Behavioral Health Integration Initiative, 60867-60875 [2021-24040]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 86, Number 211 (Thursday, November 4, 2021)]
[Notices]
[Pages 60867-60875]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-24040]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Behavioral Health Integration Initiative

    Announcement Type: New.
    Funding Announcement Number: HHS-2022-IHS-BH2I-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.654.

Key Dates

    Application Deadline Date: February 2, 2022.
    Earliest Anticipated Start Date: March 21, 2022.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for 
grants for the Behavioral Health Integration Initiative (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; the Transfer Act, 42 U.S.C. 2001(a); and the Indian Health 
Care Improvement Act, Subchapter V-A (Behavioral Health Programs), 25 
U.S.C. 1665 et seq. This program is described in the Assistance 
Listings located at https://sam.gov/content/home (formerly known as the 
CFDA) under 93.654.

Background

    The IHS supports changing the paradigm of mental health and 
substance use disorder to the patient-centered home model from the 
episodic, fragmented, specialty, and/or disease focused former models. 
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 
United States (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

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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 measuring socially destructive behaviors 
are often used to illustrate impacts of trauma through lifespan 
accumulation and chronic stress. Studies now indicate that trauma can 
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 are 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. The majority of people with behavioral health 
disorders treated within an integrated primary care setting have 
improved outcomes because behavioral and physical health problems are 
interwoven, and the delivery of behavioral health services in primary 
care settings reduces stigma and discrimination often associated with 
seeking help for behavioral health disorders.

Purpose

    The purpose of the BH2I program is to improve the physical and 
mental health status of people with behavioral health issues by 
developing an integrated and coordinated system of care. This effort 
supports the IHS mission to raise the physical, mental, social, and 
spiritual health of AI/AN individuals to the highest level. Increasing 
capacity among Tribal and Urban Indian Organization (UIO) 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 to improve 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 to 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

    The 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 
program will support sites that have identified gaps in services and 
established efforts to link critical policy and service-level 
connections, including new and innovative ways of conducting business 
between differing management and operations of Federal and Tribal 
health services and programs. In addition, participants can expect to 
use technologies that facilitate behavioral health integration 
including technology that increases the site's ability to create a 
patient registry; document current procedural terminology (CPT) codes; 
and track behavioral health assessment scores with the capacity to 
provide care coordination between the behavioral health and primary 
care team.

Additional Required Activity

    Grantees must plan to send a minimum of two people (including the 
project director) to at least one joint grantee meeting in every other 
year of the period of performance. For this grant cohort, grantee 
meetings will likely be held in years one, three, and five of the 
period of performance. You must include a detailed budget and narrative 
for this travel in your budget. At these meetings, grantees will 
present the results of their projects and Federal staff will provide 
technical assistance. Each meeting will be up to three days. These 
meetings are usually held in the Washington, DC, area and attendance is 
mandatory. The IHS reserves the right to hold these grantee meetings 
through virtual/remote teleconference if the IHS budget or travel 
restrictions are prohibitive for holding an in-person meeting.

II. Award Information

Type of Award--Grant

Estimated Funds Available
    The total funding identified for fiscal year (FY) 2022 is 
approximately $6,000,000. Individual award amounts for the first budget 
year are anticipated to be between $300,000 and $400,000. The funding 
available for competing and subsequent continuation awards issued under 
this announcement is subject to the availability of appropriations and 
budgetary priorities of the agency. The IHS is under no obligation to 
make awards that are selected for funding under this announcement.
Anticipated Number of Awards
    Approximately 15 awards will be issued under this program 
announcement, with a set aside of up to two awards issued to eligible 
UIOs.
Period of Performance
    The period of performance is for 5 years.

