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HomeMy WebLinkAboutCFC Grant - Drug-Free CommunitiesDepartment of Health and Human Services Substance Abuse and Mental Health Services Administration Drug-Free Communities (DFC) Support Program Request for Applications (RFA) No. SP-13-002 Catalogue of Federal Domestic Assistance (CFDA) No.: 93.276 Key Dates: Application Deadline Applications are due by March 22, 2013 Intergovernmental Review (E.O. 12372) Applicants must comply with E.O. 12372 if their s tate(s) participates. Review process recommendations from the state Single Point of Contact (SPOC) are due no later than 60 days after application deadline. Public Health System Impact Statement (PHSIS)/Single State Agency Coordination Applicants must send the PHSIS to appropriate state and local health agencies by application deadline. Comments from Single State Agency are due no later than 60 days after application deadline. Table of Contents EXECUTIVE SUMMARY………………………………………………………………………1 I. FUNDING OPPORTUNITY DESCRIPTION……………………………………..........2 1. PURPOSE………………………………………………………………………........2 2. WHAT DFC FUNDS……………………………………………………….………..2 3. COMMUNITY DEFINITION…………………………………………………….....3 4. EXPECTATIONS………………………………………………………………........3 5. TECHNICAL ASSISTANCE RELATED TO THIS RFA ..………………………...6 II. ELIGIBILITY INFORMATION ..………………………………….……………….......7 1. ELIGIBLE APPLICANTS………………………………………………………......7 2. COST SHARING AND MATCH REQUIREMENTS……………………………..15 3. ADDITIONAL ELIGIBILITY REQUIREMENTS/AWARD INFORMATION.....17 III. APPLICATION AND SUBMISSION INFORMATION……………………………....18 1. ADDRESS TO REQUEST APPLICATION PACKAGE………………………….18 2. CONTENT AND GRANT APPLICATION SUBMISSION………………………18 3. APPLICATION SUBMISSION…………………………………………………....21 4. INTERGOVERNMENTAL REVIEW (E.O.12372) REQUIREMENTS………….22 5. FUNDING LIMITATIONS/RESTRICTIONS…………………………………….22 IV. APPLICATION REVIEW INFORMATION………………………………………….23 1. GENERAL INSTRUCTIONS….………………………………………………….23 2. EVALUATION CRITERIA……………………………………………………….23 3. APPLICATION SCORING INSTRUCTIONS……………………………………24 4. REVIEW AND SELECTION PROCESS…………………………………………26 V. RESPONDING TO THE DFC RFA…………………………………………………...26 1. COMMUNITY OVERVIEW……………………………………………………...26 2. SECTION A: PROJECT NARRATIVE ……………………………………….. . 27 3. SECTION B: BUDGET NARRATIVE ……………………………………….....31 4. SECTION C: REQUIRED ATTACHMENTS ..…………………………………32 VI. ADMINISTRATIVE INFORMATION………………………………………………34 1. AWARD NOTICES……………………………………………………………....34 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS………....35 3. REPORTING REQUIREMENTS………………………………………………...35 APPENDIX A: SAMPLE BUDGET……………………………………………………….....37 APPENDIX B: FORMATTING REQUIREMENTS FOR SAMHSA GRANT APPLICATIONS……………………………………………………………………………...52 APPENDIX C: GUIDANCE FOR ELECTRONIC SUBMISSION………………...………..54 APPENDIX D: COALITION ROLES AND RELATIONSHIPS TO SECTOR MEMBERS…………………………………………………………………………………….58 APPENDIX E: COALITION INVOLVEMENT AGREEMENTS………………………..….60 APPENDIX F: ASSURANCE OF LEGAL ELIGIBILITY…………………………..………62 APPENDIX G: GRANTEE/LEGAL APPLICANT ROLES AND RELATIONSHIP WITH COALITION…………………………………………………………………………………..63 APPENDIX H: ASSURANCE OF ONE DFC GRANT AT A TIME………………………...65 APPENDIX I: ASSURANCE OF 10-YEAR FUNDING LIMIT…………………………….66 APPENDIX J: RESUMES AND JOB DESCRIPTIONS…………………………………….68 APPENDIX K: GENERAL APPLICANT INFORMATION………………………………...69 APPENDIX L: INTERGOVERNMENTAL REVIEW (E.O.12372) REQUIREMENTS………………………………………………………………………….....71 APPENDIX M: DISCLOSURE OF ALL PRIOR DFC FUNDING……………………….....73 APPENDIX N: DFC NATIONAL CROSS-SITE EVALUATION REQUIREMENTS…... ..74 APPENDIX O: SAMPLE CONGRESSIONAL NOTIFICATION…………………………..75 APPENDIX P: PRE-SUBMISSION VERIFICATION…………………................................76 APPENDIX Q: GLOSSARY OF TERMS…………………………………………………....78 1 EXECUTIVE SUMMARY The Executive Office of the President, Office of National Drug Control Policy (ONDCP), and the Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP) are accepting applications for fiscal year FY 2013 Drug-Free Communities (DFC) Support Program grants. The purpose of the DFC Program is to establish and strengthen collaboration to support the efforts of community coalitions working to prevent youth substance use. Funding Opportunity Title: Drug-Free Communities Support Program Funding Opportunity Number: SP-13-002 Due Date for Applications: March 22, 2013 Anticipated Total Available Funding: $18,750,000 Estimated Number of Awards: Approximately 150 Estimated Award Amount: Up to $125,000 per year Cost Sharing/Match Required Yes [See Section II-2 of this RFA] Length of Project Period: Up to 5 years Eligible Applicants: The application can be submitted only to support a community-based coalition addressing youth substance use that meets all Statutory Eligibility Requirements. See Table 1 of this RFA for complete eligibility information. As of the release of this RFA, the FY2013 federal budget is still pending before Congress; therefore, projections for available funding and for the number of potential awards are based on the appropriation for FY2012 and are subject to change based on passage of the final FY2013 Federal Budget. 2 I FUNDING OPPORTUNITY DESCRIPTION 1. PURPOSE The DFC Program was created by the Drug-Free Communities Act of 1997 (Public Law 105-20. This announcement addresses Healthy People 2020 Substance Abuse Topic Area HP 2020-SA. The DFC Program is a collaborative effort directed by the Office of National Drug Control Policy (ONDCP) in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (CSAP). The DFC Program has two goals: 1. Establish and strengthen collaboration among communities, public and private non-profit agencies, and federal, state, local, and tribal governments to support the efforts of community coalitions working to prevent and reduce substance use among youth*. 2. Reduce substance use among youth and, over time, reduce substance abuse among adults by addressing the factors in a community that increase the risk of substance abuse and promoting the factors that minimize the risk of substance abuse. *For the purposes of this RFA, “youth” is defined as individuals 18 years of age and younger. 2. WHAT DFC FUNDS Grants awarded through the DFC Program are intended to support established community- based youth substance use prevention coalitions capable of effecting community-level change. For the purposes of this RFA and the DFC Program, a coalition is defined as a community- based formal arrangement for cooperation and collaboration among groups or sectors of a community in which each group retains its identity, but all agree to work together toward a common goal of building a safe, healthy, and drug-free community. Coalitions receiving DFC funds are expected to work with leaders within their communities to identify and address local youth substance use problems and create sustainable community-level change through the use of environmental prevention strategies. For more information on environmental strategies please refer to the Expectations section of this RFA. DFC does not fund the following (not a fully exhaustive list):  After-school programs  Youth mentoring programs  Sports programs  Treatment services/programs/facilities  Drug Courts  Construction  Landscaping/neighborhood revitalization projects 3 3. COMMUNITY DEFINITION The DFC Program does not prescribe the size, borders, demographics, or geographic location of DFC grantee communities. DFC grantees use various physical demarcations, including neighborhoods, census tracts, zip codes, and school districts, as well as township, county, or parish lines, among others, to define their community. However, applicants are encouraged to be realistic about the area in which the coalition will have the ability to create change. For example, choosing a community that is too large may be problematic due to inclusion of neighborhoods that have significantly different problems to be addressed. The DFC Program does not make funding decisions based on geographic boundaries (e.g., number of grants within states/towns/cities). Applicants should consider that adjacent neighborhoods/towns/cities with coalitions operating in different areas are encouraged. However, when determining the parameters of a community, multiple DFC grantees may not serve the same zip code(s) unless there is written evidence of cooperation between the overlapping coalitions. 4. EXPECTATIONS Strategic Prevention Framework DFC-funded coalitions are expected to utilize SAMHSA’s Strategic Prevention Framework (SPF) as the planning model to develop long-range plans. The SPF is a five-step evidence-based process for community planning and decision-making. Cultural competence and sustainability should be considered throughout all five steps of the process. The five-step process includes: 1. Assessment: Identify local youth substance use problems and the community conditions that contribute to the specific identified issues. 2. Capacity: Mobilize/build capacity to change the conditions and address the youth substance use problems. 3. Planning: Develop a logic model, comprehensive 12-month Action Plan, and multi-year Strategic Plan. 4. Implementation: Implement action and strategic plans with multiple objectives, strategies, and activities. 5. Evaluation: Monitor, sustain, improve, or replace prevention activities, efforts, and strategies. Use of Environmental Prevention Strategies Environmental prevention strategies incorporate efforts aimed at changing or influencing community conditions, standards, institutions, structures, systems, and policies to shift attitudes and change behavior. More specifically, environmental prevention strategies seek to: (1) limit 4 access to substances; (2) change the culture and context within which decisions about substance use are made; and/or (3) shift the consequences associated with youth substance use. Ample evidence exists that well-conceived and implemented policies at the local, state, and national level can reduce community-level alcohol, tobacco, and other drug problems. The Seven Strategies for Community Change, which are a conceptual understanding of strategies a coalition may employ, include efforts that affect individuals, as well as those that have the potential to reach an entire community. The DFC Program requires the use of environmental prevention strategies, items 4 through 7 on the following page, as part of a coalition’s comprehensive planning efforts to prevent youth substance use. A comprehensive Action Plan will include an appropriate mixture of all seven strategies listed below with DFC funding being dedicated toward strategies 4 through 7. Efforts listed in strategies 1 through 3 are good sources for match and should not be the focus of DFC expenditures. It is not required for applicants to name the seven strategies listed below in the Action Plan, but should use them as a framework for ensuring comprehensiveness. Seven Strategies for Community Change Individual Prevention Strategies 1. Provide Information: Educational presentations, workshops or seminars, and data or media presentations (e.g., PSAs, brochures, town halls, forums, web communication). 2. Enhance Skills: Workshops, seminars, or activities designed to increase the skills of participants, members and staff (e.g., training and technical assistance, parenting classes, strategic planning retreats, model programs in schools). 3. Provide Support: Creating opportunities to support people to participate in activities that reduce risk or enhance protection (e.g., alternative activities, mentoring, referrals for service, support groups, youth clubs). Environmental Prevention Strategies 4. Enhance Access/Reduce Barriers: Improving systems/processes to increase the ease, ability, and opportunity to utilize those systems and services (e.g., assuring transportation, housing, education, safety, and cultural sensitivity) in prevention initiatives. Reduce Access/Enhance Barriers: Improving systems/processes to decrease the ease, ability, and opportunity for youth to access substances (e.g., raising the price of single- serve cans of alcohol, implementing retail alcohol/tobacco compliance checks). 5. Change Consequences (Incentives/Disincentives): Increasing or decreasing the probability of a behavior by altering the consequences for performing that behavior (e.g., increasing taxes, citations, and fines; revocation/loss of driver’s license). 6. Change Physical Design: Changing the physical design of the environment to reduce risk or enhance protection (e.g., re-routing foot/car traffic, adjusting park hours, 5 alcohol/tobacco outlet density). NOTE: DFC federal funds cannot support landscape and lighting projects. As such, costs for these projects cannot be used as match. 7. Modify/Change Policies: Formal change in written procedures, by-laws, proclamations, rules, or laws (e.g., workplace initiatives, law enforcement procedures and practices, public policy actions, systems change). NOTE: Lobbying with federal dollars is not permitted. As such, costs for lobbying cannot be used as match. For more information on environmental prevention strategies, please see http://www.cadca.org/files/resources/Beyond_the-Basics-Environmental_Strategies-11-2010.pdf. DFC National Cross-site Evaluation DFC grantees are required to participate in the DFC National Cross-Site Evaluation, intended to measure the effectiveness of the DFC Program in reducing youth substance use. DFC grantees are required to provide data every two years on the following core measures for alcohol, tobacco, marijuana, and prescription drugs for three grades (6-12th): 1. Past 30–day use 2. Perception of risk or harm 3. Perception of parental disapproval of use 4. Perception of peer disapproval of use Applicants must provide information about their ability to comply with the DFC National Cross- Site Evaluation Requirements in Attachment 16; refer to Appendix N for more information. An inability to supply the above core measures in the specific increment (every 2 years) for the substances named in the grades required means a coalition is not eligible to apply for DFC funds. The terms and conditions of the grant award will specify how the data is to be submitted and the schedule for submission using an online data reporting system. In the case that a Year One DFC grantee does not have the core measures at the time of application and/or award of the grant, the coalition will have two years from the time of award to report their first complete set of core measure data. Each Year One grantee will be required to submit a data collection plan to the Government Project Officer outlining specifically how the coalition will comply with the data reporting requirements. The plan is due no later than 60 days after the start of the grant award. After awarded a grant it is the responsibility of the coalition to know the National Cross-site Evaluation reporting schedule. New Grantee Meeting Requirement Applicants funded through this RFA are required to budget for and send two people (one must be the person charged with daily oversight of the coalition) to a three-day DFC New Grantee Meeting in Washington, DC in the first year of the grant award. This requirement applies to grantees that receive Year One or Year Six funding or are returning to the DFC Program after a lapse in funding. The DFC New Grantee Meeting usually takes place in early December. 6 National Coalition Academy Requirement Applicants applying to become Year One DFC grantees are expected to budget and send two people to the National Coalition Academy (NCA). One person must be the same all three weeks and should be the person in charge of daily operations of the coalition. The second person can vary each week. This requirement does not apply to coalitions that have already attended the NCA, although these coalitions may choose to send additional coalition staff/members to the NCA if awarded the DFC grant. The NCA is a three-week training program spread out over the course of several months. It is designed to train coalitions in the SPF process and guide the creation of the products necessary for successful coalition functioning and operation. Costs associated with the NCA are generally limited to travel (e.g., flight, car rental, per diem). Lodging, dependent upon location, may be provided. There are several locations across the United States where the NCA is held. It is highly recommended that you contact the National Coalition Institute immediately after being awarded the DFC grant to register for the NCA location of your choice. More information on the National Coalition Academy can be found at http://www.cadca.org/trainingevents/training_coalitions/national-coalition-academy. Applicants can also call the National Coalition Institute’s Technical Assistance Manager at 1- 800-542-2322, ext. 240 for more information. 5. TECHNICAL ASSISTANCE RELATED TO THIS RFA NEW APPLICANT WORKSHOPS Potential applicants, those applying for the first time (Year One), current grantees applying for a second cycle of five years of funding (Year Six), or former grantees who experienced a lapse in funding during a five-year cycle, are encouraged to attend one of the following pre-application workshops. To register for a New Applicant Workshop in a location listed below, go to: https://www.cmpinc.net/dfc/registration.aspx. Phoenix, AZ Tuesday, January 29, 2013 Little Rock, AR Thursday, January 31, 2013 National Harbor, MD Friday, February 8, 2013 (near Washington, DC) These workshops are not mandatory in order to apply for this grant. These workshops provide technical assistance to help applicants complete their applications. They are not general technical assistance workshops for coalitions. Attendees must read this RFA in advance and come prepared to ask questions related to the completion of an application. After each 7 workshop, a question and answer session will be held to specifically address applicants working with American Indian/Alaska Native communities. If an applicant is unable to travel to a workshop, a recorded version will be posted to the DFC website by the end of January 2013. The workshop registration link and the link for the online videos can be found at http://www.whitehouse.gov/ondcp/information-for-potential-applicants. SAMHSA CONTACTS If you have questions related to this RFA, use the following contacts for assistance. Please allow 48 business hours for your question to be answered. Once the application deadline is reached, these SAMHSA contacts are no longer in use. For questions about program issues contact: For questions about forms & budgets: DFC RFA Helpline Team DFC Federal Form/Budget Helpline Division of Community Programs Division of Grants Management (240) 276-1270 Virginia Simmons dfcnew2013@samhsa.hhs.gov (240) 276-1422 Virginia.simmons@samhsa.hhs.gov SAMHSA strongly encourages all grantees to provide a tobacco-free work place and promote abstinence from all tobacco products (except in regard to accepted tribal traditions and practices). II ELIGIBILITY INFORMATION 1. ELIGIBLE APPLICANTS Statutory Eligibility Requirements, written into the DFC Act, are inherent in the DFC Program. Read Table 1: Statutory Eligibility Requirements, which contains a summary of the Statutory Eligibility Requirements and the minimum documentation applicants must provide to meet the eligibility criteria. The “Where to Document” section in the table shows applicants where to include the required information in their applications (e.g., as an attachment, in the Project Narrative, or in the Budget Narrative). Failure to meet any single eligibility requirement will cause the application to be deemed ineligible, and the application will not move forward to peer review. Should your application fail to meet the eligibility requirements, the person listed as the Business Official on the Application for Federal Assistance (SF-424) will receive a letter stating why the application was deemed ineligible to apply. No additional information may be added to an application after it has been submitted. Final authority lies with the DFC Administrator to determine the eligibility of an application. All DFC applications will be jointly screened by ONDCP and SAMHSA to determine whether an applicant meets all the DFC Program statutory eligibility requirements identified in Table 1. In addition, the non-profit status of the grantee/legal applicant (if applicable) will be verified along with its ability to fiscally manage federal funds. Applications submitted by eligible 8 coalitions that demonstrate they meet all requirements will then be scored through a peer review process according to the evaluation criteria described in the Application Review Information of this RFA. Each year, DFC grantees must demonstrate compliance with all of the Statutory Eligibility Requirements to be considered for continued funding. 