[Federal Register Volume 59, Number 57 (Thursday, March 24, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6864]


[[Page Unknown]]

[Federal Register: March 24, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
RIN 0905-ZA23

 

Mental Health Care Provider Education in HIV/AIDS

AGENCY: Center for Mental Health Services, Substance Abuse and Mental 
Health Services Administration, HHS.

ACTION: Request for applications.

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SUMMARY: The Center For Mental Health Services (CMHS), of the Substance 
Abuse and Mental Health Services Administration (SAMHSA), is interested 
in supporting a limited number of proposals to train both traditional 
and nontraditional mental health care providers to address the 
psychological and the neuropsychiatric sequelae of HIV/AIDS.
    Since 1986, first the National Institute of Mental Health (NIMH), 
and now CMHS, have provided support for a program to develop model 
educational approaches to train mental health care providers in 
neuropsychiatric and psychosocial aspects of HIV/AIDS. The focus has 
been on training traditional mental health care providers 
(psychiatrists, psychologists, nurses, social workers and marriage and 
family counselors), other first line providers of mental health 
services (e.g., medical students, primary care physicians), and 
nontraditional providers (e.g., the clergy and other spiritual 
providers, alternative health care workers, counselors).
    The Health Resources and Services Administration (HRSA) supports a 
similar program, the National AIDS Education and Training (AETC) 
Centers Program, which consists of a network of 17 centers 
geographically distributed throughout the U.S.A., the Virgin Islands 
and Puerto Rico. This program emphasizes training primary care 
providers on the clinical aspects of HIV management; however, multiple 
AETCs offer training for allied health care providers.
    This notice consists of three parts:
    Part I covers information on the legislative authority and the 
applicable regulations and policies related to the Mental Health Care 
Provider Education in HIV/AIDS program.
    Part II describes the programmatic goals and scope of the program 
and discusses eligibility, availability of funds, period of support and 
receipt date for applications.
    Part III describes special requirements of the program, the 
application process, the review and award criteria and provides 
contacts for additional information.

Part I--Legislative Authority and Other Applicable Regulations and 
Policies

    Grants awarded under this RFA are authorized under section 
303(a)(1) of the Public Health Service Act, (42 U.S.C. 242a).
    Federal regulations at Title 45 CFR parts 74 and 92, generic 
requirements concerning the administration of grants, are applicable to 
these awards.
    Grants must be administered in accordance with the PHS Grants 
Policy Statement (Rev. April 1, 1994).
    The Catalog of Federal Domestic Assistance (CFDA) number for this 
program is 93.244.
    Interim and final progress reports and financial status and 
expenditure reports will be required and specified to awardees in 
accord with PHS Grants Policy requirements.
    Healthy People 2000: The Public Health Service (PHS) is committed 
to achieving the health promotion and disease prevention objectives of 
Healthy People 2000, a PHS-led national activity for setting priority 
areas. This Request for Applications (RFA), Mental Health Care Provider 
Education in HIV/AIDS, is related to the priority of HIV/AIDS. 
Potential applicants may obtain a copy of Healthy People 2000 (Full 
Report: Stock No. 017-001-00474-0; or Summary Report: Stock No. 017-
001-00473-1) through the Superintendent of Documents, Government 
Printing Office, Washington, D.C. 20402-9325 (Telephone: 202-783-3238).
    Promoting Non-use of Tobacco: Studies have clearly established that 
the use of tobacco products increases mortality and morbidity, not only 
for the primary users of these products but for those in close 
proximity to the user. Statistics published by the National Cancer 
Institute indicate that cigarette smoking and chewing of tobacco are 
responsible for as many as 1,500 deaths per day in the United States. 
Recent studies conducted by the Environmental Protection Agency 
indicate that prolonged exposure to second-hand smoke significantly 
increases the probability of developing heart and lung disease. 
Therefore, the CMHS strongly encourages all grantees to provide smoke-
free project and work environments.
    This program supports one of the tenants of health care reform that 
appropriate and adequate care be provided by trained providers. It also 
supports the HHS Secretary's themes of fostering independence through 
empowering the people, preventing future problems, and improving 
services to our customers.

