Division of Behavioral Health; Office of Clinical and Preventive Services; Behavioral Health Integration Initiative (BH2I), 37869-37877 [2017-17103]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 82, Number 155 (Monday, August 14, 2017)]
[Notices]
[Pages 37869-37877]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-17103]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Division of Behavioral Health; Office of Clinical and Preventive 
Services; Behavioral Health Integration Initiative (BH2I)

    Announcement Type: New.

[[Page 37870]]

    Funding Announcement Number: HHS-2017-IHS-BH2I-0001.
    Catalog of Federal Domestic Assistance Number: 93.933.

Key Dates

    Application Deadline Date: September 16, 2017.
    Review Date: September 18, 2017.
    Earliest Anticipated Start Date: September 30, 2017.
    Signed Tribal Resolutions Due Date: September 16, 2017.
    Proof of Non-Profit Status Due Date: September 16, 2017.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) Office of Clinical and Preventative 
Services, Division of Behavioral Health, is accepting applications for 
its Behavioral Health Integration Initiative (Short Title: BH2I) to 
plan, develop, implement, and evaluate behavioral health integration 
with primary care, community based settings, and/or integrating primary 
care, nutrition, diabetes care, and chronic disease management with 
behavioral health. This program is authorized under: The Snyder Act, 25 
U.S.C. 13, and 25 U.S.C. 1665j. This program is described in the 
Catalog of Federal Domestic Assistance (CFDA) under 93.933.

Background

    IHS supports changing the paradigm of mental health and substance 
use disorder services from being episodic, fragmented, specialty, and/
or disease focused to incorporating it into the patient-centered home 
model. Research has shown that more than 70 percent of primary care 
visits stem from behavioral health issues. Depression is the most 
common type of mental illness, currently affecting more than a quarter 
of the U.S. adult population. With major depression currently the 
second leading cause of disability, it is clear that primary care 
settings have become an important access point for addressing both 
physical and behavioral health care needs. In addition, American Indian 
and Alaska Native (AI/AN) communities experience alarming rates of 
suicide, alcohol and drug-related deaths, domestic and sexual violence, 
and homicide. Describing the burden of trauma within any population is 
difficult, however indicators in terms of socially destructive 
behaviors are often used to illustrate this public health issue that 
creates impact through lifespan accumulation and chronic stress. 
Studies now indicate that resulting trauma from such events can even be 
passed from one generation to the next, resulting in intergenerational 
and historical trauma. While mental health needs can often go untreated 
and even unnoticed, the lasting effects of childhood trauma into 
adulthood is often evident in physical manifestations leading to 
negative health consequences. These extreme disparities highlight an 
urgent need for improving access to mental health services in primary 
care for children and families through the integration of behavioral 
health services, including trauma-informed care, within primary care 
settings. In addition, recognizing that behavioral and physical health 
problems are interwoven, delivery of behavioral health services in 
primary care settings reduces stigma and discrimination, and the 
majority of people with behavioral health disorders treated within an 
integrated primary care setting have improved outcomes.

Purpose

    The purpose of the Behavioral Health Integration Initiative (BH2I) 
grant opportunity is to improve the physical and mental health status 
of people with behavioral health issues by developing an integrative, 
coordinated system of care between behavioral health and primary care 
providers. This effort supports the IHS mission to raise the physical, 
mental, social and spiritual health of AI/ANs to the highest level. 
Increasing capacity among IHS, Tribal, and Urban Indian Organization 
(I/T/U) health facilities to implement an integrative approach in the 
delivery of behavioral health services, including trauma-informed care, 
nutrition, exercise, social, spiritual, cultural, and primary care 
services will improve morbidity and mortality outcomes among the AI/AN 
population. In addition, this effort will support activities that 
address improving the quality of life for individuals suffering from 
mental illness, substance use disorders, and adverse childhood 
experiences. Other outcomes related to this effort include improved 
behavioral health services that will increase access to integrated 
health and social well-being services and the early identification and 
intervention of mental health, substance use, and serious physical 
health issues, including chronic disease. This work will also identify 
and assess various models addressing unique integrative needs and the 
challenges, barriers and successes in AI/AN health systems. Finally, an 
improvement in the overall health of patients participating in 
integrative programs is expected.
    For this grant, the full spectrum of behavioral health services are 
strongly encouraged and are defined as: Screening for mental and 
substance use disorders, including serious mental illness; alcohol, 
substance, and opioid use disorders; suicidality and trauma (e.g., 
interpersonal violence, physical abuse, adverse childhood experiences) 
assessment, including risk assessment and diagnosis; patient-centered 
treatment planning, evidence based outpatient mental and substance use 
disorder treatment services (including pharmacological and psychosocial 
services); crisis services; peer support services; and care 
coordination.

