instructions 

provided in #1, #2 or #3 below, as 

appropriate: 

1. If you are proposing to implement 

a service/practice included in NREPP 

(see Appendix C), one of the CMHS toolkits on evidence-based practices (see 

Appendix D), the list of Effective 

Substance Abuse Treatment Practices 

(see Appendix E), or the NOFA (if 

applicable), simply identify the practice 

and state the source from which it was 

selected. You do not need to provide 

further evidence of effectiveness. 

2. If you are providing evidence that 

includes scientific studies published in 

the peer-reviewed literature or other 

studies that have not been published, 

describe the extent to which: 

—The service/practice has been 

evaluated and the quality of the 

evaluation studies (e.g., whether they 

are descriptive, quasi-experimental 

studies, or experimental studies). 

—The services/practice has 

demonstrated positive outcomes and 

for what populations the positive 

outcomes have been demonstrated. 

—The service/practice has been 

documented (e.g., through 

development of guidelines, tool kits, 

treatment protocols, and/or manuals) 

and replicated. 

—Fidelity measures have been 

developed (e.g., no measures 

developed, key components 

identified, or fidelity measures 

developed). 

3. If you are providing evidence based 

on a formal consensus process involving 

recognized experts in the field, describe: 

—The experts involved in developing 

consensus on the proposed service/ 

practice (e.g., members of an expert 

panel formally convened by 

SAMHSA, NIH, the Institute of 

Medicine or other nationally 

recognized organization). The 

consensus must have been developed 

by a group of experts whose work is 

recognized and respected by others in 

the field. Local recognition of an 

individual as a respected or 

influential person at the community 

level is not considered a ‘‘recognized 

expert’’ for this purpose. 

—The nature of the consensus that has 

been reached and the process used to 

reach consensus 

—The extent to which the consensus 

has been documented (e.g., in a 

consensus panel report, meeting 

minutes, or an accepted standard 

practice in the field) 

—Any empirical evidence (whether 

formally published or not) supporting 

the effectiveness of the proposed 

service/practice 

—The rationale for concluding that 

further empirical evidence does not 

exist to support the effectiveness of 

the proposed service/practice 

fi Justify the use of the proposed 

service/practice for the target 

population. Describe and justify any 

adaptations necessary to meet the 

needs of the target population as well 

as evidence that such adaptations will 

be effective for the target population. 

62334 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

fi Identify and justify any additional 

adaptations or modifications to the 

proposed service/practice. 

fi Describe how the proposed project 

will address issues of age, race, 

ethnicity, culture, language, sexual 

orientation, disability, literacy, and 

gender in the target population, while 

retaining fidelity to the chosen practice. 

fi Demonstrate how the proposed 

service/practice will meet your goals 

and objectives. Provide a logic model 

(see Glossary) that links need, the 

services or practice to be implemented, 

and outcomes. 

fi Check the NOFA for any 

additional requirements. 

Section C: Proposed Implementation 

Approach (25 Points) 

fi Describe how the proposed service 

or practice will be implemented. 

Address any and all expectations/ 

required activities specified in the 

NOFA. 

fi Provide a realistic time line for the 

project (chart or graph) showing key 

activities, milestones, and responsible 

staff. [Note: The time line should be part 

of the Project Narrative. It should not be 

placed in an appendix.] 

fi Clearly state the unduplicated 

number of individuals you propose to 

serve (annually and over the entire 

project period) with grant funds, 

including the types and numbers of 

services to be provided and anticipated 

outcomes. Describe how the target 

population will be identified, recruited, 

and retained. 

fi Describe how members of the 

target population helped prepare the 

application, and how they will help 

plan, implement, and evaluate the 

project. 

fi Describe how the project 

components will be embedded within 

the existing service delivery system, 

including other SAMHSA-funded 

projects, if applicable. Identify any other 

organizations that will participate in the 

proposed project. Describe their roles 

and responsibilities and demonstrate 

their commitment to the project. Include 

letters of commitment from community 

organizations supporting the project in 

Appendix 1. Identify any cash or inkind contributions that will be made to 

the project by the applicant or other 

partnering organizations. 

fi Show that the necessary 

groundwork (e.g., planning, consensus 

development, development of 

memoranda of agreement, identification 

of potential facilities) has been 

completed or is near completion so that 

the project can be implemented and 

service delivery can begin as soon as 

possible and no later than 4 months 

after grant award. 

fi Describe the potential barriers to 

successful conduct of the proposed 

project and how you will overcome 

them. 

fi Provide a plan to secure resources 

to sustain the proposed project when 

Federal funding ends. 

fi Check the NOFA for any 

additional requirements. 

Section D: Staff and Organizational 

Experience (20 Points) 

fi Discuss the capability and 

experience of the applicant organization 

and other participating organizations 

with similar projects and populations, 

including experience in providing 

culturally appropriate/competent 

services. 

fi Provide a list of staff who will 

participate in the project, showing the 

role of each and their level of effort and 

qualifications. Include the Project 

Director and other key personnel, such 

as the evaluator and treatment/ 

prevention personnel. 

fi Describe the racial/ethnic 

characteristics of key staff and indicate 

if any are members of the target 

population/community. If the target 

population is multi-linguistic, indicate 

if the staffing pattern includes bilingual 

and bicultural individuals. 

fi Describe the resources available 

for the proposed project (e.g., facilities, 

equipment), and provide evidence that 

services will be provided in a location 

that is adequate, accessible, compliant 

with the Americans with Disabilities 

Act (ADA), and amenable to the target 

population. 

fi Check the NOFA for any 

additional requirements. 

Section E: Evaluation and Data (15 

Points) 

fi Document your ability to collect 

and report on the required performance 

measures as specified in the NOFA. 

Specify and justify any additional 

measures you plan to use for your grant 

project. 

fi Describe plans for data collection, 

management, analysis, interpretation 

and reporting. Describe the existing 

approach to the collection of data, along 

with any necessary modifications. Be 

sure to include data collection 

instruments/interview protocols in 

Appendix 2. 

fi Discuss the reliability and validity 

of evaluation methods and instrument(s) 

in terms of the gender/age/culture of the 

target population. 

fi 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. 

fi Describe how the evaluation will 

be used to ensure the fidelity to the 

practice. 

fi 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. 

fi Check the NOFA for any 

additional requirements. 

Note: Although the budget for the proposed 

project is not a review criterion, the Review 

Group will be asked to comment on the 

appropriateness of the budget after the merits 

of the application have been considered. 

2. Review and Selection Process 

SAMHSA applications are peerreviewed 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: 

fi The strengths and weaknesses of 

the application as identified by peer 

reviewers and, when applicable, 

approved by the appropriate National 

Advisory Council; 

fi Availability of funds; 

fi Equitable distribution of awards in 

terms of geography (including urban, 

rural and remote settings) and balance 

among target populations and program 

size; and 

fi 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 (Proposed Evidence-Based 

Service/Practice—30 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. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62335 

VI. Award Administration Information 

1. Award Notices 

After your application has been 

reviewed, you will receive a letter from 

SAMHSA through postal mail that 

describes the general results of the 

review, including the score that your 

application received. 

If you are approved for funding, you 

will receive an additional notice, the 

Notice of Grant Award, signed by 

SAMHSA’s Grants Management Officer. 

The Notice of Grant Award is the sole 

obligating document that allows the 

grantee to receive Federal funding for 

work on the grant project. It is sent by 

postal mail and is addressed to the 

contact person listed on the face page of 

the application. 

If you are not funded, you can reapply if there is another receipt date for 

the program. 

2. Administrative and National Policy 

Requirements 

fi You must comply with all terms 

and conditions of the grant award. 

SAMHSA’s standard terms and 

conditions are available on the 

SAMHSA Web site at http:// 

www.samhsa.gov/grants/generalinfo/ 

useful_info.aspx. 

fi Depending on the nature of the 

specific funding opportunity and/or the 

proposed project as identified during 

review, additional terms and conditions 

may be identified in the NOFA or 

negotiated with the grantee prior to 

grant award. These may include, for 

example: 

» Actions required to be in 

compliance with human subjects 

requirements; 

» Requirements relating to additional 

data collection and reporting; 

» Requirements relating to 

participation in a cross-site evaluation; 

or 

» Requirements to address problems 

identified in review of the application. 

fi 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. 

fi In an effort to improve access to 

funding opportunities for applicants, 

SAMHSA is participating in the U.S. 

Department of Health and Human 

Services ‘‘Survey on Ensuring Equal 

Opportunity for Applicants.’’ This 

survey is included in the application kit 

for SAMHSA grants. Applicants are 

encouraged to complete the survey and 

return it, using the instructions 

provided on the survey form. 

3. Reporting Requirements 

3.1 Progress and Financial Reports 

fi Grantees must provide annual and 

final progress reports. The final report 

must summarize information from the 

annual reports, describe the 

accomplishments of the project, and 

describe next steps for implementing 

plans developed during the grant 

period. 

fi Grantees must provide annual and 

final financial status reports. These 

reports may be included as separate 

sections of annual and final progress 

reports or can be separate documents. 

Because SAMHSA is extremely 

interested in ensuring that treatment or 

prevention 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. 

fi SAMHSA will provide guidelines 

and requirements for these reports to 

grantees at the time of award and at the 

initial grantee orientation meeting after 

award. SAMHSA staff will use the 

information contained in the reports to 

determine the grantee’s progress toward 

meeting its goals. 

3.2 Government Performance and 

Results Act (GPRA) 

The Government Performance and 

Results Act (GPRA) mandates 

accountability and performance-based 

management by Federal agencies. To 

meet the GPRA requirements, SAMHSA 

must collect performance data (i.e., 

‘‘GPRA data’’) from grantees. These 

requirements will be specified in the 

NOFA for each funding opportunity. 

3.3 Publications 

If you are funded under this grant 

program, you are required to notify the 

Government Project Officer (GPO) and 

SAMHSA’s Publications Clearance 

Officer (240–276–2130) of any materials 

based on the SAMHSA-funded grant 

project that are accepted for publication. 

In addition, SAMHSA requests that 

grantees: 

fi Provide the GPO and SAMHSA 

Publications Clearance Officer with 

advance copies of publications. 

fi Include acknowledgment of the 

SAMHSA grant program as the source of 

funding for the project. 

fi 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 

The NOFAs provide contact 

information for questions about program 

issues. 

For questions on grants management 

issues, contact: Kimberly Pendleton, 

Office of Program Services, Division of 

Grants Management, Substance Abuse 

and Mental Health Services 

Administration, 1 Choke Cherry Road, 

Room 7–1097, Rockville, Maryland 

20857, (240) 276–1421, 

kimberly.pendleton@samhsa.hhs.gov. 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria 

for SAMHSA Grant Applications 

SAMHSA’s goal is to review all 

applications submitted for grant funding. 

However, this goal must be balanced against 

SAMHSA’s obligation to ensure equitable 

treatment of applications. For this reason, 

SAMHSA has established certain formatting 

requirements for its applications. If you do 

not adhere to these requirements, your 

application will be screened out and returned 

to you without review. In addition to these 

formatting requirements, programmatic 

requirements (e.g., relating to eligibility) may 

be stated in the specific NOFA and in Section 

III of the standard grant announcement. 

Please check the entire NOFA and Section III 

of the standard grant announcement before 

preparing your application. 

b Use the PHS 5161–1 application. 

b Applications must be received by the 

application deadline or have proof of timely 

submission, as detailed in Section IV–3 of the 

grant announcement. 

b Information provided must be sufficient 

for review. 

b 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.) 

fi Text in the Project Narrative cannot 

exceed 6 lines per vertical inch. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

62336 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

b To ensure equity among applications, 

the amount of space allowed for the Project 

Narrative cannot be exceeded. 

• Applications would meet this 

requirement by using all margins (left, right, 

top, bottom) of at least one inch each, and 

adhering to the page limit for the Project 

Narrative stated in the specific funding 

announcement. 

• Should an application not conform to 

these margin or page limits, SAMHSA will 

use the following method to determine 

compliance: The total area of the Project 

Narrative (excluding margins, but including 

charts, tables, graphs and footnotes) cannot 

exceed 58.5 square inches multiplied by the 

page limit. This number represents the full 

page less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the physical 

page. Space left blank within the Project 

Narrative (excluding margins) is considered 

part of the Project Narrative, in determining 

compliance. 

To facilitate review of your application, 

follow these additional guidelines. Failure to 

adhere to the following guidelines will not, 

in itself, result in your application being 

screened out and returned without review. 

However, the information provided in your 

application must be sufficient for review. 

Following these guidelines will help ensure 

your application is complete, and will help 

reviewers to consider your application. 

b The 10 application components 

required for SAMHSA applications should be 

included. These are: 

• 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). 

b Applications should comply with the 

following requirements: 

• Provisions relating to confidentiality, 

participant protection and the protection of 

human subjects specified in Section IV–2.4 of 

the FY 2005 standard funding 

announcements. 

• Budgetary limitations as specified in 

Section I, II, and IV–5 of the FY 2005 

standard funding announcements. 

• Documentation of nonprofit status as 

required in the PHS 5161–1. 

b Pages should be typed single-spaced in 

black ink, with one column per page. Pages 

should not have printing on both sides. 

b Please number pages consecutively from 

beginning to end so that information can be 

located easily during review of the 

application. The cover page should be page 

1, the abstract page should be page 2, and the 

table of contents page should be page 3. 

Appendices should be labeled and separated 

from the Project Narrative and budget 

section, and the pages should be numbered 

to continue the sequence. 

b The page limits for Appendices stated 

in the specific funding announcement should 

not be exceeded. 

b Send the original application and two 

copies to the mailing address in the funding 

announcement. Please do not use staples, 

paper clips, and fasteners. Nothing should be 

attached, stapled, folded, or pasted. Do not 

use heavy or lightweight paper or any 

material that cannot be copied using 

automatic copying machines. Odd-sized and 

oversized attachments such as posters will 

not be copied or sent to reviewers. Do not 

include videotapes, audiotapes, or CD-ROMs. 

Appendix B—Glossary 

Best Practice: Best practices are practices 

that incorporate the best objective 

information currently available regarding 

effectiveness and acceptability. 

Catchment Area: A catchment area is the 

geographic area from which the target 

population to be served by a program will be 

drawn. 

Cooperative Agreement: A cooperative 

agreement is a form of Federal grant. 

Cooperative agreements are distinguished 

from other grants in that, under a cooperative 

agreement, substantial involvement is 

anticipated between the awarding office and 

the recipient during performance of the 

funded activity. This involvement may 

include collaboration, participation, or 

intervention in the activity. HHS awarding 

offices use grants or cooperative agreements 

(rather than contracts) when the principal 

purpose of the transaction is the transfer of 

money, property, services, or anything of 

value to accomplish a public purpose of 

support or stimulation authorized by Federal 

statute. The primary beneficiary under a 

grant or cooperative agreement is the public, 

as opposed to the Federal Government. 

Cost Sharing or Matching: Cost sharing 

refers to the value of allowable non-Federal 

contributions toward the allowable costs of a 

Federal grant project or program. Such 

contributions may be cash or in-kind 

contributions. For SAMHSA grants, cost 

sharing or matching is not required, and 

applications will not be screened out on the 

basis of cost sharing. However, applicants 

often include cash or in-kind contributions in 

their proposals as evidence of commitment to 

the proposed project. This is allowed, and 

this information may be considered by 

reviewers in evaluating the quality of the 

application. 

Fidelity: Fidelity is the degree to which a 

specific implementation of a program or 

practice resembles, adheres to, or is faithful 

to the evidence-based model on which it is 

based. Fidelity is formally assessed using 

rating scales of the major elements of the 

evidence-based model. A toolkit on how to 

develop and use fidelity instruments is 

available from the SAMHSA-funded 

Evaluation Technical Assistance Center at 

http://tecathsri.org or by calling (617) 876–

0426. 

Grant: A grant is the funding mechanism 

used by the Federal Government when the 

principal purpose of the transaction is the 

transfer of money, property, services, or 

anything of value to accomplish a public 

purpose of support or stimulation authorized 

by Federal statute. The primary beneficiary 

under a grant or cooperative agreement is the 

public, as opposed to the Federal 

Government. 

In-Kind Contribution: In-kind contributions 

toward a grant project are non-cash 

contributions (e.g., facilities, space, services) 

that are derived from non-Federal sources, 

such as State or sub-State non-Federal 

revenues, foundation grants, or contributions 

from other non-Federal public or private 

entities. 

Logic Model: A logic model is a 

diagrammatic representation of a theoretical 

framework. A logic model describes the 

logical linkages among program resources, 

conditions, strategies, short-term outcomes, 

and long-term impact. More information on 

how to develop logics models and examples 

can be found through the resources listed in 

Appendix G. 

Practice: A practice is any activity, or 

collective set of activities, intended to 

improve outcomes for people with or at risk 

for substance abuse and/or mental illness. 

Such activities may include direct service 

provision, or they may be supportive 

activities, such as efforts to improve access 

to and retention in services, organizational 

efficiency or effectiveness, community 

readiness, collaboration among stakeholder 

groups, education, awareness, training, or 

any other activity that is designed to improve 

outcomes for people with or at risk for 

substance abuse or mental illness. 

Practice Support System: This term refers 

to contextual factors that affect practice 

delivery and effectiveness in the preadoption phase, delivery phase, and postdelivery phase, such as (a) community 

collaboration and consensus building, (b) 

training and overall readiness of those 

implementing the practice, and (c) sufficient 

ongoing supervision for those implementing 

the practice. 

Stakeholder: A stakeholder is an 

individual, organization, constituent group, 

or other entity that has an interest in and will 

be affected by a proposed grant project. 

Sustainability: Sustainability is the ability 

to continue a program or practice after 

SAMHSA grant funding has ended. 

Target Population: The target population is 

the specific population of people whom a 

particular program or practice is designed to 

serve or reach. 

Wraparound Service: Wraparound services 

are non-clinical supportive services—such as 

child care, vocational, educational, and 

transportation services—that are designed to 

improve the individual’s access to and 

retention in the proposed project. 

Appendix C—National Registry of 

Effective Programs and Practices 

To help SAMHSA’s constituents learn 

more about science-based programs, 

SAMHSA’s Center for Substance Abuse 

Prevention (CSAP) created a National 

Registry of Effective Programs and Practices 

(NREPP) to review and identify effective 

programs. NREPP seeks candidates from the 

practice community and the scientific 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62337 

literature. While the initial focus of NREPP 

was substance abuse prevention 

programming, NREPP has expanded its scope 

and now includes prevention and treatment 

of substance abuse and of co-occurring 

substance abuse and mental disorders, and 

psychopharmacological programs and 

workplace programs. 

NREPP includes three categories of 

programs: Effective Programs, Promising 

Programs, and Model Programs. Programs 

defined as Effective have the option of 

becoming Model Programs if their developers 

choose to take part in SAMHSA 

dissemination efforts. The conditions for 

making that choice, together with definitions 

of the three major criteria, are as follows. 

Promising Programs have been 

implemented and evaluated sufficiently and 

are scientifically defensible. They have 

positive outcomes in preventing substance 

abuse and related behaviors. However, they 

have not yet been shown to have sufficient 

rigor and/or consistently positive outcomes 

required for Effective Program status. 

Nonetheless, Promising Programs are eligible 

to be elevated to Effective/Model status after 

review of additional documentation 

regarding program effectiveness. Originated 

from a range of settings and spanning target 

populations, Promising Programs can guide 

prevention, treatment, and rehabilitation. 

Effective Programs are well-implemented, 

well-evaluated programs that produce 

consistently positive pattern of results (across 

domains and/or replications). Developers of 

Effective Programs have yet to help 

SAMHSA/CSAP disseminate their programs, 

but may do so themselves. 

Model Programs are also wellimplemented, well-evaluated programs, 

meaning they have been reviewed by NREPP 

according to rigorous standards of research. 

Their developers have agreed with SAMHSA 

to provide materials, training, and technical 

assistance for nationwide implementation. 

That helps ensure the program is carefully 

implemented and likely to succeed. 

Programs that have met the NREPP 

standards for each category can be identified 

by accessing the NREPP Model Programs 

Web site at http:// 

www.modelprograms.samhsa.gov. 

Appendix D—Center for Mental Health 

Services Evidence-Based Practice 

Toolkits 

SAMHSA’s Center for Mental Health 

Services and the Robert Wood Johnson 

Foundation initiated the Evidence-Based 

Practices Project to: (1) Help more consumers 

and families access services that are effective, 

(2) help providers of mental health services 

develop effective services, and (3) help 

administrators support and maintain these 

services. The project is now also funded and 

endorsed by numerous national, State, local, 

private and public organizations, including 

the Johnson & Johnson Charitable Trust, the 

MacArthur Foundation, and the West Family 

Foundation. 

The project has been developed through 

the cooperation of many Federal and State 

mental health organizations, advocacy 

groups, mental health providers, researchers, 

consumers and family members. A Web site 

(http://www.mentalhealthpractices.org) was 

created as part of Phase I of the project, 

which included the identification of the first 

cluster of evidence-based practices and the 

design of implementation resource kits to 

help people understand and use these 

practices successfully. 

Basic information about the first six 

evidence-based practices is available on the 

web site. The six practices are: 

1. Illness Management and Recovery. 

2. Family Psychoeducation. 

3. Medication Management Approaches in 

Psychiatry. 

4. Assertive Community Treatment. 

5. Supported Employment. 

6. Integrated Dual Disorders Treatment. 

Each of the resource kits contains 

information and materials written by and for 

the following groups: 

—Consumers. 

—Families and Other Supporters. 

—Practitioners and Clinical Supervisors. 

—Mental Health Program Leaders. 

—Public Mental Health Authorities. 

Material on the web site can be printed or 

downloaded with Acrobat Reader, and 

references are provided where additional 

information can be obtained. 

Once published, the full kits will be 

available from National Mental Health 

Information Center at http://www.health.org 

or 1–800–789–CMHS (2647). 

Appendix E—Effective Substance Abuse 

Treatment Practices 

To assist potential applicants, SAMHSA’s 

Center for Substance Abuse Treatment 

(CSAT) has identified the following listing of 

current publications on effective treatment 

practices for use by treatment professionals 

in treating individuals with substance abuse 

disorders. These publications are available 

from the National Clearinghouse for Alcohol 

and Drug Information (NCADI); Tele: 1–800–

729–6686 or http://www.health.org and 

http://www.samhsa.gov/centers/csat2002/ 

publications.html. 

CSAT Treatment Improvement Protocols 

(TIPs) are consensus-based guidelines 

developed by clinical, research, and 

administrative experts in the field. 

• Integrating Substance Abuse Treatment 

and Vocational Services. TIP 38 (2000) 

NCADI # BKD381. 

• Substance Abuse Treatment for Persons 

with Child Abuse and Neglect Issues. TIP 36 

(2000) NCADI # BKD343. 

• Substance Abuse Treatment for Persons 

with HIV/AIDS. TIP 37 (2000) NCADI # 

BKD359. 

• Brief Interventions and Brief Therapies 

for Substance Abuse. TIP 34 (1999) NCADI # 

BKD341. 

• Enhancing Motivation for Change in 

Substance Abuse Treatment. TIP 35 (1999) 

NCADI # BKD342. 

• Screening and Assessing Adolescents for 

Substance Use Disorders. TIP 31 (1999) 

NCADI # BKD306. 

• Treatment for Stimulant Use Disorders. 

TIP 33 (1999) NCADI # BKD289. 

• Treatment of Adolescents with 

Substance Use Disorders. TIP 32 (1999) 

NCADI # BKD307. 

• Comprehensive Case Management for 

Substance Abuse Treatment. TIP 27 (1998) 

NCADI # BKD251. 

• Continuity of Offender Treatment for 

Substance Use Disorders From Institution to 

Community. TIP 30 (1998) NCADI # BKD304. 

• Naltrexone and Alcoholism Treatment. 

TIP 28 (1998) NCADI # BKD268. 

• Substance Abuse Among Older Adults. 

TIP 26 (1998) NCADI # BKD250. 

• Substance Use Disorder Treatment for 

People With Physical and Cognitive 

Disabilities. TIP 29 (1998) NCADI # BKD288. 

• A Guide to Substance Abuse Services for 

Primary Care Clinicians. TIP 24 (1997) 

NCADI # BKD234. 

• Substance Abuse Treatment and 

Domestic Violence. TIP 25 (1997) NCADI # 

BKD239. 

• Treatment Drug Courts: Integrating 

Substance Abuse Treatment With Legal Case 

Processing. TIP 23 (1996) NCADI # BKD205. 

• Alcohol and Other Drug Screening of 

Hospitalized Trauma Patients. TIP 16 (1995) 

NCADI # BKD164. 

• Combining Alcohol and Other Drug 

Abuse Treatment With Diversion for 

Juveniles in the Justice System. TIP 21 (1995) 

NCADI # BKD169. 

• Detoxification From Alcohol and Other 

Drugs. TIP 19 (1995) NCADI # BKD172. 

• LAAM in the Treatment of Opiate 

Addiction. TIP 22 (1995) NCADI # BKD170. 

• Matching Treatment to Patient Needs in 

Opioid Substitution Therapy. TIP 20 (1995) 

NCADI # BKD168. 

• Planning for Alcohol and Other Drug 

Abuse Treatment for Adults in the Criminal 

Justice System. TIP 17 (1995) NCADI # 

BKD165. 

• Assessment and Treatment of CocaineAbusing Methadone-Maintained Patients. TIP 

10 (1994) NCADI # BKD157. 

• Assessment and Treatment of Patients 

With Coexisting Mental Illness and Alcohol 

and Other Drug Abuse. TIP 9 (1994) NCADI 

# BKD134. 

• Intensive Outpatient Treatment for 

Alcohol and Other Drug Abuse. TIP 8 (1994) 

NCADI # BKD139. 

Other Effective Practice Publications: 

CSAT Publications—

• Anger Management for Substance Abuse 

and Mental Health Clients: A Cognitive 

Behavioral Therapy Manual (2002) NCADI # 

BKD444. 

• Anger Management for Substance Abuse 

and Mental Health Clients: Participant 

Workbook (2002) NCADI # BKD445. 

• Multidimensional Family Therapy for 

Adolescent Cannabis Users. CYT Cannabis 

Youth Treatment Series Vol. 5 (2002) NCADI 

# BKD388. 

• Navigating the Pathways: Lessons and 

Promising Practices in Linking Alcohol and 

Drug Services with Child Welfare. TAP 27 

(2002) NCADI # BKD436. 

• The Motivational Enhancement Therapy 

and Cognitive Behavioral Therapy 

Supplement: 7 Sessions of Cognitive 

Behavioral Therapy for Adolescent Cannabis 

Users. CYT Cannabis Youth Treatment Series 

Vol. 2 (2002) NCADI # BKD385. 

• Family Support Network for Adolescent 

Cannabis Users. CYT Cannabis Youth 

Treatment Series Vol. 3 (2001) NCADI # 

BKD386. 

62338 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

• Identifying Substance Abuse Among 

TANF-Eligible Families. TAP 26 (2001) 

NCADI # BKD410. 

• Motivational Enhancement Therapy and 

Cognitive Behavioral Therapy for Adolescent 

Cannabis Users: 5 Sessions. CYT Cannabis 

Youth Treatment Series Vol. 1 (2001) NCADI 

# BKD384. 

• The Adolescent Community 

Reinforcement Approach for Adolescent 

Cannabis Users. CYT Cannabis Youth 

Treatment Series Vol. 4 (2001) NCADI # 

BKD387. 

• Substance Abuse Treatment for Women 

Offenders: Guide to Promising Practices. TAP 

23 (1999) NCADI # BKD310. 

• Addiction Counseling Competencies: 

The Knowledge, Skills, and Attitudes of 

Professional Practice. TAP 21 (1998) NCADI 

# BKD246. 

• Bringing Excellence to Substance Abuse 

Services in Rural and Frontier America. TAP 

20 (1997) NCADI # BKD220. 

• Counselor’s Manual for Relapse 

Prevention with Chemically Dependent 

Criminal Offenders. TAP 19 (1996) NCADI # 

BKD723. 

• Draft Buprenorphine Curriculum for 

Physicians (Note: the Curriculum is in 

DRAFT form and is currently being updated) 

http://www.buprenorphine.samhsa.gov. 

• CSAT Guidelines for the Accreditation of 

Opioid Treatment Programs http:// 

www.samhsa.gov/centers/csat/content/dpt/ 

accreditation.htm. 

• Model Policy Guidelines for Opioid 

Addiction Treatment in the Medical Office 

http://www.samhsa.gov/centers/csat/content/ 

dpt/model_policy.htm. 

NIDA Manuals—Available through 

NCADI—

• Brief Strategic Family Therapy. Manual 

5 (2003) NCADI # BKD481. 

• Drug Counseling for Cocaine Addiction: 

The Collaborative Cocaine Treatment Study 

Model. Manual 4 (2002) NCADI # BKD465. 

• The NIDA Community-Based Outreach 

Model: A Manual to Reduce Risk HIV and 

Other Blood-Borne Infections in Drug Users. 

(2000) NCADI # BKD366. 

• An Individual Counseling Approach to 

Treat Cocaine Addiction: The Collaborative 

Cocaine Treatment Study Model. Manual 3 

(1999) NCADI # BKD337. 

• Cognitive-Behavioral Approach: Treating 

Cocaine Addiction. Manual 1 (1998) NCADI 

# BKD254. 

• Community Reinforcement Plus 

Vouchers Approach: Treating Cocaine 

Addiction. Manual 2 (1998) NCADI # 

BKD255. 

NIAAA Publications—* These publications 

are available in PDF format or can be ordered 

on-line at http://www.niaaa.nih.gov/ 

publications/guides.htm. An order form for 

the Project MATCH series is available on-line 

at http://www.niaaa.nih.gov/publications/ 

match.htm. All publications listed can be 

ordered through the NIAAA Publications 

Distribution Center, P.O. Box 10686, 

Rockville, MD 20849–0686. 

• * Alcohol Problems in Intimate 

Relationships: Identification and 

Intervention. A Guide for Marriage and 

Family Therapists (2003) NIH Pub. No. 03–

5284. 

• * Helping Patients with Alcohol 

Problems: A Health Practitioner’s Guide. 

(2003) NIH Pub. No. 03–3769. 

• Cognitive-Behavioral Coping Skills 

Therapy Manual. Project MATCH Series, Vol. 

3 (1995) NIH Pub. No. 94–3724. 

• Motivational Enhancement Therapy 

Manual. Project MATCH Series, Vol. 2 (1994) 

NIH Pub. No. 94–3723. 

Appendix F—Statement Of Assurance. 

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 constitute 

adequate documentation.) 

lllllllllllllllllllll

Signature of Authorized Representative 

lllllllllllllllllllll

Date 

Appendix G ‘‘ Logic Model Resources 

Chen, W.W., Cato, B.M., & Rainford, N. 

(1998–9). Using a logic model to plan and 

evaluate a community intervention program: 

A case study. International Quarterly of 

Community Health Education, 18(4), 449–

458. 

Edwards, E.D., Seaman, J.R., Drews, J., & 

Edwards, M.E. (1995). A community 

approach for Native American drug and 

alcohol prevention programs: A logic model 

framework. Alcoholism Treatment Quarterly, 

13(2), 43–62. 

Hernandez, M. & Hodges, S. (2003). 

Crafting Logic Models for Systems of Care: 

Ideas into Action. [Making children’s mental 

health services successful series, volume 1]. 

Tampa, FL: University of South Florida, The 

Louis de la Parte Florida Mental Health 

Institute, Department of Child & Family 

Studies. http://cfs.fmhi.usf.edu or phone 

(813) 974–4651 

Hernandez, M. & Hodges, S. (2001). 

