[Federal Register Volume 66, Number 197 (Thursday, October 11, 2001)]
[Rules and Regulations]
[Pages 51873-51880]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-25451]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

42 CFR Part 51d

RIN 0930-AA09


Substance Abuse and Mental Health Services Administration; Mental 
Health and Substance Abuse Emergency Response Criteria

AGENCY: Substance Abuse and Mental Health Services Administration 
(SAMHSA), HHS.

ACTION: Interim final rule.

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SUMMARY: Section 3102 of the Children's Health Act of 2000, Pub. L. 
106-310, amends section 501 of the Public Health Service (PHS) Act (42 
U.S.C. 290aa) to add a new subsection (m) entitled ``Emergency 
Response.'' This newly enacted subsection 501(m) authorizes the 
Secretary to use up to, but no more than, 2.5% of all amounts 
appropriated under Title V of the PHS Act, other than those 
appropriated under Part C, in each

[[Page 51874]]

fiscal year to make ``noncompetitive grants, contracts or cooperative 
agreements to public entities to enable such entities to address 
emergency substance abuse or mental health needs in local 
communities.''
    Because Congress believed the Secretary needed the ability to 
respond to emergencies, it exempted any grants, contracts, or 
cooperative agreements authorized under this section from the peer 
review process otherwise required by section 504 of the PHS Act. See 
section 501(m)(1) of the PHS Act. Instead, the Secretary is to use an 
objective review process by establishing objective criteria to review 
applications for funds under this authority.
    Pursuant to Public Law 106-310, the Secretary is required to 
establish, and publish in the Federal Register, criteria for 
determining when a mental health or substance abuse emergency exists. 
In this interim final rule, the Secretary sets out these criteria, as 
well as the intended approach for implementing this new mental health 
and substance abuse emergency response authority. The Secretary invites 
public comments on both the criteria and the approach described in this 
interim final rule.

DATES: This regulation is effective on October 11, 2001. Written 
comments must be received on or before December 10, 2001.

ADDRESSES: Written comments should be sent to Judith B. Braslow, Deputy 
Associate Administrator for Policy and Program Coordination, Substance 
Abuse and Mental Health Services Administration (SAMHSA), Room 12C-06, 
Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857. Submit 
comments on the information collection requirements to the Office of 
Information and Regulatory Affairs, Office of Management and Budget, 
New Executive Office Building, 725 17th St. NW, Washington DC 20503, 
Attention: Desk Officer for SAMHSA.

FOR FURTHER INFORMATION CONTACT: Judith B. Braslow, Deputy Associate 
Administrator for Policy and Program Coordination, Substance Abuse and 
Mental Health Services Administration (SAMHSA), (301)443-4111.

SUPPLEMENTARY INFORMATION:

