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Date: Wed, 10 Apr 91 14:36 EST
From: Dot Baker <UNCDOT@UNC.BITNET>
Subject: RFA MH-9l-l0.910412    April l2, l99l NIH Guide
To: pjones@UNCVX1.BITNET

Hi Paul,
   Please post this one to the NIH Listserver as:
     RFAMH-91-10.910412
                       Thanks.   dottie
 ---------------------------- Text of forwarded message -----------------------
 
$$XID RFA MH9110 MH-91-10 P1O1 *****************************************
INSTITUTIONAL CLINICAL TRAINING GRANTS:
PROFESSIONAL TRAINING ADDRESSING SEVERE MENTAL DISORDERS
 
RFA:  MH-91-10
 
P.T. 44; K.W. 0720005, 0715129, 0715177, 0715180
 
National Institute of Mental Health
 
Application Receipt Date:  June 12, 1991
 
Catalog of Federal Domestic Assistance 93.244
 
Under the authority of Section 303, Public Health Service
Act, 42 U.S.C. 242a; 42 CFR Part 64a, the National
Institute of Mental Health will accept applications in
response to this request under the single receipt date
of June 12, 1991.
 
Darrel A. Regier, M.D., M.P.H.
Director
Division of Clinical Research
 
Alan I. Leshner, Ph.D.
Acting Director
National Institute of Mental Health
 
PURPOSE
 
The purpose of the National Institute of Mental Health
(NIMH) clinical training program is to enhance the
quality and effectiveness of services to persons with
major mental disorders.  Insufficient numbers of well-
trained mental health professionals are available to
serve (1) severely and persistently mentally ill adults,
e.g., adults with schizophrenic disorders or mood
disorders, including homeless persons with these
disorders; (2) seriously emotionally disturbed children
and adolescents; (3) elderly persons with mental
disorders; (4) individuals with mental disorders in
rural areas; (5) racial/ethnic minorities with mental
disorders.
 
This program is designed to recruit and prepare mental
health professionals in the core mental health
disciplines of social work, psychiatric nursing,
psychology, psychiatry, and marriage and family therapy
who are well trained and experienced in modern mental
health diagnostic, treatment, and rehabilitation
techniques, research methodologies and findings, and the
delivery of care within community-based systems.
 
TRAINING ISSUES
 
Applicants under this Request for Applications (RFA) must
focus in depth on one or
more of the priority populations described below.
Programs must demonstrate that they incorporate the
latest diagnostic and treatment procedures, as well as
the latest relevant research findings.
 
The priority service populations for this RFA are:
 
o Severely and Persistently Mentally Ill Adults
 
This priority population includes, but is not limited to,
adults with schizophrenic disorders, major mood
disorders, including homeless persons with these
disorders, and persons with co-morbidity, i.e., the
mentally ill who are also alcohol and/or drug abusers.
 
o Children and Adolescents with Mental Disorders
 
Mental disorders of children and adolescents include, but
are not limited to, serious emotional disturbances;
childhood psychoses; major mood disorders; disruptive
behavior and personality disorders; and serious
developmental disorders or alcohol and/or drug abuse when
combined with other mental disorders.
 
o Elderly with Mental Disorders
 
Mental disorders of the aging include Alzheimer's disease
and other dementias; affective disorders with their
associated medical, behavioral, cognitive, social, and
emotional aspects; as well as anxiety disorders, late-
onset schizophrenia, and personality disorders.
 
o Mentally Ill in Rural Areas
 
This population includes individuals with severe and
persistent mental and emotional disorders living in rural
areas, especially those areas--rural towns and
communities--with low population density and limited
access to health, mental health, and social services.
Applicant institutions selecting this priority must
include a strategy for the recruitment of students from
rural areas and the development of curriculum addressing
rural mental health issues.
 
o Racial/Ethnic Minorities with Mental Disorders
 
While minority persons are represented among the priority
service populations listed above, developing and
implementing targeted, culturally appropriate mental
health services for minorities within these groups (i.e.,
severely ill minority adults, minority children and
adolescents, minority elderly, and minorities in rural
areas) are a complex and challenging priority.  Applicant
institutions selecting this priority must, therefore,
demonstrate a capacity to develop and implement a
focused, culturally appropriate clinical training program
with curriculum and clinical experiences based on
culturally relevant concepts and the latest scientific
findings.  (The term "minority" in this announcement
refers to Blacks or African Americans, Hispanics or Latin
Americans, Asian/Pacific Island Americans (including
Native Hawaiians and Samoans), and American
Indians/Alaskan Natives.)
 
