Center for Mental Health Services Technical Assistance Conference – January 6-7 and 10-11, 2005 Basics of the Funding Opportunity – Day 1 Nuts and Bolts Discussion Appendices (1-5) Mary Phillips, BME Former Circles of Care Program Coordinator, Oakland and an Evaluator, Los Angeles, CA

I.Overview  The appendices should be succinct with information cited in the narrative.  If submitting hard copies double-check that you have also numbered the appendices. When copies are made at the Grants Management office they may get out of order or misplaced.  The appendices just as the narrative should be single sided.

II.Items from Standard Infrastructure Program Announcement and Circles of Care NOFA.  Appendices 1 through 5 – Use only the appendices listed below.  If your application includes any appendices not required in the grant announcement or NOFA, they will be disregarded.  Do not use more than a total of 30 pages for Appendices 1, 3 and 4 combined.  There are no page limitations for Appendices 2 and 5.  Do not use appendices to extend or replace any of the sections of the Project Narrative unless specifically required in the NOFA. Reviewers will not consider them if you do.

Appendix 1: Letters of Support oSince there are a variety of formats out there and not just ‘one’ way to format the letter this is a suggested Letter of Support format outline: Important:Supporting organization letterhead Title:Letter of Commitment, Letter of Support, Memorandum of Understanding Date:Usually within 3 months of the due date of the proposal Heading:Name, Title (i.e. Project director, President, Chair, signing authority) Address Re:Circles of Care proposal to CMHS, SAMHSA Addressing:Dear (i.e. Project director, President, Chair, signing authority), Body:Name of supporting agency. History of collaborative work or description of organization. Statement of support. Current contracts or collaborative projects. A sentence that states what agency will support/collaborate/participate with the Tribal organization to carry out aspects of the Circles of Care. Describe the services or functions the supporting agency will be providing. List any other Circles of Care support that might transpire. Closing: Sincerely, Signed:Original signatures required depending on NOFA. (See electronic sending instructions for signed documents required)

Example: (also see sample forms on TA CD):

Continued from previous requirement oLetters are an important source for reviewers to find out if the project is working with other resources in the community to accomplish systems change. oBegin coordinating the letters as soon as possible. Invariably letters sent to other organizations will have to go through an approval process, which takes time. oBefore asking the collaborating agency for a support letter prepare information that will help them understand more of the proposed project. A general summary sheet or statement that describes the core components of the proposed project, along with the name of the funder and attach your abstract. In some cases you can expedite the letter of support process if the body of the letter is written by the requesting agency. oMake a list of the letters that are needed and keep in mind how each letter will be obtained. If time is running short (and it will) plan out separate meeting times to get letter of support signatures from each organization.

 Appendix 2: Data Collection Instruments/Interview Protocols oNo Page Limit oThis can include but not limited to:  Previously implemented youth/SA/MH GPRA tool.  Consumer Satisfaction & Quality of Services Survey  Initial SA/MH assessment data collection forms.  Parent Surveys  Youth Surveys  Appendix 3: Sample Consent Forms oForms used in the clinical setting oForm used for students at the public school to receive/refer services. oForms to exchange client information to interagency team or assigned counselors. oForms that allow children to receive services from the clinic or youth services.

Example (also see sample forms on TA CD):

 Appendix 4: Letter to the SSA (if applicable; see Section IV-4 of this document) oThis is 1 page of the Appendice section oSSA – Single State Agency oSPOC-Single Point of Contact oIntergovernmental Review (SPOC List)  Appendix 5: A copy of the State or County Strategic Plan, a State or county needs assessment, or a letter from the State or county indicating that the proposed project addresses a State- or county- identified priority.  Non-tribal applicants must show that identified needs are consistent with priorities of the State or county that has primary responsibility for the service delivery system. Include, in Appendix 5, a copy of the State or County Strategic Plan, a State or county needs assessment, or a letter from the State or county indicating that the proposed project addresses a State- or county-identified priority. Tribal applicants must provide similar documentation relating to tribal priorities. (Standard Infrastructure Program Announcement, INF 05 PA, p. 22).

Continued from previous requirement oTribal governments should submit tribal resolution documents that explain how the proposed project will be aligned with tribal youth mental health priorities. This document is specific to Tribal guidelines for resolution protocols. Language in the document can include statements like, “ WHEREAS, [Tribe] is a federally recognized tribe”, WHEREAS [Tribe] has developed a 6 year Southwest American Indian Systems of Care Strategic Plan that identifies resources to improve the capacity of the child development and mental health/substance abuse treatment system to provide services to American Indian/Alaska Native children, youth and their families”. oTribal Colleges and Urban programs can find information on the state mental health plan and priorities at the State Mental Health Department’s website. A list of the state MH department websites our posted on the National Association of State Mental Health Program Directors (NASMHPD) URL oThe State Mental Health Plan can sometimes be found in the ‘publications’ link, or through search engine of the state website. This is the same for the County plans on the web.

Example letter to SSA (See TA CD):

Example letter from the State or county indicating that the proposed project addresses a State- or county-identified priority (See example TA CA):