Background

    The Department of Health and Human Services (the Department) has 
been called upon in recent years to play an increasingly active 
leadership role in responding to the behavioral health needs that arise 
as the result of both natural and human-caused emergencies and 
disasters. To date, the grant assistance rendered by the Substance 
Abuse and Mental Health Services Administration (SAMHSA) has been 
limited primarily to crisis counseling services in the aftermath of 
Presidentially declared disasters. Through an interagency agreement 
with the Federal Emergency Management Agency (FEMA), SAMHSA's Center 
for Mental Health Services (CMHS) provides technical assistance, 
training, consultation, and grant monitoring for the Crisis Counseling 
Assistance and Training Program (CCP), which is authorized through the 
Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public 
Law 100-707, Section 416, and implementing regulations (44 CFR 
206.171). This jointly-administered program allows States to apply for 
Federal support for services to ameliorate the mental and emotional 
crises and their subsequent psychological and behavioral conditions 
resulting from a major disaster. The services provided through the 
FEMA/CMHS Crisis Counseling Assistance and Training Program remain a 
cornerstone of the Federally-supported mental health response to 
Presidentially-declared disasters. However, Congress recognized the 
need to expand emergency services to include both mental health and 
substance abuse needs, whether or not a Presidential disaster is 
declared under the above authority.
    To help address these needs the Secretary, through SAMHSA, was 
given the mandate to develop a new emergency grant program under its 
recent reauthorization legislation, which was signed into law on 
October 17, 2000, Pub. L. 106-310. Section 3102 of this law adds a new 
subsection, entitled ``Emergency Response'' to section 501 of the 
Public Health Service (PHS) Act. This newly enacted subsection enables 
the Secretary to use a small portion of funds appropriated each fiscal 
year to make ``noncompetitive grants, contracts or cooperative 
agreements to public entities to enable such entities to address 
emergency substance abuse or mental health needs in local 
communities.'' This Interim Final Rule establishes procedures by which 
the Department may provide these funds.
    This new authority permits the Department to respond in emergency 
situations when behavioral health needs overwhelm State, Tribal or 
local resources, and other resources are unavailable. Because of the 
urgent necessity of assuring a Federal response capacity in emergency 
situations, the Secretary is issuing an interim final rule, which will 
allow the Secretary, through SAMHSA, to respond immediately under 
emergency circumstances.
    In implementing this new authority, the Department is placing an 
emphasis on coordination among Federal funding entities. In order to 
avoid duplication of services, the Department will coordinate closely 
with other Federal agencies that may provide funding support for 
behavioral health services in emergency situations. These other funding 
sources include the Readiness, Response and Recovery Directorate within 
the Federal Emergency Management Agency (FEMA), the Safe and Drug Free 
Schools Program within the U.S. Department of Education, the Office for 
Victims of Crime (OVC) within the U.S. Department of Justice, the 
National Transportation Safety Board (NTSB) within the U.S. Department 
of Transportation, the Emergency Response Program within the 
Environmental Protection Agency (EPA), the Bureau of Indian Affairs 
(BIA) within the U.S. Department of the Interior, the Animal and Plant 
Health Inspection Service within the U.S. Department of Agriculture, 
and the Indian Health Service (IHS) within the U.S. Department of 
Health and Human Services. The funds identified for use under this 
Interim Final Rule are considered ``funds of last resort'' and may not 
be used to supplant or replace other existing funds. Therefore, we view 
this new authority as an important adjunct to the existing authority to 
make ``Mental Health Crisis Counseling Grant'' awards to States because 
we are able to fund different types of services beyond crisis 
counseling.

Summary of Regulation

Emergency Criteria

    This Interim Final Rule identifies noncompetitive, objective 
conditions and criteria the government will use to expedite the 
allocation of funds. In establishing the criteria used to determine 
whether an emergency exists, we have described the following minimum 
elements: (1) Existing State, Tribal and local systems for mental 
health and/or substance abuse services are overwhelmed or unable to 
meet the existing mental health or substance abuse needs of the local 
community at issue; and (2) this inability to meet the mental health 
and/or substance abuse service needs of a local community is the direct 
consequence of a clear precipitating event. This precipitating event 
must have a sudden, rapid onset and a definite conclusion, such as a 
natural disaster (such as a hurricane, tornado, storm, flood, 
earthquake, fire, drought, or other natural catastrophe), a

[[Page 51875]]

technological disaster (such as a chemical spill, a major industrial 
accident, or a transportation accident), or a criminal act (such as a 
domestic act of terrorism, a hostage situation, or an incident of mass 
violence including school shootings and riots) and result in 
significant death, injury, exposure to life-threatening circumstances, 
hardship, suffering, loss of property, or loss of community 
infrastructure (e.g., loss of treatment facilities, staff, public 
transportation and/or utilities, or isolation from services); and (3) 
no other local, State, Tribal or Federal funding is available to 
adequately address the specific level of need resulting from the 
precipitating event and resulting emergency mental health and/or 
substance abuse service needs of the impacted community.

Eligible Applicants

    Eligible applicants are limited to public entities, which are 
defined in the rule as any State, any political subdivision of a State, 
any Federally recognized Indian tribal government or tribal 
organization. Eligibility is restricted to public entities as required 
by the authorizing legislation.

Types of Awards

    Eligible applicants may apply to the Secretary for either of two 
types of substance abuse and mental health emergency response grants: 
Immediate awards and Intermediate awards. The former are designed to be 
funded up to $50,000, or such greater amount as determined by the 
Secretary on a case-by-case basis, and are to be used over the initial 
90-day period commencing as soon as possible after the precipitating 
event; the latter awards require more documentation, including a needs 
assessment, other data and related budgetary detail. The Intermediate 
awards have no predefined budget limit. Typically, Intermediate awards 
would be used to meet systemic mental health and/or substance abuse 
needs during the recovery period following the Immediate award period. 
Such awards may be used for up to one year, with a possible second year 
supplement based on submission of additional required information and 
data.

