[Federal Register Volume 69, Number 102 (Wednesday, May 26, 2004)]
[Notices]
[Pages 29964-29968]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-11940]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Notice of Funding Availability (NOFA) for a Grant for Networking 
and Certifying Suicide Prevention Hotlines

    Announcement Type: Initial.
    Funding Opportunity Number: SM 04-013.
    Catalog of Federal Domestic Assistance (CFDA) Number: 93.243.
    Due Date for Applications: July 21, 2004.

(Note: Letters from State Single Point of Contact (SPOC) in response 
to E.O. 12372 are due September 20, 2004.)

SUMMARY: The Substance Abuse and Mental Health Services Administration 
(SAMHSA), Center for Mental Health Services, announces the availability 
of FY 2004 grant funds for Networking and Certifying Suicide Prevention 
Hotlines. A synopsis of this funding opportunity, as well as many other 
Federal Government funding opportunities, is also available at the 
Internet site: http://www.grants.gov.
    For complete instructions, potential applicants must obtain a copy 
of SAMHSA's standard Infrastructure Grants announcement (INF-04 PA 
(MOD)), and the PHS 5161-1 (Rev. 7/00) application form before 
preparing and submitting an application. The INF-04 PA (MOD) describes 
the general program design and provides instructions for applying for 
all SAMHSA Infrastructure Grants, including the Networking and 
Certifying Suicide Prevention Hotlines grant. Additional instructions 
and specific requirements for this funding opportunity are described 
below.

I. Funding Opportunity Description:

    Authority: Section 520A of the Public Health Service Act, as 
amended and subject to the availability of funds.

    Networking and Certifying Suicide Prevention Hotlines grant program 
is one of SAMHSA's Infrastructure Grants. In general, SAMHSA's 
Infrastructure Grants provide funds to increase the capacity of mental 
health and/or substance abuse service systems to support effective 
programs and services. This particular grant will provide funding to 
manage a toll-free national suicide prevention hotline network 
utilizing a life affirming number which routes calls from anywhere in 
the United States to a network of local crisis centers that can link 
callers to local emergency, mental health and social service resources. 
Grant funds must also be used to increase the number of crisis centers 
certified in suicide prevention.
    The goals of the Networking and Certifying Suicide Prevention 
Hotlines grant program are to:
    (1) Increase the number of crisis programs offering hotline 
services which are networked through a single, nationally accessible 
telephone number, utilizing telecommunications technology that links 
callers to their geographically nearest crisis center. It is expected 
that there will be at least one crisis program offering hotline 
services in all 50 states;
    (2) Increase the number of crisis centers/hotlines certified in 
suicide prevention, e.g., having achieved defined standards in crisis 
worker training, service delivery, lethality assessments, 
organizational administration and program evaluation; and
    (3) Evaluate, collect and analyze data regarding such issues as: As 
the use of the national suicide prevention number (including variations 
by State and area code); reasons for callers' use of the service; the 
nature and appropriateness of services provided; outcomes of the 
intervention (i.e., referrals made to emergency, mental health and 
social services resources); and the technical efficiency and 
effectiveness of the telephone service that is provided to callers. The 
evaluation must address the effectiveness of intervention services 
provided by crisis centers within the network as compared to crisis 
centers not in the network.
    To achieve these goals, the applicant will be required to engage in 
the following activities:
    (1) Network Centers: The applicant must demonstrate a capacity to 
network centers using telephone technology that permits national access 
to crisis centers or hotline services through a single toll-free 
number. This number will be selected by SAMHSA and maintained by the 
applicant. SAMHSA will choose a number that is easy to remember and is 
life affirming. The applicant will use this telephone number to 
establish and maintain the hotline network. At the end of the grant 
period, SAMHSA will determine whether if it will continue to retain the 
number or release it to the grantee. This determination will be made no 
later than six months prior to the end of the grant period. The 
technology utilized must permit calls to be directed immediately to a 
telephone suicide prevention worker who is within geographic proximity 
to the caller. The network must have the capacity to assist local 
crisis centers in identifying the telephone numbers of callers at 
imminent risk of suicide in need of emergency rescue who are unable or 
unwilling to provide a telephone number or location (e.g., caller ID, 
ANI, or call tracing). The applicant must describe in their proposed 
approach the type of call routing system to be used (i.e., carrier 
driven advanced business networking or a customized service hosted by a 
carrier but maintained through the applicant organization or through 
subcontracts). The applicant should clearly explain why they are 
proposing a particular approach. This discussion should include the 
following information: review literature that discusses determination 
of peak usage periods in order to determine the size of the network, 
average call drop rates and how the proposed approach seeks to reduce 
call drops, the cost benefits to the approach, and the specific 
features of the approach that will enhance the