9 Table 1: Statutory Eligibility Requirements Eligibility Requirement Item: Evidence Required and Where to Document: Requirement 1: 12 Sectors Evidence Required: The coalition must consist of one or more representatives from each of the following required 12 sectors:  Youth (18 or younger)  Parent  Business  Media  School  Youth-serving organization  Law enforcement  Religious/Fraternal organization  Civic/Volunteer groups (i.e., local organizations committed to volunteering, not a coalition member designated as a “volunteer”)  Healthcare professional  State, local, or tribal governmental agency with expertise in the field of substance abuse (including, if applicable, the state agency with primary authority for substance abuse)  Other organization involved in reducing substance abuse (21 USC 1531 §1032 (a)(2)(A)) An individual who is a member of the coalition may serve on the coalition as a representative of not more than one sector category. (21 USC 1531 §1032 (a)(2)(C)) Using the template in Appendix D, Table 23, applicants must list: 1. Each of the required 12 sectors (must identify age of youth sector); 2. Only one person for each sector (the individual involved in the coalition who has the most influence with others in that sector); 3. Individual sector members may not serve as sector representatives for more than one DFC funded coalition at a time. 4. The agency/organization each person represents; and the specific, unique contribution of each individual toward the coalition’s work. NOTE: Neither paid staff (current or proposed), nor the person signing the Coalition Involvement Agreement (CIA) on behalf of the coalition (e.g., coalition chair), can serve as a sector representative. Applicants must attach a matching CIA from each person listed in the Sector Member Table. A total of 12 CIAs are required. Including more than 12 will not increase the applicant’s score. CIAs cannot be more than 12 months old at the time of application. The name on the CIA, or the name of the person indicated as the sector representative by the person signing the CIA, must match the name in the Sector Member Table. If someone must sign the CIA other than the person listed as the sector member, see Appendix D of this RFA for instructions. Table 23 must be included at the top of each of the 12 CIAs. Two signatures are required on each CIA. One signature must be that of the individual listed in the Sector Member Table, and the other must be the signature of someone (i.e., coalition chair, paid staff, etc.) who represents the coalition. All signatures must be hand written and dated. A sample CIA is provided in Appendix E of this RFA and provides the minimal requirements for a CIA. 10 Where to Document: Attachment 1 – Sector Member Table Attachment 2 – 12 CIAs (provide in the same order as the Sector Member Table) Requirement 2: Six Month Existence Evidence Required: The coalition must demonstrate that members have worked together on substance abuse reduction initiatives for a period of not less than 6 months at the time of the application, acting through entities such as task forces, subcommittees, or community boards. (21 USC 1531 §1032 (a)(3)(A)) The coalition must also demonstrate substantial participation from volunteer leaders in the community. (21 USC 1531 §1032 (a)(3)(B)) Applicants must submit two sets of the coalition’s meeting minutes from within the time period described below. Additional sets of minutes will not increase the applicant’s score. Both sets of meeting minutes must show that the coalition has been actively involved in working to reduce youth substance use in the applicant community and must demonstrate substantial participation from volunteer leaders. One set of minutes must be from a coalition meeting that took place between January 1, 2012 and September 30, 2012. The second set of minutes must be from a coalition meeting that took place between October 1, 2012 and the deadline for submission of this application. These specific timeframes are used to determine the coalition’s length of existence and current activities. Both sets of minutes must:  Represent the coalition’s meetings and not those of an outside agent applying on behalf of a coalition;  include the month, date, and year of the coalition meeting;  indicate that the coalition has been involved in reducing community youth substance use;  demonstrate coalition membership involvement, including, but not limited to, the 12 required sectors (all 12 sectors do not have to be present at all meetings); and  include a list of attendees, noting the sector that each attendee represents. Where to Document: Attachment 3 – Two sets of coalition minutes, one within each of the specified timeframes. Requirement 3: Mission Statement Evidence Required: The coalition must have as its principal mission the reduction of youth Applicants must provide a copy of the coalition’s Mission Statement. The statement cannot be that of 11 substance use, which, at a minimum, includes the use and abuse of drugs in a comprehensive and long-term manner, with a primary focus on youth in the community. (21 USC 1531 §1032 (a)(3)(B)(4)(A) an outside agent being used as the legal grantee (if applicable) for a coalition. It must be clear during the eligibility screening process that the Mission Statement belongs to the applicant coalition and that the principal mission of the coalition is the reduction and/or prevention of youth substance use. Where to Document: Attachment 4 – Coalition’s Mission Statement Requirement 4: Multiple Drugs of Abuse Evidence Required: The coalition must have developed an Action Plan to reduce substance use among youth which targets multiple drugs of abuse. Substances may include, but are not limited to, narcotics, depressants, stimulants, hallucinogens, inhalants, marijuana, alcohol, and tobacco, where their use is prohibited by federal, state, or local law. (21 USC 1531 §1032 (a)(4)(D)) Applicants must identify strategies that target, at a minimum, two specific drugs of use. Each drug must be named specifically and individually. For example, a coalition may choose to address alcohol and prescription drugs. This must be specifically outlined and these drugs must be named in the Action Plan. Do not use the following terminology in the application when naming the drugs the coalition will address:  ATOD (Alcohol, Tobacco, and Other Drugs)  Substances or Substance Use/Abuse  Drugs or Drug Use/Abuse NOTE: The term “prescription drugs” is allowable as a specific targeted substance. However, if desired, you may specify by type or category which prescription drugs the coalition is addressing, if any (e.g., pain killers, stimulants). Where to Document: Project Narrative, Questions 5 and 7 Requirement 5: DFC National Evaluation Requirement Evidence Required: The coalition must establish a system to measure and report outcomes, established and approved by the DFC Administrator, to the federal government. (21 USC 1531 §1032 (a)(5)(A)) Applicants must demonstrate an ability to comply with the National Evaluation Requirements for the DFC Program as outlined in the National DFC Cross- Site Evaluation Requirements section of this RFA. It is insufficient to simply state that the grantee will supply the data necessary to meet the DFC National Evaluation requirements. See below for further details that must be provided in order to meet this 12 requirement. Regardless of the substances a coalition is choosing to address, the following measures have been approved by the DFC Administrator and must be collected by each DFC grantee every two years, on four substances (alcohol, tobacco, marijuana, and prescription drugs) in three grades (6th-12th): 1. Past 30-day use 2. Perception of risk or harm of use 3. Perception of parental disapproval of use 4. Perception of peer disapproval of use Each applicant must provide, using Appendix N, the following information: 1. The name of the survey instrument(s) utilized to collect the data required in the four core measures listed above. 2. How often/when will the survey(s) be administered for core measure data collection? 3. What, if any, supplemental survey(s)/data will be used to meet the requirements of the DFC National Cross-Site Evaluation? Where to Document: Attachment 16 - DFC National Cross-Site Evaluation Information Requirement 6: Entity Eligible to Receive Federal Grants Evidence Required: The applicant must demonstrate that the coalition is an ongoing concern by demonstrating that the coalition is a non-profit organization or has made arrangements with a legal entity that is eligible to receive federal grants. (21 USC 1531 §1032 (a)(5)(A)) Organizations eligible to receive federal funds as applicants must be legally recognized domestic public or private nonprofit entities. For example, state and local governments; federally recognized tribes; state recognized tribes; urban Indian organizations (as defined in P.L. For the purposes of the DFC Program, coalitions are seen as entities that are separate from any organization represented on the coalition. A coalition that is eligible to receive federal grant funds and is applying for this grant on its own must complete Appendix F. If a coalition is not eligible to receive federal grant funds on its own, it must make arrangements with a legal entity that will apply for the grant on behalf of the coalition. In this case, the grantee/legal applicant is the recipient of the award, and the entity legally responsible for satisfying the grant requirements, including terms and conditions of award. This includes conformance with HHS grantee financial 13 94-437, as amended); public or private universities and colleges; professional associations, voluntary organizations, self-help groups, consumer and provider services-oriented constituency groups; community- and faith-based organizations; and tribal organizations. (HHS Grants Policy Statement, January 1, 2007 – Eligibility, page I - 11) Grantee Financial Management Requirements: Federal regulations governing SAMHSA grants (45 CFR Part 74 and 45 CFR Part 92) provide standards for financial management systems of grantee organizations. To determine whether grantees have financial management systems that conform to those standards, SAMHSA’s Financial Advisory Services Officers (FASO) perform Financial Capability Reviews of new or prospective grantees. If needed, FASO will request that the grantee take necessary corrective action to conform to the financial management standards. For more information, go to http://www.samhsa.gov/grants/managem ent.aspx management requirements, fulfilling audit requirements, and reporting financial status, progress, and other related documents. In the case that the staff charged with daily operations of a coalition is employed by an outside agency acting as the grantee/legal applicant, an MOU must be signed between the coalition and the grantee/legal applicant. A sample MOU between a coalition and a partnering organization serving as the grantee/legal applicant is provided in Appendix G. The coalition and grantee are not required to use the exact template provided, however, it must include a coalition representative hand written signature and the grantee/legal applicant signatures and dated within 12 months of the date of application. Where to Document: Attachment 5 –Signed Assurance of Legal Eligibility or MOU between applicant coalition and grantee/legal applicant. Requirement 7: Substantial Support from Non-Federal Sources Evidence Required: The coalition must have a strategy to solicit substantial financial support from non-federal sources to ensure that the coalition is self-sustaining. (21 USC 1531 §1032 (a)(5)(C)) & (21 USC 1531 §1032 (b)(1)(A)(i)) Applicants must show at least dollar-for-dollar (1:1) matching funds in their Budget and Budget Narrative. These matching funds must come from non-federal sources.* Matching funds can be in-kind or donations, but must be compliant with federal regulations regarding allowable expenses. Applicants must itemize the matching funds separately in the Budget SF-424A, available at http://www.samhsa.gov/grants/applicationkit.aspx and explain the matching funds separately in the Budget Narrative section of this RFA. 14 *In the case of a coalition that includes a representative of the Bureau of Indian Affairs, the Indian Health Service, or a tribal government agency with expertise in the field of substance abuse and serving a tribal community, federal funds may be used as match. Where to Document: SF-424, Section 18 SF-424A Budget Narrative NOTE: Those applying for a second 5-year funding cycle must comply with the increase in match requirement for Years 7-10. Please refer to Match Requirements section of this RFA, Part II-2. Requirement 8: Federal Request Evidence Required: The applicant must not request more than $125,000 in federal funds per year. (PL 109-469 §803) The budget may not show a request for federal funds exceeding $125,000/year, excluding federal match from Requirement 7 above. Where to Document: SF-424, Section 18 SF-424A Budget Narrative Requirement 9: Zip Code Overlap Evidence Required: Two coalitions may not serve the same zip code(s) unless both coalitions have clearly described their plan for collaboration in their applications and each coalition has independently met the eligibility requirements. (21 USC 1531 §1032 (a)(5)(C)) Each applicant that proposes to serve a community that overlaps an existing or applicant coalition must provide a Letter of Mutual Cooperation between the coalition and the overlapping coalition outlining their efforts to collaborate. The letter must include two signatures: one from the applicant coalition and one from the currently funded/applying coalition. In the case of two first-time applicants, a Letter of Mutual Cooperation must be included in each application. As part of the eligibility screening process, zip codes will be checked. “Zip codes served” from Appendix K, Table 25 of the application is used to determine overlaps. If the applicant coalition overlaps with another applicant coalition and/or with an existing DFC 15 grantee, a Letter of Mutual Cooperation between the applicant and each overlapping coalition must be included as Attachment 6 in your application. In cases of overlap where there is no evidence of collaboration between two coalitions:  Coalitions already inside a five-year grant cycle will be given preference.  If the overlap occurs between two new applicants, the one that scores higher in peer review will be given preference. See http://www.whitehouse.gov/ondcp/Drug-Free- Communities-Support-Program for a list of existing DFC grantees by state. Where to Document: Attachment 6 – Letter(s) of Mutual Cooperation, signed by both coalitions, or statement that there is no overlap between the applicant and other coalitions Attachment 10 – General Applicant Information Table. Requirement 10: One grant at a time Evidence Required: Grantees/coalitions may be awarded only one grant at a time through the DFC Program. Applicants must sign and submit the Assurance of One DFC Grant at a Time document in Appendix H. Where to Document: Attachment 7 –Assurance of One DFC Grant at a Time Requirement 11: No more than 10 years of DFC funding Evidence Required: Coalitions may not receive more than 10 years of DFC funding. Applicants must sign the Assurance of 10-Year Funding Limit in Appendix I. Applicants should be certain that they are not reapplying as a previously funded coalition. A coalition requesting first year funding should be serving a different catchment area and the coalition staff and volunteers should be different from that of any previously or currently funded coalition. Where to Document: Attachment 8 – Assurance of 10-Year Funding Limit 16 2. COST SHARING AND MATCH REQUIREMENTS The DFC authorizing legislation requires grantees to demonstrate that they have matching funds from non-federal sources equivalent to federal funds requested from the DFC Program. Applicants must itemize the match separately in the budget and explain the match separately in the Budget Narrative. A sample Budget Narrative is provided in Appendix A of this RFA. Applicants in their first cycle of DFC funding (Years One - Year Five), and those in Year Six, are required to have 100 percent match (1:1) from non-federal sources. Beginning in Year Seven, the percentage increases. The table below indicates the percentage of match required for DFC grantees in each year of the grant. Table 2: Percentage of Match In -kind support may be used for the match requirement. In-kind support includes the value of goods and services donated to the operation of the DFC coalition, including but not limited to office space, volunteer secretarial services, pro bono accounting services, and other volunteer services to support the coalition’s work. All match must follow the federal cost principles and be allowable, reasonable, and documented. Applicants cannot submit match that would not be allowable to be purchased with DFC funds. For example, since grantees are not allowed to purchase food with federal dollars, they cannot count the value of food donated as match. A match level over the required amount will not result in a higher peer review score. All proposed match included in the budget, if the application is approved for funding, becomes an obligation on the part of the applicant. For example, if an applicant proposes that they will gather 300 percent in matching funds and receives a grant, the grantee is legally responsible to collect, document, and substantiate all 300 percent of those funds or in-kind support. The HHS Grants Policy Statement will help you understand allowable costs, volunteer rates, and conflict of interest issues. This document is available at http://www.samhsa.gov/grants/management.aspx. Federal funds, including those passed through a state or local government cannot, be used toward the required match. The only exception in the DFC Program is in the case of a coalition that includes a representative of the Bureau of Indian Affairs, the Indian Health Service, or a tribal government agency with expertise in the field of substance abuse and serving a tribal community. Coalitions with these conditions may use federal funds as match. Year of Funding Requested Matching Requirement 1-6 100% 7-8 125% 9-10 150% 17 3. ADDITIONAL ELIGIBILITY REQUIREMENTS/AWARD INFORMATION Award Information DFC grants will be available to eligible applicants in amounts of up to $125,000 per year for up to five years. Applicants may not ask for more than $125,000 in total costs (direct and/or indirect) in any year of the proposed project. To apply for a DFC grant under this RFA, a coalition must fall into one of the following three categories: 1. A coalition that has never received a DFC grant; 2. A coalition that previously received a DFC grant, but experienced a lapse in funding; or 3. A coalition that has concluded the first five-year funding cycle and is applying for a second five-year funding cycle. If selected to receive a DFC grant, coalitions will be awarded funds for one year (covering the 12 - month period from September 30, 2013–September 29, 2014). Funds for subsequent years within a grant cycle are distributed on an annual basis as non-competing continuation awards. Annual continuation awards are contingent upon the availability of DFC funds, the continued ability of the coalition to demonstrate eligibility, grantee progress in meeting grant requirements, timely submission of the continuation application and all required data and reports, and compliance with all terms and conditions of the award. Coalitions that have previously received DFC funding, but experienced a lapse in their five-year funding cycle, may re-apply for funding to complete their five-year funding cycle. For example, if Coalition X received DFC funding for Years One and Two, but did not receive funding for Year Three, Coalition X may apply for funding for Years Three, Four, and Five under this RFA. Coalition X may not, however, reapply for Year One or Year Two funding. Coalitions that have received 10 years of DFC funding are not eligible for this grant. NOTE: All applicants must clearly state the program award year for which they are applying (e.g., Year One, Year Two). Please indicate the status of the coalition and for which specific years the coalition received DFC support in the past in Attachment 15 of your application. If your coalition had a break in funding, indicate each year you did not receive funding from the DFC Program. Application for Federal Assistance Application Package Applicants must use the Application for Federal Assistance Application Package available at http://www.samhsa.gov/grants/applicationkit.aspx and must follow all application submission requirements and formatting requirements or their application will not be considered for funding. Application formatting requirements are provided in Appendix B of this RFA. 18 III APPLICATION AND SUBMISSION INFORMATION 1. ADDRESS TO REQUEST APPLICATION PACKAGE You may request a complete application package from SAMHSA at 1-877-SAMHSA7 [TDD: 1- 800-487-4889]. You also may download the required documents from the SAMHSA website at http://www.samhsa.gov/grants/apply.aspx. Additional materials available on this website include:  a list of Frequently Asked Questions;  a list of all the Attachments and Appendices;  a grant writing technical assistance manual for potential applicants;  standard terms and conditions for SAMHSA grants;  guidelines and policies that relate to SAMHSA grants (e.g., guidelines on consumer and family participation, and evaluation); and  a list of certifications and assurances referenced in item 21 of the SF-424. DFC application support information can be found at http://www.whitehouse.gov/ondcp/Drug- Free-Communities-Support-Program. General information about writing applications for SAMHSA grants is available online at http://www.samhsa.gov/grants/apply.aspx. 2. CONTENT AND GRANT APPLICATION SUBMISSION Application Package A complete list of documents included in the Application Package is available at http://www.samhsa.gov/Grants/ApplicationKit.aspx. This includes:  Application Package: Includes the Face page (SF-424), Budget Information forms (SF- 424A), Project/Performance Site Location(s) form, Disclosure of Lobbying Activities (SF- LLL) if applicable, and Checklist. Applications that do not include the required forms will be screened out and will not be reviewed.  