Division of Behavioral Health; Office of Clinical and Preventive Services; Zero Suicide Initiative-Support, 39600-39609 [2017-17599]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 82, Number 160 (Monday, August 21, 2017)]
[Notices]
[Pages 39600-39609]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-17599]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Division of Behavioral Health; Office of Clinical and Preventive 
Services; Zero Suicide Initiative--Support

    Announcement Type: New.
    Funding Announcement Number: HHS-2018-IHS-ZSI-0001.
    Catalog of Federal Domestic Assistance Number: 93.933.

Key Dates

    Application Deadline Date: October 12, 2017.
    Review Date: October 16-20, 2017.
    Earliest Anticipated Start Date: November 1, 2017.
    Signed Tribal Resolution Due Date: October 12, 2017.
    Proof of Non-Profit Status Due Date: October 12, 2017.

[[Page 39601]]

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS), Office of Clinical and Preventive 
Service, Division of Behavioral Health (DBH), is accepting applications 
for cooperative agreements for Zero Suicide Initiative (ZSI)--to 
develop a comprehensive model of culturally informed suicide care 
within a system of care framework. This program was first established 
by the Consolidated Appropriations Act of 2017, Public Law 115-31, 131 
Stat. 135 (2017). This program is authorized under the Snyder Act, 25 
U.S.C. 13 and the Indian Health Care Improvement Act, Subchapter V-A 
(Behavioral Health Programs), 25 U.S.C. 1665 et seq.

Background

    For at least the past fifteen years deaths by suicide have been 
steadily increasing. On April 22, 2016, the Centers for Disease Control 
and Prevention's National Center for Health Statistics released a data 
report, Increase in Suicide in the United States, 1999-2014, which 
underscores this fact.
     From 1999 through 2014, the age-adjusted suicide rate in 
the United States increased 24%, from 10.5 to 13.0 per 100,000 
population, with the pace of increase greater after 2006.
     Suicide rates increased from 1999 through 2014 for both 
males and females and for all ages 10-74.
     The percent increase in suicide rates for females was 
greatest for those aged 10-14, and for males, those aged 45-64.
     The most frequent suicide method in 2014 for males 
involved the use of firearms (55.4%), while poisoning was the most 
frequent method for females (34.1%).
    There is a sizable disparity when comparing the rate for the 
general U.S. population to the rate for American Indians and Alaska 
Natives (AI/AN). During 2007-2009, the suicide rate for AI/ANs was 1.6 
times greater than the U.S. all-races rate for 2008 (18.5 vs. 11.6 per 
100,000 population).\1\
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    \1\ Trends in Indian Health U.S. Dept. of Health and Human 
Services, Public Health Service, Indian Health Service, Office of 
Planning, Evaluation and Legislation, Division of Program Statistics
---------------------------------------------------------------------------

    The `Zero Suicide' initiative is a key concept of the National 
Strategy for Suicide Prevention (NSSP) and is a priority of the 
National Action Alliance for Suicide Prevention (Action Alliance). The 
`Zero Suicide' model focuses on developing a system-wide approach to 
improving care for individuals at risk of suicide who are currently 
utilizing health and behavioral health systems. This award will support 
implementation of the `Zero Suicide' model within federal, Tribal, and 
urban Indian health care facilities and systems that provide direct 
care services to AI/AN in order to raise awareness of suicide, 
establish integrated system of care, and improve outcomes for such 
individuals.
    Applicants are encouraged to visit: https://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full_report-rev.pdf to access a copy of the 2012 National Strategy.

Purpose

    The purpose of this cooperative agreement is to improve the system 
of care for those at risk for suicide by implementing a comprehensive, 
culturally informed, multi-setting approach to suicide prevention in 
Indian health systems. This award represents a continuation of IHS's 
efforts to implement the Zero Suicide approach in Indian Country. 
Existing efforts have focused on training, technical assistance, and 
consultation for several `pilot' AI/AN Zero Suicide communities. As a 
result of these efforts, both the unique opportunities and challenges 
of implementing Zero Suicide in Indian Country have been identified. To 
best capitalize on opportunities and surmount such challenges, this 
award focuses on the core Seven Elements of the Zero Suicide model as 
developed by the Suicide Prevention Resource Center (SPRC):
     Lead--Create a leadership-driven, safety-oriented culture 
committed to dramatically reducing suicide among people under care. 
Include survivors of suicide attempts and suicide loss in leadership 
and planning roles;
     Train--Develop a competent, confident, and caring 
workforce;
     Identify--Systematically identify and assess suicide risk 
among people receiving care;
     Engage--Ensure every individual has a pathway to care that 
is both timely and adequate to meet his or her needs. Include 
collaborative safety planning and restriction of lethal means;
     Treat--Use effective, evidence-based treatments that 
directly target suicidal thoughts and behaviors;
     Transition--Provide continuous contact and support, 
especially after acute care; and
     Improve--Apply a data-driven, quality improvement approach 
to inform system changes that will lead to improved patient outcomes 
and better care for those at risk.
    More specifically, each applicant will be required to address the 
following goals in their project narrative.
     Establishment of a leadership-driven commitment to 
transform the way suicide care is delivered within AI/AN health 
systems. Associated activities should describe the organizational steps 
to broaden the responsibility for suicide care to the entire system and 
emphasize the specific role of leadership to ensure that it is 
achieved.
     Assessment of training needs and creation of a training 
plan to develop and advance the skills of health care staff and 
providers at all levels. The aim of such trainings must target 
increased competence and confidence in the delivery of culturally 
informed, evidence-based suicide care.
     Implementation of policies and procedures for 
comprehensive clinical standards, including universal screening, 
assessment, treatment, discharge planning, follow-up, and means 
restriction for all patients under care and at risk for suicide (see 
https://www.jointcommission.org/sea_issue_56/).
     Development of strategy to collect, analyze, use, and 
disseminate data to enhance and better inform suicide care across the 
health system.
     Application of evidence-based practices to screen, assess, 
and treat individuals at risk for suicide that incorporates culturally 
informed practices and activities.
     Development of a Suicide Care Management Plan for every 
individual identified as at risk of suicide to include continuous 
monitoring of the individual's progress through their electronic health 
record (EHR) or other data management system, and adjust treatment as 
necessary. The Suicide Care Management Plan must include the following:
    [cir] Protocols for safety planning and reducing access to lethal 
means;
    [cir] Rapid follow-up of adults who have attempted suicide or 
experienced a suicidal crisis after being discharged from a treatment 
facility e.g., local emergency departments, inpatient psychiatric 
facilities, including direct linkage with appropriate health care 
agencies to ensure coordinated care services are in place;
    [cir] Protocols to ensure client safety, especially among high-risk 
adults in health care systems who have attempted suicide, experienced a 
suicidal crisis, and/or have a serious mental illness. This must 
include outreach telephone contact within 24 to 48 hours after 
discharge and securing an appointment within 1 week of discharge.
    Applicants are encouraged to visit https://zerosuicide.sprc.org to 
review the Zero Suicide strategies and tools required for this grant 
program.