Additional cross-cutting priorities are linkages between
academic programs and State/community service systems,
i.e., public-academic linkages (PAL) and linkages with
clinical researchers and research trainers.  Therefore,
training institutions are strongly encouraged to
collaborate with State and local Mental Health and State
and local Alcohol and Drug Abuse service systems in order
to make training sites available in public facilities and
to ensure that trainees receive high-quality relevant
clinical experiences in these settings.  Similarly,
intra-institution collaboration with ongoing clinical
research components is also encouraged.
 
All programs must also show evidence that curriculum
content addresses ethnic and cultural issues.  Programs
must ensure that, in the clinical field experience,
significant numbers of minority clients or patients are
seen by all trainees.
 
ELIGIBILITY
 
Accredited and/or approved departments/divisions in the
mental health disciplines of psychiatric nursing,
psychiatry, psychology, social work, and marriage and
family therapy in colleges or universities of the United
States, including territories and possessions, are
eligible to apply.  Multidisciplinary applications are
encouraged.  Applications may be for predoctoral and/or
postdoctoral training in any of these fields.  Requests
for support of trainees at multiple levels, e.g.,
master's, post-master's, doctoral, postdoctoral, that
are consistent with the disciplines' educational
patterns, may be incorporated into single applications,
if appropriate.  The disciplines and eligible
institutional units are:
 
o    an accredited college or university school of
nursing that offers a graduate program in psychiatric
nursing
 
o a department of psychiatry, a division of child
psychiatry, or a division of geriatric psychiatry having
an accredited training program for general and/or child
psychiatry residents in an accredited medical school or
a free-standing institution
 
o    a department of psychology, a school of professional
psychology, or an internship program, each with
appropriate accreditation for training in clinical,
counseling, or school psychology
 
o    a school or department of social work offering
accredited master's/doctoral programs; accredited
baccalaureate programs in States having no graduate
program; and postmaster's and postdoctoral training
programs
 
o    a college or university-based accredited graduate
program in marriage and family therapy and accredited
postmaster's and postdoctoral training programs
 
Important Note:  A grantee eligible for a noncompeting
continuation award in fiscal year 1991 may not apply for
a new award in the same priority area.
 
One clinical training grant may be applied for in each
of the core disciplines under this
RFA.  However, NIMH encourages
multidisciplinary training programs whenever appropriate.
 
APPLICATION CHARACTERISTICS
 
Applications must include a brief description of the
applicant educational institution and, where appropriate,
associated service and clinical research settings,
including background, history, programmatic focus,
organization, resources, personnel, and record of
educational/service/research linkage achievements.  Any
existing mental health or substance abuse clinical or
research training activities in the priority area(s)
addressed by an application must be described.  A
carefully organized plan for teaching the mental health
skills necessary must be presented.  Of particular
interest are linkages of ongoing or proposed clinical
training activities with clinical research or research
training at the applicant institution.
 
Each application must include descriptions of the:
 
o    goals and objectives of the program and specify one
or more of the priority populations
 
o    key faculty members and clinical supervisors or
field instructors, including their assignment of
responsibility to the program, and other qualifications,
experience, and roles
 
o    history and current structure of the proposed
education/training program, with an overall
characterization of principles and conceptual framework
around which the program is organized
 
o    differences between the proposed program and ongoing
general mental health training at the institution
highlighting how the proposed program enhances ongoing
training particularly in the focused priority area
 
o    educational and training components of the proposed
program, highlighting courses and clinical experiences
that are proposed but not yet implemented:
 
-    a didactic component that is designed to make
available to the student the latest scientific
knowledge regarding the designated priority population,
including minority content where appropriate
 
