ࡱ>  bjbjWW 55F/,'<'L'L'L'$p'p'p'P'*p',x. 7"7778OXadikkkkkk$.L'we88weweL'L'77hhhweL'7L'7ihweihh`k7Bkf3U0gh"kkL'Mwewehwewewewewehwewewewewewewewewewewewewewewewe %: Department of Health and Human Services Substance Abuse and Mental Health Services Administration Transforming Lives through Supported Employment Short Title: Supported Employment Program (Modified Announcement) Request for Applications (RFA) No. SM-14-011 Catalogue of Federal Domestic Assistance (CFDA) No.: 93.243 Key Dates: Application DeadlineApplications are due by April 21, 2014.  Table of Contents TOC \o "1-2" \h \z \u  HYPERLINK \l "_Toc381864839"    HYPERLINK \l "_Toc381864840" EXECUTIVE SUMMARY:  PAGEREF _Toc381864840 \h 4  HYPERLINK \l "_Toc381864841" I. FUNDING OPPORTUNITY DESCRIPTION  PAGEREF _Toc381864841 \h 5  HYPERLINK \l "_Toc381864842" 1. PURPOSE  PAGEREF _Toc381864842 \h 5  HYPERLINK \l "_Toc381864843" 2. EXPECTATIONS  PAGEREF _Toc381864843 \h 7  HYPERLINK \l "_Toc381864844" II. AWARD INFORMATION  PAGEREF _Toc381864844 \h 15  HYPERLINK \l "_Toc381864845" III. ELIGIBILITY INFORMATION  PAGEREF _Toc381864845 \h 16  HYPERLINK \l "_Toc381864846" 1. ELIGIBLE APPLICANTS  PAGEREF _Toc381864846 \h 16  HYPERLINK \l "_Toc381864847" 2. COST SHARING and MATCH REQUIREMENTS  PAGEREF _Toc381864847 \h 16  HYPERLINK \l "_Toc381864848" 3. OTHER  PAGEREF _Toc381864848 \h 16  HYPERLINK \l "_Toc381864849" IV. APPLICATION AND SUBMISSION INFORMATION  PAGEREF _Toc381864849 \h 17  HYPERLINK \l "_Toc381864850" 1. CONTENT AND GRANT APPLICATION SUBMISSION  PAGEREF _Toc381864850 \h 17  HYPERLINK \l "_Toc381864851" 2. APPLICATION SUBMISSION REQUIREMENTS  PAGEREF _Toc381864851 \h 20  HYPERLINK \l "_Toc381864852" 3. FUNDING LIMITATIONS/RESTRICTIONS  PAGEREF _Toc381864852 \h 20  HYPERLINK \l "_Toc381864853" V. APPLICATION REVIEW INFORMATION  PAGEREF _Toc381864853 \h 21  HYPERLINK \l "_Toc381864854" 1. EVALUATION CRITERIA  PAGEREF _Toc381864854 \h 21  HYPERLINK \l "_Toc381864855" 2. REVIEW AND SELECTION PROCESS  PAGEREF _Toc381864855 \h 25  HYPERLINK \l "_Toc381864856" VI. ADMINISTRATION INFORMATION  PAGEREF _Toc381864856 \h 25  HYPERLINK \l "_Toc381864857" 1. AWARD NOTICES  PAGEREF _Toc381864857 \h 25  HYPERLINK \l "_Toc381864858" 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS  PAGEREF _Toc381864858 \h 26  HYPERLINK \l "_Toc381864859" 3. REPORTING REQUIREMENTS  PAGEREF _Toc381864859 \h 27  HYPERLINK \l "_Toc381864860" VII. AGENCY CONTACTS  PAGEREF _Toc381864860 \h 27  HYPERLINK \l "_Toc381864861" Appendix A Checklist for Formatting Requirements and Screen-out Criteria for SAMHSA Grant Applications  PAGEREF _Toc381864861 \h 28  HYPERLINK \l "_Toc381864862" Appendix B Guidance for Electronic Submission of Applications  PAGEREF _Toc381864862 \h 30  HYPERLINK \l "_Toc381864863" Appendix C Funding Restrictions  PAGEREF _Toc381864863 \h 37  HYPERLINK \l "_Toc381864864" Appendix D Biographical Sketches and Job Descriptions  PAGEREF _Toc381864864 \h 39  HYPERLINK \l "_Toc381864865" Appendix E Sample Budget and Justification (no match required)  PAGEREF _Toc381864865 \h 40  HYPERLINK \l "_Toc381864866" Appendix F Confidentiality and SAMHSA Participant Protection/Human Subjects Guidelines  PAGEREF _Toc381864866 \h 49  HYPERLINK \l "_Toc381864867" Appendix G Addressing Behavioral Health Disparities  PAGEREF _Toc381864867 \h 53  HYPERLINK \l "_Toc381864868" Appendix H Electronic Health Record (EHR) Resources  PAGEREF _Toc381864868 \h 58  EXECUTIVE SUMMARY: The Substance Abuse and Mental Health Services Administration, Center for Mental Health Services is accepting applications for fiscal year (FY) 2014 for the Mental Health Transformation Grant Program: Transforming Lives through Supported Employment (Short Title: Supported Employment Program). The purpose of this program is to enhance state and community capacity to provide and expand evidence-based supported employment programs (such as the Individual Placement and Support model) to adults with serious mental illnesses including persons with co-occurring mental and substance use disorders. The expected outcome of the program is for states to have the necessary infrastructure in place to maintain and expand supported employment services throughout the state and increase the number of individuals with serious mental illness and co-occurring mental and substance use disorders who obtain and retain competitive employment. Funding Opportunity Title: Mental Health Transformation Grant Program: Transforming Lives through Supported Employment (Short Title: Supported Employment Program) Funding Opportunity Number: SM-14-011 Due Date for Applications: April 21, 2014 Anticipated Total Available Funding: $4,800,000 Estimated Number of Awards: 6 Estimated Award Amount: $800,000 Cost Sharing/Match Required no Length of Project Period: Up to 5 years Eligible Applicants: Eligible applicants are mental health authorities in states, territories, and the District of Columbia; federally recognized American Indian/Alaska Native tribes and tribal organizations, or urban Indian organization authorized to develop or direct the state/tribal-sponsored supported employment programs. [See  HYPERLINK \l "_1._ELIGIBLE_APPLICANTS" Section III-1 of this RFA for complete eligibility information.] I. FUNDING OPPORTUNITY DESCRIPTION 1. PURPOSE The Substance Abuse and Mental Health Services Administration, Center for Mental Health Services is accepting applications for fiscal year (FY) 2014 for the Mental Health Transformation Grant Program: Transforming Lives through Supported Employment (Short Title: Supported Employment Program). The purpose of this program is to enhance state and community capacity to provide and expand evidence-based supported employment programs (such as the Individual Placement and Support model) to adults with serious mental illnesses including persons with co-occurring mental and substance use disorders. The expected outcome of the program is for states to have the necessary infrastructure in place to maintain and expand supported employment services throughout the state and increase the number of individuals with serious mental illness and co-occurring mental and substance use disorders who obtain and retain competitive employment. Grantees will establish a robust SE program in two communities within the state, secure sustainable funding for on-going community SE services, establish a permanent training program using in-person and virtual platforms, and collect and analyze program data. Research has shown that supported employment helps individuals achieve and sustain recovery. Supported employment occurs within the most integrated and competitive setting that enables individuals with disabilities to interact with non-disabled persons to the fullest extent possible. Integrated settings are those that provide individuals with disabilities opportunities to live, work, and receive services in the community, like individuals without disabilities. The SE Program seeks to address behavioral health disparities among racial, ethnic, and sexual/gender minorities by encouraging the implementation of strategies to decrease the differences in access, service use, and outcomes among the racial, ethnic, and sexual/gender minority populations served (see  HYPERLINK \l "_Appendix_H__2" Appendix G: Addressing Behavioral Health Disparities). The Supported Employment Program will focus on enhancing state and community capacity to provide evidence-based SE programs to adults with serious mental illnesses. Expanding opportunities for employment of persons with serious mental illness supports SAMHSA's four pillars of recovery: Health, Home, Purpose, and Community. With gainful employment as the target outcome, mental health consumers, their treatment providers, and their employers will develop mutual understanding and successful relationships. The Supported Employment Program will help people with serious mental illnesses discover paths of self-sufficiency and recovery rather than disability and dependence. Employment is both an outcome and a core component of recovery. SAMHSAs Recovery Support Strategic Initiative (RSSI) emphasizes meaningful work and the ability to enhance skills through education in recovery from mental and substance use disorders and sets as its goal increasing gainful employment and educational opportunities, while decreasing legal and policy barriers, for individuals in recovery. Most people with serious mental illnesses want to work and yet too often find little support in traditional community mental health programs. With support, consumers can work in competitive jobs or start their own businesses and increase their work activity and earnings over time. Public and private-sector employers have become more engaged in disability employment. In 2010, on the 20th anniversary of the signing of the Americans with Disabilities Act (ADA), President Obama called on the federal government to hire an additional 100,000 workers with disabilities by 2015 (Executive Order 13548). Last year, the U.S. Chamber of Commerce called on the private sector to increase the disability labor force by over 1 million workers by 2015. In 2013, the Chair of the National Governors Association, Governor Jack Markell of Delaware, launched his initiative A Better Bottom Line: Employing People with Disabilities to provide governors and other state policymakers with better policy options to assess the environment in their state and strategies designed to support employment of persons with disabilities. The U.S. Department of Labor has issued a final rule effective March 14, 2014 for implementing Section 503 of the Rehabilitation Act of 1973, prohibiting federal contractors and subcontractors from discriminating in employment against individuals with disabilities (IWDs), and requiring these employers to take affirmative action to recruit, hire, promote, and retain these individuals toward the goal that at least seven percent of their workforce, at all levels, are people with disabilities ( HYPERLINK "http://www.dol.gov/ofccp/regs/compliance/section503.htm" http://www.dol.gov/ofccp/regs/compliance/section503.htm). Large corporations are setting ambitious goals for disability employment, and extolling the business benefits that have come from recruiting, retaining and promoting these talent pools. These benefits include improved productivity, fewer missed days of work, reduced turnover of personnel and innovative thinking (Senator Tom Harkin, 07/16/2012, Disability Employment: Are We at the Tipping Point? Huffington Post). In 2010, SAMHSA released its Supported Employment Evidence-Based Practices KIT  HYPERLINK "http://store.samhsa.gov/product/SMA08-4365" http://store.samhsa.gov/product/SMA08-4365 which provides information to policy makers, providers, consumers, and others on how to implement SE initiatives. The Individual Placement and Support (IPS) model is an enhanced version of SAMHSAs Supported Employment Evidence-Based Practices KIT. Since that time, SE efforts have continued to be refined, for example, the Individual Placement and Support (IPS) model is an evidence-based practice specifically for individuals with serious mental illness. A key feature of SE is integrating employment services with mental health services. There are a number of reasons for adopting the IPS model described in the Federal Financing of Supported Employment and Customized Employment For People With Mental Illnesses (2011) that include its effectiveness, durability of results, reasonable costs, ease of implementation and sustainability, and adaptability to diverse client groups ( HYPERLINK "http://aspe.hhs.gov/daltcp/reports/2011/supempFR.pdf" http://aspe.hhs.gov/daltcp/reports/2011/supempFR.pdf). The IPS model is based on core principles that include: Every consumer/client who wants to work is eligible; Competitive jobs are the primary goal of supported employment; Supported employment services are integrated with comprehensive mental health treatment; Personalized benefits counseling is provided to every consumer/client; Job placements happens when the individual believes they are ready; Employment specialists (job coaches) receive extensive training in SE and developing relationships with businesses and other employment opportunities; and Consumer/clients receive job supports for as long as required The Supported Employment Program is authorized under Section 520A of the Public Health Service Act, amended. This announcement addresses Healthy People 2020 Mental Health and Mental Disorders Topic Area HP 2020-MHMD and/or Substance Abuse Topic Area HP 2020-SA. 2. EXPECTATIONS Applicants will develop infrastructure that supports the implementation and sustainability of supported employment throughout the state and will implement programs locally that assist adults with serious mental illnesses including persons with co-occurring mental and substance use disorders obtain employment. Among infrastructure activities, grantees are expected to: Create and oversee the Supported Employment Coordinating Committee (SECC) (e.g., to create a locus of responsibilility for a specific issue/population, address behavioral health disparities or to increase access to or efficiency of services); Develop and implement a strategic plan; Oversee two community implementation sites and ensure that local implementation adheres to the evidence-based SE practice; Develop training curricula and deliver training, technical assistance, and on-going guidance to community implementation sites; Policy development to support needed service system improvements (e.g., rate-setting activities, establishment of standards of care, adherence to the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, development/revision of creditialing, licensure, or accreditation requirements); Develop a statewide supported employment workforce and provide training.(e.g., in person, virtual and web based training, on-going coaching, and support for credentialing or accreditation); Create sustainable funding approaches which may include Home & Community-Based Services under Medicaid 1915 (i); the 5% set-aside from the SAMHSA Community Mental Health Services Block Grant, and other sources of funding across state departments such as Vocational Rehabilitation; Participate in a SAMHSA funded cross-site evaluation. 