Application Procedure

    Applications for Immediate awards must be submitted on a form that 
has been approved by the Office of Management and Budget (OMB), and 
include the following information: a certification by the State's chief 
executive officer that a mental health or substance abuse emergency 
exists, as well as a written statement setting out the basis for the 
certification; a brief program plan describing needs; an estimate of 
the number of people to be served and the geographical area to be 
served; a description of the types of services to be provided; a budget 
justifying the amount of the request; other required certifications 
included in the application; and such other pertinent information the 
Secretary may require.
    The Department is requiring that the certification of the mental 
health or substance abuse emergency is made by the State's chief 
executive officer, rather than from a local government, based on the 
governor's experience and expertise in disaster declarations gleaned 
from the FEMA grants. In addition, the Department believes that it is 
important to have high-level certification so that any available State 
funds can be allocated to the emergency in accordance with the 
conditions of this grant. However, it is important to note that 
although the certification must be obtained from the chief executive 
office, local governments are eligible to seek the grant and must sign 
the application as the responsible fiscal party.
    The Department encourages applicants to submit the application to 
the single state agency for Alcohol and Drug abuse and/or the State 
mental health program for comments.
    Applications for Intermediate awards must be submitted on a form 
that has been approved by the OMB, and include the following 
information: if the applicant has not applied previously for an 
Immediate award, a certification by the State's chief executive officer 
that a mental health or substance abuse emergency exists, as well as a 
written statement setting out the basis for the certification, an 
application submission date within three months of the date of the 
event that precipitated the mental health or substance abuse emergency 
(unless waived by the Secretary), a detailed and comprehensive 
assessment of need, demographics specific to the number of people to be 
served, a description of the services that were provided up to the date 
of the submission of the Intermediate award application, the 
geographical area to be served, a detailed implementation program plan 
and related time line, including a description of outreach to special 
population groups affected by the crisis, a budget justifying the 
amount of the request for personnel, equipment, supplies, travel, 
training, data collection and any technical assistance required, and 
any information that has changed since an Immediate application was 
submitted, if one was submitted.

Objective Criteria for Application Evaluation

    Applications for both Immediate and Intermediate grants will be 
evaluated using the following objective criteria: (1) Documentation of 
need, (2) plan of services, and (3) organizational capability. In 
assessing documentation of need, the applicant needs to demonstrate 
that the mental health and/or substance abuse needs are a direct result 
of the precipitating event; identify any high risk groups or 
populations with special concerns that may impact the delivery of 
services (e.g., children, adolescents, older adults, ethnic and 
cultural groups, lower income populations); and clearly document that 
no other local, State, Tribal or Federal funding sources are available 
to address the need. An adequate plan of services must clearly identify 
the types of services to be provided (e.g., outreach, crisis 
counseling, public education on stress management and crisis mental 
health, public education on substance abuse prevention, information and 
referral services, short term substance abuse or mental health 
prevention and/or treatment services); strategies for targeting those 
identified as needing services, including high risk groups or 
populations with special concerns identified in the needs assessment; 
appropriate training to be provided to staff to assure that services 
are appropriate to the crisis situation and the plans for community 
recovery; quality control methods in place to assure appropriate 
services to the target population; staff support mechanisms that are 
available; and plans for coordination of services with key local, 
State, Tribal and Federal partners involved in addressing the 
precipitating event (e.g., emergency management agencies, law 
enforcement, education agencies, public health agencies, agricultural 
extension agencies, environmental agencies, and other agencies active 
in crisis response). In assessing organizational capability, the 
applicant needs to demonstrate a history of service delivery to the 
target population within the defined service area for the program. The 
budget submitted must provide sufficient justification and demonstrate 
that it is consistent with the documentation of need and plan of 
services. Finally, SAMHSA may consult with other Federal agencies 
responsible for responding to crisis incidents, to ensure that these 
are ``funds of last resort.''
    The Department is soliciting formal comments on this Interim Final 
Rule in order to assure that the proposed criteria, procedures and 
requirements

[[Page 51876]]

are responsive and address the needs, issues and concerns of potential 
grantees, and the public at large.

Justification for Interim Final Rule

    The Department has decided to issue this document as an Interim 
Final Rule with an immediate effective date as well as a comment period 
of 60 days after publication in the Federal Register. It is the 
Department's view that good cause exists that notice and comment are 
``impracticable, * * * or contrary to the public interest.'' 5 U.S.C. 
553(b)(B). We make this finding for the following reasons:
    The purpose of the statute is to provide funding for noncompetitive 
grants to public entities to enable such entities to address emergency 
substance abuse or mental health needs in local communities. In light 
of the current emergency situations with respect to the terrorist 
attacks, it has been determined that a delay for the purpose of comment 
and the effective date would be contrary to the public interest. 
Although we are making the rule effective immediately without first 
obtaining public comment, we are providing for a 60-day comment period 
after publication. Thus, should we receive any significant comments 
that would cause us to revise this rule in any way, we will be able to 
do so.

