Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS),
a Project of the Substance Abuse and Mental Health Services Administration (SAMHSA)
Request for Applications
2014 Peer Awards for Health Reform Education
Application Deadlines:
Optional Letter of Intent: January 24, 2014 5:00 pm EST
Complete Application: February 19, 2014 5:00 pm EST
SCHEDULE
January 2, 2014
Request for Applications (RFA) Announced
January 24, 2014
Written Intent to Apply (Optional)
February 19, 2014
Applications Must be Received by 5:00 p.m. EST
March 14, 2014
Awardees Notified
March 28 – September 29, 2014
Award Period
SUMMARY
The Substance Abuse and Mental Health Services Administration (SAMHSA)’s Bringing Recovery
Supports to Scale Technical Assistance Center Strategy (BRSS TACS) is currently accepting applications
for 2014 BRSS TACS Peer Awards for Health Reform Education. BRSS TACS is a SAMHSA project
operated under a contract with the Center for Social Innovation.
The purpose of the 2014 BRSS TACS Peer Awards for Health Reform Education is to enable Peer-Run
Organizations/Recovery Community Organizations in the states, District of Columbia, territories, and
tribal jurisdictions located in states that have expanded Medicaid eligibility in 2014 to build and/or
engage with existing statewide networks among Peer-Run Organizations/Recovery Community
Organizations with the goals of:
1. Creating and disseminating among the members of these networks state or territory-specific
educational materials on health reform initiated by the Patient Protection and Affordable Care Act
(ACA) of 2010. This includes providing information on the state, territorial, or tribal
jurisdiction’s affordable insurance exchange, expanded Medicaid program, Navigator programs,
and other outreach, enrollment and treatment access services.
2. Soliciting informal information about the experiences of the providers and recipients of outreach
and enrollment services during the affordable insurance exchange open enrollment period
(October 1, 2013–March 31, 2014), and the year-round rolling enrollment for the state or
territory’s Medicaid program. Informal information may also be gathered about the experiences
of those who meet qualifying life event exemption criteria and are permitted to enroll for private
coverage through the health insurance exchange outside the open enrollment period. This
information will assist with collaborative efforts to identify and overcome barriers to effective
outreach and enrollment services and to develop strategies to support those who are newly
2014 BRSS TACS State Peer Awards for Health Reform Education
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insured and Medicaid-eligible access treatment. The findings of these collaborative efforts will be
shared as appropriate with behavioral health authorities in the state, territory or tribal jurisdiction
(i.e., Single State Agency (SSA) for Substance Abuse Services, Mental Health Commissioner, or
Behavioral Health Commissioner), as well as Peer-Run Organizations/Recovery Community
Organizations.
Within this initiative, Peer-Run Organizations/Recovery Community Organizations are required to
educate people with behavioral health conditions on the implementation of health reform in their state or
territory and to understand how best to facilitate their enrollment in programs for which they eligible.
This Request for Applications (RFA) invites Peer-Run Organizations/Recovery Community
Organizations in the states, District of Columbia, territories, and tribal jurisdictions located in states that
have expanded Medicaid eligibility in 2014 to propose activities that develop learning networks to
increase peer organizations’ awareness of health reform programs and to provide effective outreach,
enrollment, and treatment access assistance to individuals with mental health and substance use needs.
Awardees must tailor their education activities to peer audiences.
Please Note: (1) Applications will only be accepted from Peer-Run Organizations and Recovery
Community Organizations located in one of the states, District of Columbia, territories, and tribal
jurisdictions in a state(s) that have expanded Medicaid eligibility in 2014. [To determine if your state or
the District of Columbia, or the state(s) in which your tribal jurisdiction is located, has/have expanded
Medicaid, see the listing of states at this URL: http://kff.org/health-reform/state-indicator/state-activityaround-expanding-medicaid-under-the-affordable-care-act/. Territories should check the official website
of the territory or contact the Medicaid Director in the territory]; (2) Organizations that received
subcontract awards under the 2012 and 2013 BRSS TACS RFA for Peer Awards for Health Reform
Education are eligible for the 2014 awards and are encouraged to apply.
Successful applicants will receive subcontract awards of $25,000 from the Center for Social Innovation.
SAMHSA intends to fund twenty-two (22) BRSS TACS Peer Awards for Health Reform Education in
2014.
Grantees will receive technical assistance (TA) and training on:
 How the Affordable Care Act affects access to recovery support services
 Changes in eligibility criteria and enrollment procedures for affordable health insurance
exchanges, Medicaid, and other programs
 Strategies for developing learning networks that can efficiently and effectively circulate and act
on new information
 Best practices in outreach, eligibility, and enrollment assistance
 Strategies for building the capacity of recovery support service providers – including PeerRun/Recovery Community Organizations – to participate in health reform activities
 Approaches to gathering, reviewing and reporting on the experiences of individuals and
organizations actively engaged in outreach, enrollment, and treatment access activities
Ongoing TA—including consultation sessions, training, webinars, and an online learning community—
will support organizations as they implement their projects throughout the award period.
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Request for Applications
INFORMATION ABOUT THE AWARD & HOW TO APPLY
Background ...................................................................................................................................... 4
About BRSS TACS ..................................................................................................................... 4
About the Patient Protection & Affordable Care Act of 2010..................................................... 5
The 2014 BRSS TACS Peer Awards for Health Reform Education ............................................... 7
About the Grant Awards .................................................................................................................. 9
Award Administration ................................................................................................................. 9
Schedule ...................................................................................................................................... 9
How Funds May Be Used.......................................................................................................... 10
Expectations of Awardees.............................................................................................................. 12
Application Guidelines .................................................................................................................. 13
Evaluation Criteria ......................................................................................................................... 14
Eligibility ....................................................................................................................................... 16
Intent to Apply (Optional) ............................................................................................................. 16
Instructions for Submitting Applications ....................................................................................... 17
Review Process .............................................................................................................................. 17
Contact Information ....................................................................................................................... 18
Additional Resources ..................................................................................................................... 19
Attachment A: Cover Sheet ........................................................................................................... 20
Attachment B: Certificate of Eligibility ......................................................................................... 21
Attachment C: Budget Instructions ................................................................................................ 22
Attachment D: Interim Report Template ....................................................................................... 23
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BACKGROUND
SAMHSA was established in 1992. In the years since, SAMHSA has demonstrated that prevention works,
treatment is effective, and people recover from mental and substance use disorders. Behavioral health
services improve health status and reduce health care and other costs to society. Continued improvement
in the delivery and financing of prevention, treatment and recovery support services provides a costeffective opportunity to advance and protect the nation’s health.