[[Page 39602]]

    Because relatively few resources currently exists that promote the 
use of culturally informed practices and activities for use with 
Evidence Based Practices (EBPs) in the treatment of suicide risk, 
applicants are also encouraged to explore, develop, and catalogue 
culturally informed practices and activities, and, utilize such 
activities and practices in conjunction with EBPs where appropriate. 
Applicants are expected to include how they plan to incorporate the use 
of culturally informed practices and activities in the Project 
Narrative.
    In addition to the Web site noted above, applicants may provide 
information on research studies to show that the services/practices 
applicants plan to implement are evidence-based. This information is 
usually published in research journals, including those that focus on 
minority populations. If this type of information is not available, 
applicants may provide information from other sources, such as 
unpublished studies or documents describing formal consensus among 
recognized experts.

II. Award Information

Type of Award

    Cooperative Agreement.

Estimated Funds Available

    The total amount of funding identified for the current fiscal year 
(FY) 2018 is approximately $2,000,000. Individual award amounts are 
anticipated to be approximately $400,000. The amount of funding 
available for non-competing and continuation awards issued under this 
announcement is subject to the availability of appropriations and 
budgetary priorities of the Agency. IHS is under no obligation to make 
awards that are selected for funding under this announcement.

Anticipated Number of Awards

    Approximately five (5) awards will be issued under this program 
announcement.

Project Period

    The project period is for three years and will run consecutively 
from November 1, 2017, to October 31, 2020.

Cooperative Agreement

    Cooperative agreements awarded by the Department of Health and 
Human Services (HHS) are administered under the same policies as a 
grant. However, the funding agency (IHS) is required to have 
substantial programmatic involvement in the project during the entire 
award segment. Below is a detailed description of the level of 
involvement required for both IHS and the grantee. IHS will be 
responsible for activities listed under section A and the grantee will 
be responsible for activities listed under section B as stated.

Substantial Involvement Description for Cooperative Agreement

    IHS is interested in assessing the extent to which strategies 
employed by grantees are consistent with the Zero Suicide model, 
assessing the feasibility of implementing the Zero Suicide model in 
health care settings, and determining the outcomes associated with 
implementation. Enhanced evaluation questions may also be required of 
grantees to address these key evaluation goals.
    The following is a partial list of the level of involvement by IHS 
and other expectations of the grantee/awardee:
A. IHS Programmatic Involvement
    (1) Approve proposed key positions/personnel.
    (2) Facilitate linkages to other IHS/federal government resources 
and help grantees access appropriate technical assistance.
    (3) Assure that the grantee's projects are responsive to IHS's 
mission, specifically the implementation of Zero Suicide Initiative.
    (4) Coordinate cross-site evaluation participation in grantee and 
staff required monitoring conference calls.
    (5) Promote collaboration with other IHS and federal health and 
behavioral health initiatives, including the Substance Abuse Mental 
Health Services Administration (SAMHSA), the National Action Alliance 
for Suicide Prevention (NAASP), the National Suicide Prevention 
Lifeline (NSPLL), and the Suicide Prevention Resource Center (SPRC).
    (6) Provide technical assistance on sustainability issues.
B. Grantee/Awardee Cooperative Agreement Award Activities
    (1) Seek IHS's approval for key positions to be filled. Key 
positions include, but are not limited to, the Project Director and 
Evaluator.
    (2) Consult and accept guidance from IHS staff on performance of 
programmatic and data collection activities to achieve the goals of the 
cooperative agreement.
    (3) Maintain ongoing communication with IHS including a minimum of 
one call per month, keeping federal program staff informed of emerging 
issues, developments, and problems as appropriate.
    (4) Invite the IHS Program Official to take part in policy, 
steering, advisory, or other task forces.
    (5) Maintain ongoing collaboration with the IHS National Evaluation 
contractor, the Suicide Prevention Resource Center, and the National 
Suicide Prevention Lifeline.
    (6) Provide required documentation for monthly and annual 
reporting, and data surveillance around suicidal behavior in selected 
health and behavioral health care systems.
    The following are examples of types of direct services that could 
be provided using the award (be sure to describe your use of grant 
funds for these activities in Project Narrative):
     Hire new staff or pay for salary;
     Universal Screening of all individuals receiving care to 
identify risk of suicidal thoughts and behaviors;
     Conducting comprehensive risk assessment of individuals 
identified at risk for suicide, and ensure reassessment as appropriate;
     Implementation of effective, evidence-based treatments 
that specifically treat suicidal ideation and behaviors;
     Training of clinical staff to provide direct treatment in 
suicide prevention and evaluate individual outcomes throughout the 
treatment process;
     Training of the health care workforce in suicide 
prevention evidence-based, best-practice services relevant to their 
position, including the identification, assessment, management and 
treatment, and evaluation of individuals throughout the overall 
process;
     Ensuring that the most appropriate, least restrictive 
treatment and support is provided, including brief intervention and 
follow-up from crisis, respite and residential care, and partial or 
full hospitalization; and
     Developing protocols for every individual identified as at 
risk of suicide to continuously monitor the individual's progress 
through their electronic health record (EHR) or other data management 
system to include the following:
    [cir] Protocols for safety planning and reducing access to lethal 
means;
    [cir] Rapid follow-up of adults who have attempted suicide or 
experienced a suicidal crisis after being discharged from a treatment 
facility e.g., local emergency departments, inpatient psychiatric 
facilities, including direct linkage with appropriate health care 
agencies to ensure coordinated care services are in place; and
    [cir] Protocols to ensure client safety, especially among high-risk 
adults in health care systems who have attempted suicide, experienced a 
suicidal crisis, and/or have a serious mental illness. This must 
include outreach telephone