III. Eligibility Information

1. Eligibility

    To be eligible for this funding opportunity 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). The term ``Indian Tribe'' means any Indian Tribe, 
band, nation, or other organized group or community, including any 
Alaska Native village or group, or regional or village corporation as 
defined in or established pursuant to the Alaska Native Claims 
Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.], which is 
recognized as eligible for the special programs and services provided 
by the United States to Indians because of their status as Indians.
     A Tribal organization as defined by 25 U.S.C. 1603(26). 
The term ``Tribal organization'' has the meaning given the term in 
section 4 of the Indian Self-Determination and Education Assistance Act 
(25 U.S.C. 5304(l)): ``Tribal organization'' means the recognized 
governing body of any Indian Tribe; any legally established 
organization of Indians which is

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controlled, sanctioned, or chartered by such governing body or which is 
democratically elected by the adult members of the Indian community to 
be served by such organization and which includes the maximum 
participation of Indians in all phases of its activities: Provided 
that, in any case where a contract is let or grant made to an 
organization to perform services benefiting more than one Indian Tribe, 
the approval of each such Indian Tribe shall be a prerequisite to the 
letting or making of such contract or grant. Applicant shall submit 
letters of support and/or Tribal Resolutions from the Tribes to be 
served.
     An Urban Indian organization, as defined by 25 U.S.C. 
1603(29). The term ``Urban Indian organization'' means 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 nonprofit status with 
the application, e.g., 501(c)(3).
    The program office will notify any applicants deemed ineligible.

    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 nonprofit 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

    Applications with budget requests that exceed the highest dollar 
amount outlined under Section II Award Information, Estimated Funds 
Available, or exceed the period of performance outlined under Section 
II Award Information, Period of Performance, are considered not 
responsive and will not be reviewed. The Division of Grants Management 
(DGM) will notify the applicant.

Additional Required Documentation

Tribal Resolution
    The DGM must receive an official, signed Tribal Resolution prior to 
issuing a Notice of Award (NoA) to any applicant selected for funding. 
An Indian Tribe or Tribal organization that is proposing a project 
affecting another Indian Tribe must include resolutions from all 
affected Tribes to be served. However, if an official, signed Tribal 
Resolution cannot be submitted with the application prior to the 
application deadline date, a draft Tribal Resolution must be submitted 
with the application by the deadline date 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 application 
without a signed Tribal Resolution is selected for funding, the 
applicant will be contacted by the Grants Management Specialist (GMS) 
listed in this funding announcement and given 90 days to submit an 
official, signed Tribal Resolution to the GMS. If the signed Tribal 
Resolution is not received within 90 days, the award will be forfeited.
    Tribes organized with a governing structure other than a Tribal 
council may submit an equivalent document commensurate with their 
governing organization.
Proof of Nonprofit Status
    Organizations claiming nonprofit status must submit a current copy 
of the 501(c)(3) Certificate with the application.

IV. Application and Submission Information

1. Obtaining Application Materials

    The application package and detailed instructions for this 
announcement are available at https://www.Grants.gov.
    Please direct questions regarding the application process to Mr. 
Paul Gettys at (301) 443-2114 or (301) 443-5204.

2. Content and Form Application Submission

    Mandatory documents for all applicants include:
     Abstract (one page) summarizing the project.
     Application forms:
    1. SF-424, Application for Federal Assistance.
    2. SF-424A, Budget Information--Non-Construction Programs.
    3. SF-424B, Assurances--Non-Construction Programs.
     Project Narrative (not to exceed 17 pages). See Section 
IV.2.A, Project Narrative for instructions.
    1. Background information on the organization.
    2. Proposed scope of work, objectives, and activities that provide 
a description of what the applicant plans to accomplish.
     Budget Justification and Narrative (not to exceed four 
pages). See Section IV.2.B, Budget Narrative for instructions.
     Tribal Resolution(s).
     Letter(s) of Support:
    1. For all applicants: From local organizational partners;
    2. For all applicants: From community partners;
    3. 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.
     Contractor/Consultant resumes or qualifications and scope 
of work.
     Disclosure of Lobbying Activities (SF-LLL), if applicant 
conducts reportable lobbying.
     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:
    1. Email confirmation from Federal Audit Clearinghouse (FAC) that 
audits were submitted; or
    2. Face sheets from audit reports. Applicants can find these on the 
FAC website at https://harvester.census.gov/facdissem/Main.aspx.
Public Policy Requirements
    All Federal public policies apply to IHS grants and cooperative 
agreements. Pursuant to 45 CFR 80.3(d), an individual shall not be 
deemed subjected to discrimination by reason of their exclusion from 
benefits limited by Federal law to individuals eligible for benefits 
and services from the IHS. See https://www.hhs.gov/grants/grants/grants-policies-regulations/.
Requirements for Project and Budget Narratives
A. Project Narrative
    This narrative should be a separate document that is no more than 
17 pages and must: (1) Have consecutively numbered pages; (2) use black 
font 12 points or larger; (3) be single-spaced; and (4) be formatted to 
fit standard letter paper (8\1/2\ x 11 inches).
    Be sure to succinctly answer all questions listed under the 
evaluation criteria (refer to Section V.1, Evaluation Criteria) and 
place all responses and required information in the correct section 
noted below or they will not be