Request for Applications (RFA): Provides a description of the program, specific information about the availability of funds, and instructions for completing the grant application. This document is the RFA. The RFA will be available on the SAMHSA website at http://www.samhsa.gov/grants/index.aspx and the DFC website at http://www.whitehouse.gov/ondcp/Drug-Free-Communities-Support-Program. A synopsis of the RFA is available on the federal grants website at http://www.Grants.gov. You must use all of the above documents in completing your application. 19 Required Application Components Applications must include all required application components. These components must be submitted in the order detailed below. Please refer to Appendix B and C for additional submission requirements (e.g., font size, page margins).  Face Page: SF-424 is the face page. This form is part of the Grant Application Package, available at http://www.samhsa.gov/grants/applicationkit.aspx. [NOTE: Applicants must provide a Dun and Bradstreet (DUNS) number to apply for a grant or cooperative agreement from the federal government.] SAMHSA applicants are required to provide their DUNS number on the face page of the application. Obtaining a DUNS number is easy and there is no charge. To obtain a DUNS number, access the Dun and Bradstreet website at http://www.dunandbradstreet.com or call 1-866-705-5711. To expedite the process, indicate to Dun and Bradstreet that you are a public/private non-profit organization getting ready to submit a federal grant application. Regardless of the method of application submission (paper or electronic), registration in the System for Award Management (SAM) is mandatory for any applicant of the DFC Program. Failure to register with SAM will lead to an application being deemed ineligible and will not proceed to peer review. It takes up to 72 hours for a SAM registration to be processed. Do not wait until the day the application is being submitted to register for SAM, as there will not be enough time for the registration to process and your application will not make the deadline. The former Central Contractor Registration (CCR) transitioned to the SAM on July 30, 2012. Any registration data in process during the transition period between July 16, 2012 and October 15, 2012 was migrated to SAM. SAM information must be updated at least every 12 months to remain active. Once you update your record in SAM, it will take up to 72 hours to complete the validation processes. The DUNS number you use on your application must be registered and active in the SAM. To create a user account, register/update entity and/or search records from SAM, refer to https://www.sam.gov.  Budget Form: Use SF-424A, which is part of the Grant Application Package. Fill out Sections B, C, and E of the SF-424A. A sample budget and justification is included in Appendix A of this RFA. Your completed SF-424A should reflect the final numbers as they appear in your Budget Narrative.  Table of Contents: Number the bottom right corner of every page in the application, including the Attachments, beginning with your Table of Contents as Page 1. In the Table of Contents, include the page numbers for each of the major sections of the application and each attachment. Hand numbering of pages is allowable.  Community Overview: The Community Overview describes the key features of the community. It should be no longer than 1 page in length.  Project Narrative: The Project Narrative (Section A of this RFA) describes the efforts the coalition will undertake to address youth substance use. It consists of 10 questions and 20 can be no longer than 30 pages. More detailed instructions for completing the Project Narrative are provided in the Application Review Information of this RFA. Applications that exceed the 30-page limit (Project Narrative only) will be screened out and will not be reviewed.  Budget Narrative: The Budget Narrative (Section B of this RFA) provides narrative detail about both the federal request and the non-federal match.  Attachments 1 through 17: Please clearly label each attachment provided, additional attachments will not receive a higher score.  Assurances and Certifications: Non-Construction Programs. Applicants must read the list of assurances and certifications provided on the SAMHSA website and check the box marked ‘I Agree’ before signing the face page (SF-424) of the application.  Project Performance Site Location(s) Form: The purpose of this form is to collect location information on the site(s) where work funded under this grant announcement will be performed. This form will be posted with the RFA on SAMHSA’s website and provided in the application package at http://www.samhsa.gov/grants/applicationkit.aspx.  Assurance of Compliance with SAMHSA Charitable Choice Statutes and Regulations Form SMA 170: Applicants are required to complete the Assurance of Compliance with SAMHSA Charitable Choice Statutes and Regulations Form SMA 170. This form is available on SAMHSA’s website and provided in the application package at http://www.samhsa.gov/grants/applicationkit.aspx.  Disclosure of Lobbying Activities: Federal law prohibits the use of appropriated funds for publicity or propaganda purposes or for the preparation, distribution, or use of the information designed to support or defeat legislation pending before the Congress or state legislatures. This includes “grass roots” lobbying, which consists of appeals to members of the public suggesting that they contact their elected representatives to indicate their support for or opposition to pending legislation or to urge those representatives to vote in a particular way. You must hand sign and submit this form, if applicable.  Checklist: Use the Checklist found in the Grant Application Package, available at http://www.samhsa.gov/grants/applicationkit.aspx. You must complete the entire form including the top portion “Type of Application” must be checked (New, Non-Competing Continuation, Competing Continuation or Supplemental). If you are submitting a paper application the Checklist should be the next-to-last page.  Documentation of non-profit status as required in the Checklist.  Pre-Submission Verification: Use the checklist found in Appendix P. This verification ensures that you have accurately documented the eligibility requirements and included all 21 major components of the application. If submitting a paper application, the Pre- Submission Verification should be the last page. 3. APPLICATION SUBMISSION REQUIREMENTS While SAMHSA requires electronic submission for grant applications, a waiver has been granted to allow paper submissions for the DFC Program for the FY 2013 application process. Within 30 days of receipt of an application, applicants will be notified by postal mail that the application has been received. If an applicant submits an application on time and does not receive notification within that 30-day timeframe, the applicant should contact SAMHSA’s Office of Grant Review at 240-276-1199 for additional information. Submission of Electronic Applications Applicants using electronic submission are subject to the registration requirements for the System of Award Management (SAM). Failure to register with SAM will lead to an application being deemed ineligible and will not proceed to peer review. SAMHSA accepts electronic submission of applications through http://www.grants.gov. If you plan to submit the application electronically through Grants.gov, it is very important that you thoroughly read the application information provided in Appendix C, Guidance for Electronic Submission of Applications. If you use electronic submission, that is the “official” submission. Paper (mailed) back-up applications for electronic submissions will not be accepted. Electronically submitted applications are due by 11:59 PM (Eastern Time) on March 22, 2013. Submission of Paper Applications Applicants using paper submission are subject to the registration requirements for the System of Award Management (SAM). Failure to register with SAM will lead to an application being deemed ineligible and will not proceed to peer review. If you are submitting a paper application, you must submit an original application and two (2) copies (including attachments). The original and copies must not be bound and nothing should be attached, stapled, folded, or pasted. Do not use staples, paper clips, or fasteners. You may use rubber bands. Paper submissions of grant applications are due by 5:00 PM (Eastern Time) on March 22, 2013. Applications may be shipped using only Federal Express (FedEx), United Parcel Service (UPS), or the United States Postal Service (USPS). NOTE: If you use the USPS, you must use Express Mail. SAMHSA will not accept any applications that are hand carried by an individual or sent by facsimile. Send paper applications to the address below : Diane Abbate, Director of Grant Review Office of Financial Resources Substance Abuse and Mental Health Services Administration Room 3-1044 22 1 Choke Cherry Road Rockville, MD 20857 (Change the zip code to 20850 if you are using FedEx or UPS) Do not send applications to other agency contacts. Be sure to include “SP-13-002 – DFC Support Program” in item number 12 on the face page (SF-424) of any paper applications. If you require a phone number for delivery, you may use (240) 276-1199. Your application must be received by the application deadline or it will be screened out and will not proceed to peer review. Please remember that mail sent to federal facilities undergoes a security screening prior to delivery. You are responsible for ensuring that you submit your application so that it will arrive by the application due date and time. If an application is mailed to a location or office (including room number) that is not designated for receipt of the application and, as a result, the designated office does not receive your application by the deadline, your application will be considered late and ineligible for review. Application Formatting Requirements Applications that do not comply with the Application Formatting Requirements will be screened out and will not be reviewed for Statutory Eligibility Requirements and will not go to peer review. Please refer to Appendix B, Checklist for Formatting Requirements and Screenout Criteria for SAMHSA Grant Applications, for SAMHSA’s basic application formatting requirements. 4. INTERGOVERNMENTAL REVIEW (E.O. 12372) REQUIREMENTS This grant program is covered under Executive Order (EO) 12372, as implemented through Department of Health and Human Services (HHS) regulation at 45 CFR Part 100. Under this Order, states may design their own processes for reviewing and commenting on proposed federal assistance under covered programs. See Appendix L for additional information on these requirements, as well as requirements for the Public Health Impact Statement. 5. FUNDING LIMITATIONS/RESTRICTIONS The governing cost principles describing allowable and unallowable expenditures for federal grantees, including SAMHSA grantees, are provided in the following documents, which are available at http://www.samhsa.gov/grants/management.aspx: Table 3: Cost Principles Applies to: Cost Principle: Educational Institutions 2 CFR Part 220 (OMB Circular A-21) State, Local and Indian Tribal Governments 2 CFR Part 225 (OMB Circular A-87) Nonprofit Organizations 2 CFR Part 230 (OMB Circular A-122) Hospitals 45 CFR Part 74, Appendix E 23 The Health and Human Services (HHS) Grant Policy Statement – This HHS directive covers grant policies, including, but not limited to general administrative and cost considerations. Part II of the HHS Grant Policy statement describes selected allowable and unallowable costs items and activities. This document is available at http://www.samhsa.gov/grants/management.aspx. In addition, SAMHSA’s DFC Support Program grant recipients must comply with the following funding restrictions:  DFC grant funds must be used for purposes supported by the DFC Program.  DFC may not be used to fund programs (i.e. after school, programs, youth mentoring programs, sports programs, treatment services/programs/facilities, and/or other programs considered “direct services”).  DFC grant funds may not be used to pay for any lease beyond the project period.  DFC grant funds may not be used to pay for the purchase or construction of any building or structure to house any part of the grant project.  Food is generally unallowable. Exceptions within the DFC Program may include when food is used as a small incentive (not to exceed $2.50 per person) to encourage participation in a community-wide event. Food costs are not allowable for general coalition or subcommittee meetings.  No more than 20 percent of the total grant award may be used for evaluation purposes.  DFC grant funds may not be passed-through to another entity to conduct the substantive programmatic work on the program. The funded coalition is expected to perform the substantive role in efforts carried out by this grant.  DFC grant funds may not be used to provide funding to community organizations through mini-grants, including one coalition funding another coalition.  DFC grant funds may not be utilized for the following: law enforcement equipment, drug search detection canines or related training, drug courts, lighting, or community gardening efforts. IV APPLICATION REVIEW INFORMATION 1. GENERAL INSTRUCTIONS Make sure that you are reading and using the correct RFA to submit your application for FY 2013 DFC funding. For FY 2013, there are 10 questions in the Project Narrative (Section A) and only these questions can be used when applying for FY 2013 funding. Failure to use the correct RFA and to answer the correct questions in the order they are presented in the FY 2013 RFA will result in an application being deemed ineligible and not proceeding to peer review. 2. EVALUATION CRITERIA The DFC Program uses a peer review process that identifies current and former DFC grantees to serve as peer reviewers. Applicants should consider the audience when assembling and writing their application. Each application is assigned to a panel of three peer reviewers for scoring. Each application is scored and the composite of the three scores becomes the application’s final score. These final scores are ranked from the highest to the lowest and sent to ONDCP for 24 review. Upon full completion of the statutory eligibility review process and review of final scores, ONDCP begins funding with the highest scoring grant until all funds are exhausted. NOTE: The DFC Act requires that all applications be considered and reviewed equally. Those applying for Year Six do not receive a higher priority than those applying for Year One. A Year Six applicant’s past performance is not a factor in funding decisions. Only the submitted application is forwarded to peer reviewers. In addition, grants are not awarded based on how many DFC-funded coalitions are within a geographic boundary (e.g., state, county, city). 3. APPLICATION SCORING INSTRUCTIONS Peer reviewers will tally the points each applicant receives for each question to create a total score for the Project Narrative (scores will range from 0 to 90 points). Project Narrative Scoring: Peer reviewers will score the responses to questions 1, 6, and 10 using the 5-point scale identified below.  5 points: Answer is outstanding. The applicant organization explicitly addresses all bullets in the question by providing comprehensive descriptions and thorough details.  4 points: Answer is very good. The applicant organization explicitly addresses the majority of the bullets and provides significant descriptions and relevant details. However, at least one bullet does not include comprehensive and detailed information to completely answer the question.  3 points: Answer is acceptable. The applicant organization explicitly addresses some of the bullets and provides adequate descriptions and sufficient details. However, two or more bullets do not include comprehensive and detailed information to completely answer the question.  2 points: Answer is marginal. The applicant organization does not explicitly address the majority of the bullets. The applicant organization provides minimal details and insufficient descriptions that do not completely answer the question.  1 point: Answer is unacceptable. The applicant organization does not explicitly address the bullets. The applicant organization states the question, but does not elaborate on the response. The applicant organization skipped or otherwise ignored the question. As a result, the answer is completely deficient in addressing the question. Peer reviewers will score the responses to questions 2, 3, 4 5, 8, and 9 using the 10-point scale identified below.  10-9 points: Answer is outstanding. The applicant organization explicitly addresses all bullets in the question by providing comprehensive descriptions and thorough details.  8 points: Answer is very good. The applicant organization explicitly addresses the majority of the bullets and provides significant descriptions and relevant details. However, at least one bullet does not include comprehensive and detailed information to completely answer the question. 25  7 points: Answer is acceptable. The applicant organization explicitly addresses some of the bullets and provides adequate descriptions and sufficient details. However, two or more bullets do not include comprehensive and detailed information to completely answer the question.  6 points: Answer is marginal. The applicant organization does not explicitly address the majority of the bullets. The applicant organization provides minimal details and insufficient descriptions that do not completely answer the question.  5-0 points: Answer is unacceptable. The applicant organization does not explicitly address the bullets. The applicant organization states the question, but does not elaborate on the response. The applicant organization skipped or otherwise ignored the question. As a result, the answer is completely deficient in addressing the question. Peer reviewers will score the responses to question 7 using the 15-point scale identified below.  15-13 points: The Action Plan is outstanding. The Action Plan fully addresses both DFC goals of increasing collaboration and reducing youth substance use. The Action Plan provides objectives that coincide with problems identified in the data provided in Question five of the Project Narrative. The strategies and activities included will effectively address each objective. The Action Plan has a comprehensive approach and includes identifiable environmental prevention strategies.  