SAMHSA’s mission is to reduce the impact of mental and substance use disorders on America’s
communities. To achieve this mission, SAMHSA has identified the following eight Strategic Initiatives,
which focus its resources on areas of urgency and emerging opportunities:
o
o
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o
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Health Reform
Prevention of Substance Abuse and Mental Illness
Trauma and Justice
Military Families
Recovery Support
Health Information Technology
Data, Outcomes, and Quality
Public Awareness and Support
Projects carried out under this RFA will support SAMHSA’s Health Reform and Recovery Support
Strategic Initiatives.
ABOUT BRSS TACS
In 2011, SAMHSA funded the Bringing Recovery Supports to Scale Technical Assistance Center
Strategy (BRSS TACS) to promote the widespread adoption of recovery concepts and practices
throughout the United States. BRSS TACS serves as a coordinated effort to facilitate the adoption and
implementation of recovery concepts, policies, practices, and services, leveraging previous and current
accomplishments by SAMHSA and other leaders in the behavioral health recovery movement.
Widespread adoption of recovery supports and services requires the participation of Peer-Run
Organizations/Recovery Community Organizations across the country in developing and implementing
new approaches to policy development, funding, infrastructure, service design and delivery, and
workforce development. To this end, the 2014 BRSS TACS Peer Awards for Health Reform Education
will support Peer-Run Organizations/Recovery Community Organizations create and disseminate
state/territory/tribal jurisdiction-specific educational materials on health reform to Peer-Run
Organization/Recovery Community Organization networks, and solicit informal information on outreach,
enrollment, and treatment access experiences in order to learn about barriers to and successful strategies
for providing outreach, enrollment, and treatment access support to newly insured and Medicaid enrollees
with behavioral health needs, including family members and children. Findings regarding barriers to and
effective strategies for providing outreach, enrollment, and treatment access support will be shared with
behavioral health authorities in the state, territory and/or tribal jurisdiction as well as Peer-Run
Organizations/Recovery Community Organizations. BRSS TACS and its partners will provide technical
assistance support relevant to these initiatives. BRSS TACS will also convene online forums and learning
communities, along with regular discussions among awardees regarding strategies and lessons learned.
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ABOUT THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010
The Patient Protection and Affordable Care Act—often referred to as health reform—is changing how
Americans access health care. In the coming years, these changes will affect many in previously
marginalized groups, including people with substance use and mental health conditions. Key provisions
of the Affordable Care Act include:
 Establishment of Affordable Insurance Exchanges where people who are not covered through
employers or other insurance affordability programs (e.g., Medicaid) can compare insurance
policies and rates and purchase coverage;
 Assurance that health plans offered in the individual and small group markets, both inside and
outside of the Affordable Insurance Exchanges, offer a comprehensive package of items and
services known as essential health benefits (EHB);
 Subsidies to low- and middle-income Americans to help cover the costs of health insurance
premiums;
 Elimination of the practice of refusing insurance coverage based on patients’ medical histories
(e.g., pre-existing conditions) and charging different rates based on medical history or gender;
 Expansion of eligibility for restricted eligibility programs such as Medicaid, which will enable
many more low-income Americans to enroll.
A crucial feature of the Affordable Care Act is ensuring access to a core set of Essential Health Benefits
(EHB) regardless of whether the patient accesses care through the Affordable Insurance Exchanges or
individual and small group plans outside the Exchanges. As described in the Affordable Care Act, EHB
must include items and services within at least the following ten categories:
1.
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5.
6.
7.
8.
9.
10.
Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental and substance use disorders services, including behavioral health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care
The benefits and services included in the benchmark health insurance plan selected by each state is the
essential health benefits package for that state. Plans could modify coverage within a benefit category as
long as they do not reduce the value of coverage. This approach provides maximum flexibility to states,
employers, and issuers while providing comprehensive, quality coverage for consumers.
Behavioral health, including mental and substance use disorder services, is one of the ten Essential Health
Benefits (EHB). The Affordable Care Act requires that covered mental and substance use disorder
services must be offered in a manner consistent with the 2008 Mental Health Parity and Addiction Equity
Act, which requires that the financial requirements (such as co-pays and deductibles) or treatment
2014 BRSS TACS State Peer Awards for Health Reform Education
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limitations for mental and substance use disorder benefits be no more restrictive than those for medical
and surgical benefits.
The Affordable Care Act greatly expands eligibility for federal and state programs. In the case of
Medicaid, the legislation fills in gaps in coverage for the poorest Americans by creating minimum
Medicaid income eligibility levels and expanding access to all individuals under 65 years of age with
income at or below 133% of the federal poverty level. Provided that the individual meets certain nonfinancial eligibility criteria, such as citizenship and immigration status, they will be eligible for benefits
beginning on January 1, 2014. These criteria will replace a wide variety of Medicaid categorical
groupings and limitations. The decision to expand Medicaid eligibility is a decision made at the state
level. Legislative requirements to implement Medicaid expansion vary across states with some requiring
authorizing language and/or budgetary authority to implement the expansion. It is important to note that
according to the Centers for Medicare and Medicaid Services (CMS) guidelines, there is no deadline for
states to implement the Medicaid expansion.