2.1.1. Form a Supported Employment Coordinating Committee at the State Level Applicants are required to convene a Supported Employment Coordinating Committee (SECC) to coordinate activities across state departments and consult the grantee on statewide infrastructure measures that will promote and sustain supported employment. These activities include: Identify new and modify existing state policies that support the supported employment program; Identify funding sources that will sustain supported employment services; Identify large business employers to participate in supported employment efforts; Provide consultation around appropriate performance standards and quality assurance processes; Provide consultation on training curricula and delivery; Participate in the SAMHSA cross-site evaluation; Engage in workforce development activities to increase qualified providers of SE services and supports including peer support staff; and Regularly and systematically review evaluation process and outcome data from local community sites to recommend improvements to program quality and to apply lessons learned to training, policy, and other infrastructure activities across the state. The SECC will consist of, at minimum, representation at the state level to include: Behavioral Health (mental health and substance abuse); Vocational Rehabilitation; Education; Medicaid; Labor; Veteran Affairs; Commerce; and other partners including Better Business Bureaus; Employers; Mental Health Planning Council; the Mental Health Block Grant Planner; and persons with lived experience (a minimum of two persons representing statewide consumer organizations exclusive of other peer representatives). 2.1.2 Create a Strategic Sustainability Plan During the first six months of the program, applicants will develop and submit a strategic sustainability plan with action steps to implement, expand, and financially sustain the SE services within their state. The plan should include the services and supports (e.g., vocational assessments, job development, assertive engagement and outreach, individual employment plans, job training, rehabilation services, benefits counseling, and follow-along supports) necessary to implement the SE practice; identification of financing strategies that will be used to support long-term implementation; and collaboration with state partners to ensure that policy and financing mechanisms will support long-term implementation. Before services can begin in the two sites, the applicant must submit the strategic plan. The plan will describe how the grantee will meet the following objectives by the end of the grant period: Access sustainable funding to provide SE services. Establish a permanent training program using in-person and virtual platforms. Ensure full participation of culturally and linguistically diverse persons with lived experience in planning, service delivery, and evaluation of supported employment programs that emerge from this initiative. Modify state policies, procedures, and processes that are needed to advance supported employment programs across the state. Develop a SE workforce including recruitment and training (e.g., in person, virtual and web based training, on-going coaching, support for credentialing or accreditation). An SE workforce includes employment specialists, peer support staff, job coaches, occupational therapists, trainers, and job developers. Coordinate cross system activities including cross training to support integration of supported employment services. Establish appropriate performance standards and quality assurance processes for supported employment services. Provide education and support to employers and other stakeholders about SE efforts. 2.2 Implement the SE Program in Two Local Communities The applicant must identify two communities where the SE program will be implemented. The two communities should be selected based on their potential to provide sufficient opportunities for competitive employment. In each of the two communities, applicants will select a local community behavioral health agency that has demonstrated the capacity to embed SE culture and practices throughout the agency. Applicants may select a local community behavioral agencies that has a SE program in place that is not being implemented effectively. Applicants should include a letter of commitment from each of the local behavioral health agencies in Attachment 4 of their application. Applicants may use up to 20 percent (i.e., $160,000) of the total grant award for infrastructure development, data collection and performance measurement, and performance assessment at the state level (see sections  HYPERLINK \l "_2.3_Data_Collection" I-2.3 and  HYPERLINK \l "_2.4_Local_Performance" 2.4). Applicants must also devote not less than 80 percent (i.e., $640,000) of the total grant award for implementing SE in the two local behavioral health agencies; each agency should receive up to 40 percent of the funds (i.e., $320,000). Each of the local behavioral health agencies, may use up to 15 percent of their funds for data collection and performance measurement, and performance assessment. In addition to providing SE services, each of the local behavioral health agencies will be required to do the following: Participate in the cross-site evaluation; Ensure that persons with lived experience are involved in all phases of service planning, delivery, and evaluation; Train staff to ensure that positive attitudes towards work are incorporated into all personnel working with and supporting the consumer/client; Increase capacity for cross-training among agencies for sustainability; Conduct outreach and engagement to ensure that a minimum of 50 (25 per site) consumers participate in the SE program in year one and 100 (50 per site) in years two through four; Ensure that on-going training and coaching of staff continue to firmly establish supported employment within the agency; and Integrate SE services with other behavioral health services, such as cognitive remediation therapy and other forms of treatment that support recovery and resiliency. The following projected milestones illustrate how a grantee may implement and expand Supported Employment across a state: 2 months: The grantee has convened the SECC and begun drafting the strategic plan. Community sites have hired staff and begun training. Potential employers have been identified. 6 months: Strategic plan has been completed, submitted by the grantee and approved by the government project officer. Grantee has investigated sustainable funding sources including Medicaid and applied for waivers. Community sites begin recruiting and enrolling program participants into the program. 12 months: Community sites are fully operating SE services. Community sites have convened local stakeholders; identified potential employers, trained and coached SE staff, ensured fidelity to the model, begun providing supported employment services, and documented program implementation status. 24 months: Training continues and is adjusted for better fit to settings and populations. The grantee has implemented the strategic plan and is making adjustments to timing and objectives. Workforce development to train SE and peer-support staff has commenced. 36 months: Funding to sustain the SE practice after the grant ends has been approved. Statewide training is fully implemented that includes: virtual, web-based and face to face sessions. On-going coaching is provided to community sites to ensure that the SE is firmly established. 48 months: Grantee monitors progress of these sites and ensures that practices are implemented with fidelity to the model. 60 months: SAMHSA grant funding ends. By the end of the grant program, the state will have established robust SE programs in at least two communities within the state, secured and used non-grant sustainable funding for community SE services, established a permanent training program using in-person and virtual platforms, and collected and shared data that demonstrate that more people with serious mental illnesses and co-occurring mental illness and substance use disorders are competitively employed. If your application is funded, you will be expected to develop a health disparities impact statement. This statement consists of three parts:(1) identify subpopulations vulnerable to disparities (e.g., racial, ethnic and sexual minority groups) and how they will be engaged in infrastructure activities (e.g., training, collaborations and partnerships, outreach, etc.); (2) propose a quality improvement plan to decrease the differences in access to, use and outcomes of these infrastructure activities among these subpopulations; and (3) the quality improvement plan should include an alignment with the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. (See  HYPERLINK \l "_Appendix_H__2" Appendix G: Addressing Behavioral Health Disparities.) SAMHSA strongly encourages all grantees to provide a tobacco-free workplace and to promote abstinence from all tobacco products (except in regard to accepted tribal traditions and practices). Grantees must utilize third party and other revenue realized from provision of services to the extent possible and use SAMHSA grant funds only for services to individuals who are ineligible for public or commercial health insurance programs, individuals for whom coverage has been formally determined to be unaffordable, or for services that are not sufficiently covered by an individuals health insurance plan. Grantees are also expected to facilitate the health insurance application and enrollment process for eligible uninsured clients. Grantees should also consider other systems from which a potential service recipient may be eligible for services (for example, the Veterans Administration or senior services) if appropriate for and desired by that individual to meet his/her needs. In addition, grantees are required to implement policies and procedures that ensure other sources of funding are secured first when available for that individual. Recovery from mental disorders and/or substance use disorders has been identified as a primary goal for behavioral health care. SAMHSAs Recovery Support Strategic Initiative is leading efforts to advance the understanding of recovery and ensure that vital recovery supports and services are available and accessible to all who need and want them. Building on research, practice, and the lived experiences of individuals in recovery from mental and/or substance use disorders, SAMHSA has developed the following working definition of recovery: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. See  HYPERLINK "http://store.samhsa.gov/product/SAMHSA-s-Working-Definition-of-Recovery/PEP12-RECDEF" http://store.samhsa.gov/product/SAMHSA-s-Working-Definition-of-Recovery/PEP12-RECDEF for further information, including the four dimensions of recovery, and 10 guiding principles. Programs and services that incorporate a recovery approach fully involve people with lived experience (including consumers/peers/people in recovery, youth, and family members) in program/service design, development, implementation, and evaluation. SAMHSAs standard, unified working definition is intended to advance recovery opportunities for all Americans, particularly in the context of health reform, and to help clarify these concepts for peers/persons in recovery, families, funders, providers and others. The definition is to be used to assist in the planning, delivery, financing, and evaluation of behavioral health services. SAMHSA grantees are expected to integrate the definition and principles of recovery into their programs to the greatest extent possible. Over 2 million men and women have been deployed to serve in support of overseas contingency operations, including Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. Individuals returning from Iraq and Afghanistan are at increased risk for suffering post-traumatic stress and other related disorders. Experts estimate that up to one-third of returning veterans will need mental health and/or substance abuse treatment and related services. In addition, the family members of returning veterans have an increased need for related support services. To address these concerns, SAMHSA strongly encourages all applicants to consider the unique needs of returning veterans and their families in developing their proposed project and consider prioritizing this population for services where appropriate. 2.3 Data Collection and Performance Measurement All SAMHSA grantees are required to collect and report certain data so that SAMHSA can meet its obligations under the Government Performance and Results (GPRA) Modernization Act of 2010. You must document your ability to collect and report the required data in  HYPERLINK \l "_1._EVALUATION_CRITERIA" Section D: Data Collection and Performance Measurement of your application. Grantees will be required to report performance using the Adult Consumer Outcome Measures for Discretionary Programs National Outcome Measures (NOMs) Tool which can be found at  HYPERLINK "https://www.cmhs-gpra.samhsa.gov/index.htm%20" https://www.cmhs-gpra.samhsa.gov/index.htm. This information will be gathered using a Web-based reporting system called Transformation Accountability (TRAC), which can be found at  HYPERLINK "https://www.cmhs-gpra.samhsa.gov/index.htm" https://www.cmhs-gpra.samhsa.gov/index.htm, along with instructions for completing it. NOMS data will be collected and reported into the TRAC system at baseline (i.e., the clients entry into the project), discharge, and at 6 month intervals post baseline. TA related to data collection and reporting will be offered. Applicants should be aware that the TRAC reporting system will migrate to the Common Data Platform (CDP) during the life of the grant. The collection of these data will enable CMHS to report on the National Outcome Measures (NOMs), which have been defined by SAMHSA as key priority areas relating to mental health. In addition to the NOMs, data collected by grantees will be used to demonstrate how SAMHSAs grant programs are reducing disparities in access, service use, and outcomes nationwide. Performance data will be reported to the public, the Office of Management and Budget (OMB) and Congress as part of SAMHSAs budget request. Grantees at the state and local level will be required to report on the following Infrastructure, Prevention, and Promotion performance measures on a quarterly basis: The number of policy changes completed as a result of the grant. The number of people in the mental health and related workforce trained in mental health-related practices/activities that are consistent with the goals of the grant. The number of financing policy changes completed as a result of the grant. The number of organizations that entered into formal written inter/intra-organizational agreements (e.g., MOUs/MOAs) to improve mental health-related practices/activities that are consistent with the goals of the grant. The number of programs/organizations/communities that implemented specific mental-health related practices/activities that are consistent with the goals of the grant. The number of individuals screened for mental health or related interventions. The amount of pooled, blended, or braided funding used for mental health-related practices/activities that are consistent with the goals of the grant. The number of consumers/family members who provide mental health-related services as a result of the grant. CMHS will award a contract to develop a cross-site evaluation that will be used to evaluate the process and outcome of this grant program. Applicants are required to participate in the cross site evaluation and required to conduct their own local evaluation. 