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considered or scored. If the narrative exceeds the page limit, the 
application will be considered not responsive and will not be reviewed. 
The 17-page limit for the narrative does not include the work plan, 
standard forms, Tribal Resolutions, budget, budget justifications, 
narratives, and/or other items.
    There are five 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.

    See below for additional details about what must be included in the 
narrative.
Part A: Statement of Need (Limit--2 Pages)
    Describe 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). Provide 
the facts and evidence that support the need for the project, and that 
establish the Tribe, Tribal organization, or UIO understands the 
problems and can reasonably address them.
Part B: Program Planning and Implementation Approach (Limit--9 Pages)
     State the purpose, goals, and objectives of your proposed 
project.
     Describe evidence-based programs, services, or practices 
you propose to implement, or to continue to implement through support 
of this grant opportunity.
     Describe your plan to formally integrate behavioral health 
through your health care system.
Part C: Staff and Organization Capacity (Limit--2 Pages)
    This section should describe the applicant's organization and 
structure and the capabilities possessed to complete proposed 
activities. This program will focus on the applicant's ability to 
implement a formalized integration plan focused on enhancing the 
clinical processes for patient care among the IHS service areas.
     Identify a program director who will implement proposed 
grant activities and 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).
Part D: Performance Assessment and Data (Limit--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.
Part E: Evaluation Plan (Limit--2 Pages)
    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 
processes including documentation of lessons learned.
     Describe efforts to monitor improvements through the 
evaluation of the following:
    1. Implementation team.
    2. Partnerships to achieve goals.
    3. Sustainability.
    4. Level of integration.
    5. Measurement-based screening tools.
    6. Patient tracking system.
B. Budget Narrative (Limit--4 Pages)
    Provide a budget narrative that explains the amounts requested for 
each line item of the budget from the SF-424A (Budget Information for 
Non-Construction Programs). The budget narrative can include a more 
detailed spreadsheet than is provided by the SF-424A. The budget 
narrative should specifically describe how each item will support the 
achievement of proposed objectives. Be very careful about showing how 
each item in the ``Other'' category is justified. For subsequent budget 
years (see Multi-Year Project Requirements in Section V.1, Application 
Review Information, Evaluation Criteria), the narrative should 
highlight the changes from year one or clearly indicate that there are 
no substantive budget changes during the period of performance. Do NOT 
use the budget narrative to expand the project narrative.

3. Submission Dates and Times

    Applications must be submitted through Grants.gov by 11:59 p.m. 
Eastern Time on the Application Deadline Date. Any application received 
after the application deadline will not be accepted for review. 
Grants.gov will notify the applicant via email if the application is 
rejected.
    If technical challenges arise and assistance is required with the 
application process, contact Grants.gov Customer Support (see contact 
information at https://www.grants.gov). If problems persist, contact 
Mr. Paul Gettys ([email protected]), Acting Director, DGM, 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.
    The IHS will not acknowledge receipt of applications.

4. Intergovernmental Review

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

5. Funding Restrictions

     Pre-award costs are allowable up to 90 days before the 
start date of the award provided the costs are otherwise allowable if 
awarded. Pre-award costs are incurred at the risk of the applicant.
     The available funds are inclusive of direct and indirect 
costs.
     Only one grant will be awarded per applicant.

