[Federal Register Volume 69, Number 134 (Wednesday, July 14, 2004)]
[Notices]
[Pages 42245-42248]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-15965]



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DEPARTMENT OF VETERANS AFFAIRS


Fund Availability Under VA Homeless Providers Grant and Per Diem 
Program; Grants for Services to Chronically Mentally Ill Homeless 
Veterans

AGENCY: Department of Veterans Affairs.

ACTION: Notice of fund availability.

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SUMMARY: The Department of Veterans Affairs (VA) is announcing the 
availability of funds for currently operational VA Homeless Providers 
Grant and Per Diem Recipients that are providing services at the time 
of the application to make applications for assistance in the delivery 
of services to the homeless chronically mentally ill veteran 
population. The focus of this Notice of Fund Availability (NOFA) under 
the Special Needs Grant Component of VA's Homeless Providers Grant and 
Per Diem (GPD) Program is to encourage applicants to collaborate with 
VA Health Care Facilities in the delivery of such services. This NOFA 
contains information concerning the program, application process, and 
amount of funding available.

DATES: Application deadline. An original completed and collated grant 
application (plus three completed collated copies) for each project 
seeking assistance under this NOFA must be received in the VA Homeless 
Providers Grant and Per Diem Field Office, by 4 p.m. eastern time on 
August 17, 2004. Applications may not be sent by facsimile (FAX), e-
mail, or other electronic means. In the interest of fairness to all 
competing applicants, this deadline is firm as to date and hour, and VA 
will treat as ineligible for consideration any application that is 
received after the deadline.
    Applicants should take this practice into account and make early 
submission of their material to avoid any risk of loss of eligibility 
brought about by unanticipated delays or other delivery-related 
problems.
    For a Copy of the Application Package: Download directly from VA's 
Homeless Providers Grant and Per Diem Program Web page at: http://www.va.gov/homeless/page.cfm?pg=3 or call the VA Homeless Providers 
Grant and Per Diem Program Field Office at (toll-free) 1-877-332-0334. 
For a document relating to the VA's Homeless Providers Grant and Per 
Diem Program, see the regulations at 38 CFR part 61.
    Submission of Application: An original completed and collated grant 
application (plus three copies) for each project must be submitted to 
the following address: VA Homeless Providers Grant and Per Diem Field 
Office, 10770 N. 46th Street, Suite C-100, Tampa, FL 33617. 
Applications must be received in the VA Homeless Providers Grant and 
Per Diem Field Office by the application deadline. Applications must 
arrive as a complete package. For those agencies that choose to 
collaborate with a VA Health Care Facility the documentation to be 
provided by the VA collaborative partner for assurance of non-
duplication of services through collaboration must be included with the 
application package (see Funding Priority 1). Materials arriving 
separately will not be included in the application package for 
consideration. If all materials are not included in the application 
package, it will result in the application being rejected or not 
funded.

FOR FURTHER INFORMATION CONTACT: Guy Liedke, VA Homeless Providers 
Grant and Per Diem Program, Department of Veterans Affairs, 10770 N. 
46th Street, Suite C-100, Tampa, FL 33617; (toll-free) 1-877-332-0334.