[[Page 29965]]

hotline network, and provide crucial data to the individual crisis 
centers and to SAMHSA.
    In addition to establishing the telephone network, the applicant 
must clearly demonstrate the capability to provide training and 
technical assistance to the individual crisis centers on utilizing the 
network technology, provide assistance to obtain or upgrade equipment 
at the local crisis centers in order to participate in the network, 
provide incentives to the local crisis centers to maintain their 
certification, continue participation in the network and provide call 
outcome data to the applicant who will then aggregate data from all 
centers, analyze and report it to SAMHSA.
    (2) Certification of Crisis Hotlines: The applicant must increase 
the number of crisis hotlines certified in suicide prevention. Crisis 
centers participating in the network should be certified in suicide 
prevention by the American Association of Suicidology (AAS), or if not 
certified by AAS, have met accreditation standards accepted by AAS as 
equivalent, such as the Joint Commission on the Accreditation of 
Healthcare Organizations (JCAHO), the Commission on the Accreditation 
of Rehabilitation Facilities (CARF), or Contact USA. The applicant 
should have experience with, or partner with, an organization that has 
experience with certification of crisis centers in suicide prevention.
    (3) Resource Database Development: The applicant must develop a 
Resource Database that can be accessed via the Internet by all crisis 
centers, regardless of their participation in the network. This 
resource database will quickly provide the hotline center with local 
information on emergency, mental health, and social service resources 
within 50 miles of the caller's geographical area. The applicant should 
either have, or partner with, an organization that has a documented 
history of developing such a comprehensive resource database. The 
applicant may also propose to use other currently existing databases.
    (4) Program Evaluation: The applicant must conduct an evaluation of 
the grant project that accurately documents the population served by 
the toll-free crisis line service, including variations in usage by 
State and area code; the reason(s) for callers' use of the service; the 
nature and appropriateness of the service that was provided; the 
outcome(s) (i.e., referrals made to emergency, mental health, and 
social service resources); and the technical efficiency and 
effectiveness of the telephone service that is provided to callers 
using the toll-free crisis service. The applicant should either have, 
or partner with, another organization that has a documented history of 
successful evaluation efforts.
    (5) Sustainability: The applicant must propose a sustainability 
plan that ensures that the program can be self-supporting when Federal 
funding ends. The applicant must demonstrate experience in sustaining 
similar initiatives through blended public and private funding.
    (6) Financial Management: The selected applicant must demonstrate 
existence of an adequate financial management system (reference 45 CFR 
part 74, subpart C), and be capable of administering Federal awards. 
Specifically, the applicant must maintain and follow adequate policies 
and procedures that safeguard assets and determine cost allowability, 
maintain an accounting system capable of segregating grant income and 
expenditures, maintain effective accountability and control over grant 
funds, maintain accounting records supported by source documentation, 
maintain an adequate procurement system (including ability to 
administer subcontracts, if applicable), and maintain property control.
    The activities described above fall within the following categories 
of allowable activities listed in the INF-04 PA (MOD): provider/network 
development, development of interagency coordination mechanisms, data 
infrastructure development, and evaluation. Activity in the other 
categories of allowable activity defined in the INF-04 PA (MOD) are 
allowed only to the extent that the applicant can demonstrate that they 
are critical to the effective implementation of the activities that are 
required for this grant.