2.4 Local Performance Assessment Grantees must periodically review the performance data they report to SAMHSA (as required above) and assess their progress and use this information to improve management of their grant projects. The assessment should be designed to help you determine whether you are achieving the goals, objectives and outcomes you intend to achieve and whether adjustments need to be made to your project. Performance assessments should be used also to determine whether your project is having/will have the intended impact on behavioral health disparities. You will be required to report on your progress achieved, barriers encountered, and efforts to overcome these barriers in a performance assessment report to be submitted at least annually. At a minimum, your performance assessment should include the required performance measures identified above. You may also consider outcome and process questions, such as the following: Outcome Questions: What was the effect of intervention on key outcome goals? What program/contextual/cultural factors were associated with outcomes? What individual factors were associated with outcomes, including race/ethnicity/sexual identity (sexual orientation/gender identity)? What impact did the use of peer support have on outcomes? How many people were employed in full time and part time work and their length of employment? Process Questions: How were persons with lived experience involved in the planning, service delivery and evaluation of the grant program? What types of changes were made to the originally proposed plan? What types of changes were made to address behavioral health disparities, including the use of National CLAS Standards? Was the SE practice implemented with fidelity to the model in each of the sites? What sustainable policy and financing changes were made? If not how did it differ from the model and why were the adaptations made? Was SE replicated in additional communities in the state? How did programs develop sustainable financing and what financing mechanisms were used? If the project includes a community site involving services delivery, the performance assessment should include client and system outcomes. At the state level no more than 20 percent ($160,000) of the total grant award may be used for infrastructure, data collection, performance measurement, and performance assessment, e.g., activities required in Sections I-2.3 and 2.4 above. At the local level no more than 15 percent ($48,000) of the grant award may be use for data collection, performance measurement, and performance assessment, e.g., activities required in Sections I-2.3 and 2.4 above. 2.5 Grantee Meetings Grantees must plan to send a minimum of two people (including the Project Director) to at least one joint in-person grantee meeting in the second and fourth year of the program. In addition, grantees should participate in virtual learning community meetings throughout the period of grant. You must include a detailed budget and narrative for travel to in-person meetings in your budget. At these meetings, grantees will present the results of their projects and federal staff along with external content experts will provide technical assistance. Each in-person meeting will be up to 3 days. These meetings are usually held in the Washington, D.C., area and attendance is mandatory. II. AWARD INFORMATION Proposed budgets cannot exceed $800,000 in total costs (direct and indirect) in any year of the proposed project. Annual continuation awards will depend on the availability of funds, grantee progress in meeting project goals and objectives, timely submission of required data and reports, and compliance with all terms and conditions of award. These awards will be made as grants. III. ELIGIBILITY INFORMATION 1. ELIGIBLE APPLICANTS Eligible applicants are the mental health authorities in states, territories, and the District of Columbia; federally recognized American Indian/Alaska Native tribes and tribal organizations, or urban Indian organization authorized to develop or direct the state/tribal-sponsored supported employment programs. The purpose of this program is to enhance state and community capacity to provide and expand evidence-based Supported Employment programs to adults with serious mental illnesses, including persons with co-occurring mental and substance use disorders. The expected outcome of the program is for states to have the necessary infrastructure in place to maintain and expand supported employment services throughout the state and increase the number of individuals with serious mental illness and co-occurring mental and substance use disorders who obtain and retain competitive employment. Since the purpose of this program is to enhance state and community capacity to provide Supported Employment programs to adults with serious mental illnesses, including persons with co-occurring disorders, eligibility is being limited to the mental health authority within states, territories, the District of Columbia, federally recognized American Indian/Alaska Native tribes since they have the capacity and infrastructure in place to implement the goals and objectives of this program. The statutory authority for this program prohibits grants to for-profit agencies. 2. COST SHARING and MATCH REQUIREMENTS Cost sharing/match is not required in this program. 3. OTHER You must comply with the following three requirements, or your application will be screened out and will not be reviewed: use of the SF-424 application form; Budget Information form SF-424A; Project/Performance Site Location(s) form; Disclosure of Lobbying Activities, if applicable; and Checklist. application submission requirements in  HYPERLINK \l "_2._APPLICATION_SUBMISSION" Section IV-2 of this document; and formatting requirements provided in  HYPERLINK \l "_Appendix_A__1" Appendix A of this document. IV. APPLICATION AND SUBMISSION INFORMATION CONTENT AND GRANT APPLICATION SUBMISSION You must go to both Grants.gov ( HYPERLINK "http://www.Grants.gov" http://www.Grants.gov) and the SAMHSA website ( HYPERLINK "http://beta.samhsa.gov/grants/applying" http://beta.samhsa.gov/grants/applying) to download the required documents you will need to apply for a SAMHSA grant. Grants.gov How to Download Forms from Grants.gov (see  HYPERLINK \l "_Appendix_B__1" Appendix B for information on applying through Grants.gov) To view and/or download the required application forms, you must first search for the appropriate funding announcement number (called the opportunity number). On the Grants.gov site ( HYPERLINK "http://www.Grants.gov" http://www.Grants.gov), select the Apply for Grants option from the Applicants Tab at top of the screen. Under STEP 1, click on the red button labeled: Download a Grant Application Package. Enter either the Funding Opportunity Number (SAMHSAs Funding Announcement #) or the Catalogue of Federal Domestic Assistance (CFDA) Number exactly as they appear on the cover page of this RFA, then click the Download Package button. In the Instructions column, click the Download link. You can view, print or save all of the forms. You can complete the forms for electronic submission to Grants.gov. Completed forms can also be saved and printed for your records. These required forms include: Application for Federal Assistance (SF-424); Budget Information Non-Construction Programs (SF-424A); Project/Performance Site Location(s) Form; Disclosure of Lobbying Activities; and Checklist. Applications that do not include these required forms will be screened out and will not be reviewed. SAMHSAs Grants Website You will find additional materials you will need to complete your application on SAMHSAs website ( HYPERLINK "http://beta.samhsa.gov/grants/applying" http://beta.samhsa.gov/grants/applying). These include: Request for Applications (RFA) Provides a description of the program, specific information about the availability of funds, and instructions for completing the grant application. This document is the RFA; Assurances Non-Construction Programs; Certifications; Pre-Application Webinar Notification; and Charitable Choice Form SMA 170. See  HYPERLINK \l "_1.1_Required_Application" Section IV-1.1-Assurances of this RFA to determine if you are required to submit Charitable Choice Form SMA 170. If you are, you can upload this form to Grants.gov when you submit your application. Be sure to check the SAMHSA website periodically for any updates on this program. 1.1 Required Application Components Applications must include the following 12 required application components: Application for Federal Assistance (SF-424) This form must be completed by applicants for all SAMHSA grants. [Note: Applicants must provide a Dun and Bradstreet (DUNS) number to apply for a grant or cooperative agreement from the federal government. SAMHSA applicants are required to provide their DUNS number on the first 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 website at  HYPERLINK "http://www.dnb.com" http://www.dnb.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. In addition, you must be registered in the new System for Award Management (SAM). The former Central Contractor Registration (CCR) transitioned to the SAM on July 30, 2012. SAM information must be updated at least every 12 months to remain active (for both grantees and sub-recipients). Once you update your record in SAM, it will take 48 to 72 hours to complete the validation processes. Grants.gov will reject submissions from applicants who are not registered in SAM or those with expired SAM registrations (Entity Registrations). The DUNS number you use on your application must be registered and active in the SAM. To Create a user account, Register/Update entity and/or Search Records from CCR, go to  HYPERLINK "https://www.sam.gov" beta://www.sam.gov.] Abstract Your total abstract must not be longer than 35 lines. It should include the project name, population(s) to be served (demographics and clinical characteristics), strategies/interventions, project goals and measurable objectives, including the number of people to be served annually and throughout the lifetime of the project, etc. In the first five lines or less of your abstract, write a summary of your project that can be used, if your project is funded, in publications, reporting to Congress, or press releases. Table of Contents Include page numbers for each of the major sections of your application and for each attachment. Budget Information Form Use SF-424A. Fill out Sections B, C, and E of the SF-424A. A sample budget and justification is included in  HYPERLINK \l "_Appendix_H__1" Appendix E of this document. Project Narrative and Supporting Documentation The Project Narrative describes your project. It consists of Sections A through D. Sections A-D together may not be longer than 30 pages. (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  HYPERLINK \l "_6._OTHER_SUBMISSION" 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 G. There are no page limits for these sections, except for Section F, Biographical Sketches/Job Descriptions. Additional instructions for completing these sections are included in  HYPERLINK \l "_V._APPLICATION_REVIEW" Section V under Supporting Documentation. Supporting documentation should be submitted in black and white (no color). Attachments 1 through 4 Use only the attachments listed below. If your application includes any attachments not required in this document, they will be disregarded. Do not use more than a total of 30 pages for Attachments 1, 3 and 4 combined. There are no page limitations for Attachment 2. Do not use attachments to extend or replace any of the sections of the Project Narrative. Reviewers will not consider them if you do. Please label the attachments as: Attachment 1, Attachment 2, etc. Attachment 1: Letters of Commitment from any organization(s) participating in the proposed project. Attachment 2: Data Collection Instruments/Interview Protocols if you are using standardized data collection instruments/interview protocols, you do not need to include these in your application. Instead, provide a web link to the appropriate instrument/protocol. If the data collection instrument(s) or interview protocol(s) is/are not standardized, you must include a copy in Attachment 2. Attachment 3: Sample Consent Forms Attachment 4: Letter of Commitment from the Local Community Behavioral Health Agencies. Project/Performance Site Location(s) Form The purpose of this form is to collect location information on the site(s) where work funded under this grant announcement will be performed. This form will be posted on SAMHSAs website with the RFA. Assurances Non-Construction Programs. You must read the list of assurances provided on the SAMHSA website and check the box marked I Agree before signing the first page (SF-424) of the application. Certifications You must read the list of certifications provided on the SAMHSA website and check the box marked I Agree before signing the first page (SF-424) of the application. Disclosure of Lobbying Activities 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 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. You must sign and submit this form, if applicable. Checklist The Checklist ensures that you have obtained the proper signatures, assurances and certifications. You must complete the entire form, including the top portion, Type of Application, indicating if this is a new, noncompeting continuation, competing continuation or supplemental application, as well as Parts A through D. Documentation of nonprofit status as required in the Checklist. 1.2 Application Formatting Requirements Please refer to  HYPERLINK \l "_Appendix_A_" Appendix A, Checklist for Formatting Requirements and Screen-out Criteria for SAMHSA Grant Applications, for SAMHSAs basic application formatting requirements. Applications that do not comply with these requirements will be screened out and will not be reviewed. 2. APPLICATION SUBMISSION REQUIREMENTS Applications are due by 11:59 PM (Eastern Time) on April 21, 2014. Your application must be submitted through http://www.Grants.gov. Please refer to  HYPERLINK \l "_Appendix_B__1" Appendix B, Guidance for Electronic Submission of Applications. 