Part II--Programmatic Goals and Scope, Eligibility and Application 
Receipt Date

    The goal of this program is to enhance the Nation's ability to have 
an impact upon the HIV/AIDS epidemic by training the traditional mental 
health care providers and other health care workers who often are 
first-line providers of mental health services, such as medical 
students, primary care physicians, and the clergy and other spiritual 
providers.
    Applicants will be expected to propose a comprehensive training 
program that addresses the needs of traditional providers 
(psychiatrists, psychologists, nurses, social workers and marriage and 
family counselors), other first line providers of mental health 
services (e.g., medical students, primary care physicians), and 
nontraditional providers (e.g., the clergy and other spiritual 
providers, alternative health care workers, counselors). Training 
programs proposed must target at least 5 provider groups. The program 
must address the neuropsychiatric and the psychosocial aspects of HIV/
AIDS; coping with HIV/AIDS; and approaches to prevent the spread of HIV 
infection.
    Applicants are expected to explore the programs offered by their 
local HRSA AETCs and other health care provider educators and, where 
appropriate, establish linkages.
    The applicant should include a plan to train at least 1,000 mental 
health care providers and students in training programs for each of the 
3 years of the grant. None of the training offerings may exceed 180 
days. Applicants must include a plan to recruit gay and bisexual men, 
women and minorities as trainers and trainees.
    The applicant should demonstrate specialized mental health 
expertise, e.g., a psychiatry, psychology or social work department in 
an academic institution, a mental health professional organization, or 
another mental health organization.
    The following are activities that a Mental Health Care Provider 
Education in HIV/AIDS project must include:

Training Activities

     The incorporation of emerging research knowledge of 
neuropsychiatric and psychosocial aspects of HIV/AIDS into the 
curriculum.
     Training for providers on aspects of the needs of 
individuals at risk, including gay and bisexual men, racial and ethnic 
minorities, injecting drug users and their sex partners, sex workers, 
women, infants, children, adolescents, and sex partners of people with 
HIV/AIDS.
     Training for mental health professionals and personnel who 
serve people with serious mental illness, both in inpatient and 
outpatient settings.
     The recruitment of gay and bisexual men, women and 
individuals from minority populations as trainers and trainees.
     Training for providers in prevention strategies and risk 
reduction to decrease the transmission of HIV infection.
     Training for providers to recognize, treat, or refer 
individuals with the psychiatric and neuropsychiatric complications of 
HIV infection and their clinical manifestation such as delirium, 
dementia, organic mood disorder, depression, and adjustment disorders.
     Training for providers about pre- and post-HIV antibody 
testing counseling.

Integration of Mental Health and Health Training

     Evidence of collaboration with relevant community-based 
AIDS organizations, medical and health professions schools, mental 
health professional organizations, hospitals, substance abuse treatment 
providers, and other health professions organizations, and local 
training programs, such as the HRSA AETC Program.
     An integrated biopsychosocial approach to understanding 
HIV/AIDS.

Mental Health Expertise

     Mental health HIV/AIDS expertise demonstrated by key staff 
trained in the core mental health disciplines (psychiatry, psychology, 
marriage and family therapy/counseling, social work, nursing) and 
experienced with HIV/AIDS.
     Inclusion of at least five (5) provider groups in the 
training project (psychiatrists, psychologists, social workers, medical 
students, primary care residents, psychiatry residents, nurses, 
counselors, the clergy and other spiritual providers, etc.).

