Matrix: Mental Health System Transformation

Developing Infrastructure to Improve Availability and
Effectiveness of Mental Health Services

Mental Health Transformation State Incentive Grant Program

Pre-Application Technical Assistance

Questions and Answers from Conference Calls, April 21, 2005

Formatting

1.  How much flexibility do we have in formatting our applications?

Very little.  The “Application Formatting Requirements” begin on page 17 of the RFA.  We suggest that you look very carefully at all the bullets under Application Formatting Requirements, and follow them exactly. 

2.  May we use grids and tables in the narrative section?

Grids and tables can be very helpful in organizing your information for the reviewers.  However, reviewers usually like to see some narrative explanation as well, so be sure you include that, and then refer to the table for more details. 

3. Can a timeline be laid out on legal paper and folded?

No.  The RFA says the “paper must be white paper and 8.5 inches by 11.0 inches in size,” so don’t use legal paper and fold it.

4.  Is it permissible for our charts and graphs to be in landscape format?

Yes.

Budget Questions

5.  Are the costs of the transformation working group meetings allowable expenses? 

You can pay for some of the costs of Transformation Working Group meetings out of the MHT SIG funds, but there are some limitations.  For example, if any food is provided, it must be incidental to the meeting, and it’s cost must be reasonable.

6.  How is our budget evaluated?

The budget is not a scored part of the application, but the reviewers give CMHS advice about the appropriateness of the budget.  They will look at whether the costs are reasonable and necessary to carry out the scope of the project you propose.  You want your budget to match what you’re proposing to do. 

The reviewers make notes on the budget and submit them to CMHS staff.  Before awards are made, the government project officer and the grants management specialist will review the budget in detail.  If they find anything they think is not reasonable or necessary or allowable, they will negotiate with the applicant about that. 

7.  If the total budgets of the top scoring applications are less than the $3 million maximum per year, will additional applications be considered for funding? 

Yes.  If we have enough money left, then more applications will be funded.   Some applicants think they will maximize the use of the grant program’s dollars all around the country if they budget on the low side.  This consideration is indeed admirable, but it is also not certain to have the desired effect.  For example, if an applicant proposes a $2 million budget instead of $3 million, and if he/she is the only one to do so, the $1 million would not be enough to fund an additional application. 

We advise you to propose the budget that is going to work best for your project.  If your project needs the maximum, go for the maximum.  If your project does not need that much money, then propose what your project really needs. 

8.  How can grantees develop an evaluation plan and project a budget for multiple years without first having developed a comprehensive mental health plan? 

The budget you are required to include in the application will be an estimate, your best guess about what your project is going to cost.  Each year, grantees have to submit a continuation application.  In the continuation application, you will propose a revised, more specific budget that becomes your actual budget for the year, one year taken at a time.  In the initial application, you do need to include projected or estimated budgets for all five years.

Regarding the evaluation plan, we highly recommend that you identify the evaluator(s) you are going to use for the project now and have them help you write the application.  That person(s) could be extremely valuable in helping you address a number of questions in the Section F: Evaluation and Data of the review criteria.

Certain types of process measures can be proposed even without knowing what the final comprehensive mental health plan will look like.  Your response to Section A:  Statement of Need will probably contain information about the areas you think you will focus on. 

You can project the types of indicators in addition to the GPRA indicators that would help you monitor your progress. Think about the data you already collect.  Think about the kind of transformation you’re trying to make happen and what would be most useful to know on an ongoing basis.  The evaluation is supposed to be a formative evaluation that feeds back into the project.  It should help you understand whether you are meeting your goals and/or how to meet them more effectively. 

Regarding GPRA, you don’t need to say exactly what your targets are for the GPRA measures until the end of year one of the grant.  However, you can have some ideas in the application phase of what you think those measure might be.  Then, based on the comprehensive mental health plan that you finally develop, you can revise those measures, working back and forth with your project officer, and fine tune them to more accurately measure what you finally do. 

General Questions

9.  Do we need to include activity projections and descriptions for five years?

No, you don’t need to project out all of your specific activities over the five years.  Just stick as specifically as possible to the bullets under each section of the Evaluation Criteria. 

10. Section E of the Evaluation Criteria states that the immediate assistant to the Transformation Working Group chairperson must be full-time on the grant.  Is it acceptable to split that full-time position between two people?

No.  The chairperson’s immediate assistant must be a single, full time person.  However, there could be additional part-time assistants. 

11.  Does it matter whether that single full-time person is paid with the grant or, if we have some other way of paying for that person, can we do that? 

Either would be fine. 

12.  Regarding the relationship between the chairperson of the transformation working group and the governor, the frequently asked questions use the phrase “report to,” while the bullets in the RFA use the word is “interface.” Which should we address?

What we’re looking for in both the terms “report to” and “interface” is for the governor to have an ongoing interest and stake in transformation.  We do not want an independent group off working by itself without the governor knowing and caring about what the group is doing.  We’re looking for a direct relationship between the chair and the governor.  In your application, propose how the relationship will work and how the governor, through that interface, will receive information from the chairperson on a regular basis and will ensure that all necessary governmental organizations are on board.