Theory-based accountability. In M. 

Hernandez & S. Hodges (Eds.), Developing 

Outcome Strategies in Children’s Mental 

Health, pp. 21–40. Baltimore: Brookes. 

Julian, D.A. (1997). Utilization of the logic 

model as a system level planning and 

evaluation device. Evaluation and Planning, 

20(3), 251–257. 

Julian, D.A., Jones, A., & Deyo, D. (1995). 

Open systems evaluation and the logic 

model: Program planning and evaluation 

tools. Evaluation and Program Planning, 

18(4), 333–341. 

Patton, M.Q. (1997). Utilization-Focused 

Evaluation (3rd Ed.), pp. 19, 22, 241. 

Thousand Oaks, CA: Sage. 

Wholey, J.S., Hatry, H.P., Newcome, K.E. 

(Eds.) (1994). Handbook of Practical Program 

Evaluation. San Francisco, CA: Jossey-Bass 

Inc. 

Appendix H—Sample Budget and 

Justification 

Illustration of a Sample Detailed Budget and 

Narrative Justification to Accompany SF 

424A: Section B for 01 Budget Period 

Object Class Categories 

Personnel 

Job title Name Annual salary Level of effort Salary being 

requested 

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

Secretary ................................................... Unnamed .................................................. 18,000 0.5 9,000 

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

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62339 

Enter Personnel subtotal on 424A, Section B, 

6.a. $64,000 

Fringe Benefits (24%) $15,360 

Enter Fringe Benefits subtotal on 424A, 

Section B, 6.b. $15,360 

Travel 

2 trips for SAMHSA Meetings for 2 Attendees (Airfare @ $600 x 4 = $2,400) + (per diem @ $120 × 4 × 6 days = $2,880) ............. $5,280 

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

Enter Travel subtotal on 424A, Section B, 

6.c. $ 5,400 

Equipment (List Individually) 

‘‘Equipment’’ means an article of 

nonexpendable, tangible personal property 

having a useful life of more than one year 

and an acquisition cost which equals the 

lesser of (a) the capitalization level 

established by the governmental unit or 

nongovernmental applicant for financial 

statement purposes, or (b) $5000. 

Enter Equipment subtotal on 424A, Section 

B, 6.d. 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Computer Software—1 WordPerfect ....................................................................................................................................................... 500 

Enter Supplies subtotal on 424A, Section B, 

6.e. $1,000 

Contractual Costs 

Evaluation 

Job title Name Annual salary Salary being 

requested Level of effort 

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

Other staff ................................................. .............................................................. 18,000 18,000 1.0 

Fringe Benefits (25%) $10,500 

Travel 

2 trips × 1 Evaluator ($600 × 2) .............................................................................................................................................................. $1,200 

per diem @ $120 × 6 .............................................................................................................................................................................. 720 

Supplies (General Office) ........................................................................................................................................................................ 500 

Evaluation Direct ...................................................................................................................................................................................... $54,920 

Evaluation Indirect Costs (19%) .............................................................................................................................................................. 10,435 

Evaluation Subtotal ........................................................................................................................................................................... 65,355 

Training 

Job title Name Level of effort Salary being 

requested 

Coordinator ............................................................... M. Smith ................................................................... 0.5 $12,000 

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

Fringe Benefits (25%) $5,250 

Travel 

2 Trips for Training Airfare @ $600 × 2 .................................................................................................................................................. $1,200 

Per Diem $120 × 2 × 2 days ................................................................................................................................................................... 480 

Local (500 miles × .24/mile) .................................................................................................................................................................... 120 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

62340 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

Software (WordPerfect) ........................................................................................................................................................................... 500 

Other 

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

Telephone ................................................................................................................................................................................................ 500 

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

Audit ......................................................................................................................................................................................................... 3,000 

Training Direct ......................................................................................................................................................................................... $40,025 

Training Indirect ....................................................................................................................................................................................... 0 

Enter Contractual subtotal on 424A, Section 

B, 6.f. $105,380 

Other 

Consultants = Expert @ $250/day × 6 day (If expert is known, should list by name) ........................................................................... $1,500 

Enter Other subtotal on 424A, Section B, 6.h.

$1,500 

Total Direct Charges (sum of 6.a–6.h) 

Enter Total Direct on 424A, Section B, 6.i.

$192,640 

Indirect Costs 

15% of Salary and Wages (copy of 

negotiated indirect cost rate agreement 

attached) 

Enter Indirect subtotal of 424A, Section B, 

6.j. $9,600 

Totals 

Enter Total on 424A, Section B, 6.k.

$202,240 

Justification 

Personnel—Describe the role and 

responsibilities of each position. 

Fringe Benefits—List all components of the 

fringe benefit rate. 

Equipment—List equipment and describe 

the need and the purpose of the equipment 

in relation to the proposed project. 

Supplies—Generally self-explanatory; 

however, if not, describe need. Include 

explanation of how the cost has been 

estimated. 

Travel—Explain need for all travel other 

than that required by SAMHSA. 

Contractual Costs—Explain the need for 

each contractual arrangement and how these 

components relate to the overall project. 

Other—Generally self-explanatory. If 

consultants are included in this category, 

explain the need and how the consultant’s 

rate has been determined. 

Indirect Cost Rate—If your organization 

has no indirect cost rate, please indicate 

whether your organization plans to a) waive 

indirect costs if an award is issued, or b) 

negotiate and establish an indirect cost rate 

with DHHS within 90 days of award 

issuance. 

CALCULATION OF FUTURE BUDGET PERIODS (BASED ON FIRST 12-MONTH BUDGET PERIOD) 

[Review and verify the accuracy of future year budget estimates. Increases or decreases in the future years must be explained and justified and 

no cost of living increases will be honored. (Note: new salary cap of $175,700 is effective for all FY 2005 awards.) *] 

First 12-month 

period 

Second 

12-month 

period 

Third 12-month 

period 

Personnel: 

Project Director ......................................................................................................... 30,000 30,000 30,000 

Secretary** ................................................................................................................ 9,000 18,000 18,000 

Counselor ................................................................................................................. 25,000 25,000 25,000 

Total Personnel ................................................................................................. 64,000 73,000 73,000 

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

Travel ............................................................................................................................... 5,400 5,400 5,400 

Equipment ........................................................................................................................ -0- -0- -0- 

Supplies*** ....................................................................................................................... 1,000 520 520 

Contractual: 

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

Training ..................................................................................................................... 40,025 40,025 40,025 

Other ......................................................................................................................... 1,500 1,500 1,500 

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

Indirect Costs (15% S&W) ....................................................................................... 9,600 9,600 9,600 

Total Costs ........................................................................................................ 202,240 216,884 219,603 

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

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

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

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

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62341 

The Federal dollars requested for all object 

class categories for the first 12-month budget 

period are entered on Form 424A, Section B, 

Column (1), lines 6a–6i. The total Federal 

dollars requested for the second through the 

fifth 12-month budget periods are entered on 

Form 424A, Section E, Columns (b)–(e), line 

20. The RFA will specify the maximum 

number of years of support that may be 

requested. 

Infrastructure Grants—INF 05 PA (Initial 

Announcement) 

Catalogue of Federal Domestic Assistance 

(CFDA) No.: 93.243 (unless otherwise 

specified in a NOFA in the Federal Register 

and on http://www.grants.gov) 

KEY DATES

Application Deadline ........................................... This Program Announcement provides general instructions and guidelines for multiple funding 

opportunities. Application deadlines for specific funding opportunities will be published in Notices of Funding Availability (NOFAs) in the Federal Register and on http://www.grants.gov. 

Intergovernmental Review (E.O. 12372) ............ Letters from State Single Point of Contact (SPOC) are due no later than 60 days after application deadline. 

Public Health System Impact Statement 

(PHSIS)/SSA Coordination.

Applicants must send the PHSIS to appropriate State and local health agencies by application 

deadline. Comments from Single State Agency are due no later than 60 days after application deadline. 

Table of Contents 

Funding Opportunity Description 

1. Introduction 

2. Expectations 

II. Award Information 

1. Award Amount 

2. Funding Mechanism 

III. Eligibility Information 

1. Eligible Applicants 

2. Cost Sharing 

IV. Application and Submission Information 

1. Address to Request Application Package 

2. Content and Form of Application 

Submission 

3. Submission Dates and Times 

4. Intergovernmental Review (E.O. 12372) 

Requirements 

5. Funding Limitations/Restrictions 

6. Other Submission Requirements 

V. Application Review Information 

1. Evaluation Criteria 

2. Review and Selection Process 

VI. Award Administration Information 

1. Award Notices 

2. Administrative and National Policy 

Requirements 

3. Reporting Requirements 

VII. Agency Contacts 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria for 

SAMHSA Grant Applications 

Appendix B—Glossary 

Appendix C—Logic Model Resources 

Appendix D—Sample Budget and 

Justification 

I. Funding Opportunity Description 

1. Introduction 

The Substance Abuse and Mental 

Health Services Administration 

(SAMHSA) announces its intent to 

solicit applications for Infrastructure 

Grants. This program announcement 

must be considered in conjunction with 

a full Notice of Funding Availability 

(NOFA), which specifies the grant 

program’s purpose, target population, 

and other requirements of the program. 

These grants will increase the capacity 

of mental health and/or substance abuse 

service systems to support effective 

programs and services. Applicants who 

seek Federal support to develop or 

enhance their service system 

infrastructure in order to support 

effective substance abuse and/or mental 

health services should apply for awards 

under this announcement. 

SAMHSA also funds grants under 

three other standard grant 

announcements: 

fi Services Grants provide funding to 

implement substance abuse and mental 

health services. 

fi Best Practices Planning and 

Implementation Grants help 

communities and providers identify 

practices to effectively meet local needs, 

develop strategic plans for 

implementing/adapting those practices 

and pilot-test practices prior to fullscale implementation. 

fi Service to Science Grants 

document and evaluate innovative 

practices that address critical substance 

abuse and mental health service gaps 

but that have not yet been formally 

evaluated. 

This announcement describes the 

general program design and provides 

application instructions for all 

SAMHSA Infrastructure Grants. The 

availability of funds for specific 

Infrastructure Grants will be announced 

in supplementary Notices of Funding 

Availability (NOFAs) in the Federal 

Register and at http://www.grants.gov—

the Federal grant announcement Web 

page. 

SAMHSA’s Infrastructure Grants are 

authorized under Section 509, 516 and/ 

or 520A of the Public Health Service 

Act, unless otherwise specified in a 

NOFA in the Federal Register and on 

http://www.grants.gov. 

Typically, funding for Infrastructure 

Grants will be targeted to specific 

populations and/or issue areas, which 

will be specified in the NOFAs. The 

NOFAs will also: 

fi Specify total funding available for 

the first year of the grants and the 

expected size and number of awards; 

fi Provide the application deadline; 

fi Note any specific program 

requirements for each funding 

opportunity; and 

fi Include any limitations or 

exceptions to the general provisions in 

this announcement (e.g., eligibility, 

allowable activities). 

It is, therefore, critical that you 

consult the NOFA as well as this 

announcement in developing your grant 

application. 

2. Expectations 

SAMHSA’s Infrastructure Grants 

support an array of activities to help the 

grantee build a solid foundation for 

delivering and sustaining effective 

substance abuse prevention and/or 

treatment and/or mental health services. 

SAMHSA recognizes that each 

applicant will start from a unique point 

in developing infrastructure and will 

serve populations/communities with 

specific needs. Awardees may pursue 

diverse strategies and methods to 

achieve their infrastructure 

development and capacity expansion 

goals. Successful applicants will 

provide a coherent and detailed 

conceptual ‘‘roadmap’’ of the process by 

which they have assessed or intend to 

assess service system needs and plan/ 

implement infrastructure development 

strategies that meet those needs. The 

plan put forward in the grant 

application must show the linkages 

among needs, the proposed 

infrastructure development strategy, and 

increased system capacity that will 

enhance and sustain effective programs 

and services. 

2.1 Allowable Activities 

SAMHSA’s Infrastructure Grants will 

support the following types of activities. 

Applicants must refer to the NOFA for 

required activities and exceptions to 

allowable activities. 

62342 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

Infrastructure Development 

Infrastructure Grant funds must be 

used primarily to support infrastructure 

development, including the following 

types of activities: 

fi Needs assessment 

fi Strategic planning 

fi Financing/coordination of funding 

streams 

fi Organizational/structural change 

(e.g., to create locus of responsibility for 

a specific issue/population, or to 

increase access to or efficiency of 

services) 

fi Development of interagency 

coordination mechanisms 

fi Provider/network development 

fi Policy development to support 

needed service system improvements 

(e.g., rate-setting activities, 

establishment of standards of care, 

development/revision of credentialing, 

licensure, or accreditation requirements) 

fi Quality improvement efforts 

fi Performance measurement 

development 

fi Workforce development (e.g., 

training, support for licensure, 

credentialing, or accreditation) 

fi Data infrastructure/MIS 

development 

Implementation Pilots (maximum 15 

percent of total grant award) 

Depending on the scope of the project 

(see description of award categories 

below), up to 15 percent of the total 

grant award may be used for 

‘‘implementation pilots’’ to test the 

effectiveness of the infrastructure 

changes on services delivery. Funds 

may not be used to provide direct 

services except in the context of an 

implementation pilot. 

2.2 Data and Performance 

Measurement 

The Government Performance and 

Results Act of 1993 (Pub. L.103–62, or 

‘‘GPRA’’) requires all Federal agencies to 

set program performance targets and 

report annually on the degree to which 

the previous year’s targets were met. 

Agencies are expected to evaluate 

their programs regularly and to use 

results of these evaluations to explain 

their successes and failures and justify 

requests for funding. 

To meet the GPRA requirements, 

SAMHSA must collect performance data 

(i.e., ‘‘GPRA data’’) from grantees. 

Grantees are required to report these 

GPRA data to SAMHSA on a timely 

basis. 

Specifically, grantees will be required 

to provide data on a set of required 

measures, as specified in the NOFA. 

The data collection tools to be used for 

reporting the required data will be 

provided in the application kits 

distributed by SAMHSA’s 

clearinghouses and posted on 

SAMHSA’s website along with each 

NOFA. In your application, you must 

demonstrate your ability to collect and 

report on these measures, and you may 

be required to provide some baseline 

data. 

The terms and conditions of the grant 

award also will specify the data to be 

submitted and the schedule for 

submission. Grantees will be required to 

adhere to these terms and conditions of 

award. 

Applicants should be aware that 

SAMHSA is working to develop a set of 

required core performance measures for 

each of SAMHSA’s standard grants (i.e., 

Services Grants, Infrastructure Grants, 

Best Practices Planning and 

Implementation Grants, and Service-toScience Grants). As this effort proceeds, 

some of the data collection and 

reporting requirements included in 

SAMHSA’s NOFAs may change. All 

grantees will be expected to comply 

with any changes in data collection 

requirements that occur during the 

grantee’s project period. 

2.3 Grantee Meetings 

You must plan to send a minimum of 

two people (including the Project 

Director) to at least one joint grantee 

meeting in each year of the grant, and 

you must include funding for this travel 

in your budget. At these meetings, 

grantees will present the results of their 

projects and Federal staff will provide 

technical assistance. Each meeting will 

be 3 days. These meetings will usually 

be held in the Washington, DC, area and 

attendance is mandatory. 

2.4 Evaluation 

Grantees must evaluate their projects, 

and applicants are required to describe 

their evaluation plans in their 

applications. The evaluation should be 

designed to provide regular feedback to 

the project to improve 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: 

fi How closely did implementation 

match the plan? 

fi What types of deviation from the 

plan occurred? 

fi What led to the deviations? 

fi What impact did the deviations 

have on the intervention and 

evaluation? 

fi 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: 

fi What was the effect of 

infrastructure development on service 

capacity and other system outcomes? 

fi What program/contextual factors 

were associated with outcomes? 

fi What individual factors were 

associated with outcomes? 

fi How durable were the effects? 

If the project includes an 

implementation pilot involving services 

delivery, the evaluation should include 

client and system outcomes. 

No more than 20% of the total grant 

award may be used for evaluation and 

data collection. The evaluation and data 

collection may be considered 

‘‘Infrastructure’’ and/or ‘‘Implementation 

Pilots’’ expenditures, depending on 

their purpose. 

II. Award Information 

1. Award Amount 

The NOFA will specify the expected 

award amount for each funding 

opportunity. Regardless of the amount 

specified in the NOFA, the actual award 

amount will depend on the availability 

of funds. 

Two types of Infrastructure Grants 

will be made: 

Category 1—Small Infrastructure 

Grants. Category 1 grants will be limited 

in scope as specified in the NOFA. For 

example, allowable activities might be 

limited to workforce development, data 

infrastructure, or strategic planning. 

Implementation pilots are not allowed 

in Category 1 awards. Category 1 awards 

are expected to be for a period of 1–3 

years in amounts ranging from 

$250,000–$500,000 per year. 

Category 2—Comprehensive 

Infrastructure Grants. The scope of the 

Category 2 grants will be much larger. 

While applicants are not required to 

include all of the allowable activities in 

their proposed projects, the proposed 

projects must encompass multiple 

domains (e.g., needs assessment, 

strategic and financial planning, 

organizational/structural change, and 

network development). Category 2 

awards may use a maximum of 15 

percent of the total grant award for 

implementation pilots. Category 2 

awards are expected to be for a period 

of 3–5 years in amounts ranging from 

$750,000–$3 million per year. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62343 

Proposed budgets cannot exceed the 

allowable amount as specified in the 

NOFA in any year of the proposed 

project. Annual continuation awards 

will depend on the availability of funds, 

grantee progress in meeting project goals 

and objectives, and timely submission 

of required data and reports. 

2. Funding Mechanism 

The NOFA will indicate whether 

awards for each funding opportunity 

will be made as grants or cooperative 

agreements (see the Glossary in 

Appendix B for further explanation of 

these funding mechanisms). For 

cooperative agreements, the NOFA will 

describe the nature of Federal 

involvement in project performance and 

specify roles and responsibilities of 

grantees and Federal staff. 

III. Eligibility Information 

1. Eligible Applicants 

Eligible applicants are domestic 

public and private nonprofit entities. 

For example, State, local or tribal 

governments; public or private 

universities and colleges; communityand faith-based organizations; and tribal 

organizations may apply. The statutory 

authority for this program precludes 

grants to for-profit organizations. The 

NOFA will indicate any limitations on 

eligibility. 

2. Cost Sharing 

Cost sharing (see Glossary) is not 

required in this program, and 

applications will not be screened out on 

the basis of cost sharing. However, you 

may include cash or in-kind (see 

Glossary) contributions in your proposal 

as evidence of commitment to the 

proposed project. 

3. Other 

Applications must comply with the 

following requirements, or they will be 

screened out and will not be reviewed: 

use of the PHS 5161–1 application; 

application submission requirements in 

Section IV–3 of this document; and 

formatting requirements provided in 

Section IV–2.3 of this document. 

Applicants should be aware that the 

NOFA may include additional 

requirements that, if not met, will result 

in applications being screened out and 

returned without review. These 

requirements will be specified in 

Section III–3 of the NOFA. 

You also must comply with any 

additional requirements specified in the 

NOFA, such as the required signature of 

certain officials on the face page of the 

application and/or required memoranda 

of understanding with certain 

signatories. 

IV. Application and Submission 

Information 

(To ensure that you have met all 

submission requirements, a checklist is 

provided for your use in Appendix A of 

this document.) 

1. Address to Request Application 

Package 

You may request a complete 

application kit by calling one of 

SAMHSA’s national clearinghouses: 

fi For substance abuse prevention or 

treatment grants, call the National 

Clearinghouse for Alcohol and Drug 

Information (NCADI) at 1–800–729–

6686. 

fi For mental health grants, call the 

National Mental Health Information 

Center at 1–800–789–CMHS (2647). 

You also may download the required 

documents from the SAMHSA Web site 

at http://www.samhsa.gov. Click on 

‘‘Grant Opportunities.’’

Additional materials available on this 

Web site include: 

fi A technical assistance manual for 

potential applicants; 

fi Standard terms and conditions for 

SAMHSA grants; 

fi Guidelines and policies that relate 

to SAMHSA grants (e.g., guidelines on 

cultural competence, consumer and 

family participation, and evaluation); 

and 

fi Enhanced instructions for 

completing the PHS 5161–1 application. 

2. Content and Form of Application 

Submission 

2.1 Application Kit 

SAMHSA application kits include the 

following documents: 

fi PHS 5161–1 (revised July 2000)—

Includes the face page, budget forms, 

assurances, certification, and checklist. 

You must use the PHS 5161–1 unless 

otherwise specified in the NOFA. 

Applications that are not submitted on 

the required application form will be 

screened out and will not be reviewed. 

fi Program Announcement (PA)—

Includes instructions for the grant 

application. This document is the PA. 

fi Notice of Funding Availability 

(NOFA)—Provides specific information 

about availability of funds, as well as 

any exceptions or limitations to 

provisions in the PA. The NOFAs will 

be published in the Federal Register, as 

well as on the Federal grants Web site 

(http://www.grants.gov). It is very 

important that you read the entire 

NOFA before beginning to write your 

application. 

You must use all of the above 

documents in completing your 

application. 

2.2 Required Application Components 

To ensure equitable treatment of all 

applications, applications must be 

complete. In order for your application 

to be complete, it must include the 

required ten application components 

(Face Page, Abstract, Table of Contents, 

Budget Form, Project Narrative and 

Supporting Documentation, 

Appendices, Assurances, Certifications, 

Disclosure of Lobbying Activities, and 

Checklist). 

b 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 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.] 

b 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. 

b Table of Contents—Include page 

numbers for each of the major sections 

of your application and for each 

appendix. 

b Budget Form—Use SF 424A, 

which is part of the 5161–1. Fill out 

Sections B, C, and E of the SF 424A. A 

sample budget and justification is 

included in Appendix D of this Program 

Announcement. 

b Project Narrative and Supporting 

Documentation—The Project Narrative 

describes your project. It consists of 

Sections A through D. These sections in 

total may not be longer than 25 pages. 

(For example, remember that if your 

Project Narrative starts on page 5 and 

ends on page 30, it is 26 pages long, not 

25 pages.) More detailed instructions for 

completing each section of the Project 

Narrative are provided in ‘‘Section V—

Application Review Information’’ of this 

document. 

The Supporting Documentation 

provides additional information 

necessary for the review of your 

application. This supporting 

documentation should be provided 

immediately following your Project 

Narrative in Sections E through H. 

62344 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

There are no page limits for these 

sections, except for Section G, 

Biographical Sketches/Job Descriptions. 

fi Section E—Literature Citations. 

This section must contain complete 

citations, including titles and all 

authors, for any literature you cite in 

your application. 

fi Section F—Budget Justification, 

Existing Resources, Other Support. You 

must provide a narrative justification of 

the items included in your proposed 

budget, as well as a description of 

existing resources and other support 

you expect to receive for the proposed 

project. Be sure to show that no more 

than 20% of the total grant award will 

be used for data collection and 

evaluation. If you are proposing a 

services implementation pilot (allowed 

only for Category 2 applicants), show 

that no more than 15% of the total grant 

award will be used for the pilot. 

fi Section G—Biographical Sketches 

and Job Descriptions. 

Æ Include a biographical sketch for 

the Project Director and other key 

positions. Each sketch should be 2 pages 

or less. If the person has not been hired, 

include a position description and/or 

letter of commitment with a current 

biographical sketch from the individual. 

Æ Include job descriptions for key 

personnel. Job descriptions should be 

no longer than 1 page each. 

Æ Sample sketches and job 

descriptions are listed on page 22, Item 

6 in the Program Narrative section of the 

PHS 5161–1. 

fi 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. 

b Appendices 1 through 5—Use only 

the appendices listed below. If your 

application includes any appendices not 

required in the grant announcement or 

NOFA, they will be disregarded. Do not 

use more than a total of 30 pages for 

Appendices 1, 3 and 4 combined. There 

are no page limitations for Appendices 

2 and 5. Do not use appendices to 

extend or replace any of the sections of 

the Project Narrative unless specifically 

required in the NOFA. Reviewers will 

not consider them if you do. 

fi Appendix 1: Letters of Support 

fi Appendix 2: Data Collection 

Instruments/Interview Protocols 

fi Appendix 3: Sample Consent 

Forms 

fi Appendix 4: Letter to the SSA (if 

applicable; see Section IV–4 of this 

document) 

fi Appendix 5: A copy of the State or 

County Strategic Plan, a State or county 

needs assessment, or a letter from the 

State or county indicating that the 

proposed project addresses a State-or 

county-identified priority. 

b Assurances—Non-Construction 

Programs. Use Standard Form 424B 

found in PHS 5161–1. Some applicants 

will be required to complete the 

Assurance of Compliance with 

SAMHSA Charitable Choice Statutes 

and Regulations Form SMA 170. If this 

assurance applies to a specific funding 

opportunity, it will be posted on 

SAMHSA’s Web site with the NOFA 

and provided in the application kits 

available at SAMHSA’s clearinghouse 

(NCADI). 

b Certifications—Use the 

‘‘Certifications’’ forms found in PHS 

5161–1. 

b 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. 

b 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. 

b Information provided must be 

sufficient for review. 

b Text must be legible. 

b 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.) 

b Text in the Project Narrative 

cannot exceed 6 lines per vertical inch. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

b To ensure equity among 

applications, the amount of space 

allowed for the Project Narrative cannot 

be exceeded. 

b 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. 

b 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. 

b Space will be measured on the 

physical page. Space left blank within 

the Project Narrative (excluding 

margins) is considered part of the 

Project Narrative, in determining 

compliance. 

To facilitate review of your 

application, follow these additional 

guidelines. Failure to adhere to the 

following guidelines will not, in itself, 

result in your application being 

screened out and returned without 

review. However, following these 

guidelines will help reviewers to 

consider your application. 

b Pages should be typed singlespaced in black ink, with one column 

per page. Pages should not have printing 

on both sides. 

b Please number pages consecutively 

from beginning to end so that 

information can be located easily during 

review of the application. The cover 

page should be page 1, the abstract page 

should be page 2, and the table of 

contents page should be page 3. 

Appendices should be labeled and 

separated from the Project Narrative and 

budget section, and the pages should be 

numbered to continue the sequence. 

b The page limit of a total of 30 pages 

for Appendices 1, 3 and 4 combined 

should not be exceeded. 

b 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 

Applicants must describe procedures 

relating to Confidentiality, Participant 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62345 

Protection and the Protection of Human 

Subjects Regulations in Section H of the 

application, using the guidelines 

provided below. Problems with 

confidentiality, participant protection, 

and protection of human subjects 

identified during peer review of the 

application may result in the delay of 

funding. 

Confidentiality and Participant 

Protection 

All applicants must describe how 

they will address the requirements for 

each of the following elements relating 

to confidentiality and participant 

protection. 

1. Protect Clients and Staff From 

Potential Risks 

fi 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. 

fi Describe the procedures you will 

follow to minimize or protect 

participants against potential risks, 

including risks to confidentiality. 

fi Identify plans to provide guidance 

and assistance in the event there are 

adverse effects to participants. 

fi 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 

fi 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. 

fi 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. 

fi Explain the reasons for including 

or excluding participants. 

fi Explain how you will recruit and 

select participants. Identify who will 

select participants. 

3. Absence of Coercion 

fi 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. 

fi If you plan to compensate 

participants, state how participants will 

be awarded incentives (e.g., money, 

gifts, etc.). 

fi 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 

fi 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. 

fi 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. 

fi Provide in Appendix 2, ‘‘Data 

Collection Instruments/Interview 

Protocols,’’ copies of all available data 

collection instruments and interview 

protocols that you plan to use. 

5. Privacy and Confidentiality 

fi Explain how you will ensure 

privacy and confidentiality. Include 

who will collect data and how it will be 

collected. 

fi Describe: 

Æ How you will use data collection 

instruments. 

Æ Where data will be stored. 

Æ Who will or will not have access to 

information. 

Æ How the identity of participants 

will be kept private, for example, 

through the use of a coding system on 

data records, limiting access to records, 

or storing identifiers separately from 

data. 

Note: If applicable, grantees must agree to 

maintain the confidentiality of alcohol and 

drug abuse client records according to the 

provisions of Title 42 of the Code of Federal 

Regulations, Part 2. 

6. Adequate Consent Procedures 

fi 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. 

fi State: 

Æ Whether or not their participation 

is voluntary. 

Æ Their right to leave the project at 

any time without problems. 

Æ Possible risks from participation in 

the project. 

Æ Plans to protect clients from these 

risks. 

fi 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 

informed consent. 

fi 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? 

fi Include, as appropriate, sample 

consent forms that provide for: (1) 

Informed consent for participation in 

service intervention; (2) informed 

consent for participation in the data 

collection component of the project; and 

(3) informed consent for the exchange 

(releasing or requesting) of confidential 

information. The sample forms must be 

included in Appendix 3, ‘‘Sample 

Consent Forms’’, of your application. If 

needed, give English translations. 

Note: Never imply that the participant 

waives or appears to waive any legal rights, 

may not end involvement with the project, or 

releases your project or its agents from 

liability for negligence. 

fi 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? 

fi 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 

Discuss why the risks are reasonable 

compared to expected benefits and 

importance of the knowledge from the 

project. 

Protection of Human Subjects 

Regulations 

SAMHSA expects that most grantees 

funded under Infrastructure Grant 

62346 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

programs will not be required to comply 

with the Protection of Human Subjects 

Regulations (45 CFR part 46). However, 

in some instances, special evaluation 

and data collection requirements for a 

particular funding opportunity may 

necessitate that all grantees comply with 

these regulations. In such instances, the 

NOFA will explicitly state that grantees 

must comply with the regulations. 

If the NOFA does not explicitly state 

that grantees must comply with the 

Protection of Human Subjects 

Regulations (45 CFR part 46), grantees 

will be required to comply with the 

regulations only if the project-specific 

evaluation design proposed by the 

grantee requires compliance with the 

regulations. 

Applicants whose projects must 

comply with the Protection of Human 

Subjects Regulations must describe the 

process for obtaining Institutional 

Review Board (IRB) approval fully in 

their applications. While IRB approval 

is not required at the time of grant 

award, these applicants will be 

required, as a condition of award, to 

provide the documentation that an 

Assurance of Compliance is on file with 

the Office for Human Research 

Protections (OHRP) and that IRB 

approval has been received prior to 

enrolling any clients in the proposed 

project. 

General information about Protection 

of Human Subjects Regulations can be 

obtained on the web at http://hhs.gov/ 

ohrp. You may also contact OHRP by email (ohrp@osophs.dhhs.gov) or by 

phone (301–496–7005). SAMHSAspecific questions related to Protection 

of Human Subjects Regulations should 

be directed to the program contact listed 

in Section VII of the NOFA. 

3. Submission Dates and Times 

Deadlines for submission of 

applications for specific funding 

opportunities will be published in the 

NOFAs in the Federal Register and 

posted on the Federal grants Web site 

(www.grants.gov). 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

Your application must be received by 

the application deadline, or you must 

have proof of its timely submission as 

specified below. 

• For packages submitted via DHL, 

Falcon Carrier, Federal Express (FedEx), 

or United Parcel Service (UPS), timely 

submission shall be evidenced by a 

delivery service receipt indicating the 

application was delivered to a carrier 

service at least 24 hours prior to the 

application deadline. 