[[Page 39603]]

contact within 24 to 48 hours after discharge and securing an 
appointment within 1 week of discharge.
    The following are examples of types of program operations and 
development that could be provided using the award (be sure to describe 
your use of grant funds for these activities in Project Narrative):
     Hire new staff or pay for salary;
     Transforming the health system to include a leadership-
driven, safety-oriented culture committed to dramatically reducing 
suicide among people under care, and to accept and embed the Zero 
Suicide model within their agencies;
     Developing partnerships with other service providers for 
service delivery;
     Adopting and/or enhancing your computer system, management 
information system (MIS), electronic health records (EHRs), etc., to 
document and manage client needs, care process, integration with 
related support services, and outcomes;
     Training/education/workforce development to aid current 
staff or other providers in the community identify mental health or 
substance abuse issues or provide effective services consistent with 
the purpose of the grant program; and
     Developing policy(ies) 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 credentialing, licensure, or accreditation 
requirements).

III. Eligibility Information

I.

1. Eligibility

    To be eligible for this new funding opportunity under this 
announcement, an applicant must be defined as one of the following 
under 25 U.S.C. 1603:
     A Federally recognized Indian Tribe as defined by 25 
U.S.C. 1603(14).
     A Tribal organization as defined by 25 U.S.C. 1603(26).
     An urban Indian organization as defined by 25 U.S.C. 
1603(29); operating an Indian health program operated pursuant to as 
contract, grant, cooperative agreement, or compact with the IHS 
pursuant to the ISDEAA, (25 U.S.C. 5301 et seq.). Applicants must 
provide proof of non-profit status with the application, e.g., 
501(c)(3).

    Note:  Please refer to Section IV.2 (Application and Submission 
Information/Subsection 2, Content and Form of Application 
Submission) for additional proof of applicant status documents 
required, such as Tribal resolutions, proof of non-profit status, 
etc.

2. Cost Sharing or Matching

    IHS does not require matching funds or cost sharing for grants or 
cooperative agreements.

3. Other Requirements

    If application budgets exceed the highest dollar amount outlined 
under the Estimated Funds Available section within this funding 
announcement, the application will be considered ineligible and will 
not be reviewed for further consideration. If deemed ineligible, IHS 
will not return the application. The applicant will be notified by 
email by the Division of Grants Management (DGM) of this decision.
Tribal Resolution
    An Indian Tribe or Tribal organization that is proposing a project 
affecting another Indian Tribe must include Tribal resolutions from all 
affected Tribes to be served. Applications by Tribal organizations will 
not require a specific Tribal resolution if the current Tribal 
resolution(s) under which they operate would encompass the proposed 
grant activities.
    An official signed Tribal resolution must be received by the DGM 
prior to a Notice of Award (NoA) being issued to any applicant selected 
for funding. However, if an official signed Tribal resolution cannot be 
submitted with the electronic application submission prior to the 
official application deadline date, a draft Tribal resolution must be 
submitted by the deadline in order for the application to be considered 
complete and eligible for review. The draft Tribal resolution is not in 
lieu of the required signed resolution, but is acceptable until a 
signed resolution is received. If an official signed Tribal resolution 
is not received by DGM when funding decisions are made, then a NoA will 
not be issued to that applicant and they will not receive any IHS funds 
until such time as they have submitted a signed resolution to the 
Grants Management Specialist listed in this Funding Announcement.
Proof of Non-Profit Status
    Organizations claiming non-profit status must submit proof. A copy 
of the 501(c)(3) Certificate must be received with the application 
submission by the Application Deadline Date listed under the Key Dates 
section on page one of this announcement.
    An applicant submitting any of the above additional documentation 
after the initial application submission due date is required to ensure 
the information was received by the IHS DGM by obtaining documentation 
confirming delivery (i.e. FedEx tracking, postal return receipt, etc.).

IV. Application and Submission Information

1. Obtaining Application Materials

    The application package and detailed instructions for this 
announcement can be found at https://www.Grants.gov or https://www.ihs.gov/dgm/funding/. Questions regarding the electronic 
application process may be directed to Mr. Paul Gettys at (301) 443-
2114 or (301) 443-5204.

2. Content and Form Application Submission

    The applicant must include the project narrative as an attachment 
to the application package. Mandatory documents for all applicants 
include:
     Table of contents.
     Abstract (one page) summarizing the project.
     Application forms:
    [cir] SF-424, Application for Federal Assistance.
    [cir] SF-424A, Budget Information--Non-Construction Programs.
    [cir] SF-424B, Assurances--Non-Construction Programs.
     Budget Justification and Narrative (must be single-spaced 
and not exceed 5 pages).
     Project Narrative (must be single-spaced and not exceed 20 
pages).
    [cir] Background information on the organization.
    [cir] Proposed scope of work, objectives, and activities that 
provide a description of what will be accomplished, including a one-
page Timeframe Chart.
     Tribal Resolution(s).
     Letters of Support from organization's Board of Directors.
     501(c)(3) Certificate (if applicable).
     Biographical sketches for all Key Personnel.
     Contractor/Consultant resumes or qualifications and scope 
of work.
     Disclosure of Lobbying Activities (SF-LLL).
     Certification Regarding Lobbying (GG-Lobbying Form).
     Copy of current Negotiated Indirect Cost rate (IDC) 
agreement (required in order to receive IDC).
     Organizational Chart (optional).
     Documentation of current Office of Management and Budget 
(OMB) Financial Audit (if applicable).
    Acceptable forms of documentation include:
    [cir] Email confirmation from Federal Audit Clearinghouse (FAC) 
that audits were submitted; or

[[Page 39604]]