3. FUNDING LIMITATIONS/RESTRICTIONS Cost principles describing allowable and unallowable expenditures for federal grantees, including SAMHSA grantees, are provided in the following documents, which are available at  HYPERLINK "http://www.samhsa.gov/grants/management.aspx" http://www.samhsa.gov/grants/management.aspx: Educational Institutions: 2 CFR Part 220 and OMB Circular A-21 State, Local and Indian Tribal Governments: 2 CFR Part 225 (OMB Circular A-87) Nonprofit Organizations: 2 CFR Part 230 (OMB Circular A-122) State and Local and Indian Tribal Governments: 45CFR Part 92 In addition, SAMHSAs Supported Employment Program grant recipients must comply with the following funding restrictions: No more than 20 percent of the grant award may be used for infrastructure, data collection, performance measurement, and performance assessment expenses. Be sure to identify these expenses in your proposed budget. SAMHSA grantees also must comply with SAMHSAs standard funding restrictions, which are included in  HYPERLINK \l "_Appendix_D_" Appendix C. V. APPLICATION REVIEW INFORMATION 1. EVALUATION CRITERIA The Project Narrative describes what you intend to do with your project and includes the Evaluation Criteria in Sections A-D below. Your application will be reviewed and scored according to the quality of your response to the requirements in Sections A-D. In developing the Project Narrative section of your application, use these instructions, which have been tailored to this program. The Project Narrative (Sections A-D) together may be no longer than 30 pages. You must use the four sections/headings listed below in developing your Project Narrative. You must 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. The Budget Justification and Supporting Documentation you provide in Sections E-G and Attachments 1-4 will be considered by reviewers in assessing your response, along with the material in the Project Narrative. The number of points after each heading is the maximum number of points a review committee may assign to that section of your Project Narrative. Although scoring weights are not assigned to individual bullets, each bullet is assessed in deriving the overall Section score. Section A: Statement of Need (15 points) Provide demographic information on the population(s) of the state or tribe to receive services through the targeted systems or agencies, e.g., race, ethnicity, federally recognized tribe, language, age, socioeconomic status, sexual identity (sexual orientation, gender identity) and other relevant factors, such as literacy. Describe the stakeholders and resources in the state or tribe that can help implement the needed infrastructure development. Describe current SE efforts in the state. Identify rates of competitive employment for people with SMI. Document the need for an enhanced infrastructure to increase the capacity to implement, sustain, and improve effective supported employment services in the proposed state or tribe that is consistent with the purpose of the program and intent of the RFA. Describe the service gaps and other problems related to the need for infrastructure development. Identify the source of the data. Documentation of need may come from a variety of qualitative and quantitative sources. Examples of data sources for the quantitative data that could be used are epidemiologic data, state data (e.g., from state needs assessments, SAMHSAs National Survey on Drug Use and Health), and/or national data (e.g., from SAMHSAs National Survey on Drug Use and Health or from National Center for Health Statistics/Centers for Disease Control reports, and Census data). This list is not exhaustive; applicants may submit other valid data, as appropriate for your program. Section B: Proposed Approach (40 points) Describe the purpose of the proposed project, including a clear statement of its goals and objectives. These must relate to the performance measures you identify in Section D, Data Collection and Performance Measurement. Describe how achievement of goals will increase system capacity to support effective supported employment services. Describe the proposed project activities, how they meet your infrastructure needs, and how they relate to your goals and objectives. Describe how the proposed activities will be implemented and how adherence to the National Standards for Culturally and Linguistic Appropriate Services (CLAS) in Health and Health Care will be monitored. For additional information go to:  HYPERLINK "http://ThinkCulturalHealth.hhs.gov" http://ThinkCulturalHealth.hhs.gov. Provide a chart or graph depicting a realistic time line for the entire project period showing key activities, milestones, and responsible staff. These key activities should include the requirements outlined in  HYPERLINK \l "_2._EXPECTATIONS" Section 1-2: Expectations. [Note: The time line should be part of the Project Narrative. It should not be placed in an attachment.] Describe how you will involve people with SMI in the planning, implementation and evaluation of the project. Describe the membership, roles and responsibilities of the Supported Employment Coordinating Committee (SECC) and how the SECC will contribute to the expansion and/or implementation and sustainability of supported employment across the state. Include letters of commitment from each of the SECC members. Describe the two communities where the SE programs will be implemented, their potential to provide sufficient opportunities for competitive employment, and other relevant factors considered in their selection. Describe the two community behavioral health agencies that will be selected to implement the SE practice and why they were selected. Provide in Attachment 4 letters of commitment from each of them. Discuss the capability and experience with similar projects and populations, including experience in providing culturally appropriate/competent services and in hiring people with mental illnesses. Describe how you will work with the two community behavioral health agencies to ensure success and implementation of the required SE activities. Applicants that have SE programs, describe how these funds will used to improve existing SE programs or to implement SE in new sites. Section C: Staff, Management, and Relevant Experience (25 points) Discuss the capability and experience of the applicant organization and other participating organizations with similar projects and populations, including experience in providing culturally appropriate/competent services.Provide a complete list of staff positions for the project, including the Project Director and other key personnel, showing the role of each and their level of effort and qualifications. Discuss how key staff has demonstrated experience and are qualified to develop the infrastructure for the population(s) to receive services and are familiar with their culture(s) and language(s). Describe the staffing plan for the local community implementation and how it will support the implementation of SE practice. Section D: Data Collection and Performance Measurement (20 points) Document your ability to collect and report on the required performance measures as specified in  HYPERLINK \l "_2.3_Data_Collection" Section I-2.3 of this RFA. Describe your plan for data collection, management, analysis and reporting of data for the population served by your infrastructure program. Specify and justify any additional measures you plan to use for your grant project. Describe how data will be used to manage the project and assure that the goals and objectives at a systems level will be tracked and achieved. Goals and objectives of your infrastructure program should map onto any continuous quality improvement plan, including consideration of behavioral health disparities. Describe how information related to process and outcomes will be routinely communicated to program staff, governing and coordinating bodies, and stakeholders. Describe your plan for conducting the local performance assessment as specified in  HYPERLINK \l "_2.4_Local_Performance" Section I-2.4 of this RFA and document your ability to conduct the assessment. Stipulate your agreement to participate in a cross-site evaluation. NOTE: Although the budget for the proposed project is not a scored review criterion, the Review Group will be asked to comment on the appropriateness of the budget after the merits of the application have been considered. Budget Justification, Existing Resources, Other Support (other federal and non-federal sources). 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. Other support is defined as funds or resources, whether federal, non-federal or institutional, in direct support of activities through fellowships, gifts, prizes, in-kind contributions or non-federal means. (This should correspond to Item #18 on your SF-424, Estimated Funding.) Other sources of funds may be used for unallowable costs, e.g., meals, sporting events, entertainment. Be sure to show that no more than 20 percent of the total grant award will be used for infrastructure, data collection, performance measurement and performance assessment, and that no more than 80 percent of the total grant award will be used for an implementation pilot. An illustration of a budget and narrative justification is included in  HYPERLINK \l "_Appendix_H__1"  HYPERLINK \l "_Appendix_I_" Appendix E, Sample Budget and Justification, of this document. The budget justification and narrative must be submitted as file BNF when you submit your application into Grants.gov. (See  HYPERLINK \l "_Appendix_B__1" Appendix B, Guidance for Electronic Submission of Applications.) SUPPORTING DOCUMENTATION Section E: Literature Citations. This section must contain complete citations, including titles and all authors, for any literature you cite in your application. Section F: Biographical Sketches and Job Descriptions. Include position descriptions for the Project Director and all key personnel. Position descriptions should be no longer than 1 page each. For staff who have been identified, include a biographical sketch for the Project Director and other key positions. Each sketch should be 2 pages or less. Reviewers will not consider information past page 2. Information on what you should include in your biographical sketches and job descriptions can be found in  HYPERLINK \l "_Appendix_E__2" Appendix D of this document. Section G: Confidentiality and SAMHSA Participant Protection/Human Subjects: You must describe procedures relating to Confidentiality, Participant Protection and the Protection of Human Subjects Regulations in Section G of your application. See  HYPERLINK \l "_Appendix_H_" Appendix F for guidelines on these requirements. 2. REVIEW AND SELECTION PROCESS SAMHSA applications are peer-reviewed according to the evaluation criteria listed above. Decisions to fund a grant are based on: the strengths and weaknesses of the application as identified by peer reviewers; Mental Health Services National Advisory Council; availability of funds; and equitable distribution of awards in terms of geography (including urban, rural and remote settings) and balance among populations to receive services and program size. VI. ADMINISTRATION INFORMATION 1. AWARD NOTICES You will receive a letter from SAMHSA through postal mail that describes the general results of the review of your application, including the score that your application received. If you are approved for funding, you will receive an additional notice through postal mail, the Notice of Award (NoA), signed by SAMHSAs Grants Management Officer. The NoA is the sole obligating document that allows you to receive federal funding for work on the grant project. If you are not funded, you will receive notification from SAMHSA. 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS If your application is funded, you must comply with all terms and conditions of the grant award. SAMHSAs standard terms and conditions are available on the SAMHSA website at  HYPERLINK "http://www.samhsa.gov/grants/management.aspx" http://www.samhsa.gov/grants/management.aspx. If your application is funded, you must also comply with the administrative requirements outlined in 45 CFR Part 74 or 45 CFR Part 92, as appropriate. For more information see the SAMHSA website ( HYPERLINK "http://www.samhsa.gov/grants/management.aspx" http://www.samhsa.gov/grants/management.aspx). Depending on the nature of the specific funding opportunity and/or your proposed project as identified during review, SAMHSA may negotiate additional terms and conditions with you prior to grant award. These may include, for example: actions required to be in compliance with confidentiality and participant protection/human subjects requirements; requirements relating to additional data collection and reporting; requirements relating to participation in a cross-site evaluation; requirements to address problems identified in review of the application; or revised budget and narrative justification. If your application is funded, you will be held accountable for the information provided in the application relating to performance targets. SAMHSA program officials will consider your progress in meeting goals and objectives, as well as your failures and strategies for overcoming them, when making an annual recommendation to continue the grant and the amount of any continuation award. Failure to meet stated goals and objectives may result in suspension or termination of the grant award, or in reduction or withholding of continuation awards. If your application is funded, you must comply with Executive Order 13166, which requires that recipients of federal financial assistance provide meaningful access to limited English proficient (LEP) persons in their programs and activities. You may assess the extent to which language assistance services are necessary in your grant program by utilizing the HHS Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, available at  HYPERLINK "http://www.hhs.gov/ocr/civilrights/resources/laws/revisedlep.html" http://www.hhs.gov/ocr/civilrights/resources/laws/revisedlep.html. Grant funds cannot be used to supplant current funding of existing activities. Supplant is defined as replacing funding of a recipients existing program with funds from a federal grant. 