Individuals who do not meet Medicaid eligibility criteria may be eligible for premium tax credits to
purchase coverage in a qualified health plan sold within an Affordable Insurance Exchange. To qualify,
one must be an uninsured adult, 18 to 64 years old, with an income at or below 399% of the federal
poverty level (FPL). In addition, many individuals under 250% of the FPL who are also eligible for
premium tax credits will be eligible for additional help through the reduction in their cost-sharing (e.g.,
co-pay, co-insurance) responsibilities. These provisions will result in new pathways to care for those not
yet in care, and will change the costs of and access to treatment for many already enrolled.
As health reform is implemented, states face the significant task of helping newly eligible people
understand their options for services, enroll in health care coverage programs, purchase insurance through
Affordable Insurance Exchanges, and apply for premium tax subsidies and cost-sharing reductions. States
also need to address eligibility recertification and the difficulties of “churning,” and “non-seamless
transitions.” “Churning” occurs when an individual is disenrolled from a program and later re-enrolls in
the same program following a gap in coverage of one to six months. “Non-seamless transitions” occur
when an individual is disenrolled from a program and later enrolled in a different program following a
gap in public coverage of one to six months.
A specific set of innovations implemented at the state level concern consumer enrollment assistance
activities, especially for individuals who will enroll in Medicaid or through Affordable Insurance
Exchanges. By 2019, an estimated 29 million people will enroll in a health insurance plan through
Affordable Insurance Exchanges, including employees of small businesses, self-employed people, or
those who do not have access to insurance through their employers.
People who purchase coverage within plans in the Affordable Insurance Exchanges must have access to
reliable information to help them compare, choose, and apply to health insurance plans. The selection of
an insurance plan is facilitated by a single application for the Exchanges, Medicaid, Children’s Health
Insurance Program (CHIP), and the optional Basic Health Plan. To assist in this process, the Affordable
Care Act requires states to establish Affordable Insurance Exchange-funded Navigator programs. The
Exchange Navigator’s job is to provide individuals and families with fair and impartial information about
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available insurance plans in a manner that is culturally and linguistically appropriate. Exchange
Navigators also help individuals and families enroll in the health plan they select and provide referrals to
an office of health insurance consumer assistance or any other appropriate agency for enrollees with
complaints, coverage appeals, or other questions regarding their health plan.
The period of time during which eligible individuals can enroll in a qualified health plan through an
Affordable Insurance Exchange is known as the “open enrollment period.” For 2014, the open enrollment
period runs from October 1, 2013 to March 31, 2014. Individuals may qualify for special enrollment
periods outside of open enrollment if they experience qualifying life events, such as moving to a new
state, certain changes in income, and changes in family size. The population that will enroll through the
Affordable Insurance Exchanges is estimated to be generally lower income than those currently covered
by private insurance. It is expected that on average they will be at 235% of the federal poverty level, with
the majority (65%) having been previously uninsured. About 80% will qualify for premium tax credits to
help defray the cost of coverage. Data suggest that people who participate in Affordable Health Insurance
Exchanges will be more racially diverse (58% White, 11% Black, 25% Hispanic) than those who
currently have private insurance (about 85% White, 5% Black and 5% Hispanic). An estimated one in
four enrollees will speak a language other than English at home and about 77% will have a high school
diploma or less. For new enrollees, health coverage starts on January 1, 2014.
THE 2014 BRSS TACS PEER AWARDS FOR HEALTH REFORM EDUCATION
SAMHSA supports a prominent role for Peer-Run Organizations/Recovery Community Organizations in
the new health care environment. Peer-Run Organizations/Recovery Community Organizations can help
people with substance use and mental health needs learn about and access health insurance coverage.
Peer-Run Organizations/Recovery Community Organizations are equipped to undertake this task because
of their expertise in state and territory health care programs; their awareness of cultural, linguistic and
geographic needs of their constituencies; and their experience working with low-income and marginalized
groups. Peer-Run Organizations/Recovery Community Organizations can also draw on their tradition of
working in alliances with behavioral health authorities and with other Peer-Run Organizations/Recovery
Community Organizations and non-peer run organizations to develop efficient and effective networks for
sharing information and knowledge about Affordable Care Act implementation in their state.
SAMHSA’s goal for the 2014 BRSS TACS State Peer Awards for Health Reform Education is to develop
learning networks that build the capacity of Peer-Run Organizations/Recovery Community Organizations
to help individuals with substance use and mental health needs access Affordable Care Act programs. In
developing proposals, applicants should consider the collaborative infrastructure and knowledge they
already have in place both to support ongoing efforts to educate Peer-Run Organizations/Recovery
Community Organizations and individuals with behavioral health needs about health reform, and to
contribute to outreach, enrollment and treatment access initiatives for people with behavioral health
conditions or those in recovery from mental and substance use disorders who are newly insured or
Medicaid-eligible. Applicants must provide plans for sharing with the state behavioral health
authority(ies) and Peer-Run Organizations/Recovery Community Organizations their findings regarding
barriers to and effect strategies for providing outreach, enrollment, and treatment access support to people
with behavioral health needs or those in recovery from mental and substance use disorders who are newly
insured or Medicaid-eligible. These findings can focus on the experiences of adults, youth and children
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with behavioral health needs, as well as the experiences of their family members and others directly
involved in their enrollment and treatment access efforts.