    [cir] Face sheets from audit reports. These can be found on the FAC 
Web site: https://harvester.census.gov/facdissem/Main.aspx
Public Policy Requirements
    All Federal-wide public policies apply to IHS grants and 
cooperative agreements with exception of the Discrimination policy.
Requirements for Proposal
    A. Project Narrative: This narrative should be a separate Word 
document that is no longer than 20 pages and must: be single-spaced; 
type written; have consecutively numbered pages; use black type not 
smaller than 12 points; and be printed on one side only of standard 
size 8\1/2\'' x 11'' paper.
    Be sure to succinctly answer all questions listed under the 
evaluation criteria (refer to Section V.1, Evaluation criteria in this 
announcement) and place all responses and required information in the 
correct section (noted below), or they will not be considered or 
scored. These narratives will assist the Objective Review Committee 
(ORC) in becoming familiar with the applicant's activities and 
accomplishments prior to this possible cooperative agreement award. If 
the narrative exceeds the page limit, only the first 20 pages will be 
reviewed. The 20-page limit for the narrative does not include the work 
plan, timeline, standard forms, Tribal resolutions, table of contents, 
budget, budget justifications, narratives, and/or other appendix items.
    Applicants must include the following required application 
components:
     Cover letter.
     Table of contents.
     Abstract (must be single-spaced and should not exceed one 
page).
     Project Narrative (must be single-spaced and not exceed 20 
pages total).
    [cir] Includes: Population of Focus and Statement of Need; 
Organizational Structure and Capacity; Implementation Approach; and 
Local Data Collection and Performance Measurement.
    B. Budget/Budget Narrative (Not to exceed 4 pages): This must 
include a line item budget with a narrative justification for all 
expenditures identifying reasonable allowable, allocable costs 
necessary to accomplish the goals and objectives as outlined in the 
project narrative. Budget should match the scope of work described 
above.

3. Submission Dates and Times

    Applications must be submitted electronically through Grants.gov by 
11:59 p.m. Eastern Daylight Time (EDT) on the Application Deadline Date 
listed in the Key Dates section on page one of this announcement. Any 
application received after the application deadline will not be 
accepted for processing, nor will it be given further consideration for 
funding. Grants.gov will notify the applicant via email if the 
application is rejected.
    If technical challenges arise and assistance is required with the 
electronic application process, contact Grants.gov Customer Support via 
email to support@grants.gov or at (800) 518-4726. Customer Support is 
available to address questions 24 hours a day, 7 days a week (except on 
Federal holidays). If problems persist, contact Mr. Gettys 
(Paul.Gettys@ihs.gov), DGM Grant Systems Coordinator, by telephone at 
(301) 443-2114 or (301) 443-5204. Please be sure to contact Mr. Gettys 
at least ten days prior to the application deadline. Please do not 
contact the DGM until you have received a Grants.gov tracking number. 
In the event you are not able to obtain a tracking number, call the DGM 
as soon as possible.

4. Intergovernmental Review

    Executive Order 12372 requiring intergovernmental review is not 
applicable to this program.

5. Funding Restrictions

     Pre-award costs are not allowable.
     The available funds are inclusive of direct and 
appropriate indirect costs.
     Only one grant/cooperative agreement will be awarded per 
applicant.
     IHS will not acknowledge receipt of applications.

6. Electronic Submission Requirements

    All applications must be submitted electronically. Please use the 
https://www.Grants.gov Web site to submit an application electronically 
and select the ``Search Grants'' link on the homepage. Follow the 
instructions for submitting an application under the Package tab. 
Electronic copies of the application may not be submitted as 
attachments to email messages addressed to IHS employees or offices.
    If the applicant needs to submit a paper application instead of 
submitting electronically through Grants.gov, a waiver must be 
requested. Prior approval must be requested and obtained from Mr. 
Robert Tarwater, Director, DGM, (see Section IV.6 below for additional 
information). A written waiver request must be sent to 
GrantsPolicy@ihs.gov with a copy to Robert.Tarwater@ihs.gov. The waiver 
must: (1) Be documented in writing (emails are acceptable), before 
submitting a paper application, and (2) include clear justification for 
the need to deviate from the required electronic grants submission 
process.
    Once the waiver request has been approved, the applicant will 
receive a confirmation of approval email containing submission 
instructions and the mailing address to submit the application. A copy 
of the written approval must be submitted along with the hardcopy of 
the application that is mailed to DGM. Paper applications that are 
submitted without a copy of the signed waiver from the Director of the 
DGM will not be reviewed or considered for funding. The applicant will 
be notified via email of this decision by the Grants Management Officer 
of the DGM. Paper applications must be received by the DGM no later 
than 5:00 p.m., EDT, on the Application Deadline Date listed in the Key 
Dates section on page one of this announcement. Late applications will 
not be accepted for processing or considered for funding. Applicants 
that do not adhere to the timelines for System for Award Management 
(SAM) and/or https://www.Grants.gov registration or that fail to request 
timely assistance with technical issues will not be considered for a 
waiver to submit a paper application.
    Please be aware of the following:
     Please search for the application package in https://www.Grants.gov by entering the CFDA number or the Funding Opportunity 
Number. Both numbers are located in the header of this announcement.
     If you experience technical challenges while submitting 
your application electronically, please contact Grants.gov Support 
directly at: support@grants.gov or (800) 518-4726. Customer Support is 
available to address questions 24 hours a day, 7 days a week (except on 
Federal holidays).
     Upon contacting Grants.gov, obtain a tracking number as 
proof of contact. The tracking number is helpful if there are technical 
issues that cannot be resolved and a waiver from the agency must be 
obtained.
     Applicants are strongly encouraged not to wait until the 
deadline date to begin the application process through Grants.gov as 
the registration process for SAM and Grants.gov could take up to 
fifteen working days.
     Please use the optional attachment feature in Grants.gov 
to attach additional documentation that may be requested by the DGM.
     All applicants must comply with any page limitation 
requirements described in this funding announcement.