Evaluation

     An evaluation of the efficiency and effectiveness of the 
proposed project, including data on the relative effectiveness of 
different training techniques in developing clinical skills, attitudes, 
and knowledge needed to prevent HIV infection and to work with people 
with HIV/AIDS.
    Eligibility: Applications may be submitted by any public or private 
nonprofit organization. Entities staffed largely by women and 
minorities are encouraged to apply.
    Availability of Funds: It is estimated that approximately $0.4 
million will be available to support approximately 2-3 awards under 
this RFA in FY 94. Actual funding levels will depend upon the 
availability of appropriated funds.
    Period of Support: Support may be requested for a period of up to 3 
years. Annual awards will be made, subject to availability of funds and 
progress achieved.
    Application Receipt and Review Schedule: The schedule for receipt 
and review of applications under this announcement is as follows: 

------------------------------------------------------------------------
                                                         Earliest start 
  Receipt date        IRG review       Council review         date      
------------------------------------------------------------------------
May 26, 1994.....  July 1994........  Sept. 1994......  Sept. 1994.     
------------------------------------------------------------------------

    Applications must be received by the published application receipt 
date to be accepted for review. However, an application received after 
the deadline may be acceptable if it carries a legible proof-of-mailing 
date, (private metered postmarks are not acceptable as proof of timely 
mailing), assigned by the carrier and the proof-of-mailing date is not 
later than one week prior to the deadline date. If the receipt date 
falls on a weekend, it will be extended to the following Monday; if the 
date falls on a national holiday, it will be extended to the following 
work day.
    Consequences of Late Submission: Applications received after the 
above receipt date will not be accepted and will be returned to the 
applicant without review.
    Subject to the availability of funds in future fiscal years, CMHS 
may reissue this announcement and publish future receipt dates and a 
notice of availability of funds in the Federal Register. Applicants are 
strongly encouraged to verify future receipt dates and the availability 
and terms of funding before preparing and submitting applications.

Part III--Special Requirements, Review/Award Criteria and Contacts for 
Additional Information

    Letter of Intent: Organizations planning to submit an application 
in response to this announcement are encouraged to submit a letter of 
intent at least 30 days prior to the receipt date. Such notification is 
used by the CMHS for purposes of review and program planning. This 
letter is voluntary and does not obligate the person/organization to 
submit an application.
    In addition, the letter should be no longer than one page and 
should succinctly indicate:

--The number and title of the RFA
--The name of the potential applicant organization, city and state
--The name and affiliation of the proposed project director, i.e., 
the individual who will be assigned to coordinate the development 
and conduct of the project
--The overall scope of the proposed project, including a brief 
description of the likely goals and objectives

    Letters of intent should be directed to: Director, Office of 
Evaluation, Extramural Policy, and Review, Center for Mental Health 
Services, 5600 Fishers Lane, Room 18C-07, Rockville, Maryland 20857, 
ATTN: RFA/Letter of Intent, FAX: (301) 443-7912.
    Coordination With Other Federal/Non-Federal Programs: Applicants 
seeking support under this announcement are encouraged to coordinate 
with other programs. Program coordination helps to better serve the 
multiple needs of the patient/client population and to maximize the 
impact of available resources, and to eliminate duplication of 
services. Applicants should identify the coordinating organizations by 
name and address and describe the process used (to be used) for 
coordinating efforts. Letters of coordination should be included in the 
application appendices. Examples of Federal programs with which 
applicants may find coordination productive are included in the 
complete application kit.
    Single State Agency Coordination: Coordination with the Single 
State Agency (SSA) for mental health is encouraged to ensure 
communication, reduce duplication, and facilitate continuity. The 
application must include a copy of a letter sent to the SSA briefly 
describing the grant application. A list of SSAs can be found in the 
grant application kit. If the target population falls within the 
jurisdiction of more than one State, all representative SSAs should be 
involved.
    Public Health System Reporting Requirements: This program is not 
subject to the Public Health System Reporting Requirements.
    Intergovernmental Review (E.O. 12372): This program is not subject 
to the intergovernmental review requirements of Executive Order 12372, 
as implemented through HHS regulations a 45 CFR part 100.
    Application Procedures: All applicants must use application form 
PHS 5161-1 (Rev. 7/92), which contains Standard Form 424 (face page). 
The following information should be typed in Item Number 10 on the face 
page of the application form:

RFA #SM-94-04: CMHS HIV/AIDS Education Program

    Grant kits (including form PHS 5161-1 with Standard Form 424, 
complete application procedures, and accompanying guidance material for 
the narrative approved under OMB No. 0937-0189) may be obtained from: 
Global Exchange, Inc., 7910 Woodmont Avenue, Suite 400, Bethesda, MD 
20814-3015, (301) 656-3100.
    Applicants must submit: (1) An original copy signed by the 
authorized official of the applicant organization, with the appropriate 
appendices; and (2) two additional, legible copies of the application 
and all appendices to the following address:

Center for Mental Health Services Programs, Division of Research 
Grants, NIH Westwood Building, Room 240, 5333 Westbard Avenue, 
Bethesda, Maryland 20892*

    *If an overnight carrier or express mail is used, the Zip Code 
is 20816.