SAMHSA recognizes that every state, territory, and tribal jurisdiction is different. Therefore, applicants
should propose activities that are responsive to the context in which they operate. Contextual factors
include but are not limited to:
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Demographics: The numbers of enrolled and unenrolled eligible individuals in racial and ethnic
minority groups within a designated geographic area
Prevalence: The prevalence of substance use and mental disorders among the uninsured
population within a designated geographic area (e.g., people with mental health or substance use
conditions, people with co-occurring disorders)
Enrollment Systems: The status of enrollment and recertification systems
Outreach & Public Literacy: History of efforts in the state, territory or tribal jurisdiction to
inform and educate individuals with behavioral health conditions and their support networks (e.g.,
family members, allies, service providers) about health reform
Proposals should include a detailed plan for activities that address the project’s goals in light of specific
contextual factors in their state, territory, or tribal jurisdiction. These activities must include:
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Steps to develop, expand, and/or strengthen networks of Peer-Run Organizations/Recovery
Community Organizations across the state, territory, or tribal jurisdiction
Opportunities for collaborating organizations to use telephone and web-based platforms to
exchange information, access resources, and/or engage in virtual train-the-trainer sessions about
health reform and outreach, enrollment, and treatment access services
Mechanisms to support individual organizations who wish to develop or are currently engaged in
health reform-related initiatives, such as direct technical assistance (TA) and/or referral to TA,
information sources, or other resources
Capacity building strategies that enable partner organizations to participate in state/territory-level
health reform activities and actively contribute to outreach and enrollment efforts that target
individuals with behavioral health needs
Plans for sharing with state, territorial or tribal jurisdiction’s behavioral health authority(ies) and
Peer-Run Organizations/Recovery Community Organizations findings drawn from the informal
information solicited regarding the experiences of newly insured or individuals newly eligible for
Medicaid as they access behavioral health care under health reform
Additional targeted and state/territory/tribal jurisdiction-specific activities might include:
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For a state/territory/tribal jurisdiction with many uninsured people with behavioral health needs,
activities may focus on designing or refining outreach and engagement strategies aimed at
reaching uninsured individuals, informing them of their eligibility for coverage through the
state’s health insurance exchange or Medicaid program
For a state/territory/tribal jurisdiction with a significant number of individuals who repeatedly
gain and lose their health insurance—known as churning—activities may focus on helping
organizations develop systems to track eligibility status among their constituency members,
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complete necessary redetermination documents in a timely manner, and maintain continuous
coverage
Activities should be innovative and focus on the needs of people in recovery from mental health and
substance use conditions. In addition, awardees should educate and disseminate information in ways that
are easily accessible to people with mental and substance use needs and their support networks, including
family members. Applications should also include outcomes for proposed activities, along with an
evaluation plan to determine whether and how those outcomes are achieved.
ABOUT THE GRANT AWARDS
Funding Mechanism
Subcontract
Anticipated Total Available Funding
$550,000
Anticipated Number of Awards
Twenty-two (22)
Anticipated Award Amount
$25,000 in total direct costs (indirect costs are not allowed)
Length of Project Period
Six months from finalization of subcontract
AWARD ADMINISTRATION
The award period is six months, beginning when the awardee signs the subcontract agreement. The
Center for Social Innovation (C4) will administer funds as contract subawards to Peer-Run
Organizations/Recovery Community Organizations. Each awardee will enter into a subcontracting
agreement directly with C4. Awards will be divided into two payments over the course of the award
period, with 50% of the award disbursed during the first week of the award period, once the awardee
signs the subcontract and submits an invoice. Reporting and communication requirements as outlined in
the award agreement must be met to qualify for the second award payment, which will be made at the
halfway point of the award period, approximately at the beginning of month four. Awardees will be
required to submit a final report at the end of the award period.
SCHEDULE
RFA Announced
January 2, 2014
Written Intent to Apply (Optional)
January 24, 2014
Applications Must be Received by 5 p.m. EST
February 19, 2014
Awardees Notified
March 14, 2014
Signed Subcontract & Invoice for First Payment
March 28, 2014
Kick-off Teleconference
April 10, 2014
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Invoice for Second Payment
June 20, 2014 (Upon Receipt of Progress Report)
Technical Assistance Activities
April – August 2014
Award Completion
September 29, 2014
HOW FUNDS MAY BE USED
SAMHSA recognizes that each 2014 BRSS TACS Peer Award for Health Reform Education awardee
will have a unique approach to educating organizations and individuals about health reform, effective
outreach and enrollment procedures, and accessing covered services. Successful applications will propose
activities that are grounded in efforts undertaken by Peer-Run Organizations/Recovery Community
Organizations in the state, territory or tribal jurisdiction on behalf of persons with substance use and
mental health needs, their state/territory/tribal jurisdiction’s current context for people with such
conditions, and how the Affordable Care Act mandate regarding Essential Health Benefits is changing
this context. They will also demonstrate the ability to prepare and provide relevant information to a state,
territory or tribal jurisdiction’s behavioral health authority(ies) .
Applicants should specify the networks of Peer-Run Organizations/Recovery Community Organizations
with which they intend to collaborate and/or to convene. A description of the capacity and focus of
organizations in the network is important as is information regarding the state, territory or tribal
jurisdiction context in order to establish a baseline against which to assess the impact of health reform
initiatives. This contextual information can include the following:
(a) The coverage of behavioral health services in commercial insurance plans prior to health reform
implementation
(b) The recent history of coverage of mental and substance use disorder services through Medicaid in
states/territories that have expanded Medicaid coverage under health reform
(c) The eligibility for and coverage of mental and substance use disorder services in other programs,
such as the Children’s Health Insurance Program (CHIP) and Medicare
(d) Who is enrolled and who is under-enrolled in private insurance plans and state, territory and tribal
jurisdiction programs
(e) The recertification and re-enrollment processes for private insurance and state, territory and tribal
jurisdiction programs and how these processes are changing under health reform
(f) The definition and implementation of state, territory or tribal jurisdiction Navigator programs,
particularly the eligibility of Peer-Run Organizations/Recovery Community Organizations to
perform these functions
Applicants do not need to give each contextual dimension equal attention. For example, a project may
choose to work with partner organizations to focus on implementing and evaluating outreach, eligibility
and enrollment strategies for one or more specific population (e.g., people who are homeless or unstably
housed, formerly incarcerated individuals, family and youth populations, people with complex behavioral
health conditions, or those with co-occurring disorders). Alternatively, the focus may be on activities that
address eligibility and enrollment procedures for the expanded Medicaid programs. In these cases,
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education materials and activities will address issues specific to these populations or program. In order to
contribute to the ongoing improvement of outreach, enrollment, and treatment access services, the
experiences of individuals from these populations or people who are Medicaid-eligible and those who
work with them that will be solicited and used, along with other information, to develop findings and
recommendations that can be shared with the state/territorial behavioral health authority(ies), and tribal
leaders, as applicable, as well as Peer-Run Organizations/Recovery Community Organizations, and, if
appropriate, the Navigator programs.