6. Electronic Submission Requirements

    All applications must be submitted via Grants.gov. Please use the 
https://www.Grants.gov website to submit an application. Find the 
application by selecting the ``Search Grants'' link on the homepage. 
Follow the instructions for submitting an application under the Package 
tab. No other method of application submission is acceptable.
    If the applicant cannot submit an application through Grants.gov, a 
waiver must be requested. Prior approval must be requested and obtained 
from Mr. Paul Gettys, Acting Director, DGM. A written waiver request 
must be sent to [email protected] with a copy to 
[email protected]. The waiver request must: (1) Be documented in 
writing (emails are acceptable) before submitting an application by 
some other method; and (2) include clear justification for the need to 
deviate from the required application submission process.
    Once the waiver request has been approved, the applicant will 
receive a confirmation of approval email containing submission 
instructions. A copy of the written approval must be included with the 
application that is submitted to the DGM. Applications that are 
submitted without a copy of the signed waiver from the Acting Director

[[Page 60871]]

of the DGM will not be reviewed. The Grants Management Officer of the 
DGM will notify the applicant via email of this decision. Applications 
submitted under waiver must be received by the DGM no later than 5:00 
p.m. Eastern Time on the Application Deadline Date. Late applications 
will not be accepted for processing. Applicants that do not register 
for both the System for Award Management (SAM) and Grants.gov and/or 
fail to request timely assistance with technical issues will not be 
considered for a waiver to submit an application via alternative 
method.
    Please be aware of the following:
     Please search for the application package in https://www.Grants.gov by entering the Assistance Listing (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, please contact Grants.gov Customer Support (see 
contact information at https://www.grants.gov).
     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 20 
working days.
     Please follow the instructions on Grants.gov to include 
additional documentation that may be requested by this funding 
announcement.
     Applicants must comply with any page limits described in 
this funding announcement.
     After submitting the application, the applicant will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The IHS will not notify the applicant that 
the application has been received.
Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS)
    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 
that 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, please access the request service through https://fedgov.dnb.com/webform, or call (866) 705-5711.
    The Federal Funding Accountability and Transparency Act of 2006, as 
amended (``Transparency Act''), requires all HHS recipients 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 are not registered with SAM must have a DUNS 
number first, then access the SAM online registration through the SAM 
home page at https://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). Please 
see SAM.gov for details on the registration process and timeline. 
Registration with the SAM is free of charge but can take several weeks 
to process. Applicants may register online at https://sam.gov.
    Additional information on implementing the Transparency Act, 
including the specific requirements for DUNS and SAM, are available on 
the DGM Grants Management, Policy Topics web page at https://www.ihs.gov/dgm/policytopics/.

V. Application Review Information

    Possible points assigned to each section are noted in parentheses. 
The project narrative and budget narrative should include only the 
first year of activities; information for multi-year projects should be 
included as a separate document. See ``Multi-year Project 
Requirements'' at the end of this section for more information. The 
project narrative 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 fully understand the project. 
Attachments requested in the criteria do not count toward the page 
limit for the narratives. Points will be assigned to each evaluation 
criteria adding up to a total of 100 possible points. 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 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)
     Describe the service area/target population demonstrating 
the need for new/increased integrated primary health care/behavioral 
health services.
     Describe the needs in your service area and/or among your 
target population for new/increased integrated primary health care/
behavioral health services.
     Describe the unique characteristics of the service area 
and population that impact access to or utilization of behavioral 
health care.
     Describe existing behavioral health care providers in the 
service area, including identified gaps in behavioral health care 
services the applicant can address via BH2I funds.
B. Program Planning and Implementation Approach (25 Points)
     Describe the purpose, goals, and objectives of the 
proposed project to address the mental and physical health needs 
through an integrated approach between primary health care/behavioral 
health services.
     Describe the evidence-based practices, practice-based 
evidence, promising practices, and intervention efforts, including 
culturally appropriate services and interventions, to produce 
meaningful and relevant results including additional details to support 
evidence of effectiveness to support the proposed project.
     Describe the 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 forecast how they will 
progress to higher levels of health integration.
     Describe the plan to formally integrate behavioral health 
through:

[[Page 60872]]