Background

    There are currently estimated to be over 500 operating ``crisis 
centers'' in the United States, exclusive of military and employee 
assistance programs. Some are specialty centers focusing on crises 
related to domestic violence or rape. Others see their mission as 
responding to the needs of all types of personal and family crises. The 
primary objective of the crisis center is to diffuse the immediate 
crisis, ensure the caller's safety, and assist the caller to take the 
next immediate steps toward resolving the problem. In any type of 
serious personal crisis, the potential for suicidal thoughts and 
behaviors exist. In published surveys, 10 percent of calls to all types 
of crisis programs involve suicidality. Hotline crisis services 
represent one of many possible effective interventions for suicidality.
    ``Hotline'' crisis services may be directly associated with a 
single crisis center, which also offers face-to-face client services, 
or be a ``hotline-only'' service in which there are no associated face-
to-face services. Such ``hotline-only'' centers may be hundreds or 
thousands of miles from the location of the caller and often maintain 
databases of crisis, mental health, and social services local to the 
caller to which that person can be referred if indicated. ``Suicide 
prevention hotlines'' are staffed with suicide prevention workers who 
establish and maintain contact with the individual while identifying 
and clarifying the problem, evaluating the potential for suicide, 
assessing the individual's strengths and resources, and mobilizing 
available resources including paramedic or police intervention and 
emergency psychiatric care as needed.
    ``Suicide prevention hotlines'' may be stand-alone ``hotline only'' 
services, may operate out of community agencies, or be part of 
organized health and mental health care delivery systems. While suicide 
prevention hotlines have been in existence for more than forty years, 
access to such services in many areas has been either highly variable 
or non-existent. The multiplicity of phone numbers for local hotlines 
made national, state or regional public education campaigns impossible. 
This led to support for a single, toll free, nationally accessible 
telephone number for suicide prevention, utilizing telecommunications 
technology that links callers to their geographically nearest crisis 
center.
    Though not all crisis centers have widely publicized ``hotline'' 
services, it is generally believed that most, if not all, centers field 
crisis calls from suicidal individuals. While face-to-face assessment 
and counseling in the work of crisis centers are to a large degree done 
by health professionals, much of the important work of telephone crisis 
intervention is done by trained volunteers. The use of trained 
volunteers in the role of telephone crisis workers has existed for many 
years and spawned the development of standards to guide them in their 
work. Workers responding to suicidal callers should be trained in the 
use of clinical intervention techniques. The certification of crisis 
centers in suicide prevention is a crucial component of this grant. 
Many crisis centers do not operate out of organized health delivery 
systems, such as hospitals or community mental health centers. State 
laws and regulations governing the use

[[Page 29966]]

of terms such as ``crisis center'', ``crisis line'', or ``hotline'' 
either do not exist or vary widely. The majority of crisis center 
workers are volunteers who do not fall under any state licensing laws 
for mental health professionals. Thus, voluntary certification for 
meeting nationally recognized suicide prevention standards is virtually 
the only form of external, task specific quality control that exists 
for many crisis centers. The success of the network is ultimately tied 
to the adherence of participating crisis centers to nationally 
recognized standards for suicide prevention.

Definitions

    Crisis center: A program that establishes immediate telephone 
communication between people who are emotionally distressed and 
individuals who have been trained to provide telephone assistance to 
diffuse the crisis, ensure the caller's safety, and assist the caller 
to take next steps toward resolving the problem.
    Hotline crisis services: A telephone service directly associated 
with a single crisis center.
    Suicide prevention hotline: A program that provides telephone 
crisis intervention services to individuals expressing suicidal 
thoughts or behavior, or to others calling on behalf of such persons in 
crisis, with the objective of exploring alternatives to self-harm.

II. Award Information

1. Estimated Funding Available/Number of Awards

    It is expected that up to $2.2 million will be available to fund 
one award in FY 2004. It is expected that only one Category 2--
Comprehensive Infrastructure Grant, as defined in the INF-04 PA (MOD), 
will be awarded. The maximum allowable award is $2.2 million in total 
costs (direct and indirect) per year for three years. Proposed budgets 
cannot exceed the allowable amount in any year of the proposed project. 
The actual amount available for the award may vary, depending on 
unanticipated program requirements and the quality of the applications 
received. Annual continuations will depend on the availability of 
funds, progress in meeting program goals and objectives, and timely 
submission of required data and reports.