Examples of project activities that may be undertaken with these funds include:
 Establishing a web-based information exchange and peer learning forum where Peer-Run
Organizations/Recovery Community Organizations and representatives of state agencies can
access and share information regarding their outreach and enrollment efforts targeting persons
with substance use and mental health needs. The forum could facilitate: 1) the coordination of
outreach and enrollment strategies; 2) the development of strategies to assist with access to
behavioral health services; and 3) the development of protocols for monitoring the experiences of
individuals as they enroll through the affordable insurance exchanges and their access to care
once they are enrolled.
 Creating partnerships and networks of Peer-Run Organizations/Recovery Community
Organizations that identify how outreach and enrollment supports, include insurance Navigator
programs, are distributed across the state/territory/tribal jurisdiction and formulate and implement
strategies for enhancing services in areas that are either not served or are noticeably underserved.
This may include information sharing and referral systems that bring Peer-Run
Organizations/Recovery Community Organizations into closer partnership with state/territorial
behavioral health authorities and programs and providers in the region.
 Coordinating and facilitating opportunities for Peer-Run Organizations/Recovery Community
Organizations, state/territorial, and/or tribal officials, insurance company representatives and
service providers to consider together how better to address the unique outreach and enrollment
and service access needs and experiences of individuals living with or in recovery from
addictions and mental illness. These consultations can lead to the drafting of guidelines for the
second enrollment period in Fall 2014, the year-round Medicaid enrollment process, the
enrollment mechanism applicable to individuals who qualify for special enrollment periods
outside of open enrollment, and recommendations for increasing access to behavioral health
services.
These examples are provided to give a sense of the possibilities of the award and are not intended to be
exhaustive. Applicants are free to propose these or any other activities that will advance the goals outlined
in this RFA. When focusing on a specific goal, applicants should consider the educational function of
proposed activities, which will require making decisions about the target populations for the proposed
activities and how members of that population will be brought into the process, the body of knowledge to
be shared and in what form, and the learning strategies to be used. Applicants should outline the steps
they will take to accomplish proposed activities. The steps should be specific, measurable, realistic, and
time-limited.
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Funding is not available for:
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Organizations in states/territories or tribal jurisdictions located in states that have not chosen to
expand Medicaid in 2014 to the new adult group as defined by the Affordable Care Act
Direct mental health or substance use treatment, services, or care
Any activity that violates local, state, or federal laws or the terms of SAMHSA’s contract with C4
for the operation of the BRSS TACS project
Payment for professional services not directly related to the proposed activities that support the
BRSS TACS project
Costs for the creation of new organizations
Fundraising
Indirect costs or institutional overhead (indirect costs are those not readily identifiable with a
particular cost objective but necessary to the general operation of a nonprofit organization and the
conduct of the activities it performs)
Awardees may not sub-grant or re-grant the awards (pass-through awards), passing the award
funds to another organization that will execute the proposed project. However, if an applicant
does not have the infrastructure in place to accept funds and provide adequate financial oversight,
it is permitted to identify a fiscal agent who will provide these financial services. Awardees may
enter into subcontracts with organizations and individuals to conduct specific activities that
support the overall project. These subcontracts will need to be reviewed and approved by the
Center for Social Innovation and SAMHSA
Lobbying activities
Travel and/or lodging expenses including mileage and other ground transportation to attend
conferences or training sessions. Please Note: Funds can be used to travel to project planning and
administration meetings
Expenses related to meetings, conferences, or events. This includes meeting space at hotels,
conference centers, or any other venue
The provision of food and/or beverages
To supplant funding for programs or activities that are currently funded
EXPECTATIONS OF AWARDEES
Organizations selected to receive a 2014 BRSS TACS Peer Award for Health Reform Education are
expected to participate in the following activities during the course of the project:
 Regularly communicate with and respond to communications from the Award Manager in order
to provide updates, receive technical assistance (TA), and discuss successes and challenges
related to the project.
 Manage funds appropriately, follow project guidelines, and comply with the subcontract.
Prepare and submit two interim reports that summarize: 1) uses of funds, 2) status of ongoing
project activities and findings from the review of experiences of individuals and organizations
regarding outreach, enrollment, and treatment access services, and 3) any policy, financing, and
infrastructure impacts or changes that have resulted from project activities, specifically the
sharing of information with state behavioral health authorities regarding barriers to and
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effectiveness of outreach, enrollment, and treatment access services (See Attachment D for an
example of the Interim Report Template).
These impacts or changes will be determined in part by the state, territory or tribal jurisdiction
health reform context and the objectives of each 2014 BRSS TACS Peer Award for Health
Reform Education project. Impacts or changes may, for example, include contributions to efforts
that result in the:
- development and adoption of or revisions to guidelines for outreach and enrollment with
individuals with mental and substance use needs in affordable health insurance plans or
Medicaid
- incorporation of SAMHSA’s recovery definition and/or principles into the definition of
behavioral health services affected by health reform
- formulation of new policies in support of recovery and recovery-oriented services and systems
- identification of additional funding for recovery support services
- creation of new recovery support services
- training and hiring of additional peer providers
- establishing Recovery-Oriented Systems of Care (ROSC), or Resiliency and Recovery-Oriented
Services and Communities (R-ROSC)
 Prepare and submit a final report within 30 days of the end of the project cycle; the Center for
Social Innovation will provide a final report template
In addition, awardees are expected to participate in six conference calls, as follows:
 One kick-off conference call on April 10, 2014, with the Awards Manager, SAMHSA staff,
BRSS TACS partners, and all awardees to clarify project goals and expectations
 Four conference calls with other awardees and BRSS TACS partners to share information on
project implementation, exchange resources to assist in the success of their projects, and discuss
ideas for ongoing communication among awardees
 A final conference call to share project outcomes and plans for ongoing health reform-related
activities
Awardees are also encouraged to take advantage of additional technical assistance, including calls with
subject matter experts.