12-10 points: The Action Plan is very good. The Action Plan does not do one of the following: (1) fully address both DFC goals of increasing collaboration and reducing youth substance use; (2) provide objectives that coincide with the problems identified in the data provided in Question 5 of the Project Narrative; (3) provide strategies and activities that will sufficiently address each objective; and (4) include some environmental prevention strategies.  9-7 points: The Action Plan is acceptable. The Action Plan does not do two of the following: (1) fully address both DFC goals of increasing collaboration and reducing youth substance use; (2) provide objectives that coincide with problems identified in the data provided in Question 5 of the Project Narrative; (3) provide strategies and activities that will at least sufficiently address each objective; and (4) include some identifiable environmental prevention strategies.  6-4 points: The Action Plan is marginal. The Action Plan does not do not do three or more of the following: (1) fully address both DFC goals of increasing collaboration and reducing youth substance use; (2) provide objectives that coincide with problems identified in the data provided in Question 5 of the Project Narrative; (3) provide strategies and activities that will at least sufficiently address each objective; and (4) include some identifiable environmental prevention strategies.  3-0 points: The Action Plan is unacceptable. The applicant organization presented an Action Plan, but does not effectively elaborate on the following: (1) fully address both DFC goals of increasing collaboration and reducing youth substance use; (2) provide objectives that coincide with problems identified in the data provided in Question 5 of the Project Narrative; (3) provide strategies and activities that will at least sufficiently address each objective; and (4) include some identifiable environmental prevention strategies. The applicant organization skipped or otherwise ignored the question. 26 Budget Narrative Scoring: Peer reviewers will determine whether items identified in the budget (federal request and non- federal match) align with the activities outlined in the Action Plan and the DFC Program priorities using the 10-point scale identified below.  10-9 points: Answer is outstanding. Budget completely supports the objectives in the Action Plan; demonstrates outstanding support of the two primary goals of the DFC grant; and makes effective use of both federal grant funds and required matching funds.  8 points: Answer is very good. Budget sufficiently supports the objectives in the Action Plan; demonstrates some support of the two primary goals of the DFC grant; and makes effective use of both federal grant funds and required matching funds.  7 points: Answer is acceptable. Budget adequately supports the objectives in the Action Plan; demonstrates sufficient support of the two primary goals of the DFC grant; and makes effective use of both federal grant funds and required matching funds.  6 points: Answer is marginal. Budget minimally supports the objectives in the Action Plan and demonstrates little support of the two primary goals of the DFC grant; and does not effectively make use of both federal grant funds and required matching funds.  5-0 points: Answer is unacceptable. Budget does not support the objectives in the Action Plan and demonstrates no support of the two primary goals of the DFC grant; and does not make effective use of both federal grant funds and required matching funds. 4. REVIEW AND SELECTION PROCESS Applications will be screened jointly by ONDCP and SAMHSA to determine whether applicants meet all eligibility requirements outlined in this RFA. Applications submitted by coalitions that meet all eligibility requirements will then be scored by a peer review panel according to the evaluation criteria described above. All applications that proceed to peer review will be rated on a 100-point scale (90 points for the Project Narrative and 10 points for the Budget Narrative). Peer reviewer ratings, and any resulting recommendations, are advisory. The primary decision criterion is the application’s final peer review score. All final grant award decisions will be made by the Director of ONDCP. In the case of ties and consistent with the DFC Act of 1997, ONDCP may give consideration to rural, American Indian/Alaska Native, and economically disadvantaged communities. V RESPONDING TO THE DFC RFA 1. COMMUNITY OVERVIEW (NOT SCORED) The Community Overview should be placed after the Table of Contents. Type the heading Community Overview, then describe the community the applicant coalition intends to serve. This is the applicant’s opportunity to educate the peer reviewers about the community, enabling them to understand the context in which the coalition will operate. This will assist the peer reviewers in scoring the Project Narrative. The Community Overview is not scored and does not count toward the 30-page limit. However, it can be no longer than one page in length. In the Community Overview, at a minimum, provide the following information: 27  Describe the community, including demographics and aspects of diversity such as age, race, ethnicity, gender, socioeconomic status, culture, religion, and sexual orientation  Describe what it is like to live and work in the community  Provide a historical perspective focusing on shifts or events that have had an impact on youth substance use in the community 2. SECTION A: PROJECT NARRATIVE (SCORED; MAXIMUM OF 90 POINTS) In developing the Project Narrative, use the instructions outlined below, which have been tailored to the DFC Program. Applicants must use these instructions and NOT the Program Narrative instructions found in the Grant Application Package.  The Project Narrative should be no longer than 30 pages. Applications with a Project Narrative that exceeds the 30-page limit will not be screened for Statutory Eligibility Requirements and will not go to peer review.  Restrictions related to font size and page margins found in Appendix B must be followed.  Respond to each question individually, building each response on previous responses so all answers together tell a cohesive story of the community and coalition.  Retype the bold question only directly above each response. Place all responses and required information under the correct question. Do not direct peer reviewers to information related to one question in another question. Each question must be answered in its entirety within the numbered question’s answer. Applicants must not direct peer reviewers to documents in the Attachments, as they are not scored. All pertinent information must be included in the Project Narrative for appropriate scoring.  The Project Narrative will be scored according to how well the applicant answers each question and inclusion of the bullets under each question. Each bullet will be assessed when determining the score for each question. Applicants should feel free to provide information beyond the bullets within each question if it expands the coalition’s ability to more effectively address the question. If a coalition cannot answer a specific bullet, then the reason for this must be explained within the answer to the question. Section A: Questions for Project Narrative The following 10 questions enable applicants to tell the story of their current and future efforts to prevent youth substance use in their community. Bolded questions are followed by bulleted items outlining the required components of each response. Applicants are required to type the question number followed by the bolded question. Responses must follow each question and address all bullets. Applicants are not required to retype the bullets, but must answer them completely. 1. What is the coalition’s developmental history? (5 points) Provide explanations of the following:  When and how the coalition started as a community-based entity addressing youth substance use (i.e., initial community concern)  Coalition’s evolution over time  Coalition’s internal structure (e.g., board, committees, leadership, etc.) 28  Coalition’s major accomplishments to date 2. How has the coalition recruited, engaged, and retained members/volunteers, including the required 12 sector members? (10 points) Provide explanations of the following:  Clearly state how each individual listed on the Sector Member Table (Attachment 1) is the best fit for the assigned sector  Technique(s) for recruiting and retaining coalition members  Active engagement of members in the coalition’s operations and activities to ensure membership alignment with coalition’s mission and Action Plan 3. What are the coalition’s decision-making processes? (10 points) Provide explanations of the following:  Coalition’s day-to-day operations to include paid staff, coalition members, and/or potential contractors  Development of policies/procedures, by-laws, roles and responsibilities of staff, coalition members and legal grantee (if different from coalition)  Current decision-making processes related to the coalition’s effort to reduce youth substance use as reflected in the Action Plan (Question 7)  Current decision-making processes related to financial management by the coalition, to include, if any, the role of the legal grantee (if different from coalition) 4. How has the coalition positioned itself as a vehicle for creating community change? (10 points) Provide explanations of the following:  Community’s view of the coalition as a change agent  Current/potential collaborations with local organizations and community leaders  Process for translating and packaging data for the community to understand local issues related to youth substance use (i.e., appropriate communication mechanisms)  Coalition’s efforts to understand the community it serves (i.e., ensuring cultural knowledge and inclusion in membership and efforts)  Coalition’s efforts to increase the capacity of its leadership 5. What are the current youth substance use problems in the community? (10 points) Provide explanations of the following:  Current quantitative and qualitative data on youth substance use (i.e., if available, provide past 30-day use, perception of risk/harm of use, perception of parental disapproval of use and perception of peer disapproval of use for alcohol, tobacco, marijuana and prescription drugs)  Data to include the consequences of youth substance use to further understanding of current local conditions (e.g., juvenile crime, school data, emergency room data, law enforcement data, etc.)  Coalition’s processes for prioritizing the substances (must name at least 2 substances) to be addressed using DFC funds 29 6. What unique factors/local conditions contribute to and/or increase the community’s youth substance use-related problems? (5 points) Provide explanations of the following:  Existing environmental conditions and/or policies and practices (e.g., increased accessibility and availability of substances, deficient licensing laws, etc.)  Community norms (e.g., denial, lack of readiness, parental attitudes, community climate, etc.)  Other community factors (e.g., geographic conditions, economic conditions, etc.) 7. What is the coalition’s Action Plan for preventing youth substance use in the first 12 months if awarded a DFC grant? (15 points) This question is answered by providing the coalition’s Action Plan using Table 4 shown below. Do not provide narrative explanation in this question. Strategies and activities should cover a period of 12 months (September 30, 2013-September 29, 2014). Objectives may cover a time period outside of the first 12 months of the DFC grant. DFC grantees are required to plan and implement environmental prevention strategies. However, Action Plans should be comprehensive and include all strategies and activities necessary to address local conditions related to youth substance use. Under DFC Goal One, include measurable objectives, strategies and activities that will strengthen the coalition’s internal capacity, as well as overall community collaboration in addressing youth substance use. Under DFC Goal Two, include measurable objectives, strategies and activities that will prevent youth substance use. Tips for Creating an Action Plan:  The Action Plan must fall within the text of the Project Narrative and will count toward the 30-page limit.  Applicants must use the template provided in Table 4.  Applicants who are mailing their applications may use Times New Roman, 10-point font in the Action Plan and a landscape page orientation.  Applicants submitting an electronic application must use Times New Roman 12-point font in the Action Plan and must adhere to all instructions provided in Appendix C, Guidance for Electronic Submission of Applications.  The Action Plan must include the two DFC goals provided in Table 4. Applicants may add additional goals.  Objectives must be measurable and include a specific date (i.e., 06/30/14) by when the change will be accomplished, as well as how much change will occur (i.e., increase/decrease) and the population addressed (i.e., youth ages 12-17).  The Action Plan should be comprehensive to include all of the coalition’s efforts. Applicants may include as many measurable objectives, strategies, and activities as necessary to create a comprehensive Action Plan. Individual strategies may be included; however, environmental prevention strategies must be included. 30  The Action Plan must address at least two named substances (in alignment with answer provided in Question 5).  Separate the objectives for each substance addressed. Do not put all substances into a single measureable objective. The strategies and activities should be specific to the named drug. Activities may be repeated under multiple objectives. Table 4: 12-Month Action Plan Applicants must use this table to outline the coalition’s plans under the two DFC goals. Cells in the following tables are intentionally left blank. DFC Goal One: Increase community collaboration Objective 1: Provide measureable objective Strategy 1: Provide specific strategy Activity Who is responsible? By when? Strategy 2: Provide specific strategy DFC Goal Two: Reduce youth substance use Objective 1: Provide measureable objective. Strategy 1: Provide specific strategy. Activity Who is responsible? By when? Strategy 2: Provide specific strategy. Activity Who is responsible? By when? Activity Who is responsible? By when? 31 8. How will staff and coalition members ensure the implementation of the activities in the Action Plan through shared work efforts? (10 points) Provide explanations of the following:  Roles of staff, coalition members, and legal grantee (if applicable) in implementing the Action Plan  Roles of key staff, coalition members, and legal grantee (if applicable) in monitoring the Action Plan  Plan for keeping the community informed of progress toward implementation, adjustments and actions related to the Action Plan 9. How will the coalition measure its impact in achieving the objectives provided in the Action Plan? (10 points) Provide explanations of the following:  Determination of data to be used to measure impact of the strategies and activities in the Action Plan on stated objectives (i.e., data sources for capturing measurements related to the Action Plan)  Processes used to collect and analyze data (e.g., frequency of data collection, role of key staff, coalition members, and evaluator, if applicable, in data collection and analysis, etc.)  When and how data will be used to adjust/update/improve the Action Plan 10. What will the coalition do to ensure its longevity within the community’s infrastructure? (5 points) Provide explanations of the following:  Necessary systems change to ensure coalition’s alignment in community  Long-term collaboration planning beyond the 12 sectors and current membership (e.g., relationship building, human, social and fiscal capital)  Process for identifying coalition outcomes that need to be sustained  Institutionalization of coalition efforts **From this point forward, the information submitted does not count against your 30-page limit.** 3. SECTION B: BUDGET NARRATIVE (SCORED; MAXIMUM OF 10 POINTS) In this section, applicants must provide a 12-month Budget Narrative to include budget details and justification for expenditures. The Budget Narrative must include a description of matching resources and other support that the coalition will receive. No more than 20 percent of grant award may be used for evaluation. Applicants must use the template provided in Appendix A, including providing a narrative description for each budget category for both federal requests and non-federal match. There is no page limit for the Budget Narrative. If you are submitting your application through Grants.gov, the Budget Narrative must be submitted as file BNF (See Appendix C, Guidance for Electronic Submission). 32 4. SECTION C: REQUIRED ATTACHMENTS (NOT SCORED) All attachment pages must be numbered. Applicants may hand-number pages if necessary. Although these sections are not scored by peer reviewers, they are critical to an application’s ability to move forward to peer review. This information should follow Sections A and B of the application with continuous page numbers. It is extremely important to order and label these documents as indicated below. NOTE: The RFA provides applicants with several “appendices”. Applicants submit all appendices as “attachments”. Coalition Roles & Relationship to Sector Members As Attachment 1, the applicants must include a completed Sector Member Table (Table 23). The DFC Program uses two pieces of evidence to prove the 12 sectors: (1) Sector Member Table and (2) Coalition Involvement Agreements (CIA). Coalition Involvement Agreements As Attachment 2, applicants must include one Coalition Involvement Agreement (CIA) for each sector member. Table 24 must be included at the top of each CIA. A total of 12 CIAs must be submitted as Attachment 2. Two Sets of Coalition Minutes As Attachment 3, applicants must include two set of coalition minutes. One set of minutes must be from a coalition meeting that took place between January 1, 2012 and September 30, 2012. The second set of minutes must be from a coalition meeting that took place between October 1, 2012 and the deadline for submission of this application. Coalition Mission Statement As Attachment 4, applicants must provide a copy of the coalition’s Mission Statement. The statement cannot be that of an outside agent being used as the grantee/legal applicant (if applicable) for a coalition. The Mission Statement must belong to the applicant coalition and the principal mission of the coalition must be the reduction and/or prevention of youth substance use. Assurance of Legal Eligibility or Grantee/Legal Applicant & Coalition As Attachment 5, an applicant coalition that is eligible to receive federal grant funds and is applying for this grant on its own must complete Appendix F and submit it as Attachment 5. If a coalition is not eligible to receive federal grant funds on its own, it must make arrangements with a legally eligible entity that will apply for the grant on behalf of the coalition. If this is the case, as Attachment 5, applicants must submit an MOU between the applicant coalition and grantee/legal applicant. The MOU must have a hand written signature of a coalition representative and the grantee/legal applicant. It must be dated within 12 months of the date of application. Letter of Mutual Cooperation As Attachment 6 (if applicable), applicants that proposes to serve a community that overlaps an existing or applicant coalition must provide a Letter of Mutual Cooperation between the coalition 33 and the overlapping coalition outlining their efforts to collaborate. If there are not zip code overlaps identified, simply state this on a piece of paper and insert as Attachment 6. Assurance of One DFC Grant at a Time As Attachment 7, Applicants must sign and submit the Assurance of One DFC Grant at a Time document. Assurance of 10-Year Funding Limit As Attachment 8, applicants must sign and submit the Assurance of 10-Year Funding Limit document. Resumes and Job Descriptions As Attachment 9, applicants must include a resume (no longer than two pages) and a position description (no longer than one page) for the Program Director and Project Coordinator, and each additional key paid or in-kind position. Information on what should be included in resumes and position descriptions can be found in Appendix J. General Applicant Information As