Models of Care

    IHS understands unique challenges and circumstances exist across 
Tribal communities and sites. In fact, integrative models of care vary 
according to needs and capabilities but all strive to enhance clinical 
processes and workflow across multi-disciplinary teams. This grant will 
support sites that have identified gaps in services and established 
efforts that moved toward linking those critical connections, including 
those with new and innovative ways of conducting business between 
differing management of operations between Federal and Tribal health 
services.

II. Award Information

    Type of Award: Grant.

Estimated Funds Available

    The total amount of funding identified for the current fiscal year 
(FY) 2017 is approximately $6,000,000. Individual award amounts are 
anticipated to be $500,000. The amount of funding available for 
competing awards issued under this announcement are 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 12 awards will be issued under this notice of funding 
opportunity announcement.

Project Period

    The project period will be for three years and will run 
consecutively from September 30, 2017, to September 29, 2020.

[[Page 37871]]

III. Eligibility Information

I.

1. Eligibility

    To be eligible for this New Funding Opportunity under this 
announcement, an applicant must be one of the following as defined by 
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); a nonprofit corporate body situated in an urban center, 
governed by an Urban Indian controlled board of directors, and 
providing for the maximum participation of all interested Indian groups 
and individuals, which body is capable of legally cooperating with 
other public and private entities for the purpose of performing the 
activities described in 25 U.S.C. 1653(a). 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

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

3. Other Requirements

    If application budgets exceeds the award 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 Notice 
of Award 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.
     Project Narrative (must be single-spaced and not exceed 12 
pages).
    [cir] Statement of need, program planning and implementation 
approach, staff and organizational capacity, performance assessment and 
data, and evaluation plan.
     Budget, Budget Justification and Narrative (must be 
single-spaced and not exceed four pages).
     Tribal Resolution(s).
     Letter(s) of Support:
    [cir] For all applicants: Local organizational partners;
    [cir] For all applicants: Community partners;
    [cir] For Tribal organizations and UIOs: From the board of 
directors (or relevant equivalent);
     501(c)(3) Certificate (if applicable).
     Biographical sketches for all Key Personnel (e.g., project 
coordinator etc.).
     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
    [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 Project and Budget Narratives
A. Project Narrative (12 pages)
    The project narrative (Parts A through E listed below) should be in 
a separate Word document that should not exceed 12 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 address all items listed under the evaluation 
criteria section (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

[[Page 37872]]