APPLICATION GUIDELINES
Applications must include the following:
 Cover Sheet (no more than one page that includes the organization’s title, address, and the tax
identification number; point of contact information; description of the project’s goal; and a brief
summary of planned activities (see Attachment A)
 Project Narrative (maximum of ten single-spaced pages using 12-point Times New Roman font
with one-inch document margins)
 Certificate of Eligibility (see Attachment B)
 Proposed Budget (see Attachment C)
 Project Director’s Résumé (maximum two pages) Applicants may also provide résumés of other
proposed key personnel (with a limit of two pages per person).
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 Two or More Signed Letters of Support from organizations with whom applicant is partnering. At
least two of these signed letters of support should describe the specific ways in which each
partner will assist in implementing the project)
EVALUATION CRITERIA
The Center for Social Innovation (C4) will administer the review process. The review panel, which will
include people in recovery, will evaluate each application according to the following criteria (for a total of
100 points):
1. Experience (10 points). Applicants, which must be Peer-Run/Recovery Community
Organizations, will describe how their organizations have participated in recovery-oriented
projects that focus on working with other agencies on educational activities regarding federal and
state policies that affect covered services for individuals with a mental health or substance use
condition. Applicants should also describe their work with people who have experienced barriers
to accessing, navigating, and maintaining enrollment in state, territory and tribal jurisdiction
programs such as Medicaid and the Children’s Health Insurance Program (CHIP). Applicants are
encouraged to include descriptions of past and current community education efforts to mitigate
barriers, as well as the activities and outcomes associated with these efforts.
2. Consumer/Peer/Person in Recovery Involvement (10 points). Applicants will demonstrate the
involvement of consumers/peers/people in recovery in proposed project activities.
3. Project Activities (30 points). Applicants must describe project objectives, target audience, and
key activities, and provide a proposed timeline. This initiative is primarily concerned with: 1)
educating Peer-Run Organizations/Recovery Community Organizations involved in
state/territory-wide networks and allied programs and organizations about the impact of health
reform on access to services for individuals with addictions and mental health needs; and 2)
soliciting informal information about the enrollment and treatment access experiences of those
who are newly insured and Medicaid-eligible. This information will form the basis of a report to
be shared with state or territorial behavioral health agency(ies), and tribal leaders, as applicable,
as well as Peer-Run Organizations/Recovery Community Organizations regarding the challenges,
promising practices, and lessons learned from the 2013/2014 enrollment period, the Medicaid
enrollment process, enrollment outside the open enrollment period, and treatment access support
efforts.
When outlining the activities related to these goals, the proposal should indicate how they
respond to relevant contextual factors in the state, such as the following:



Demographics: The numbers of enrolled and unenrolled eligible individuals in racial and
ethnic minority groups within a designated geographic area
Prevalence: The prevalence of behavioral health conditions among the uninsured population
within a designated geographic area (e.g., people with mental or substance use conditions;
people with co-occurring disorders)
Enrollment Systems: The status of enrollment and recertification systems, and projected
enrollment numbers once the enrollment period ends
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
Outreach & Public Literacy: History of efforts to inform and educate people in recovery from
behavioral health conditions, and their support networks, including family members, allies,
and service providers working on health reform efforts
 Cultural & Language Differences: The range of cultural and language differences across
Peer-Run Organizations/Recovery Community Organizations that project activities will take
into account when developing and delivering training and other information.
Please note: Subcontract award funds cannot be used for any travel or conference or
professional meeting expenses. This includes ground or air transportation, lodging, and venue
space, including hotel or conference center meetings rooms. Funds may not be used for the
provision of food and/or beverages. Any proposed activities that include training events,
conferences, or meetings must include a plan to externally fund or host events at no cost. Funds
may be used to develop materials or curricula for such events. Some expenses may be approved
for travel for project planning and administration meetings. Funds may be used to support virtual
training events.
4. Project Staff & Management (10 points). Applicants will describe the experience of the
proposed Project Director and include a résumé of no more than two pages. Applicants may also
provide résumés of other proposed key personnel (with a limit of two pages per person).
5. Letters of Support (10 points). Applicants will provide signed letters of support from two or
more partner organizations associated with the project’s implementation. Letters should outline
the partner’s commitment to recovery supports and the engagement of the recovery community.
At least two of these support letters should specify the role the partner will assume, activities in
which the partner will participate, and duration of the partner’s participation. If partnering with
state, territorial or a tribal jurisdiction behavioral health authority(ies), the application must
include a letter(s) of support from each behavioral health authority(ies).
6. Documentation of Project Activities and Impacts (15 points). Awardees will be asked to
submit an interim report and a final report. These reports will provide information on program
activities and any impact on policy, financial and infrastructure initiatives. To help gather this
information, applicants will include a plan to track project activities, gather project-specific
materials and resources, and document impacts and accomplishments.
A. Track Project Activities. The plan should outline a simple process to record the
strategies used and actions taken to achieve each of the objectives listed in Item 3
(Project Activities) above. This may, for example, be a procedure for documenting the
steps taken to convene a network of Peer-Run Organizations/Recovery Community
Organizations and guide a collaborative process to monitor outreach and enrollment
procedures.
B. Gather Project–Specific Materials and Resources. The plan should also describe how
the applicant will gather and archive resources and tools developed over the course of the
award period to achieve the proposed objectives.