    1. Improving workflow in the assessment of behavioral health in 
primary care such as screenings, referral, and policy development;
    2. Improving or changing health information technology in ways that 
facilitate behavioral health integration;
    3. Improving physical environment barriers in the delivery of 
integrated health care;
    4. Cross training of staff, including psycho-education training for 
staff within primary care settings and basic medical education for 
behavioral health staff;
    5. Establishing formal and informal channels of communication to 
facilitate behavioral health integration.
C. Staff and Organizational Capacity (20 Points)
     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. Describe the delivery, 
operation, and/or management of at least one portion of direct primary 
care or behavioral health treatment services.
     Describe how you will 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.
     Describe the organization's plan to hire full-time 
equivalent (FTE) licensed behavioral health provider(s).
     Include a biographical sketch for individuals identified 
and currently on staff in the project director, project coordinator, 
and other key positions as attachments to the project proposal/
application. Each biographical sketch should not exceed one page. Do 
not include any of the following:
    1. Personally Identifiable Information;
    2. Resumes; or
    3. Curriculum Vitae.
D. Performance Assessment & Data (10 Points)
     Describe plans for data collection, management, analysis, 
and reporting for integration activities.
     Describe your process for data collection that will be 
required as part of the evidence-based practice, or proposed evidence-
based projects.
     Explain the proposed efforts to utilize health information 
technology including accessibility, collection, and monitoring of 
relevant data for proposed BH2I project.
     Discuss the proposed evaluation methods (including 
expertise and tools) to assess impacts and outcomes.
E. Evaluation Plan (10 Points)
     Describe proposed methods, including quantitative and 
qualitative tools and resources, techniques to measure outcomes, and 
any partners who will conduct evaluation if separate from the primary 
applicant.
     Describe performance measures and other data relevant to 
evaluation outcomes, including intended results (i.e., impact and 
outcomes).
     Discuss how expected results will be measured (define 
indicators or tools used to monitor and measure progress).
     Describe 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 at 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 and include anticipated travel 
to the grantee meeting in the first year. Anticipated travel in 
subsequent years should be included in the multi-year project narrative 
and budget. The budget and budget narrative should not exceed four 
pages.
Multi-Year Project Requirements
    Applications must include a brief project narrative and budget (one 
additional page per year) addressing the developmental plans for each 
additional year of the project. This attachment will not count as part 
of the project narrative or the budget narrative.
    Additional documents can be uploaded as Other Attachments in 
Grants.gov. These can include:
     Work plan, logic model, and/or timeline for proposed 
objectives.
     Position descriptions for key staff.
     Resumes of key staff to 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 for eligibility and 
completeness as outlined in the funding announcement. Applications that 
meet the eligibility criteria shall be reviewed for merit by the 
Objective Review Committee (ORC) based on evaluation criteria. 
Incomplete applications and applications that are not responsive to the 
administrative thresholds (budget limit, project period limit) will not 
be referred to the ORC and will not be funded. The applicant will be 
notified of this determination.
    Applicants must address all program requirements and provide all 
required documentation.

3. Notifications of Disposition

    All applicants will receive an Executive Summary Statement from the 
IHS Division of Behavioral Health 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 Authorizing Official 
identified on the face page (SF-424) of the application.
A. Award Notices for Funded Applications
    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 award, the terms and conditions of the 
award, the effective date of the award, and the budget/project period. 
Each entity approved for funding must have a user account in 
GrantSolutions in order to retrieve the NoA. Please see the Agency 
Contacts list in Section VII for the systems contact information.
B. Approved But Unfunded Applications
    Approved applications not funded due to lack of available funds 
will be held for 1 year. If funding becomes available during the course 
of the year, the application may be reconsidered.

    Note: Any correspondence, other than the official NoA executed 
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 the IHS.