SUPPLEMENTARY INFORMATION: This NOFA announces the availability of 
funds for assistance under the VA Homeless Providers Grant and Per Diem 
Program (Program) for eligible operational grant and per diem 
recipients to receive grant assistance with additional operational 
costs that would not otherwise be incurred but for the fact that the 
recipient is providing supportive housing beds and services or at 
service centers for the special needs of the chronically mentally ill 
homeless veteran population.
    ``Chronically mentally ill'' is for purposes of this Program 
defined in 38 CFR 61.1, Definitions, as: * * * a condition of 
schizophrenia or major affective disorder (including bipolar disorder) 
or post-traumatic stress disorder (PTSD), based on a diagnosis from a 
licensed mental health professional, with at least one documented 
hospitalization for this condition sometime in the last 2 years or with 
documentation of a formal assessment on a standardized scale of any 
serious symptomology or serious impairment in the areas of work, family 
relations, thinking, or mood.''
    It is widely accepted by the mental health community that the 
chronically mentally ill population requires additional resources due 
to the intensive nature of their care.
    Additionally, it has been noted that a significant contributing 
factor to homelessness is chronic mental illness. Consequently, VA has 
decided to offer funding to providers who serve this special need 
population in a separate NOFA. In an effort to prevent non-duplication 
of services, encourage cost effectiveness, and ensure the use of 
appropriate models for treatment of the chronically mentally ill, a 
funding priority will be given to applicants who collaborate their 
delivery of services to this veteran population with their local VA 
Medical Center by agreeing to use a portion of their funding to provide 
services within the guidelines of the models listed in this NOFA.
    VA is seeking, through this NOFA, to identify and select several 
grant and per diem providers and VA Health Care Facilities to 
collaborate through the use of the ``Critical Time Intervention'' (CTI) 
model and ``Vet-to-Vet'' (VTV) counseling/assistance model with 
``Permanent Housing Assistance'' (PHA) that will involve treatment of 
the chronically mentally ill homeless veteran population. Eligible 
applicants that choose to provide these types of services to the 
homeless chronically mentally ill will be given a funding priority (see 
Funding Priority 1). Additionally, VA anticipates that not all eligible 
entities will have the ability to deliver services in collaboration as 
listed above and therefore encourages all eligible faith-based and 
community entities regardless of service delivery method and type to 
seek funding under this NOFA (see Funding Priority 2).
    Public Law 107-95, the Homeless Veterans Comprehensive Assistance 
Act of 2001, authorizes this Program. It authorizes grants to be 
offered to both VA health care facilities and operational grant and per 
diem providers to encourage development by those facilities and 
providers of programs for homeless veterans with special needs (38 
U.S.C. 2061).
    Grant and per diem providers may only apply under this Notice for: 
The provision of service, operation, or personnel with regard to the 
homeless chronically mentally ill special needs veteran population.
    Generally, providers may, in addition to establishing the Vet-to-
Vet/Permanent Housing Assistance model, offer the following:
    Chronically Mentally Ill:

    (1) Help participants join in and engage with the community;
    (2) Facilitate reintegration with the community and provide 
services that may optimize reintegration, such as life-skills 
education, recreational activities, and follow-up case management;
    (3) Ensure that participants have opportunities and services for 
re-establishing relationships with family;

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    (4) Ensure adequate supervision, including supervision of 
medication and monitoring of medication compliance; and
    (5) Provide opportunities for participants, either directly or 
through referral, to obtain other services particularly relevant for a 
chronically mentally ill population, such as vocational development, 
benefits management, fiduciary or money management services, medication 
compliance, and medication education.


    Note: Successful applicants will be required to designate at 
least one representative from the organization to attend a post-
award conference. The conference will be held in Washington, DC and 
is expected to extend over a two-day period. Applicants will be 
required to cover costs of travel, lodging, and meals associated 
with their attendance at the post-award conference; however, these 
costs can be included in budgets submitted for consideration for 
reimbursement of allowable costs under the grant.