C. Document Impacts and Accomplishments. Project accomplishments may include
preparing a report on outreach, enrollment, and treatment access experiences that is used
to inform state health reform policies. The project may also help identify new funding
2014 BRSS TACS State Peer Awards for Health Reform Education
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Request for Applications
sources and lead to improved infrastructure for outreach, enrollment, and treatment
access supports. To identify these accomplishments, the plan may include a process for
gathering information from network members about their experiences developing and/or
implementing outreach to and enrollment of uninsured persons with addictions and
mental health needs. The information gathered will be shared with state behavioral health
entities and other partners in qualitative (e.g., narrative descriptions of project activities)
and quantitative formats as appropriate.
7. Budget (15 points). Applicants will provide a detailed line item budget and justification for the
funding amount (see Attachment C for budget instructions).
ELIGIBILITY
Eligible applicants are nonprofit entities that meet the following requirements:
 Are located in one of the states, District of Columbia, territories, or tribal jurisdiction located in a
state(s) or territory that has/have expanded Medicaid eligibility.
 Consumers/peers/people in recovery who are dedicated to recovery-oriented transformation of
systems and services must lead and run applicant organizations.
Please Note: The term “consumer/peer/person in recovery” includes those who have experienced
mental or substance use disorders and are in recovery within the context of the SAMHSA
recovery definition and principle. SAMHSA recognizes there are many different terms by which
people may prefer to designate themselves as having lived experience with mental health and/or
substance use conditions, such as peer, consumer, survivor, client, patient, ex-patient, recovering
person, recovered person, and others. Within the context of the SAMHSA recovery definition and
principles, the term “consumer/peer/person in recovery” is used here to include those who have
experienced mental health problems or substance use conditions and are in recovery, while the
term “peer” refers to all individuals who share direct experiences of addiction and recovery.
 The organization must have a board of directors or advisory board that includes meaningful
representation of consumers/peers/persons in addiction recovery. The Board of Directors or
Advisory Board must have been in operation for at least six months before the date of issuance of
this grant announcement.
Please Note: An applicant organization must be able to demonstrate meaningful representation
of individuals who meet the definition of consumer/peer/person in recovery on its board of
directors or advisory board.
 An applicant organization must complete the Certificate of Eligibility (see Attachment B), which
indicates that the applicant meets all eligibility requirements.
 An applicant organization must be dedicated to providing education on recovery and promoting
recovery to people with mental health and/or substance use needs.
The statutory authority for this program prohibits the funding of for-profit agencies.
Please Note: Organizations that received subcontract awards under the 2012 and 2013 BRSS TACS RFA
for Peer Awards for Health Reform Education are eligible for the 2014 awards.
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Request for Applications
INTENT TO APPLY LETTER (OPTIONAL)
Please email Rebecca Stouff at rstouff@center4si.com indicating your intent to submit an application. A
letter of intent is not required and it will not obligate your organization to submit an application. It will
assist in planning the review process. Submit letters of intent by January 24, 2014. Applicants may also
mail letters to:
Rebecca Stouff, Center for Social Innovation
200 Reservoir Street, Suite 202, Needham, MA 02494
INSTRUCTIONS FOR SUBMITTING APPLICATIONS
Submit applications by email (preferred method) or mail (overnight courier or US Postal Service). Faxed
applications will not be accepted. If submitting an application package by email, attach all application
documents including the cover sheet to a single email and, if possible, submit all application components
as a single electronic file. Email application packages to Rebecca Stouff at rstouff@center4si.com.
If submitting an application package by mail, provide one original and six copies of the application, cover
sheet (see Attachment A), and completed application package, including the items listed in the Application
Guidelines section in the specified format. Secure each copy with a binder clip—no staples, folders, or
binders. Applications must be received no later than 5:00pm EST on February 19, 2014. Mail application
packages to:
Rebecca Stouff, Center for Social Innovation
200 Reservoir Street, Suite 202, Needham, MA 02494
Applications must be in 12-point Times New Roman font with one-inch document margins.
Please do not send back-up materials unless specifically requested (e.g., videotapes). They will not be
reviewed and cannot be returned. Late and/or incomplete applications will not be accepted or reviewed.
REVIEW PROCESS
The 2014 BRSS TACS Peer Awards for Health Reform Education Award Manager, in collaboration
with SAMHSA, will lead the review process. During an initial screening, the Award Manager will review
applications for completeness and adherence to the instructions given in this announcement. The Award
Manager will eliminate late and incomplete applications or those that do not adhere to the instructions
from further consideration. The Award Manager will assemble a team of experts, including
consumers/peers/people in recovery, to evaluate and score the applications based on the evaluation
criteria.
The scored applications will be sent to SAMHSA; of this group, twenty-two (22) applications will be
selected and approved. The evaluation score given by the expert panel, along with considerations of
geographic distribution, and racial/cultural/ethnic diversity, will form the basis for the final selection of
award recipients.
The Award Manager will notify successful applicants by March 14, 2014.
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CONTACT INFORMATION
You may send questions via email to Rebecca Stouff at rstouff@center4si.com or you may call (617)
467-6014 ext. 252. Staff will answer questions verbally or via email on an individual basis.
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Request for Applications
ADDITIONAL RESOURCES
For an expanded review of the effect that the Affordable Care Act (ACA) will have on behavioral health
services delivery and care access, please see the following:
Online Enrollment Portal:
https://www.healthcare.gov
SAMHSA Enrollment Coalitions Initiative (includes a Consumer, Family, Peer and Recovery Community
Organizations Toolkit)
http://beta.samhsa.gov/health-reform/samhsa-health-reform-efforts/enrollment-coalitions-initiative
Insurance Exchange Marketplace training (available in English and Spanish):
http://marketplace.cms.gov/getofficialresources/training-materials/training-materials-links.html
Messages that Motivate Enrollment in Medicaid and CHIP
http://www.youtube.com/watch?v=aAXMNF2D1eE.