VI. Award Administration Information

1. Administrative Requirements

    Awards issued under this announcement are subject to, and are

[[Page 60873]]

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, Cost Principles, and 
Audit Requirements for HHS Awards currently in effect or implemented 
during the period of award, other Department regulations and policies 
in effect at the time of award, and applicable statutory provisions. At 
the time of publication, this includes 45 CFR part 75, at https://www.govinfo.gov/content/pkg/CFR-2020-title45-vol1/pdf/CFR-2020-title45-vol1-part75.pdf.
     Please review all HHS regulatory provisions for 
Termination at 45 CFR 75.372, at https://www.ecfr.gov/cgi-bin/retrieveECFR?gp&SID=2970eec67399fab1413ede53d7895d99&mc=true&n=pt45.1.75&r=PART&ty=HTML&se45.1.75_1372#se45.1.75_1372.
    C. Grants Policy:
     HHS Grants Policy Statement, Revised January 2007, at 
https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.
    D. Cost Principles:
     Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' at 45 CFR part 75 subpart E.
    E. Audit Requirements:
     Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' at 45 CFR part 75 subpart F.
    F. As of August 13, 2020, 2 CFR 200 was updated to include a 
prohibition on certain telecommunications and video surveillance 
services or equipment. This prohibition is described in 2 CFR 200.216. 
This will also be described in the terms and conditions of every IHS 
grant and cooperative agreement awarded on or after August 13, 2020.

2. Indirect Costs

    This section applies to all 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 and submit it to the DGM prior to 
the DGM issuing an 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 agreement 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.
    Per 45 CFR 75.414(f) Indirect (F&A) costs, ``any non-Federal entity 
(NFE) [i.e., applicant] that has never received a negotiated indirect 
cost rate, . . . may elect to charge a de minimis rate of 10 percent of 
modified total direct costs which may be used indefinitely. As 
described in Section 75.403, costs must be consistently charged as 
either indirect or direct costs, but may not be double charged or 
inconsistently charged as both. If chosen, this methodology once 
elected must be used consistently for all Federal awards until such 
time as the NFE chooses to negotiate for a rate, which the NFE may 
apply to do at any time.''
    Electing to charge a de minimis rate of 10 percent only applies to 
applicants that have never received an approved negotiated indirect 
cost rate from HHS or another cognizant Federal agency. Applicants 
awaiting approval of their indirect cost proposal may request the 10 
percent de minimis rate. When the applicant chooses this method, costs 
included in the indirect cost pool must not be charged as direct costs 
to the grant.
    Available funds are inclusive of direct and appropriate indirect 
costs. Approved indirect funds are awarded as part of the award amount, 
and no additional funds will be provided.
    Generally, IDC rates for IHS grantees are negotiated with the 
Division of Cost Allocation at https://rates.psc.gov/ or the Department 
of the Interior (Interior Business Center) at https://ibc.doi.gov/ICS/tribal. 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.

3. 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 the imposition of special award 
provisions and/or 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 awardee organization 
or the individual responsible for preparation of the reports. Per DGM 
policy, all reports must 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. The progress 
reports are due within 30 days after the reporting period ends 
(specific dates will be listed in the NoA Terms and Conditions). These 
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 NoA, if funded. A final report must be submitted within 90 
days of expiration of the period of performance.
B. Financial Reports
    Federal Cash Transaction Reports are due 30 days after the close of 
every calendar quarter to the Payment Management Services at https://pms.psc.gov. Failure to submit timely reports may result in adverse 
award actions blocking access to funds.
    Federal Financial Reports are due 30 days after the end of each 
budget period, and a final report is due 90 days after the end of the 
Period of Performance.
    Grantees are responsible and accountable for reporting accurate 
information on all required reports: The Progress Reports, the Federal 
Cash Transaction Report, and the Federal Financial Report.
C. Data Collection and Reporting
    All grantees will be required to collect and report data pertaining 
to activities, processes, and outcomes via the IHS Behavioral Health 
Portal, within 30 days after the budget period ends for each project 
year (specific dates will be listed in the NoA Terms and Conditions). 
The behavioral health online data portal will be open to project staff 
on a 24 hour/7 day per week basis for the duration of each reporting 
period. Technical assistance for web-based data entry will be timely 
and readily available to awardees by assigned IHS staff.
    The annual data reports will include compilation of quantitative 
data (e.g., number served, screenings completed, etc.) and qualitative 
or narrative (text) data. Reporting elements should be specific to 
activities/programs, processes, and outcomes, such as