Executive Order 12866: Economic Impact

    Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, when rulemaking is 
necessary, to select regulatory approaches that provide the greatest 
net benefits (including potential economic, environmental, public 
health, safety distributive and equity effects). We have determined 
that the rule is not a ``significant regulatory action'' under Section 
3(f) of the Executive Order. This rule does not have an annual effect 
on the economy of $100 million or more, create a serious inconsistency 
or otherwise interfere with an action taken or planned by another 
agency, materially alter the budgetary impact of entitlements, grants, 
user fees, or loan programs or the rights and obligations of recipients 
thereof, or raise novel legal or policy issues. Therefore, this interim 
final rule does not require an assessment of the potential costs and 
benefits under Section 6(a)(3) of that Order and thus has been exempted 
from review by the Office of Management and Budget under that Order.

Regulatory Flexibility

    The Regulatory Flexibility Act (5 U.S.C. chapter 6) requires that 
regulatory actions be analyzed to determine whether they will have a 
significant impact on a substantial number of small entities. We have 
determined that this is not a ``major'' rule under the Regulatory 
Flexibility Act of 1980, and that it will not have an effect on the 
States or on the distribution of power and responsibilities among the 
various levels of government.

Unfunded Mandates

    The Unfunded Mandates Reform Act requires that agencies prepare an 
assessment of anticipated costs and benefits before developing any rule 
that may result in an expenditure by State, local, or tribal 
governments, in the aggregate, or by the private sector of $100 million 
or more in any given year. This rule contains no Federal mandates for 
State, tribal, or local governments or for the private sector.

Executive Order 13132: Federalism Implications

    Executive Order 13132, Federalism, requires that Federal agencies 
consult with State and local government officials in the development of 
regulatory policies with federalism implications. We reviewed the rule 
as required under the Order and determined that it does not have any 
federalism implications. This rule will not have an effect on the 
States or on the distribution of power and responsibilities among the 
various levels of government.

Paperwork Reduction Act of 1995

    This Interim Final Rule contains information collections which are 
subject to review by the Office of Management and Budget (OMB) under 
the Paperwork Reduction Act of 1995 (the PRA) (44 U.S.C. 3507(d)). The 
title, description and respondent description of the information 
collections are shown in the following paragraphs with an estimate of 
the annual reporting and recordkeeping burden. Included in the estimate 
is the time for reviewing instructions, searching existing data 
sources, gathering and maintaining the data needed, and completing and 
reviewing the collection of information.
    Title: Emergency Response Grants Regulations--42 CFR part 51
    Description: This rule implements Section 501(m) of the Public 
Health Service Act (42 U.S.C. 290aa), which authorizes the Secretary to 
make noncompetitive grants, contracts or cooperative agreements to 
public entities to enable such entities to address emergency substance 
abuse or mental health needs in local communities. The rule establishes 
criteria for determining that a substance abuse or mental health 
emergency exists, the minimum content for an application, and reporting 
requirements for recipients of such funding.
    Description of Respondents: State, local or tribal governments
    Response Burden Estimates: This program will be an approved user of 
the PHS-5161 application form, approved by OMB under control number 
0920-0428. The quarterly financial status reports in 42 CFR 
51d.10(a)(2) and (b)(2) are as permitted by 45 CFR 92.41(b); the final 
program report, financial status report and final voucher in 42 CFR 
51d.10(a)(3), 51d.10(b)(3), and 51d.10(b)(4) are in accordance with 45 
CFR 92.50(b). Information collection requirements of 45 CFR part 92 are 
approved by OMB under control number 0990-0169. The following table 
presents annual burden estimates for the information collection 
requirements of this regulation.

----------------------------------------------------------------------------------------------------------------
                                                                                   Burden per
    42 CFR citation and type of application         Number of      Responses/       response       Total burden
                                                   respondents     respondent        (Hrs.)
----------------------------------------------------------------------------------------------------------------
51d.4(a) and 51d.6(a)(2) Immediate awards--                   3               1               3           \1\(9)
 application...................................
51d.4(b) and 51d.6(a)(2)--Intermediate Awards--               3               1              10          \1\(30)
 application...................................
51d.10(a)(1)--Immediate awards--mid-program                   3               1               2               6
 report as part of Intermediate award
 application...................................
51d.10(c)--Final report content................               3               1               3               9
                                                ----------------------------------------------------------------
    Total......................................               6  ..............  ..............              15
----------------------------------------------------------------------------------------------------------------
\1\ This burden is carried under OMB control number 0920-0428.