• For packages submitted via the 

United States Postal Service (USPS), 

proof of timely submission shall be a 

postmark not later than 1 week prior to 

the application deadline, and the 

following upon request by SAMHSA: 

Æ Proof of mailing using USPS Form 

3817 (Certificate of Mailing), or 

Æ A receipt from the Post Office 

containing the post office name, 

location, and date and time of mailing. 

You will be notified by postal mail 

that your application has been received. 

Applications not meeting the timely 

submission requirements above will not 

be considered for review. Please 

remember that mail sent to Federal 

facilities undergoes a security screening 

prior to delivery. Allow sufficient time 

for your package to be delivered. 

If an application is mailed to a 

location or office (including room 

number) that is not designated for 

receipt of the application, and that 

results in the designated office not 

receiving your application in 

accordance with the requirements for 

timely submission, it will cause the 

application to be considered late and 

ineligible for review. 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

SAMHSA is collaborating with http: 

//www.grants.gov to accept electronic 

submission of applications only for 

select funding opportunities. Unless 

specifically indicated in the NOFA, 

electronic submission of applications 

will not be accepted. 

4. Intergovernmental Review (E.O. 

12372) Requirements 

Executive Order 12372, as 

implemented through Department of 

Health and Human Services (DHHS) 

regulation at 45 CFR Part 100, sets up 

a system for State and local review of 

applications for Federal financial 

assistance. A current listing of State 

Single Points of Contact (SPOCs) is 

included in the application kit and can 

be downloaded from the Office of 

Management and Budget (OMB) Web 

site at http://www.whitehouse.gov/omb/ 

grants/spoc.html. 

fi 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. 

fi 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. 

fi For proposed projects serving 

more than one State, you are advised to 

contact the SPOC of each affiliated 

State. 

fi The SPOC should send any State 

review process recommendations to the 

following address within 60 days of the 

application deadline: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857, ATTN: SPOC—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SPOC—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition, community-based, nongovernmental service providers who are 

not transmitting their applications 

through the State must submit a Public 

Health System Impact Statement 

(PHSIS) (approved by OMB under 

control no. 0920–0428; see burden 

statement below) to the head(s) of 

appropriate State or local health 

agencies in the area(s) to be affected no 

later than the pertinent receipt date for 

applications. The PHSIS is intended to 

keep State and local health officials 

informed of proposed health services 

grant applications submitted by 

community-based, non-governmental 

organizations within their jurisdictions. 

State and local governments and Indian 

tribal government applicants are not 

subject to these requirements. 

The PHSIS consists of the following 

information: 

fi A copy of the face page of the 

application (SF 424); and 

fi 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 

http://www.samhsa.gov. If the proposed 

project falls within the jurisdiction of 

more than one State, you should notify 

all representative SSAs. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62347 

Applicants who are not the SSA must 

include a copy of a letter transmitting 

the PHSIS to the SSA in Appendix 4, 

‘‘Letter to the SSA.’’ The letter must 

notify the State that, if it wishes to 

comment on the proposal, its comments 

should be sent not later than 60 days 

after the application deadline to: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20850, ATTN: SSA—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SSA—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition: 

fi Applicants may request that the 

SSA send them a copy of any State 

comments. 

fi The applicant must notify the SSA 

within 30 days of receipt of an award. 

[Public reporting burden for the Public 

Health System Reporting Requirement is 

estimated to average 10 minutes per 

response, including the time for copying 

the face page of SF 424 and the abstract 

and preparing the letter for mailing. An 

agency may not conduct or sponsor, and 

a person is not required to respond to, 

a collection of information unless it 

displays a currently valid OMB control 

number. The OMB control number for 

this project is 0920–0428. Send 

comments regarding this burden to CDC 

Clearance Officer, 1600 Clifton Road, 

MS D–24, Atlanta, GA 30333, ATTN: 

PRA (0920–0428).] 

5. Funding Limitations/Restrictions 

Cost principles describing allowable 

and unallowable expenditures for 

Federal grantees, including SAMHSA 

grantees, are provided in the following 

documents: 

fi Institutions of Higher Education: 

OMB Circular A–21 

fi State and Local Governments: 

OMB Circular A–87 

fi Nonprofit Organizations: OMB 

Circular A–122 

fi Appendix E Hospitals: 45 CFR Part 

74 

In addition, SAMHSA Infrastructure 

Grant recipients must comply with the 

following funding restrictions: 

fi Infrastructure grant funds must be 

used for purposes supported by the 

program. 

fi If requested project funds exceed 

$750,000, a maximum of 15% of grant 

award funds may be used for 

implementation pilots. Direct services 

may be funded only in the context of an 

implementation pilot. 

fi No more than 20% of the grant 

award may be used for evaluation and 

data collection expenses. These 

expenses may be considered 

infrastructure or implementation pilot 

expenses, depending on the nature of 

the evaluation and data collection. 

fi Infrastructure funds may not be 

used to pay for the purchase or 

construction of any building or structure 

to house any part of the grant project. 

Applications may request up to $75,000 

for renovations and alterations of 

existing facilities. 

fi SAMHSA will not accept a 

‘‘research’’ indirect cost rate. The 

grantee must use the ‘‘other sponsored 

program rate’’ or the lowest rate 

available. 

6. Other Submission Requirements 

6.1 Where to Send Applications 

Send applications to the following 

address: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20850. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850. 

Do not send applications to other 

agency contacts, as this could delay 

receipt. Be sure to include the funding 

announcement number from the NOFA 

in item number 10 on the face page of 

the application. If you require a phone 

number for delivery, you may use (240) 

276–1199. 

6.2 How To Send Applications 

Mail or deliver an original application 

and 2 copies (including appendices) to 

the mailing address provided above, 

according to the instructions in Section 

IV–3. The original and copies must not 

be bound. Do not use staples, paper 

clips, or fasteners. Nothing should be 

attached, stapled, folded, or pasted. 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

Unless specifically indicated in the 

NOFA, electronic submission of 

applications will not be accepted. 

V. Application Review Information 

1. Evaluation Criteria 

Your application will be reviewed 

and scored according to the quality of 

your response to the requirements listed 

below for developing the Project 

Narrative (Sections A–D). These 

sections describe what you intend to do 

with your project. 

fi In developing the Project Narrative 

section of your application, use these 

instructions along with any additional 

instructions found in the NOFA. These 

are to be used instead of the ‘‘Program 

Narrative’’ instructions found in the 

PHS 5161–1. 

fi 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. 

fi 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 

http://www.samhsa.gov. Click on ‘‘Grant 

Opportunities.’’

fi 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. 

fi The number of points after each 

heading below is the maximum number 

of points a review committee may assign 

to that section of your Project Narrative. 

Bullet statements in each section do not 

have points assigned to them. They are 

provided to invite the attention of 

applicants and reviewers to important 

areas within each section. 

Section A: Statement of Need (10 

Points) 

fi Describe the target population (see 

Glossary) and the proposed catchment 

area (see Glossary), and justify the 

selection of both. Be sure to check the 

NOFA for any specific requirements 

regarding the target population and/or 

catchment area. Include the numbers to 

be served and demographic information. 

62348 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

Discuss the target population’s 

language, beliefs, norms and values, as 

well as socioeconomic factors that must 

be considered in delivering programs to 

this population. 

fi Document the need for an 

enhanced infrastructure to increase the 

capacity to implement, sustain, and 

improve effective substance abuse 

prevention and/or treatment and/or 

mental health services for the proposed 

target population in the proposed 

catchment area. Documentation of need 

may come from local data or trend 

analyses, State data (e.g., from State 

Needs Assessments), and/or national 

data (e.g., from SAMHSA’s National 

Household Survey on Drug Abuse and 

Health or from National Center for 

Health Statistics/Centers for Disease 

Control reports). For data sources that 

are not well known, provide sufficient 

information on how the data were 

collected so reviewers can assess the 

reliability and validity of the data. 

fi Describe the service gaps, barriers, 

and other problems related to the need 

for infrastructure development. Describe 

the stakeholders (see Glossary) and 

resources in the target area that can help 

implement the needed infrastructure 

development. 

fi Non-tribal applicants must show 

that identified needs are consistent with 

priorities of the State or county that has 

primary responsibility for the service 

delivery system. Include, in Appendix 

5, a copy of the State or County Strategic 

Plan, a State or county needs 

assessment, or a letter from the State or 

county indicating that the proposed 

project addresses a State- or countyidentified priority. Tribal applicants 

must provide similar documentation 

relating to tribal priorities. 

fi Check the NOFA for any 

additional requirements. 

Section B: Proposed Approach (35 

Points) 

fi Clearly state the purpose of the 

proposed project, with goals and 

objectives. Describe how achievement of 

goals will address the overall program 

purpose specified in the NOFA and 

increase system capacity to support 

effective substance abuse and/or mental 

health services. 

fi Describe the proposed project. 

Address any and all expectations/ 

required activities specified in the 

NOFA. Provide evidence that the 

proposed activities meet the 

infrastructure needs and show how your 

proposed infrastructure development 

strategy will meet the goals and 

objectives. 

fi Provide a logic model (see 

Glossary) that demonstrates the linkage 

between the identified need, the 

proposed approach, and outcomes. 

fi If you plan to include an advisory 

body in your project, describe its 

membership, roles and functions, and 

frequency of meetings. 

fi Describe any other organizations 

that will participate and their roles and 

responsibilities. Demonstrate their 

commitment to the project. Include 

letters of commitment/coordination/ 

support from these community 

organizations in Appendix 1 of the 

application. Identify any cash or in-kind 

contributions that will be made to the 

project. 

fi Describe how the proposed project 

will address issues of age, race/ 

ethnicity, culture, language, sexual 

orientation, disability, literacy, and 

gender in the target population. 

fi Describe how members of the 

target population were involved in the 

preparation of the application, and how 

they will be involved in the planning, 

implementation, and evaluation of the 

project. 

fi Describe the potential barriers to 

successful conduct of the proposed 

project and how you will overcome 

them. 

fi Describe how your activities will 

improve substance abuse prevention 

and/or treatment and/or mental health 

services. 

fi Provide a plan to secure resources 

to sustain the proposed infrastructure 

enhancements when Federal funding 

ends. 

fi Check the NOFA for any 

additional requirements. 

Section C: Staff, Management, and 

Relevant Experience (25 Points) 

fi Provide a realistic time line for the 

project (chart or graph) showing key 

activities, milestones, and responsible 

staff. [Note: The time line should be part 

of the Project Narrative. It should not be 

placed in an appendix.] 

fi Discuss the capability and 

experience of the applicant organization 

and other participating organizations 

with similar projects and populations, 

including experience in providing 

culturally appropriate/competent 

services. 

fi Provide a list of staff who will 

participate in the project, showing the 

role of each and their level of effort and 

qualifications. Include the Project 

Director and other key personnel, such 

as the evaluator and treatment/ 

prevention personnel. 

fi Describe the racial/ethnic 

characteristics of key staff and indicate 

if any are members of the target 

population/community. If the target 

population is multi-linguistic, indicate 

if the staffing pattern includes bilingual 

and bicultural individuals. 

fi Describe the resources available 

for the proposed project (e.g., facilities, 

equipment). If an implementation pilot 

is proposed that includes direct 

services, provide evidence that services 

will be provided in a location that is 

adequate, accessible, compliant with the 

Americans with Disabilities Act (ADA), 

and amenable to the target population. 

fi Check the NOFA for any 

additional requirements. 

Section D: Evaluation and Data (30 

Points) 

fi Describe the process and outcome 

evaluation. Include specific 

performance measures and target 

outcomes related to the goals and 

objectives identified for the project in 

Section B of your Project Narrative. 

fi Document your ability to collect 

and report on the required performance 

measures as specified in the NOFA, 

including data required by SAMHSA to 

meet GPRA requirements. Specify and 

justify any additional measures you 

plan to use for your grant project. 

fi Describe plans for data collection, 

management, analysis, interpretation 

and reporting. Describe the existing 

approach to the collection of data, along 

with any necessary modifications. Be 

sure to include data collection 

instruments/interview protocols in 

Appendix 2. 

fi Discuss the reliability and validity 

of evaluation methods and 

instruments(s) in terms of the gender/ 

age/culture of the target population. 

fi Describe how collection, analysis 

and reporting of performance data will 

be integrated into the evaluation 

activities. 

fi Check the NOFA for any 

additional requirements. 

Note: Although the budget for the proposed 

project is not a review criterion, the Review 

Group will be asked to comment on the 

appropriateness of the budget after the merits 

of the application have been considered. 

2. Review and Selection Process 

SAMHSA applications are peerreviewed 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: 

fi The strengths and weaknesses of 

the application as identified by peer 

reviewers and, when appropriate, 

approved by the appropriate National 

Advisory Council; 

fi Availability of funds; 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62349 

fi Equitable distribution of awards in 

terms of geography (including urban, 

rural and remote settings) and balance 

among target populations and program 

size; and 

fi 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 (Proposed Approach—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 

1. Award Notices 

After your application has been 

reviewed, you will receive a letter from 

SAMHSA through postal mail that 

describes the general results of the 

review, including the score that your 

application received. 

If you are approved for funding, you 

will receive an additional notice, the 

Notice of Grant Award, signed by 

SAMHSA’s Grants Management Officer. 

The Notice of Grant Award is the sole 

obligating document that allows the 

grantee to receive Federal funding for 

work on the grant project. It is sent by 

postal mail and is addressed to the 

contact person listed on the face page of 

the application. 

If you are not funded, you can reapply if there is another receipt date for 

the program. 

2. Administrative and National Policy 

Requirements 

2.1 General Requirements 

fi You must comply with all terms 

and conditions of the grant award. 

SAMHSA’s standard terms and 

conditions are available on the 

SAMHSA Web site at http:// 

www.samhsa.gov/grants/generalinfo/ 

useful_info.aspx. 

fi Depending on the nature of the 

specific funding opportunity and/or the 

proposed project as identified during 

review, additional terms and conditions 

may be identified in the NOFA or 

negotiated with the grantee prior to 

grant award. These may include, for 

example: 

» Actions required to be in 

compliance with human subjects 

requirements; 

» Requirements relating to additional 

data collection and reporting; 

» Requirements relating to 

participation in a cross-site evaluation; 

or 

» Requirements to address problems 

identified in review of the application. 

fi 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. 

fi In an effort to improve access to 

funding opportunities for applicants, 

SAMHSA is participating in the U.S. 

Department of Health and Human 

Services ‘‘Survey on Ensuring Equal 

Opportunity for Applicants.’’ This 

survey is included in the application kit 

for SAMHSA grants. Applicants are 

encouraged to complete the survey and 

return it, using the instructions 

provided on the survey form. 

3. Reporting Requirements 

3.1 Progress and Financial Reports 

fi Grantees must provide annual and 

final progress reports. The final progress 

report must summarize information 

from the annual reports, describe the 

accomplishments of the project, and 

describe next steps for implementing 

plans developed during the grant 

period. 

fi Grantees must provide annual and 

final financial status reports. These 

reports may be included as separate 

sections of annual and final progress 

reports or can be separate documents. 

Because SAMHSA is extremely 

interested in ensuring that infrastructure 

development and enhancement efforts 

can be sustained, your financial reports 

must explain plans to ensure the 

sustainability (see Glossary) of efforts 

initiated under this grant. Initial plans 

for sustainability should be described in 

year 1 of the grant. In each subsequent 

year, you should describe the status of 

the project, successes achieved and 

obstacles encountered in that year. 

fi SAMHSA will provide guidelines 

and requirements for these reports to 

grantees at the time of award and at the 

initial grantee orientation meeting after 

award. SAMHSA staff will use the 

information contained in the reports to 

determine the grantee’s progress toward 

meeting its goals. 

3.2 Government Performance and 

Results Act 

The Government Performance and 

Results Act (GPRA) mandates 

accountability and performance-based 

management by Federal agencies. To 

meet the GPRA requirements, SAMHSA 

must collect performance data (i.e., 

‘‘GPRA data’’) from grantees. These 

requirements will be specified in the 

NOFA for each funding opportunity. 

3.3 Publications 

If you are funded under this grant 

program, you are required to notify the 

Government Project Officer (GPO) and 

SAMHSA’s Publications Clearance 

Officer (240–276–2130) of any materials 

based on the SAMHSA-funded project 

that are accepted for publication. 

In addition, SAMHSA requests that 

grantees: 

fi Provide the GPO and SAMHSA 

Publications Clearance Officer with 

advance copies of publications. 

fi Include acknowledgment of the 

SAMHSA grant program as the source of 

funding for the project. 

fi 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 

The NOFAs provide contact 

information for questions about program 

issues. 

For questions on grants management 

issues, contact: Kimberly Pendleton, 

Office of Program Services, Division of 

Grants Management, Substance Abuse 

and Mental Health Services 

Administration, 1 Choke Cherry Road, 

Room 7–1097, Rockville, Maryland 

20857, (240) 276–1421, 

kimberly.pendleton@samhsa.hhs.gov. 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria 

for SAMHSA Grant Applications 

SAMHSA’s goal is to review all 

applications submitted for grant funding. 

62350 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

However, this goal must be balanced against 

SAMHSA’s obligation to ensure equitable 

treatment of applications. For this reason, 

SAMHSA has established certain formatting 

requirements for its applications. If you do 

not adhere to these requirements, your 

application will be screened out and returned 

to you without review. In addition to these 

formatting requirements, programmatic 

requirements (e.g., relating to eligibility) may 

be stated in the specific NOFA and in Section 

III of the standard grant announcement. 

Please check the entire NOFA and Section III 

of the standard grant announcement before 

preparing your application. 

b Use the PHS 5161–1 application. 

b Applications must be received by the 

application deadline or have proof of timely 

submission, as detailed in Section IV–3 of the 

grant announcement. 

b Information provided must be sufficient 

for review. 

b 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. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

b To ensure equity among applications, 

the amount of space allowed for the Project 

Narrative cannot be exceeded. 

• Applications would meet this 

requirement by using all margins (left, right, 

top, bottom) of at least one inch each, and 

adhering to the page limit for the Project 

Narrative stated in the specific funding 

announcement. 

• Should an application not conform to 

these margin or page limits, SAMHSA will 

use the following method to determine 

compliance: The total area of the Project 

Narrative (excluding margins, but including 

charts, tables, graphs and footnotes) cannot 

exceed 58.5 square inches multiplied by the 

page limit. This number represents the full 

page less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the physical 

page. Space left blank within the Project 

Narrative (excluding margins) is considered 

part of the Project Narrative, in determining 

compliance. 

To facilitate review of your application, 

follow these additional guidelines. Failure to 

adhere to the following guidelines will not, 

in itself, result in your application being 

screened out and returned without review. 

However, the information provided in your 

application must be sufficient for review. 

Following these guidelines will help ensure 

your application is complete, and will help 

reviewers to consider your application. 

b The 10 application components 

required for SAMHSA applications should be 

included. These are: 

• 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) 

b Applications should comply with the 

following requirements: 

• Provisions relating to confidentiality, 

participant protection and the protection of 

human subjects specified in Section IV–2.4 of 

the FY2005 standard funding 

announcements. 

• Budgetary limitations as specified in 

Section I, II, and IV–5 of the FY2005 standard 

funding announcements. 

• Documentation of nonprofit status as 

required in the PHS 5161–1. 

b Pages should be typed single-spaced in 

black ink, with one column per page. Pages 

should not have printing on both sides. 

b Please number pages consecutively from 

beginning to end so that information can be 

located easily during review of the 

application. The cover page should be page 

1, the abstract page should be page 2, and the 

table of contents page should be page 3. 

Appendices should be labeled and separated 

from the Project Narrative and budget 

section, and the pages should be numbered 

to continue the sequence. 

b The page limits for Appendices stated 

in the specific funding announcement should 

not be exceeded. 

b Send the original application and two 

copies to the mailing address in the funding 

announcement. Please do not use staples, 

paper clips, and fasteners. Nothing should be 

attached, stapled, folded, or pasted. Do not 

use heavy or lightweight paper or any 

material that cannot be copied using 

automatic copying machines. Odd-sized and 

oversized attachments such as posters will 

not be copied or sent to reviewers. Do not 

include videotapes, audiotapes, or CD–

ROMs. 

Appendix B—Glossary 

Best Practice: Best practices are practices 

that incorporate the best objective 

information currently available regarding 

effectiveness and acceptability. 

Catchment Area: A catchment area is the 

geographic area from which the target 

population to be served by a program will be 

drawn. 

Cooperative Agreement: A cooperative 

agreement is a form of Federal grant. 

Cooperative agreements are distinguished 

from other grants in that, under a cooperative 

agreement, substantial involvement is 

anticipated between the awarding office and 

the recipient during performance of the 

funded activity. This involvement may 

include collaboration, participation, or 

intervention in the activity. HHS awarding 

offices use grants or cooperative agreements 

(rather than contracts) when the principal 

purpose of the transaction is the transfer of 

money, property, services, or anything of 

value to accomplish a public purpose of 

support or stimulation authorized by Federal 

statute. The primary beneficiary under a 

grant or cooperative agreement is the public, 

as opposed to the Federal Government. 

Cost Sharing or Matching: Cost sharing 

refers to the value of allowable non-Federal 

contributions toward the allowable costs of a 

Federal grant project or program. Such 

contributions may be cash or in-kind 

contributions. For SAMHSA grants, cost 

sharing or matching is not required, and 

applications will not be screened out on the 

basis of cost sharing. However, applicants 

often include cash or in-kind contributions in 

their proposals as evidence of commitment to 

the proposed project. This is allowed, and 

this information may be considered by 

reviewers in evaluating the quality of the 

application. 

Fidelity: Fidelity is the degree to which a 

specific implementation of a program or 

practice resembles, adheres to, or is faithful 

to the evidence-based model on which it is 

based. Fidelity is formally assessed using 

rating scales of the major elements of the 

evidence-based model. A toolkit on how to 

develop and use fidelity instruments is 

available from the SAMHSA-funded 

Evaluation Technical Assistance Center at 

http://tecathsri.org or by calling (617) 876–

0426. 

Grant: A grant is the funding mechanism 

used by the Federal Government when the 

principal purpose of the transaction is the 

transfer of money, property, services, or 

anything of value to accomplish a public 

purpose of support or stimulation authorized 

by Federal statute. The primary beneficiary 

under a grant or cooperative agreement is the 

public, as opposed to the Federal 

Government. 

In-Kind Contribution: In-kind contributions 

toward a grant project are non-cash 

contributions (e.g., facilities, space, services) 

that are derived from non-Federal sources, 

such as State or sub-State non-Federal 

revenues, foundation grants, or contributions 

from other non-Federal public or private 

entities. 

Logic Model: A logic model is a 

diagrammatic representation of a theoretical 

framework. A logic model describes the 

logical linkages among program resources, 

conditions, strategies, short-term outcomes, 

and long-term impact. More information on 

how to develop logics models and examples 

can be found through the resources listed in 

Appendix C. 

Practice: A practice is any activity, or 

collective set of activities, intended to 

improve outcomes for people with or at risk 

for substance abuse and/or mental illness. 

Such activities may include direct service 

provision, or they may be supportive 

activities, such as efforts to improve access 

to and retention in services, organizational 

efficiency or effectiveness, community 

readiness, collaboration among stakeholder 

groups, education, awareness, training, or 

any other activity that is designed to improve 

outcomes for people with or at risk for 

substance abuse or mental illness. 

Practice Support System: This term refers 

to contextual factors that affect practice 

delivery and effectiveness in the preadoption phase, delivery phase, and postVerDate Aug<04>2004 16:16 Oct 22, 2004 Jkt 205001 PO 00000 Frm 00028 Fmt 4701 Sfmt 4703 E:\FR\FM\25OCN2.SGM 25OCN2
Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62351 

delivery phase, such as (a) community 

collaboration and consensus building, (b) 

training and overall readiness of those 

implementing the practice, and (c) sufficient 

ongoing supervision for those implementing 

the practice. 

Stakeholder: A stakeholder is an 

individual, organization, constituent group, 

or other entity that has an interest in and will 

be affected by a proposed grant project. 

Sustainability: Sustainability is the ability 

to continue a program or practice after 

SAMHSA grant funding has ended. 

Target Population: The target population is 

the specific population of people whom a 

particular program or practice is designed to 

serve or reach. 

Wraparound Service: Wraparound services 

are non-clinical supportive services—such as 

child care, vocational, educational, and 

transportation services—that are designed to 

improve the individual’s access to and 

retention in the proposed project. 

Appendix C—Logic Model Resources 

Chen, W.W., Cato, B.M., & Rainford, N. 

(1998–9). Using a logic model to plan and 

evaluate a community intervention program: 

A case study. International Quarterly of 

Community Health Education, 18(4), 449–

458. 

Edwards, E.D., Seaman, J.R., Drews, J., & 

Edwards, M.E. (1995). A community 

approach for Native American drug and 

alcohol prevention programs: A logic model 

framework. Alcoholism Treatment Quarterly, 

13(2), 43–62. 

Hernandez, M. & Hodges, S. (2003). 

Crafting Logic Models for Systems of Care: 

Ideas into Action. [Making children’s mental 

health services successful series, volume 1]. 

Tampa, FL: University of South Florida, The 

Louis de la Parte Florida Mental Health 

Institute, Department of Child & Family 

Studies. http://cfs.fmhi.usf.edu or phone 

(813) 974–4651 

Hernandez, M. & Hodges, S. (2001). 

Theory-based accountability. In M. 

Hernandez & S. Hodges (Eds.), Developing 

Outcome Strategies in Children’s Mental 

Health, pp. 21–40. Baltimore: Brookes. 

Julian, D.A. (1997). Utilization of the logic 

model as a system level planning and 

evaluation device. Evaluation and Planning, 

20(3), 251–257. 

Julian, D.A., Jones, A., & Deyo, D. (1995). 

Open systems evaluation and the logic 

model: Program planning and evaluation 

tools. Evaluation and Program Planning, 

18(4), 333–341. 

Patton, M.Q. (1997). Utilization-Focused 

Evaluation (3rd Ed.), pp. 19, 22, 241. 

Thousand Oaks, CA: Sage. 

Wholey, J.S., Hatry, H.P., Newcome, K.E. 

(Eds.) (1994). Handbook of Practical Program 

Evaluation. San Francisco, CA: Jossey-Bass 

Inc. 

Appendix D—Sample Budget and 

Justification 

Illustration of a Sample Detailed Budget and 

Narrative Justification to Accompany SF 

424A: Section B for 01 Budget Period 

Object Class Categories 

Personnel 

Job title Name Annual salary Level of 

effort 

Salary being 

requested 

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

Secretary ................................................... Unnamed .................................................. 18,000 0.5 9,000 

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

Enter Personnel subtotal on 424A, Section 

B, 6.a. $64,000 

Fringe Benefits (24%) $15,360 

Enter Personnel subtotal on 424A, Section B, 

6.a.—$64,000 

Enter Fringe Benefits subtotal on 424A, 

Section B, 6.b. $15,360 

Travel 

2 trips for SAMHSA Meetings for 2 Attendees (Airfare @ $600 × 4 = $2,400) + (per diem @ $120 × 4 × 6 days = $2,880) ............. $5,280 

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

Enter Travel subtotal on 424A, Section B, 

6.c. $5,400 

Equipment (List Individually) 

‘‘Equipment’’ means an article of 

nonexpendable, tangible personal property 

having a useful life of more than one year 

and an acquisition cost which equals the 

lesser of (a) the capitalization level 

established by the governmental unit or 

nongovernmental applicant for financial 

statement purposes, or (b) $5000. 

Enter Equipment subtotal on 424A, Section 

B, 6.d. 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Computer Software–1 WordPerfect ......................................................................................................................................................... 500 

Enter Supplies subtotal on 424A, Section B, 

6.e. $1,000 

Contractual Costs 

Evaluation 

Job title Name Annual 

salary 

Salary being requested Level of 

effort 

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

Other Staff ................................................ — .............................................................. $18,000 18,000 1.0 

62352 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

Fringe Benefits (25%) $10,500 

Travel 

2 trips × 1 Evaluator ($600 × 2) .............................................................................................................................................................. $1,200 

Per diem @ $120 × 6 .............................................................................................................................................................................. 720 

Supplies (General Office) ........................................................................................................................................................................ 500 

Evaluation Direct ...................................................................................................................................................................................... $54,920 

Evaluation Indirect Costs (19%) .............................................................................................................................................................. 10,435 

Evaluation Subtotal ........................................................................................................................................................................... $65,355 

Training 

Job title Name Level of 

effort 

Salary being 

requested 

Coordinator ............................................................... M. Smith ................................................................... 0.5 $12,000 

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

Fringe Benefits (25%) $5,250 

Travel 

2 Trips for Training Airfare @ $600 × 2 .................................................................................................................................................. $1,200 

Per Diem $120 × 2 × 2 days ................................................................................................................................................................... 480 

Local (500 miles × .24/mile) .................................................................................................................................................................... 120 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Software (WordPerfect) ........................................................................................................................................................................... 500 

Other 

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

Telephone ................................................................................................................................................................................................ 500 

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

Audit ......................................................................................................................................................................................................... 3,000 

Training Direct ......................................................................................................................................................................................... $40,025 

Training Indirect ....................................................................................................................................................................................... 0 

Enter Contractual subtotal on 424A, Section 

B, 6.f. $105,380 

Other 

Consultants = Expert @ $250/day × 6 day (If expert is known, should list by name) ........................................................................... $1,500 

Enter Other subtotal on 424A, Section B, 6.h.

$1,500 

Total Direct Charges (sum of 6.a–6.h) 

Enter Total Direct on 424A, Section B, 6.i.

$192,640 

Indirect Costs 

15% of Salary and Wages (copy of 

negotiated indirect cost rate agreement 

attached) 

Enter Indirect subtotal of 424A, Section B, 

6.j. $9,600 

Totals 

Enter TOTAL on 424A, Section B, 6.k.

$202,240 

Justification 

Personnel—Describe the role and 

responsibilities of each position. 

Fringe Benefits—List all components of the 

fringe benefit rate. 

Equipment—List equipment and describe 

the need and the purpose of the equipment 

in relation to the proposed project. 

Supplies—Generally self-explanatory; 

however, if not, describe need. Include 

explanation of how the cost has been 

estimated. 

Travel—Explain need for all travel other 

than that required by SAMHSA. 

Contractual Costs—Explain the need for 

each contractual arrangement and how these 

components relate to the overall project. 

Other—Generally self-explanatory. If 

consultants are included in this category, 

explain the need and how the consultant’s 

rate has been determined. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62353 

Indirect Cost Rate—If your organization 

has no indirect cost rate, please indicate 

whether your organization plans to a) waive 

indirect costs if an award is issued, or b) 

negotiate and establish an indirect cost rate 

with DHHS within 90 days of award 

issuance. 

CALCULATION OF FUTURE BUDGET PERIODS (BASED ON FIRST 12-MONTH BUDGET PERIOD) 

[Review and verify the accuracy of future year budget estimates. Increases or decreases in the future years must be explained and justified and 

no cost of living increases will be honored. (NOTE: new salary cap of $175,700 is effective for all FY 2005 awards.) *] 

First 12-month 

period 

Second 12- 

month 

period 

Third 12-month 

period 

Personnel: 

Project Director ......................................................................................................... 30,000 30,000 30,000 

Secretary** ................................................................................................................ 9,000 18,000 18,000 

Counselor ................................................................................................................. 25,000 25,000 25,000 

Total Personnel ................................................................................................. 64,000 73,000 73,000 

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

Travel ............................................................................................................................... 5,400 5,400 5,400 

Equipment ........................................................................................................................ -0- -0- -0- 

Supplies *** ...................................................................................................................... 1,000 520 520 

Contractual: 

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

Training ............................................................................................................................ 40,025 40,025 40,025 

Other ................................................................................................................................ 1,500 1,500 1,500 

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

Indirect Costs (15% S&W) ............................................................................................... 9,600 9,600 9,600 

Total Costs ............................................................................................................... 202,240 216,884 219,603 

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

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

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

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

The Federal dollars requested for all object 

class categories for the first 12-month budget 

period are entered on Form 424A, Section B, 

Column (1), lines 6a-6i. The total Federal 

dollars requested for the second through the 

fifth 12-month budget periods are entered on 

Form 424A, Section E, Columns (b) ‘‘ (e), line 

20. The RFA will specify the maximum 

number of years of support that may be 

requested. 