Attachment 10, applicants must use the table provided in Appendix K. Answer all questions. Organizational Chart As Attachment 11, include the coalition’s Organizational Chart. The Organizational Chart should display the relationship between the coalition, its subcommittees, and the grantee/legal entity, as applicable. Logic Model As Attachment 12, include the coalition’s Logic Model in whatever format the coalition is currently using. No specific template is required. If you need assistance with Logic Model development, contact CADCA’s Technical Assistance Manager at 1-800-542-2322, ext. 240 or consults the CADCA Planning Primer at http://www.cadca.org/files/resources/Planning-Primer- 07-2010.pdf. Single State Agency Letter As Attachment 13, include a copy of the letter to the Single State Agency (SSA) showing that the applicant has informed the SSA contact person that an application has been submitted for a DFC grant. Information related to this attachment is found in Appendix L, Intergovernmental Review Requirements. Certifications, Disclosures, and Checklists As Attachment 14, include the site location(s) form, certifications, assurances, and disclosures noted in Section III-2 of this RFA. Disclosure of Prior DFC Funding As Attachment 15, include the information requested in Appendix M related to prior DFC funding for the legal applicant/grantee and applicant coalition for this RFA. 34 DFC National Cross-site Evaluation Requirements As Attachment 16, include the information requested in Appendix N related to the ability to collect the data necessary to be in compliance with the DFC National Cross-site Evaluation. Congressional Notification As Attachment 17, all applicants must include a Congressional Notification. The Project Description section must not be more than 35 lines; therefore, the entire document must not exceed one page. This document should include a simple summary of your coalition’s efforts. This information will be utilized to provide 48-hours of notice to your Congressional Members should you receive DFC funding. Using the template provided in Appendix O, as requested, and include specific information pertaining to your grant application. Grant Application Package Checklist The next to last page within your application should be the checklist found in the Application Package. Pre-Submission Verification Checklist The final page of your application should be the checklist found in Appendix P, the Pre- Submission Verification Checklist. Ensure that you have included all documents listed in the application before submitting. VI ADMINISTRATIVE INFORMATION 1. AWARD NOTICES AND APPLICATION SUMMARY STATEMENTS By the end of August 2013, the list of awardees will be posted at http://www.whitehouse.gov/ondcp/Drug-Free-Communities-Support-Program. For all awardees, a Notice of Award (NoA) will then be mailed from SAMHSA’s Division of Grants Management to the individual listed as the Business Official on the Application for Federal Assistance. The NoA is the sole obligating document that allows the grantee to receive federal funding for work on the grant project. By the end of October 2013, all applicants whose applications were sent to peer review will receive a letter from SAMHSA through postal mail and sent to the individual listed as the Business Official on the Application for Federal Assistance. This document contains the peer review score and summarized comments. If an application is not funded, the applicant may re- apply if there is another receipt date for the program. 2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS  If your application is funded, you must comply with all Terms and Conditions of the grant award. The DFC Program standard terms and conditions are available on the DFC website at http://www.whitehouse.gov/ondcp/Drug-Free-Communities-Support-Program. 35  If your application is funded, you must also comply with the administrative requirements outlined in 45 CFR Part 74 or 45 CFR Part 92, as appropriate. For more information, visit SAMHSA’s website at http://www.samhsa.gov/grants/management.aspx.  If your application is funded, you will be held accountable for the information provided in the application relating to performance targets. Government Project Officers will consider the coalition’s progress in meeting goals and objectives, as well as challenges and strategies for overcoming them, when making an annual recommendation to continue the grant and the amount of any continuation award. Failure to meet stated goals and objectives may result in suspension or termination of the grant award, or in reduction or withholding of continuation awards. Complete details related to the DFC Appeals Process are available at http://www.whitehouse.gov/ondcp/information-for-current-grantees.  Grant funds cannot be used to supplant current funding of existing activities. “Supplant” is defined as replacing funding of a recipient’s existing program with funds from a federal grant.  In an effort to improve access to funding opportunities for applicants, SAMHSA is participating in the U.S. Department of Health and Human Services “Survey on Ensuring Equal Opportunity for Applicants.” This survey is included in the application package for SAMHSA grants and is posted on the SAMHSA website at http://www.samhsa.gov/grants/downloads/SurveyEnsuringEqualOpp.pdf. You are encouraged to complete the survey and return it, using the instructions provided on the survey form. 3. REPORTING REQUIREMENTS In addition to the data reporting requirements listed in Section I-4 you must comply with the following reporting requirements: Progress and Financial Reports Each year, grantees are required to submit two program progress reports, an annual coalition classification tool survey, and various financial reports. Full details regarding specific due dates are available at http://www.whitehouse.gov/ondcp/information-for-current-grantees. Publications If you are funded under this grant program, you are required to notify the Government Project Officer and SAMHSA’s Publications Clearance Officer (240-276-2130) of any materials based on the SAMHSA-funded grant project that are accepted for publication. In addition, SAMHSA requests that grantees:  Provide the Government Project Officer and SAMHSA Publications Clearance Officer with advance copies of publications. 36  Include acknowledgment of the ONDCP and SAMHSA grant program as the source of funding for the project.  Include a disclaimer stating that the views and opinions contained in the publication do not necessarily reflect those of SAMHSA, the U.S. Department of Health and Human Services, or the Executive Office of the President, Office of National Drug Control Policy, and should not be construed as such. SAMHSA and ONDCP reserve the right to issue a press release about any publication deemed by SAMHSA and ONDCP to contain information of program or policy significance to the substance abuse prevention community. 37 Appendix A: Sample Budget (Includes Budget Terminology and Sample Budget Narrative) Budget Preparation The Budget Narrative is used to determine reasonableness and allowability of costs in a DFC application. All of the proposed costs listed, whether supported by grant funds or match, must be reasonable, necessary to accomplish project objectives, allowable in accordance with applicable Federal Cost Principles, auditable, and incurred during the project period. All figures must be rounded to the nearest dollar. Before developing a budget, applicants should review SAMHSA’s guidelines available at http://www.samhsa.gov/grants/management.aspx to determine cost sharing expectations and restrictions on the types of costs that may appear in the budget. Budget Terminology Allowability of Cost: An allowable project cost is a cost that is: 1. Reasonable for the performance of the award. 2. Allocable. 3. In conformance with any limitations or exclusions set forth in the Federal Cost Principles applicable to the organization incurring the cost. 4. Consistent with the recipient’s regulations, policies, and procedures which are applied uniformly to both federally-supported and other activities of the organization. 5. Accorded consistent treatment as a direct or indirect cost. 6. Determined in accordance with generally accepted accounting principles. 7. Not included as a cost in any other federally-supported award. Cost Principles: The cost principles address the following four tests in determining the allowability of costs: 1. Reasonableness - (including necessity). A cost is reasonable if it does not exceed that which would be incurred by a prudent person under the circumstances prevailing at the time the decision was made to incur the cost. 2. Allocability - A cost is allocable to a specific grant, function, department, or other component, known as a cost objective, if the goods or services involved are chargeable or assignable to that cost objective in accordance with the relative benefits received or other equitable relationship. 3. Consistency - Regulations regarding cost assignment must be consistent for all work of the organization under similar circumstances, regardless of the source of funding, to avoid duplicate charges. 4. Conformance - Conformance with limitations and exclusions contained in the terms and conditions of award, including those in the cost principles, may vary by the type of activity, the type of recipient, and other characteristics of individual awards. 38 These four tests apply regardless of whether the particular category of costs is one specified in the cost principles or one governed by other terms and conditions of an award. These tests also apply regardless of categorization as a direct cost or an indirect cost. The fact that a grant is awarded does not indicate a determination of allowability of all proposed costs. Key Personnel: Individuals who contribute to the project in a substantive, measurable way, whether or not they receive salaries or other compensation under the grant (i.e., Program Director, Project Coordinator). The Program Director and the Project Coordinator may be the same person.  Program Director: An individual who provides daily oversight of the grant, including fiscal and personnel management, community relations, implementation, and evaluation (Person listed in Part C of the Checklist found in the Grant Application Package).  Project Coordinator: An individual who coordinates the work of the coalition and DFC activities, including training, coalition communication, data collection, and information dissemination. The Project Coordinator will be listed on the DFC website if a grant is awarded. Level of Effort: The direct time spent by an individual on DFC Program-related work. Across all projects/grants/positions, the level of effort for an individual may not exceed 100 percent. Direct Costs: Costs that can be identified specifically with a particular award, project, program, service, or other organizational activity, or that can be directly assigned to an activity with a high degree of accuracy. Normally, direct costs include, but are not limited to, salaries, travel, equipment, and supplies directly benefiting the grant-supported project or program. Indirect Costs (if applicable): Also known as “facilities and administrative costs,” indirect costs are costs that cannot be specifically identified with a particular project, program, or activity, but are necessary to the operation of the organization (i.e., overhead). Facilities operation and maintenance costs, depreciation, and administrative expenses are examples of costs that are usually treated as indirect costs. The organization must not include costs associated with its indirect rate as direct costs. Indirect costs require a negotiated indirect cost rate agreement. If indirect costs are claimed, an indirect cost rate agreement must be submitted with the application. Research indirect cost rates are not allowable and will not be accepted. For more information on the establishment of indirect cost rate agreements, contact the Division of Cost Allocation (DCA). Regional contact information can be found at the following DCA website: http://rates.psc.gov/fms/dca/orgmenu1.html. Total Project Costs (Direct and Indirect): The total allowable costs charged to the award during a budget period, whether paid by federal funds or contributed to meet the matching requirement, and the value of any third-party in-kind contributions counted toward the recipient’s matching requirement. 39 Budget Expectations: If an applicant has sufficient match to allow a budget request of the full $125,000, the applicant should round up the final budget figures to equal $125,000. Applicants will not receive a higher score for requesting less than $125,000. Applicants are strongly encouraged to apply for the full $125,000 for each of the four subsequent renewal years of funding in their budget forecast even if they are not able to apply for full funding in Year One due to insufficient match. The amount requested in this original application for the four future years establishes the maximum amount that an applicant can receive in future years if awarded the grant. Grantees are required to submit an annual budget request each year. The annual amount requested can be less than $125,000 due to challenges such as insufficient match, but can never be greater than the amount indicated in this submission. Therefore, it is more advantageous to request the full $125,000 for each out-year of funding. Avoid conflict of interest within proposed contractual costs. See the definition of Conflict of Interest and examples below: Conflict of Interest: Federal regulations prohibit the appearance and existence of conflict of interest situations for employees, officials, and agents of the organization. Reference – 45 CFR 74.42 & 43; 45 CFR 92.36; Part II-7 of the HHS Grants Policy Statement, issued January 1, 2007. Examples: An officer or employee has an interest in a company selected for a contract or consulting relationship, such as through their ownership, the ownership by a family member or through financial or other business ties (for example, sector members). Nepotism - an employee is supervised by a family member under the federally sponsored project. An individual is contracted to be a grant writer and/or provide input into the grant application. This individual is then written into the grant application to be an evaluator, program director, project coordinator, etc. for the applicant organization. This would violate the federal competition rules because contractors involved with the writing or preparation of the application cannot compete for contracts under the grant. Applicant, if awarded, will be required to alert to organizational conflicts of interest as well as noncompetitive practices among contractors that may restrict or eliminate competition. NOTE: In the Budget Narrative, applicants must provide Table 20: Future Years Budget Summary and Table 21: Calculation of Future Budget Period. 40 SAMPLE BUDGET NARRATIVE (FOR COMPLETING SF-424A: SECTION B FOR FIRST YEAR OF THE FUNDING CYCLE) Please use the format below for submitting a Budget Narrative. Applicants must provide clear and specific breakout of cost for each cost category. A. Personnel: An employee of the applying agency whose work is tied to the application. Proposed salaries must be reasonable. Compensation paid for employees must be reasonable and consistent with that paid for similar work within the applicant’s organization and similar positions in the industry. Table 5: Federal Request Position Name Annual Salary/Rate Level of Effort Cost Program Director John Doe $64,890 10% $6,489 Project Coordinator TBD $46,276 100% $46,276 TOTAL $52,765 NARRATIVE JUSTIFICATION: Enter a description of the personnel funds requested and how their use will support the purpose and goals of this proposal. Describe the role, responsibilities, and unique qualifications of each position. Table 6: Non-Federal Match Position Name Annual Salary/Rate Level of Effort Cost Clerical Support Jane Doe $13.38/hr x 100 hr. 100 hrs/year $1,338 TOTAL $1,338 NARRATIVE JUSTIFICATION: Enter a description of the personnel matching funds provided and how their use will support the purpose and goals of this proposal. Describe how the matching funds will enhance the federal budget request. SOURCE OF MATCH FUNDS: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6a of form SF-424A): $52,765 NON-FEDERAL MATCH (enter in Section B column 2 line 6a of form SF-424A): $1,338 B. Fringe Benefits: Fringe benefits may include contributions for items such as social security, employee insurance, and pension plans. Only those benefits not included in an organization's indirect cost pool may be shown as direct costs. List all components of the fringe benefits rate. 41 Table 7: Federal Request Component Rate Wage Cost FICA 7.65% $52,765 $4,037 Workers Compensation 2.5% $52,765 $1,319 Insurance 10.5% $52,765 $5,540 TOTAL $10,896 NARRATIVE JUSTIFICATION: Enter a description of the fringe matching funds provided and how the rate was determined. Table 8: Non-Federal Match Component Rate Wage Cost FICA 7.65% $1,338 $102 Workers Compensation 2.5% $1,338 $33 Insurance 10.5% $1,338 $140 TOTAL $275 NARRATIVE JUSTIFICATION: Enter a description of the fringe matching funds provided and how the rate was determined. SOURCE OF MATCH FUNDS: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6b of form SF-424A): $10,896 NON-FEDERAL MATCH (enter in Section B column 2 line 6b of form SF-424A): $275 C. Travel: The lowest available commercial fares for coach or equivalent accommodations must be used. NOTE: Grantees will be expected to follow federal travel policies found at http://www.gsa.gov. Table 9: Federal Request Purpose of Travel Location Item Rate Cost New Grantee Meeting Washington, DC Airfare $300/flight x 2 persons $600 New Grantee Meeting Washington, DC Hotel $200/night x 2 persons x 4 nights $1,600 42 Purpose of Travel Location Item Rate Cost New Grantee Meeting Washington, DC Per Diem (meals) $64/day x 2 persons x 4 days $512 Coalition Academy Week 1 Ft. Indiantown Gap, PA (tentative site) Airfare $200/flight x 2 persons $400 Coalition Academy Week 1 Ft. Indiantown Gap, PA Car Rental $200/week, unlimited miles $200 Coalition Academy Week 2 Ft. Indiantown Gap, PA (tentative site) Airfare $200/flight x 2 persons $400 Coalition Academy Week 2 Ft. Indiantown Gap, PA Car Rental $200/week, unlimited miles $200 Coalition Academy Week 3 Ft. Indiantown Gap, PA (tentative site) Airfare $200/flight x 2 persons $400 Coalition Academy Week 3 Ft. Indiantown Gap, PA Car Rental $200/week, unlimited miles $200 Local travel County-wide Mileage 3,000 miles@ $0.50/mile $1,500 TOTAL $6,012 NARRATIVE JUSTIFICATION: Explain the purpose for all travel (other than that required by this application) and how costs were determined. The grant requires that two members attend the New Grantee Meeting in Washington, DC. Attendance at the National Coalition Academy is required of all Year One grantees. In addition to the required trainings, funds for local travel are needed to attend local meetings, project activities, and training events. Local travel rate should be based on agency’s personally owned vehicle (POV) reimbursement rate, which should correspond with the GSA rate found at http://www.gsa.gov. Table 10: Non-Federal Justification Purpose of Travel Location Item Rate Cost Regional Training Conference Chicago, IL Airfare $300/flight x 2 persons $600 Regional Training Conference Chicago, IL Hotel $155/night x 2 persons x 2 nights $620 43 Purpose of Travel Location Item Rate Cost Regional Training Conference Chicago, IL Per Diem (meals) $46/day x 2 persons x 2 days $184 Local Travel Outreach workshops Mileage 304 miles x $0.50/mile $152 TOTAL $1,556 NARRATIVE JUSTIFICATION: Enter a description of the travel matching funds provided and how their use will support the purpose and goals of this proposal. Describe how the matching funds will enhance the Federal budget request. Local travel rate should be based on agency’s POV reimbursement rate, which should correspond with the GSA rate found at http://www.gsa.gov. SOURCE OF MATCH FUNDS: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6c of form SF-424A): $6,012 NON-FEDERAL MATCH (enter in Section B column 2 line 6c of form SF-424A): $1,556 D. Equipment: Permanent equipment may be charged to the project only if the applicant can demonstrate that purchase will be less expensive than rental. Permanent equipment is defined as nonexpendable personal property having a useful life of more than one year and an acquisition cost of $5,000 