[[Page 51877]]

    As required by section 3507(d) of the PRA the Secretary has 
submitted a copy of the information collection requirements in the 
interim final rule to OMB for its review. The Secretary has requested 
emergency review and approval of this information collection and OMB 
has approved it under control number 0930-0229 through 03/31/2002.
    Comments on the information collection requirements are 
specifically solicited in order to: (1) Evaluate whether the collection 
of information is necessary for the proper performance of DHHS's 
functions, including whether the information will have practical 
utility; (2) evaluate the accuracy of DHHS's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used; (3) enhance the quality, utility, and 
clarity of the information to be collected and (4) minimize the burden 
of the collection of information on those who are to respond, including 
through the use of appropriate automated, electronic, mechanical, or 
other technological collection techniques or other forms of information 
technology.
    Organizations and individuals desiring to submit comments on the 
information collection requirements should direct them to the Office of 
Information and Regulatory Affairs, OMB (address above). Comments to 
OMB are best assured of having their full effect if OMB receives them 
by November 13, 2001. This does not affect the deadline for the public 
to comment to DHHS on the proposed regulation.

Executive Order 13175: Consultation and Coordination With Indian Tribal 
Governments

    Executive Order 13175 (65 FR 67249, November 6, 2000) requires us 
to develop an accountable process to ensure ``meaningful and timely 
input by tribal officials in the development of regulatory policies 
that have tribal implications.'' ``Policies that have tribal 
implications'' is defined in the Executive Order to include regulations 
that have ``substantial direct effects on one or more Indian tribes, on 
the relationship between the Federal government and the Indian tribes, 
or on the distribution of power and responsibilities between the 
Federal government and Indian tribes.''
    This proposed rule does not have tribal implications. It will not 
have substantial direct effects on tribal governments, on the 
relationship between the Federal government and Indian tribes, or on 
the distribution of power and responsibilities between the Federal 
government and Indian tribes, as specified in Executive Order 13175.
    Today's rule does not significantly or uniquely affect the 
communities of Indian tribes and tribal organizations. The rule 
specifically permits Indian tribes and tribal organizations to apply 
for emergency mental health and substance abuse funding in ways that 
are similar to the way States and local governments apply, but more 
directly tailored to the functioning of the tribes. Thus, Executive 
Order 13175 does not apply to this rule.
    In the spirit of Executive Order 13175, and consistent with our 
policy to promote communications between the Department and tribes and 
tribal organizations, we specifically solicit additional comment on 
this proposed rule from tribal officials.

List of Subjects in 42 CFR Part 51d

    Administrative practice and procedure, Grant programs-health, 
Health facilities, Emergency medical services, Disaster assistance, 
Mental health programs, Drug abuse, Privacy, Reporting and 
recordkeeping requirements.

    Dated: September 20, 2001.
Tommy G. Thompson,
Secretary.

    For the reasons stated above, the Department of Health and Human 
Services adds to Subchapter D of Title 42 CFR, a new part 51d to read 
as follows:

PART 51d--MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE 
PROCEDURES

Sec.
51d.1  To what does this subpart apply?
51d.2  Definitions.
51d.3  Who is eligible for an award under this subpart?
51d.4  What information is required in the application?
51d.5  How is an emergency determined to exist?
51d.6  How will funding applications be evaluated and awarded?
51d.7  What are the limitations on how award funds may be used?
51d.8  Which other HHS regulations apply to these awards?
51d.9  What other conditions apply to these awards?
51d.10  What are the reporting requirements?

    Authority: 42 U.S.C. 290aa(m).


Sec. 51d.1  To what does this subpart apply?

    The regulations in this subpart apply to grants that enable public 
entities to respond to needs in local communities created by mental 
health or substance abuse emergencies, as authorized under section 
501(m) of the Public Health Service Act (42 U.S.C. 290aa(m)).


Sec. 51d.2  Definitions.