Overview of the ACA:
http://beta.samhsa.gov/health-reform
Summary of New Health Reform Law (Kaiser Family Foundation):
http://www.kff.org/healthreform/upload/8061.pdf
Implications for the ACA on Mental Health and Behavioral Health Services Delivery
(SAMHSA Newsletter, page 15):
http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_3/MayJune2010.pdf
Health Disparities and the Affordable Care Act:
http://www.samhsa.gov/healthReform/docs/ConsumerTipSheet_Disparities.pdf
Quick Facts on Health Reform:
http://www.samhsa.gov/healthreform/docs/ConsumerTipSheet_QuickFactsHealth%20Reform-508.pdf
Commonly Used Terms in Health Reform:
http://www.samhsa.gov/healthreform/docs/ConsumerTipSheet_CommonTerms_HealthReform_508.pdf
Health Reform Core Consensus Principles, a Framework for Discussion:
http://www.samhsa.gov/healthreform/docs/HealthReformCoreConsensusPrinciples.pdf
SAMHSA’s Strategic Plan. Leading Change: A Plan for SAMHSA’s Roles and Actions 2011 – 2014:
http://store.samhsa.gov/shin/content/SMA11-4629/01-FullDocument.pdf
SAMHSA Grant Opportunities:
http://www.samhsa.gov/grants
SAMHSA’s Working Definition of Recovery:
http://store.samhsa.gov/product/SAMHSA-s-Working-Definition-of-Recovery/PEP12-RECDEF
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Request for Applications
ATTACHMENT A
2014 BRSS TACS Peer Award for Health Reform Education
Check List (must be checked and signed by the applicant before application is accepted for review)
 Completed Cover Sheet (Attachment A)
 Project Summary
Ensure application follows these guidelines:
 Signed Certificate of Eligibility (Attachment B)
 No more than 10 single-spaced pages
 Proposed Budget (Attachment C)
 12-point Times New Roman font
 Resume(s) for Project Director and Key Staff
 1-inch margins
The signature below certifies that the submitted application adheres to the guidelines outlined on page 13 in the Request for
Applications and includes the required items listed above. The signatory acknowledges that failure to follow the application
guidelines will render the application incomplete and ineligible for review.
______________________________________________________________________________
Signature of Authorized Representative
FULL NAME OF APPLYING ENTITY
Date Submitted
ADDRESS:
TAX ID #:
E-MAIL:
DESIGNATED CONTACT (must be an authorized
representative of the organization)
DIRECT PHONE #:
Name:
FAX #: (optional)
Title:
Please provide a brief summary that includes a description of the goal that your proposal is addressing and
a list of the planned activities.
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ATTACHMENT B
2014 BRSS TACS Peer Awards for Health Reform Education
Certificate of Eligibility
An authorized representative of the applicant organization (whose name appears on the Cover Sheet) must
complete and sign this certificate. Upon submission, the application must include this certificate and all
documentation specified within it.
I certify the following:

The applicant organization is a nonprofit Peer-Run Organization/Recovery Community
Organization led and operated by consumers/peers/people in recovery and is dedicated to
recovery-oriented transformation of systems and services. Note: Peer-Run Organizations are
fully independent, separate and autonomous from other mental health agencies, with the
authority and responsibility for all oversight and decision making on governance, finance,
personnel, policy, and program issues. Recovery community organizations (RCOs) are
organizations comprised of and led primarily by people in recovery. These organizations directly
provide recovery support services. RCOs are independent organizations with nonprofit status.
RCOs share three core principles: recovery vision, authenticity of voice, and accountability to the
recovery community.

The applicant organization has a Board of Directors or Advisory Board that includes meaningful
representation of consumers/peers/people in recovery.

The consumers/peers/people in recovery on the Board of Directors or Advisory Board are
individuals who have experienced mental health and/or substance use conditions and are in
recovery within the context of the SAMHSA recovery definition and principles.

The Board of Directors or Advisory Board has been in operation for at least six months before the
date of issuance of this grant announcement.

The applicant organization will take an active role in the fiscal management and oversight of the
project.
An authorized representative of the applicant organization must sign and date this form to certify that the
aforementioned statements are accurate.
___________________________________________
Type or print name
__________________________
Title
____________________________________________ _________________________
Signature
Date
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ATTACHMENT C
BRSS TACS Peer Awards for Health Reform Education
Budget Instructions
Include personnel and operating expenses in your budget.
Personnel: Provide the title, a brief description of individual staff member role for the project, an
estimated hourly rate, and number of hours he or she will work on this project. Multiply rate with
number of hours, then list the total dollar amount per staff person. Group staff together within
similar categories (e.g., administrative assistants, educators, coordinators).
Operating Expenses: Break out expenses required to carry out the project, including shipping,
incentives, printing, travel, etc., with a brief description of the expenses you expect to incur. Do
not include indirect expenses related to the general operation of the agency.
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ATTACHMENT D
[NOTE: FOR REFERENCE ONLY. DO NOT COMPLETE AND SUBMIT WITH APPLICATION]
2014 BRSS TACS Peer Awards for Health Reform Education
Interim Report Template
Organization Name:
Date of Submission:
Report Period: from __/__/____
Submitted by:
to __/__/____
A. Project Activities:
1. What have been the key project activities during this period?
(Please provide a brief description for each activity.)
2. Please identify key events or accomplishments during this period. (These may include
accomplishing project goals and objectives as well as unexpected or unplanned
accomplishments.)
3. Have you encountered any challenges in implementing project activities and/or have
you adjust your project strategies or goals? If so, please provide additional information as
well as any lessons learned. If none, let us know.
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B. Impacts and Changes:
Please describe any contributions your project activities may have made to the formulation
of new policies, identification of new funding sources for recovery support services, or
development of the recovery support services infrastructure. (Note: This can include
information about your participation in and contribution to processes designed to inform
statewide activities connected to fostering and supporting recovery.)
C. Technical Assistance:
1. What technical assistance activities have you participated in during this period? Please
provide a brief description of how this assistance informed your project activities.
2. What unmet technical assistance needs do you have? (If none, please let us know.)
C. Expenditures:
Please provide a brief list of expenditures (categories and amounts) during this period.
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