or more. If the applying agency defines “equipment” at a lower rate, then follow the applying agency’s policy. Table 11: Federal Request Item(s) Rate Cost None $0 $0 TOTAL $0 NARRATIVE JUSTIFICATION: Enter a description of the equipment and how its purchase will support the purpose and goals of this proposal. Table 12: Non-Federal Match Item(s) Rate Cost None $0 $0 TOTAL $0 44 NARRATIVE JUSTIFICATION: Enter a description of the equipment match provided and how its use will support the purpose and goals of this proposal. Describe how the matching funds will enhance the federal budget request. SOURCE OF MATCH FUNDS: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6e of form SF-424A): $0 NON-FEDERAL MATCH (enter in Section B column 2 line 6e of form SF-424A): $0 E. Supplies: Materials costing less than $5,000 per unit and often having one-time use. Table 13: Federal Request Item(s) Rate Cost General office supplies $50/mo. x 12 mo. $600 Postage $37/mo. x 8 mo. $296 Coalition promotional items 200 items @ $1.39 each $278 Laptop computer $600 $600 Printer $300 $300 Projector $700 $700 Copies 8000 copies x $0.10/copy $800 Laptop Computer update $100 $100 TOTAL $3,674 NARRATIVE JUSTIFICATION: Enter a description of the supplies requested and how their purchase will support the purpose and goals of this proposal. Table 14: Non-Federal Match Item(s) Rate Cost General Office Supplies $50/mo. X 12 mo. $600 Computer $500 $500 Postage $37/mo. x 4 mo. $148 Computer update (if needed) $100 $100 TOTAL $1,348 NARRATIVE JUSTIFICATION: Enter a description of the supplies match provided and how their use will support the purpose and goals of this proposal. Describe how the matching funds 45 will enhance the federal budget request. Please note that items such as computers, desks, and projection equipment may be counted as match only once throughout the life of the project. SOURCE OF MATCH: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6e of form SF-424A): $3,674 NON-FEDERAL MATCH (enter in Section B column 2 line 6e of form SF-424A): $1,348 F. Contract: A contractual arrangement cost to carry out a portion of the programmatic effort by a third-party contractor or for the acquisition of goods or services under the grant. Such arrangements may be in the form of consortium agreements or contracts. If there is more than one contractor, each must be budgeted separately. A consultant is a non-employee retained to provide advice and expertise in a specific program area for a fee. The Grantee must establish written procurement policies and procedures that are consistently applied. All procurement transactions are required to be conducted in a manner to provide to the maximum extent practical, open and free competition. The Grantee will be required to be alert to organizational conflicts of interest as well as noncompetitive practices among contractors that may restrict or eliminate competition or otherwise restrain trade. Table 15: Federal Request Name Service or Products Cost To be selected Environmental Strategy Consultation $150/day x 35 days = $5,250 Travel 380 miles @ $0.50/mile = $190 $5,440 To be selected Board and Committee Leadership Consultation $300/trainer x 2 trainers x 10 days = $6,000 $100/hour for individual TA x 15 hours = $1,500 $7,500 To be selected Evaluation Contractor $200/hour x 50 hours to include collection of core measures, creation of evaluation report, coalition evaluation support (e.g., member survey), and activity evaluation support (e.g., pre/post survey development) $10,000 To be selected Substance Abuse Training for Coalition Members Trainers: $300/day x 4 days = $1,200 Materials: approx. $5/person x 25 people = $125 Room Rental = $75 Travel for Trainers: Flight $300/person x 2 people = $600 Per Diem: $46/day x 4 days x 2 people = $368 $2,368 Local Police Department Alcohol Compliance Checks (6 hours each)Officer Overtime: 6 officers @ $50/hour x 6 checks @ $300/check $1,800 46 Name Service or Products Cost To be selected Responsible Server 3-Day Training Trainer: $500/day $1,500 TOTAL $28,608 NARRATIVE JUSTIFICATION: Explain the need for each agreement and how it will support the purpose and goals of this proposal. Table 16: Non-Federal Match Name Product or Service Cost Coalition members Participation in coalition activities outlined in Action Plan 18 members @ $17.50/hr. x 10 hr./mo. (average) x 12 mo. $37,800 Local School District Student Assistance Program – CIA demonstrates breakout of services $15,400 Local Police Department Alcohol Compliance Checks (1 hour each) Officer Overtime: 8 officers @ $50/hour x 6 checks $2,400 Youth members Alcohol Compliance Checks 8 youth @ $50/youth x 6 checks = $2400 16 parent chaperones x 6 checks x $25/check = $2,400 $4,800 Media sponsorship Local cable station agrees to run coalition promotion PSA an average of 5 times/week for 24 weeks 5 PSAs/week $50/PSA x 24 weeks $6,000 Advertising Billboards @$600 x 12 = $7,200 $7,200 TOTAL $73,600 NARRATIVE JUSTIFICATION: Explain the need for each match contract agreement and how it will support the purpose and goals of this proposal. Describe how the matching funds will enhance the federal budget request. SOURCE OF MATCH FUNDS: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6f of form SF-424A): $28,608 NON-FEDERAL MATCH (enter in Section B column 2 line 6f of form SF-424A): $73,600 G. Construction: NOT ALLOWED - On the SF-424A, leave the following section blank: Section B columns 1& 2 line 6g. 47 H. Other: Expenses not covered in any of the previous budget categories. *If rent is requested (direct or indirect), provide the name of the owner(s) of the space/facility. If anyone related to the project owns the building which is less-than-arm’s length1 arrangement, provide cost of ownership/use allowance calculations. Additionally, the lease is required and must be submitted for all projects allocating rent costs. Table 17: Federal Request Item Rate Cost Rent* $550/mo x 12 mo. $6,600 Telephone (land line) $100/mo. x 12 mo. $1,200 Student Surveys $1/survey x 4884 $4,884 Brochures $0.89/brochure x 1500 brochures $1,335 Meth literature for merchants Window Clings: 1,500 clings x $2 each = $3,000 Handouts: 3,000 copies x $0.50 each = $1,500 $4,500 TOTAL $18,519 NARRATIVE JUSTIFICATION: Explain the need for each item and how it will support the purpose and goals of this proposal. Break down costs into cost/unit (e.g., cost/square foot). Table 18: Non-Federal Match Item Rate Cost Space rental Varies between $75/event to over $300/event $8,300 Mentoring Program 12 mentors x 10 hrs./mo. x $17.50/hr. x 12 mo. CIA demonstrates breakout of services $25,200 Internet service $26/mo. x 12 mo. $312 Student surveys $1/survey x 1946 surveys $1,946 Printing $300/run x 6 runs $1,800 1 “less-than-arms-length” lease is one under which one party to the lease agreement is able to control or substantially influence the actions of the other. Such leases include, but are not limited to those between a division of a non -profit organization, non-profit organization and a director, trustee, officer, or key employee of the non -profit organization or his immediate family, either directly or through corporations, trusts, or similar arrangements in which they hold a controlling interest) 48 Item Rate Cost Transition program for youth & parents 1 person x $25/hr. x 3 hrs = $75 100 parent packets x $3.50/packet = 350 $425 Health Fair Coordination and administration CIA demonstrates breakout of services $1,500 Physician/Health Provider diagnostic tools and training Coordination and administration CIA demonstrates breakout of services $1,700 Drug-Free Workplace Initiative Coordination and administration CIA demonstrates breakout of services $3,000 Underage Drinking Initiative Coordination and administration CIA demonstrates breakout of services $2,700 TOTAL $46,883 NARRATIVE JUSTIFICATION: Explain the need for each match item and how it will support the purpose and goals of this proposal. Break down costs into cost/unit (e.g., cost/square foot) and explain the use of each item requested. Describe how the matching funds will enhance the federal budget request. SOURCE OF MATCH FUNDS: State source of match funds. FEDERAL REQUEST (enter in Section B column 1 line 6h of form SF-424A): $18,519 NON-FEDERAL MATCH (enter in Section B column 2 line 6h of form SF-424A): $46,883 TOTAL DIRECT COSTS: FEDERAL REQUEST (enter in Section B column 1 line 6i of form SF-424A): $120,474 NON-FEDERAL MATCH (enter in Section B column 2 line 6i of form SF-424A): $125,000 TOTAL INDIRECT COSTS2: FEDERAL REQUEST (enter in Section B column 1 line 6j of form SF-424A): $4,526 2 Indirect costs can be claimed only if the applicant has a negotiated indirect cost rate agreement . It is applied only to direct costs as allowed in the agreement. If claiming indirect costs, include a copy of the fully executed, negotiated, indirect cost agreement. For information on applying for an indirect cost rate, see “Indirect Costs” under Appendix A – Sample Budget. 49 NON-FEDERAL MATCH (enter in Section B column 2 line 6j of form SF-424A): $0 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):$125,000 NON-FEDERAL MATCH (enter in Section B column 2 line 6k of form SF-424A): $125,000 Table 19: Budget Summary Category Federal Request Non-Federal Match Total Personnel $52,765 $1,338 $54,103 Fringe $10,896 $275 $11,171 Travel $6,012 $1,556 $7,568 Equipment $0 $0 $0 Supplies $3,674 $1,348 $5,022 Contractual $28,608 $73,600 $102,208 Other $18,519 $46,883 $65,402 Total Direct Costs $120,474 $125,000 $245,474 Indirect Costs $4,526 $0 $4,526 Total Project Costs $125,000 $125,000 $250,000 The federal dollars requested for all object class categories for the first 12-month period are entered on Form 424A, Section B, Column 1, line 6a-6i. Table 20: Future Years Budget Summary (Enter “Total Costs” calculations from Table 21.) Projected Future Years Federal Request Non-Federal Match Year 2 or 7 (select one) Year 3 or 8 (select one) Year 4 or 9 (select one) Year 5 or 10 (select one) TOTAL (2-5 or 7-10) 50 CALCULATION OF FUTURE BUDGET PERIODS BASED ON THE FIRST 12-MONTH BUDGET PERIOD Table 21: Sample of Future Budget Periods Category 2nd Project Year Federal 2nd Project Year Match 3rd Project Year Federal 3rd Project Year Match 4th Project Year Federal 4th Project Year Match 5th Project Year Federal 5th Project Year Match Personnel Program Director $6,489 $0 $6,489 $0 $6,489 $0 $6,489 $0 Project Coordinator $46,276 $0 $46,276 $0 $46,276 $0 $46,276 $0 Clerical Support $0 $1,338 $0 $1,338 $0 $1,338 $0 $1,338 Fringe Benefits $10,896 $275 $10,896 $275 $10,896 $275 $10,896 $275 Travel $5,000 $2,000 $5,000 $2,250 $4,000 $2,500 $4,000 $2,500 Equipment $0 $0 $0 $0 $0 $0 $0 $0 Supplies $4,500 $2,000 $4,500 $2,000 $4000 $2,000 $4,000 $2,000 Contract Evaluation $4,500 $0 $4,500 $0 $4,500 $0 $4,500 $0 Targeted Media $15,000 $20,000 $15,000 $30,000 $15,000 $30,000 $10,000 $35,000 Campaigns Training $4,000 $0 $3,000 $0 $2,500 $0 $2,500 $0 Compliance Checks $1,000 $12,000 $1,500 $14,000 $1,500 $14,000 $1,500 $14,000 Coalition Members $0 $35,000 $0 $40,000 $0 $40,000 $0 $40,000 Other $24,497 $52,387 $24,997 $35,137 $26,997 $34,887 $31,997 $29,887 Total Direct Costs $122,158 $125,000 $122,158 $125,000 $122,158 $125,000 $122,158 $125,000 Total Indirect Costs $2,842 $0 $2,842 $0 $2,842 $0 $2,842 $0 Total Costs $125,000 $125,000 $125,000 $125,000 $125,000 $125,000 $125,000 $125,000 Provide reason(s) for anticipated changes from the first year budget. 51 NOTE: The total federal dollars (direct + indirect costs) requested for the second through the fifth 12-month budget periods are entered on SF-424A, Section E: Column (b) = Year 2; Column (c) = Year 3; Column (d) = Year 4; Column (e) = Year 5. The amounts entered onto SF-424A, Section E of the SF-424A is used to determine the maximum federal funds a grantee may request in each of the project years. Failure to complete this chart will mean that a funded application cannot receive funding in the remaining years of the 5-year funding cycle. If a coalition is applying for a second 5-year funding cycle, see Table 2 of this RFA for a breakdown of the required matching funds for each year. 52 Appendix B: Formatting Requirements for SAMHSA Grant Applications While SAMHSA requires electronic submission for grant applications, a waiver has been granted to allow paper submissions for the DFC Program for the FY 2013 application process. If submitting a paper application, applicants must follow SAMHSA’s Formatting Requirements as outlined below. Regardless of the method of application submission (paper or electronic), registration in the System for Award Management (SAM) is mandatory for any applicant for the DFC Program. Failure to register with SAM will lead to an application being deemed ineligible and will not proceed to peer review. It takes up to 72 hours for a SAM registration to be processed. Do not wait until the day the application is being submitted to register for SAM, as there will not be enough time for the registration to process and your application will not make the deadline. 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 will not be considered for funding.  Use the Application Package: Application for Federal Assistance SF-424, Budget Information Form SF-424A (Non-Construction Programs), Checklist, Disclosure of Lobbying Activities, if applicable and the Project/Performance Site Location(s) form.  You must be registered in the System Award Management (SAM) prior to submitting your application. The DUNS number used on your application must be registered and active in SAM prior to submitting your application. If the SAM is not active prior to submission, the application will be screened out and will not be reviewed.  Applications must be received by the application due date and time, as detailed in on the cover page of this RFA.  Information provided must be sufficient for review.  Text must be legible. Pages must be typed in black ink, single-spaced, using a font of Times New Roman 12, with all margins (left, right, top, bottom) at least one inch each. For applications submitted via hard copy, tables may be included using a font of Times New Roman 10 and may have a landscape orientation, if desired. For Project Narratives submitted electronically, see separate requirements in Appendix C of this RFA.  The 30-page limit for the Project Narrative cannot be exceeded.  Paper must be white paper and 8.5 inches by 11.0 inches in size. 53 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 required application components should be submitted in the order described in Section III-2 of this RFA.  Pages should be typed single-spaced in black ink with one column per page. Pages should not have printing on both sides.  Pages should be numbered consecutively from beginning to end, starting with the Table of Contents as page 1, so that information can be located easily during review of the application (hand write page numbers if necessary). The four pages of SF-424 and the two pages of the SF-424A placed before the Table of Contents are not to be numbered. Attachments should be labeled and separated from the Project Narrative and Budget Narrative, and the pages should be numbered to continue the sequence. Hand numbering of pages is allowed.  If you are submitting a paper application, send the original application and two copies to the mailing address provided in Section III-3 of this RFA. Please do not use staples, paper clips, or fasteners. Nothing should be stapled, folded, or pasted. Do not use heavy or lightweight paper or any material that cannot be copied using automatic copying machines. Inserting a piece of colored paper between the original each of the two copies of the application is recommended. Odd-sized and oversized attachments such as posters will not be copied or sent to reviewers. Do not include brochures, PowerPoints, training handouts, videotapes, audiotapes, CD-ROMs, or DVDs. 54 Appendix C: Guidance for Electronic Submission of Applications While SAMHSA requires electronic submission for grant applications, a waiver has been granted to allow paper submissions for the DFC Program for the FY 2013 application process. If submitting a paper application, applicants must follow SAMHSA’s Formatting Requirements as outlined in Appendix B of this RFA. If submitting electronically, you must use the instructions provided below. Regardless of the method of application submission (paper or electronic) registration in the System for Award Management (SAM) is mandatory for any applicant for the DFC Program. Failure to register with SAM will lead to an application being deemed ineligible and will not proceed to peer review. If you are choosing to submit your DFC application using electronic submission, please do so well in advance of the deadline. Applicants are strongly encouraged to submit their applications to Grants.gov early enough to resolve any unanticipated difficulties prior to the deadline. If your application is not successfully validated by Grants.gov it will not be forwarded to SAMHSA as the receiving institution. If this is the first time you have submitted an application through Grants.gov, you must complete three separate registration processes before you can submit your application. Allow at least two weeks (10 business days) for these registration processes, prior to submitting your application. The processes are: 1. DUNS Number registration: The DUNS number you use on your application must be registered and active in the SAM. 2. System for Award Management (SAM) registration: The System for Award Management (SAM) is a federal government owned and operated free website that replaces capabilities of the former Central Contractor Registry (CCR) system, as well as EPLS. Future phases of SAM will add the capabilities of other systems used in federal awards processes. SAM information must be updated at least every 12 months to remain active (for both grantees and sub-recipients). Once you update your record in SAM, it will take 48 to 72 hours to complete the validation processes. Grants.gov will reject electronic submissions from applicants with expired registrations. To create a user account, Register/Update entity and/or Search Records from CCR, go to https://www.sam.gov. You will find a Quick Start Guide for Entities Interested in Being Eligible for Grants through SAM at https://www.sam.gov/sam/transcript/Quick_Guide_for_Grants_Registrations.pdf. 3. Grants.gov Registration (get username and password): 55 Be sure the person submitting your application is properly registered with Grants.gov as the Authorized Organization Representative (AOR) for the specific DUNS number cited on the SF-424 (face page). See the Organization Registration User Guide for details at the following Grants.gov link: http:/www.grants.gov/applicants/get_registered.jsp. You can find additional information on the registration process at http://www.grants.gov/assets/organizationregcheck_092112.pdf. The Organization Registration Checklist available at this site provides registration guidance for a company, institution, state, local or tribal government, or other type of organization submitting for the first time through Grants.gov. To submit your application electronically, you may search http://www.Grants.gov for the downloadable application package by the funding announcement number (called the opportunity number) or by the Catalogue of Federal Domestic Assistance (CFDA) number. You can find the funding announcement number and CFDA number on the cover page of this funding announcement. You must follow the instructions in the User Guide available at the http://www.Grants.gov apply site, on the Help page. In addition to the User Guide, you may wish to use the following sources for technical (IT) help:  By e-mail: support@Grants.gov  By phone: 1-800-518-4726 (1-800-518-GRANTS). The Grants.gov Contact Center is available 24 hours a day, 7 days a week, excluding federal holidays. Please also allow sufficient time for entering your application into Grants.gov. When you submit your application you will receive a notice that your application is being processed and you will receive two emails from Grants.gov within the next 24-48 hours. One will confirm receipt of the application in Grants.gov and the other will indicate that the application was either successfully validated by the system (with a tracking number) or rejected due to errors. If you do not receive a receipt confirmation and a validation confirmation or a rejection e-mail within 48 hours, you must contact Grants.gov directly. Please note that it is incumbent on the applicant to monitor their application to ensure that it is successfully received and validated by Grants.gov. It is strongly recommended that you prepare your Project Narrative and other attached documents in Adobe PDF format. If you do not have access to Adobe software, you may submit in Microsoft Office 2007 products (e.g., Microsoft Word 2007, Microsoft Excel 2007, etc.). Directions for creating PDF files can be found on the Grants.gov website. Use of file formats other than Adobe PDF or Microsoft Office 2007 may result in your file being unreadable by our staff. The Abstract, Table of Contents, Project Narrative, Supporting Documentation, Budget Justification, and Attachments must be combined into 4 separate files in the electronic submission. If the number of files exceeds 4, only the four files will be downloaded and considered in the peer review of applications. 