3. REPORTING REQUIREMENTS In addition to the data reporting requirements listed in  HYPERLINK \l "_2.4_Data_Collection" Section I-2.3, grantees must comply with the reporting requirements listed on the SAMHSA website at  HYPERLINK "http://beta.samhsa.gov/grants/applying" http://beta.samhsa.gov/grants/applying VII. AGENCY CONTACTS For questions about program issues contact: Risa S. Fox 1 Choke Cherry Road Room 6-1013 Rockville, Maryland 20857 (240) 276-1907 Risa.fox@samhsa.hhs.gov For questions on grants management and budget issues contact: Gwendolyn Simpson Office of Financial Resources, Division of Grants Management Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road Room 7-1091 Rockville, Maryland 20857 (240) 276-1408  HYPERLINK "mailto:gwendolyn.simpson@samhsa.hhs.gov" gwendolyn.simpson@samhsa.hhs.gov Appendix A Checklist for Formatting Requirements and Screen-out Criteria for SAMHSA Grant Applications SAMHSAs goal is to review all applications submitted for grant funding. However, this goal must be balanced against SAMHSAs obligation to ensure equitable treatment of applications. For this reason, SAMHSA has established certain formatting requirements for its applications. If you do not adhere to these requirements, your application will be screened out and returned to you without review. Use the SF-424 Application form; Budget Information form SF-424A; Project/Performance Site Location(s) form; Disclosure of Lobbying Activities, if applicable; and Checklist. Applications must be received by the application due date and time, as detailed in  HYPERLINK \l "_2._APPLICATION_SUBMISSION" Section IV-2 of this grant announcement. You must be registered in the System Award Management (SAM) prior to submitting your application. The DUNS number used on your application must be registered and active in the SAM prior to submitting your application. Information provided must be sufficient for review. Text must be legible. Pages must be typed in black, single-spaced, using a font of Times New Roman 12, with all margins (left, right, top, bottom) at least one inch each. You may use Times New Roman 10 only for charts or tables. (See additional requirements in  HYPERLINK \l "_Appendix_B__1" Appendix B, Guidance for Electronic Submission of Applications.) To ensure equity among applications, page limits for the Project Narrative cannot be exceeded. To facilitate review of your application, follow these additional guidelines. Failure to adhere to the following guidelines will not, in itself, result in your application being screened out and returned without review. However, the information provided in your application must be sufficient for review. Following these guidelines will help ensure your application is complete, and will help reviewers to consider your application. Applications should comply with the following requirements: Provisions relating to confidentiality and participant protection/human subjects specified in  HYPERLINK \l "_Appendix_I_" Appendix F of this announcement. Budgetary limitations as specified in Sections I, II, and IV-5 of this announcement. Documentation of nonprofit status as required in the Checklist. Black print should be used throughout your application, including charts and graphs (no color). Materials with printing on both sides will be excluded from the application and not sent to peer reviewers. Pages should be numbered consecutively from beginning to end so that information can be located easily during review of the application. The abstract page should be page 1, the table of contents should be page 2, etc. The four pages of SF-424 are not to be numbered. Attachments 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 Attachments stated in  HYPERLINK \l "_1.1_Required_Application" Section IV-1.1of this announcement should not be exceeded. Appendix B Guidance for Electronic Submission of Applications SAMHSA discretionary grant applications must be submitted electronically through Grants.gov. SAMHSA will not accept paper applications, except when a waiver of this requirement is approved by SAMHSA. The process for applying for a waiver is described later in this appendix. If this is the first time you have submitted an application through Grants.gov, you must complete three separate registration processes before you can submit your application. Allow at least two weeks (10 business days) for these registration processes, prior to submitting your application. The processes are: DUNS Number registration: The DUNS number you use on your application must be registered and active in the SAM. System for Award Management (SAM) registration: The System for Award Management (SAM) is a federal government owned and operated free website that replaces capabilities of the former Central Contractor Registry (CCR) system, as well as EPLS. Future phases of SAM will add the capabilities of other systems used in federal awards processes. SAM information must be updated at least every 12 months to remain active (for both grantees and sub-recipients). Once you update your record in SAM, it will take 48 to 72 hours to complete the validation processes. Grants.gov will reject electronic submissions from applicants with expired registrations. To Create a user account, Register/Update entity and/or Search Records from CCR, go to  HYPERLINK "https://www.sam.gov" https://www.sam.gov. You will find a Quick Start Guide for Entities Interested in Being Eligible for Grants through SAM at  HYPERLINK "https://www.sam.gov/sam/transcript/Quick_Guide_for_Grants_Registrations.pdf" https://www.sam.gov/sam/transcript/Quick_Guide_for_Grants_Registrations.pdf. Grants.gov Registration (get username and password): Be sure the person submitting your application is properly registered with Grants.gov as the Authorized Organization Representative (AOR) for the specific DUNS number cited on the SF-424 (first page). See the Organization Registration User Guide for details at the following Grants.gov link:  HYPERLINK "http://www.grants.gov/web/grants/applicants/organization-registration.html" http://www.grants.gov/web/grants/applicants/organization-registration.html. . You can find additional information on the registration process at  HYPERLINK "http://www.grants.gov/web/grants/outreach/grantsgov-training.html" http://www.grants.gov/web/grants/outreach/grantsgov-training.html. The Organization Registration Checklist available at this site provides registration guidance for a company, institution, state, local or tribal government, or other type of organization submitting for the first time through Grants.gov. To submit your application electronically, you may search  HYPERLINK "http://www.Grants.gov" http://www.Grants.gov for the downloadable application package by the funding announcement number (called the opportunity number) or by the Catalogue of Federal Domestic Assistance (CFDA) number. You can find the funding announcement number and CFDA number on the cover page of this funding announcement. You must follow the instructions in the User Guide available at the  HYPERLINK "http://www.Grants.gov" http://www.Grants.gov apply site, on the Help page. In addition to the User Guide, you may wish to use the following sources for technical (IT) help: By e-mail: support@Grants.gov By phone: 1-800-518-4726 (1-800-518-GRANTS). The Grants.gov Contact Center is available 24 hours a day, 7 days a week, excluding federal holidays. Please allow sufficient time to enter your application into Grants.gov. When you submit your application, you will receive a notice that your application is being processed and that you will receive two e-mails from Grants.gov within the next 24-48 hours. One will confirm receipt of the application in Grants.gov, and the other will indicate that the application was either successfully validated by the system (with a tracking number) or rejected due to errors. It will also provide instructions that if you do not receive a receipt confirmation and a validation confirmation or a rejection e-mail within 48 hours, you must contact Grants.gov directly. It is important that you retain this tracking number. Receipt of the tracking number is the only indication that Grants.gov has successfully received and validated your application. If you do not receive a Grants.gov tracking number, you may want to contact the Grants.gov help desk for assistance. Please note that it is incumbent on the applicant to monitor your application to ensure that it is successfully received and validated by Grants.gov. If your application is not successfully validated by Grants.gov, it will not be forwarded to SAMHSA as the receiving institution. If you experience issues/problems with electronic submission of your application through Grants.gov, contact the Grants.gov helpdesk by email at  HYPERLINK "mailto:support@grants.gov" support@grants.gov or by phone at 1-800-518-4726 (1-800-518-GRANTS). Make sure you get a case/ticket/reference number that documents the issues/problems with Grants.gov. It is critical that you initiate electronic submission in sufficient time to resolve any issues/problems that may prevent the electronic submission of your application. Grants.gov will reject applications submitted after 11:59 PM on the application due date. SAMHSA highly recommends that you submit your application 24-48 hours before the submission deadline. Many submission issues can be fixed within that time and you can attempt to re-submit. However, if you have not completed your Grants.gov, SAM, and DUNS registration at least 2 weeks prior to the submission deadline, it is highly unlikely that these issues will be resolved in time to successfully submit an electronic application. It is strongly recommended that you prepare your Project Narrative and other attached documents in Adobe PDF format. If you do not have access to Adobe software, you may submit in Microsoft Office 2007 products (e.g., Microsoft Word 2007, Microsoft Excel 2007, etc.). Directions for creating PDF files can be found on the Grants.gov website. Use of file formats other than Adobe PDF or Microsoft Office 2007 may result in your file being unreadable by our staff. The Abstract, Table of Contents, Project Narrative, Supporting Documentation, Budget Justification, and Attachments must be combined into 4 separate files in the electronic submission. If the number of files exceeds 4, only the four files will be downloaded and considered in the peer review of applications. Formatting requirements for SAMHSA e-Grant application files are as follows: Project Narrative File (PNF): The PNF consists of the Abstract, Table of Contents, and Project Narrative (Sections A-D) in this order and numbered consecutively. Budget Narrative File (BNF): The BNF consists of only the budget justification narrative. Other Attachment File 1: The first Other Attachment file will consist of the Supporting Documentation (Sections E-G) in this order and lettered consecutively. Other Attachment File 2: The second Other Attachment file will consist of the Attachments (Attachments 1-4) in this order and numbered consecutively. If you have documentation that does not pertain to any of the 4 listed attachment files, include that documentation in Other Attachment File 2. Other Grants.gov Requirements Applicants are limited to using the following characters in all attachment file names: Valid file names may include only the following characters: A-Z a-z 0-9 Underscore _ Hyphen Space Period . If your application uses any other characters when naming your attachment files, your application will be rejected by Grants.gov. Do not use special characters in file names, such as parenthesis ( ), #, , etc. Scanned images must be scanned at 150-200 dpi/ppi resolution and saved as a jpeg or pdf file. Using a higher resolution setting or different file type could result in rejection of your application. Waiver Request Process Applicants may request a waiver of the requirement for electronic submission if they are unable to submit electronically through the Grants.gov portal because their physical location does not have adequate access to the Internet. Inadequate Internet access is defined as persistent and unavoidable access problems/issues that would make compliance with the electronic submission requirement a hardship. The process for applying for a waiver is described below. Questions on applying for a waiver may be directed to SAMHSAs Division of Grant Review, 240-276-1199. All applicants must register in the System for Award Management (SAM) and Grants.gov, even those who intend to request a waiver. If you do not have an active SAM registration prior to submitting your paper application, it will be screened out and returned to you without review. Registration is necessary to ensure that information required for paper submission is available and that the applicant is ready to submit electronically if the waiver is denied. (See directions for registering in SAM and on Grants.gov above.) A written waiver request must be received by SAMHSA at least 15 calendar days in advance of the application due date stated on the cover page of this RFA. The request must be either e-mailed to  HYPERLINK "mailto:DGR.Waivers@samhsa.hhs.gov" DGR.Waivers@samhsa.hhs.gov, or mailed to: Diane Abbate, Director of Grant Review Office of Financial Resources Substance Abuse and Mental Health Services Administration Room 3-1044 1 Choke Cherry Road Rockville, MD 20857 Applicants are encouraged to request a waiver by e-mail, when possible. When requesting a waiver, the following information must be included: SAMHSA RFA title and announcement number; Name, address, and telephone number of the applicant organization as they will appear in the application; Applicant organizations DUNS number; Authorized Organization Representative (AOR) for the named applicant; Name, telephone number, and e-mail of the applicant organizations Contact Person for the waiver; and Details of why the organization is unable to submit electronically through the Grants.gov portal, explaining why their physical location does not have adequate access to the Internet. The Office of Grant Review will either e-mail (if the waiver request was received by e-mail) or express mail/deliver (if the waiver request was received by mail) the waiver decision to the Contact Person no later than seven calendar days prior to the application due date. If the waiver is approved, a paper application must be submitted. (See instructions for submitting a paper application below.) SAMHSA will not accept any applications that are sent by e-mail or facsimile or hand carried. If the waiver is disapproved, the applicant organization must be prepared to submit through Grants.gov or forfeit the opportunity to apply. The written approval must be included as the cover page of the paper application and the application must be received by the due date. A waiver approval is valid for the remainder of the fiscal year and may be used for other SAMHSA discretionary grant applications during that fiscal year. When submitting a subsequent paper application within the same fiscal year, this waiver approval must be included as the cover page of each paper application. The organization and DUNS number named in the waiver and any subsequent application must be identical. A paper application will not be accepted without the waiver approval and will be returned to the applicant if it is not included. Paper applications received after the due date will