Best Practices Planning and Implementation 

Grants BPPI 05 PA (Initial Announcement) 

Catalogue of Federal Domestic Assistance 

(CFDA) No.: 93.243 (unless otherwise 

specified in a NOFA in the Federal Register 

and on http://www.grants.gov) 

Application Deadline ........................................... This Program Announcement provides instructions and guidelines for multiple funding opportunities. Application deadlines for specific funding opportunities will be published in Notices of 

Funding Availability (NOFAs) in the FEDERAL REGISTER and on http://www.grants.gov. 

Intergovernmental Review (E.O. 12372) ............ Letters from State Single Point of Contact (SPOC) are due 60 days after application deadline. 

Public Health System Impact Statement 

(PHSIS)/Single State Agency Coordination.

Applicants must send the PHSIS to appropriate State and local health agencies by application 

deadline. Comments from Single State Agency are due 60 days after application deadline. 

Table of Contents 

I. Funding Opportunity Description 

1. Introduction 

2. Expectations 

II. Award Information 

1. Award Amount 

2. Funding Mechanism 

III. Eligibility Information 

1. Eligible Applicants 

2. Cost Sharing 

3. Other 

IV. Application and Submission Information 

1. Address to Request Application Package 

2. Content and Form of Application 

Submission 

3. Submission Dates and Times 

4. Intergovernmental Review (E.O. 12372) 

Requirements 

5. Funding Limitations/Restrictions 

6. Other Submission Requirements 

V. Application Review Information 

1. Evaluation Criteria 

2. Review and Selection Process 

VI. Award Administration Information 

1. Award Notices 

2. Administrative and National Policy 

Requirements 

3. Reporting Requirements 

VII. Agency Contacts 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria for 

SAMHSA 

Grant Applications 

Appendix B—Glossary 

Appendix C—National Registry of Effective 

Programs and Practices 

Appendix D—Center for Mental Health 

Services Evidence-Based Practice 

Toolkits 

Appendix E—Effective Substance Abuse 

Treatment Practices 

Appendix F—Logic Model Resources 

Appendix G—Sample Budget and 

Justification 

I. Funding Opportunity Description 

1. Introduction 

The Substance Abuse and Mental 

Health Services Administration 

(SAMHSA) announces its intent to 

solicit applications for Best Practices 

Planning and Implementation (BPPI) 

grants for substance abuse prevention, 

substance abuse treatment, and mental 

health services. This program 

announcement must be considered in 

conjunction with a full Notice of 

Funding Availability (NOFA), which 

specifies the grant program’s purpose, 

target population, and other 

requirements of the program. These 

grants will help communities and 

providers identify substance abuse 

prevention, substance abuse treatment, 

62354 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

and/or mental health practices, develop 

strategic plans for implementing/ 

adapting those practices, and pilot-test 

the practices. The practices proposed by 

applicants for SAMHSA’s BPPI grants 

must incorporate the best objective 

information available regarding 

effectiveness and acceptability. Often, 

these practices will have strong 

evidence of effectiveness. However, 

because the evidence base is limited in 

some areas, SAMHSA may fund some 

practices for which the evidence base, 

while limited, is sound. 

SAMHSA also funds grants under 

three other standard grant 

announcements: 

fi Services Grants provide funding to 

implement substance abuse and mental 

health services. 

fi Infrastructure Grants support 

identification and implementation of 

systems changes but are not designed to 

fund services. 

fi Service to Science Grants 

document and evaluate innovative 

practices that address critical substance 

abuse and mental health service gaps 

but that have not yet been formally 

evaluated. 

This announcement describes the 

general program design and provides 

application instructions for all 

SAMHSA BPPI Grants. The availability 

of funds for specific BPPI Grants will be 

announced in supplementary Notices of 

Funding Availability (NOFAs) in the 

Federal Register and at http:// 

www.grants.gov—the Federal grant 

announcement web page. 

SAMHSA’s BPPI Grants are 

authorized under Section 509, 516 and/ 

or 520A of the Public Health Service 

Act, unless otherwise specified in a 

NOFA in the Federal Register and on 

http://www.grants.gov. 

Typically, funding for BPPI Grants 

will be targeted to specific populations 

and/or issue areas, which will be 

specified in the NOFAs. The NOFAs 

will also: 

fi Specify total funding available for 

the first year of the grants and the 

expected size and number of awards; 

fi Provide the application deadline; 

fi Note any specific program 

requirements for each funding 

opportunity; and 

fi Include any limitations or 

exceptions to the general provisions in 

this announcement (e.g., eligibility, 

award size, allowable activities). 

It is, therefore, critical that you 

consult the NOFA as well as this 

announcement in developing your grant 

application. 

2. Expectations 

SAMHSA’s BPPI program promotes 

the use of practices that incorporate the 

best objective information available 

regarding effectiveness and 

acceptability. SAMHSA refers to these 

as ‘‘best practices.’’ BPPI grants may 

address needs in the areas of substance 

abuse prevention, substance abuse 

treatment and/or mental health services. 

SAMHSA understands that the ‘‘best 

practices’’ proposed for BPPI grants may 

need to be adapted to certain 

populations. Therefore, SAMHSA’s 

BPPI grants support adaptation and 

evaluation of best practices in addition 

to planning and implementation. 

2.1 Documenting the Evidence-Base 

for Selected Practices 

Applicants must document in their 

applications that the practices they 

propose to implement are evidencebased practices. In addition, applicants 

must justify use of the proposed 

practices for the target population along 

with any adaptations or modifications 

necessary to meet the unique needs of 

the target population or otherwise 

increase the likelihood of achieving 

positive outcomes. Further guidance on 

each of these requirements is provided 

below. 

Documenting the Evidence-Based 

Practice/Service 

SAMHSA has already determined that 

certain practices are solidly evidencebased practices and encourages 

applicants to select practices from the 

following sources (though this is not 

required): 

fi SAMHSA’s National Registry of 

Effective Programs and Practices 

(NREPP) (see Appendix C). 

fi Center for Mental Health Services 

(CMHS) Evidence Based Practice Tool 

Kits (see Appendix D). 

fi List of Evidence-Based Substance 

Abuse Treatment Practices (see 

Appendix E). 

fi Additional practices identified in 

the NOFA for a specific funding 

opportunity, if applicable. 

Applicants proposing practices that 

are not included in the above-referenced 

sources must provide a narrative 

justification that summarizes the 

evidence for effectiveness and 

acceptability of the proposed practice. 

The preferred evidence of effectiveness 

and acceptability will include the 

findings from clinical trials, efficacy 

and/or effectiveness studies published 

in the peer-reviewed literature. 

In areas where little or no research 

has been published in the peer-reviewed 

scientific literature, the applicant may 

present evidence involving studies that 

have not been published in the peerreviewed research literature and/or 

documents describing formal consensus 

among recognized experts. If consensus 

documents are presented, they must 

describe consensus among multiple 

experts whose work is recognized and 

respected by others in the field. Local 

recognition of an individual as a 

respected or influential person at the 

community level is not considered a 

‘‘recognized expert’’ for this purpose. 

In presenting evidence in support of 

the proposed practice, applicants must 

show that the evidence presented is the 

best objective information available. 

Justifying Selection of the Practice/ 

Service for the Target Population 

Regardless of the strength of the 

evidence-base for the practice, all 

applicants must show that the proposed 

practice is appropriate for the proposed 

target population. Ideally, this evidence 

will include research findings on 

effectiveness and acceptability specific 

to the proposed target population. 

However, if such evidence is not 

available, the applicant should provide 

a justification for using the proposed 

practice with the target population. This 

justification might involve, for example, 

a description of adaptations to the 

proposed practice based on other 

research involving the target population. 

Justifying Adaptations/Modifications of 

the Proposed Practice 

SAMHSA has found that a high 

degree of faithfulness or ‘‘fidelity’’ (see 

Glossary) to the original model for an 

evidence-based practice increases the 

likelihood that positive outcomes will 

be achieved when the model is used by 

others. Therefore, SAMHSA encourages 

fidelity to the original evidence-based 

practice to be implemented. However, 

SAMHSA recognizes that adaptations or 

modifications to the original model may 

be necessary for a variety of reasons: 

• To allow implementers to use 

resources efficiently. 

• To adjust for specific needs of the 

client population. 

• To address unique characteristics of 

the local community where the practice 

will be implemented. 

All applicants must describe and 

justify any adaptations or modifications 

to the proposed practice that will be 

made. 

2.2 Program Design 

SAMHSA will fund BPPI grants in 

two phases. Phase I is a planning and 

consensus-building phase that supports 

grantees for up to 18 months. Phase II 

is a pilot, adaptation, implementation, 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62355 

and evaluation phase that supports 

grantees for up to 3 years. The program 

design requirements for Phase I and 

Phase II are described below. Applicants 

must, however, consult the NOFA for 

any program design requirements (e.g., 

required activities) specific to the 

funding opportunity. 

Phase I: Planning and Consensus 

Building 

The goals of Phase I are to achieve 

consensus among community 

stakeholders to adopt a best practice and 

to engage in strategic planning for its 

implementation. Phase I grants may 

include, but are not limited to, the 

following types of activities: 

fi Build and maintain a coalition of 

stakeholders to fund, oversee, use, and 

provide a sustainable best practice. 

fi Train and educate key 

stakeholders about the best practice. 

fi Consult experts about the practice. 

fi Consult leaders from other 

communities about their experiences in 

implementing the practice. 

fi Reimburse stakeholders for their 

transportation or child care costs. 

fi Engage professionals to help build 

consensus and plan strategy. 

fi Adapt the best practice to 

community needs without sacrificing its 

effectiveness. 

fi Identify and obtain the 

commitment of permanent sources to 

fund the best practice. 

fi Design the evaluation of the best 

practice. 

fi Evaluate the process of consensus 

building among stakeholders (required). 

Phase II: Pilot Test, Adaptation, 

Implementation, and Evaluation 

The goals of Phase II grants are to 

pilot test and evaluate the best practices 

before full implementation, modify 

strategic/financial plans, and prepare for 

full-scale implementation. 

Implementation does not include 

service delivery. The following are 

examples of activities that can be 

funded during Phase II: 

fi Pilot test the practice on a sample 

of service recipients and evaluate the 

pilot test. 

fi Modify the best practice based on 

consultation with stakeholders and 

practice experts, other community 

experiences, and pilot test results. 

fi Revise the manual or 

documentation that describes in detail 

how the best practice was modified. 

fi Maintain the coalition of 

stakeholders to oversee Phase II 

activities. 

fi Secure consultants to make 

changes required to implement and 

finance the best practice. 

fi Make organizational changes (e.g., 

hiring staff) necessary to implement the 

best practice. 

fi Provide necessary education, 

training, and technical assistance for 

staff. 

Up to 25% of the Phase II grant award 

may be used to evaluate the pilot test of 

the best practice. During the course of 

a Phase II award, SAMHSA will provide 

funding for direct services as part of the 

pilot test. 

2.3 Performance Requirements 

All grantees will be required to meet 

the following evaluation and 

performance requirements. Applicants 

are not required to receive a Phase I 

award before applying for a Phase II 

award. However, all Phase II applicants 

must meet the Phase I performance 

requirements (i.e., documentation that 

consensus has been achieved and that a 

strategic plan is in place) before 

applying for a Phase II award. Phase II 

applicants need not have been Phase I 

grantees. 

Phase I: Planning and Consensus 

Building 

By the end of Phase I, grantees will be 

required to provide documentation that 

consensus has been achieved for 

adopting a best practice. That 

documentation must include: 

fi A report that summarizes the 

evaluation of the consensus building 

process. 

fi A description of how key 

stakeholders were included in the 

consensus building. 

fi Letters of support or other 

demonstration of stakeholders’

commitment to adopt the practice. 

fi A strategic plan for implementing 

the best practice that includes a 

financing plan, signed by the funding 

source(s) that will provide the resources 

necessary to address barriers and 

implement a sustainable best practice. 

[Note: If it is not possible for a grantee 

to complete a strategic plan, grantees 

will be required to provide an analysis 

of progress made and barriers to 

completing the strategic plan instead.] 

Phase II: Pilot Test, Adaptation, 

Implementation, and Evaluation 

By the end of Phase II, grantees must 

provide the following information: 

fi Pilot test results. 

fi Results from process/outcome 

evaluation of full Phase II project. 

fi In cases where the implementation 

was judged a success, a manual 

describing the practice in detail for 

replication of the practice. The manual 

should explain how the project team 

determined the degree of success, 

referring to qualitative and quantitative 

data. 

fi In cases where the implementation 

was judged not to be successful, a report 

detailing the lessons learned, with 

recommendations for other programs 

interested in implementing the best 

practice. The report should explain how 

the project team determined the degree 

of success, referring to qualitative and 

quantitative data. 

fi Documentation that staff are 

trained in the practice and of a 

mechanism for training new staff. 

fi Process evaluation results that 

describe how the practice was 

operationalized, including changes in 

the organizational infrastructure, 

permanent funding sources, and staff 

consultation and training activities. 

■ Outcome evaluation results that 

describe: 

Æ Demographic characteristics of the 

clients served. 

Æ Service utilization. 

Æ Practice outcomes. 

Æ Client satisfaction. 

Æ Fidelity of the modified practice to 

the best practice. 

Æ Plans for fully implementing the 

best practice after the end of the Phase 

II award. 

2.4 Performance Measurement 

The Government Performance and 

Results Act of 1993 (Pub. L. 103–62, or 

‘‘GPRA’’) requires all Federal agencies to 

set program performance targets and 

report annually on the degree to which 

the previous year’s targets were met. 

Agencies are expected to evaluate 

their programs regularly and to use 

results of these evaluations to explain 

their successes and failures and justify 

requests for funding. 

To meet the GPRA requirements, 

SAMHSA must collect performance data 

(i.e., ‘‘GPRA data’’) from grantees. 

Grantees are required to report these 

GPRA data to SAMHSA on a timely 

basis. 

Specifically, grantees will be required 

to provide data on a set of required 

measures, as specified in the NOFA. 

The data collection tools to be used for 

reporting the required data will be 

provided in the application kits 

distributed by SAMHSA’s 

clearinghouses and posted on 

SAMHSA’s Website along with each 

NOFA. In your application, you must 

demonstrate your ability to collect and 

report on these measures, and you may 

be required to provide some baseline 

data. 

The terms and conditions of the grant 

award also will specify the data to be 

submitted and the schedule for 

submission. Grantees will be required to 

62356 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

adhere to these terms and conditions of 

award. 

Applicants should be aware that 

SAMHSA is working to develop a set of 

required core performance measures for 

each of SAMHSA’s standard grants (i.e., 

Services Grants, Infrastructure Grants, 

Best Practices Planning and 

Implementation Grants, and Service-toScience Grants). As this effort proceeds, 

some of the data collection and 

reporting requirements included in 

SAMHSA’s NOFAs may change. All 

grantees will be expected to comply 

with any changes in data collection 

requirements that occur during the 

grantee’s project period. 

2.5 Evaluation 

Grantees must evaluate their projects, 

and applicants are required to describe 

their evaluation plans in their 

applications. The evaluation should be 

designed to provide regular feedback to 

the project to improve implementation 

of the best practice and, ultimately, the 

outcomes that will result from 

implementation of the best practice. 

Phase I grantees must conduct a 

process evaluation. Phase II grantees 

must conduct a process and outcome 

evaluation of the pilot test, as well as a 

process and outcome evaluation of the 

full Phase II project. 

Process and outcome evaluations 

must measure change relating to project 

goals and objectives over time compared 

to baseline information. Both Phase I 

and Phase II grantees must include the 

required performance measures 

described in the NOFA in their 

evaluations. 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 intervention and evaluation? 

■ For pilot test evaluations, 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 the project 

on the service delivery system and/or on 

participants in the project? 

■ 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 Phase 

I grant award and 25% of the total Phase 

II grant award may be used for 

evaluation and data collection. 

2.6 Grantee Meetings 

You must plan to send a minimum of 

two people (including the Project 

Director) to at least one joint grantee 

meeting in each year of the grant, and 

you must include funding for this travel 

in your budget. At these meetings, 

grantees will present the results of their 

projects and Federal staff will provide 

technical assistance. Each meeting will 

be 3 days. These meetings will usually 

be held in the Washington, DC, area and 

attendance is mandatory. 

II. Award Information 

1. Award Amount 

The NOFA will specify the expected 

award amount for each funding 

opportunity. Regardless of the amount 

specified, the actual award amount will 

depend on the availability of funds. 

Awards for SAMHSA’s BPPI grants 

will be made in two phases: 

Phase I—Phase I awards are expected 

to range from $150,000–$200,000 in 

total costs (direct and indirect) for a 

project period of up to 18 months. 

Phase II—Phase II awards will range 

from $300,000–$500,000 per year in 

total costs (direct and indirect) for a 

project period of up to 3 years. 

Proposed budgets cannot exceed the 

allowable amount as specified in the 

NOFA in any year of the proposed 

project. Annual continuation awards 

will depend on the availability of funds, 

grantee progress in meeting project goals 

and objectives, and timely submission 

of required data and reports. 

2. Funding Mechanism 

The NOFA will indicate whether 

awards for each funding opportunity 

will be made as grants or cooperative 

agreements (see the Glossary in 

Appendix B for further explanation of 

these funding mechanisms). For 

cooperative agreements, the NOFA will 

describe the nature of Federal 

involvement in project performance and 

specify roles and responsibilities of 

grantees and Federal staff. 

III. Eligibility Information 

1. Eligible Applicants 

Eligible applicants are domestic 

public and private nonprofit entities. 

For example, State, local or tribal 

governments; public or private 

universities and colleges; communityand faith-based organizations; and tribal 

organizations may apply. The statutory 

authority for this program precludes 

grants to for-profit organizations. The 

NOFA will indicate any limitations on 

eligibility. 

2. Cost Sharing 

Cost sharing (see Glossary) is not 

required in this program, and 

applications will not be screened out on 

the basis of cost sharing. However, you 

may include cash or in-kind (see 

Glossary) contributions in your proposal 

as evidence of commitment to the 

proposed project. 

3. Other 

Applications must comply with the 

following requirements, or they will be 

screened out and will not be reviewed: 

Use of the PHS 5161–1 application; 

application submission requirements in 

Section IV–3 of this document; and 

formatting requirements provided in 

Section IV–2.3 of this document. 

Applicants should be aware that the 

NOFA may include additional 

requirements that, if not met, will result 

in applications being screened out and 

returned without review. These 

requirements will be specified in 

Section III–3 of the NOFA. 

You also must comply with any 

additional program requirements 

specified in the NOFA, such as the 

required signature of certain officials on 

the face page of the application and/or 

required memoranda of understanding 

with certain signatories. 

IV. Application and Submission 

Information 

(To ensure that you have met all 

submission requirements, a checklist is 

provided for your use in Appendix A of 

this document.) 

1. Address to Request Application 

Package 

You may request a complete 

application kit by calling one of 

SAMHSA’s national clearinghouses: 

■ For substance abuse prevention or 

treatment grants, call the National 

Clearinghouse for Alcohol and Drug 

Information (NCADI) at 1–800–729–

6686. 

■ For mental health grants, call the 

National Mental Health Information 

Center at 1–800–789–CMHS (2647). 

You also may download the required 

documents from the SAMHSA Web site 

at http://www.samhsa.gov. Click on 

‘‘Grant Opportunities.’’

Additional materials available on this 

Web site include: 

■ A technical assistance manual for 

potential applicants; 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62357 

■ Standard terms and conditions for 

SAMHSA grants; 

■ Guidelines and policies that relate 

to SAMHSA grants (e.g., guidelines on 

cultural competence, consumer and 

family participation, and evaluation); 

and 

■ Enhanced instructions for 

completing the PHS 5161–1 application. 

2. Content and Form of Application 

Submission 

2.1 Application Kit 

SAMHSA application kits include the 

following documents: 

■ PHS 5161–1 (revised July 2000)—

Includes the face page, budget forms, 

assurances, certification, and checklist. 

Applicants must use the PHS 5161–1 for 

their application, unless otherwise 

specified in the NOFA. Applications 

that are not submitted on the required 

application form (i.e., the PHS 5161–1 

in most situations) will be screened out 

and will not be reviewed. 

■ Program Announcement (PA)—

Includes instructions for the grant 

application. This document is the PA. 

■ Notice of Funding Availability 

(NOFA)—Provides specific information 

about availability of funds, as well as 

any exceptions or limitations to 

provisions in the PA. The NOFAs will 

be published in the Federal Register as 

well as on the Federal grants Web site 

(http://www.grants.gov). It is very 

important that you read the entire 

NOFA before beginning to write your 

application. 

You must use all of the above 

documents in completing your 

application. 

2.2 Required Application Components 

To ensure equitable treatment of all 

applications, applications must be 

complete. In order for your application 

to be complete, it must include the 

required ten application components 

(Face Page, Abstract, Table of Contents, 

Budget Form, Project Narrative and 

Supporting Documentation, 

Appendices, Assurances, Certifications, 

Disclosure of Lobbying Activities, and 

Checklist). 

b 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 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.] 

b Abstract—Your total abstract 

should be no longer than 35 lines. In the 

first five lines or less of your abstract, 

write a summary of your project that can 

be used, if your project is funded, in 

publications, reporting to Congress, or 

press releases. 

b Table of Contents—Include page 

numbers for each of the major sections 

of your application and for each 

appendix. 

b Budget Form—Use SF 424A, 

which is part of the PHS 5161–1. Fill 

out Sections B, C, and E of the SF 424A. 

A sample budget and justification is 

included in Appendix G of this Program 

Announcement. 

b Project Narrative and Supporting 

Documentation—The Project Narrative 

describes your project. It consists of 

Sections A through E for Phase I and 

Sections A through D for Phase II. 

Sections A–E (Phase I) together may not 

be longer than 30 pages and Sections A 

though D (Phase II) together may not be 

longer than 30 pages. (For example, 

remember that if your Project Narrative 

starts on page 5 and ends on page 35, 

it is 31 pages long, not 30 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 F through I. (Note: 

Phase II applications will not have a 

Section E.) There are no page limits for 

these sections, except for Section H, the 

Biographical Sketches/Job Descriptions. 

■ Section F—Literature Citations. 

This section must contain complete 

citations, including titles and all 

authors, for any literature you cite in 

your application. 

■ Section G—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. If you are applying for a Phase 

II award, show that no more than 25% 

of the total grant award will be used for 

evaluation of the pilot test of the best 

practice. 

■ Section H—Biographical Sketches 

and Job Descriptions. 

» Include a biographical sketch for 

the Project Director and other key 

positions. Each sketch should be 2 pages 

or less. If the person has not been hired, 

include a position description and/or a 

letter of commitment with a current 

biographical sketch from the individual. 

» Include job descriptions for key 

personnel. Job descriptions should be 

no longer than 1 page each. 

» Sample sketches and job 

descriptions are listed on page 22, Item 

6 in the Program Narrative section of the 

PHS 5161–1. 

■ Section I—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. 

b Appendices 1 through 6—Use only 

the appendices listed below. If your 

application includes any appendices not 

required in the grant announcement or 

NOFA, they will be disregarded. Do not 

use more than a total of 30 pages for 

Appendices 1, 3, 4 and 6 combined. 

There are no page limitations for 

Appendices 2 and 5. Do not use 

appendices to extend or replace any of 

the sections of the Project Narrative 

unless specifically required in the 

NOFA. Reviewers will not consider 

them if you do. 

■ Appendix 1: Letters of Support. 

■ Appendix 2: Data Collection 

Instruments/Interview Protocols. 

■ Appendix 3: Sample Consent 

Forms. 

■ Appendix 4: Letter to the SSA (if 

applicable; see Section IV–4 of this 

document). 

■ Appendix 5: A copy of the State or 

County Strategic Plan, a State or county 

needs assessment, or a letter from the 

State or county indicating that the 

proposed project addresses a State- or 

county-identified priority. 

■ Appendix 6: Evidence of Intent to 

Adopt (Phase II only). 

b Assurances—Non-Construction 

Programs. Use Standard Form 424B 

found in PHS 5161–1. Some applicants 

will be required to complete the 

Assurance of Compliance with 

SAMHSA Charitable Choice Statutes 

and Regulations Form SMA 170. If this 

assurance applies to a specific funding 

opportunity, it will be posted on 

SAMHSA’s Web site with the NOFA 

and provided in the application kits 

available at SAMHSA’s clearinghouse 

(NCADI). 

b Certifications—Use the 

‘‘Certifications’’ forms found in PHS 

5161–1. 

62358 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

b Disclosure of Lobbying Activities—

Use Standard Form LLL found in PHS 

5161–1. Federal law prohibits the use of 

appropriated funds for publicity or 

propaganda purposes, or for the 

preparation, distribution, or use of 

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. 

b 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. 

b Information provided must be 

sufficient for review. 

b 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. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

b 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 30-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 30. 

This number represents the full page 

less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the 

physical page. Space left blank within 

the Project Narrative (excluding 

margins) is considered part of the 

Project Narrative, in determining 

compliance. 

To facilitate review of your 

application, follow these additional 

guidelines. Failure to adhere to the 

following guidelines will not, in itself, 

result in your application being 

screened out and returned without 

review. However, following these 

guidelines will help reviewers to 

consider your application. 

b Pages should be typed singlespaced in black ink, with one column 

per page. Pages should not have printing 

on both sides. 

b Please number pages consecutively 

from beginning to end so that 

information can be located easily during 

review of the application. The cover 

page should be page 1, the abstract page 

should be page 2, and the table of 

contents page should be page 3. 

Appendices should be labeled and 

separated from the Project Narrative and 

budget section, and the pages should be 

numbered to continue the sequence. 

b The page limit of a total of 30 pages 

for Appendices 1, 3, 4 and 6 combined 

should not be exceeded. 

b 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 

Applicants must describe procedures 

relating to Confidentiality, Participant 

Protection and the Protection of Human 

Subjects Regulations in Section I of the 

application, using the guidelines 

provided below. Problems with 

confidentiality, participant protection, 

and protection of human subjects 

identified during peer review of the 

application may result in the delay of 

funding. 

Confidentiality and Participant 

Protection 

All applicants must describe how 

they will address requirements for each 

of the following elements relating to 

confidentiality and participant 

protection. 

1. Protect Clients and Staff from 

Potential Risks: 

fi 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. 

fi Describe the procedures you will 

follow to minimize or protect 

participants against potential risks, 

including risks to confidentiality. 

fi Identify plans to provide guidance 

and assistance in the event there are 

adverse effects to participants. 

fi 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: 

fi 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 target groups. 

fi 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. 

fi Explain the reasons for including 

or excluding participants. 

fi Explain how you will recruit and 

select participants. Identify who will 

select participants. 

3. Absence of Coercion: 

fi 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. 

fi If you plan to compensate 

participants, state how participants will 

be awarded incentives (e.g., money, 

gifts, etc.). 

fi 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: 

fi 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. 

fi 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 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62359 

made. Also, if needed, describe how the 

material will be monitored to ensure the 

safety of participants. 

fi Provide in Appendix 2, ‘‘Data 

Collection Instruments/Interview 

Protocols,’’ copies of all available data 

collection instruments and interview 

protocols that you plan to use. 

5. Privacy and Confidentiality: 

fi Explain how you will ensure 

privacy and confidentiality. Include 

who will collect data and how it will be 

collected. 

fi Describe: 

Æ How you will use data collection 

instruments. 

Æ Where data will be stored. 

Æ Who will or will not have access to 

information. 

Æ How the identity of participants 

will be kept private, for example, 

through the use of a coding system on 

data records, limiting access to records, 

or storing identifiers separately from 

data. 

Note: If applicable, grantees must agree to 

maintain the confidentiality of alcohol and 

drug abuse client records according to the 

provisions of Title 42 of the Code of Federal 

Regulations, Part 2. 

6. Adequate Consent Procedures: 

fi 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. 

fi State: 

Æ Whether or not their participation 

is voluntary. 

Æ Their right to leave the project at 

any time without problems. 

Æ Possible risks from participation in 

the project. 

Æ Plans to protect clients from these 

risks. 

fi 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 

informed consent. 

fi 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? 

fi Include, as appropriate, sample 

consent forms that provide for: (1) 

Informed consent for participation in 

service intervention; (2) informed 

consent for participation in the data 

collection component of the project; and 

(3) informed consent for the exchange 

(releasing or requesting) of confidential 

information. The sample forms must be 

included in Appendix 3, ‘‘Sample 

Consent Forms,’’ of your application. If 

needed, give English translations. 

Note: Never imply that the participant 

waives or appears to waive any legal rights, 

may not end involvement with the project, or 

releases your project or its agents from 

liability for negligence. 

fi 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? 

fi 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: 

Discuss why the risks are reasonable 

compared to expected benefits and 

importance of the knowledge from the 

project. 

Protection of Human Subjects 

Regulations 

All applicants proposing a pilot test of 

the best practice as part of a Phase II 

project must comply with the Protection 

of Human Subjects Regulations (45 CFR 

part 46). 

Even if you are not proposing a Phase 

II pilot test of the best practice, the 

Protection of Human Subjects 

Regulations could apply depending on 

the evaluation you propose. 

If you are a Phase II applicant 

proposing a pilot test or your project 

otherwise falls under the Protection of 

Human Subjects Regulations, you must 

describe the process for obtaining 

Institutional Review Board (IRB) 

approval in your application. While IRB 

approval is not required at the time of 

grant award, you will be required, as a 

condition of award, to provide the 

documentation that an Assurance of 

Compliance is on file with the Office for 

Human Research Protections (OHRP) 

and the IRB approval has been received 

before enrolling clients in the proposed 

project. 

General information about Protection 

of Human Subjects Regulations can be 

obtained on the web at http://hhs.gov/ 

ohrp. You may also contact OHRP by email (ohrp@osophs.dhhs.gov) or by 

phone (301–496–7005). SAMHSAspecific questions related to Protection 

of Human Subjects Regulations should 

be directed to the program contact listed 

in Section VII of the NOFA. 

3. Submission Dates and Times 

Deadlines for submission of 

applications for specific funding 

opportunities will be published in the 

NOFAs in the Federal Register and 

posted on the Federal grants Web site 

(www.grants.gov). 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

Your application must be received by 

the application deadline, or you must 

have proof of its timely submission as 

specified below. 

• For packages submitted via DHL, 

Falcon Carrier, Federal Express (FedEx), 

or United Parcel Service (UPS), timely 

submission shall be evidenced by a 

delivery service receipt indicating the 

application was delivered to a carrier 

service at least 24 hours prior to the 

application deadline. 

• For packages submitted via the 

United States Postal Service (USPS), 

proof of timely submission shall be a 

postmark not later than 1 week prior to 

the application deadline, and the 

following upon request by SAMHSA: 

Æ Proof of mailing using USPS Form 

3817 (Certificate of Mailing), or 

Æ A receipt from the Post Office 

containing the post office name, 

location, and date and time of mailing. 