56 Formatting requirements for SAMHSA e-Grant application files are as follows:  Project Narrative File (PNF): The PNF consists of the Abstract, Table of Contents, and Project Narrative (Section A)  Budget Narrative File (BNF): The BNF consists of only the budget justification narrative.  Other Attachment File 1: The first Other Attachment file will consist of the Attachments 1-9.  Other Attachment File 2: The second Other Attachment file will consist of the Attachments 10-17. If you have documentation that does not pertain to any of the 4 listed attachment files, include that documentation in Other Attachment File 2. New for FY 2013 Applicants are now limited to using the following characters in all attachment file names: Valid file names may include only the following characters: A-Z, a-z, 0-9, underscore ( _ ), hyphen (-), space, period. If your application uses any other characters when naming your attachment files, your application will be rejected by Grants.gov. Scanned images must be scanned at 150-200 dpi/ppi resolution and saved as a jpeg or pdf file. Using a higher resolution setting or different file type could result in rejection of your application. It is strongly recommended that you prepare your Project Narrative and other attached documents using Microsoft Office 2007 products (e.g., Microsoft Word 2007, Microsoft Excel 2007, etc.). If you do not have access to Microsoft Office 2007 products, you may submit PDF files. Directions for creating PDF files can be found on the Grants.gov website. Use of file formats other than Microsoft Office 2007 or PDF may result in your file being unreadable by our staff. The DFC Program requires a large number of attachments in order to be accepted. This part of the electronic submission can be challenging. Keep the Project Narrative as a separate document. Consolidate all other materials in your application to ensure the fewest possible number of attachments. Be sure to label each file according to its contents, e.g., “Attachments 1- 9”, “Attachments 10-17.” Failure to properly upload all required documents for the DFC application will cause the application to be deemed ineligible and it will be screened out. With the exception of the standard forms in the application package, all pages in your application should be numbered consecutively. Documents containing scanned images must also contain page numbers to continue the sequence. 57 If an applicant chooses to use Grants.gov, a paper back up copy will not be accepted as the official submission and no part of the paper application can supplement what is submitted through Grants.gov. 58 Appendix D: Coalition Roles and Relationship to Sector Members As Attachment 1, the coalition must include a completed Sector Member Table (Table 23). The DFC Program uses two pieces of evidence to prove the 12 sectors: (1) Sector Member Table and (2) Coalition Involvement Agreements (CIA). Tips for Completing the Sector Member Table: 1. Remove all italicized instructions in the template. 2. Sector Member Name: Choose sector member that best fits each sector. Do not provide more than one name per sector. Paid staff nor the person signing the CIA can be sector members. 3. Organization Name and Role: Identify organization member represents and position held in the organization (e.g., Youth sector: Johnson High School, student body president). Provide sufficient information that indicates an individual’s fit within a sector. For example, for “State, Local or Tribal Government Agency with Expertise in the Field of Substance Abuse,” it may not be clear by listing the name of the organization that it fits this sector. State type of funding the organization receives that makes it fit this sector. 4. Specific Contribution to Coalition: Provide tasks sector member performs for coalition. 5. Page Number for Matching CIA: Give page number for first page of the matching CIA. 6. An individual must not represent more than one of the 12 sectors. 7. For the youth sector, list the member’s age. 8. If someone other than the individual listed in the “Member Name” column signs the CIA, the person listed in the “Member Name” column must be identified in the CIA as the sector representative. For example, if the Chief of Police signs the CIA instead of an officer who is listed in the Sector Member Table as the sector representative, he/she must identify by name the sector representative listed. Table 22: Sector Descriptions Sector Sector Description Youth A person 18 or younger (must identify age) Parent Someone who has a child/grandchild/foster child Business Owner/Manager of business; business-related organization Media Outlet where community gets information School Person able to influence school policy/procedure Youth-Serving Organization Provide services to youth Law Enforcement Sworn law enforcement officer Religious/Fraternal Organization Leader of faith-based organization Civic/Volunteer Group Member of organization that provides civic or volunteer activities to community (not a coalition volunteer) Healthcare Professional Any physical/mental/behavioral healthcare professional State, Local or Tribal Governmental Agency with Expertise in the Field of Substance Abuse Employee of a government funded agency with a focus on substance abuse Other Organization Involved in Reducing Substance Abuse Any community organization that addresses substance abuse 59 Table 23: Sector Member Table Sector Member Name (first and last name) Organization Name and Role (name of organization and role) Specific Contribution to Coalition (tasks performed as part of coalition) Page Number for Matching CIA (provide page number only) Youth (an individual 18 or younger, provide age) Parent Business Media School Youth-Serving Organization Law Enforcement Religious or Fraternal Organization Civic or Volunteer Group Healthcare Professional State, Local, or Tribal Governmental Agency with Expertise in the Field of Substance Abuse Other Organization Involved in Reducing Substance Abuse 60 Appendix E: Coalition Involvement Agreements As Attachment 2, applicants must include one Coalition Involvement Agreement (CIA) for each sector member identified in Attachment 1. The following page provides a sample CIA. Applicants can tailor the agreement as needed, but must include table below (Table 24) at the top of each CIA. Tips for Coalition Involvement Agreements: 1. Insert Table 24 at the top of each CIA. Remove the italicized language and enter the correct information. 2. There must be one CIA for each sector member listed in the Sector Member Table (Attachment 1). The “Member Name” must match. Do not provide more than 12 CIAs. 3. CIAs must not be more than 12 months old at the time the application is submitted. 4. CIAs must be hand signed and dated. Do not used typed/electronic signatures. 5. CIAs must have two signatures: one for the sector member and one for the individual representing the coalition. 6. This document is not considered legally binding by the Government or the DFC Program, but instead allows an applicant to indicate compliance with the required 12 sectors. By signing a CIA, an individual is affirming that he/she represents a specific sector within the coalition. 7. The CIA on the following page is a template and can be tailored by the coalition, but must meet all of the above requirements. 8. Paid staff (current or proposed), nor the person signing the CIA on behalf of the coalition can serve as sector members. Table 24: CIA Information Table Sector Member Name Organization Name Insert name of one of the 12 sectors. Insert Individual’s Name listed on the Sector Member Table, Attachment 1) Insert Organization Name 61 Sample Coalition Involvement Agreement (CIA) Sector Member Name Organization Name Insert name of one of the 12 sectors. Insert Individual’s Name listed on the Sector Member Table, Attachment 1 Insert Organization Name This agreement between [Coalition Name] and the [Sector] Representative, [Sector Representative’s Name] shall be from [Start Date] until terminated by a mutual accord. This agreement will be reevaluated on a yearly basis. [Coalition Name] will be held responsible to: 1. Create and follow by-laws and policies. 2. Formulate coalition goals and objectives. 3. Oversee operations of activities, programs, and paid staff. 4. Continue to increase new membership of the coalition. 5. Create and follow a strategic Action Plan. 6. Create a credible and relevant sustainability plan which includes volunteer membership and resources, both financial and material. 7. Respects the rights of [Coalition Name] members to hold their own opinions and beliefs. The [Sector] Representative, [Sector Representative’s Name], will be held responsible to: 1. Be a community leader amongst the represented sector. 2. Ensure clear communication between the sector represented and the coalition. 3. Act as a positive role model for youth, families, and peers. 4. Support the coalition’s mission. 5. Attend coalition meetings which are held on a [Frequency] basis. 6. Participate in at least one subcommittee. 7. Attend coalition sponsored trainings, town hall meetings, and community events. 8. Contribute to the strategic planning process. 9. Participate in sustaining the coalition’s capacity, involvement, and energy. 10. Participate in the DFC Workstation, a communication vehicle used by the DFC federal partners to provide timely information to coalitions. 11. Prevent youth substance use through environmental strategies. 12. Provides the following services to be used as match, if applicable: _______________________________ ___________________________ Coalition Representative’s Name Sector Representative’s Name ________________________________ ____________________________ Coalition Representative’s Signature Sector Representative’s Signature _________________________ __/__/__ _____________________ __/__/__ Title Date Title Date 62 Appendix F: Assurance of Legal Eligibility As Attachment 5, attach either Appendix F or G. Use Appendix F, if the coalition is applying for this grant on its own behalf. Use Appendix G, if the coalition is partnering with an outside agency as its grantee/legal applicant. A coalition applying on its own behalf must answer the following questions and sign below. 1. Is the coalition serving as its own legal grantee? Yes [ ] No [ ] 2. Is the coalition’s name listed in Item #8 on the SF-424 (face page) of this application? Yes [ ] No [ ] If the answer to any of these questions is “no”, then the coalition must enter into a relationship with an entity eligible to receive federal funds and submit a Memorandum of Understanding (see Appendix G) and include as Attachment 5. If the answer to all of these questions is “yes”, the applicant coalition must sign and date the Statement of Legal Eligibility below and include as Attachment 5. Statement of Legal Eligibility I, [Coalition Representative] hereby certify that [Coalition Name] is legally eligible to receive federal funding. ______________________________ Coalition Representative’s Name __________________________________ Coalition Representative’s Signature ___________________________ __/__/__ Title Date 63 Appendix G: Grantee/Legal Applicant Roles and Relationship with Coalition As Attachment 5, attach either Appendix F or G. Use Appendix F, if the coalition is applying for this grant on its own behalf. Use Appendix G, if the coalition is partnering with an outside agency as its grantee/legal applicant. The signatures on the MOU must include that of the grantee/legal applicant and the coalition. The date must not be older than 12 months at the time of application. A sample MOU is on the following page. Below are considerations when developing a relationship with an outside partnering agency serving as the grantee/legal applicant on behalf of a community coalition: 1. Through the Drug-Free Communities Act of 1997, it is the intent of Congress to fund the work of community coalitions addressing youth substance use. Furthermore, DFC funds are not meant to substantially supplement the budget of a partnering agency. While it is allowable for a reasonable amount of funds to be retained by the partnering agency for administration of the DFC grant, DFC funds are intended to support the work of a community-based coalition. 2. It is the intent of the DFC Program that a coalition’s volunteer leadership has a management role in all financial decisions related to a DFC grant applied for on their behalf by a partnering organization. 3. Arrangements for grantee services should be treated as a business transaction. It is suggested that the grantee and coalition seek guidance from an attorney and/or accountant when entering into such an agreement. Both the grantee and coalition should be fully aware of and understand the commitment placed on the grantee through provision of this service. Accounting Requirements Another consideration for the coalition applying for this grant is the administration of accounts receivable and payable. In accordance with OMB Circular A-110, a federal grant recipient must be capable of accounting for the expenditure of federal funds. Upon award of grant funds, the grantee is subject to a Financial Capability Review. The review typically includes an examination of financial statements, including those contained in reports issued to stockholders, lending institutions, and SEC filings; cash flow forecasts; loan agreements and evidence showing compliance with these agreements; aging of accounts receivable and payable; and financial history of the grantee and affiliated concerns. Details discussed in this circular should be reviewed by the grantee/legal applicant. For further assistance on understanding issues regarding the grantee role, responsibilities, or expectations, contact SAMHSA’s Division of Grants Management at 240-276-1422. 64 Sample MOU between Coalition and Grantee/Legal Applicant This agreement between [Grantee/Legal Applicant] and [Coalition] shall be from [Date] until terminated by mutual agreement: RESPONSIBILITIES OF THE COALITION: a. Set policy for and oversee its own programs including goals and objectives in alignment with the DFC Program’s Terms and Conditions. b. Select and direct staff and volunteers, set goals and objectives for contract employees, and negotiate and approve contracts. c. Create, approve, and follow its budget in compliance with DFC requirements. d. Provide copies of all required documentation to the grantee/legal applicant as requested. e. Reimburse grantee/legal applicant for any indirect or direct expenses incurred by the coalition with prior approval of the grantee/legal applicant. f. Be solely responsible for liabilities arising out of its program and its interaction with program participants. RESPONSIBILITIES OF THE GRANTEE/LEGAL APPLICANT: a. Provide the coalition staff with office space. b. Compile financial reports on a mutually agreed upon schedule and provide to coalition. c. Provide accounting services to prepare and distribute payroll, pay invoices, prepare and submit the appropriate forms for employment, wages and payroll taxes on behalf of the coalition. d. Negotiate and/or bid and approve contracts. e. Maintain all records pertaining to costs and expenses to reflect costs of labor, materials, equipment, supplies, services, and other costs and expenses when reimbursement is claimed or payment is made. f. Obtain Workman's Compensation Insurance and liability coverage for the coalition’s employees. [Grantee/Legal Applicant] and [Coalition] mutually agree to abide by all applicable federal and state anti-discrimination statutes, regulations, policies, and procedures. This agreement shall be subject to all applicable provisions of state and federal law and regulations related to the delivery and funding of social service. ________________________________ ___________________________ Coalition Representative’s Name Grantee Representative’s Name ________________________________ ____________________________ Coalition Representative’s Signature Grantee Representative’s Signature ________________________ __/__/__ ____________________ __/__/__ Title Date Title Date 65 Appendix H: Assurance of One DFC Grant at a Time As Attachment 7, the grantee/legal applicant should read the statement below and sign and date this document to assure that it will not hold more than one DFC grant during the FY 2013-2017 funding cycles. NOTE: DFC Mentoring and STOP ACT grants are in a separate category and do not apply to this assurance. Applicant Assurance of One DFC at a Time I attest that the [Grantee/Legal Applicant] will be in receipt of only one DFC grant during FY 2013 through FY 2017. ____________________________ Authorized Official’s Name for the Grantee/Legal Applicant (print) ____________________________ Authorized Official’s Signature for the Grantee/Legal Applicant ____________________________ Title ____________________________ Organization/Agency ____________________________ Date 66 Appendix I: Assurance of 10-Year Funding Limit As Attachment 8, the grantee/legal applicant should read the statement below and sign and date this document to assure that the applicant coalition has not already had 10 years of DFC funding. Under the DFC Act, coalitions may not receive more than 10 years of DFC funding. This policy does not apply to agencies serving as grantees/legal applicants on behalf of DFC-funded coalitions. This policy does not apply to DFC Mentoring funds . Specific restrictions on DFC coalitions and grantee/legal applicants are outlined below. Agencies serving as Grantee/Legal Applicant on behalf of a coalition: 1. An organization serving as the grantee/legal applicant on behalf of a coalition may not receive DFC funds on behalf of the same coalition for more than 10 years. Example: Grantee/Legal Applicant X has received DFC funds on behalf of Coalition Y for 10 years. Grantee/Legal Applicant X may no longer receive funds on behalf of Coalition Y. Additionally, Coalition Y must not apply for DFC funds (directly or through a different grantee agency) in the future. 2. An organization serving as grantee/legal applicant on behalf of a coalition that has already received 10 years of DFC funding may apply for DFC funds on behalf of a new “unique and distinct” coalition. Example: Grantee/Legal Applicant X has received DFC funds on behalf of Coalition Y for 10 years. Coalition Z is a new coalition and wants Grantee/Legal Applicant X to apply for DFC funds on its behalf. This is allowable. 3. An organization serving as grantee/legal applicant on behalf of a coalition may receive DFC funds on behalf of any coalition that has not received a full 10 years of funding. Example: Coalition Y previously received four years of DFC funding using Grantee/Legal Applicant X. Coalition Y can ask Grantee/Legal Applicant A to apply for its remaining years of DFC funding (up to 6 years). Coalitions: 1. A coalition that is its own grantee/legal applicant may receive up to 10 years of DFC funding. Under all situations, a coalition may not receive more than10 years of DFC funding. 2. A coalition that has received 10 years of DFC funding through an outside agency serving as grantee/legal applicant may not receive DFC funding through a different grantee/legal applicant. 3. A coalition that has received DFC funding through a series of grantees/legal applicants is not eligible to receive more than 10 years of DFC funding. Example: Coalition X received DFC funding through Grantee Y for six years, and Grantee Z for four years, Coalition X is no longer eligible to receive any DFC funds. 4. A coalition that proposes to serve a community (or any part of a community) that has already been served for 10 years by another DFC-funded coalition must demonstrate to the satisfaction of the DFC grant review officials and the final determination of the DFC Administrator that it is “unique and distinct” from the coalition that previously served the same community. 