not be accepted. Instructions for Submitting a Paper Application with a Waiver Paper submissions are due by 5:00 PM on the application due date stated on the cover page of this RFA. Applications may be shipped using only Federal Express (FedEx), United Parcel Service (UPS), or the United States Postal Service (USPS). You will be notified by postal mail that your application has been received. Note: If you use the USPS, you must use Express Mail. SAMHSA will not accept or consider any applications that are sent by e-mail or facsimile or hand carried. If you are submitting a paper application, you must submit an original application and 2 copies (including attachments). The original and copies must not be bound and nothing should be attached, stapled, folded, or pasted. Do not use staples, paper clips, or fasteners. You may use rubber bands. Send applications to the address below: For United States Postal Service: Diane Abbate, Director of Grant Review Office of Financial Resources Substance Abuse and Mental Health Services Administration Room 3-1044 1 Choke Cherry Road Rockville, MD 20857 Change the zip code to 20850 if you are using FedEx or UPS. Do not send applications to other agency contacts, as this could delay receipt. Be sure to include Supported Employment Program RFA #SM-14-0011 in item number 12 on the first page (SF-424) of your paper application. If you require a phone number for delivery, you may use (240) 276-1199. Your application must be received by the application deadline or it will not be considered for review. Please remember that mail sent to federal facilities undergoes a security screening prior to delivery. You are responsible for ensuring that you submit your application so that it will arrive by the application due date and time. If an application is mailed to a location or office (including room number) that is not designated for receipt of the application and, as a result, the designated office does not receive your application by the deadline, your application will be considered late and ineligible for review. If you are submitting a paper application, the application components required for SAMHSA applications should be submitted in the following order: Application for Federal Assistance (SF-424) Abstract Table of Contents Budget Information Form (SF-424A) Project Narrative and Supporting Documentation Attachments Project/Performance Site Location(s) Form Disclosure of Lobbying Activities (Standard Form LLL, if applicable) Checklist the Checklist should be the last page of your application. Documentation of nonprofit status as required in the Checklist 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. Black print should be used throughout your application, including charts and graphs (no color). Pages should be typed single-spaced with one column per page. Pages should not have printing on both sides. Pages with printing on both sides run the risk of an incomplete application going to peer reviewers, since scanning and copying may not duplicate the second side. Materials with printing on both sides will be excluded from the application and not sent to peer reviewers. With the exception of standard forms in the application package, all pages in your application should be numbered consecutively. Documents containing scanned images must also contain page numbers to continue the sequence. Failure to comply with these requirements may affect the successful transmission and consideration of your application. Appendix C Funding Restrictions SAMHSA grant funds must be used for purposes supported by the program and may not be used to: Pay for any lease beyond the project period. Provide services to incarcerated populations (defined as those persons in jail, prison, detention facilities, or in custody where they are not free to move about in the community). Pay for the purchase or construction of any building or structure to house any part of the program. (Applicants may request up to $75,000 for renovations and alterations of existing facilities, if necessary and appropriate to the project.) Provide residential or outpatient treatment services when the facility has not yet been acquired, sited, approved, and met all requirements for human habitation and services provision. (Expansion or enhancement of existing residential services is permissible.) Pay for housing other than residential mental health and/or substance abuse treatment. Provide inpatient treatment or hospital-based detoxification services. Residential services are not considered to be inpatient or hospital-based services. Only allowable costs associated with the use of federal funds are permitted to fund evidence-based practices (EBPs). Other sources of funds may be used for unallowable costs (e.g., meals, sporting events, entertainment). Other support is defined as funds or resources, whether federal, non-federal or institutional, in direct support of activities through fellowships, gifts, prizes, or in-kind contributions. Make direct payments to individuals to induce them to enter prevention or treatment services. However, SAMHSA discretionary grant funds may be used for non-clinical support services (e.g., bus tokens, child care) designed to improve access to and retention in prevention and treatment programs. Make direct payments to individuals to encourage attendance and/or attainment of prevention or treatment goals. However, SAMHSA discretionary grant funds may be used for non-cash incentives of up to $30 to encourage attendance and/or attainment of prevention or treatment goals when the incentives are built into the program design and when the incentives are the minimum amount that is deemed necessary to meet program goals. SAMHSA policy allows an individual participant to receive more than one incentive over the course of the program. However, non-cash incentives should be limited to the minimum number of times deemed necessary to achieve program outcomes. A grantee or treatment or prevention provider may also provide up to $30 cash 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. Meals are generally unallowable unless they are an integral part of a conference grant or specifically stated as an allowable expense in the RFA. Grant funds may be used for light snacks, not to exceed $2.50 per person. Funds may not be used to distribute sterile needles or syringes for the hypodermic injection of any illegal drug. Pay for pharmacologies for HIV antiretroviral therapy, sexually transmitted diseases (STD)/sexually transmitted illnesses (STI), TB, and hepatitis B and C, or for psychotropic drugs. SAMHSA will not accept a research indirect cost rate. The grantee must use the other sponsored program rate or the lowest rate available. Appendix D Biographical Sketches and Job Descriptions Biographical Sketch Existing curricula vitae of project staff members may be used if they are updated and contain all items of information requested below. You may add any information items listed below to complete existing documents. For development of new curricula vitae include items below in the most suitable format: Name of staff member Educational background: school(s), location, dates attended, degrees earned (specify year), major field of study Professional experience Honors received and dates Recent relevant publications Other sources of support [Other support is defined as all funds or resources, whether federal, non-federal, or institutional, available to the Project Director/Program Director (and other key personnel named in the application) in direct support of their activities through grants, cooperative agreements, contracts, fellowships, gifts, prizes, and other means.] Job Description Title of position Description of duties and responsibilities Qualifications for position Supervisory relationships Skills and knowledge required Personal qualities Amount of travel and any other special conditions or requirements Salary range Hours per day or week Appendix E Sample Budget and Justification (no match required) THIS IS AN ILLUSTRATION OF A SAMPLE DETAILED BUDGET AND NARRATIVE JUSTIFICATION WITH GUIDANCE FOR COMPLETING SF-424A: SECTION B FOR THE BUDGET PERIOD A. Personnel: Provide employee(s) (including names for each identified position) of the applicant/recipient organization, including in-kind costs for those positions whose work is tied to the grant project. FEDERAL REQUEST PositionNameAnnual Salary/RateLevel of EffortCost(1) Project DirectorJohn Doe$64,89010%$6,489(2) Grant CoordinatorTo be selected$46,276100%$46,276(3) Clinical DirectorJane DoeIn-kind cost20%0TOTAL$52,765 JUSTIFICATION: Describe the role and responsibilities of each position. The Project Director will provide daily oversight of the grant and will be considered key staff. The Coordinator will coordinate project services and project activities, including training, communication and information dissemination. The Clinical Director will provide necessary medical direction and guidance to staff for 540 clients served under this project. Key staff positions require prior approval by SAMHSA after review of credentials of resume and job description. FEDERAL REQUEST (enter in Section B column 1 line 6a of form S-424A) $52,765 B. Fringe Benefits: List all components that make up the fringe benefits rate FEDERAL REQUEST ComponentRateWageCostFICA7.65%$52,765 $4,037Workers Compensation2.5%$52,765 $1,319Insurance10.5%$52,765 $5,540TOTAL $10,896 JUSTIFICATION: Fringe reflects current rate for agency. FEDERAL REQUEST (enter in Section B column 1 line 6b of form SF-424A) $10,896 C. Travel: Explain need for all travel other than that required by this application. Local travel policies prevail. FEDERAL REQUEST Purpose of TravelLocationItemRateCost(1) Grantee Conference Washington, DCAirfare$200/flight x 2 persons$400Hotel$180/night x 2 persons x 2 nights$720Per Diem (meals and incidentals)$46/day x 2 persons x 2 days$184(2) Local travelMileage3,000 miles@.38/mile$1,140TOTAL$2,444 JUSTIFICATION: Describe the purpose of travel and how costs were determined. (1) Two staff (Project Director and Evaluator) to attend mandatory grantee meeting in Washington, DC. (2) Local travel is needed to attend local meetings, project activities, and training events. Local travel rate is based on organizations policies/procedures for privately owned vehicle reimbursement rate. If policy does not have a rate use GSA. FEDERAL REQUEST (enter in Section B column 1 line 6c of form SF-424A) $2,444 D. Equipment: An article of tangible, nonexpendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit (federal definition). FEDERAL REQUEST (enter in Section B column 1 line 6d of form SF-424A) $ 0 E. Supplies: Materials costing less than $5,000 per unit and often having one-time use FEDERAL REQUEST Item(s)RateCostGeneral office supplies$50/mo. x 12 mo.$600Postage$37/mo. x 8 mo.$296Laptop Computer$900$900Printer$300$300Projector$900$900Copies8000 copies x .10/copy$800TOTAL$3,796 JUSTIFICATION: Describe the need and include an adequate justification of how each cost was estimated. (1) Office supplies, copies and postage are needed for general operation of the project. (2) The laptop computer and printer are needed for both project work and presentations for Project Director. (3) The projector is needed for presentations and workshops. All costs were based on retail values at the time the application was written. FEDERAL REQUEST (enter in Section B column 1 line 6e of form SF-424A) $ 3,796 F. Contract: A contractual arrangement to carry out a portion of the programmatic effort or for the acquisition of routine goods or services under the grant. Such arrangements may be in the form of consortium agreements or contracts. A consultant is an individual retained to provide professional advice or services for a fee. The applicant/grantee must establish written procurement policies and procedures that are consistently applied. All procurement transactions shall be conducted in a manner to provide to the maximum extent practical, open and free competition. COSTS FOR CONTRACTS MUST BE BROKEN DOWN IN DETAIL AND A NARRATIVE JUSTIFICATION PROVIDED. IF APPLICABLE, NUMBERS OF CLIENTS SHOULD BE INCLUDED IN THE COSTS. FEDERAL REQUEST NameServiceRateOtherCost(1) State Department of Human ServicesTraining $250/individual x 3 staff5 days$750 (2) Treatment Services 1040 Clients $27/client per year$28,080(3) John Smith (Case Manager)Treatment Client Services 1FTE @ $27,000 + Fringe Benefits of $6,750 = $33,750 *Travel at 3,124 @ .50 per mile = $1,562 *Training course $175 *Supplies @ $47.54 x 12 months or $570 *Telephone @ $60 x 12 months = $720 *Indirect costs = $9,390 (negotiated with contractor) $46,167 (4) Jane Smith Evaluator$40 per hour x 225 hours12 month period $9,000(5) To Be AnnouncedMarketing Coordinator Annual salary of $30,000 x 10% level of effort $3,000TOTAL$86,997 JUSTIFICATION: Explain the need for each contractual agreement and how it relates to the overall project. Certified trainers are necessary to carry out the purpose of the statewide Consumer Network by providing recovery and wellness training, preparing consumer leaders statewide, and educating the public on mental health recovery. Treatment services for clients to be served based on organizational history of expenses. Case manager is vital to client services related to the program and outcomes. Evaluator is provided by an experienced individual (Ph.D. level) with expertise in substance abuse, research and evaluation, is knowledgeable about the population of focus, and will report GPRA data. Marketing Coordinator will develop a plan to include public education and outreach efforts to engage clients of the community about grantee activities, and provision of presentations at public meetings and community events to stakeholders, community civic organizations, churches, agencies, family groups and schools. *Represents separate/distinct requested funds by cost category FEDERAL REQUEST (enter in Section B column 1 line 6f of form SF-424A) $86,997 G. Construction: NOT ALLOWED Leave Section B columns 1& 2 line 6g on SF-424A blank. H. Other: Expenses not covered in any of the previous budget categories FEDERAL REQUEST ItemRateCost(1) Rent*$15/sq.ft x 700 sq. feet$10,500(2) Telephone$100/mo. x 12 mo.