You will be notified by postal mail 

that your application has been received. 

Applications not meeting the timely 

submission requirements above will not 

be considered for review. Please 

remember that mail sent to Federal 

facilities undergoes a security screening 

prior to delivery. Allow sufficient time 

for your package to be delivered. 

If an application is mailed to a 

location or office (including room 

number) that is not designated for 

receipt of the application, and that 

results in the designated office not 

receiving your application in 

accordance with the requirements for 

timely submission, it will cause the 

application to be considered late and 

ineligible for review. 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

SAMHSA is collaborating with http:// 

www.grants.gov to accept electronic 

submission of applications only for 

select funding opportunities. Unless 

specifically indicated in the NOFA, 

62360 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

electronic submission of applications 

will not be accepted. 

4. Intergovernmental Review (E.O. 

12372) Requirements 

Executive Order 12372, as 

implemented through Department of 

Health and Human Services (DHHS) 

regulation at 45 CFR Part 100, sets up 

a system for State and local review of 

applications for Federal financial 

assistance. A current listing of State 

Single Points of Contact (SPOCs) is 

included in the application kit and can 

be downloaded from the Office of 

Management and Budget (OMB) Web 

site at http://www.whitehouse.gov/omb/ 

grants/spoc.html. 

fi 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. 

fi 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. 

fi For proposed projects serving 

more than one State, you are advised to 

contact the SPOC of each affiliated 

State. 

fi The SPOC should send any State 

review process recommendations to the 

following address within 60 days of the 

application deadline: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857, ATTN: SPOC—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from the 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SPOC—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from the NOFA]. 

In addition, community-based, nongovernmental service providers who are 

not transmitting their applications 

through the State must submit a Public 

Health System Impact Statement 

(PHSIS) (approved by OMB under 

control no. 0920–0428; see burden 

statement below) to the head(s) of 

appropriate State or local health 

agencies in the area(s) to be affected no 

later than the pertinent receipt date for 

applications. The PHSIS is intended to 

keep State and local health officials 

informed of proposed health services 

grant applications submitted by 

community-based, non-governmental 

organizations within their jurisdictions. 

State and local governments and Indian 

tribal government applicants are not 

subject to these requirements. 

The PHSIS consists of the following 

information: 

fi A copy of the face page of the 

application (SF 424); and 

fi 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 

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 

include a copy of a letter transmitting 

the PHSIS to the SSA in Appendix 4, 

‘‘Letter to the SSA.’’ The letter must 

notify the State that, if it wishes to 

comment on the proposal, its comments 

should be sent not later than 60 days 

after the application deadline to: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857, ATTN: SSA—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SSA—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition: 

fi Applicants may request that the 

SSA send them a copy of any State 

comments. 

fi The applicant must notify the SSA 

within 30 days of receipt of an award. 

[Public reporting burden for the 

Public Health System Reporting 

Requirement is estimated to average 10 

minutes per response, including the 

time for copying the face page of SF 424 

and the abstract and preparing the letter 

for mailing. An agency may not conduct 

or sponsor, and a person is not required 

to respond to, a collection of 

information unless it displays a 

currently valid OMB control number. 

The OMB control number for this 

project is 0920–0428. Send comments 

regarding this burden to CDC Clearance 

Officer, 1600 Clifton Road, MS D–24, 

Atlanta, GA 30333, ATTN: PRA (0920–

0428).] 

5. Funding Limitations/Restrictions 

Cost principles describing allowable 

and unallowable expenditures for 

Federal grantees, including SAMHSA 

grantees, are provided in the following 

documents: 

fi Institutions of Higher Education: 

OMB Circular A–21. 

fi State and Local Governments: 

OMB Circular A–87. 

fi Nonprofit Organizations: OMB 

Circular A–122. 

fi Appendix E Hospitals: 45 CFR Part 

74. 

In addition, SAMHSA BPPI Grant 

recipients must comply with the 

following funding restrictions: 

fi No more than 25% of Phase II 

funding may be used to evaluate the 

pilot test. 

BPPI grant funds may not be used to: 

fi Pay for any lease beyond the 

project period. 

fi 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). 

fi Pay for the purchase or 

construction of any building or structure 

to house any part of the program. 

(Applicants may request no more than 

$75,000 for renovations and alterations 

of existing facilities, if appropriate and 

necessary to the project.) 

fi 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.) 

fi Pay for housing other than 

residential mental health and/or 

substance abuse treatment. 

fi Provide inpatient treatment or 

hospital-based detoxification services. 

Residential services are not considered 

to be inpatient or hospital-based 

services. 

fi Pay for incentives to induce clients 

to enter treatment. However, a grantee 

or treatment provider may provide up to 

$20 or equivalent (coupons, bus tokens, 

gifts, childcare, and vouchers) to clients 

as incentives to participate in required 

data collection follow-up. This amount 

may be paid for participation in each 

required interview. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62361 

fi Implement syringe exchange 

programs, such as the purchase and 

distribution of syringes and/or needles. 

fi Pay for pharmacologies for HIV 

antiretroviral therapy, sexually 

transmitted diseases (STDs)/sexually 

transmitted illness (STI), TB, and 

hepatitis B and C, or for psychotropic 

drugs. 

fi SAMHSA will not accept a 

‘‘research’’ indirect cost rate. The 

grantee must use the ‘‘other sponsored 

program rate’’ or the lowest rate 

available. 

6. Other Submission Requirements 

6.1 Where to Send Applications 

Send applications to the following 

address: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850. 

Do not send applications to other 

agency contacts, as this could delay 

receipt. Be sure to include the funding 

announcement number from the NOFA 

in item number 10 on the face page of 

the application. If you require a phone 

number for delivery, you may use (240) 

276–1199. 

6.2 How to Send Applications 

Mail 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. 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

Unless specifically indicated in the 

NOFA, electronic submission of 

applications will not be accepted. 

V. Application Review Information 

1. Evaluation Criteria 

Your application will be reviewed 

and scored according to the quality of 

your response to the requirements listed 

below for developing the Project 

Narrative (Sections A–E for Phase I 

applications and A–D for Phase II 

applications). These sections describe 

what you intend to do with your project. 

fi In developing the Project Narrative 

section of your application, use these 

instructions along with any additional 

instructions found in the NOFA. These 

are to be used instead of the ‘‘Program 

Narrative’’ instructions found in the 

PHS 5161–1. 

fi The Project Narrative may be no 

longer than 30 pages. 

fi You must use the 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. 

fi 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 

http://www.samhsa.gov. Click on ‘‘Grant 

Opportunities.’’

fi The Supporting Documentation 

you provide in Sections F–I and 

Appendices 1–5 will be considered by 

reviewers in assessing your response, 

along with the material in the Project 

Narrative. 

fi The number of points after each 

heading is the maximum number of 

points a review committee may assign to 

that section of your Project Narrative. 

Bullet statements in each section do not 

have points assigned to them. They are 

provided to invite the attention of 

applicants and reviewers to important 

areas within the criterion. 

1.1 Phase I Criteria 

Section A: Statement of Need (10 

Points) 

fi Describe the environment 

(organization, community, city, or State) 

where the project will be implemented. 

fi Describe the target population (see 

Glossary) as well as the geographic area 

to be served, and justify the selection of 

both. Be sure to check the NOFA for any 

specific requirements regarding the 

target population and/or catchment 

area. Include numbers to be served and 

demographic information. Discuss the 

target population’s language, beliefs, 

norms and values, as well as 

socioeconomic factors that must be 

considered in delivering programs to 

this population. 

fi Describe the problem the project 

will address. Documentation of the 

problem may come from local data or 

trend analyses, State data (e.g., from 

State Needs Assessments), and/or 

national data (e.g., from SAMHSA’s 

National Household Survey on Drug 

Abuse and Health or from National 

Center for Health Statistics/Centers for 

Disease Control reports). For data 

sources that are not well known, 

provide sufficient information on how 

the data were collected so reviewers can 

assess the reliability and validity of the 

data. 

fi Non-tribal applicants must show 

that identified needs are consistent with 

the priorities of the State or county that 

has primary responsibility for the 

service delivery system. Include, in 

Appendix 5, a copy of the State or 

County Strategic Plan, a State or county 

needs assessment, or a letter from the 

State or county indicating that the 

proposed project addresses a State-or 

county-identified priority. Tribal 

applicants must provide similar 

documentation relating to tribal 

priorities. 

fi Describe the best practice selected 

and how it will impact the problem. 

fi Check the NOFA for any 

additional requirements. 

Section B: Proposed Evidence-Based 

Practice (30 Points) 

fi Clearly state the purpose, goals 

and objectives of your proposed project. 

Describe how achievement of the goals 

will address both the overall program 

purpose as specified in the NOFA and 

the needs you have identified in Section 

A. Provide a logic model (see Glossary) 

that links need, key components of the 

proposed project, and goals/objectives/ 

outcomes of the proposed project. 

fi Identify the evidenced based 

practice that you propose to implement. 

Describe the evidence-base for the 

proposed practice and show that it 

incorporates the best objective 

information available regarding 

effectiveness and acceptability. Follow 

the instructions provided in #1, #2 or #3 

below, as appropriate. Depending on the 

evidence you provide, you may follow 

more than one set of instructions: 

1. If you are proposing to implement 

a practice included in NREPP (see 

Appendix C), one of the CMHS tool-kits 

on evidence-based practices (see 

Appendix D), the list of Effective 

Substance Abuse Treatment Practices 

(see Appendix E), or the NOFA (if 

applicable), simply identify the practice 

and state the source from which it was 

selected. You do not need to provide 

further evidence of effectiveness. 

2. If you are providing evidence that 

includes scientific studies published in 

the peer-reviewed literature or other 

62362 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

studies that have not been published, 

describe the extent to which: 

—The practice has been evaluated and 

the quality of the evaluation studies 

(e.g., whether they are descriptive, 

quasi-experimental studies, or 

experimental studies) 

—The practice has demonstrated 

positive outcomes and for what 

populations the positive outcomes 

have been demonstrated 

—The practice has been documented 

(e.g., through development of 

guidelines, tool kits, treatment 

protocols, and/or manuals) and 

replicated 

—Fidelity measures have been 

developed (e.g., no measures 

developed, key components 

identified, or fidelity measures 

developed) 

3. If you are providing evidence based 

on a formal consensus process involving 

recognized experts in the field, describe: 

—The experts involved in developing 

consensus on the proposed service/ 

practice (e.g., members of an expert 

panel formally convened by 

SAMHSA, NIH, the Institute of 

Medicine or other nationally 

recognized organization). The 

consensus must have been developed 

by a group of experts whose work is 

recognized and respected by others in 

the field. Local recognition of an 

individual as a respected or 

influential person at the community 

level is not considered a ‘‘recognized 

expert’’ for this purpose. 

—The nature of the consensus that has 

been reached and the process used to 

reach consensus 

—The extent to which the consensus 

has been documented (e.g., in a 

consensus panel report, meeting 

minutes, or an accepted standard 

practice in the field) 

—Any empirical evidence (whether 

formally published or not) supporting 

the effectiveness of the proposed 

services/practice 

—The rationale for concluding that 

further empirical evidence does not 

exist to support the effectiveness of 

the proposed services/practice 

fi Justify the use of the proposed 

practice for the target population. 

Describe the types of modifications/ 

adaptations that may be necessary to 

meet the needs of the target population, 

and describe how you will make a final 

determination about the adaptations/ 

modifications to be made to meet the 

needs of the population. 

fi Identify any additional adaptations 

or modifications that may be necessary 

to successfully implement the proposed 

practice in the target community. 

Describe how you will make a final 

determination about the adaptations/ 

modifications to be made. 

fi Describe how the proposed project 

will address issues of age, race, 

ethnicity, culture, language, sexual 

orientation, disability, literacy, and 

gender in the target population, while 

retaining fidelity to the chosen practice. 

fi Check the NOFA for any 

additional requirements. 

Section C: Proposed Implementation 

Approach (25 Points) 

fi Describe how the proposed grant 

project will be implemented. Address 

any and all expectations/required 

activities specified in the NOFA. 

fi Provide a realistic time line for the 

project (chart or graph) showing key 

activities, milestones, and responsible 

staff. [Note: The timeline should be part 

of the Project Narrative. It should not be 

placed in an appendix.] 

fi Describe the strategies or models 

that will be used to build consensus, 

including a description of how key 

stakeholders (see Glossary) will be 

educated about the best practice. 

Describe potential barriers to achieving 

consensus among stakeholders. What 

resources and plans will you use to 

overcome these barriers? 

fi Describe the process that will be 

used to develop a strategic plan to 

implement the best practice. Address 

such issues as needs assessment, 

identification of specific milestones that 

must be achieved in order to implement 

the best practice, and plans for assigning 

responsibility for achieving milestones 

among participating organizations/ 

stakeholders. Identify potential funding 

source(s) that will help implement the 

best practice. Describe how the 

funder(s) will join in the consensus 

building and strategic planning. 

fi Describe the key stakeholders 

(including representatives of the target 

population), how they were selected for 

participation in the project, and how 

they represent the community. 

fi Describe the involvement of key 

stakeholders in the proposed project, 

including roles and responsibilities of 

each stakeholder. Clearly demonstrate 

each stakeholder’s commitment to the 

consensus building and strategic 

planning processes. Attach letters of 

support and other documents showing 

stakeholder commitment in Appendix 1: 

Letters of Support. Identify any cash or 

in-kind contributions that will be made 

to the project by the applicant or other 

partnering organizations. 

fi Describe how the project 

components will be embedded within 

the existing service delivery system, 

including other SAMHSA-funded 

projects, if applicable. 

fi Check the NOFA for any 

additional requirements. 

Section D: Management Plan and 

Staffing (20 Points) 

fi Discuss the capability and 

experience of the applicant organization 

and other participating organizations 

with similar projects and populations, 

including experience in providing 

culturally appropriate/competent 

services. 

fi Provide a list of staff members who 

will conduct the project, showing the 

role of each and their level of effort and 

qualifications. Include the Project 

Director and other key personnel, 

including evaluators and database 

management personnel. 

fi Provide evidence that the service 

staff proposed to conduct the evidencebased practice have the level of abilities 

and experience necessary to implement 

the practice with fidelity to the model, 

once they have received any necessary 

training. 

fi Identify the project staff or 

contractor(s) who will develop the 

implementation manual, and 

demonstrate that they have the requisite 

skills and experience. 

fi Describe the racial/ethnic 

characteristics of key staff and indicate 

if any are members of the target 

population/community. If the target 

population is multi-linguistic, indicate 

if the staffing pattern includes bilingual 

or bicultural individuals. 

fi If you plan to have an advisory 

body, describe its composition, roles, 

and frequency of meetings. 

fi Describe the resources available 

for the proposed project (e.g., facilities, 

equipment), and provide evidence that 

services will be provided in a location 

that is adequate, accessible, compliant 

with the Americans with Disabilities 

Act (ADA), and amenable to the target 

population. 

fi Check the NOFA for any 

additional requirements. 

Section E:Evaluation Design and 

Analysis (15 Points) 

fi Describe the design for evaluating 

the consensus building and strategic 

planning processes. Include a detailed 

discussion of how all variables (e.g., 

community representation and 

stakeholder support) will be defined 

and measured. Explain how the 

evaluation plan will ensure that the 

decision to adopt is an accurate 

reflection of the stakeholders’ intent. 

fi Document your ability to collect 

and report on the required performance 

measures as specified in the NOFA, 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62363 

including data required by SAMHSA to 

meet GPRA requirements. Specify and 

justify any additional measures you 

plan to use for your grant project. 

fi Describe the process for providing 

regular feedback from evaluation 

activities to the Project Director and 

participants. 

fi Describe plans for data collection, 

management, analysis, interpretation 

and reporting. Describe the existing 

approach to the collection of relevant 

data, along with any necessary 

modifications. 

fi Discuss the reliability and validity 

of evaluation methods and 

instruments(s) in terms of the gender/ 

age/ culture of the target population. 

fi Check the NOFA for any 

additional requirements. 

1.2 Phase II Criteria 

Section A: Need, Justification of Best 

Practice, and Readiness (30 Points) 

If you previously received a Phase I 

BBPI award and are applying for a Phase 

II award to continue the project, include 

the following information: 

fi Describe briefly the target 

population (see Glossary), setting, need 

and best practice approved for the Phase 

I award. 

fi Describe and justify any changes to 

the target population and setting. 

Discuss the factors that led to a decision 

change in the target population and 

setting. 

fi Describe any changes in the need 

for the best practice in the target 

community. The statement of need 

should include a clearly established 

baseline for the project. Documentation 

of need may come from a variety of 

qualitative and quantitative sources. 

The quantitative data could come from 

local data or trend analyses, State data 

(e.g., from State Needs Assessments), 

and/or national data (e.g., from 

SAMHSA’s National Household Survey 

on Drug Abuse and Health or from 

National Center for Health Statistics/ 

Centers for Disease Control reports). For 

data sources that are not well known, 

provide sufficient information on how 

the data were collected so reviewers can 

assess the reliability and validity of the 

data. 

fi Provide an updated projection of 

the number of individuals to be served 

as well as demographic information. 

Discuss the target population’s 

language, beliefs, norms and values, as 

well as socioeconomic factors that must 

be considered in delivering programs to 

this population. 

fi Describe and justify any additional 

modifications or adaptations to the best 

practice as compared to the practice 

approved for your Phase I project. 

fi Provide evidence that the 

community of stakeholders (see 

Glossary) achieved a ‘‘decision to adopt’’

the practice. Attach a copy of the Phase 

I process evaluation or other evidence 

including contracts, memoranda of 

agreement, administrative memos, or 

other documents signed by key 

stakeholders that show their firm 

commitment to support the practice. 

Attach these supporting documents in 

Appendix 6: Evidence of Intent to 

Adopt. 

fi Provide and describe the financing 

plan. Include anticipated costs and 

sources of revenue that will maintain 

the practice. Attach the financing plan, 

signed by the funding source(s), stating 

their intent to fund in Appendix 6: 

Evidence of Intent to Adopt. 

fi Check the NOFA for any 

additional requirements. 

If you are applying for a Phase II 

award but did not previously receive a 

Phase I award, include the following 

information: 

fi Clearly state the purpose, goals 

and objectives of your proposed project. 

Describe how achievement of the goals 

will address the overall program 

purpose as specified in the NOFA and 

produce meaningful and relevant 

results. Provide a logic model (see 

Glossary) that links need, the services or 

practice to be implemented, and 

outcomes. 

fi Describe the target population as 

well as the geographic area to be served, 

and justify the selection of both. Include 

the numbers to be served and 

demographic information. Discuss the 

target population’s language, beliefs, 

norms and values, as well as 

socioeconomic factors that must be 

considered in delivering programs to 

this population. 

fi Describe the nature of the problem 

and extent of the need for the target 

population based on data. The statement 

of need should include a clearly 

established baseline for the project. 

Documentation of need may come from 

a variety of qualitative and quantitative 

sources. The quantitative data could 

come from local data or trend analyses, 

State data (e.g., from State Needs 

Assessments), and/or national data (e.g., 

from SAMHSA’s National Household 

Survey on Drug Abuse and Health or 

from National Center for Health 

Statistics/Centers for Disease Control 

reports). For data sources that are not 

well known, provide sufficient 

information on how the data were 

collected so reviewers can assess the 

reliability and validity of the data. 

fi Non-tribal applicants must show 

that identified needs are consistent with 

priorities of the State or county. Include, 

in Appendix 5, a copy of the State or 

County Strategic Plan, a State or county 

needs assessment, or a letter from the 

State or county indicating that the 

proposed project addresses a State-or 

county-identified priority. Tribal 

applicants must provide similar 

documentation relating to tribal 

priorities. 

fi Identify the evidenced based 

service/practice that you propose to 

implement. Describe the evidence-base 

for the proposed service/practice and 

show that it incorporates the best 

objective information available 

regarding effectiveness and 

acceptability. Follow the instructions 

provided in #1, #2 or #3 below, as 

appropriate: 

1. If you are proposing to implement 

a service/practice included in NREPP 

(see Appendix C), one of the CMHS toolkits on evidence-based practices (see 

Appendix D), the list of Effective 

Substance Abuse Treatment Practices 

(see Appendix E), or the NOFA (if 

applicable), simply identify the practice 

and state the source from which it was 

selected. You do not need to provide 

further evidence of effectiveness. 

2. If you are providing evidence that 

includes scientific studies published in 

the peer-reviewed literature or other 

studies that have not been published, 

describe the extent to which: 

—The service/practice has been 

evaluated and the quality of the 

evaluation studies (e.g., whether they 

are descriptive, quasi-experimental 

studies, or experimental studies) 

—The service/practice has 

demonstrated positive outcomes and 

for what populations the positive 

outcomes have been demonstrated 

—The service/practice has been 

documented (e.g., through 

development of guidelines, tool kits, 

treatment protocols, and/or manuals) 

and replicated 

—Fidelity measures have been 

developed (e.g., no measures 

developed, key components 

identified, or fidelity measures 

developed) 

3. If you are providing evidence based 

on a formal consensus process involving 

recognized experts in the field, describe: 

—The experts involved in developing 

consensus on the proposed service/ 

practice (e.g., members of an expert 

panel formally convened by 

SAMHSA, NIH, the Institute of 

Medicine or other nationally 

recognized organization). The 

consensus must have been developed 

by a group of experts whose work is 

recognized and respected by others in 

the field. Local recognition of an 

62364 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

individual as a respected or 

influential person at the community 

level is not considered a ‘‘recognized 

expert’’ for this purpose. 

—The nature of the consensus that has 

been reached and the process used to 

reach consensus 

—The extent to which the consensus 

has been documented (e.g., in a 

consensus panel report, meeting 

minutes, or an accepted standard 

practice in the field) 

—Any empirical evidence (whether 

formally published or not) supporting 

the effectiveness of the proposed 

services/practice 

—The rationale for concluding that 

further empirical evidence does not 

exist to support the effectiveness of 

the proposed services/practice 

fi Justify the use of the proposed 

service/practice for the target 

population. Describe and justify any 

adaptations necessary to meet the needs 

of the target population, as well as 

evidence that such adaptations will be 

effective for the target population. 

fi Identify and justify any additional 

adaptations or modifications to the 

proposed service/practice. 

fi Describe the community of 

stakeholders in the project, and provide 

evidence that they have achieved a 

‘‘decision to adopt’’ the practice. Such 

evidence may include contracts, 

memoranda of agreement, 

administrative memos, or other 

documents signed by key stakeholders 

that show their firm commitment to 

support the practice. Attach these 

supporting documents in Appendix 6: 

Evidence of Intent to Adopt. 

fi Provide and describe the financing 

plan. Include anticipated costs and 

sources of revenue that will maintain 

the practice. Attach the financing plan, 

signed by the funding source(s), stating 

their intent to fund in Appendix 6: 

Evidence of Intent to Adopt. 

fi Check the NOFA for any 

additional requirements. 

Section B: Proposed Approach (25 

Points) 

fi Provide a strategic plan, including 

key action steps, that addresses each of 

the following elements, as appropriate: 

pilot testing the best practice, evaluating 

the pilot test, modifying the best 

practice based on the pilot test, 

developing training materials, hiring/ 

training staff, and securing funding to 

sustain services beyond the project 

period. Address any and all 

expectations/required activities 

specified in the NOFA. 

fi Describe the involvement of key 

stakeholders in the proposed project, 

including roles and responsibilities of 

each stakeholder. Demonstrate each 

stakeholder’s commitment to the 

proposed project. Attach letters of 

support and similar documents showing 

stakeholder commitment in Appendix 1: 

Letters of Support. Identify any cash or 

in-kind contributions that will be made 

to the project. 

fi Describe how the proposed project 

will address issues of age, race/ 

ethnicity, culture, language, sexual 

orientation, disability, literacy, and 

gender in the target population. 

fi Describe potential barriers to the 

successful conduct of the proposed 

project and how you will overcome 

them. 

fi Describe oversight or feedback 

mechanisms to ensure that the 

implemented practice is consistent with 

the best practice model. 

fi Check the NOFA for any 

additional requirements. 

Section C: Management Plan and 

Staffing (25 Points) 

fi Provide a realistic time line for the 

project (chart or graph) showing key 

activities, milestones, and responsible 

staff. [Note: The time line should be part 

of the Project Narrative. It should not be 

placed in an appendix.] 

fi Discuss the capability and 

experience of the applicant organization 

and other participating organizations 

with similar projects and populations, 

including experience in providing 

culturally appropriate/competent 

services. 

fi Provide a list of staff members who 

will conduct the project, showing the 

role of each and their level of effort and 

qualifications. Include the Project 

Director and other key personnel, 

including evaluators and database 

managers. 

fi Describe the racial/ethnic 

characteristics of key staff and indicate 

if any are members of the target 

population/community. If the target 

population is multi-linguistic, indicate 

if the staffing pattern includes bilingual 

and bicultural individuals. 

fi Describe the resources available 

for the proposed project (e.g., facilities, 

equipment), and provide evidence that 

services will be provided in a location 

that is adequate, accessible, Americans 

with Disabilities Act (ADA) compliant, 

and is amenable to the target 

population. 

fi Check the NOFA for any 

additional requirements. 

Section D: Evaluation Design and 

Analysis (20 Points) 

fi Document your ability to collect 

and report on the required performance 

measures as specified in the NOFA, 

including data required by SAMHSA to 

meet GPRA requirements. Specify and 

justify any additional measures you 

plan to use for your grant project. 

fi Provide a logic model (see 

Glossary) for the evaluation of the pilot 

test of the best practice as well as other 

implementation activities (e.g., training, 

securing financing). 

fi Provide a plan for evaluating the 

pilot test of the best practice and other 

implementation activities that includes 

both process and client outcome 

measures. Describe the recruitment plan 

and sample size for your project. 

Describe any literature or pilot testing 

done to verify the validity and 

reliability of the instruments to be used. 

Also discuss the appropriateness of the 

evaluation methods and instrument(s) 

in terms of the gender/age/culture of the 

target population. Attach 

instrumentation in Appendix 2: Data 

Collection Instruments. 

fi Describe how the adaptations of 

the best practice will be documented. 

Demonstrate its fidelity to the best 

practice model. If no fidelity scale exists 

for the practice, describe how you will 

develop one. 

fi Describe the process for providing 

regular feedback from evaluation 

activities to the Project Director and 

participants. 

fi Describe the database management 

system that will be developed. 

fi Check the NOFA for any 

additional requirements. 

Note: Although the budget for the proposed 

project is not a review criterion, the Review 

Group will be asked to comment on the 

appropriateness of the budget after the merits 

of the application have been considered. 

2. Review and Selection Process 

SAMHSA applications are peerreviewed 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: 

fi The strengths and weaknesses of 

the application as identified by peer 

reviewers and, when appropriate, 

approved by the appropriate National 

Advisory Council; 

fi Availability of funds; 

fi Equitable distribution of awards in 

terms of geography (including urban, 

rural and remote settings) and balance 

among target populations and program 

size; and 

fi After applying the aforementioned 

criteria, the following method for 

breaking ties: When funds are not 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62365 

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 (for Phase I, Proposed EvidenceBased Practice’30 points; for Phase II, 

Need, Justification of Best Practice, and 

Readiness’30 points). Should a tie still 

exist, the evaluation criterion with the 

next highest possible point value will be 

used, continuing sequentially to the 

evaluation criterion with the lowest 

possible point value, should that be 

necessary to break all ties. If an 

evaluation criterion to be used for this 

purpose has the same number of 

possible points as another evaluation 

criterion, the criterion listed first in 

Section V–1 will be used first. 

VI. Award Administration Information 

1. Award Notices 

After your application has been 

reviewed, you will receive a letter from 

SAMHSA through postal mail that 

describes the general results of the 

review, including the score that your 

application received. 

If you are approved for funding, you 

will receive an additional notice, the 

Notice of Grant Award, signed by 

SAMHSA’s Grants Management Officer. 

The Notice of Grant Award is the sole 

obligating document that allows the 

grantee to receive Federal funding for 

work on the grant project. It is sent by 

postal mail and is addressed to the 

contact person listed on the face page of 

the application. 

If you are not funded, you can reapply if there is another receipt date for 

the program. 

2. Administrative and National Policy 

Requirements 

fi You must comply with all terms 

and conditions of the grant award. 

SAMHSA’s standard terms and 

conditions are available on the 

SAMHSA Web site at http:// 

www.samhsa.gov/grants/generalinfo/ 

useful_info.aspx. 

fi Depending on the nature of the 

specific funding opportunity and/or the 

proposed project as identified during 

review, additional terms and conditions 

may be identified in the NOFA or 

negotiated with the grantee prior to 

grant award. These may include, for 

example: 

» Actions required to be in 

compliance with human subjects 

requirements; 

» Requirements relating to additional 

data collection and reporting; 

» Requirements relating to 

participation in a cross-site evaluation; 

or 

» Requirements to address problems 

identified in review of the application. 

fi 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. 

fi In an effort to improve access to 

funding opportunities for applicants, 

SAMHSA is participating in the U.S. 

Department of Health and Human 

Services ‘‘Survey on Ensuring Equal 

Opportunity for Applicants.’’ This 

survey is included in the application kit 

for SAMHSA grants. Applicants are 

encouraged to complete the survey and 

return it, using the instructions 

provided on the survey form. 

3. Reporting Requirements 

3.1 Progress and Financial Reports 

fi Grantees must provide annual and 

final progress reports. The final progress 

report must summarize information 

from the annual reports, describe the 

accomplishments of the project, and 

describe next steps for implementing 

plans developed during the grant 

period. 

fi Grantees must provide annual and 

final financial status reports. These 

reports may be included as separate 

sections of annual and final progress 

reports or can be separate documents. 

Because SAMHSA is extremely 

interested in ensuring that its best 

practices efforts can be sustained, your 

financial reports must explain plans to 

ensure the sustainability (see Glossary) 

of efforts initiated under this grant. 

Initial plans for sustainability should be 

described in year 1 of the grant. In each 

subsequent year, you should describe 

the status of the project, successes 

achieved and obstacles encountered in 

that year. 

fi SAMHSA will provide guidelines 

and requirements for these reports to 

grantees at the time of award and at the 

initial grantee orientation meeting after 

award. SAMHSA staff will use the 

information contained in the reports to 

determine the grantee’s progress toward 

meeting its goals. 

3.2 Government Performance and 

Results Act 

The Government Performance and 

Results Act (GPRA) mandates 

accountability and performance-based 

management by Federal agencies. To 

meet the GPRA requirements, SAMHSA 

must collect performance data (i.e., 

‘‘GPRA data’’) from grantees. These 

requirements will be specified in the 

NOFA for each funding opportunity. 

3.3 Publications 

If you are funded under this grant 

program, you are required to notify the 

Government Project Officer (GPO) and 

SAMHSA’s Publications Clearance 

Officer (240–276–2130) of any materials 

based on the SAMHSA-funded project 

that are accepted for publication. 

In addition, SAMHSA requests that 

grantees: 

fi Provide the GPO and SAMHSA 

Publications Clearance Officer with 

advance copies of publications. 

fi Include acknowledgment of the 

SAMHSA grant program as the source of 

funding for the project. 

fi 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 

The NOFAs provide contact 

information for questions about program 

issues. 

For questions on grants management 

issues, contact: Kimberly Pendleton, 

Office of Program Services, Division of 

Grants Management, Substance Abuse 

and Mental Health Services 

Administration, 1 Choke Cherry Road, 

Room 7–1097, Rockville, Maryland 

20850, (240) 276–1421, 

kimberly.pendleton@samhsa.hhs.gov. 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria 

for SAMHSA Grant Applications 

SAMHSA’s goal is to review all 

applications submitted for grant funding. 