[[Page 39605]]

     After electronically submitting the application, the 
applicant will receive an automatic acknowledgment from Grants.gov that 
contains a Grants.gov tracking number. The DGM will download the 
application from Grants.gov and provide necessary copies to the 
appropriate agency officials. Neither the DGM nor the DBH will notify 
the applicant that the application has been received.
     Email applications will not be accepted under this 
announcement.
Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS)
    All IHS applicants and grantee organizations are required to obtain 
a DUNS number and maintain an active registration in the SAM database. 
The DUNS number is a unique 9-digit identification number provided by 
D&B which uniquely identifies each entity. The DUNS number is site 
specific; therefore, each distinct performance site may be assigned a 
DUNS number. Obtaining a DUNS number is easy, and there is no charge. 
To obtain a DUNS number, you may access it through https://fedgov.dnb.com/webform, or to expedite the process, call (866) 705-
5711.
    All HHS recipients are required by the Federal Funding 
Accountability and Transparency Act of 2006, as amended (``Transparency 
Act''), to report information on sub-awards. Accordingly, all IHS 
grantees must notify potential first-tier sub-recipients that no entity 
may receive a first-tier sub-award unless the entity has provided its 
DUNS number to the prime grantee organization. This requirement ensures 
the use of a universal identifier to enhance the quality of information 
available to the public pursuant to the Transparency Act.
System for Award Management (SAM)
    Organizations that were not registered with Central Contractor 
Registration and have not registered with SAM will need to obtain a 
DUNS number first and then access the SAM online registration through 
the SAM home page at https://www.sam.gov (U.S. organizations will also 
need to provide an Employer Identification Number from the Internal 
Revenue Service that may take an additional 2-5 weeks to become 
active). Completing and submitting the registration takes approximately 
one hour to complete and SAM registration will take 3-5 business days 
to process. Registration with the SAM is free of charge. Applicants may 
register online at https://www.sam.gov.
    Additional information on implementing the Transparency Act, 
including the specific requirements for DUNS and SAM, can be found on 
the IHS Grants Management, Grants Policy Web site: https://www.ihs.gov/dgm/policytopics/.

V. Application Review Information

    The instructions for preparing the application narrative also 
constitute the evaluation criteria for reviewing and scoring the 
application. Weights assigned to each section are noted in parentheses. 
The 20-page narrative should include only the first year of activities; 
information for multi-year projects should be included as an appendix. 
See ``Multi-year Project Requirements'' at the end of this section for 
more information. The narrative section should be written in a manner 
that is clear to outside reviewers unfamiliar with prior related 
activities of the applicant. It should be well organized, succinct, and 
contain all information necessary for reviewers to understand the 
project fully. Points will be assigned to each evaluation criteria 
adding up to a total of 100 points. A minimum score of 70 points is 
required for funding. Points are assigned as follows:

1. Criteria

A. Population Focus/Statement of Need (20 points)
    The criteria in this section being evaluated includes the scope and 
scale of suicide behavior within the community served and systems 
challenges to providing comprehensive (see 7 Elements), culturally 
informed suicide care to those at risk for suicide. The following 
aspects will be assessed:
     A clear description of the proposed catchment area and 
demographic information on the population(s) to receive services 
through the targeted systems or agencies, e.g., race, ethnicity, 
Federally recognized Tribe, language, age, socioeconomic status, sex, 
and other relevant factors, such as literacy.
     Presentation of the prevalence of suicidal behavior (i.e., 
ideation, attempts, and deaths) within the population(s) of focus, 
including any current limitations of data collection in the health 
system. In addition, discuss how the proposed project will address 
disparities in access, service use, and outcomes for the population(s) 
of focus.
     Documentation of the need for an enhanced infrastructure 
(system/process improvements) to increase the capacity to implement, 
sustain, and improve comprehensive, integrated, culturally informed, 
evidence-based suicide care within the identified health care system 
that is consistent with the purpose of the program as stated in this 
announcement. This may also include a clear description of any service 
gaps, staff/provider training deficits, service delivery 
fragmentations, and other barriers that could impact comprehensive 
suicide care for patients seen in the health system.
    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 local epidemiologic data (Tribal 
Epidemiology Centers, IHS Area offices), state data (e.g., from state 
needs assessments), and/or national data (e.g., SAMHSA's National 
Survey on Drug Use and Health or from National Center for Health 
Statistics/Centers for Disease Control reports, and census data). 
Additionally, you may also submit data obtained as a result 
participating in any previous Zero Suicide model training or technical 
assistance activity (e.g., Zero Suicide Academy, Community of Learning, 
Workforce Survey, Organization Self Study, etc.). This list is not 
exhaustive; applicants may submit other valid data, as appropriate for 
the applicant's program.
B. Organizational Infrastructure/Capacity (25 points)
    This section focuses on how the organization may capitalize on 
existing resources, such as human capital, quality initiatives, 
collaborative agreements, and surveillance capabilities, as a means of 
overcoming barriers to a comprehensive, culturally informed, system of 
suicide care. The following aspects will be assessed:
     Thorough description of experience (successes and/or 
challenges) with the Zero Suicide model (e.g., attended a Zero Suicide 
Academy, etc.) or similar collaborative efforts (e.g. patient centered 
medical home, behavioral integration, trauma-informed systems, and 
improving patient care, etc.).
     Discussion of the applicant Tribe or Tribal organization 
experience with and capacity (or detailed plan) to provide culturally 
informed practices and activities for specific populations of focus.
     Identification of how all departments/units/divisions will 
be involved in administering this project. May also include how 
applicant organization currently (or plans to) collaborate with other 
organizations and agencies to provide care, including critical 
transition of care.
     Describe the resources available for the proposed project 
(e.g., facilities, equipment, information technology systems, and 
financial management

[[Page 39606]]

systems, data sharing agreement, MOUs, etc.).
     Listing of all staff positions for the project, such as 
Project Director, project coordinator, and other key personnel, showing 
the role of each and their level of effort and qualifications. 
Demonstrate successful project implementation for the level of effort 
budgeted for Project Director, Project Coordinator, and other key 
staff.
    Include position descriptions as attachments to the application for 
the Project Director, project coordinator, and all key personnel. 
Position descriptions should not exceed one page each.

    Note: Attachments will not count against the 20 page maximum.