$1,200(3) Client Incentives$10/client follow up x 278 clients $2,780(4) Brochures.89/brochure X 1500 brochures$1,335TOTAL$15,815 JUSTIFICATION: Break down costs into cost/unit (e.g. cost/square foot). Explain the use of each item requested. (1) Office space is included in the indirect cost rate agreement; however, if other rental costs for service site(s) are necessary for the project, they may be requested as a direct charge. The rent is calculated by square footage or FTE and reflects SAMHSAs fair share of the space. *If rent is requested (direct or indirect), provide the name of the owner(s) of the space/facility. If anyone related to the project owns the building which is less than an arms length arrangement, provide cost of ownership/use allowance calculations. Additionally, the lease and floor plan (including common areas) is required for all projects allocating rent costs. (2) The monthly telephone costs reflect the percent of effort for the personnel listed in this application for the SAMHSA project only. (3) The $10 incentive is provided to encourage attendance to meet program goals for 278 client follow-ups. (4) Brochures will be used at various community functions (health fairs and exhibits). FEDERAL REQUEST (enter in Section B column 1 line 6h of form SF-424A) $15,815 Indirect Cost Rate: Indirect costs can be claimed if your organization has a negotiated indirect cost rate agreement. It is applied only to direct costs to the agency as allowed in the agreement. For information on applying for the indirect rate go to:  HYPERLINK "https://rates.psc.gov/fms/dca/map1.html" https://rates.psc.gov/fms/dca/map1.html. FEDERAL REQUEST (enter in Section B column 1 line 6j of form SF-424A) 8% of personnel and fringe (.08 x $63,661) $5,093 ================================================================== TOTAL DIRECT CHARGES: FEDERAL REQUEST (enter in Section B column 1 line 6i of form SF-424A) $172,713 INDIRECT CHARGES: FEDERAL REQUEST (enter in Section B column 1 line 6j of form SF-424A) $5,093 TOTAL: (sum of 6i and 6j) FEDERAL REQUEST (enter in Section B column 1 line 6k of form SF-424A) $177,806 ================================================================== Provide the total proposed project period and federal funding as follows: Proposed Project Period: a. Start Date: 09/30/2014 b. End Date: 09/29/2019 BUDGET SUMMARY (should include future years and projected total) CategoryYear 1Year 2*Year 3*Year 4*Year 5*Total Project CostsPersonnel$52,765$54,348$55,978$57,658$59,387$280,136Fringe$10,896$11,223$11,559$11,906$12,263$57,847Travel$2,444$2,444$2,444$2,444$2,444$12,220Equipment000000Supplies$3,796$3,796$3,796$3,796$3,796$18,980Contractual$86,997$86,997$86,997$86,997$86,997$434,985Other$15,815$13,752$11,629$9,440$7,187$57,823Total Direct Charges$172,713$172,560$172,403$172,241$172,074$861,991Indirect Charges$5,093$5,246$5,403$5,565$5,732$27,039Total Project Costs$177,806$177,806$177,806$177,806$177,806$889,030 TOTAL PROJECT COSTS: Sum of Total Direct Costs and Indirect Costs FEDERAL REQUEST (enter in Section B column 1 line 6k of form SF-424A) $889,030 *FOR REQUESTED FUTURE YEARS: 1. Please justify and explain any changes to the budget that differs from the reflected amounts reported in the 01 Year Budget Summary. 2. If a cost of living adjustment (COLA) is included in future years, provide your organizations personnel policy and procedures that state all employees within the organization will receive a COLA. IN THIS SECTION, REFLECT OTHER FEDERAL AND NON-FEDERAL SOURCES OF FUNDING BY DOLLAR AMOUNT AND NAME OF FUNDER e.g., Applicant, State, Local, Other, Program Income, etc. Other support is defined as funds or resources, whether federal, non-federal or institutional, in direct support of activities through fellowships, gifts, prizes, in-kind contributions or non-federal means. [Note: Please see  HYPERLINK \l "_Appendix_F_" Appendix D, Funding Restrictions, regarding allowable costs.] IN THIS SECTION, include a separate budget for each year of the grant that shows that no more than 20 percent of the total grant award will be used for data collection, performance measurement, and performance assessment. Data Collection & Performance MeasurementYear 1Year 2Year 3Year 4Year 5Total Data Collection & Performance Measurement CostsPersonnel$6,700$6,700$6,700$6,700$6,700$33,500Fringe$2,400$2,400$2,400$2,400$2,400$12,000Travel$100$100$100$100$100$500Equipment000000Supplies$750$750$750$750$750$3,750Contractual$24,950$24,950$24,950$24,950$24,950$124,750Other000000Total Direct Charges$34,300$34,300$34,300$34,300$34,300$171,500Indirect Charges$698$698$698$698$698$3,490Data Collection & Performance Measurement$34,900$34,900$34,900$34,900$34,900$174,500 Appendix F Confidentiality and SAMHSA Participant Protection/Human Subjects Guidelines Confidentiality and Participant Protection: Because of the confidential nature of the work in which many SAMHSA grantees are involved, it is important to have safeguards protecting individuals from risks associated with their participation in SAMHSA projects. All applicants (including those who plan to obtain IRB approval) must address the seven elements below. If some are not applicable or relevant to the proposed project, simply state that they are not applicable and indicate why. In addition to addressing these seven elements, read the section that follows entitled Protection of Human Subjects Regulations to determine if the regulations may apply to your project. If so, you are required to describe the process you will follow for obtaining Institutional Review Board (IRB) approval. While we encourage you to keep your responses brief, there are no page limits for this section and no points will be assigned by the Review Committee. Problems with confidentiality, participant protection, and the protection of human subjects identified during peer review of the application must be resolved prior to funding. 1. Protect Clients and Staff from Potential Risks 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. Describe the procedures you will follow to minimize or protect participants against potential risks, including risks to confidentiality. Identify plans to provide guidance and assistance in the event there are adverse effects to participants. Where appropriate, describe alternative treatments and procedures that may be beneficial to the participants. If you choose not to use these other beneficial treatments, provide the reasons for not using them. 2. Fair Selection of Participants Describe the population(s) of focus for the proposed project. Include age, gender, and racial/ethnic background and note if the population includes homeless youth, foster children, children of substance abusers, pregnant women, or other targeted groups. Explain the reasons for including groups of pregnant women, children, people with mental disabilities, people in institutions, prisoners, and individuals who are likely to be particularly vulnerable to HIV/AIDS. Explain the reasons for including or excluding participants. Explain how you will recruit and select participants. Identify who will select participants. 3. Absence of Coercion Explain if participation in the project is voluntary or required. Identify possible reasons why participation is required, for example, court orders requiring people to participate in a program. If you plan to compensate participants, state how participants will be awarded incentives (e.g., money, gifts, etc.). Provide justification that the use of incentives is appropriate, judicious, and conservative and that incentives do not provide an undue inducement which removes the voluntary nature of participation. Incentives should be the minimum amount necessary to meet the programmatic and performance assessment goals of the grant. Applicants should determine the minimum amount that is proven effective by consulting with existing local programs and reviewing the relevant literature. In no case may the value if an incentive paid for with SAMHSA discretionary grant funds exceed $30. 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 Identify from whom you will collect data (e.g., from participants themselves, family members, teachers, others). Describe the data collection procedures and specify the sources for obtaining data (e.g., school records, interviews, psychological assessments, questionnaires, observation, or other sources). Where data are to be collected through observational techniques, questionnaires, interviews, or other direct means, describe the data collection setting. Identify what type of specimens (e.g., urine, blood) will be used, if any. State if the material will be used just for evaluation or if other use(s) will be made. Also, if needed, describe how the material will be monitored to ensure the safety of participants. Provide in Attachment 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 Explain how you will ensure privacy and confidentiality. Include who will collect data and how it will be collected. Describe: How you will use data collection instruments. Where data will be stored. Who will or will not have access to information. How the identity of participants will be kept private, for example, through the use of a coding system on data records, limiting access to records, or storing identifiers separately from data. NOTE: If applicable, grantees must agree to maintain the confidentiality of alcohol and drug abuse client records according to the provisions of Title 42 of the Code of Federal Regulations, Part II. 6. Adequate Consent Procedures List what information will be given to people who participate in the project. Include the type and purpose of their participation. Identify the data that will be collected, how the data will be used and how you will keep the data private. State: Whether or not their participation is voluntary. Their right to leave the project at any time without problems. Possible risks from participation in the project. Plans to protect clients from these risks. 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. Indicate if you will obtain informed consent from participants or assent from minors along with consent from their parents or legal guardians. Describe how the consent will be documented. For example: Will you read the consent forms? Will you ask prospective participants questions to be sure they understand the forms? Will you give them copies of what they sign? Include, as appropriate, sample consent forms that provide for: (1) informed consent for participation in service intervention; (2) informed consent for participation in the data collection component of the project; and (3) informed consent for the exchange (releasing or requesting) of confidential information. The sample forms must be included in Attachment 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. Describe if separate consents will be obtained for different stages or parts of the project. For example, will they be needed for both participant protection in treatment intervention and for the collection and use of data? Additionally, if other consents (e.g., consents to release information to others or gather information from others) will be used in your project, provide a description of the consents. Will individuals who do not consent to having individually identifiable data collected for evaluation purposes be allowed to participate in the project? 7. Risk/Benefit Discussion 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 this announcement will not have to comply with the Protection of Human Subjects Regulations (45 CFR 46), which requires Institutional Review Board (IRB) approval. However, in some instances, the applicants proposed performance assessment design may meet the regulations criteria for research involving human subjects. For assistance in determining if your proposed performance assessment meets the criteria in 45 CFR 46, Protection of Human Subjects Regulations, refer to the SAMHSA decision tree on the SAMHSA website, under Applying for a New SAMHSA Grant,  HYPERLINK "http://www.samhsa.gov/grants/apply.aspx" http://www.samhsa.gov/grants/apply.aspx. In addition to the elements above, applicants whose projects must comply with the Human Subjects Regulations must fully describe the process for obtaining IRB approval. While IRB approval is not required at the time of grant award, these grantees will be required, as a condition of award, to provide documentation that an Assurance of Compliance is on file with the Office for Human Research Protections (OHRP). IRB approval must be received in these cases prior to enrolling participants in the project. General information about Human Subjects Regulations can be obtained through OHRP at  HYPERLINK "http://www.hhs.gov/ohrp" http://www.hhs.gov/ohrp, or ohrp@osophs.dhhs.gov, or (240) 453-6900. SAMHSAspecific questions should be directed to the program contact listed in  HYPERLINK \l "_VII._AGENCY_CONTACTS" Section VII of this announcement. Appendix G Addressing Behavioral Health Disparities In April 2011, the Department of Health and Human Services (HHS) released its Action Plan to Reduce Racial and Ethnic Health Disparities. This plan outlines goals and actions HHS agencies, including SAMHSA, will take to reduce health disparities among racial and ethnic minorities. Agencies are required to continuously assess the impact of their policies and programs on health disparities. The Action Plan is available at:  HYPERLINK "http://minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf" http://minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf. The number one Secretarial priority in the Action Plan is to: Assess and heighten the impact of all HHS policies, programs, processes, and resource decisions to reduce health disparities. HHS leadership will assure that: Program grantees, as applicable, will be required to submit health disparity impact statements as part of their grant applications. Such statements can inform future HHS investments and policy goals, and in some instances, could be used to score grant applications if underlying program authority permits. To accomplish this, SAMHSA expects grantees to utilize their data to: (1) identify subpopulations (i.e., racial, ethnic, sexual/gender minority groups) vulnerable to health disparities; and (2) implement strategies to decrease the differences in access, service use, and outcomes among those subpopulations. A strategy for addressing health disparities is use of the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. Definition of Health Disparities: Healthy People 2020 defines a health disparity as a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. Subpopulations SAMHSA grant applicants are routinely asked to define the population they intend to serve given the focus of a particular grant program (e.g., adults with serious mental illness [SMI] at risk for chronic health conditions; young adults engaged in underage drinking; populations at risk for contracting HIV/AIDS, etc.). Within these populations of focus are subpopulations that may have disparate access to, use of, or outcomes from provided services. These disparities may be the result of differences in language, beliefs, norms, values, and/or socioeconomic factors specific to that subpopulation. For instance, Latino adults with SMI may be at heightened risk for metabolic disorder due to lack of