-    an experiential component that involves direct
service to priority population patients or clients,
including minorities whenever practicable, as well as
exposure to issues of services delivery
 
o    evidence of training directed to promoting an
understanding of research methodologies, and the
incorporation of research findings into clinical practice
 
o    documentation of support for the proposed program
by the educational/training institution and the related
State/community service systems
 
o    documentation of linkages between the academic
institution and public mental health service systems
 
o    documentation of linkages between clinical
researchers and research and clinical trainers within the
institution
 
o    professional activities of all trainees who have
completed this specialty program in the last five years,
indicating minority students, and specifying effects of
previous NIMH grant support, if any
 
o    documentation of numbers of students currently
enrolled in the program receiving training in working
with the designated priority service populations,
indicating the number of minority students so enrolled
 
o    specific steps taken for the recruitment, retention,
and graduation of minority trainees.
 
o    review of the pool from which trainees will be
recruited, recruitment strategies, selection criteria,
and numbers of minority students to be enrolled, as well
as the total number of trainees, including those who
would not receive a stipend but who would benefit
directly and indirectly from the supported training
 
o    an evaluation plan that addresses all aspects of the
training program, including formative and summative
evaluations to provide feedback for program improvement
 
TERMS AND CONDITIONS OF SUPPORT
 
In fiscal year 1991, approximately $1.2 million will be available to
fund approximately 15 to 20 three-year awards under this RFA.  However,
since the program is proposed in the FY 1991 President's budget for
phase down over three years, no guarantee can be provided for funding
beyond the first year.  The objectives and activities of the first year
should be designed to be significant in themselves.  Awards will be
limited to a maximum of $80,000 (total costs) per year, with the
exception of multidisciplinary awards which may be funded up to $120,000
(total costs) per year.
 
Direct Costs
 
Support under this program is primarily to provide for
trainee stipends, and stipend requests must be included
in all applications.
Awards are made directly to eligible applicant
institutions.  Funds may be used only for those expenses
that are directly related to and necessary for carrying
out the project and must be expended in conformance with
DHHS cost principles, the Public Health Service (PHS)
Grants Policy Statement (Public Health Service Grants
Policy Statement, DHHS Publication No. (OASH) 90-50,000
(rev. October 1, 1990), and conditions set forth in this
document.
 
Grantees are expected to be familiar and comply with
applicable cost policies.
 
Trainee Stipends
 
Trainee stipends are intended to assist students in
meeting subsistence expenses and to enable them to pursue
education on a full-time basis.  No part-time stipends
are allowed.  The amount of the stipend is determined by
the academic status of the appointee.  Stipends for full-
time trainees enrolled in educational programs leading
to or based on a degree are as follows:
 
Prebaccalaureate - These stipends are at a level of
$6,504 for a 12-month program, prorated according to
actual length of support.
 
Postbaccalaureate-predoctoral - These stipends will be
paid at an annual (12 months) rate of $8,800, prorated
according to the length of the training program.
 
Postdoctoral - Postdoctoral stipends range from $18,600
to $32,300 per year, depending upon the level of relevant
experience of the students at the time of appointment.
These amounts must be prorated according to actual length
of support.
 
Years of Relevant Experience       Stipend
 
               0                   $18,600
               1                   $19,700
               2                   $25,600
               3                   $26,900
               4                   $28,200
               5                   $29,500
               6                   $30,800
               7 or more           $32,300
 
Relevant experience is considered to include activities
beyond the doctoral degree such as internship, residency,
teaching, or providing services in the specific area of
training.  For trainees who receive a stipend for the
first time in a second or later year in the NIMH training
program, the level of support shall be determined by
relevant experience before entry into the program plus
full-time years in the program without a stipend.
 
Stipends for full-time trainees enrolled in postdoctoral
programs that are not degree related may be paid
commensurate with the trainee's career status and
experience in accordance with the above schedule.
Maximum support is $32,300, prorated according to the
length of the program.
 
Allowances are available for medical students to engage
in not-for-credit supervised clinical experience and/or
related special studies/projects in any of the NIMH-
supported programs in psychiatry.
 