For individuals that are currently on staff, include a biographical 
sketch (not to include personally identifiable information) for Project 
Director, project coordinator, and other key positions. Describe the 
experience of identified staff in suicide care, behavioral health & 
primary care integration, quality and process improvement, and related 
work within the community/communities. Include each biographical sketch 
as attachments to the project proposal/application. Biographical 
sketches should not exceed one page per staff member. Reviewers will 
not consider information past page one.

    Note: Attachments will not count against the 20 page maximum.

Do not include any of the following:
    [ssquf] Personally Identifiable Information;
    [ssquf] Resumes; or
    [ssquf] Curriculum Vitae.
C. Implementation Approach/Plan (30 points)
    The criteria being evaluated is the quality of your strategic 
approach and logical steps to implement a Zero Suicide Initiative 
within your health system. The following aspects will be assessed:
     A viable plan to address each of the 7 Elements in a 
systematic, measureable, and interrelated manner. Evidence of plan to 
the identification, use, and measurement of the use of culturally 
informed practices and activities. Please Include a Project Timeline as 
part of this section.
     A clear description of strategies to engage the highest 
levels of leadership and a broad cross section of the hospital system 
in order to develop organizational commitment, participation and 
sustainability (Letters of Commitment should be included as 
attachments). If the program is to be managed by a consortium or Tribal 
organization, identify how the project office relates to the member 
community/communities.
     A contingency plan that addresses short-term maintenance 
and long-term sustainability. How will continuity be maintained if/when 
there is a change in the operational environment (e.g., health care 
system leadership, staff turnover, change in project leadership, change 
in elected officials, etc.) to ensure project stability over the life 
of the grant. Additionally, describe long-term plan for sustainability 
of the ZSI model beyond the life of Cooperative Agreement project 
period.
     Describe: (a) how achievement of goals will increase the 
health system's capacity to provide timely, integrated, culturally 
informed, evidenced-based system of suicide care; (b) how project 
activities will increase the capacity of the health system to 
collaborate with community-based organizations to plan and improve the 
overall delivery of suicide care; and (c) what overall impact that the 
successful implementation of this ZSI model will have on the specific 
AI/AN community served.
     Include input of survivors of suicide attempts and suicide 
loss in assessing, planning and implementing your project.
D. Data Collection, Performance Assessment & Evaluation (20 points)
    In this area applicants need to clearly demonstrate the ability to 
collect and report on required data elements associated with Zero 
Suicide and this particular project; and engage in all aspects of local 
and national evaluation. The following aspects will be assessed:
     Ability to collect and report on the required performance 
measures specified in the Data Collection and Performance Management 
section.
     A clear, specific plan for data collection, management, 
analysis, and reporting. Indication of the staff person(s) responsible 
for tracking the measureable objectives that are identified above.
     Description of your plan for conducting the local 
performance assessment as specified above and evidence of your ability 
to conduct the assessment.
     Description of the quality improvement process that will 
be used to track progress towards your performance measures and 
objectives, and how these data will be used to inform the ongoing 
implementation of the project and beyond.
E. Categorical Budget and Budget Justification (5 points)
    Applicants must provide a budget and narrative justification for 
proposed project budget. The following aspects will be assessed:
     Evidence of reasonable, allowable costs necessary to 
achieve the objective outlined in the project narrative.
     Description of how the budget aligns with the overall 
scope of work.
     Please use Budget/Budget Narrative Template Worksheet to 
support your responses in this section.
    The Biographical Sketch, Timeline Chart, Local Data Collection Plan 
Worksheet, and Budget/Budget Narrative templates can be downloaded at 
the ZSI Web site.
Multi-Year Project Requirements
    Projects requiring a second and third year must include a brief 
project narrative and budget (one additional page per year) addressing 
the developmental plans for each additional year of the project.
Additional Documents Can Be Uploaded as Appendix Items in Grants.gov
     Work plan, logic model and/or time line for proposed 
objectives.
     Position descriptions for key staff.
     Resumes of key staff that reflect current duties.
     Consultant or contractor proposed scope of work and letter 
of commitment (if applicable).
     Current Indirect Cost Agreement.
     Organizational chart.
     Map of area identifying project location(s).
     Additional documents to support narrative (i.e. data 
tables, key news articles, etc.).

2. Review and Selection

    Each application will be prescreened by the DGM staff for 
eligibility and completeness as outlined in the funding announcement. 
Applications that meet the eligibility criteria shall be reviewed for 
merit by the ORC based on evaluation criteria in this funding 
announcement. The ORC could be composed of both Tribal and Federal 
reviewers appointed by the IHS Program to review and make 
recommendations on these applications. The technical review process 
ensures selection of quality projects in a national competition for 
limited funding. Incomplete applications and applications that are non-
responsive to the eligibility criteria will not be referred to the ORC. 
The applicant will be notified via email of this decision by the Grants 
Management Officer of the DGM. Applicants will be notified by DGM, via 
email, to outline minor missing components (i.e., budget narratives, 
audit documentation, key

[[Page 39607]]

contact form) needed for an otherwise complete application. All missing 
documents must be sent to DGM on or before the due date listed in the 
email of notification of missing documents required.
    To obtain a minimum score for funding by the ORC, applicants must 
address all program requirements and provide all required 
documentation.

VI. Award Administration Information

1. Award Notices

    The Notice of Award (NoA) is a legally binding document signed by 
the Grants Management Officer and serves as the official notification 
of the grant award. The NoA will be initiated by the DGM in our grant 
system, GrantSolutions (https://www.grantsolutions.gov). Each entity 
that is approved for funding under this announcement will need to 
request or have a user account in GrantSolutions in order to retrieve 
their NoA. The NoA is the authorizing document for which funds are 
dispersed to the approved entities and reflects the amount of Federal 
funds awarded, the purpose of the grant, the terms and conditions of 
the award, the effective date of the award, and the budget/project 
period.
Disapproved Applicants
    Applicants who received a score less than the recommended funding 
level for approval, 70, and were deemed to be disapproved by the ORC, 
will receive an Executive Summary Statement from the IHS program office 
within 30 days of the conclusion of the ORC outlining the strengths and 
weaknesses of their application. The summary statement will be sent to 
the Authorized Organizational Representative that is identified on the 
face page (SF-424) of the application. The IHS program office will also 
provide additional contact information as needed to address questions 
and concerns as well as provide technical assistance if desired.
Approved but Unfunded Applicants
    Approved but unfunded applicants that met the minimum scoring range 
and were deemed by the ORC to be ``Approved,'' but were not funded due 
to lack of funding, will have their applications held by DGM for a 
period of one year. If additional funding becomes available during the 
course of FY 2018 the approved but unfunded application may be re-
considered by the awarding program office for possible funding. The 
applicant will also receive an Executive Summary Statement from the IHS 
program office within 30 days of the conclusion of the ORC.