    No part of a special need grant may be used for any purpose that 
would change significantly the scope of the specific grant and per diem 
project for which a capital grant and per diem was awarded. As a part 
of the review process, VA will review the original project listed in 
the special need application to ensure significant scope changes do not 
occur displacing other homeless veteran populations. VA may reject for 
Special Needs Funding those applications that significantly alter the 
original scope (38 CFR 61.62).
    Example 1: A provider currently has 50 beds and finds in the course 
of normal operation that at any given time the project is serving 20 
homeless veterans who are chronically mentally ill. This provider could 
apply for special needs funding to assist in the additional operational 
costs that are incurred due to providing services to these 20 
chronically mentally ill homeless veterans.
    Example 2: A provider currently has 50 beds and finds in the course 
of normal operation that the addition of a staff member would allow the 
project to serve homeless chronically mentally ill veterans who must be 
currently referred to other sources. This provider could apply for 
special needs funding to assist in the additional operational costs 
that are incurred due to development of providing services to homeless 
chronically mentally ill veterans.
    Example 3: A provider currently has 50 beds serving the general 
homeless veteran population and now wants to serve ``only'' chronically 
mentally ill homeless veterans in the 50 beds. This provider could not 
apply for special needs funding, as it would significantly alter the 
scope of the original project.
    A separate special needs application is required for each 
previously funded grant and per diem project identified by unique 
project number (see Application Requirements in this NOFA).
    Special needs funding may not be used for capital improvements or 
to purchase vans or real property. However, the leasing of vans or real 
property may be acceptable. Questions regarding acceptability should be 
directed to VA's Homeless Providers Grant and Per Diem Field Office, at 
1-877-332-0334. Applicants may not receive special needs assistance to 
replace funds provided by any Federal, State, or local government 
agency or program to assist homeless persons.

    Authority: VA's Homeless Providers Grant and Per Diem Program is 
authorized by Pub. L. 107-95, the Homeless Veterans Comprehensive 
Assistance Act of 2001, section 5(a)(1), codified at 38 U.S.C. 
chapter 20 (38 U.S.C. 2001 through 2066). The program is implemented 
by regulations at 38 CFR part 61, codifying final rules published in 
the Federal Register on September 26, 2003 (68 FR 55467), and on 
June 8, 2004 (69 FR 31883) (revising, effective July 8, 2004, 38 CFR 
61.64, Religious organizations). The regulations can be found in 
their entirety in 38 CFR 61.0 through 61.82. Funds made available 
under this NOFA are subject to the requirements of those 
regulations.

    Allocation: Approximately $7.5 million is available for the 
Chronically Mentally Ill (CMI) Homeless Providers Grant and Per Diem 
grant component of this program. Funding will be for a period not to 
exceed 36 months, beginning on January 1, 2005. Based on the amount of 
funding available, the maximum allowable funding to any one operational 
Grant and Per Diem Special Needs recipient will be $250,000.00 per 
project, per year, for three (3) years for a total of $750,000.00. 
Based on Grant and Per Diem funding availability, approximately $6.4 
million is expected to be made available over 3 years (internally) for 
the VA collaborative partners, if any. Maximum funding for VA 
collaborative partners is $215,000.00 per project, per year, for (3) 
three years, beginning in FY 2005, for a total of $645,000.00 per 
project. The goal will be to fund 10 CMI GPD projects and 10 VA 
collaborative partners supporting homeless chronically mentally ill 
veterans in 20 to 40 beds in each project.
    It is important to be aware that VA places great emphasis on 
responsibility and accountability. VA has procedures in place to 
monitor services provided to homeless veterans and outcomes associated 
with the services provided in grant and per diem-funded programs. 
Applicants should be aware of the following:
    VA per diem payment is limited to the applicant's cost of care per 
eligible veteran minus other sources of payments to the applicant for 
furnishing services to homeless veterans up to the per day rate VA pays 
for State Home Domiciliary care, which is currently $27.19. 
Additionally, potential applicants should take into consideration the 
provisions of 38 CFR 61.61(h): ``Grant recipients that concurrently 
receive per diem and special needs payments shall not be paid more than 
100 percent of the cost for the bed per day, product, operation, 
personnel, or service provided.'' Awardees will be required to support 
their request for per diem and special needs payments with adequate 
fiscal documentation as to program income and expenses.
    All awardees that are conditionally selected in response to this 
NOFA must meet the Life Safety Code of the National Fire and Protection 
Association as it relates to their specific facility. VA will conduct 
an inspection or review a current inspection prior to awardees being 
able to submit a request for payment, to ensure this requirement is 
met.
    Each grant awardee will have the VA liaison that was appointed for 
its corresponding grant and per diem program monitor services to ensure 
the special needs grant is being met.
    Monitoring will include at least an annual review of each program's 
progress toward meeting internal goals and objectives in helping the 
chronically mentally ill homeless veterans as identified in each 
applicant's original special need application. Monitoring for all 
participants will also include a review of the agency's income and 
expenses as they relate to this project to ensure per diem and special 
needs payments are accurate.
    Monitoring of Homeless CMI participants and services provided by 
GPD recipients and VA collaborative partners will be accomplished 
according to Northeast Program Evaluation Center (NEPEC) procedures. In 
the event that the special needs funded program has chosen a 
collaborative partner, participation in the NEPEC monitoring will also 
include the collaborative partner. These monitoring procedures will be 
used to determine successful accomplishment of outcomes for each funded 
program.
    VA encourages all faith-based and community organizations that are 
eligible entities to carefully review this

