Download Complete RFA Announcement (PDF | 351 KB)

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Category Year 1 Year 2* Year 3* Year 4* Total Project Costs Total Project Costs $1,194,067 $1,194,067 $1,194,067 $1,194,067 $4,776,268 TOTAL PROJECT COSTS: Sum of Total Direct Costs and Indirect Costs FEDERAL REQUEST (enter in Section B column 1 line 6k of form SF-424A) $4,776,268 *FOR REQUESTED FUTURE YEARS: 1. Please justify and explain any changes to the budget that differs from the reflected amounts reported in the 01 Year Budget Summary. 2. If a cost of living adjustment (COLA) is included in future years, provide your organization’s personnel policy and procedures that state all employees within the organization will receive a COLA. 54
Appendix G – Confidentiality and SAMHSA Participant Protection/Human Subjects Guidelines Confidentiality and Participant Protection: Because of the confidential nature of the work in which many SAMHSA grantees are involved, it is important to have safeguards protecting individuals from risks associated with their participation in SAMHSA projects. All applicants must address the two elements below. While we encourage you to keep your responses brief, there are no page limits for this section and no points will be assigned by the Review Committee. Problems with confidentiality and participant protection identified during peer review of the application must be resolved prior to funding. 1. Privacy and Confidentiality o Explain how you will ensure privacy and confidentiality. Include who will collect data and how it will be collected. o Describe: o How you will use data collection instruments. o Where data will be stored. o Who will or will not have access to information. o How the identity of participants will be kept private, for example, through the use of a coding system on data records, limiting access to records, or storing identifiers separately from data. 2. Adequate Consent Procedures o List what information will be given to people who participate in the project. Include the type and purpose of their participation. Identify the data that will be collected, how the data will be used and how you will keep the data private. o State: o Whether or not their participation is voluntary. o Their right to leave the project at any time without problems. o Possible risks from participation in the project. o Plans to protect clients from these risks. o Explain how you will get consent for youth, the elderly, people with limited reading skills, and people who do not use English as their first language. 55
Page 1 and 2:
Department of Health and Human Serv
Page 3 and 4: Appendix B - Guidance for Electroni
Page 5 and 6: Cost Sharing/Match Required: No Len
Page 7 and 8: programming and policies will be ac
Page 9 and 10: • Assist grantees with developing
Page 11 and 12: • Participate in state, regional,
Page 13 and 14: Freedom (OIF), and Operation New Da
Page 15 and 16: and performance assessment, e.g., a
Page 17 and 18: Tribal organization means the recog
Page 19 and 20: (demographics and clinical characte
Page 21 and 22: Your application must be received b
Page 23 and 24: Section B: Proposed Approach (35 po
Page 25 and 26: • Demographics - race, ethnicity,
Page 27 and 28: Note: There should be separate colu
Page 29 and 30: termination of the grant award, or
Page 31 and 32: Appendix A - Checklist for Formatti
Page 33 and 34: Appendix B - Guidance for Electroni
Page 35 and 36: that these issues will be resolved
Page 37 and 38: • Name, telephone number, and e-m
Page 39 and 40: o Documentation of nonprofit status
Page 41 and 42: grant applications submitted by com
Page 43 and 44: prevention provider may also provid
Page 45 and 46: Appendix F - Sample Budget and Just
Page 47 and 48: FEDERAL REQUEST Purpose of Travel L
Page 49 and 50: Item(s) Rate SS/HS Costs Project LA
Page 51 and 52: (2) Consultant is needed to provide
Page 53: FEDERAL REQUEST - (enter in Section
Page 57 and 58: Appendix H- Addressing Behavioral H
Page 59 and 60: You can learn more about the CLAS m
Page 61 and 62: Appendix I - Sample Logic Model A l
Page 63 and 64: Sample Logic Model 63
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