appropriate in-language primary care services; Native American youth may have an increased incidence of underage drinking due to coping patterns related to historical trauma within the Native American community; and African American women may be at greater risk for contracting HIV/AIDS due to lack of access to education on risky sexual behaviors in urban low-income communities. While these factors might not be pervasive among the general population served by a grantee, they may be predominant among subpopulations or groups vulnerable to disparities. It is imperative that grantees understand who is being served within their community in order to provide care that will yield positive outcomes, per the focus of that grant. In order for organizations to attend to the potentially disparate impact of their grant efforts, applicants are asked to address access, use and outcomes for subpopulations, which can be defined by the following factors: By race By ethnicity By gender (including transgender), as appropriate By sexual orientation (i.e., lesbian, gay, bisexual), as appropriate HHS published final standards for data collection on race, ethnicity, sex, primary language and disability status, as required by Section 4302 of the Affordable Care Act in October 2011,  HYPERLINK "http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208" http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=208. The ability to address the quality of care provided to subpopulations served within SAMHSAs grant programs is enhanced by programmatic alignment with the federal CLAS standards. National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care (CLAS) The National CLAS standards were initially published in the Federal Register on December 22, 2000. Culturally and linguistically appropriate health care and services, broadly defined as care and services that are respectful of and responsive to the cultural and linguistic needs of all individuals, is increasingly seen as essential to reducing disparities and improving health care quality. The National CLAS Standards have served as catalyst and conduit for the evolution of the field of cultural and linguistic competency over the course of the last 12 years. In recognition of these changes in the field, the HHS Office of Minority Health undertook the National CLAS Standards Enhancement Initiative from 2010 to 2012. The enhanced National CLAS Standards seek to set a new bar in improving the quality of health to our nations ever diversifying communities. Enhancements to the National CLAS Standards include the broadening of the definitions of health and culture, as well as an increased focus on institutional governance and leadership. The enhanced National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care are comprised of 15 Standards that provide a blueprint for health and health care organizations to implement culturally and linguistically appropriate services that will advance health equity, improve quality, and help eliminate health care disparities. You can learn more about the CLAS mandates, guidelines, and recommendations at:  HYPERLINK "http://www.ThinkCulturalHealth.hhs.gov" http://www.ThinkCulturalHealth.hhs.gov Sample Health Disparities Impact Statement: Proposed number of individuals to be reached by subpopulations in the geographic area Access: The numbers in the chart below reflect the proposed number of individuals to be reached during the grant period and all identified subpopulations in the geographic area. The disparate populations are highlighted in the narrative below. FY 1FY 2FY 3FY 4TotalsNumber to be reached200175100125600By Race/EthnicityAfrican American1095630American Indian/Alaska Native11013Asian22116White (non-Hispanic)103915265311Hispanic or Latino (not including Salvadoran)3228162096 Salvadoran44372228130Native Hawaiian/Other Pacific Islander432211Two or more Races442313By GenderFemale110965569330Male89794456268Transgender10102By Sexual Orientation/Identity Status Lesbian22116Gay864523Bisexual11013The population of Middle Lake, Massachusetts is predominantly represented by first- and second-generation Latino immigrants, mainly from El Salvador. There has been a recent increase of the immigrant population in the city with individuals primarily from Haiti and El Salvador. There is also a smaller Cambodian and African American population in the city. Nearly 40% of residents speak a language other than English in their homes, and a majority of those individuals are Spanish speakers. There is a high unemployment rate, low literacy rate and high level of poverty, in particular among the Salvadoran subpopulation, putting these individuals at greater risk for behavioral health issues when compared to national trends. However, our agency has reached relatively low numbers of Salvadorans. Therefore, we have chosen to focus our efforts on the Salvadoran subpopulation. A Quality Improvement Plan Using Our Data Use: Activities will be designed and implemented in accordance with the cultural and linguistic needs of individuals in the community. The project team will collaborate with the community enrichment program and the county health specialist consortium in planning the design and implementation of program activities to ensure the cultural and linguistic needs of grant participants are effectively addressed, particularly the disparate population. A continuous quality improvement approach will be used to analyze, assess and monitor key performance indicators as a mechanism to ensure high-quality and effective program operations. Program data will be used to monitor and manage program outcomes by race, ethnicity, and LGBT status within a quality improvement process. Programmatic adjustments will be made as indicated to address identified issues, including behavioral health disparities, across program domains. A primary objective of the data collection and reporting will be to monitor/measure project activities in a manner that optimizes the usefulness of data for project staff and consumers; evaluation findings will be integrated into program planning and management on an ongoing basis (a self-correcting model of evaluation). For example, screening and outreach data will be reported to staff on an ongoing basis, including analyses and discussions of who may be more or less likely to be exposed to outreach activities. The Evaluator will meet on a bi-weekly basis with staff, providing an opportunity for staff to identify successes and barriers encountered in the process of project implementation. These meetings will be a forum for discussion of evaluation findings, allowing staff to adjust or modify project services to maximize project success. Outcomes for all activities will be monitored across race and ethnicity to determine the grants impact on behavioral health disparities. Adherence to the CLAS Standards Our quality improvement plan will ensure adherence to the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS Standards) in Health and Health Care. This will include attention to: Diverse cultural health beliefs and practices Training and hiring protocols will be implemented to support the culture and language of all subpopulations, with a focus on the Salvadoran subpopulation. Preferred languages Interpreters and translated materials will be used for non-English speaking clients as well as those who speak English, but prefer materials in their primary language. Key documents will be translated into Spanish. Health literacy and other communication needs of all sub-populations identified in your proposal All interventions will be tailored to include limited English proficient individuals. Staff will receive training to ensure capacity to provide interventions that are culturally and linguistically appropriate. Appendix H Electronic Health Record (EHR) Resources The following is a list of websites for EHR information: For additional information on EHR implementation please visit:  HYPERLINK "http://www.healthit.gov/providers-professionals" http://www.healthit.gov/providers-professionals For a comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified under the Temporary Certification Program maintained by the Office of the National Coordinator for Health IT (ONC) please see:  HYPERLINK "http://onc-chpl.force.com/ehrcert" http://onc-chpl.force.com/ehrcert For a listing of Regional Extension Centers (REC) for technical assistance, guidance, and information to support efforts to become a meaningful user of Electronic Health Records (EHRs), see:  HYPERLINK "http://www.healthit.gov/providers-professionals/regional-extension-centers-recs" \l "listing" http://www.healthit.gov/providers-professionals/regional-extension-centers-recs#listing Behavioral healthcare providers should also be aware of federal confidentiality regulations including HIPPA and 42CRF Part 2 ( HYPERLINK "http://www.samhsa.gov/HealthPrivacy/" http://www.samhsa.gov/HealthPrivacy/). EHR implementation plans should address compliance with these regulations. For questions on EHRs and HIT, contact:  HYPERLINK "mailto:SAMHSA.HIT@samhsa.hhs.gov" SAMHSA.HIT@samhsa.hhs.gov.  SAMHSA-RSSI involves partnering with people in recovery from mental and substance use disorders to guide the behavioral health system and promote individual level, program level, and system-level approaches that foster health and resilience; increase permanent housing, employment, education, and other necessary supports; and reduce barriers to social inclusion.  HYPERLINK "http://store.samhsa.gov/shin/content/SMA11-4629/06-RecoverySupport.pdf" http://store.samhsa.gov/shin/content/SMA11-4629/06-RecoverySupport.pdf  Swanson, S.J. & Becker, D.R. SE Supported Employment: A Practical Guide. Lebanon, NH: Dartmouth Psychiatric Research Center, 2013.     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9"&8ETUWW@XXXX[[[\"\J]Y]Z]]]0^X^_ab9bTbgb|bbbggg@hhiiZjljkloopVpppv+zzw{Z|xɕ.%.6P] "#;DQ`ho>   $')/27=@CFJMOPRSTVWXYZ[\]^_abcdefgijklmnopqrtuvwxyz{|~*,-/Nr+-.0Of:=>@_?[^_a2568W|!9UXY[z=Oknoq < ? @ B a w " > A B D c  $ ' ( * I  ! $ % ' F  4 7 8 : Y p''"(*Q*|*-7.l.`KKKKKK,\M\\c%dzdTl}llmmmsnnn/P[ "=r AL6Zp8Kϟ<G }# Bsn'Fn|.78N1<HgrGA$YDz)i>I)+v 5 Y o    #)$D$@nvnnw x+x؜V|8DAߢV׸~!N'Z'A XX%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%X%̕XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX̕XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX&)1!!n XL# @0(  B S  ? _Toc381864839 _Toc381864840 _Toc139161419 _Toc143489856 _Toc139161420 _Toc143489857 _Toc139161421 _Toc143489858 _Toc139161422 _Toc143489859 _Toc139161423 _Toc143489860 _Toc139161424 _Toc143489861 _Toc381864841 _Toc381864842_2._EXPECTATIONS _Toc381864843 _Toc198626943 _Toc198626944_2.3_Data_Collection _Toc198626945_2.4_Local_Performance _Toc198626946 _Toc198626947 _Toc197933190 _Toc381864844 _Toc197933192 _Toc381864845_1._ELIGIBLE_APPLICANTS _Toc197933193 _Toc381864846 _Toc197933194 _Toc381864847 _Toc197933195 _Toc381864848 _Toc197933198 _Toc381864849_2.2_Required_Application _Toc371518995 _Toc381864850 _Toc197933202_1.1_Required_Application _Toc197933203 _Toc198626959_3._APPLICATION_SUBMISSION_2._APPLICATION_SUBMISSION _Toc266262534 _Toc381864851_4._INTERGOVERNMENTAL_REVIEW _Toc197933206 _Toc381864852_6._OTHER_SUBMISSION_V._APPLICATION_REVIEW _Toc197933210 _Toc381864853_1._EVALUATION_CRITERIA _Toc197933211 _Toc381864854 _Toc197933217 _Toc198626968 _Toc266802824 _Toc266803113 _Toc197933218 _Toc198626969 _Toc197933220 _Toc198626971 _Toc197933221 _Toc198626972 _Toc197933224 _Toc381864855 _Toc197933225 _Toc381864856 _Toc197933226 _Toc381864857 _Toc197933227 _Toc381864858 _Toc197933228 _Toc381864859 _Toc197933229 _Toc198626980 _Toc197933232 _Toc381864860_Appendix_A_ _1_Appendix_A_ _ _Appendix_A_ _Toc197933233 _Toc381864861_Appendix_B_ _1_Appendix_B_ _ _Appendix_B_ _Toc197933234 _Toc381864862 _Appendix_F_ _Appendix_D_ _Toc197933240 _Toc381864863_Appendix_E_ _2 _Appendix_C_ _Appendix_E_ _ _Appendix_E_ _Appendix_G_ _1_Appendix_G_ _ _Appendix_G_ _Toc306973090 _Toc197933241 _Toc197933242 _Toc198626992 _Toc381864864_Appendix_H_ _1 _Toc381864865 _Toc198626993 _Toc266800788 _Toc266802838 _Toc266803127 _Toc266955506 _Appendix_H_ _Toc280258986 _Toc306973092 _Toc317150077 _Toc318707614 _Toc280258987 _Toc306973093 _Toc317150078 _Toc318707615 _Toc280258988 _Toc306973094 _Toc317150079 _Toc318707616 _Toc280258989 _Toc306973095 _Toc317150080 _Toc318707617 _Toc280258990 _Toc306973096 _Toc317150081 _Toc318707618 _Toc280258991 _Toc306973097 _Toc317150082 _Toc318707619 _Toc342484289 _Toc280258992 _Toc306973098 _Toc317150083 _Toc318707620 _Toc280258993 _Toc306973099 _Toc317150084 _Toc318707621 _Toc280258994 _Toc306973100 _Toc317150085 _Toc318707622 _Toc280258995 _Toc306973101 _Toc317150086 _Toc318707623 _Toc280258996 _Toc306973102 _Toc317150087 _Toc318707624 _Toc280258997 _Toc306973103 _Toc317150088 _Toc318707625 _Toc280258998 _Toc306973104 _Toc317150089 _Toc318707626 _Toc280258999 _Toc306973105 _Toc317150090 _Toc318707627 _Toc280259000 _Toc306973106 _Toc317150091 _Toc318707628 _Toc280259001 _Toc306973107 _Toc317150092 _Toc318707629 _Toc280259002 _Toc306973108 _Toc317150093 _Toc318707630 _Toc280259003 _Toc306973109 _Toc317150094 _Toc318707631 _Toc280259004 _Toc306973110 _Toc317150095 _Toc318707632 _Toc280259005 _Toc306973111 _Toc317150096 _Toc318707633 _Toc280259006 _Toc306973112 _Toc317150097 _Toc318707634 _Toc280259007 _Toc306973113 _Toc317150098 _Toc318707635 _Toc280259008 _Toc306973114 _Toc317150099 _Toc318707636 _Toc280259009 _Toc306973115 _Toc317150100 _Toc318707637 _Toc90713308 _Toc93133740 _Toc93133798 _Toc93134310 _Toc90713309 _Toc93133741 _Toc93133799 _Toc93134311 _Toc280259010 _Toc306973116 _Toc317150101 _Toc318707638 _Toc280259011 _Toc306973117 _Toc317150102 _Toc318707639 _Toc280259012 _Toc306973118 _Toc317150103 _Toc318707640 _Toc90713311 _Toc93133743 _Toc93133801 _Toc93134313 _Toc280259013 _Toc306973119 _Toc317150104 _Toc318707641 _Toc280259014 _Toc306973120 _Toc317150105 _Toc318707642 _Toc280259015 _Toc306973121 _Toc317150106 _Toc318707643 _Toc280259016 _Toc306973122 _Toc317150107 _Toc318707644 _Toc280259017 _Toc306973123 _Toc317150108 _Toc318707645 _Toc280259018 _Toc306973124 _Toc317150109 _Toc318707646 _Toc280259019 _Toc306973125 _Toc317150110 _Toc318707647 _Toc90713314 _Toc93133746 _Toc93133804 _Toc93134316 _Appendix_K_ _Toc381864866 _Toc197933223_Appendix_H_ _2 _Toc318707649 _Toc381864867 _Toc317087821 _Toc318707650_Appendix_I_ _1 _Toc381864868 ??11YYYYkk*x*xuu &&&^^rrʙ[[222llQQDD^^;;;;+I,I,I,I,I,I,I,I,I,I,I-I N N7N7N7N7N7NKNOOOOOOOOOOOOOOOOOOOOPPPPPuSuSuSuSSSSSSSSSSSSSSSSS/U/U/U/UAUAUAUAUJUJUJUJUOUOUOUOUTUTUTUTUYYYYYYYYYYYY____________________ffffggggggggggggggggllllqqqqqqqqqqqqqqqqqqqqrrrr r r r r\t\t\t\t{{___  !"#$%&'(*)+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghklmijnopqrstuvwxyz{|}~      55[[ 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