    Only one application seeking Public Health Service (PHS) support 
for the same programmatic service activities with the same population 
may be submitted to SAMHSA and that same application may be submitted 
in response to only one SAMHSA Program Announcement or RFA.
    Review Process: Applications submitted in response to this RFA will 
be reviewed for technical merit in accordance with established PHS/
SAMHSA peer review procedures for grants.
    Applications that are accepted for review will be assigned to an 
Initial Review Group (IRG) composed primarily of non-Federal experts. 
Notification of the IRG's recommendation will be sent to the applicant 
upon completion of the initial review. In addition, the IRG 
recommendations on technical merit of applications will undergo a 
second level of review by the appropriate advisory council whose review 
may be based on policy considerations as well as technical merit. 
Applications may be considered for funding only if the advisory council 
concurs with the IRG's recommendation for approval.
    Review Criteria: The points noted in the parentheses for each 
criterion indicate the maximum number of points the reviewers may 
assign to that criterion. These points will be used to calculate a raw 
score for each application. The raw score will be converted to the 
official priority score.

Significance of the Project (30)

     Appropriateness of the proposed project to the goals of 
the announcement.
     Degree of creativity of the training program.
     Consistency of the proposed project relative to the state 
of the art with respect to knowledge of biologic, neuropsychiatric, and 
psychosocial aspects of HIV/AIDS.

Adequacy and Appropriateness of Project Plans (30)

     In terms of the applicant's stated goals and objectives.
     In terms of the proposed trainers and trainees, especially 
from special populations (i.e., appropriate inclusion of gay and 
bisexual men, women and minorities), and resources.
     In terms of the project management plan.
     In terms of the implementation plan.
     In terms of collaborations with relevant community 
agencies.

Adequacy and Appropriateness of Evaluation Plans (20)

     In terms of the applicant's stated goals and objectives.
     In terms of the proposed staffing and resources.
     In terms of the project management plan.
     In terms of the implementation plan.
     In terms of procedures to identify, recruit, and retain 
trainers and trainees.

Appropriateness of Staffing, Project Organization, and Resources 
(20)

     Qualifications and experience of the project director and 
other key personnel.
     Adequacy of available resources (e.g., facilities, 
equipment).
     Feasibility of the project.
     Capability and experience of the applicant organization 
with similar projects.
     Adequacy of support for the project from other relevant 
organizations.
     Appropriateness of proposed budget for each of the 
requested years (the committee may recommend either increases or 
decreases in the budget based on their review of the application or on 
the adequacy of the budget justification).
    Award Criteria: Applications recommended for approval by the 
Initial Review Group (IRG) and the appropriate advisory council will be 
considered for funding on the basis of their overall technical merit as 
determined through the review process. Other award criteria will 
include:
     programmatic balance.
     geographic distribution.
     availability of funds.

Contacts for Additional Information

    Questions concerning program issues may be directed to: Ms. Elaine 
Corrigan, Program Management Officer, HIV/AIDS Program, Center for 
Mental Health Services, 5600 Fishers Lane, room 11C-21, Rockville, MD 
20857, (301) 443-7817.
    Questions regarding grants management issues may be directed to: 
Ms. Carole Edison, Grants Management Officer, Center for Mental Health 
Services, 5600 Fishers Lane, room 15-87, Rockville, Maryland 20857, 
(301) 443-4456.

    Dated: March 15, 1994.
Richard Kopanda,
Acting Executive Officer, SAMHSA.
[FR Doc. 94-6864 Filed 3-23-94; 8:45 am]
BILLING CODE 4162-20-P