    As used in this part:
    Federally recognized Indian Tribal government means the governing 
body of any Indian tribe, band, nation, or other organized group or 
community, including any Native village as defined in, or established 
pursuant to, the Alaska Native Claims Settlement Act (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;
    Immediate award means a short term award of up to $50,000, or such 
greater amount as determined by the Secretary on a case-by-case basis, 
to address the immediate needs resulting from a mental health or 
substance abuse emergency. Such funding may be provided for a period of 
up to 90 days.
    Intermediate award means an award intended to meet the more ongoing 
needs resulting from a mental health or substance abuse emergency than 
is possible under an Immediate award. Intermediate awards may fund up 
to one year of services, although in some exceptional circumstances, 
and to the extent that funding is available, such funding may be 
continued for an additional period of up to one year.
    Presidential disaster declaration means a declaration pursuant to 
the Robert T. Stafford Disaster Relief and Emergency Assistance Act 
(Stafford Act), 42 U.S.C. 5121 et seq.
    Public entity means any State, any political subdivision of a 
State, any

[[Page 51878]]

Federally recognized Indian tribal government or tribal organization.
    Secretary means the Secretary of Health and Human Services (HHS) or 
any other officer or employee of that Department to whom the authority 
involved has been delegated.
    State means one of the 50 States, the District of Columbia, Guam, 
the Commonwealth of Puerto Rico, the Northern Mariana Islands, the 
Virgin Islands, American Samoa, and the Trust Territory of the Pacific 
Islands.
    Tribal organization means the recognized governing body of any 
Indian tribe; any legally established organization of Indians which is 
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.


Sec. 51d.3  Who is eligible for an award under this subpart?

    An applicant must be a public entity as defined by this subpart. 
Applicants are eligible for either or both Immediate and Intermediate 
awards.


Sec. 51d.4  What information is required in the application?

    (a) Application for Immediate awards: The application is to contain 
the following information:
    (1) A certification by the State's chief executive officer, or, for 
the purposes of a Federally recognized Indian tribal government, the 
principal elected official, or such officer's or official's designee, 
that a mental health or substance abuse emergency exists, as well as a 
written statement setting out the basis for the certification;
    (2) A brief program plan describing needs;
    (3) An estimate of the number of people to be served and the 
geographical area to be served;
    (4) A description of the types of services to be provided;
    (5) A budget justifying the amount of the request;
    (6) Required certifications; and
    (7) Such other pertinent information as the Secretary may require.
    (b) Application for Intermediate awards: The application is to be 
submitted on an OMB-approved application form and contain the 
following:
    (1) If the applicant has not applied previously for an Immediate 
award, a certification by the State's chief executive officer, or, for 
the purposes of a Federally recognized Indian tribal government, the 
principal elected official, or such officer's or official's designee, 
that a mental health or substance abuse emergency exists, as well as a 
written statement setting out the basis for the certification;
    (2) An application submission date within three months of the date 
of the event that precipitated the mental health or substance abuse 
emergency, as certified in accordance with 51d.4(a)(1) or (b)(1), 
except that upon the request of a State, the Secretary may provide a 
waiver of this application submission deadline if the Secretary 
determines there is good cause to justify the waiver;
    (3) A detailed and comprehensive assessment of need;
    (4) Demographics specific to the estimated number of people to be 
served;
    (5) A description of the services that were provided up to the date 
of the submission of the Intermediate award application;
    (6) The geographical area to be served;
    (7) A detailed implementation program plan and related time line, 
including a description of outreach to special population groups 
affected by the crisis;
    (8) A budget justifying the amount of the request for personnel, 
equipment, supplies, travel, training, data collection and any 
technical assistance required; the budget shall include an 
identification of the resources the applicant is able to commit to the 
project, if any, including any in-kind contributions;
    (9) Any information that has changed since an Immediate application 
was submitted, if one was submitted; and
    (10) such other pertinent information as the Secretary may require.
    (c) Signature on Award Applications. The application must be signed 
by an individual authorized to act for the applicant and to assume on 
behalf of the applicant the obligations imposed by the statute, all 
applicable regulations, and any additional conditions of the grant.


Sec. 51d.5  How is an emergency determined to exist?

