FY 2009 Grant Announcement: CMHS Grants for Primary and Behavioral Health Care Integration (Short title: PBHCI)

FY 2009 Grant Announcement - CMHS Grants for Primary and Behavioral Health Care Integration (Short title: PBHCI)

Application Information Center for Mental Health Services (CMHS)

Request for Applications (RFA)

Grants for Primary and Behavioral Health Care Integration (Short title: PBHCI)

Announcement No. SM-09-011

Request for Applications (RFA) No. SM-09-011
Posting on Grants.gov: April 10, 2008

Catalogue of Federal Domestic Assistance (CFDA) No.: 93.243

Key Dates:

Application Deadline	Applications are due by May 27, 2009
Intergovernmental Review (E.O. 12372)	Applicants must comply with E.O. 12372 if their State(s) participates. Review process recommendations from the State Single Point of Contact (SPOC) are due no later than 60 days after application deadline.

The Substance Abuse and Mental Health Services Administration, Center for Mental Health Services is accepting applications for fiscal year (FY) 2009 for Grants for Primary and Behavioral Health Care Integration (PBHCI). The purpose of this program is to improve the physical health status of people with serious mental illnesses (SMI) by supporting communities to coordinate and integrate primary care services into publicly funded community mental health and other community-based behavioral health settings. By building the necessary partnerships and infrastructure to support this goal, the expected outcome is for grantees to enter into partnerships to develop or expand their offering of primary healthcare services for people with SMI, resulting in improved health status. The population of focus for this grant program is individuals with serious mental illness served in the public mental health system.

Physical health conditions among people with serious mental illnesses impact their quality of life and contribute to disproportionate premature death. In 2006, the National Association of State Mental Health Program Directors (NASMHPD) issued a technical report, Morbidity and Mortality in People with Serious Mental Illness, which revealed that people with serious mental illness on the average die 25 years earlier than people without serious mental illness. While several factors contribute to this alarming disparity (including barriers to appropriate care, stigma and the lack of cross-discipline training), empirical findings indicate that early mortality among people with serious mental illnesses is clearly linked to the lack of access to primary care services for this population. People with serious mental illnesses have elevated rates of hypertension, diabetes, obesity and cardiovascular disease as compared to people without serious mental illnesses. Many of these health conditions are exacerbated by unhealthy practices like inadequate physical activity, poor nutrition, smoking, substance abuse, and by the side effects of psychotropic medication, including weight gain. Many of these health conditions are preventable through routine health promotion activities, primary care screening, monitoring, treatment and care management /coordination strategies and/or other outreach programs at home or community sites. Because people with serious mental illnesses frequently seek and obtain services from community-based behavioral health providers, these organizations must be able to formulate partnerships to foster integration of primary care services and provide wellness education on site with the goal of improving health outcomes for clients.

The purpose of this program is to improve the overall wellness and physical health status of people with serious mental illnesses by making available coordinated primary care services in community mental health and other community-based behavioral health settings. SAMHSA expects that people with serious mental illnesses will show improvement in their physical health status through participation in the programs associated with this grant. PBHCI also includes a focus on providing wellness education and support services. This grant program supports SAMHSA’s Pledge for Wellness 10 by 10 Campaign to prevent and reduce early mortality among people with mental illness by 10 years over the next 10 years. It is projected that better coordination and integration of primary and behavioral health care should lead to outcomes such as improved access to primary care services; improved prevention, early identification and intervention to avoid serious health issues including chronic diseases; enhanced capacity to holistically serve those with mental and/or substance use disorders; and better overall health status of clients.

Grants for Primary and Behavioral Health Care Integration (PBHCI) is one of SAMHSA’s services grant programs. SAMHSA’s services grants are designed to address gaps in substance abuse and mental health prevention and treatment services and increase the ability of States, units of local government, American Indian/Alaska Native Tribes and tribal organizations, and community- and faith-based organizations to help specific populations or geographic areas with serious, emerging physical health, mental health and substance abuse problems. SAMHSA intends that its services grants result in the delivery of services as soon as possible after award. Service delivery should begin by the 4th month of the project at the latest.

Primary and Behavioral Health Care Integration grants are authorized under Section 520A of the Public Health Service Act, as amended. This announcement addresses Healthy People 2010 focus areas 18 (Mental Health and Mental Disorders) and 26 (Substance Abuse).

Eligibility

Applicants will be limited to publicly funded community mental health and other community-based behavioral health agencies. Community-based behavioral health agencies are in a unique position to carry out the activities of this grant. People with serious mental illness frequently seek and obtain services from community-based behavioral health agencies, thereby forming long-lasting relationships. Many individuals served by the behavioral health treatment system are unable to access primary care settings due to coverage issues, stigma, and the difficulties fitting into the fast-paced model of primary care. Without appropriate outpatient primary care services, people with serious mental illness commonly seek primary healthcare services in emergency rooms, often resulting in overcrowding, high costs, inappropriate care, and poor health outcomes. Because those with serious mental illness are more likely to visit their community-based behavioral health agencies, these agencies are well primed to formulate partnerships with primary care organizations in order to facilitate improved health outcomes for clients.

For the purposes of this announcement, community mental health and other behavioral health agencies are defined as the following: 1) an entity that meets applicable licensing or certification requirements in the State in which it is located; and 2) provides outpatient mental health and/or other behavioral health services for individuals with serious mental illness. SAMHSA will use the Assurance Statement (see Appendix C) to determine eligibility. See also Section III – 3.2, Evidence of Experience and Credential, below.

Existing Federally Qualified Health Centers may participate as a partner organization but only community mental health and other behavioral health agencies are eligible to be the applicant organization.

Award Information

Funding Mechanism:	Cooperative Agreement
Anticipated Total Available Funding:	$5,500,000
Anticipated Number of Awards:	11
Anticipated Award Amount:	Up to $500,000 per year
Length of Project Period:	Up to 4 years

Proposed budgets cannot exceed $500,000 in total costs (direct and indirect) in any year of the proposed project. Annual continuation awards will depend on the availability of funds, grantee progress in meeting project goals and objectives, timely submission of required data and reports, and compliance with all terms and conditions of award.

Contact Information

For questions on mental health topics, contact:

Christopher Carroll
Office of the Director
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Room 6-1059
Rockville, MD 20857
(240) 276-1765
christopher.carroll@samhsa.hhs.gov

For questions on grants management issues, contact:

Gwendolyn Simpson
Office of Program Services, Division of Grants Management
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Room 7-1085
Rockville, Maryland 20857
(240) 276-1408
gwendolyn.simpson@samhsa.hhs.gov