    Note: Any correspondence other than the official NoA signed by 
an IHS grants management official announcing to the Project Director 
that an award has been made to their organization is not an 
authorization to implement their program on behalf of IHS.

2. Administrative Requirements

    Cooperative Agreements are administered in accordance with the 
following regulations and policies:
    A. The criteria as outlined in this program announcement.
    B. Administrative Regulations for Grants:
     Uniform Administrative Requirements for HHS Awards, 
located at 45 CFR part 75.
    C. Grants Policy:
     HHS Grants Policy Statement, Revised 01/07.
    D. Cost Principles:
     Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' located at 45 CFR part 75, subpart E.
    E. Audit Requirements:
     Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' located at 45 CFR part 75, subpart F.

3. Indirect Costs

    This section applies to all grant recipients that request 
reimbursement of indirect costs (IDC) in their grant application. In 
accordance with HHS Grants Policy Statement, Part II-27, IHS requires 
applicants to obtain a current IDC rate agreement prior to award. The 
rate agreement must be prepared in accordance with the applicable cost 
principles and guidance as provided by the cognizant agency or office. 
A current rate covers the applicable grant activities under the current 
award's budget period. If the current rate is not on file with the DGM 
at the time of award, the IDC portion of the budget will be restricted. 
The restrictions remain in place until the current rate is provided to 
the DGM.
    Generally, IDC rates for IHS grantees are negotiated with the 
Division of Cost Allocation (DCA) https://rates.psc.gov/ and the 
Department of Interior (Interior Business Center) https://www.doi.gov/ibc/services/finance/indirect-Cost-Services/indian-tribes. For 
questions regarding the indirect cost policy, please call the Grants 
Management Specialist listed under ``Agency Contacts'' or the main DGM 
office at (301) 443-5204.

4. Reporting Requirements

    The grantee must submit required reports consistent with the 
applicable deadlines. Failure to submit required reports within the 
time allowed may result in suspension or termination of an active 
grant, withholding of additional awards for the project, or other 
enforcement actions such as withholding of payments or converting to 
the reimbursement method of payment. Continued failure to submit 
required reports may result in one or both of the following: (1) The 
imposition of special award provisions; and (2) the non-funding or non-
award of other eligible projects or activities. This requirement 
applies whether the delinquency is attributable to the failure of the 
grantee organization or the individual responsible for preparation of 
the reports. Per DGM policy, all reports are required to be submitted 
electronically by attaching them as a ``Grant Note'' in GrantSolutions. 
Personnel responsible for submitting reports will be required to obtain 
a login and password for GrantSolutions. Please see the Agency Contacts 
list in section VII for the systems contact information.
    The reporting requirements for this program are noted below.
A. Progress Reports
    Program progress reports are required annually, within 30 days 
after the budget period ends. These reports must include a brief 
comparison of actual accomplishments to the goals established for the 
period, a summary of progress to date or, if applicable, provide sound 
justification for the lack of progress, and other pertinent information 
as required. A final report must be submitted within 90 days of 
expiration of the budget/project period.
B. Financial Reports
    Federal Financial Report (FFR or SF-425), Cash Transaction Reports 
are due 30 days after the close of every calendar quarter to the 
Payment Management Services, HHS at https://pms.psc.gov. It is 
recommended that the applicant also send a copy of the FFR (SF-425) 
report to the Grants Management Specialist. Failure to submit timely 
reports may cause a disruption in timely payments to the organization.
    Grantees are responsible and accountable for accurate information 
being reported on all required reports: The Progress Reports and 
Federal Financial Report.
C. Federal Sub-Award Reporting System (FSRS)
    This award may be subject to the Transparency Act sub-award and 
executive compensation reporting requirements of 2 CFR part 170.
    The Transparency Act requires the OMB to establish a single 
searchable database, accessible to the public, with

[[Page 39608]]