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NOFA and consider applying for funds to provide services for special 
needs homeless veteran populations.
    Funding Priorities: VA establishes the following funding priorities 
in order to: (1) Implement the provisions of Public Law 107-95 
regarding non-duplication of service and the mandate to make funding 
available to both the health care facilities of the Department and 
Grant and Per Diem Providers; (2) promote collaboration between 
providers and the Department's health care facilities in the delivery 
of quality services to the chronically mentally ill special needs 
populations in a cost effective manner, and (3) address geographic 
dispersion. In this round of special needs funding, VA expects to award 
approximately $7.5 million to operational Grant and Per Diem applicants 
to support beds, services, products, operation, or personnel directly 
serving the chronically mentally ill special needs homeless veteran 
population.
    Funding priority 1. Eligible operational grant and per diem 
recipients that choose to (1) focus on serving the needs of the most 
severe chronically mentally ill with the longest duration of 
homelessness and (2) collaborate and provide services with a VA 
collaborative partner as outlined in the models below, and provide 
documentation of the same in the form of a Memorandum of Agreement 
(MOA) will be grouped in the first funding priority. The goal will be 
to fund approximately 10 collaborative projects. Not more than one (1) 
homeless chronically mentally ill special needs grant will be awarded 
to the same Grant and Per Diem recipient (defined by tax identification 
number), and no more than two (2) grants will be awarded to the VA 
collaborative partner (defined by VA medical facility) regardless of 
priority. With this criteria, of those eligible entities in the first 
funding priority that are legally fundable, the highest scoring 
applicant will be funded first, followed by the second highest scoring 
applicant, and then by the next highest scoring applicant until 10 
collaborative projects are funded. Using the guidance above, should the 
goal not be met and if funding is still available, remaining funding 
will go to the second funding priority.
    First Funding Priority MOA and Service Delivery Information: The VA 
collaborative partner will provide the Critical Time Intervention 
program and the community-based grant and per diem project will provide 
the Vet-to-Vet with Permanent Housing Assistance program for 
chronically mentally ill homeless veterans [as is being sought under 
the Special Needs Grant Component of VA's Homeless Providers Grant and 
Per Diem Program.] These programs are to be jointly implemented by VA 
health care facilities and community-based grant and per diem provider 
programs, working closely together. These programs will have three 
components: (i) Critical Time intervention, a time-limited intensive 
case management intervention for homeless veterans with severe mental 
illness; (ii) the Vet-to-Vet peer education program coupled with 
Permanent Housing Assistance; and (iii) time-limited residential 
treatment offered through the community-based program that is a grant 
and per diem provider program.
    Responsibilities of the VA health center facility (VA collaborative 
partner): The VA collaborative partner will only provide services to 
eligible veterans. The VA collaborative partner will also provide the 
Critical Time Intervention (CTI). It is most likely that staff of the 
Health Care for Homeless Veterans (HCHV) Program will be able to take 
the lead in developing the CTI Initiative. CTI is a time-limited 
intervention designed to provide intensive case management to severely 
mentally ill homeless veterans to assure their successful transition to 