becoming familiar with the applicant's activities and accomplishments 
prior to this possible grant award. If the narrative exceeds the page 
limit, only the first 12 pages will be reviewed. The 12-page limit for 
the narrative does not include the table of contents, abstract, 
standard forms, Tribal resolutions, budget, budget justification 
narrative, and/or other appendix items.
    There are five (5) parts to the project narrative:
    Part A--Statement of Need;
    Part B--Program Planning and Implementation Approach;
    Part C--Staff and Organization Capacity;
    Part D--Performance Assessment and Data; and
    Part E--Evaluation Plan.
    Below are additional details about what must be included in the 
project narrative.
Part A: Statement of Need (2 pages)
    The statement of need describes the current situation in the 
applicant's Tribal community (``community'' means the applicant's 
Tribe, village, Tribal organization, or consortium of Tribes or Tribal 
organizations). The statement of need provides the facts and evidence 
that support the need for the project and establishes that the Tribe, 
Tribal organization, or UIO understands the problems and can reasonably 
address them. The statement of need must not exceed two single-spaced 
pages.
     Describe the community and priority population for your 
program including the patients or participants that you expect to serve 
and the reasons integrated behavioral health and primary care services 
are needed.
     Describe current behavioral health and/or primary care 
services in place along with challenges and gaps to provide integrated 
behavioral health/primary care services to individuals.
     Explain how the BH2I can improve or enhance the current 
systems in place.
Part B: Program Planning and Implementation Approach (5 pages)
     State the purpose, goals and objectives of your proposed 
project.
     Describe evidence-based programs, services or practices 
proposed for implementation, or will continue implementation through 
support of this grant opportunity.
     Describe your current level of behavioral health 
integration (using the SAMHSA-HRSA Center for Integrated Health 
Solutions six-level framework (https://www.integration.samhsa.gov/integrated-care-models/A_Standard_Framework_for_Levels_of_Integrated_Healthcare.pdf) and 
forecast how you will progress to higher levels of health integration.
     Describe your plan to formally integrate behavioral health 
through:
    [cir] Improving workflow in the assessment of behavioral health in 
primary care such as screenings, referral, and policy development.
    [cir] Health information technology changes or improvements that 
facilitate behavioral health integration
    [cir] Improving physical environment barriers in the delivery of 
integrated health care
    [cir] Cross training staff, including psycho-education training for 
staff within primary care settings and basic medical education for 
behavioral health staff.
    [cir] Establishing formal and informal channels of communication 
that facilitates behavioral health integration.
    [cir] Describe how you will identify those individuals during the 
screening process who may indicate opioid and/or alcohol use disorders 
and how you will refer them to Medication-Assisted Treatment (MAT)-
qualified specialty treatment providers.
Part C: Staff and Organization Capacity (2 pages)
    This section should describe applicant agency organization and 
structure and the capabilities possessed to complete proposed 
activities. This grant opportunity will focus on applicants and the 
applicant's ability to implement a formalized integration plan focused 
on the enhancing the clinical processes for patient care among the IHS 
service areas.
     Identify qualified professionals who will implement 
proposed grant activities, administer the grant, including progress and 
financial reports or provide salary costs for the addition of full-time 
equivalent (FTE) licensed behavioral health provider(s).
     Describe the organization's current system of providing at 
least one service of primary care and/or behavioral health, including 
screening, assessment, and care management. The primary applicant must 
directly deliver, operate, and/or manage at least one portion of direct 
primary care or behavioral health treatment services.
     Describe the organization's plan to hire full-time 
equivalent (FTE) licensed behavioral health provider(s).
Part D: Performance Assessment and Data (2 pages)
    This section of the application should describe efforts to collect 
and report project data that will support and demonstrate BH2I 
activities. BH2I grantees will be required to collect and report data 
pertaining to activities, processes and outcomes. Data collection 
activities should capture and document actions conducted throughout 
awarded years including those that will contribute relevant project 
impact.
     Describe specific data collection efforts that will be 
required as part of the EBP, or proposed evidence-based projects.
     Describe data collection process and workflow that will 
assist in completing progress and evaluation requirements.
     Explain proposed efforts to utilize health technology 
including accessibility, collection and monitoring of relevant data for 
proposed BH2I project.
Part E: Evaluation Plan (1 page)
    The evaluation section should describe applicant's plan to evaluate 
program activities. The evaluation plan should describe expected 
results and any identified metrics to support program effectiveness. 
Evaluation plans should incorporate questions related to outcomes and 
process including documentation of lessons learned.
     Describe proposed evaluation methods including performance 
measures and other data relevant to evaluation outcomes including 
intended results (i.e., impact and outcomes), including any partners 
who will conduct evaluation if separate from the primary applicant.
     Describe efforts to monitor improvements through the 
evaluation of increased coordination of care, co-located care, and 
integrated care with reference to the SAMHSA-HRSA Center for Integrated 
Health Solutions framework at https://www.integration.samhsa.gov/integrated-care-models/CIHS_Framework_Final_charts.pdf.
B. Budget Narrative (4 pages)
    This narrative 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 in the project narrative. The budget and budget 
narrative should not exceed 4 pages.

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

[[Page 37873]]

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 ``Find Grant Opportunities'' 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.
     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

[[Page 37874]]

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 12 page project narrative should include only the first budget 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 65 points is required for funding. Points are assigned as follows:

1. Evaluation Criteria

    Applications will be reviewed and scored according to the quality 
of responses to the required application components in Sections A-F 
outlined below. In developing the required sections of this 
application, use the instructions provided for each section, which have 
been tailored to this program. The application must use the six 
sections (Sections A-F) in developing the application. The applicant 
must place the required information in the correct section or it will 
not be considered for review. The application will be scored according 
to how well the applicant addresses the requirements for each section 
listed below. The number of points after each section heading is the 
maximum number of points the review committee may assign to that 
section. Although scoring weights are not assigned to individual 
bullets, each bullet is assessed deriving the overall section score.
A. Statement of Need (25 points)
     The degree to which the applicant's description of the 
service area/target population demonstrates the need for new/increased 
integrated primary health care/behavioral health services.
     How well the applicant describes the unique 
characteristics of the service area and population that impact access 
to or utilization of behavioral health care.
     How well the applicant describes existing behavioral 
health care providers in the service area, including identified gaps in 
behavioral health care services that the applicant can address via BH2I 
funds.
B. Program Planning and Implementation Approach (25 points)
     The degree to which the applicant's purpose, goals and 
objectives of proposed project will address the mental and physical 
health needs through integrated an approach between primary health 
care/behavioral health services.
     How well the applicant describes the evidence-based 
practices, practice-based evidence, promising practices and 
intervention efforts, including culturally appropriate services and 
interventions, to produce meaning and relevant results including 
additional detail to support evidence of effectiveness will support 
proposed project.
     How well the applicant describes their current level of 
behavioral health integration (using the SAMHSA-HRSA Center for 
Integrated Health Solutions framework at https://www.integration.samhsa.gov/integrated-care-models/CIHS_Framework_Final_charts.pdf) and forecasts how they will progress 
to higher levels of health integration.
     How well the applicant describe their plan to formally 
integrate behavioral health through:
    [cir] Improving workflow in the assessment of behavioral health in 
primary care such as screenings, referral, and policy development.
    [cir] Health information technology changes or improvements that 
facilitate behavioral health integration.
    [cir] Improving physical environment barriers in the delivery of 
integrated health care.
    [cir] Cross training staff, including psycho-education training for 
staff within primary care settings and basic medical education for 
behavioral health staff.
    [cir] Establishing formal and informal channels of communication 
that facilitates behavioral health integration.
    [cir] How well the applicant describes how they will identify those 
individuals during the screening process who may indicate opioid and/or 
alcohol use disorders and how they will refer them to Medication-
Assisted Treatment (MAT)-qualified specialty treatment providers.
C. Staff and Organizational Capacity (20 points)
     The degree to which the applicant describes the 
organization's current system of providing at least one service of 
primary care and/or behavioral health, including screening, assessment, 
and care management. Does the applicant directly deliver, operate, and/
or manage at least one portion of direct primary care or behavioral 
health treatment services?
     How well does the applicant identify qualified 
professionals who will implement proposed grant activities, administer 
the grant, including completion and submission of progress and 
financial reports, and how project continuity will be maintained if/
when there is a change in the operational environment (e.g., staff 
turnover, change in project leadership) to ensure project stability 
over the life of the grant.
     The degree to which the applicant describes the 
organization's plan to hire full-time equivalent (FTE) licensed 
behavioral health provider(s).
     For individuals that are identified and currently on 
staff, include a biographical sketch for the project director, project 
coordinator, and other key positions as attachments to the project 
proposal/application. Each biographical sketch should not exceed one 
page. [Note: Attachments will not count against the 12 page maximum]. 
Do not include any of the following:
    [ssquf] Personally Identifiable Information;
    [ssquf] Resumes; or
    [ssquf] Curriculum Vitae.
D. Performance Assessment & Data (10 points)
     How well does the applicant describe plans for data 
collection, management, analysis and reporting for integration 
activities.
     The degree to which the applicant lists expected data 
collection efforts that will be required as part of the EBP, or 
proposed evidence-based projects.
     How well does the applicant explain proposed efforts to 
utilize health information technology including accessibility, 
collection and monitoring of relevant data for proposed BH2I project.
     The degree to which the applicant discusses evaluation 
methods (including expertise and tools) that will be used to assess 
impacts and outcomes.
E. Evaluation Plan (10 points)
     How well did the applicant propose methods including 
quantitative and qualitative tools and resources, including techniques 
that will be utilized to measure outcomes, and partners who will 
conduct evaluation if separate from the primary applicant.
     The degree to which the applicant describes performance 
measures and other data relevant to evaluation

[[Page 37875]]

outcomes including intended results (i.e., impact and outcomes).
     The degree to which the applicant discusses how expected 
results will be measured (define indicators or measures that will be 
used to monitor and measure progress).
     The degree to which the applicant describes a plan to 
monitor improvements through the evaluation of increased coordinated 
care, co-located care, and integrated care using the SAMHSA-HRSA Center 
for Integrated Health Solutions six-level framework (https://www.integration.samhsa.gov/integrated-care-models/A_Standard_Framework_for_Levels_of_Integrated_Healthcare.pdf.)
F. Categorical Budget and Budget Justification (10 points)
    This narrative 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 in the project narrative. The budget and budget 
narrative should not exceed 4 pages.
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 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 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, 65 points, 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 2017 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

    Grants 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

[[Page 37876]]

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 to be submitted annually, 
within 30 days after the budget period ends. Progress reports will 
include a set of standard questions that will be provided to each 
grantee. Additional information for reporting and associated 
requirements will be in the ``Programmatic Terms and Conditions'' in 
the official Notice of Award, if funded.
    A final program progress report must be submitted within 90 days of 
expiration of the budget/project period at the end of the grant funding 
cycle.
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 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, Notice of Funding Opportunities 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/civil-rights/ 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.
E. 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

[[Page 37877]]

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: Miranda 
Carman, Public Health Advisor, Mental Health Lead, Division of 
Behavioral Health, 5600 Fishers Lane, Mail Stop 08N34A, Rockville, MD 
20857, Phone: (301) 443-2038, Fax: (301) 594-6213, Email: 
Miranda.Carman@ihs.gov.
    2. Questions on grants management and fiscal matters may be 
directed to: Willis Grant, Senior Grants Management Specialist, 5600 
Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, Phone: (301) 443-
5204, Fax: (301) 594-0899, Email: Willis.Grant@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 8, 2017.
Michael D. Weahkee,
Assistant Surgeon General, U.S. Public Health Service, Acting Director, 
Indian Health Service.
[FR Doc. 2017-17103 Filed 8-11-17; 8:45 am]
 BILLING CODE 4165-16-P