Teaching and Associated Costs
 
Direct cost items are allowable for teaching costs
associated with these projects.  Direct cost items
include personnel, consultants, supplies, travel,
reproduction and printing costs, rental equipment, minor
equipment items, and other items that are directly
related to the proposed clinical training program and are
otherwise unavailable from the institution.  It is
expected that the educational institutions will fund a
substantial part of the support for personnel costs.
Teaching costs may be requested up to a ceiling of $1,500
per predoctoral stipend and $2,500 per postdoctoral
stipend.  No teaching costs are permitted except in
association with stipends.
 
Other Trainee Costs
 
In addition to stipends, the institution may request
funds for tuition, fees, and trainee travel.  Trainee
travel costs are allowable only between the institutional
and field training sites or in the special cases
indicated on pages
7-16 of the PHS Grants Policy Statement.  Requests for
tuition must not exceed $8,000 per stipend.
 
Indirect Costs
 
All grants under this RFA will be reimbursed at 8 percent
of total allowable direct costs or actual indirect costs,
whichever is less.
 
Payback Provisions
 
Any trainee who receives a clinical traineeship in
psychology, psychiatry, psychiatric nursing, social work,
or marriage and family therapy, in an established
training program, designed to be for a period of 180 days
or more under an NIMH clinical training grant, must pay
back a period of obligated service equal to the length
of the traineeship.  The period of support need not be
continuous.  Any support received for any period of time
under previous NIMH clinical training grants, if the
stipend and/or other allowances were awarded on or after
September 1, 1981, will be added to the total length of
service required.  The conditions of the obligated
service requirement are set forth in 42 Code of Federal
Regulations Part 64a and include a triple damages
repayment provision for the failure to fulfill the
obligated service.  No trainee may receive a stipend or
other allowance from the grant until he/she has signed
and submitted a Payback Agreement form, a Statement of
Appointment of Trainee form (PHS 2271), and a
certification of Non-Delinquency on Federal Debt.
 
Additional information on payback requirements and fiscal and
administrative issues is available from:
 
Mr. Stephen Hudak
Chief, Grants Management Section
Grants Management Branch
National Institute of Mental Health
5600 Fishers Lane, Room 7C-26
Rockville, MD  20857
Telephone:  (301) 443-4456
 
APPLICATION PROCEDURES
 
Prospective applicants are encouraged to consult NIMH
Educational and Training staff for
assistance in developing applications.  Prospective
applicants are also encouraged to notify appropriate NIMH
staff of their intent to apply.  Applications kits (PHS
398, rev. 10/88) containing the necessary forms and
Special Instructions must be obtained by contacting the
Education and Training Branch staff.  Applicants must use
the Special Instructions included in the application kit
specifically designed for this NIMH Institutional
Clinical Training Grant program.
 
Applications must be complete and contain all information
needed for initial and Advisory Council review.  No
addenda will be accepted later unless specifically
requested by the Executive Secretary of the review
committee.  No site visits will be made.
 
The applicant must include a project abstract that cannot
exceed the space provided in the application.
 
The narrative section of the application may not exceed
20 pages.  Appendices may be used but not to expand the
narrative section.  Applications exceeding this
limitation will be returned without review.  The original
and five (5) copies of the application must be
submitted to:
 
Division of Research Grants
Westwood Building, Room 240
5333 Westbard Avenue
Bethesda, MD  20892**
 
Complete line 2 of the application by typing in the RFA number and
title.  The RFA label (found in the 10/88 revision of application form
PHS 398) must be affixed to the bottom of the face page of the original
copy of the application.  Failure to use this label could result in
delayed processing of your application such that it will not reach the
review committee in time for review.
 
Because of the very short time available for initial and
Council reviews, it is requested that one additional copy
of the application be sent directly to:
 
NIMH Division of Extramural Activities
Room 9C-23, 5600 Fishers Lane
Rockville, MD  20857
Attention:  Ms. Edna Hardy-Hill
 
REVIEW OF APPLICATIONS
A dual review system is used to ensure expert, objective
review of the quality of applications.  The first step,
peer review for educational and technical merit, is by
primarily non-Federal experts comprising Initial Review
Groups.  Notification of the review recommendations will
be sent to the applicant after the initial review.  The
final review is by the National Advisory Mental Health
Council.  Only applications recommended for approval by
the Council may be considered for funding.
 