2. Funding Instrument

    Cooperative agreement.
    Role of the Grantee:
     Comply with the terms of the award and all applicable 
grant rules and regulations, and satisfactorily perform activities to 
achieve the goals described below;
     Seek SAMHSA approval for key positions to be filled. The 
key positions include: project director, networking/telephony director, 
certification director, evaluation director, database director;
     Seek SAMHSA approval of proposed approach to networking of 
hotlines prior to implementing proposed design and accept SAMHSA-
recommended modifications to approach;
     Consult with and accept guidance from CMHS staff on 
performance of activities to achieve goals described below;
     Respond to requests for information from CMHS;
     Agree to provide SAMHSA with data required for the 
Government Performance and Results Act (GPRA);
     Manage the toll free telephone number selected by SAMHSA 
through the end of the grant period and relinquish control of the 
telephone number to SAMHSA or to another organization, if required;
     Produce required SAMHSA reports.
    Role of SAMHSA staff:
     Maintain overall responsibility for monitoring the conduct 
and progress of the suicide prevention hotline networking and 
certification program;
     Approve proposed key positions/personnel
     Review proposed approach and request modifications to 
approach and/or approve the approach;
     Make recommendations regarding continued funding;
     Provide guidance and technical assistance on project 
design;
     Approve all proposed subcontracts;
     Review quarterly reports and conduct a site visit, if 
warranted;
     Review and approve the evaluation plan, including the 
sites selected to participate in the evaluation;
     Approve data collection plans and institute policies 
regarding data collection;
     Recommend consultants for assisting with the resource 
database, evaluation, and data collection, if needed; and
     Provide technical assistance, as needed, on sustainability 
and to assist in disseminating the resource database to non-networked 
crisis centers.
     Provide a toll free number that is easy to remember, life 
affirming and test marketed.

III. Eligibility Information

1. Eligible Applicants

    Eligible applicants are domestic public and private nonprofit 
entities. For example, State, local or tribal governments; public or 
private universities and colleges; community- and faith-based 
organizations; and tribal organizations may apply. The statutory 
authority for this program precludes grants to for-profit 
organizations.

2. Cost Sharing or Matching

    Is not required.

3. Other

    Applicants must also meet certain application formatting and 
submission requirements, or the application will be screened out and 
will not be reviewed. These requirements are described in Section IV-2 
below, as well as in the INF-04 PA (MOD).

IV. Application and Submission Information

1. Address To Request Application Package

    Complete application kits may be obtained from the National Mental 
Health Information Center at 1-800-789-2647. When requesting an 
application kit for this program, the applicant must specify the 
funding opportunity title (Networking and Certifying Suicide Prevention 
Hotlines) and the funding opportunity number (SM 04-013) for which 
detailed information is desired. All information necessary to apply, 
including where to submit applications and application deadline 
instructions, is included in the application kit. The PHS 5161-1 
application form is also available electronically via SAMHSA's World 
Wide Web home page: http://www.samhsa.gov (Click on ``Grant 
Opportunities'') and the INF-04 PA (MOD) is available electronically at 
http://www.samhsa.gov/grants/2004/standard/Infrastructure/index.asp.
    When submitting an application, be sure to type ``SM 04-013 
Networking and Certifying Suicide Prevention Hotlines'' in Item Number 
10 on the face page of the application form. Also, SAMHSA applicants 
are required to provide a DUNS Number on the face page of the 
application. To obtain a DUNS Number, access the Dun and Bradstreet Web 
site at http://www.dunandbradstreet.com or call 1-866-705-5711.