However, this goal must be balanced against 

SAMHSA’s obligation to ensure equitable 

treatment of applications. For this reason, 

SAMHSA has established certain formatting 

requirements for its applications. If you do 

not adhere to these requirements, your 

application will be screened out and returned 

62366 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

to you without review. In addition to these 

formatting requirements, programmatic 

requirements (e.g., relating to eligibility) may 

be stated in the specific NOFA and in Section 

III of the standard grant announcement. 

Please check the entire NOFA and Section III 

of the standard grant announcement before 

preparing your application. 

❑ Use the PHS 5161–1 application. 

❑ Applications must be received by the 

application deadline or have proof of timely 

submission, as detailed in Section IV–3 of the 

grant announcement. 

❑ Information provided must be sufficient 

for review. 

❑ Text must be legible. 

• Type size in the Project Narrative cannot 

exceed an average of 15 characters per inch, 

as measured on the physical page. (Type size 

in charts, tables, graphs, and footnotes will 

not be considered in determining 

compliance.) 

• Text in the Project Narrative cannot 

exceed 6 lines per vertical inch. 

❑ Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

❑ To ensure equity among applications, 

the amount of space allowed for the Project 

Narrative cannot be exceeded. 

• Applications would meet this 

requirement by using all margins (left, right, 

top, bottom) of at least one inch each, and 

adhering to the page limit for the Project 

Narrative stated in the specific funding 

announcement. 

• Should an application not conform to 

these margin or page limits, SAMHSA will 

use the following method to determine 

compliance: The total area of the Project 

Narrative (excluding margins, but including 

charts, tables, graphs and footnotes) cannot 

exceed 58.5 square inches multiplied by the 

page limit. This number represents the full 

page less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the physical 

page. Space left blank within the Project 

Narrative (excluding margins) is considered 

part of the Project Narrative, in determining 

compliance. 

To facilitate review of your application, 

follow these additional guidelines. Failure to 

adhere to the following guidelines will not, 

in itself, result in your application being 

screened out and returned without review. 

However, the information provided in your 

application must be sufficient for review. 

Following these guidelines will help ensure 

your application is complete, and will help 

reviewers to consider your application. 

❑ The 10 application components 

required for SAMHSA applications should be 

included. These are: 

• 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) 

❑ Applications should comply with the 

following requirements: 

• Provisions relating to confidentiality, 

participant protection and the protection of 

human subjects specified in Section IV–2.4 of 

the FY2005 standard funding 

announcements. 

• Budgetary limitations as specified in 

Section I, II, and IV–5 of the FY 2005 

standard funding announcements. 

• Documentation of nonprofit status as 

required in the PHS 5161–1. 

❑ Pages should be typed single-spaced in 

black ink, with one column per page. Pages 

should not have printing on both sides. 

❑ Please number pages consecutively from 

beginning to end so that information can be 

located easily during review of the 

application. The cover page should be page 

1, the abstract page should be page 2, and the 

table of contents page should be page 3. 

Appendices should be labeled and separated 

from the Project Narrative and budget 

section, and the pages should be numbered 

to continue the sequence. 

❑ The page limits for Appendices stated in 

the specific funding announcement should 

not be exceeded. 

❑ Send the original application and two 

copies to the mailing address in the funding 

announcement. Please do not use staples, 

paper clips, and fasteners. Nothing should be 

attached, stapled, folded, or pasted. Do not 

use heavy or lightweight paper or any 

material that cannot be copied using 

automatic copying machines. Odd-sized and 

oversized attachments such as posters will 

not be copied or sent to reviewers. Do not 

include videotapes, audiotapes, or CD-ROMs. 

Appendix B—Glossary 

Best Practice: Best practices are practices 

that incorporate the best objective 

information currently available regarding 

effectiveness and acceptability. 

Catchment Area: A catchment area is the 

geographic area from which the target 

population to be served by a program will be 

drawn. 

Cooperative Agreement: A cooperative 

agreement is a form of Federal grant. 

Cooperative agreements are distinguished 

from other grants in that, under a cooperative 

agreement, substantial involvement is 

anticipated between the awarding office and 

the recipient during performance of the 

funded activity. This involvement may 

include collaboration, participation, or 

intervention in the activity. HHS awarding 

offices use grants or cooperative agreements 

(rather than contracts) when the principal 

purpose of the transaction is the transfer of 

money, property, services, or anything of 

value to accomplish a public purpose of 

support or stimulation authorized by Federal 

statute. The primary beneficiary under a 

grant or cooperative agreement is the public, 

as opposed to the Federal Government. 

Cost sharing or Matching: Cost sharing 

refers to the value of allowable non-Federal 

contributions toward the allowable costs of a 

Federal grant project or program. Such 

contributions may be cash or in-kind 

contributions. For SAMHSA grants, cost 

sharing or matching is not required, and 

applications will not be screened out on the 

basis of cost sharing. However, applicants 

often include cash or in-kind contributions in 

their proposals as evidence of commitment to 

the proposed project. This is allowed, and 

this information may be considered by 

reviewers in evaluating the quality of the 

application. 

Fidelity: Fidelity is the degree to which a 

specific implementation of a program or 

practice resembles, adheres to, or is faithful 

to the evidence-based model on which it is 

based. Fidelity is formally assessed using 

rating scales of the major elements of the 

evidence-based model. A toolkit on how to 

develop and use fidelity instruments is 

available from the SAMHSA-funded 

Evaluation Technical Assistance Center at 

http://tecathsri.org or by calling (617) 876–

0426. 

Grant: A grant is the funding mechanism 

used by the Federal Government when the 

principal purpose of the transaction is the 

transfer of money, property, services, or 

anything of value to accomplish a public 

purpose of support or stimulation authorized 

by Federal statute. The primary beneficiary 

under a grant or cooperative agreement is the 

public, as opposed to the Federal 

Government. 

In-Kind Contribution: In-kind contributions 

toward a grant project are non-cash 

contributions (e.g., facilities, space, services) 

that are derived from non-Federal sources, 

such as State or sub-State non-Federal 

revenues, foundation grants, or contributions 

from other non-Federal public or private 

entities. 

Logic Model: A logic model is a 

diagrammatic representation of a theoretical 

framework. A logic model describes the 

logical linkages among program resources, 

conditions, strategies, short-term outcomes, 

and long-term impact. More information on 

how to develop logics models and examples 

can be found through the resources listed in 

Appendix F. 

Practice: A practice is any activity, or 

collective set of activities, intended to 

improve outcomes for people with or at risk 

for substance abuse and/or mental illness. 

Such activities may include direct service 

provision, or they may be supportive 

activities, such as efforts to improve access 

to and retention in services, organizational 

efficiency or effectiveness, community 

readiness, collaboration among stakeholder 

groups, education, awareness, training, or 

any other activity that is designed to improve 

outcomes for people with or at risk for 

substance abuse or mental illness. 

Practice Support System: This term refers 

to contextual factors that affect practice 

delivery and effectiveness in the preadoption phase, delivery phase, and postdelivery phase, such as (a) community 

collaboration and consensus building, (b) 

training and overall readiness of those 

implementing the practice, and (c) sufficient 

ongoing supervision for those implementing 

the practice. 

Stakeholder: A stakeholder is an 

individual, organization, constituent group, 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62367 

or other entity that has an interest in and will 

be affected by a proposed grant project. 

Sustainability: Sustainability is the ability 

to continue a program or practice after 

SAMHSA grant funding has ended. 

Target Population: The target population is 

the specific population of people whom a 

particular program or practice is designed to 

serve or reach. 

Wraparound Service: Wraparound services 

are non-clinical supportive services’such as 

child care, vocational, educational, and 

transportation services’that are designed to 

improve the individual’s access to and 

retention in the proposed project. 

Appendix C—National Registry of 

Effective Programs and Practices 

To help SAMHSA’s constituents learn 

more about science-based programs, 

SAMHSA’s Center for Substance Abuse 

Prevention (CSAP) created a National 

Registry of Effective Programs and Practices 

(NREPP) to review and identify effective 

programs. NREPP seeks candidates from the 

practice community and the scientific 

literature. While the initial focus of NREPP 

was substance abuse prevention 

programming, NREPP has expanded its scope 

and now includes prevention and treatment 

of substance abuse and of co-occurring 

substance abuse and mental disorders, and 

psychopharmacological programs and 

workplace programs. 

NREPP includes three categories of 

programs: Effective Programs, Promising 

Programs, and Model Programs. Programs 

defined as Effective have the option of 

becoming Model Programs if their developers 

choose to take part in SAMHSA 

dissemination efforts. The conditions for 

making that choice, together with definitions 

of the three major criteria, are as follows. 

Promising Programs have been 

implemented and evaluated sufficiently and 

are scientifically defensible. They have 

positive outcomes in preventing substance 

abuse and related behaviors. However, they 

have not yet been shown to have sufficient 

rigor and/or consistently positive outcomes 

required for Effective Program status. 

Nonetheless, Promising Programs are eligible 

to be elevated to Effective/Model status after 

review of additional documentation 

regarding program effectiveness. Originated 

from a range of settings and spanning target 

populations, Promising Programs can guide 

prevention, treatment, and rehabilitation. 

Effective Programs are well-implemented, 

well-evaluated programs that produce 

consistently positive pattern of results (across 

domains and/or replications). Developers of 

Effective Programs have yet to help 

SAMHSA/CSAP disseminate their programs, 

but may do so themselves. 

Model Programs are also wellimplemented, well-evaluated programs, 

meaning they have been reviewed by NREPP 

according to rigorous standards of research. 

Their developers have agreed with SAMHSA 

to provide materials, training, and technical 

assistance for nationwide implementation. 

That helps ensure the program is carefully 

implemented and likely to succeed. 

Programs that have met the NREPP 

standards for each category can be identified 

by accessing the NREPP Model Programs 

Web site at http:// 

www.modelprograms.samhsa.gov. 

Appendix D—Center for Mental Health 

Services Evidence-Based Practice 

Toolkits 

SAMHSA’s Center for Mental Health 

Services and the Robert Wood Johnson 

Foundation initiated the Evidence-Based 

Practices Project to: (1) Help more consumers 

and families find effective services, (2) help 

providers of mental health services develop 

effective services, and (3) help administrators 

support and maintain these services. The 

project is now also funded and endorsed by 

numerous national, State, local, private and 

public organizations, including the Johnson 

& Johnson Charitable Trust, MacArthur 

Foundation, and the West Family 

Foundation. 

The project has been developed through 

the cooperation of many Federal and State 

mental health organizations, advocacy 

groups, mental health providers, researchers, 

consumers and family members. A Web site 

(http://www.mentalhealthpractices.org) was 

created as part of Phase I of the project, 

which included the identification of the first 

cluster of evidence-based practices and the 

design of implementation resource kits to 

help people understand and use these 

practices successfully. 

Basic information about the first six 

evidence-based practices is available on the 

Web site. The six practices are: 

1. Illness Management and Recovery 

2. Family Psychoeducation 

3. Medication Management Approaches in 

Psychiatry 

4. Assertive Community Treatment 

5. Supported Employment 

6. Integrated Dual Disorders Treatment 

Each of the resource kit contains 

information and materials written by and for 

the following groups: 

—Consumers 

—Families and Other Supporters 

—Practitioners and Clinical Supervisors 

—Mental Health Program Leaders 

—Public Mental Health Authorities 

Material on the web site can be printed or 

downloaded with Acrobat Reader, and 

references are provided where additional 

information can be obtained. 

Once published, the full kits will be 

available from National Mental Health 

Information Center at http://www.health.org 

or 1–800–789–CMHS (2647). 

Appendix E—Effective Substance Abuse 

Treatment Practices 

To assist potential applicants, SAMHSA’s 

Center for Substance Abuse Treatment 

(CSAT) has identified the following listing of 

current publications on effective treatment 

practices for use by treatment professionals 

in treating individuals with substance abuse 

disorders. These publications are available 

from the National Clearinghouse for Alcohol 

and Drug Information (NCADI); Tele: 1–800–

729–6686 or http://www.health.org and 

http://www.samhsa.gov/centers/csat2002/ 

publications.html. 

CSAT Treatment Improvement Protocols 

(TIPs) are consensus-based guidelines 

developed by clinical, research, and 

administrative experts in the field. 

• Integrating Substance Abuse Treatment 

and Vocational Services. TIP 38 (2000) 

NCADI # BKD381 

• Substance Abuse Treatment for Persons 

with Child Abuse and Neglect Issues. TIP 

36 (2000) NCADI # BKD343 

• Substance Abuse Treatment for Persons 

with HIV/AIDS. TIP 37 (2000) NCADI # 

BKD359 

• Brief Interventions and Brief Therapies for 

Substance Abuse. TIP 34 (1999) NCADI # 

BKD341 

• Enhancing Motivation for Change in 

Substance Abuse Treatment. TIP 35 (1999) 

NCADI # BKD342 

• Screening and Assessing Adolescents for 

Substance Use Disorders. TIP 31 (1999) 

NCADI # BKD306 

• Treatment for Stimulant Use Disorders. TIP 

33 (1999) NCADI # BKD289 

• Treatment of Adolescents with Substance 

Use Disorders. TIP 32 (1999) NCADI # 

BKD307 

• Comprehensive Case Management for 

Substance Abuse Treatment. TIP 27 (1998) 

NCADI # BKD251 

• Continuity of Offender Treatment for 

Substance Use Disorders From Institution 

to Community. TIP 30 (1998) NCADI # 

BKD304 

• Naltrexone and Alcoholism Treatment. TIP 

28 (1998) NCADI # BKD268 

• Substance Abuse Among Older Adults. TIP 

26 (1998) NCADI # BKD250 

• Substance Use Disorder Treatment for 

People With Physical and Cognitive 

Disabilities. TIP 29 (1998) NCADI # 

BKD288 

• A Guide to Substance Abuse Services for 

Primary Care Clinicians. TIP 24 (1997) 

NCADI # BKD234 

• Substance Abuse Treatment and Domestic 

Violence. TIP 25 (1997) NCADI # BKD239 

• Treatment Drug Courts: Integrating 

Substance Abuse Treatment With Legal 

Case Processing. TIP 23 (1996) NCADI # 

BKD205 

• Alcohol and Other Drug Screening of 

Hospitalized Trauma Patients. TIP 16 

(1995) NCADI # BKD164 

• Combining Alcohol and Other Drug Abuse 

Treatment With Diversion for Juveniles in 

the Justice System. TIP 21 (1995) NCADI # 

BKD169 

• Detoxification From Alcohol and Other 

Drugs. TIP 19 (1995) NCADI # BKD172 

• LAAM in the Treatment of Opiate 

Addiction. TIP 22 (1995) NCADI # BKD170 

• Matching Treatment to Patient Needs in 

Opioid Substitution Therapy. TIP 20 (1995) 

NCADI # BKD168 

• Planning for Alcohol and Other Drug 

Abuse Treatment for Adults in the 

Criminal Justice System. TIP 17 (1995) 

NCADI # BKD165 

• Assessment and Treatment of CocaineAbusing Methadone-Maintained Patients. 

TIP 10 (1994) NCADI # BKD157 

• Assessment and Treatment of Patients 

With Coexisting Mental Illness and 

Alcohol and Other Drug Abuse. TIP 9 

(1994) NCADI # BKD134 

62368 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

• Intensive Outpatient Treatment for Alcohol 

and Other Drug Abuse. TIP 8 (1994) NCADI 

# BKD139 

Other Effective Practice Publications 

CSAT Publications—

Anger Management for Substance Abuse and 

Mental Health Clients: A Cognitive 

Behavioral Therapy Manual (2002) NCADI 

# BKD444 

• Anger Management for Substance Abuse 

and Mental Health Clients: Participant 

Workbook (2002) NCADI # BKD445 

• Multidimensional Family Therapy for 

Adolescent Cannabis Users. CYT Cannabis 

Youth Treatment Series Vol. 5 (2002) 

NCADI # BKD388 

• Navigating the Pathways: Lessons and 

Promising Practices in Linking Alcohol 

and Drug Services with Child Welfare. TAP 

27 (2002) NCADI # BKD436 

• The Motivational Enhancement Therapy 

and Cognitive Behavioral Therapy 

Supplement: 7 Sessions of Cognitive 

Behavioral Therapy for Adolescent 

Cannabis Users. CYT Cannabis Youth 

Treatment Series Vol. 2 (2002) NCADI # 

BKD385 

• Family Support Network for Adolescent 

Cannabis Users. CYT Cannabis Youth 

Treatment Series Vol. 3 (2001) NCADI # 

BKD386 

• Identifying Substance Abuse Among 

TANF-Eligible Families. TAP 26 (2001) 

NCADI # BKD410 

• Motivational Enhancement Therapy and 

Cognitive Behavioral Therapy for 

Adolescent Cannabis Users: 5 Sessions. 

CYT Cannabis Youth Treatment Series Vol. 

1 (2001) NCADI # BKD384 

• The Adolescent Community Reinforcement 

Approach for Adolescent Cannabis Users. 

CYT Cannabis Youth Treatment Series Vol. 

4 (2001) NCADI # BKD387 

• Substance Abuse Treatment for Women 

Offenders: Guide to Promising Practices. 

TAP 23 (1999) NCADI # BKD310 

• Addiction Counseling Competencies: The 

Knowledge, Skills, and Attitudes of 

Professional Practice. TAP 21 (1998) 

NCADI # BKD246 

• Bringing Excellence to Substance Abuse 

Services in Rural and Frontier America. 

TAP 20 (1997) NCADI # BKD220 

• Counselor’s Manual for Relapse Prevention 

with Chemically Dependent Criminal 

Offenders. TAP 19 (1996) NCADI # 

BKD723 

• Draft Buprenorphine Curriculum for 

Physicians (Note: the Curriculum is in 

DRAFT form and is currently being 

updated) http:// 

www.buprenorphine.samhsa.gov 

• CSAT Guidelines for the Accreditation of 

Opioid Treatment Programs http:// 

www.samhsa.gov/centers/csat/content/dpt/ 

accreditation.htm 

• Model Policy Guidelines for Opioid 

Addiction Treatment in the Medical Office 

http://www.samhsa.gov/centers/csat/ 

content/dpt/model_policy.htm 

NIDA Manuals—Available through NCADI 

• Brief Strategic Family Therapy. Manual 5 

(2003) NCADI # BKD481 

• Drug Counseling for Cocaine Addiction: 

The Collaborative Cocaine Treatment 

Study Model. Manual 4 (2002) NCADI # 

BKD465 

• The NIDA Community-Based Outreach 

Model: A Manual to Reduce Risk HIV and 

Other Blood-Borne Infections in Drug 

Users. (2000) NCADI # BKD366 

• An Individual Counseling Approach to 

Treat Cocaine Addiction: The Collaborative 

Cocaine Treatment Study Model. Manual 3 

(1999) NCADI # BKD337 

• Cognitive-Behavioral Approach: Treating 

Cocaine Addiction. Manual 1 (1998) 

NCADI # BKD254 

• Community Reinforcement Plus Vouchers 

Approach: Treating Cocaine Addiction. 

Manual 2 (1998) NCADI # BKD255 

NIAAA Publications—* These publications 

are available in PDF format or can be ordered 

on-line at http://www.niaaa.nih.gov/ 

publications/guides.htm. An order form for 

the Project MATCH series is available on-line 

at http://www.niaaa.nih.gov/publications/ 

match.htm. All publications listed can be 

ordered through the NIAAA Publications 

Distribution Center, P.O. Box 10686, 

Rockville, MD 20849–0686. 

• * Alcohol Problems in Intimate 

Relationships: Identification and 

Intervention. A Guide for Marriage and 

Family Therapists (2003) NIH Pub. No. 03–

5284 

• * Helping Patients with Alcohol Problems: 

A Health Practitioner’s Guide. (2003) NIH 

Pub. No. 03–3769 

• Cognitive-Behavioral Coping Skills 

Therapy Manual. Project MATCH Series, 

Vol. 3 (1995) NIH Pub. No. 94–3724 

• Motivational Enhancement Therapy 

Manual. Project MATCH Series, Vol. 2 

(1994) NIH Pub. No. 94–3723 

Appendix F—Logic Model Resources 

Chen, W.W., Cato, B.M., & Rainford, N. 

(1998–9). Using a logic model to plan and 

evaluate a community intervention 

program: A case study. International 

Quarterly of Community Health Education, 

18(4), 449–458. 

Edwards, E.D., Seaman, J.R., Drews, J., & 

Edwards, M.E. (1995). A community 

approach for Native American drug and 

alcohol prevention programs: A logic 

model framework. Alcoholism Treatment 

Quarterly, 13(2), 43–62. 

Hernandez, M. & Hodges, S. (2003). Crafting 

Logic Models for Systems of Care: Ideas 

into Action. [Making children’s mental 

health services successful series, volume 

1]. Tampa, FL: University of South Florida, 

The Louis de la Parte Florida Mental 

Health Institute, Department of Child & 

Family Studies. http://cfs.fmhi.usf.edu or 

phone (813) 974–4651. 

Hernandez, M. & Hodges, S. (2001). Theorybased accountability. In M. Hernandez & S. 

Hodges (Eds.), Developing Outcome 

Strategies in Children’s Mental Health, pp. 

21–40. Baltimore: Brookes. 

Julian, D.A. (l997). Utilization of the logic 

model as a system level planning and 

evaluation device. Evaluation and 

Planning, 20(3), 251–257. 

Julian, D.A., Jones, A., & Deyo, D. (1995). 

Open systems evaluation and the logic 

model: Program planning and evaluation 

tools. Evaluation and Program Planning, 

18(4), 333–341. 

Patton, M.Q. (1997). Utilization-Focused 

Evaluation (3rd Ed.), pp. 19, 22, 241. 

Thousand Oaks, CA: Sage. 

Wholey, J.S., Hatry, H.P., Newcome, K.E. 

(Eds.) (1994). Handbook of Practical 

Program Evaluation. San Francisco, CA: 

Jossey-Bass Inc. 

Appendix G—Sample Budget and 

Justification 

Illustration of a Sample Detailed Budget and 

Narrative Justification To Accompany SF 

424A: Section B for 01 Budget Period 

Object Class Categories 

Personnel 

Job title Name Annual salary Level of effort Salary being 

requested 

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

Secretary ................................................... Unnamed .................................................. 18,000 0.5 9,000 

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

Enter Personnel subtotal on 424A, Section B, 

6.a. $64,000 

Fringe Benefits (24%) $15,360 

Enter Fringe Benefits subtotal on 424A, 

Section B, 6.b. $15,360 

Travel 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62369 

2 trips for SAMHSA Meetings for 2 Attendees (Airfare @ $600 × 4 = $2,400) × (per diem @ $120 × 4 × 6 days = $2,880) ............. $5,280 

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

Enter Travel subtotal on 424A, Section B, 

6.c. $5,400 

Equipment (List Individually) 

‘‘Equipment’’ means an article of 

nonexpendable, tangible personal property 

having a useful life of more than one year 

and an acquisition cost which equals the 

lesser of (a) the capitalization level 

established by the governmental unit or 

nongovernmental applicant for financial 

statement purposes, or (b) $5000. 

Enter Equipment subtotal on 424A, Section 

B, 6.d. 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Computer Software—1 WordPerfect ....................................................................................................................................................... 500 

Enter Supplies subtotal on 424A, Section B, 

6.e. $1,000 

Contractual Costs 

Evaluation 

Job title Name Annual salary Salary being requested 

Level 

of effort 

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

Other Staff ........................................................................................................... ............................ $18,000 $18,000 1.0 

Fringe Benefits (25%) $10,500 

Travel 

2 trips × 1 Evaluator ($600 × 2) .............................................................................................................................................................. $ 1,200 

per diem @ $120 × 6 .............................................................................................................................................................................. 720 

Supplies (General Office) ........................................................................................................................................................................ 500 

Evaluation Direct ...................................................................................................................................................................................... $54,920 

Evaluation Indirect Costs (19%) .............................................................................................................................................................. 10,435 

Evaluation Subtotal ........................................................................................................................................................................... 65,355 

Training 

Job title Name Level of effort Salary being 

requested 

Coordinator ............................................................... M. Smith ................................................................... 0.5 $12,000 

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

Fringe Benefits (25%) $5,250 

Travel 

2 Trips for Training Airfare @ $600 × 2 .................................................................................................................................................. $1,200 

Per Diem $120 × 2 × 2 days ................................................................................................................................................................... 480 

Local (500 miles x .24/mile) .................................................................................................................................................................... 120 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Software (WordPerfect) ........................................................................................................................................................................... 500 

Other 

62370 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

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

Telephone ................................................................................................................................................................................................ 500 

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

Audit ......................................................................................................................................................................................................... 3,000 

Training Direct ......................................................................................................................................................................................... $40,025 

Training Indirect ....................................................................................................................................................................................... 0 

Enter Contractual subtotal on 424A, Section 

B, 6.f. $105,380 

Other 

Consultants = Expert @ $250/day × 6 day (If expert is known, should list by name) ........................................................................... $1,500 

Enter Other subtotal on 424A, Section B, 6.h.

$1,500 

Total Direct Charges (sum of 6.a–6.h) 

Enter Total Direct on 424A, Section B, 6.i.

$192,640 

Indirect Costs 

15% of Salary and Wages (copy of 

negotiated indirect cost rate agreement 

attached) 

Enter Indirect subtotal of 424A, Section B, 

6.j. $9,600 

Totals 

Enter Total on 424A, Section B, 6.k.

$202,240 

Justification 

Personnel—Describe the role and 

responsibilities of each position. 

Fringe Benefits—List all components of the 

fringe benefit rate. 

Equipment—List equipment and describe 

the need and the purpose of the equipment 

in relation to the proposed project. 

Supplies—Generally self-explanatory; 

however, if not, describe need. Include 

explanation of how the cost has been 

estimated. 

Travel—Explain need for all travel other 

than that required by SAMHSA. 

Contractual Costs—Explain the need for 

each contractual arrangement and how these 

components relate to the overall project. 

Other—Generally self-explanatory. If 

consultants are included in this category, 

explain the need and how the consultant’s 

rate has been determined. 

Indirect Cost Rate—If your organization 

has no indirect cost rate, please indicate 

whether your organization plans to (a) waive 

indirect costs if an award is issued, or (b) 

negotiate and establish an indirect cost rate 

with DHHS within 90 days of award 

issuance. 

CALCULATION OF FUTURE BUDGET PERIODS (BASED ON FIRST 12-MONTH BUDGET PERIOD) 

[Review and verify the accuracy of future year budget estimates. Increases or decreases in the future years must be explained and justified and 

no cost of living increases will be honored. (NOTE: new salary cap of $175,700 is effective for all FY 2005 awards.)*] 

First 12-month 

period 

Second 12- 

month period 

Third 12-month 

period 

Personnel: 

Project Director ......................................................................................................... 30,000 30,000 30,000 

Secretary** ................................................................................................................ 9,000 18,000 18,000 

Counselor ................................................................................................................. 25,000 25,000 25,000 

Total Personnel ................................................................................................. 64,000 73,000 73,000 

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

Travel ............................................................................................................................... 5,400 5,400 5,400 

Equipment ........................................................................................................................ -0- -0- -0- 

Supplies*** ....................................................................................................................... 1,000 520 520 

Contractual: 

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

Training ..................................................................................................................... 40,025 40,025 40,025 

Other ......................................................................................................................... 1,500 1,500 1,500 

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

Indirect Costs (15% S&W) ....................................................................................... 9,600 9,600 9,600 

Total Costs ........................................................................................................ 202,240 216,884 219,603 

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

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

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

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

The Federal dollars requested for all object 

class categories for the first 12-month budget 

period are entered on Form 424A, Section B, 

Column (1), lines 6a–6i. The total Federal 

dollars requested for the second up to the 

fifth 12-month budget periods are entered on 

Form 424A, Section E, Columns (b)–(e), line 

20. The RFA will specify the maximum 

number of years of support that may be 

requested. 

Service-to-Science Grants—STS 05 PA 

(Initial Announcement) 

Catalogue of Federal Domestic Assistance 

(CFDA) No.: 93.243 (unless otherwise 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62371 

specified in a NOFA in the Federal Register 

and on http://www.grants.gov) 

KEY DATES

Application Deadline ........................................... This Program Announcement provides instructions and guidelines for multiple funding opportunities. Application deadlines for specific funding opportunities will be published in Notices of 

Funding Availability (NOFAs) in the FEDERAL REGISTER and on www.grants.gov. 

Intergovernmental Review (E.O. 12372) ............ Letters from State Single Point of Contact (SPOC) are due 60 days after application deadline. 

Public Health System Impact Statement 

(PHSIS)/ Single State Agency Coordination.

Applicants must send the PHSIS to appropriate State and local health agencies by application 

deadline. Comments from Single State Agency are due 60 days after application deadline. 

Table of Contents 

Funding Opportunity Description 

1. Introduction 

2. Expectations 

II. Award Information 

1. Award Amount 

2. Funding Mechanism 

III. Eligibility Information 

1. Eligible Applicants 

2. Cost Sharing 

3. Other 

IV. Application and Submission Information 

1. Address to Request Application Package 

2. Content and Form of Application 

Submission 

3. Submission Dates and Times 

4. Intergovernmental Review (E.O. 12372) 

Requirements 

5. Funding Limitations/Restrictions 

6. Other Submission Requirements 

V. Application Review Information 

1. Evaluation Criteria 

2. Review and Selection Process 

VI. Award Administration Information 

1. Award Notices 

2. Administrative and National Policy 

Requirements 

3. Reporting Requirements 

VII. Agency Contacts 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria for 

SAMHSA 

Grant Applications 

Appendix B—Glossary 

Appendix C—Logic Model Resources 

Appendix D—Sample Budget and 

Justification 

I. Funding Opportunity Description 

1. Introduction 

The Substance Abuse and Mental 

Health Services Administration 

(SAMHSA) announces its intent to 

solicit applications for Service-toScience grants. This program 

announcement must be considered in 

conjunction with a full Notice of 

Funding Availability (NOFA), which 

specifies the grant program’s purpose, 

target population, and other 

requirements of the program. These 

grants will document and evaluate 

innovative practices that address critical 

substance abuse and mental health 

service gaps but have not yet been 

formally evaluated. Applicants who 

seek to stabilize, document, and 

evaluate promising practices for mental 

health and/or substance abuse 

treatment, prevention, and support 

services should apply for awards under 

this announcement. 

SAMHSA also funds grants under 

three other standard grant 

announcements: 

• Services Grants provide funding to 

implement substance abuse and mental 

health services. 

• Infrastructure Grants support 

identification and implementation of 

systems changes but are not designed to 

fund services. 

• Best Practices Planning and 

Implementation Grants help 

communities and providers identify 

practices to effectively meet local needs, 

develop strategic plans for 

implementing/adapting those practices 

and pilot-test practices prior to fullscale implementation. 

This announcement describes the 

general program design and provides 

application instructions for all 

SAMHSA Service-to-Science Grants. 

The availability of funds for specific 

Service-to-Science Grants will be 

announced in supplementary Notices of 

Funding Availability (NOFAs) in the 

Federal Register and at http:// 

www.grants.gov—the Federal grant 

announcement web page. 

SAMHSA’s Service-to-Science Grants 

are authorized under Section 509, 516 

and/or 520A of the Public Health 

Service Act, unless otherwise specified 

in a NOFA in the Federal Register and 

on http://www.grants.gov. 