Each grant application is evaluated on its own merits.
The following criteria are used in the initial review:
 
(1)  Quality of education/training program
 
o    clarity of the goals of the proposed
educational/training program and their consonance with
the purposes and requirements of this RFA
 
o    relevance, feasibility, and specificity of the
content, methods, and organization of the training
program in relation to specified project goals and
objectives, including minority content whenever appropriate
 
o    subpopulations adequately addressed
 
o    soundness of the plan for providing balanced
didactic and experiential educational content, including
existing and/or new and innovative curricular offerings
and teaching methods oriented to the priority
population(s), including minority content where
appropriate
 
o    inclusion in the curriculum of up-to-date research
findings and scientific knowledge about diagnostic and
treatment services for the priority population(s),
including minority content where appropriate
 
o    inclusion of research methods and evaluation
 
o    appropriateness of plans for evaluating the proposed
program
 
(2)  Budget
 
o    adequacy of the budget projections and other
resources for carrying out the project activities
 
(3)  Quality of public-academic linkages
 
o    degree to which the educational plan has been
developed and will be implemented in conjunction with
public mental health systems and services, and commitment
of key personnel and institutions to public-academic
linkages
 
o    availability and extent of trainee experience in
publicly funded (including private non-profit) clinical
programs
 
(4)  Quality of faculty
 
o    expertise with the priority population(s), including
national leadership and publications
 
o    clinical qualifications of faculty, including
appropriateness as role models
 
(5)  Quality of students/trainees
 
o    feasibility of the plan to recruit from a high-
quality pool of potential students and to retain and
graduate competent students, including minority students
 
o    degree to which students who do not receive stipends
will also have appropriate exposure to special content
and skills development relevant to the priority
populations
 
(5)  Training record
 
o    evidence of applicant's history and commitment to
educate professionals for publicly funded service to the
identified priority population(s), as documented in the
career patterns of graduates of this specialty program
in the last five years
 
o    evidence of successful use of previous NIMH grants,
if any, to train professionals for service in the
priority areas, including minority and disadvantaged
professionals
 
RECEIPT AND REVIEW SCHEDULE
 
                            National Advisory
Receipt of     Initial      Mental Health       Earliest
Application    Review       Council Review      Award
Date
 
June 12, 1991   July        September       September 1991
 
Applications received after the above receipt date will
not be reviewed and will be returned to the applicant.
 
AWARD OF GRANTS
 
Awards will be made on the basis of the following
criteria:
 
o    quality of proposed education/training programs as
determined by the review process
 
o    balance among programs directed to the priority
populations, among the disciplines and, if
appropriate, among geographic, especially rural,
locations
 
o    availability of funds
 
STAFF CONSULTATION
 
Staff consultation on clinical training grants is
available from the following:
 
General Information      Lemuel B. Clark, M.D., Chief
                         Education and Training Branch
                         (301) 443-5850
 
Social Work and          Neilson F. Smith, D.S.W., Chief,
Marriage and Family      Social Work Education Program
Therapy                  (301) 443-5850
 
Psychiatry               Melvyn R. Haas, M.D., Chief
                         Psychiatry Education Program
                         (301) 443-2120
 
Psychology               Paul Wohlford, Ph.D., Chief
                         Psychology Education Program
                         (301) 443-5850
 
Psychiatric Nursing      Carol Bush, Ph.D., R.N., Chief
                         Psychiatric Nursing
                         Education Program
                         (301) 443-5850
 
The mailing address for all the above is:
 
Education and Training Branch
Division of Clinical Research
National Institute of Mental Health
5600 Fishers Lane, Room 7C02
Rockville, MD  20857
 
Applications submitted in response to this announcement
are not subject to the intergovernmental review
requirements of Executive Order 12372 as implemented
through HHS regulations at 45 CFR Part 100, and are not
subject to Health Systems Agency review.