2. Content and Form of Application Submission

    Appendices 3 and 5, referenced in the INF-04 PA (MOD) in Section 
IV-2, are

[[Page 29967]]

not required and should not be included in the application. Additional 
information including required documents, required application 
components, and application formatting requirements is available in the 
INF-04 PA (MOD) in Section IV-2.
Checklist for Formatting Requirements and Screenout Criteria for SAMHSA 
Grant Applications
    SAMHSA's goal is to review all applications submitted for grant 
funding. However, this goal must be balanced against SAMHSA's 
obligation to ensure equitable treatment of applications. For this 
reason, SAMHSA has established certain formatting requirements for its 
applications. If you do not adhere to these requirements, your 
application will be screened out and returned to you without review.
     Use the PHS 5161-1 application.
     Applications must be received by the application deadline. 
Applications received after this date must have a proof of mailing date 
from the carrier dated at least 1 week prior to the due date. Private 
metered postmarks are not acceptable as proof of timely mailing. 
Applications not received by the application deadline or not postmarked 
at least 1 week prior to the application deadline will not be reviewed.
     Information provided must be sufficient for review.
     Text must be legible.

--Type size in the Project Narrative cannot exceed an average of 15 
characters per inch, as measured on the physical page. (Type size in 
charts, tables, graphs, and footnotes will not be considered in 
determining compliance.)
--Text in the Project Narrative cannot exceed 6 lines per vertical 
inch.

     Paper must be white paper and 8.5 inches by 11.0 inches in 
size.
     To ensure equity among applications, the amount of space 
allowed for the Project Narrative cannot be exceeded.

--Applications would meet this requirement by using all margins (left, 
right, top, bottom) of at least one inch each, and adhering to the page 
limit for the Project Narrative stated in the specific funding 
announcement.
--Should an application not conform to these margin or page limits, 
SAMHSA will use the following method to determine compliance: The total 
area of the Project Narrative (excluding margins, but including charts, 
tables, graphs and footnotes) cannot exceed 58.5 square inches 
multiplied by the page limit. This number represents the full page less 
margins, multiplied by the total number of allowed pages.
--Space will be measured on the physical page. Space left blank within 
the Project Narrative (excluding margins) is considered part of the 
Project Narrative, in determining compliance.

     The page limit for Appendices stated in the specific 
funding announcement cannot be exceeded.
    To facilitate review of your application, follow these additional 
guidelines. Failure to adhere to the following guidelines will not, in 
itself, result in your application being screened out and returned 
without review. However, the information provided in your application 
must be sufficient for review. Following these guidelines will help 
ensure your application is complete, and will help reviewers to 
consider your application.
     The 10 application components required for SAMHSA 
applications should be included. These are:

--Face Page (Standard Form 424, which is in PHS 5161-1)
--Abstract
--Table of Contents
--Budget Form (Standard Form 424A, which is in PHS 5161-1)
--Project Narrative and Supporting Documentation
--Appendices
--Assurances (Standard Form 424B, which is in PHS 5161-1)
--Certifications (a form in PHS 5161-1)
--Disclosure of Lobbying Activities (Standard Form LLL, which is in PHS 
5161-1)
--Checklist (a form in PHS 5161-1)

     Applications should comply with the following 
requirements:

--Provisions relating to confidentiality, participant protection and 
the protection of human subjects, as indicated in the specific funding 
announcement.
--Budgetary limitations as indicated in Sections I, II, and IV-5 of the 
specific funding announcement.
--Documentation of nonprofit status as required in the PHS 5161-1.

     Pages should be typed single-spaced with one column per 
page.
     Pages should not have printing on both sides.
     Please use black ink, and number pages consecutively from 
beginning to end so that information can be located easily during 
review of the application. The cover page should be page 1, the 
abstract page should be page 2, and the table of contents page should 
be page 3. Appendices should be labeled and separated from the Project 
Narrative and budget Section, and the pages should be numbered to 
continue the sequence
     Send the original application and two copies to the 
mailing address in the funding announcement. Please do not use staples, 
paper clips, and fasteners. Nothing should be attached, stapled, 
folded, or pasted. Do not use heavy or lightweight paper, or any 
material that cannot be copied using automatic copying machines. Odd-
sized and oversized attachments such as posters will not be copied or 
sent to reviewers. Do not include videotapes, audiotapes, or CD-ROMs.

3. Submission Dates and Times

    Applications must be received by July 21, 2004. You will be 
notified by postal mail that your application has been received. 
Additional submission information is available in the INF-04 PA (MOD) 
in Section IV-3.