the community. Each CTI program will be based on a multidisciplinary 
team with at least 3 clinicians/case managers. One member of the team 
must also function as clinical evaluator to facilitate the collection 
of program information between all parties. The team should also 
include social workers, nurses or other appropriate personnel with 
skills in community-based service delivery. Caseloads will be low, 
similar to those in Assertive Community Treatment (ACT).
    The work of the VA CTI team can be described in three phases. 
During the first phase (3 months) the team establishes a working 
relationship with the homeless veteran to identify their needs and 
develop a treatment plan and begin its implementation. During this 
period the treatment plan is implemented, where possible and 
appropriate, with placement in a grant and per diem residence on a 
time-limited basis.
    The second 3 months is focused on the transition to the community 
and to a permanent housing placement wherever possible or another 
appropriate long-term arrangement where specifically indicated.
    The third 3-month period would be devoted to a transition out of 
the VA CTI Program and into mainstream permanent housing coupled with 
mainstream mental health and general medical clinical supports as 
needed.
    A primary portal of entry for this program would be inpatient units 
where the most seriously troubled, dually diagnosed, homeless veterans 
could also be referred from other sources. Severity of the population's 
need and duration of homelessness will be important considerations in 
application reviews. The target population would be veterans who have 
been homeless for 30 days or more (when last in the community) and who 
have severe mental illness and co-morbid substance abuse. A second 
target population would be severely mentally ill homeless veterans who 
had been homeless for less than a month, are in need of intensive 
services, but were not currently hospitalized. A third target 
population would be severely mentally ill veterans who are not 
literally homeless at present but who have been homeless in the past 
and are currently at high risk for homelessness.
    Responsibilities of the community-based grant and per diem provider 
program: While VA staff would implement the CTI Program, their efforts 
would be to coordinate with the grant and per diem provider who would 
provide time limited residential treatment and develop the Vet-to-Vet 
and Permanent Housing Assistance program. Staff from the Grant Per Diem 
Provider Program will support the development of peer education 
programs, under the Vet-to-Vet model, and initiate community-based 
housing support through the Permanent Housing Assistance model which 
would be available for participants in the VA CTI Program, as well as 
for other homeless veterans receiving treatment through the grant and 
per diem provider.
    The Vet-to-Vet Program is based on a model of peer education, 
specifically targeted at veterans with serious mental illness. In this 
educational effort, veterans with serious mental illness, many of whom 
have been homeless, provide a daily group activity in which homeless 
veterans with mental illnesses learn from each other how to cope with 
serious mental illness and how to cope with leaving the ranks of 
homelessness and return to living as independently as possible in 
society. Peer educator groups meet every day on an elective basis. 
While staff may help initiate the program, it is operated by veterans 
for themselves and the peer counselors are paid for their efforts.
    The Permanent Housing Assistance Program is based on community 
referral models and community supported-housing program models 
successfully implemented to assist the chronically mentally ill 
homeless population