Typically, funding for Service-toScience Grants will be targeted to 

specific populations and/or issue areas, 

which will be specified in the NOFAs. 

The NOFAs will also: 

fi Specify total funding available for 

the first year of the grants and the 

expected size and number of awards; 

fi Provide the application deadline; 

fi Note any specific program 

requirements for each funding 

opportunity; and 

fi Include any limitations or 

exceptions to the general provisions in 

this announcement (e.g., eligibility, 

award size, allowable activities). 

It is, therefore, critical that you 

consult the NOFA as well as this 

announcement in developing your grant 

application. 

2. Expectations 

While there is a well-established 

evidence base for many behavioral 

health practices, critical service gaps 

exist for which there is no formal 

evidence base. Stakeholders have 

developed many innovative practices to 

fill these gaps, but they may lack the 

expertise and/or resources to formally 

document and evaluate their practices. 

Consequently, it is not clear whether 

these innovative practices are effective, 

and they are not disseminated widely. 

SAMHSA seeks to encourage continued 

development of evidence-based 

practices to fill service gaps by 

documenting and evaluating promising 

stakeholder-initiated practices. This 

program will help organizations that 

have identified promising new practices 

to evaluate and package those 

innovations for review and inclusion in 

the National Registry of Effective 

Programs and Practices (NREPP) as well 

as for further research. 

2.1 Program Design 

SAMHSA will fund Service-toScience grants in two phases. You may 

apply for Phase I and II combined or for 

Phase II alone. Applications for Phase I 

alone will not be accepted. The program 

design requirements for Phase I and 

Phase II are described below. Applicants 

must, however, consult the NOFA for 

any program design requirements (e.g., 

required activities) specific to the 

funding opportunity. 

Phase I provides support for up to 2 

years to stabilize and document an 

existing practice that fills an identified 

gap. During Phase I, you may: 

fi Further develop or refine the 

promising practice; 

fi Develop training and practice 

manuals; 

fi Train persons who are 

implementing the practice; 

fi More systematically implement 

the practice; 

fi Develop measurement 

instruments; and 

62372 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

fi Ensure that the intended target 

population (see Glossary) is being 

reached by the practice. 

The desired endpoint of Phase I is 

readiness to conduct a high-quality, 

systematic evaluation. 

Phase II provides support for 1–3 

years to evaluate the success of the 

practice. The purpose of Phase II is to 

conduct a high-quality, systematic 

evaluation to document short-term 

outcomes and demonstrate that the 

practice is worthy of an experimental 

study. On the basis of the evaluation, 

you may need to further refine the 

practice and further refine the practice 

manual. The evaluation may use a prepost approach, an open trial model, 

other quasi or non-experimental model, 

or an experimental model. 

The desired endpoint for Phase II is 

readiness to submit the practice for 

inclusion in SAMHSA’s NREPP and/or 

to submit applications to various 

research institutions for additional 

research. 

SAMHSA’s Service-to-Science grants 

will provide support to stabilize 

practices so that they may be 

documented and evaluated. However, 

these grants are not intended to support 

development of entirely new practices. 

The practices must be in place and 

operational for at least one year prior to 

application, and you must have at least 

anecdotal evidence that the practice is 

effective. 

You may apply for a combination of 

Phases I and II in a single grant 

application if you have identified a 

priority gap for which a fully developed 

and documented practice currently does 

not exist. 

fi During Phase I, you will further 

develop and document the practice. 

fi During Phase II, you will evaluate 

the practice. 

At the conclusion of Phase I, 

SAMHSA staff will review your 

progress to determine whether Phase II 

is warranted. This decision will be 

based on review of the documentation 

required by the end of Phase I, as 

described under the Performance 

Expectations section below. You must 

provide compelling evidence that the 

practice has been sufficiently developed 

and documented to be evaluated and 

has produced positive results. 

For practices that are already fully 

developed, implemented, stabilized, 

and documented but that have not yet 

been formally evaluated, you may apply 

for Phase II only. Applications for Phase 

I alone will not be accepted. 

Depending on your readiness, you 

may receive a combination of Phases I 

and II for a period of up to, but not more 

than, 5 years. You may apply for a 

shorter grant period than the maximum, 

and SAMHSA may award a grant for a 

shorter time period than you request. 

2.2 Establishing Need 

Service-to-Science grants are intended 

to develop solutions to widespread 

needs. This grant program is not 

intended to address a local community’s 

need for funds to solve a local problem. 

Therefore, you must demonstrate that 

the broader substance abuse and/or 

mental health field—not just your local 

community—has a need for the practice. 

You must also show that no welldocumented solution to the problem 

exists, and that your local community 

can support an evaluation that will 

increase the knowledge base of the field. 

2.3 Allowable Activities 

Phase I: Practice Development and 

Documentation 

In Phase I, you will further develop 

and document the practice. The types of 

activities that may be needed and that 

are allowable include, but are not 

limited to, the following: 

fi Strategic planning. 

fi Convening stakeholder meetings. 

fi Training of practitioners. 

fi Efforts to overcome policy and 

funding barriers to practice stability. 

fi Development of an action plan for 

systematizing and stabilizing the 

practice. 

fi Development of a practice support 

system. 

fi Developing needed partnerships 

for ongoing implementation. 

fi Logic model development. 

fi Documentation of core elements of 

the practice. 

fi Practice manual development. 

fi Measurement instrument 

development/selection. 

fi Participant recruitment. 

fi Development of quality assurance 

and accountability mechanisms. 

fi Implementation and refinement of 

the practice. 

fi Implementation process 

evaluation. 

fi Management information system 

development. 

fi Collection of pilot outcome data. 

Phase II: Practice Evaluation. 

During Phase II, SAMHSA will (if 

necessary) continue to fund 

implementation of the practice being 

evaluated. Other types of allowable 

activities include, but are not limited to, 

the following: 

fi Convening relevant stakeholder 

meetings. 

fi Alignment of management 

information systems with data 

collection needs. 

fi Training evaluators. 

fi Measurement instrument 

development/selection. 

fi Data collection. 

fi Database management. 

fi Data and cost analysis. 

fi Dissemination of results. 

fi Refinement of logic model and 

practice manual based on evaluation 

results. 

2.4 Performance Expectations 

All grantees will be expected to meet 

the following performance requirements 

by the end of their grant projects. 

Phase I 

By the end of Phase I, documentation 

for the practice must include: 

fi A logic model depicting the 

principles and concepts underlying the 

practice. 

fi A manual describing the practice 

in detail that would allow others to 

replicate the practice. 

fi Documentation of how critical 

stakeholders were included in the 

development of the practice. 

fi A detailed description of the 

population that the practice is designed 

to serve, and demographic 

characteristics of the people served by 

the practice over the past year. 

fi Documentation that the number of 

people being served by the practice has 

been stabilized. 

fi Documentation of the number and 

percentage of staff trained in the 

practice, and a mechanism for ongoing 

training for any new staff. 

fi A process evaluation 

demonstrating that the practice is in full 

operation and that a routine service 

delivery process is in place. 

fi Pilot outcome results. (Note: 

Collection of these data need not 

include an extensive set of outcomes 

systematically collected on all 

participants, but quantitative project 

data should provide some indication 

that key outcomes are being achieved.) 

Phase II 

By the end of Phase II, the evaluation 

of the practice must have demonstrated 

that: 

fi Key outcome measures have been 

clearly identified and defined. 

fi Participant data collection systems 

are in place that include: 

Æ Demographic characteristics. 

Æ Practice outcomes. 

Æ Service utilization. 

Æ Service delivery costs. 

Æ Satisfaction with services. 

fi Demographic characteristics of 

participants, as well as the types of 

services that participants have received, 

are consistent with expectations based 

on the logic model for the practice. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62373 

fi Service delivery patterns are 

stable. 

fi A fidelity scale has been 

developed for assessing the integrity of 

the practice, and the practice has been 

implemented with fidelity according to 

the scale. 

fi Systematically collected shortterm outcome measures indicate 

meaningful results. 

fi Consumers, family members, and 

other critical stakeholders are satisfied 

with the practice. 

In addition, at the end of Phase II, 

grantees must: 

fi Demonstrate how consumers, 

family members, and other critical 

stakeholders participated in the 

evaluation of the practice. 

fi Demonstrate how the practice will 

be sustained over the 5 years following 

the end of the grant period. 

fi As appropriate, submit the 

practice to the SAMHSA National 

Registry of Effective Programs and 

Practices (NREPP). 

fi Demonstrate the willingness of 

those who initiated the practice to 

participate in rigorous research over the 

next 5 years (e.g., through submission of 

grant applications to the National 

Institutes of Health, private foundations, 

or other research funding sources; 

through formal agreements between 

practice initiators and researchers; etc.) 

2.5 Data and Performance 

Measurement 

The Government Performance and 

Results Act of 1993 (Pub. L.103–62, or 

‘‘GPRA’’) requires all Federal agencies to 

set program performance targets and 

report annually on the degree to which 

the previous year’s targets were met. 

Agencies are expected to evaluate 

their programs regularly and to use 

results of these evaluations to explain 

their successes and failures and justify 

requests for funding. 

To meet the GPRA requirements, 

SAMHSA must collect performance data 

(i.e., ‘‘GPRA data’’) from grantees. 

Grantees are required to report these 

GPRA data to SAMHSA on a timely 

basis. 

Specifically, grantees will be required 

to provide data on a set of required 

measures, as specified in the NOFA. 

The data collection tools to be used for 

reporting the required data will be 

provided in the application kits 

distributed by SAMHSA’s 

clearinghouses and posted on 

SAMHSA’s website along with each 

NOFA. In your application, you must 

demonstrate your ability to collect and 

report on these measures, and you may 

be required to provide some baseline 

data. 

The terms and conditions of the grant 

award also will specify the data to be 

submitted and the schedule for 

submission. Grantees will be required to 

adhere to these terms and conditions of 

award. 

Applicants should be aware that 

SAMHSA is working to develop a set of 

required core performance measures for 

each of SAMHSA’s standard grants (i.e., 

Services Grants, Infrastructure Grants, 

Best Practices Planning and 

Implementation Grants, and Service-toScience Grants). As this effort proceeds, 

some of the data collection and 

reporting requirements included in 

SAMHSA’s NOFAs may change. All 

grantees will be expected to comply 

with any changes in data collection 

requirements that occur during the 

grantee’s project period. 

2.6 Grantee Meetings 

You must plan to send a minimum of 

two people (including the Project 

Director) to at least one joint grantee 

meeting in each year of the grant, and 

you must include funding for this travel 

in your budget. At these meetings, 

grantees will present the results of their 

projects and Federal staff will provide 

technical assistance. Each meeting will 

be 3 days. These meetings will usually 

be held in the Washington, DC, area and 

attendance is mandatory. 

II. Award Information 

1. Award Amount 

The NOFA will specify the expected 

award amount for each funding 

opportunity. Regardless of the amount 

specified in the NOFA, the actual award 

amount will depend on the availability 

of funds. 

You may apply for either a combined 

Phase I & II grant or for a Phase II only 

grant. 

fi Awards for Phase I of the 

combined grants are for up to $150,000 

(direct and indirect costs) per year for 

up to 2 years. 

fi Awards for Phase II are $300,000–

$500,000 (direct and indirect costs) per 

year for 1–3 years. 

fi Awards for combined Phase I and 

II grants may not exceed 5 years. 

Phase II funding will be approved 

only if you provide compelling evidence 

that the practice has been sufficiently 

developed and documented to be 

evaluated and has produced positive 

results. 

Proposed budgets cannot exceed the 

allowable amount as specified in the 

NOFA in any year of the proposed 

project. Annual continuation awards 

will depend on the availability of funds, 

grantee progress in meeting project goals 

and objectives, and timely submission 

of required data and reports. 

Summary Table: 

Phase and activity focus Years of 

support Application requirement Funding level (direct and indirect costs) 

I—Practice Development and 

Documentation.

0–2 Optional .................................... Up to $150,000 per year. 

II Practice Evaluation ................. 1–3 Required ................................... $300,000–$500,000 per year. 

Total ................................ 1–5 

2. Funding Mechanism 

The NOFA will indicate whether 

awards for each funding opportunity 

will be made as grants or cooperative 

agreements (see the Glossary in 

Appendix B for further explanation of 

these funding mechanisms). For 

cooperative agreements, the NOFA will 

describe the nature of Federal 

involvement in project performance and 

specify roles and responsibilities of 

grantees and Federal staff. 

III. Eligibility Information 

1. Eligible Applicants 

Eligible applicants are domestic 

public and private nonprofit entities. 

For example, State, local or tribal 

governments; public or private 

universities and colleges; communityand faith-based organizations; and tribal 

organizations may apply. The statutory 

authority for this program precludes 

grants to for-profit organizations. The 

NOFA will indicate any limitations on 

eligibility. 

Though not required, SAMHSA 

encourages community-based providers 

and independent researchers to partner 

when applying for Service-to-Science 

grants. Such partnerships will use the 

62374 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

expertise of each partner to ensure 

sound service delivery, high-quality 

evaluation, independent results, and 

relevance of the evaluation design to 

service delivery outcomes. 

2. Cost Sharing 

Cost sharing (see Glossary) is not 

required in this program, and 

applications will not be screened out on 

the basis of cost sharing. However, you 

may include cash or in-kind (see 

Glossary) contributions in your proposal 

as evidence of commitment to the 

proposed project. 

3. Other 

Applications must comply with the 

following requirements, or they will be 

screened out and will not be reviewed: 

Use of the PHS 5161–1 application; 

application submission requirements in 

Section IV–3 of this document; and 

formatting requirements provided in 

Section IV–2.3 of this document. 

Applicants should be aware that the 

NOFA may include additional 

requirements that, if not met, will result 

in applications being screened out and 

returned without review. These 

requirements will be specified in 

Section III–3 of the NOFA. 

You also must comply with any 

additional program requirements 

specified in the NOFA, such as the 

required signature of certain officials on 

the face page of the application and/or 

required memoranda of understanding 

with certain signatories. 

IV. Application and Submission 

Information 

(To ensure that you have met all 

submission requirements, a checklist is 

provided for your use in Appendix A of 

this document.) 

1. Address to Request Application 

Package 

You may request a complete 

application kit by calling one of 

SAMHSA’s national clearinghouses: 

fi For substance abuse prevention or 

treatment grants, call the National 

Clearinghouse for Alcohol and Drug 

Information (NCADI) at 1–800–729–

6686. 

fi For mental health grants, call the 

National Mental Health Information 

Center at 1–800–789–CMHS (2647). 

You also may download the required 

documents from the SAMHSA Web site 

at http://www.samhsa.gov. Click on 

‘‘Grant Opportunities.’’

Additional materials available on this 

web site include: 

fi A technical assistance manual for 

potential applicants; 

fi Standard terms and conditions for 

SAMHSA grants; 

fi Guidelines and policies that relate 

to SAMHSA grants (e.g., Guidelines on 

cultural competence, consumer and 

family participation, and evaluation); 

and 

fi Enhanced instructions for 

completing the PHS 5161–1 application. 

2. Content and Form of Application 

Submission 

2.1 Application Kit 

SAMHSA application kits include the 

following documents: 

fi PHS 5161–1 (revised July 2000)—

Includes the face page, budget forms, 

assurances, certification, and checklist. 

You must use the PHS 5161–1 unless 

otherwise specified in the NOFA. 

Applications that are not submitted on 

the required application form will be 

screened out and will not be reviewed. 

fi Program Announcement (PA)—

Includes instructions for the grant 

application. This document is the PA. 

fi Notice of Funding Availability 

(NOFA)—Provides specific information 

about availability of funds, as well as 

any exceptions or limitations to 

provisions in the PA. The NOFAs will 

be published in the Federal Register as 

well as on the Federal grants Web site 

(http://www.grants.gov). It is very 

important that you read the entire 

NOFA before beginning to write your 

application. 

You must use all of the above 

documents in completing your 

application. 

2.2 Required Application Components 

To ensure equitable treatment of all 

applications, applications must be 

complete. In order for your application 

to be complete, it must include the 

required ten application components 

(Face Page, Abstract, Table of Contents, 

Budget Form, Project Narrative and 

Supporting Documentation, 

Appendices, Assurances, Certifications, 

Disclosure of Lobbying Activities, and 

Checklist). 

b 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 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.] 

b Abstract—Your total abstract 

should be no longer than 35 lines. In the 

first five lines or less of your abstract, 

write a summary of your project that can 

be used, if your project is funded, in 

publications, reporting to Congress, or 

press releases. 

b Table of Contents—Include page 

numbers for each of the major sections 

of your application and for each 

appendix. 

b Budget Form—Use SF 424A, 

which is part of the PHS 5161–1. Fill 

out Sections B, C, and E of the SF 424A. 

A sample budget and justification is 

included in Appendix D of this Program 

Announcement. 

b Project Narrative and Supporting 

Documentation—The Project Narrative 

describes your project. It consists of 

Sections A through D. These sections in 

total may be no longer than 25 pages. 

(For example, remember that if your 

Project Narrative starts on page 5 and 

ends on page 30, it is 26 pages long, not 

25 pages.) More detailed instructions for 

completing each section of the Project 

Narrative are provided in ‘‘Section V—

Application Review Information’’ of this 

document. 

The Supporting Documentation 

provides additional information 

necessary for the review of your 

application. This supporting 

documentation should be provided 

immediately following your Project 

Narrative in Sections E through H. 

There are no page limits for these 

sections, except for Section G, the 

Biographical Sketches/Job Descriptions. 

■ Section E—Literature Citations. 

This section must contain complete 

citations, including titles and all 

authors, for any literature you cite in 

your application. 

■ Section F—Budget Justification, 

Existing Resources, Other Support. You 

must provide a narrative justification of 

the items included in your proposed 

budget, as well as a description of 

existing resources and other support 

you expect to receive for the proposed 

project. 

■ Section G—Biographical Sketches 

and Job Descriptions. 

Æ Include a biographical sketch for 

the Project Director and other key 

positions. Each sketch should be 2 pages 

or less. If the person has not been hired, 

include a position description/and or a 

letter of commitment with a current 

biographical sketch from the individual. 

Æ Include job descriptions for key 

personnel. Job descriptions should be 

no longer than 1 page each. 

Æ Sample sketches and job 

descriptions are listed on page 22, Item 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62375 

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. 

b Appendices 1 through 5—Use only 

the appendices listed below. If your 

application includes any appendices not 

required in the grant announcement or 

NOFA, they will be disregarded. Do not 

use more than a total of 30 pages for 

Appendices 1, 4, and 5 combined. There 

are no page limitations for Appendices 

2 and 3. Do not use appendices to 

extend or replace any of the sections of 

the Project Narrative unless specifically 

required in the NOFA. Reviewers will 

not consider them if you do. 

fi Appendix 1: Letters of Support. 

fi Appendix 2: Documentation of the 

Practice (Phase II only applicants) 

fi Appendix 3: Data Collection 

Instruments/Interview Protocols 

fi Appendix 4: Sample Consent 

Forms 

fi Appendix 5: Letter to the SSA (if 

applicable; see Section IV–4 of this 

ocument) 

b Assurances—Non-Construction 

Programs. Use Standard Form 424B 

found in PHS 5161–1. Some applicants 

will be required to complete the 

Assurance of Compliance with 

SAMHSA Charitable Choice Statutes 

and Regulations Form SMA 170. If this 

assurance applies to a specific funding 

opportunity, it will be posted on 

SAMHSA’s web site with the NOFA and 

provided in the application kits 

available at SAMHSA’s clearinghouse 

(NCADI). 

b Certifications—Use the 

‘‘Certifications’’ forms found in PHS 

5161–1. 

b Disclosure of Lobbying Activities—

Use form SF LLL found in the PHS 

5161–1. Federal law prohibits the use of 

appropriated funds for publicity or 

propaganda purposes, or for the 

preparation, distribution, or use of the 

information designed to support or 

defeat legislation pending before the 

Congress or State legislatures. This 

includes ‘‘grass roots’’ lobbying, which 

consists of appeals to members of the 

public suggesting that they contact their 

elected representatives to indicate their 

support for or opposition to pending 

legislation or to urge those 

representatives to vote in a particular 

way. 

b 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. 

b Information provided must be 

sufficient for review. 

b 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. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

❑ To ensure equity among 

applications, the amount of space 

allowed for the Project Narrative cannot 

be exceeded. 

• Applications would meet this 

requirement by using all margins (left, 

right, top, bottom) of at least one inch 

each, and adhering to the 25-page limit 

for the Project Narrative. 

• Should an application not conform 

to these margin or page limits, SAMHSA 

will use the following method to 

determine compliance: The total area of 

the Project Narrative (excluding 

margins, but including charts, tables, 

graphs and footnotes) cannot exceed 

58.5 square inches multiplied by 25. 

This number represents the full page 

less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the 

physical page. Space left blank within 

the Project Narrative (excluding 

margins) is considered part of the 

Project Narrative, in determining 

compliance. 

To facilitate review of your 

application, follow these additional 

guidelines. Failure to adhere to the 

following guidelines will not, in itself, 

result in your application being 

screened out and returned without 

review. However, following these 

guidelines will help reviewers to 

consider your application. 

❑ Pages should be typed singlespaced in black ink, with one column 

per page. Pages should not have printing 

on both sides. 

❑ Please number pages consecutively 

from beginning to end so that 

information can be located easily during 

review of the application. The cover 

page should be page 1, the abstract page 

should be page 2, and the table of 

contents page should be page 3. 

Appendices should be labeled and 

separated from the Project Narrative and 

budget section, and the pages should be 

numbered to continue the sequence. 

❑ The page limit of a total of 30 pages 

for Appendices 1, 4 and 5 combined 

should not be exceeded. 

❑ Send the original application and 

two copies to the mailing address in 

Section IV–6.1 of this document. Please 

do not use staples, paper clips, and 

fasteners. Nothing should be attached, 

stapled, folded, or pasted. Do not use 

heavy or lightweight paper or any 

material that cannot be copied using 

automatic copying machines. Odd-sized 

and oversized attachments such as 

posters will not be copied or sent to 

reviewers. Do not include videotapes, 

audiotapes, or CD–ROMs. 

2.4 Confidentiality and Human 

Subjects Protection 

Applicants must describe procedures 

relating to Confidentiality and the 

Protection of Human Subjects 

Regulations in Section H of the 

application, using the guidelines 

provided below. Problems with 

confidentiality and protection of human 

subjects identified during peer review of 

the application may result in the delay 

of funding. 

Confidentiality and Participant 

Protection 

All applicants must describe how 

they will address the requirements for 

each of the following elements relating 

to confidentiality and participant 

protection. 

1. Protect Clients and Staff from 

Potential Risks: 

fi 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. 

fi Describe the procedures you will 

follow to minimize or protect 

participants against potential risks, 

including risks to confidentiality. 

fi Identify plans to provide guidance 

and assistance in the event there are 

adverse effects to participants. 

fi 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: 

fi 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, 

62376 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

children of substance abusers, pregnant 

women, or other targeted groups. 

fi 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. 

fi Explain the reasons for including 

or excluding participants. 

fi Explain how you will recruit and 

select participants. Identify who will 

select participants. 

3. Absence of Coercion: 

fi 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. 

fi If you plan to compensate 

participants, state how participants will 

be awarded incentives (e.g., money, 

gifts, etc.). 

fi 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: 

fi 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. 

fi 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. 

fi Provide in Appendix 3: Data 

Collection Instruments/Interview 

Protocols, copies of all available data 

collection instruments and interview 

protocols that you plan to use. 

5. Privacy and Confidentiality: 

fi Explain how you will ensure 

privacy and confidentiality. Include 

who will collect data and how it will be 

collected. 

fi Describe: 

Æ How you will use data collection 

instruments. 

Æ Where data will be stored. 

Æ Who will or will not have access to 

information. 

Æ How the identity of participants 

will be kept private, for example, 

through the use of a coding system on 

data records, limiting access to records, 

or storing identifiers separately from 

data. 

Note: If applicable, grantees must agree to 

maintain the confidentiality of alcohol and 

drug abuse client records according to the 

provisions of Title 42 of the Code of Federal 

Regulations, Part 2. 

6. Adequate Consent Procedures: 

fi 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. 

fi State: 

Æ Whether or not their participation 

is voluntary. 

Æ Their right to leave the project at 

any time without problems. 

Æ Possible risks from participation in 

the project. 

Æ Plans to protect clients from these 

risks. 

fi 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 

informed consent. 

fi 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? 

fi 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. 

fi 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? 

fi 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: 

Discuss why the risks are reasonable 

compared to expected benefits and 

importance of the knowledge from the 

project. 

Protection of Human Subjects 

Regulations 

All applicants for Service-to-Science 

grants must comply with the Protection 

of Human Subjects Regulations (45 CFR 

part 46). 

Applicants must describe the process 

for obtaining Institutional Review Board 

(IRB) approval fully in their 

applications. While IRB approval is not 

required at the time of grant award, you 

will be required, as a condition of 

award, to provide the documentation 

that an Assurance of Compliance is on 

file with the Office for Human Research 

Protections (OHRP) and that IRB 

approval has been received prior to 

enrolling any participants in the 

proposed project. 

General information about Protection 

of Human Subjects Regulations can be 

obtained on the web at http:// 

www.hhs.gov/ohrp. You may also 

contact OHRP by e-mail 

(ohrp@osophs.dhhs.gov) or by phone 

(301–496–7005). SAMHSA-specific 

questions related to Protection of 

Human Subjects Regulations should be 

directed to the program contact listed in 

Section VII of the NOFA. 

3. Submission Dates and Times 

Deadlines for submission of 

applications for specific funding 

opportunities will be published in the 

NOFAs in the Federal Register and 

posted on the Federal grants web site 

(www.grants.gov). 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

Your application must be received by 

the application deadline, or you must 

have proof of its timely submission as 

specified below. 

• For packages submitted via DHL, 

Falcon Carrier, Federal Express (FedEx), 

or United Parcel Service (UPS), timely 

submission shall be evidenced by a 

delivery service receipt indicating the 

application was delivered to a carrier 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62377 

service at least 24 hours prior to the 

application deadline. 

• For packages submitted via the 

United States Postal Service (USPS), 

proof of timely submission shall be a 

postmark not later than 1 week prior to 

the application deadline, and the 

following upon request by SAMHSA: 

Æ Proof of mailing using USPS Form 

3817 (Certificate of Mailing), or 

Æ A receipt from the Post Office 

containing the post office name, 

location, and date and time of mailing. 

You will be notified by postal mail 

that your application has been received. 

Applications not meeting the timely 

submission requirements above will not 

be considered for review. Please 

remember that mail sent to Federal 

facilities undergoes a security screening 

prior to delivery. Allow sufficient time 

for your package to be delivered. 

If an application is mailed to a 

location or office (including room 

number) that is not designated for 

receipt of the application, and that 

results in the designated office not 

receiving your application in 

accordance with the requirements for 

timely submission, it will cause the 

application to be considered late and 

ineligible for review. 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

SAMHSA is collaborating with 

http://www.grants.gov to accept 

electronic submission of applications 

only for select funding opportunities. 

Unless specifically indicated in the 

NOFA, electronic submission of 

applications will not be accepted. 

4. Intergovernmental Review (E.O. 

12372) Requirements 

Executive Order 12372, as 

implemented through Department of 

Health and Human Services (DHHS) 

regulation at 45 CFR Part 100, sets up 

a system for State and local review of 

applications for Federal financial 

assistance. A current listing of State 

Single Points of Contact (SPOCs) is 

included in the application kit and can 

be downloaded from the Office of 

Management and Budget (OMB) Web 

site at http://www.whitehouse.gov/omb/ 

grants/spoc.html. 

fi 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. 

fi 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. 

fi For proposed projects serving 

more than one State, you are advised to 

contact the SPOC of each affiliated 

State. 

fi The SPOC should send any State 

review process recommendations to the 

following address within 60 days of the 

application deadline: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20850, ATTN: SPOC ‘‘ Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SPOC—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition, community-based, nongovernmental service providers who are 

not transmitting their applications 

through the State must submit a Public 

Health System Impact Statement 

(PHSIS) (approved by OMB under 

control no. 0920–0428; see burden 

statement below) to the head(s) of 

appropriate State or local health 

agencies in the area(s) to be affected no 

later than the pertinent receipt date for 

applications. The PHSIS is intended to 

keep State and local health officials 

informed of proposed health services 

grant applications submitted by 

community-based, non-governmental 

organizations within their jurisdictions. 

State and local governments and Indian 

tribal government applicants are not 

subject to these requirements. 

The PHSIS consists of the following 

information: 

fi A copy of the face page of the 

application (SF 424); and 

fi 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 

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 

include a copy of a letter transmitting 

the PHSIS to the SSA in Appendix 4, 

‘‘Letter to the SSA.’’ The letter must 

notify the State that, if it wishes to 

comment on the proposal, its comments 

should be sent not later than 60 days 

after the application deadline to: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857, ATTN: SSA—Funding 

Announcement No. [fill in pertinent 

funding opportunity number from 

NOFA]. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850, 

ATTN: SSA—Funding Announcement 

No. [fill in pertinent funding 

opportunity number from NOFA]. 

In addition: 

fi Applicants may request that the 

SSA send them a copy of any State 

comments. 

fi The applicant must notify the SSA 

within 30 days of receipt of an award. 

[Public reporting burden for the 

Public Health System Reporting 

Requirement is estimated to average 10 

minutes per response, including the 

time for copying the face page of SF 424 

and the abstract and preparing the letter 

for mailing. An agency may not conduct 

or sponsor, and a person is not required 

to respond to, a collection of 

information unless it displays a 

currently valid OMB control number. 

The OMB control number for this 

project is 0920–0428. Send comments 

regarding this burden to CDC Clearance 

Officer, 1600 Clifton Road, MS D–24, 

Atlanta, GA 30333, ATTN: PRA (0920–

0428).] 

5. Funding Limitations/Restrictions 

Cost principles describing allowable 

and unallowable expenditures for 

Federal grantees, including SAMHSA 

grantees, are provided in the following 

documents: 

fi Institutions of Higher Education: 

OMB Circular A–21. 

fi State and Local Governments: 

OMB Circular A–87. 

fi Nonprofit Organizations: OMB 

Circular A–122. 

fi Appendix E Hospitals: 45 CFR Part 

74. 

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

fi Pay for any lease beyond the 

project period. 

62378 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

fi 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). 

fi 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.) 

fi 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.) 

fi Pay for housing other than 

residential mental health and/or 

substance abuse treatment. 

fi Provide inpatient treatment or 

hospital-based detoxification services. 

Residential services are not considered 

to be inpatient or hospital-based 

services. 

fi Pay for incentives to induce clients 

to enter treatment. However, a grantee 

or treatment provider may provide up to 

$20 or equivalent (coupons, bus tokens, 

gifts, childcare, and vouchers) to clients 

as incentives to participate in required 

data collection follow-up. This amount 

may be paid for participation in each 

required interview. 

fi Implement syringe exchange 

programs, such as the purchase and 

distribution of syringes and/or needles. 

fi Pay for pharmacologies for HIV 

antiretroviral therapy, sexually 

transmitted diseases (STDs)/sexually 

transmitted illnesses (STI), TB, and 

hepatitis B and C, or for psychotropic 

drugs. 

fi SAMHSA will not accept a 

‘‘research’’ indirect cost rate. The 

grantee must use the ‘‘other sponsored 

program rate’’ or the lowest rate 

available. 