    (a) In making a decision as to whether a mental health or substance 
abuse emergency exists for purposes of section 501(m) of the PHS Act, 
the Secretary, using discretion, will consider all relevant factors, 
but at a minimum the following must exist:
    (1) Existing State, Tribal and local systems for mental health and/
or substance abuse services are overwhelmed or unable to meet the 
existing mental health or substance abuse needs of the local community 
at issue; and
    (2) This inability to meet the mental health and/or substance abuse 
service needs of a local community is the direct consequence of a clear 
precipitating event. This precipitating event must:
    (i) Have a sudden, rapid onset and a definite conclusion, such as:
    (A) A natural disaster (including, but not limited to, a hurricane, 
tornado, storm, flood, earthquake, fire, drought, or other natural 
catastrophe); or
    (B) A technological disaster (including, but not limited to, a 
chemical spill, a major industrial accident, or a transportation 
accident); or
    (C) A criminal act with significant casualties (including, but not 
limited to, a domestic act of terrorism, a hostage situation, or an 
incident of mass violence including school shootings and riots); and
    (ii) Result in significant:
    (A) Death,
    (B) Injury,
    (C) Exposure to life-threatening circumstances,
    (D) Hardship,
    (E) Suffering,
    (F) Loss of property, or
    (G) Loss of community infrastructure (e.g., loss of treatment 
facilities, staff, public transportation and/or utilities, or isolation 
from services); and
    (3) No other local, State, Tribal or Federal funding is available 
to adequately address the specific level of need resulting from the 
precipitating event and resulting emergency mental health and/or 
substance abuse service needs of the impacted community.
    (b) In making a determination that a mental health or substance 
abuse emergency exists, the Secretary will consider the certification 
and written statements provided in accordance with Sec. 51d.4(a)(1) or 
(b)(1), and other information independently available to the Secretary.
    (c) Once the Secretary determines that a mental health or substance 
abuse emergency exists, the Secretary may exercise discretion to make 
awards to enable public entities to respond to the emergency, within 
the limits of funds available.


Sec. 51d.6  How will applications be evaluated and awarded?

    (a) In assessing applications for funding, the Secretary will 
utilize the following criteria.
    (1) Documentation of Need. Applicant has demonstrated mental health 
and/or substance abuse needs directly resulting from the precipitating 
event. The precipitating event is clearly identified along with 
information regarding its impact. Applicant has identified any

[[Page 51879]]

high risk groups or populations with special concerns that may impact 
the delivery of services (e.g., children, adolescents, older adults, 
ethnic and cultural groups, lower income populations). This 
documentation of need shall include the extent of physical, 
psychological and social problems observed, and a description of how 
the estimate of the number of people to be served was made. Applicant 
has clearly documented that no other local, State, Tribal or Federal 
funding sources are available to address the need.
    (2) Plan of Services. Applicant has a clear plan of services to 
address documented needs within a defined geographic area and in a 
specified time period. The plan of services is appropriate to the type 
of grant requested (e.g., Immediate or Intermediate) and specifically 
addresses the needs of any high risk groups or populations with special 
concerns identified in the assessment of need. The plan of services 
clearly identifies the following:
    (a) The types of services to be provided (e.g., outreach, crisis 
counseling, public education on stress management and crisis mental 
health, public education on substance abuse prevention, information and 
referral services, short term substance abuse or mental health 
prevention and/or treatment services);
    (b) Strategies for targeting those identified as needing services, 
including high risk groups or populations with special concerns 
identified in the needs assessment;
    (c) Appropriate training to be provided to staff to assure that 
services are appropriate to the crisis situation and the plans for 
community recovery;
    (d) Quality control methods in place to assure appropriate services 
to the target population;
    (e) Staff support mechanisms that are available;
    (f) Plans for coordination of services with key local, State, 
Tribal and Federal partners involved in addressing the precipitating 
event (e.g., emergency management agencies, law enforcement, education 
agencies, public health agencies, and other agencies active in crisis 
response); and
    (g) An estimate of the length of time for which said services 
requiring Federal funding will be needed, and the manner in which long-
term cases will be referred for continued assistance after Federal 
funds have ended.
    (3) Organizational Capability. Applicant is a public entity with 
demonstrated organizational capacity to deliver services as described 
in the plan of services. The applicant should also have a demonstrated 
history of service delivery to the target population within the defined 
service area for the program. The budget submitted shall provide 
sufficient justification and demonstrate that it is consistent with the 
documentation of need and plan of services. This shall include a 
description of the facilities to be utilized, including plans for 
securing office space if necessary to the project.
    (b) In determining the appropriateness and necessity of funding, 
the Secretary may consult with other Federal agencies responsible for 
responding to crisis incidents, including the Readiness, Response and 
Recovery Directorate within the Federal Emergency Management Agency 
(FEMA), the Safe and Drug Free Schools Program within the U.S. 
Department of Education, the Office for Victims of Crime (OVC) within 
the U.S. Department of Justice, the National Transportation Safety 
Board (NTSB) within the U.S. Department of Transportation, the 
Emergency Response Program within the Environmental Protection Agency 
(EPA), the Bureau of Indian Affairs (BIA) within the U.S. Department of 
the Interior, the Animal and Plant Health Inspection Service within the 
U.S. Department of Agriculture, the Indian Health Service (IHS) within 
the U.S. Department of Health and Human Services, and other Federal 
agencies with jurisdiction over specific types of crisis response.