4. Intergovernmental Review

    Applicants for this funding opportunity must comply with Executive 
Order 12372 (E.O. 12372). E.O. 12372, as implemented through Department 
of Health and Human Services (DHHS) regulation at 45 CFR part 100, sets 
up a system for State and local review of applications for Federal 
financial assistance. Instructions for complying with E.O. 12372 are 
provided in the INF-04 PA (MOD) in Section IV-4. A current listing of 
State Single Points of Contact (SPOCs) is included in the application 
kit and is available at http://www.whitehouse.gov/omb/grants/spoc.html.

5. Funding Restrictions

    Funds for the Networking and Certification of Suicide Prevention 
Hotlines grant may not be used for implementation pilots, as stated in 
the INF-04 PA (MOD). Additional information concerning funding 
restrictions is available in the INF-04 PA (MOD) in Section IV-5.

V. Application Review Information

1. Evaluation Criteria

    Applications will be reviewed against the Evaluation Criteria and 
requirements for the Project Narrative specified in the INF-04 PA 
(MOD). The following information describes exceptions or limitations to 
the INF-04 PA (MOD) and provides special requirements that pertain only 
to the grant for Networking and Certifying Suicide Prevention Hotlines.
    Note that implementation pilots referenced in the INF-04 PA (MOD) 
may not be included in this grant program.
    Applicants must discuss the following requirements in their 
applications, in addition to the requirements specified in the INF-04 
PA (MOD):

[[Page 29968]]

1.1 In ``Section A: Statement of Need''
    a. The target population for this program is the total potential 
number of suicidal persons who may seek help through hotline services 
in the United States. The applicant should address the needs of this 
target population in Section A of the Project Narrative.
    b. Applicants may disregard the 4th bullet in Section A that 
requests applicants to show that the identified need for the proposed 
project is consistent with the State's priorities. This requirement 
does not apply because the scope of this grant program is nationwide.
1.2 In ``Section B: Proposed Approach''
    Applicants must address the goals and activities of the grant for 
Networking and Certifying Suicide Prevention Hotlines identified in 
Section I of this NOFA when responding to the bullets in Section B of 
the INF-04 PA (MOD).
1.3 In ``Section D: Evaluation and Data''
    All SAMHSA grantees are required to collect and report certain 
data, so that SAMHSA can meet its obligations under the Government 
Performance and Results Act (GPRA). The Networking and Certifying 
Suicide Prevention Hotlines grantee will be required to report on the 
increase in the number of hotline centers included in the network and 
the increase in the number certified in suicide prevention. Applicants 
must document their ability to collect and report on these measures in 
``Section E: Evaluation and Data'' of their applications

2. Review and Selection Process

    Information about the review and selection process is available in 
the INF-04 PA (MOD) in Section V-2.

VI. Award Administration Information

    Award administration information, including award notices, 
administrative and national policy requirements, and reporting 
requirements are available in the INF-04 PA (MOD) in Section VI. 
SAMHSA's standard terms and conditions are available at http://www.samhsa.gov/grants/2004/useful_info.asp. Note that the Networking 
and Certifying Suicide Prevention Hotlines grantee will be required to 
provide quarterly progress/financial reports in addition to annual 
progress/financial reports. The quarterly reporting format, including 
crisis center call data, is under development by SAMHSA.

VII. Agency Contact for Additional Information

    For questions about program issues, contact: Brenda Bruun, SAMHSA/
CMHS, Division of Prevention, Traumatic Stress and Special Programs, 
5600 Fishers Lane, Room 17C-26, Rockville, MD 20857; 301-443-4669; e-
mail: [email protected]. For questions on grants management issues, 
contact: Gwendolyn Simpson, SAMHSA/Division of Grants Management, 5600 
Fishers Lane, Room 13-103, Rockville, MD 20857; 301-443-4456; e-mail: 
[email protected].

    Dated: May 20, 2004.
Daryl Kade,
Director, Office of Policy, Planning and Budget, Substance Abuse and 
Mental Health Services Administration.
[FR Doc. 04-11940 Filed 5-25-04; 8:45 am]
BILLING CODE 4162-20-P