13.  Do you have an expectation about whether the transformation workgroup should convene in the process of writing the application?

No, that’s completely up to you.  We do want to make sure that some stakeholders, particularly consumers and family members, have participated in the writing of the grant application, but it doesn’t have to be the whole transformation working group as a body.

14.  Do the people on the transformation working group have to read and approve the application before it is submitted? 

Not necessarily.  The reviewers will never know who has read it and approve it.  However, members of the transformation working group will no doubt want to know what they are committing their agency to.  For example, if the application states that the grantee intends to put evidence-based programs in every one of the high schools in the state, then the Commissioner of Education needs to know and approve that. 

In addition, the letters of commitment will be stronger if they specifically show that the writer understands what he/she is committing to.  Sometimes applications contain a big package of support letters, which are really just form letters, and they do not make much of an impression on reviewers.  If you want to have a really competitive application, have letters that are meaningful and knowledgeable.

15. The RFA states that a Federal Transformation Working Group was convened and that it has developed a Federal Agenda for Action.  It further says that grantees will be expected to follow a comparable process.  Where can we find information about the Agenda and the process?

Unfortunately, the Federal Action Agenda has not yet been released. We included the information about the Federal Working Group as a possible model for applicants and grantees.  The Action Agenda goes through, step by step, the 6 goals and 19 recommendations of the New Freedom Commission report.  It describes specific actions that different Federal partners will take regarding each goal and recommendation.  Your process does not need to look exactly like what has been done on the Federal level, but ours is one model that we think might work for states, tribes, territories, and the District of Columbia.

16. What are the criteria for the reviewers for these applications?  What type of independent reviewers are you all looking for?

SAMHSA’s Grants Review Office is quite separate from the offices that write RFAs and manage grant programs, which is what those of us on the call do.  The Grants Review Office will select the reviewers and set up the review.  Reviewers are selected based on expertise, and the Review Office tries to ensure diversity in the review panels.  We, the programs people, will give the Review office a list of the types of expertise we’re looking for, and they will be the ones who actually select the reviewers. 

17. Some organizations in our Transformation Working Group have not actually worked with mental health in the past.  Would that be a detriment?

No.  Clearly, you want agencies that can bring resources to your transformation efforts.  They may not be traditional mental health agencies or have a “history of mental health services,” but they may provide resources that will help bring about a positive transformation of the mental health system. Also, their services must be culturally appropriate, whatever agency they are from. 

18.  How much emphasis must we place on youth and adult consumer involvement in the application preparation? 

Goal two of the New Freedom Commission’s report emphasizes the need for mental health services to be consumer and family driven.  That value has to be fundamental in the development of your application.  You need to tap the consumer and family leaders within your state and have them at the table with you developing your proposal.   

19. We’re considering getting consumer and family input by means of a web-based survey.  Would that be a good idea?

A survey by itself does not guarantee that the proposed services are consumer and family driven.  You could propose in the application that you will do an in-depth survey through the planning process to try to get as broad a representation of stakeholder input as possible into the final comprehensive mental health plan, but a survey would not replace actually having consumers and family members at the table.

20.  How detailed do we need to be in describing the members of the Transformation Working Group? 

The RFA instructs you to identify the people, the “role of each, their level of effort and qualifications, and evidence of their commitment to transformation.”  In describing their qualifications, we don’t need – and you do not have room to include – a resume.  If a member is the head of the Department of Education, that’s a major qualification.  If he or she is the head of the Department of Education and has a history of supporting mental health services in schools, then that would be an excellent qualification to mention in the application.

21.  If someone is already being paid by a grant from another federal agency, can we transform what they are doing now and pay their salaries under this grant?

You can’t supplant other federal funds.  If you hire a person that already has a job under a federal grant, then that federal grant would have to replace the person with someone to do the activities required by that grant.  In addition, for SAMHSA grants (and maybe those of other agencies as well), you can’t replace key personnel without the government project officer’s approval. 

Try to think from a reviewer’s point of view.  If you think the reviewers might ask themselves, “If person X is already committed to something else, how can I be sure she’s really going to become committed to this project?”, then make that person’s commitment clear to the reviewers and stress how she will make a significant contribution to the successful of the project.

One other thing to consider is that, in transformation, we are trying to get all relevant agencies on board.  If you have a stellar person in a different agency, leaving her there can be a very valuable asset; she can become the transformation champion within that agency. 

22.  We might contract out for services like training or dissemination of evidence-based practices.  Is that permissible under this grant?   

The most frequent problem we encounter with contracting is that grantees sometimes merely pass through the funds to another agency that is not eligible to apply.  That’s probably not the issue with the MHT SIG program.  It is conceivable that you might want to contract out some tasks associated with your thorough needs and resources assessment.  And certainly, once you have your comprehensive mental health plan in place, you will probably need to contract for various types of services –social marketing, training, etc.  That type of contracting is acceptable. The more specificity you can put in the application, the better, but you obviously will think of more specific services you need as you develop your comprehensive mental health plan after the grant has been awarded and later in your continuation applications.