information on financial assistance awards made by Federal agencies. 
The Transparency Act also includes a requirement for recipients of 
Federal grants to report information about first-tier sub-awards and 
executive compensation under Federal assistance awards.
    IHS has implemented a Term of Award into all IHS Standard Terms and 
Conditions, NoAs and funding announcements regarding the FSRS reporting 
requirement. This IHS Term of Award is applicable to all IHS grant and 
cooperative agreements issued on or after October 1, 2010, with a 
$25,000 sub-award obligation dollar threshold met for any specific 
reporting period. Additionally, all new (discretionary) IHS awards 
(where the project period is made up of more than one budget period) 
and where: (1) The project period start date was October 1, 2010 or 
after, and (2) the primary awardee will have a $25,000 sub-award 
obligation dollar threshold during any specific reporting period will 
be required to address the FSRS reporting.
    For the full IHS award term implementing this requirement and 
additional award applicability information, visit the DGM Grants Policy 
Web site at https://www.ihs.gov/dgm/policytopics/.
D. Compliance With Executive Order 13166 Implementation of Services 
Accessibility Provisions for All Grant Application Packages and Funding 
Opportunity Announcements
    Recipients of federal financial assistance (FFA) from HHS must 
administer their programs in compliance with federal civil rights law. 
This means that recipients of HHS funds must ensure equal access to 
their programs without regard to a person's race, color, national 
origin, disability, age and, in some circumstances, sex and religion. 
This includes ensuring your programs are accessible to persons with 
limited English proficiency. HHS provides guidance to recipients of FFA 
on meeting their legal obligation to take reasonable steps to provide 
meaningful access to their programs by persons with limited English 
proficiency. Please see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/guidance-federal-financial-assistance-recipients-title-VI/.
    The HHS Office for Civil Rights (OCR) also provides guidance on 
complying with civil rights laws enforced by HHS. Please see https://www.hhs.gov/civil-rights/for-individuals/section-1557/; and 
https://www.hhs.gov/civil-rights/. Recipients of FFA also have 
specific legal obligations for serving qualified individuals with 
disabilities. Please see https://www.hhs.gov/civil-rights/for-individuals/disability/. Please contact the HHS OCR for more 
information about obligations and prohibitions under federal civil 
rights laws at https://www.hhs.gov/ocr/about-us/contact-us/ 
or call 1-800-368-1019 or TDD 1-800-537-7697. Also note it is an HHS 
Departmental goal to ensure access to quality, culturally competent 
care, including long-term services and supports, for vulnerable 
populations. For further guidance on providing culturally and 
linguistically appropriate services, recipients should review the 
National Standards for Culturally and Linguistically Appropriate 
Services in Health and Health Care at: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53.
    Pursuant to 45 CFR 80.3(d), an individual shall not be deemed 
subjected to discrimination by reason of his/her exclusion from 
benefits limited by federal law to individuals eligible for benefits 
and services from the IHS.
    Recipients will be required to sign the HHS-690 Assurance of 
Compliance form which can be obtained from the following Web site: 
https://www.hhs.gov/sites/default/files/forms/hhs-690.pdf, and send it 
directly to the: U.S. Department of Health and Human Services, Office 
of Civil Rights, 200 Independence Ave. SW., Washington, DC 20201.
F. Federal Awardee Performance and Integrity Information System 
(FAPIIS)
    The IHS is required to review and consider any information about 
the applicant that is in the Federal Awardee Performance and Integrity 
Information System (FAPIIS) before making any award in excess of the 
simplified acquisition threshold (currently $150,000) over the period 
of performance. An applicant may review and comment on any information 
about itself that a federal awarding agency previously entered. IHS 
will consider any comments by the applicant, in addition to other 
information in FAPIIS in making a judgment about the applicant's 
integrity, business ethics, and record of performance under federal 
awards when completing the review of risk posed by applicants as 
described in 45 CFR 75.205.
    As required by 45 CFR part 75 Appendix XII of the Uniform Guidance, 
non-federal entities (NFEs) are required to disclose in FAPIIS any 
information about criminal, civil, and administrative proceedings, and/
or affirm that there is no new information to provide. This applies to 
NFEs that receive federal awards (currently active grants, cooperative 
agreements, and procurement contracts) greater than $10,000,000 for any 
period of time during the period of performance of an award/project.
Mandatory Disclosure Requirements
    As required by 2 CFR part 200 of the Uniform Guidance, and the HHS 
implementing regulations at 45 CFR part 75, effective January 1, 2016, 
the IHS must require a non-federal entity or an applicant for a federal 
award to disclose, in a timely manner, in writing to the IHS or pass-
through entity all violations of federal criminal law involving fraud, 
bribery, or gratuity violations potentially affecting the federal 
award.
    Submission is required for all applicants and recipients, in 
writing, to the IHS and to the HHS Office of Inspector General all 
information related to violations of federal criminal law involving 
fraud, bribery, or gratuity violations potentially affecting the 
federal award. 45 CFR 75.113.
    Disclosures must be sent in writing to:

U.S. Department of Health and Human Services, Indian Health Service, 
Division of Grants Management, ATTN: Robert Tarwater, Director, 5600 
Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, (Include 
``Mandatory Grant Disclosures'' in subject line), Office: (301) 443-
5204, Fax: (301) 594-0899, Email: Robert.Tarwater@ihs.gov;
AND
U.S. Department of Health and Human Services, Office of Inspector 
General, ATTN: Mandatory Grant Disclosures, Intake Coordinator, 330 
Independence Avenue SW., Cohen Building, Room 5527, Washington, DC 
20201, URL: https://oig.hhs.gov/fraud/report-fraud/index.asp, (Include 
``Mandatory Grant Disclosures'' in subject line), Fax: (202) 205-0604 
(Include ``Mandatory Grant Disclosures'' in subject line) or Email: 
MandatoryGranteeDisclosures@oig.hhs.gov.

    Failure to make required disclosures can result in any of the 
remedies described in 45 CFR 75.371. Remedies for noncompliance, 
including suspension or debarment (See 2 CFR parts 180 & 376 and 31 
U.S.C. 3321).

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: Sean 
Bennett, LCSW, BCD, Public Health Advisor, Division of Behavioral 
Health, 5600 Fishers Lane, Mail Stop: 08N34, Rockville, MD 20857, 
Telephone: (301)

[[Page 39609]]

443-0104, Fax: (301) 443-5610, Email: Sean.Bennett@ihs.gov.
    2. Questions on grants management and fiscal matters may be 
directed to: Andrew Diggs, 5600 Fishers Lane, Mail Stop: 09E70, 
Rockville, MD 20857, Phone: (301) 443-2241, Fax: (301) 594-0899, Email: 
Andrew.Diggs@ihs.gov.
    3. Questions on systems matters may be directed to: Paul Gettys, 
Grant Systems Coordinator, 5600 Fishers Lane, Mail Stop: 09E70, 
Rockville, MD 20857, Phone: (301) 443-2114; or the DGM main line (301) 
443-5204, Fax: (301) 594-0899, EMail: Paul.Gettys@ihs.gov.

VIII. Other Information

    The Public Health Service strongly encourages all cooperative 
agreement and contract recipients to provide a smoke-free workplace and 
promote the non-use of all tobacco products. In addition, Public Law 
103-227, the Pro-Children Act of 1994, prohibits smoking in certain 
facilities (or in some cases, any portion of the facility) in which 
regular or routine education, library, day care, health care, or early 
childhood development services are provided to children. This is 
consistent with the HHS mission to protect and advance the physical and 
mental health of the American people.

    Dated: August 12, 2017.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Acting 
Director, Indian Health Service.
[FR Doc. 2017-17599 Filed 8-18-17; 8:45 am]
 BILLING CODE 4165-16-P