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transition to and maintain permanent housing. The Permanent Housing 
Assistance Program includes designated staff that are knowledgeable 
about the local community's housing resources; have the abilities to 
appropriately refer veterans to this housing after careful assessment 
of each veteran's needs, capabilities, and supportive/financial 
resources; and are able to provide on-going case management support 
while veterans are transitioning and eventually living independently in 
the community. Ongoing follow-up and aftercare strategies are an 
integral part of the permanent housing assistance program.
    Evaluation Procedures and Internal Review Board (IRB) Approval. VA 
health care facilities that apply for this initiative should be aware 
that while the evaluation protocol will be designed centrally by VA's 
Northeast Program Evaluation Center (NEPEC), the VA health care 
facility will be responsible for having the protocol reviewed by the 
local Internal Review Board to get proper approval of the written 
informed consent that veterans will have to sign to participate in the 
evaluation. NEPEC will provide all necessary materials as well as 
technical support to assist programs in obtaining this approval. Sites 
involved in this program do not need to have any previous evaluation 
experienced staff, as NEPEC staff will guide them through the necessary 
procedures. Grant and per diem providers should be aware that their 
staff will be required to participate in training, such as ethics, 
patient confidentiality, and other similar activities in order to 
facilitate the evaluation and services to the CMI homeless.
    Funding priority 2. Should funding still be available, eligible 
operational grant and per diem applicants that choose not to 
collaborate or are unable to collaborate with VA Health Care Facilities 
will be grouped in the second funding priority. Not more than one (1) 
special need grant will be awarded to the same Grant and Per Diem 
recipient (defined by tax identification number). Of those eligible 
entities in the second funding priority, that are legally fundable, the 
highest scoring applicants will be funded first until funding is 
expended.
    Agreement and Funding Actions: Conditionally selected applicants 
will complete a funding agreement with VA in accordance with 38 CFR 
61.61 and provide any additional information as required by VA under 38 
CFR part 61. Upon signature by the Secretary or designated 
representative final selection will be completed.
    Funding for operational grant and per diem applicants that are 
finally selected will be for a period not to exceed 36 months beginning 
on January 1, 2005. VA collaborative partners of finally selected 
applicants will be funded in accordance with Department internal fiscal 
guidance for a period of 36 months beginning on January 1, 2005.
    Should either the VA collaborative partner or GPD provider not 
provide services as outlined in their application and MOA, VA may 
deobligate or discontinue payments for special needs grants to either 
or both collaborative partners.
    A condition to obtain the Special Needs Grant is for the applicant 
to maintain the original (grant or per diem) program for which the 
special needs grant is sought. This is not a problem when considering 
eligible capital grantees. However, by VA calculation it is possible 
that some of the eligible ``Per Diem Only'' applicant programs would 
have their original award expire prior to fully utilizing the special 
needs funding. This is counterproductive to the intent of the special 
needs grant. Therefore, if finally selected, ``Per Diem Only'' 
applicants will be considered to have met the reapplication 
requirements of 38 CFR 61.33(b) and their corresponding per diem only 
award will be extended to run concurrently with their special needs 
grant. Example: A ``Per Diem Only'' award funded in 2003 would expire 
in 2006. Based on the funding availability date of January 1, 2005, if 
selected under this special need NOFA that corresponding PDO award 
would be extended to December 31, 2007.
    Application Requirements: A separate application is needed for each 
project number for which you are requesting Chronically Mentally Ill 
Special Needs Funding. A project number is the last two digits of the 
year funded, the sequence the application was received, and the State 
abbreviation for the project location (e.g., 00-125-MA would have been 
funded in the year 2000, the 125th application received, and the 
project is located in Massachusetts). If you do not know your project 
number, call the VA Homeless Providers Grant and Per Diem Field Office 
(toll-free) at 1-877-332-0334.
    The grant application requirements are specified in the application 
package and this NOFA. The package includes the applicant's required 
forms and certifications. Additional collaborative documentation as 
outlined in this NOFA is needed to collaborate with a VA health care 
facility for the purpose of this grant. Selections will be made based 
on criteria described in the application and this NOFA. Applicants who 
are selected will be notified of any additional information needed to 
confirm or clarify information provided in the application. Applicants 
will then be notified of the deadline to submit such information. If an 
applicant is unable to meet any conditions for grant award within the 
specified time frame, VA reserves the right to not award funds and to 
use the funds available for other grant and per diem applicants.
    Eligible operational grant and per diem recipients that choose to 
participate in the study must provide a jointly signed Memorandum of 
Agreement (MOA) with the applicant agency and the VA collaborative 
partner under which, if funded, the VA health care facility and the 
community-based grant and per diem provider agree to offer the 
services, staff, and documentation as described in the evaluation 
procedures developed by NEPEC.

    Dated: July 8, 2004.
Anthony J. Principi,
Secretary of Veterans Affairs.
[FR Doc. 04-15965 Filed 7-13-04; 8:45 am]
BILLING CODE 8320-01-P