67 I attest that [Coalition Name] is in compliance with the 10-Year Funding Limit Policy. I also attest that the information provided on this form is true and correct. Providing false or misleading information is unlawful and subject to criminal penalties, 18 USC1001. _________________________ ___________________________ Authorized Official Name of Authorized Official Name of Grantee/Legal Applicant (Print) Applicant Coalition (Print) _________________________ ___________________________ Authorized Official Signature of Authorized Official Signature of Grantee/Legal Applicant Applicant Coalition _________________________ ___________________________ Title Title _________________________ ___________________________ Organization/Agency Organization/Agency _________________________ ___________________________ Date Date 68 Appendix J: Resumes and Job Descriptions As Attachment 9, applicants must include a resume (no longer than two pages) and a position description (no longer than one page) for the Program Director and Project Coordinator, and each additional key paid or in-kind position. If a person has been selected but not yet hired, include a letter of commitment from that individual along with a resume and position description. If no individual has been identified for a position, a position description is still required, along with an overview of the hiring plan. Resumes Existing curricula vitae of project staff members may be used if they are updated and contain all items of information requested below. You may add any information items listed below to complete existing documents. For development of new curricula vitae include items below in the most suitable format: 1. Name of staff member 2. Educational background: school(s), location, dates attended, degrees earned (specify year), major field of study 3. Professional experience 4. Honors received and dates 5. Recent relevant publications 6. Other sources of support [Other support is defined as all funds or resources, whether federal, non-federal, or institutional, available to the Project Director/Program Director (and other key personnel named in the application) in direct support of their activities through grants, cooperative agreements, contracts, fellowships, gifts, prizes, and other means.] Job Description 1. Title of position 2. Description of duties and responsibilities 3. Qualifications for position 4. Supervisory relationships 5. Skills and knowledge required 6. Personal qualities 7. Amount of travel and any other special conditions or requirements 8. Salary range 9. Hours per day or week 69 Appendix K: General Applicant Information As Attachment 10, complete this table (2 pages) with the requested information. Table 25: General Applicant Information Information Requested Response 1. Grantee/Legal Applicant Name (Item 8 on SF-424) 2. Applicant Coalition Name (Item 15 of SF-424; if same as Grant Applicant Name, skip to question 3) 3. Coalition Contact Person & Phone Number & Email Address *person charged with day-to-day operations of coalition 4. Coalition Mailing Address 5. Grantee/Legal Applicant Contact Person & Phone Number & Email Address *person at grantee/legal applicant organization charged with oversight of grant 6. Grantee/Legal Applicant Mailing Address 7. List Federal Congressional Districts served by coalition. Go to http://www.house.gov for more information. (Item 16 on SF-424) 8. Geographical boundaries served by the coalition (e.g., city, county, streets, etc.) 9. List all zip codes served by the coalition. Go to http://zip4.upsp.com/zip4/welcome.jsp. 10. Total population served by the coalition. 11. Total number of students in grades 6-12 in schools/districts served by coalition. 12. Coalition must identify service area as “rural” or “urban” (see Appendix Q). Applicants must choose one response. If rural, provide county name coalition is serving. 13. Coalition must identify if the service area is “Economically Disadvantaged” (see Appendix Q). Indicate yes or no. 14. Does the coalition serve a federally recognized tribal area? Indicate yes or no. 70 Information Requested Response 15. Does the coalition have representation that includes at least one representative of the Bureau of Indian Affairs, the Indian Health Service, or a tribal government agency with expertise in the field of substance abuse? Indicate yes or no. 16. Provide the contact information for the proposed evaluator for the DFC grant (include name, phone number, and e-mail address). 17. Is the applicant a religious or faith-based organization? Indicate yes or no. 18. Year the coalition was established. 19. Has the applicant coalition been mentored through DFC’s Mentoring grant program? Indicate yes or no. Provide Mentoring grant’s award number (SP-xxxxx). 20. Provide the date you registered the applicant in the System for Award Management (SAM). *Failure to have an active registration will make your application ineligible. 71 Appendix L: Intergovernmental Review (E.O. 12373) Requirements This grant program is covered under Executive Order (EO) 12372, as implemented through Department of Health and Human Services (HHS) regulation at 45 CFR Part 100. Under this Order, States may design their own processes for reviewing and commenting on proposed federal assistance under covered programs. Certain jurisdictions have elected to participate in the EO process and have established State Single Points of Contact (SPOCs). A current listing of SPOCs is included in the application package and can be downloaded from the Office of Management and Budget (OMB) website at http://www.whitehouse.gov/omb/grants_spoc.  Check the list to determine whether your state participates in this program. You do not need to do this if you are an American Indian/Alaska Native Tribe or tribal organization.  If your state participates, contact your SPOC as early as possible to alert him/her to the prospective application(s) and to receive any necessary instructions on the State’s review process.  For proposed projects serving more than one state, you are advised to contact the SPOC of each affiliated State.  The SPOC should send any state review process recommendations to the following address within 60 days of the application deadline. For United States Postal Service: Diane Abate, Director of Grant Review, Office of Financial Resources, Substance Abuse and Mental Health Services Administration, Room 3-1044, 1 Choke Cherry Road, Rockville, MD 20857. ATTN: SPOC – Funding Announcement No. SP-13-002. Change the zip code to 20850 if you are using another delivery service. In addition, if you are a community-based, non-governmental service provider and you are not transmitting your application through the state, you must submit a Public Health System Impact Statement (PHSIS)3 to the head(s) of appropriate state and local health agencies in the area(s) to be affected no later than the application deadline. The PHSIS is intended to keep state and local health officials informed of proposed health services grant applications submitted by community-based, non-governmental organizations within their jurisdictions. If you are a state, local government, American Indian/Alaska Native Tribe, or tribal organization, you are not subject to these requirements. 3 Approved by OMB under control no. 0920 -0428; Public reporting burden for the Public Health System Reporting Requirement is estimated to average 10 minutes per response, including the time for copying the face page of SF-424 and the abstract and preparing the letter for mailing. An agency may no t conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0920 -0428. Send comments regarding this burden to CDC Clearance Officer, 1600 Clifton Road, MS D-24, Atlanta, GA 30333, ATTN: PRA (0920-0428). 72 The PHSIS consists of the following information:  a copy of the face page of the application (SF-424); and  a summary of the project, no longer than one page in length, that provides: 1) a description of the population to be served; 2) a summary of the services to be provided; and 3) a description of the coordination planned with appropriate state or local health agencies. For SAMHSA grants, the appropriate state agencies are the Single State Agencies (SSAs) for substance abuse and mental health. A listing of the SSAs for substance abuse can be found on SAMHSA’s website at http://www.samhsa.gov. A listing of the SSAs for mental health can be found on SAMHSA’s website at http://www.samhsa.gov/grants/SSAdirectory-MH.pdf. If the proposed project falls within the jurisdiction of more than one state, you should notify all representative SSAs. If applicable, you must include a copy of a letter transmitting the PHSIS to the SSA in Attachment 13, “Letter to the SSA.” The letter must notify the state that, if it wishes to comment on the proposal, its comments should be sent no later than 60 days after the application deadline to the following address. For United States Postal Service: Diane Abbate, Director of Grant Review, Office of Financial Resources, Substance Abuse and Mental Health Services Administration, Room 3-1044, 1 Choke Cherry Road, Rockville, MD 20857. ATTN: SSA – Funding Announcement No. SP-13-002. Change the zip code to 20850 if you are using another delivery service. In addition:  Applicants may request that the SSA send them a copy of any state comments.  The applicant must notify the SSA within 30 days of receipt of an award. 73 Appendix M: Disclosure of All Prior DFC Funding As Attachment 15, indicate the status of the grantee/legal applicant and/or coalition, complete the table below, sign and date the form. Do not include information about STOP Act or DFC Mentoring grants on this form. Indicate the status of the Grantee/Legal Applicant and/or the applicant coalition for this application: [ ] Coalition has had no prior funding [ ] Coalition formerly funded through DFC (not DFC Mentoring Program) [ ] Grantee/Applicant has had no prior DFC funding [ ] Grantee/Applicant formerly funded through DFC (not DFC Mentoring Program) List all of the DFC funding received or expended by either the Grantee/Legal Applicant and/or the coalition. For example, if the applicant previously received DFC funding as a member of a coalition unrelated to the coalition currently applying for funding, that information must be entered below. NOTE: Add as many rows as needed to include all required information for all prior DFC funding associated with the Grantee / Legal Applicant and Applicant Coalition for this application. Table 26: Disclosure of All Prior DFC Funding Fiscal Year of Funding DFC Award Number(s) (for current and all previous years) Grantee/Legal Applicant Name Coalition Name Names of Paid Staff By signing below, I attest that [Coalition name] is applying for Year [enter year number] of DFC funding. I also attest that the information provided in the above chart is true and correct. Providing false or misleading information is unlawful and subject to criminal penalties, 18 USC1001. _________________________ ___________________________ Authorized Official for Authorized Official Name for Grantee/Legal Applicant (Print) Applicant Coalition (Print) _________________________ ___________________________ Authorized Official Signature for Authorized Official Signature for Grantee/Legal Applicant Applicant Coalition _________________________ ___________________________ Title Title _________________________ ___________________________ Organization/Agency Organization/Agency _________________________ ___________________________ Date Date 74 Appendix N: DFC National Cross-Site Evaluation Requirements As Attachment 16, the applicant grantee/legal applicant and/or coalition must provide the information in the table below. The DFC Program collects four specific measures (core measures) to determine the effectiveness of the DFC Program. The core measures are: 1. Past 30-day use 2. Perception of risk or harm of use 3. Perception of parental disapproval of use 4. Perception of peer disapproval of use Each of the above core measures must be collected every two years, in three grades (6th-12) on four substances (alcohol, tobacco, marijuana, and prescription drugs). Grantees are allowed to collect other data as they see fit to meet their local and coalition evaluation needs. Provide the following information to indicate the applicant coalition’s ability to meet the DFC National Cross-Site Evaluation requirements: Table 27: DFC National Cross-Site Evaluation Requirements Questions Answer Name of the survey(s) used to collect data required to obtain the core measures: 1. Past 30-day use 2. Perception of risk or harm of use 3. Perception of parental disapproval of use 4. Perception of peer disapproval of use How often/when will the survey(s) be administered and collected? What, if any, supplemental survey(s) and/or data will be used to meet the DFC National Cross-Site Evaluation requirements? When was the data collected used to answer Question 5 of the Project Narrative? 75 Appendix O: Sample Congressional Notification As Attachment 17, applicants must follow the exact format below and include the completed Congressional Notification. The Project Description must not be more than 35 lines; therefore, the entire document must not exceed more than one page. This information will be shared with members of Congress and the media, and may be posted to the DFC website, if the application is funded. Grant Award # SP0_____ (if applicable) Coalition Name: Coalition Contact Name: Coalition Contact E-Mail: Coalition Contact Phone: If different, from above: Grantee/Legal Applicant Name: Grantee/Legal Applicant Contact: Grantee/Legal Applicant E-Mail: Grantee/Legal Applicant Contact Phone: [Coalition Name] [State] Serving Congressional District(s) [__] Project Description The [Coalition Name] was awarded a FY 2013 Drug-Free Communities Support Program grant in the amount of $ [fill in amount requested] by the White House Office of National Drug Control Policy, in cooperation with the Substance Abuse and Mental Health Services Administration. The Coalition serves [Community/Town], [State], a community of [total population]. The goals of the coalition are to establish and strengthen community collaboration in support of local efforts to prevent youth substance use. The coalition will achieve its goals by implementing these strategies [provide a one-sentence description of each strategy that the coalition will implement below]: 76 Appendix P: Pre-Submission Verification Use the checklist below to ensure that the application meets all submission requirements. Please place an “X” beside each item that has been completed. Include the completed verification as the last page of the application. NOTE: This checklist is not the same as the required Checklist found in the Grant Application Package. You must include both checklists. Table 28: Pre-Submission Verification Items to Complete “X” if Completed Did you complete and sign the Application for Federal Assistance (SF-424)? Did you complete Sections B, C, and E of the Non-Construction Budget Worksheet (SF-424A)? Did you include a Table of Contents and numbered it page 1? Did you include a Community Overview after the Table of Contents (page 2)? Is your Project Narrative (scored section) no longer than 30 pages? Does your Project Narrative address all 10 questions? Did you include the Action Plan (question 7)? Is a one-year Budget Narrative and future years funding table included? Did you include a lease agreement and floor plan for proposed cost for Rent, if applicable? Did you include an Indirect Cost Rate Agreement for proposed indirect cost, if applicable? Did you demonstrate that your coalition will meet the matching fund requirements (Budget Narrative, SF-424, and SF-424A)? Did you meet all Statutory Eligibility Requirements (see Table 1 of this RFA)? In Attachment 1, did you list all 12 community sectors (see Appendix D, Table 23)? In Attachment 2, did you include one CIA from each person listed in the Sector Member Table (see Appendix E; including Table 24 on each CIA)? In Attachment 3, did you provide two sets of meeting minutes from the specified timeframes? In Attachment 4, did you include the coalition’s Mission Statement? In Attachment 5, did you include an MOU between the coalition and the grantee/legal entity or a statement that the coalition is legally eligible to receive a grant (see Appendix F or G)? 77 Items to Complete “X” if Completed In Attachment 6, if applicable, did you include Letter(s) of Mutual Cooperation, with other coalition(s) that are serving a same zip code or partial zip code area as the applicant coalition? In Attachment 7, did you include the Assurance of One Grant at a Time (see Appendix H)? In Attachment 8, did you include Assurance of 10-Year Funding Limit (see Appendix I)? In Attachment 9, did you include the required resumes and job descriptions (see Appendix J)? In Attachment 10, did you include the completed General Applicant Information Table (see Appendix K)? In Attachment 11, did you include the coalition’s Organizational Chart? In Attachment 12, did you include the coalition Logic Model? In Attachment 13, did you include a copy of the letter to the SSA (see Appendix L)? In Attachment 14, did you include all required forms, certifications, disclosures, and assurances? In Attachment 15, did you include the Disclosure of All Prior DFC Funding (see Appendix M)? In Attachment 16, did you include the DFC National Cross-site Evaluation Requirements (see Appendix N)? In Attachment 17, did you include the Congressional Notification (see Appendix O)? Did you include the Checklist found in the Grant Application Package as the next-to- last page of the application? Is this completed Pre-Submission Verification the last page of the application (see Appendix P)? 78 Appendix Q: Glossary of Terms Activities: Efforts conducted to achieve identified objectives. Example: Conduct three responsible beverage server trainings with 15 businesses represented at each training. Authorized Representative/Official: The person authorized to sign the grant application as the official representative of the applicant organization who has the fiduciary authority to act on behalf of the applicant and assume the obligations imposed by the federal laws, regulations, requirements, and conditions that apply to grant applications or awards. Business Official: The individual responsible for the financial aspects of the grant (i.e. Authorized Representative/Official, Accountant, Bookkeeper). Coalition Involvement Agreement (CIA): An agreement between the coalition and each of its 12 sector members that establishes the minimum acceptable contribution to be considered an active coalition member. It is not considered a legally binding document for the purposes of this RFA. It is only to allow a coalition to demonstrate compliance with the12 required sectors. Community-Level Change: Change that occurs within the overall population of the community. Economically Disadvantaged Area: An area with 20 percent or more children living in households below the poverty line as defined by the U.S. Census Bureau. Grantee: The recipient of grant funds. For the purposes of this RFA, it is either a coalition that is a legally eligible entity (to receive federal funds) or a partnering agency that has agreed to be the legal applicant on behalf of a coalition and serve as the grantee if awarded. Objectives: What is to be accomplished during a specific period of time to move toward achievement of a goal. Objectives should be expressed in specific, measurable terms. Example: By 10/30/16, decrease the percentage of alcohol sales to minors by 10% as measured by the rate of failed compliance checks (currently 25%). Rural: According to the Drug-Free Communities Act of 1997, rural is defined as a county with a population that does not exceed 30,000 individuals. Strategy: The overarching approach of how the coalition will achieve intended results. Example: Increase enforcement of laws prohibiting the sale of alcohol to minors through compliance checks. Urban: The Census Bureau classifies as "urban" all territory, population, and housing units located within an urbanized area (UA) or urban cluster (UC). It delineates UA and UC boundaries to encompass densely settled territory, which consists of: Core Census block groups or blocks that have a population density of at least 1,000 people per square mile and surrounding census blocks that have an overall density of at least 500 people per square mile.