[[Page 60874]]

performance measures and other data relevant to evaluation outcomes 
including intended results (i.e., impact and outcomes).
    For program purposes, the IHS will compile and provide aggregate 
program statistics, including associated community-level health care 
facility data available in the National Data Warehouse related to 
suicide risk screenings. For the Behavioral Health Integration program, 
the IHS may monitor and collect data related to behavioral health 
integration services and outcomes for all health care facilities 
associated with the organizations awarded.
D. 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.
    The 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 threshold met for any specific 
reporting period.
    For the full IHS award term implementing this requirement and 
additional award applicability information, visit the DGM Grants 
Management website at https://www.ihs.gov/dgm/policytopics/.
E. Compliance With Executive Order 13166 Implementation of Services 
Accessibility Provisions for All Grant Application Packages and Funding 
Opportunity Announcements
    Should you successfully compete for an award, recipients of Federal 
financial assistance (FFA) from HHS must administer their programs in 
compliance with Federal civil rights laws that prohibit discrimination 
on the basis of race, color, national origin, disability, age and, in 
some circumstances, religion, conscience, and sex (including gender 
identity, sexual orientation, and pregnancy). This includes ensuring 
programs are accessible to persons with limited English proficiency and 
persons with disabilities. The HHS Office for Civil Rights provides 
guidance on complying with civil rights laws enforced by HHS. Please 
see https://www.hhs.gov/civil-rights/for-providers/provider-obligations/ and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/.
     Recipients of FFA must ensure that their programs are 
accessible to persons with limited English proficiency. For guidance on 
meeting your legal obligation to take reasonable steps to ensure 
meaningful access to your programs or activities by limited English 
proficiency individuals, see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/ and https://www.lep.gov.
     For information on your specific legal obligations for 
serving qualified individuals with disabilities, including reasonable 
modifications and making services accessible to them, see https://www.hhs.gov/ocr/civilrights/understanding/disability/.
     HHS funded health and education programs must be 
administered in an environment free of sexual harassment. See https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/.
     For guidance on administering your program in compliance 
with applicable Federal religious nondiscrimination laws and applicable 
Federal conscience protection and associated anti-discrimination laws, 
see https://www.hhs.gov/conscience/conscience-protections/ 
and https://www.hhs.gov/conscience/religious-freedom/.
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 FAPIIS at https://www.fapiis.gov, before 
making any award in excess of the simplified acquisition threshold 
(currently $250,000) over the period of performance. An applicant may 
review and comment on any information about itself that a Federal 
awarding agency previously entered. The 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, 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, the IHS must require an NFE 
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.
    All applicants and recipients must disclose in writing, in a timely 
manner, to the IHS and to the HHS Office of Inspector General of 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: Paul Gettys, Acting 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: [email protected];

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/ (Include 
``Mandatory Grant Disclosures'' in subject line), Fax: (202) 205-0604 
(Include ``Mandatory Grant Disclosures'' in subject line) or Email: 
[email protected].
    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 part 180 and 2 CFR part 
376).

[[Page 60875]]

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: Steven 
Whitehorn, Public Health Advisor, Indian Health Service, Division of 
Behavioral Health, 5600 Fishers Lane, Mail Stop 08N34A, Rockville, MD 
20857, Phone: (301) 443-6581, Fax: (301) 594-6213, Email: 
[email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Willis Grant, Senior Grants Management Specialist, Indian 
Health Service, Division of Grants Management, 5600 Fishers Lane, Mail 
Stop: 09E70, Rockville, MD 20857, Phone: (301) 443-5204, Fax: (301) 
594-0899, Email: [email protected].
    3. Questions on systems matters may be directed to: Paul Gettys, 
Acting Director, Indian Health Service, Division of Grants Management, 
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: [email protected].

VIII. Other Information

    The Public Health Service strongly encourages all grant, 
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.

Elizabeth A. Fowler,
Acting Director, Indian Health Service.
[FR Doc. 2021-24040 Filed 11-3-21; 8:45 am]
BILLING CODE 4165-16-P