6. Other Submission Requirements 

6.1 Where To Send Applications 

Send applications to the following 

address: 

For United States Postal Service: 

Crystal Saunders, Director of Grant 

Review, Office of Program Services, 

Substance Abuse and Mental Health 

Services Administration, Room 3–1044, 

1 Choke Cherry Road, Rockville, MD 

20857. 

For other delivery service: Crystal 

Saunders, Director of Grant Review, 

Office of Program Services, Substance 

Abuse and Mental Health Services 

Administration, Room 3–1044, 1 Choke 

Cherry Road, Rockville, MD 20850. 

Do not send applications to other 

agency contacts, as this could delay 

receipt. Be sure to include the funding 

announcement number from the NOFA 

in item number 10 on the face page of 

the application. If you require a phone 

number for delivery, you may use (240) 

276–1199. 

6.2 How To Send Applications 

Mail or deliver an original application 

and 2 copies (including appendices) to 

the mailing address provided above, 

according to the instructions in Section 

IV–3. The original and copies must not 

be bound. Do not use staples, paper 

clips, or fasteners. Nothing should be 

attached, stapled, folded, or pasted. 

Hand carried applications will not be 

accepted. Applications may be shipped 

using only DHL, Falcon Carrier, Federal 

Express (FedEx), United Parcel Service 

(UPS), or the United States Postal 

Service (USPS). 

SAMHSA will not accept or consider 

any applications sent by facsimile. 

Unless specifically indicated in the 

NOFA, electronic submission of 

applications will not be accepted. 

V. Application Review Information 

1. Evaluation Criteria 

Your application will be reviewed 

and scored according to the quality of 

your response to the requirements listed 

below for developing the Project 

Narrative (Sections A–D). These 

sections describe what you intend to do 

with your project. 

fi In developing the Project Narrative 

section of your application, use these 

instructions along with any additional 

instructions found in the NOFA. These 

are to be used instead of the ‘‘Program 

Narrative’’ instructions found in the 

PHS 5161–1. 

fi 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. 

fi 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. Click on ‘‘Grant 

Opportunities.’’

fi The Supporting Documentation 

you provide in Sections E–H and 

Appendices 1 through 5 will be 

considered by reviewers in assessing 

your response, along with the material 

in the Project Narrative. 

fi The number of points after each 

heading below is the maximum number 

of points a review committee may assign 

to that section of your Project Narrative. 

Bullet statements in each section do not 

have points assigned to them. They are 

provided to invite the attention of 

applicants and reviewers to important 

areas within each section. 

Section A: Statement of Need (15 

Points) 

fi Describe the problem the project 

will address. Describe the national 

significance of the problem. 

Documentation of need may come from 

a variety of qualitative and quantitative 

sources in the professional literature. 

The quantitative data could also come 

from national data available regarding 

mental health and substance use needs, 

gaps, and priorities. For example: 

Æ Applications focusing on substance 

abuse might draw from SAMHSA’s 

National Household Survey on Drug Use 

and Health (NHSDUH); Drug Abuse 

Warning Network (DAWN); and Drug 

and Alcohol Services Information 

System (DASIS), which includes the 

Treatment Episode Data Set (TEDS). 

Æ Applications focusing on mental 

health might draw on data available 

from the National Association of State 

Mental Health Program Directors 

(NASMHPD), SAMHSA (http:// 

www.samhsa.gov/cmhs/ 

MentalHealthStatistics), or other 

sources. 

Qualitative sources may also include 

conclusions of conferences and events 

of national significance. 

fi Describe the target population for 

the practice, including demographic 

information. Be sure to check the NOFA 

for any specific requirements regarding 

the target population and catchment 

area. Discuss the target population’s 

language, beliefs, norms and values, as 

well as socioeconomic factors that must 

be considered in delivering programs to 

this population. 

fi Review the literature that 

demonstrates a need to develop or adapt 

an effective practice for the target 

population. Demonstrate through the 

literature review that current evidencebased approaches to the problem do not 

exist or have not been evaluated for the 

specific target populations, or that 

approaches of greater clinical or cost 

effectiveness are needed. 

fi Demonstrate that the need in the 

community in which the project will be 

carried out is of sufficient magnitude 

that an adequate evaluation of the 

practice can be conducted. To the extent 

possible, use locally generated data or 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62379 

State data such as that available through 

State needs assessments. 

fi Check the NOFA for any 

additional requirements. 

Section B: Proposed Approach (30 

Points) 

fi Describe the practice proposed for 

evaluation. Document that the practice 

has been in place and operational for at 

least one year prior to the application 

due date. 

fi Describe how the proposed 

practice will respond to the needs 

described in Section A of your Project 

Narrative and is consistent with the 

program purpose described in the 

NOFA. Address any and all program 

requirements specified in the NOFA. 

fi Discuss the potential effectiveness 

of the practice proposed for evaluation. 

Why has this practice been selected? 

Present the theoretical underpinnings, 

core principles, and major assumptions 

of the proposed practice. Outline the 

key operational elements of the practice 

and summarize any relevant literature. 

fi Identify any necessary 

collaborators on the project, including 

their roles and responsibilities. 

Demonstrate their commitment to the 

project. Include letters of support in 

Appendix 1: Letters of Support. Identify 

any cash or in-kind contributions that 

will be made to the project by the 

applicant or other partnering 

organizations. 

fi Describe your experience with 

similar collaborative projects, and 

explain why you believe you will be 

able to sustain this collaboration 

throughout the project period. 

fi If applying for combined Phase I 

and II, describe the extent to which the 

practice has been previously developed, 

implemented, stabilized, and 

documented. Include a description of 

the extent to which the support system 

needed for full implementation of the 

proposed practice is in place—e.g., 

community collaboration and consensus 

building; alignment of management 

information systems, policies, and 

funding mechanisms; documentation of 

core elements of the practice; reliable 

recruitment and intake procedures; 

quality assurance and accountability 

mechanisms; training and overall 

readiness of those implementing the 

practice; and involvement of families 

and consumers in the project. 

fi If applying for Phase II only, show 

that the practice is ready for systematic 

evaluation by providing documentation, 

in Appendix 2, that includes all of the 

following: 

Æ A logic model depicting the 

principles and concepts underlying the 

practice. 

Æ A copy of the Title Page and Table 

of Contents for a manual describing the 

practice in detail that would allow 

others to replicate the practice, and 

details on how the manual can be 

acquired. 

Æ Documentation of how critical 

stakeholders were included in the 

development of the practice. 

Æ A detailed description of the 

population that the practice is designed 

to serve, and demographic 

characteristics of the people served by 

the practice over the past year. 

Æ Demonstration of stability in the 

number of people being served by the 

practice. 

Æ Documentation that staff are trained 

in the practice (via the number and 

percentage of staff trained), and a 

mechanism for ongoing training for any 

new staff. 

Æ Evidence demonstrating that the 

practice is in full operation and that a 

routine service delivery process is in 

place. 

Æ Pilot outcome results. (Note: 

Collection of these data need not 

include an extensive set of outcomes 

systematically collected on all 

participants, but quantitative project 

data should provide some indication 

that key outcomes are being achieved.) 

fi Present the goals and measurable 

objectives of the project. Describe why 

the practice can better be evaluated for 

effectiveness following completion of 

the grant activities. For applications that 

include Phase I, include in your 

description how achievement of your 

goals will fulfill the Performance 

Expectations cited in Section I–2 of this 

document. 

fi Describe the action steps to 

accomplish the goals and objectives. 

Demonstrate that the action steps will 

lead to successful accomplishment of 

the goals and objectives. 

fi Describe the potential barriers to 

successful conduct of the proposed 

project and how you will overcome 

them. 

fi Describe how the proposed project 

will address issues of age, race/ 

ethnicity, culture, language, sexual 

orientation, disability, literacy, and 

gender in the target population. 

fi Check the NOFA for any 

additional requirements. 

Section C: Evaluation Design and 

Analysis (40 Points) 

fi Describe in detail your evaluation 

design for determining the effectiveness 

of the practice. For applications that 

include Phase I, describe your process 

evaluation to determine that the practice 

is in full operation, as well as how you 

will track the number and percentage of 

staff fully trained in the practice. 

fi Describe the process and outcome 

evaluation protocols you intend to use. 

Include in Appendix 3 evaluation 

instruments to be used. Describe any 

literature or pilot testing done to verify 

the validity and reliability of the 

instruments to be used or how you plan 

to develop the instruments during the 

grant period. 

fi Discuss the reliability and validity 

of evaluation methods and instrument(s) 

in terms of the gender/age/culture of the 

target population. 

fi Describe how you will develop 

and manage a database management 

system to record participant 

demographic characteristics, practice 

outcomes, service utilization, practice 

costs, and satisfaction of stakeholders 

with the practice. 

fi Describe how the integrity of the 

practice will be assessed using a fidelity 

(see Glossary) scale. If no fidelity scale 

currently exists for the practice, 

describe the process by which you will 

develop one during the grant period. 

Describe how you will document and 

assess changes to the model that occur 

throughout the project. 

fi Document your ability to collect 

and report on the required performance 

measures as specified in the NOFA, 

including data required by SAMHSA to 

meet GPRA requirements. Specify and 

justify any additional measures you 

plan to use for your grant project. 

fi Describe how you will analyze the 

data collected. Include any analyses that 

will be done to determine the 

effectiveness of the practice for diverse 

subgroups, as well as the satisfaction of 

various stakeholder groups with the 

practice. 

fi Describe how your process 

evaluation will document the role of 

critical stakeholders in the development 

and/or evaluation of the practice. 

fi Check the NOFA for any 

additional requirements. 

Section D: Management Plan and 

Staffing (15 Points) 

fi Provide a realistic time line for the 

project (chart or graph) showing key 

activities, milestones, and responsible 

staff. [Note: The time line should be part 

of the Project Narrative. It should not be 

placed in an appendix.] 

fi Discuss the capability and 

experience of the applicant organization 

and other participating organizations 

with similar projects and populations, 

including experience in providing 

culturally appropriate/competent 

services. 

fi Provide a list of staff members who 

will conduct the project, showing the 

62380 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

role of each and their level of effort and 

qualifications. Include the Project 

Director and other key personnel, such 

as evaluators and database management 

personnel. 

fi Describe the racial/ethnic 

characteristics of key staff and indicate 

if any are members of the target 

population/community. If the target 

population is multi-linguistic, indicate 

if the staffing pattern includes bilingual 

and bicultural individuals. 

fi If you plan to include an advisory 

body in your project, describe its 

membership, roles and functions, and 

frequency of meetings. 

fi Describe the resources available 

for the proposed project (e.g., facilities, 

equipment), and provide evidence that 

resources are adequate for conducting a 

high-quality evaluation of the identified 

practice. 

fi Check the NOFA for any 

additional requirements. 

Note: Although the budget for the proposed 

project is not a review criterion, the review 

group will be asked to comment on the 

appropriateness of the budget after the merits 

of the application have been considered. 

2. Review and Selection Process 

SAMHSA applications are peerreviewed 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: 

fi The strengths and weaknesses of 

the application as identified by the peer 

review committee and approved by the 

appropriate National Advisory Council; 

fi Availability of funds; and 

fi After applying the aforementioned 

criteria, the following method for 

breaking ties: When funds are not 

available to fund all applications with 

identical scores, SAMHSA will make 

award decisions based on the 

application(s) that received the greatest 

number of points by peer reviewers on 

the evaluation criterion in Section V–1 

with the highest number of possible 

points (Evaluation Design and 

Analysis—40 points). Should a tie still 

exist, the evaluation criterion with the 

next highest possible point value will be 

used, continuing sequentially to the 

evaluation criterion with the lowest 

possible point value, should that be 

necessary to break all ties. If an 

evaluation criterion to be used for this 

purpose has the same number of 

possible points as another evaluation 

criterion, the criterion listed first in 

Section V–1 will be used first. 

VI. Award Administration Information 

1. Award Notices 

After your application has been 

reviewed, you will receive a letter from 

SAMHSA through postal mail that 

describes the general results of the 

review, including the score that your 

application received. 

If you are approved for funding, you 

will receive an additional notice, the 

Notice of Grant Award, signed by 

SAMHSA’s Grants Management Officer. 

The Notice of Grant Award is the sole 

obligating document that allows the 

grantee to receive Federal funding for 

work on the grant project. It is sent by 

postal mail and is addressed to the 

contact person listed on the face page of 

the application. 

If you are not funded, you can reapply if there is another receipt date for 

the program. 

2. Administrative and National Policy 

Requirements 

fi You must comply with terms and 

conditions of the grant award. Standard 

SAMHSA terms and conditions are 

available on SAMHSA’s Web site at 

http://www.samhsa.gov/grants/ 

generalinfo/useful_info.aspx. 

fi Depending on the nature of the 

specific funding opportunity and/or the 

proposed project as identified during 

review, additional terms and conditions 

may be identified in the NOFA or 

negotiated with the grantee prior to 

grant award. These may include, for 

example: 

Æ Actions required to be in 

compliance with human subjects 

requirements; 

Æ Requirements relating to additional 

data collection and reporting; 

Æ Requirements relating to 

participation in a cross-site evaluation; 

or 

Æ Requirements to address problems 

identified in review of the application. 

fi 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. 

fi In an effort to improve access to 

funding opportunities for applicants, 

SAMHSA is participating in the U.S. 

Department of Health and Human 

Services ‘‘Survey on Ensuring Equal 

Opportunity for Applicants.’’ This 

survey is included in the application kit 

for SAMHSA grants. Applicants are 

encouraged to complete the survey and 

return it, using the instructions 

provided on the survey form. 

3. Reporting Requirements 

3.1 Progress and Financial Reports 

fi Grantees must provide annual and 

final progress reports. The final progress 

report must summarize information 

from the annual reports, describe the 

accomplishments of the project, and 

describe next steps for implementing 

plans developed during the grant 

period. 

fi Grantees must provide annual and 

final financial status reports. These 

reports may be included as separate 

sections of annual and final progress 

reports or can be separate documents. 

Because SAMHSA is extremely 

interested in ensuring that treatment or 

prevention service efforts are sustained, 

your financial reports should explain 

plans to ensure the sustainability (see 

Glossary) of efforts initiated under this 

grant. Initial plans for sustainability 

should be described in year 1 of the 

grant. In each subsequent year, you 

should describe the status of the project, 

successes achieved and obstacles 

encountered in that year. 

fi SAMHSA will provide guidelines 

and requirements for these reports to 

grantees at the time of award and at the 

initial grantee orientation meeting after 

award. SAMHSA staff will use the 

information contained in the reports to 

determine the grantee’s progress toward 

meeting its goals. 

3.2 Government Performance and 

Results Act (GPRA) 

The Government Performance and 

Results Act (GPRA) mandates 

accountability and performance-based 

management by Federal agencies. To 

meet the GPRA requirements, SAMHSA 

must collect performance data (i.e., 

‘‘GPRA data’’) from grantees. These 

requirements will be specified in the 

NOFA for each funding opportunity. 

3.3 Publications 

If you are funded under this grant 

program, you are required to notify the 

Government Project Officer (GPO) and 

SAMHSA’s Publications Clearance 

Officer (240–276–2130) of any materials 

based on the SAMHSA-funded project 

that are accepted for publication. 

In addition, SAMHSA requests that 

grantees: 

fi Provide the GPO and SAMHSA 

Publications Clearance Officer with 

advance copies of publications. 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62381 

fi Include acknowledgment of the 

SAMHSA grant program as the source of 

funding for the project. 

fi 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 

The NOFAs provide contact 

information for questions about program 

issues. 

For questions on grants management 

issues, contact: Kimberly Pendleton, 

Office of Program Services, Division of 

Grants Management, Substance Abuse 

and Mental Health Services 

Administration, 1 Choke Cherry Road, 

Room 7–1097, Rockville, Maryland 

20857, (240) 276–1421, 

kimberly.pendleton@samhsa.hhs.gov. 

Appendix A—Checklist for Formatting 

Requirements and Screenout Criteria 

for SAMHSA Grant Applications 

SAMHSA’s goal is to review all 

applications submitted for grant funding. 

However, this goal must be balanced against 

SAMHSA’s obligation to ensure equitable 

treatment of applications. For this reason, 

SAMHSA has established certain formatting 

requirements for its applications. If you do 

not adhere to these requirements, your 

application will be screened out and returned 

to you without review. In addition to these 

formatting requirements, programmatic 

requirements (e.g., relating to eligibility) may 

be stated in the specific NOFA and in Section 

III of the standard grant announcement. 

Please check the entire NOFA and Section III 

of the standard grant announcement before 

preparing your application. 

b Use the PHS 5161–1 application. 

b Applications must be received by the 

application deadline or have proof of timely 

submission, as detailed in Section IV–3 of the 

grant announcement. 

b Information provided must be sufficient 

for review. 

b 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. 

b Paper must be white paper and 8.5 

inches by 11.0 inches in size. 

b To ensure equity among applications, 

the amount of space allowed for the Project 

Narrative cannot be exceeded. 

• Applications would meet this 

requirement by using all margins (left, right, 

top, bottom) of at least one inch each, and 

adhering to the page limit for the Project 

Narrative stated in the specific funding 

announcement. 

• Should an application not conform to 

these margin or page limits, SAMHSA will 

use the following method to determine 

compliance: The total area of the Project 

Narrative (excluding margins, but including 

charts, tables, graphs and footnotes) cannot 

exceed 58.5 square inches multiplied by the 

page limit. This number represents the full 

page less margins, multiplied by the total 

number of allowed pages. 

• Space will be measured on the physical 

page. Space left blank within the Project 

Narrative (excluding margins) is considered 

part of the Project Narrative, in determining 

compliance. 

To facilitate review of your application, 

follow these additional guidelines. Failure to 

adhere to the following guidelines will not, 

in itself, result in your application being 

screened out and returned without review. 

However, the information provided in your 

application must be sufficient for review. 

Following these guidelines will help ensure 

your application is complete, and will help 

reviewers to consider your application. 

b The 10 application components 

required for SAMHSA applications should be 

included. These are: 

• 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). 

b Applications should comply with the 

following requirements: 

• Provisions relating to confidentiality, 

participant protection and the protection of 

human subjects specified in Section IV–2.4 of 

the FY 2005 standard funding 

announcements. 

• Budgetary limitations as specified in 

Section I, II, and IV–5 of the FY 2005 

standard funding announcements. 

• Documentation of nonprofit status as 

required in the PHS 5161–1. 

b Pages should be typed single-spaced in 

black ink, with one column per page. Pages 

should not have printing on both sides. 

b Please number pages consecutively from 

beginning to end so that information can be 

located easily during review of the 

application. The cover page should be page 

1, the abstract page should be page 2, and the 

table of contents page should be page 3. 

Appendices should be labeled and separated 

from the Project Narrative and budget 

section, and the pages should be numbered 

to continue the sequence. 

b The page limits for Appendices stated 

in the specific funding announcement should 

not be exceeded. 

b Send the original application and two 

copies to the mailing address in the funding 

announcement. Please do not use staples, 

paper clips, and fasteners. Nothing should be 

attached, stapled, folded, or pasted. Do not 

use heavy or lightweight paper or any 

material that cannot be copied using 

automatic copying machines. Odd-sized and 

oversized attachments such as posters will 

not be copied or sent to reviewers. Do not 

include videotapes, audiotapes, or CD–

ROMs. 

Appendix B—Glossary 

Best Practice: Best practices are practices 

that incorporate the best objective 

information currently available regarding 

effectiveness and acceptability. 

Catchment Area: A catchment area is the 

geographic area from which the target 

population to be served by a program will be 

drawn. 

Cooperative Agreement: A cooperative 

agreement is a form of Federal grant. 

Cooperative agreements are distinguished 

from other grants in that, under a cooperative 

agreement, substantial involvement is 

anticipated between the awarding office and 

the recipient during performance of the 

funded activity. This involvement may 

include collaboration, participation, or 

intervention in the activity. HHS awarding 

offices use grants or cooperative agreements 

(rather than contracts) when the principal 

purpose of the transaction is the transfer of 

money, property, services, or anything of 

value to accomplish a public purpose of 

support or stimulation authorized by Federal 

statute. The primary beneficiary under a 

grant or cooperative agreement is the public, 

as opposed to the Federal Government. 

Cost Sharing or Matching: Cost sharing 

refers to the value of allowable non-Federal 

contributions toward the allowable costs of a 

Federal grant project or program. Such 

contributions may be cash or in-kind 

contributions. For SAMHSA grants, cost 

sharing or matching is not required, and 

applications will not be screened out on the 

basis of cost sharing. However, applicants 

often include cash or in-kind contributions in 

their proposals as evidence of commitment to 

the proposed project. This is allowed, and 

this information may be considered by 

reviewers in evaluating the quality of the 

application. 

Fidelity: Fidelity is the degree to which a 

specific implementation of a program or 

practice resembles, adheres to, or is faithful 

to the evidence-based model on which it is 

based. Fidelity is formally assessed using 

rating scales of the major elements of the 

evidence-based model. A toolkit on how to 

develop and use fidelity instruments is 

available from the SAMHSA-funded 

Evaluation Technical Assistance Center at 

http://tecathsri.org or by calling (617) 876–

0426. 

Grant: A grant is the funding mechanism 

used by the Federal Government when the 

principal purpose of the transaction is the 

transfer of money, property, services, or 

anything of value to accomplish a public 

62382 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

purpose of support or stimulation authorized 

by Federal statute. The primary beneficiary 

under a grant or cooperative agreement is the 

public, as opposed to the Federal 

Government. 

In-Kind Contribution: In-kind contributions 

toward a grant project are non-cash 

contributions (e.g., facilities, space, services) 

that are derived from non-Federal sources, 

such as State or sub-State non-Federal 

revenues, foundation grants, or contributions 

from other non-Federal public or private 

entities. 

Logic Model: A logic model is a 

diagrammatic representation of a theoretical 

framework. A logic model describes the 

logical linkages among program resources, 

conditions, strategies, short-term outcomes, 

and long-term impact. More information on 

how to develop logics models and examples 

can be found through the resources listed in 

Appendix C. 

Practice: A practice is any activity, or 

collective set of activities, intended to 

improve outcomes for people with or at risk 

for substance abuse and/or mental illness. 

Such activities may include direct service 

provision, or they may be supportive 

activities, such as efforts to improve access 

to and retention in services, organizational 

efficiency or effectiveness, community 

readiness, collaboration among stakeholder 

groups, education, awareness, training, or 

any other activity that is designed to improve 

outcomes for people with or at risk for 

substance abuse or mental illness. 

Practice Support System: This term refers 

to contextual factors that affect practice 

delivery and effectiveness in the preadoption phase, delivery phase, and postdelivery phase, such as (a) community 

collaboration and consensus building, (b) 

training and overall readiness of those 

implementing the practice, and (c) sufficient 

ongoing supervision for those implementing 

the practice. 

Stakeholder: A stakeholder is an 

individual, organization, constituent group, 

or other entity that has an interest in and will 

be affected by a proposed grant project. 

Sustainability: Sustainability is the ability 

to continue a program or practice after 

SAMHSA grant funding has ended. 

Target Population: The target population is 

the specific population of people whom a 

particular program or practice is designed to 

serve or reach. 

Wraparound Service: Wraparound services 

are non-clinical supportive services—such as 

child care, vocational, educational, and 

transportation services—that are designed to 

improve the individual’s access to and 

retention in the proposed project. 

Appendix C—Logic Model Resources 

Chen, W.W., Cato, B.M., & Rainford, N. 

(1998–9). Using a logic model to plan and 

evaluate a community intervention program: 

A case study. International Quarterly of 

Community Health Education, 18(4), 449–

458. 

Edwards, E.D., Seaman, J.R., Drews, J., & 

Edwards, M.E. (1995). A community 

approach for Native American drug and 

alcohol prevention programs: A logic model 

framework. Alcoholism Treatment Quarterly, 

13(2), 43–62. 

Hernandez, M. & Hodges, S. (2003). 

Crafting Logic Models for Systems of Care: 

Ideas into Action. [Making children’s mental 

health services successful series, volume 1]. 

Tampa, FL: University of South Florida, The 

Louis de la Parte Florida Mental Health 

Institute, Department of Child & Family 

Studies. http://cfs.fmhi.usf.edu or phone 

(813) 974–4651. 

Hernandez, M. & Hodges, S. (2001). 

Theory-based accountability. In M. 

Hernandez & S. Hodges (Eds.), Developing 

Outcome Strategies in Children’s Mental 

Health, pp. 21–40. Baltimore: Brookes. 

Julian, D.A. (l997). Utilization of the logic 

model as a system level planning and 

evaluation device. Evaluation and Planning, 

20(3), 251–257. 

Julian, D.A., Jones, A., & Deyo, D. (1995). 

Open systems evaluation and the logic 

model: Program planning and evaluation 

tools. Evaluation and Program Planning, 

18(4), 333–341. 

Patton, M.Q. (1997). Utilization-Focused 

Evaluation (3rd Ed.), pp. 19, 22, 241. 

Thousand Oaks, CA: Sage. 

Wholey, J.S., Hatry, H.P., Newcome, K.E. 

(Eds.) (1994). Handbook of Practical Program 

Evaluation. San Francisco, CA: Jossey-Bass 

Inc. 

Appendix D—Sample Budget and 

Justification 

Illustration of a Sample Detailed Budget and 

Narrative Justification to Accompany SF 

424A: Section B for 01 Budget Period 

Object Class Categories 

Personnel 

Job title Name Annual salary Level of effort Salary being requested 

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

Secretary ................................................... Unnamed .................................................. 18,000 0.5 9,000 

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

Enter Personnel subtotal on 424A, Section B, 

6.a. $64,000 

Fringe Benefits (24%) $15,360 

Enter Fringe Benefits subtotal on 424A, 

Section B, 6.b. $15,360 

Travel 

2 trips for SAMHSA Meetings for 2 Attendees (Airfare @ $600 x 4 = $2,400) + (per diem @ $120 x 4 x 6 days = $2,880) .............. $5,280 

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

Enter Travel subtotal on 424A, Section B, 

6.c. $5,400 

Equipment (List Individually) 

‘‘Equipment’’ means an article of 

nonexpendable, tangible personal property 

having a useful life of more than one year 

and an acquisition cost which equals the 

lesser of (a) the capitalization level 

established by the governmental unit or 

nongovernmental applicant for financial 

statement purposes, or (b) $5000. 

Enter Equipment subtotal on 424A, Section 

B, 6.d. 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Computer Software–1 WordPerfect ......................................................................................................................................................... 500 

Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 62383 

Enter Supplies subtotal on 424A, Section B, 

6.e. $1,000 

Contractual Costs 

Evaluation 

Job title Name Annual salary Salary being 

requested Level of effort 

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

Other Staff ................................................ .............................................................. 18,000 18,000 1.0 

Fringe Benefits (25%) $10,500 

Travel 

2 trips x 1 Evaluator ($600 x 2) ............................................................................................................................................................... $1,200 

per diem @ $120 x 6 .............................................................................................................................................................................. 720 

Supplies (General Office) ........................................................................................................................................................................ 500 

Evaluation Direct ...................................................................................................................................................................................... $54,920 

Evaluation Indirect Costs (19%) .............................................................................................................................................................. 10,435 

Evaluation Subtotal ........................................................................................................................................................................... 65,355 

Training 

Job title Name Level of effort Salary being 

requested 

Coordinator ............................................................... M. Smith ................................................................... 0.5 $12,000 

2Admin. Asst. ............................................................ N. Jones ................................................................... 0.5 9,000 

Fringe Benefits (25%) $5,250 

Travel 

2 Trips for Training Airfare @ $600 x 2 .................................................................................................................................................. $1,200 

Per Diem $120 x 2 x 2 days ................................................................................................................................................................... 480 

Local (500 miles x .24/mile) .................................................................................................................................................................... 120 

Supplies 

Office Supplies ......................................................................................................................................................................................... $500 

Software (WordPerfect) ........................................................................................................................................................................... 500 

Other 

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

Telephone ................................................................................................................................................................................................ 500 

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

Audit ......................................................................................................................................................................................................... 3,000 

Training Direct ......................................................................................................................................................................................... $40,025 

Training Indirect ....................................................................................................................................................................................... -0- 

Enter Contractual subtotal on 424A, Section 

B, 6.f. $105,380 

Other 

Consultants = Expert @ $250/day X 6 day (If expert is known, should list by name) ........................................................................... $1,500 

62384 Federal Register / Vol. 69, No. 205 / Monday, October 25, 2004 / Notices 

Enter Other subtotal on 424A, Section B, 6.h.

$1,500 

Total Direct Charges (sum of 6.a–6.h) 

Enter Total Direct on 424A, Section B, 6.i.

$192,640 

Indirect Costs 

15% of Salary and Wages (copy of 

negotiated indirect cost rate agreement 

attached) 

Enter Indirect subtotal of 424A, Section B, 

6.j. $9,600 

Totals 

Enter TOTAL on 424A, Section B, 6.k.

$202,240 

Justification 

Personnel—Describe the role and 

responsibilities of each position. 

Fringe Benefits—List all components of the 

fringe benefit rate. 

Equipment—List equipment and describe 

the need and the purpose of the equipment 

in relation to the proposed project. 

Supplies—Generally self-explanatory; 

however, if not, describe need. Include 

explanation of how the cost has been 

estimated. 

Travel—Explain need for all travel other 

than that required by SAMHSA. 

Contractual Costs—Explain the need for 

each contractual arrangement and how these 

components relate to the overall project. 

Other—Generally self-explanatory. If 

consultants are included in this category, 

explain the need and how the consultant’s 

rate has been determined. 

Indirect Cost Rate—If your organization 

has no indirect cost rate, please indicate 

whether your organization plans to (a) waive 

indirect costs if an award is issued, or (b) 

negotiate and establish an indirect cost rate 

with DHHS within 90 days of award 

issuance. 

CALCULATION OF FUTURE BUDGET PERIODS (BASED ON FIRST 12-MONTH BUDGET PERIOD) 

[Review and verify the accuracy of future year budget estimates. Increases or decreases in the future years must be explained and justified and 

no cost of living increases will be honored. (Note: new salary cap of $175,700 is effective for all FY 2005 awards.) *] 

First 12-month 

Period 

Second 12- 

month Period 

Third 12-month 

Period 

Personnel: 

Project Director ......................................................................................................... 30,000 30,000 30,000 

Secretary ** ............................................................................................................... 9,000 18,000 18,000 

Counselor ................................................................................................................. 25,000 25,000 25,000 

Total Personnel ................................................................................................. 64,000 73,000 73,000 

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

Travel ............................................................................................................................... 5,400 5,400 5,400 

Equipment ........................................................................................................................ -0- -0- -0- 

Supplies *** ...................................................................................................................... 1,000 520 520 

Contractual: 

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

Training ..................................................................................................................... 40,025 40,025 40,025 

Other ......................................................................................................................... 1,500 1,500 1,500 

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

Indirect Costs (15% S&W) ....................................................................................... 9,600 9,600 9,600 

Total Costs ........................................................................................................ 202,240 216,884 219,603 

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

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

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

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

The Federal dollars requested for all object 

class categories for the first 12-month budget 

period are entered on Form 424A, Section B, 

Column (1), lines 6a-6i. The total Federal 

dollars requested for the second through the 

fifth 12-month budget periods are entered on 

Form 424A, Section E, Columns (b)–(e), line 

20. The RFA will specify the maximum 

number of years of support that may be 

requested. 

Dated: October 12, 2004. 

Daryl Kade, 

Director, Office of Policy, Planning and 

Budget, Substance Abuse and Mental Health 

Services Administration. 

[FR Doc. 04–23297 Filed 10–22–04; 8:45 am] 

BILLING CODE 4162–20–P