Sec. 51d.7  What are the limitations on how award funds may be used?

    Unallowable Expenses: The following expenses will not be reimbursed 
under section 501(m) of the PHS Act:
    (1) Major construction costs;
    (2) Childcare services, unless provided by the institution or 
entity providing mental health or substance abuse treatment and 
integral to the treatment program;
    (3) Services outside of the geographic area specified in the 
application, except to the extent that the precipitating event requires 
physical relocation of either affected parties or facilities;
    (4) Any mental health or substance abuse services not directly 
related to the mental health or substance abuse emergency;
    (5) Any expenses that supplant ongoing local, State, Tribal or 
Federal expenditures; and
    (6) Any other costs unallowable by Federal law or regulation.


Sec. 51d.8  Which other HHS regulations apply to these awards?

    Several other HHS regulations apply to grants under this part. 
These include, but are not limited to:

42 CFR part 50, subpart D--Public Health Service grant appeals 
procedure
45 CFR part 16--Procedures of the Departmental Grant Appeals Board
45 CFR part 74--Administration of grants
45 CFR part 75--Informal grant appeals procedures
45 CFR part 76--Debarment and suspension from eligibility for financial 
assistance
45 CFR part 80--Nondiscrimination under programs receiving Federal 
assistance through the Department of Health and Human Services 
effectuation of title VI of the Civil Rights Act of 1964
45 CFR part 81--Practice and procedure for hearings under part 80 of 
this title
45 CFR part 84--Nondiscrimination on the basis of handicap in programs 
and activities receiving or benefitting from Federal financial 
assistance
45 CFR part 86--Nondiscrimination on the basis of sex in education 
programs and activities receiving or benefitting from Federal financial 
assistance
45 CFR part 91--Nondiscrimination on the basis of age in HHS programs 
or activities receiving Federal financial assistance
45 CFR part 92--Uniform administrative requirements for grants and 
cooperative agreements to state and local governments


Sec. 51d.9  What other conditions apply to these awards?

    Award funding made under this authority is to be supplemental in 
nature. Consistent with the criteria in Sec. 51d.5 and the 
certification in Sec. 51d.4(a)(1), such funds will only be made 
available if no other local, State, Tribal or Federal source is 
available to adequately address the emergency mental health and/or 
substance abuse service needs of the impacted community.


Sec. 51d.10  What are the reporting requirements?

    (a) For immediate awards:
    (1) A mid-program report only if an Intermediate award application 
is being prepared and submitted. This report shall be included as part 
of the Intermediate award application,
    (2) Quarterly financial status reports of expenditures to date, due 
30 days

[[Page 51880]]

following the end of the reporting period, as permitted by 45 CFR 
92.41(b),
    (3) A final program report, a financial status report, and a final 
voucher 90 days after the last day of Immediate award services, in 
accordance with 45 CFR 92.50(b).
    (b) For intermediate awards:
    (1) Quarterly progress reports, due 30 days following the end of 
the reporting period, as permitted by 45 CFR 92.40(b),
    (2) Quarterly financial status reports of expenditures to date, due 
30 days following the end of the reporting period, as permitted by 45 
CFR 92.41(b),
    (3) A final program report, to be submitted within 90 days after 
the end of the program services period, in accordance with 45 CFR 
92.50(b),
    (4) A financial status report, to be submitted within 90 days after 
the end of the program services period, in accordance with 45 CFR 
92.50(b),
    (5) Such additional reports as the Secretary may require.
    (c) The following shall be specifically addressed in final program 
reports:
    (1) Description of services provided,
    (2) Number of individuals assisted,
    (3) Amount of funding expended and for what purposes,
    (4) Personnel costs,
    (5) Training costs,
    (6) Technical consultation costs,
    (7) Equipment costs,
    (8) Travel and transportation costs, and
    (9) A narrative describing lessons learned and exemplary practices, 
and a description of the transition plan, for how services will be 
funded or provided when Federal funds have been exhausted.
[FR Doc. 01-25451 Filed 10-10-01; 8:45 am]
BILLING CODE 4110-60-P