GAIN-Q3 Service Package & Costs
(2-27-2013)
GAIN family of instruments
The Global Appraisal of Individual Needs (GAIN) is a family of evidence-based assessment
instruments ranging from a 5 minute screener to a 30 minute brief assessment to a 90-120 minute
biopsychosocial assessment. The system includes web based software application, training,
coaching, and monitoring protocols that have been developed by Chestnut Health Systems
(Chestnut) in collaboration with several federal agencies (SAMHSA, NIDA, NIAAA, OJJDP),
states, local governments and researchers. The GAIN has been used by over 1700 agencies in 50
states and several other countries and supported over 200 evaluation reports and publications to
date. The GAIN tools are designed both to guide clinical decision making at the individual level
around diagnosis, placement, treatment planning, and outcome monitoring. They are also
designed to be interoperable with electronic health record and reporting systems and to support
pooling data across individuals to guide program level reporting, needs assessment, evaluation
and program planning both during the grant and beyond.
Due to the widespread use of the GAIN, there are substantial benefits for grantees (and by
extension the field of substance abuse research) when the GAIN infrastructure system is used: 1)
the majority of development costs have been already been covered by previous collaboration
efforts and new development costs are shared across many grants, 2) it includes individual level
reports to link assessment to evidence-based practice recommendations and support clinical
decision making; 3) it includes program level reports and data to support and improve the
evaluation of client needs (again linked to evidence-based practices), track implementation,
evaluate treatment clinical and economic outcomes, and program planning, 4) it allows pooling
of data to examine common needs and evaluate outcomes across sites within similar programs,
5) it allows pooling of data that provides practice based evidence that can be used to support
comparisons of populations, interventions and secondary analysis that benefits the field at large,
6) it captures client information, including race/ethnicity, gender, sexual orientation/identity, that
can be used in reporting health disparities, 7) if required, the GPRA instruments are already
incorporated to support reporting requirements, and 8) the system provides monthly and
quarterly reports that are used instead of site generated quarterly reports.
Summary of the GAIN-Q3 service package
For sites who wish to use the GAIN family of assessments as the evidence-based assessment tool
for a grant application, the following section explains what is included in the GAIN-Q3 service
package. Below are sections describing 1) the components of the service package, 2) the cost of
the service package, 3) sample language you may include in various sections of the RFA
(Approach, Budget, Performance Assessment and Data), and 4) responses to frequently asked
questions. The sample text in italics summarizes this information in a way you can use in your
grant application. All text in this document is in the public domain and can be used in an
applicant’s proposal without further permission. Copies of the actual instruments, training
manuals, training schedules, psychometrics and publications are available online at
http://www.gaincc.org/publications.
GAIN Coordinating Center
gaininfo@chestnut.org
309-451-7900
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Using an evidence-based assessment system implies real costs in terms of training, coaching,
monitoring, certification, technical assistance, data collection, software, data management, and
reporting. If the applicant is proposing to use the GAIN-Q3 infrastructure, two standard packages
are available:
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GAIN-Q3 standard service package for lite or standard versions at a cost of $13,478 per
year ($40,433 for 3 years).
GAIN-Q3 service package for Q3+Motivational Interviewing at a cost of $16,389 per
year ($49,167 for 3 years)
The following two sections give a detailed breakdown of what is included in the GAIN Standard
Service package, the cost, and how it relates to aspects of your proposal. If you have questions
about using the GAIN-Q3 or potentially discounting costs because you already have staff
certified on either the GAIN Initial or GAIN-Q3, please contact Kate Moritz, MA, GAIN
Projects Manager, at (309) 451-7831 before applying.
Components of the GAIN-Q3 service package
As part of the GAIN-Q3 service package, Chestnut will provide the grantee with:
1. Distance learning training, quality assurance/coaching, certification and on-going
monitoring of 2 people to get GAIN-Q3 Local Trainer certification;
2. Distance learning training, quality assurance/coaching, certification and on-going
monitoring of 1 person to get GAIN Program Management and Evaluation certification;
3. Distance learning training of the person acting as the local GAIN Data Manager;
4. Review and technical assistance to the above staff as they train, coach, certify and
monitor other local staff using the GAIN;
5. GAIN ABS web account to support conducting the assessment, generating and editing
the narrative report summarizing clinically relevant information, other interpretative
reports, the required GPRA reports, and ability to export the data for analysis (or local IT
system depending on what it is and/or someone doing the work to link them outside of
this subcontract);
6. Data cleaning, analysis, and reporting, including providing the grantee with monthly
follow-up and treatment reports, quarterly site profile reports and clean analytic files to
use for local evaluation;
7. Project coordination, monitoring, coaching and technical assistance, including the cost of
calls and teleconferences, to implement and use the data to support both individual level
clinical decision making and program level evaluation and program development;
8. The GAIN license fee (unlimited use across the agency for 5 years);
9. This package includes accessing pooled data from other grantees to support monitoring,
evaluation and program planning, and adding site data to the pooled data.
Additional components in GAIN-Q3+Motivational Interviewing (MI) package
10. An option to purchase GAIN-Q3+Motivational Interviewer training and certification to
the supervisory level at a discounted price;
GAIN Coordinating Center
gaininfo@chestnut.org
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11. Travel expenses for grantee staff to come to GAIN-Q3+Motivational Interviewer in
person trainings and the cost of calls and teleconferences;
12. Expanded coordination and management reports related to MI.
Note: any additional training slots to address turnover will be purchased separately on an as
needed basis over the course of the grant.
The goal of the above components are to help you implement the technical and human aspects of
the infrastructure in a way that the organization will be able to afford and have the technical
capacity to continue after the grant, including the in-house ability to train staff. In the technical
approach of your proposal you may want to include text like the following:
The applicant will implement the Global Appraisal of Individual Needs (GAIN; Dennis et
al 2003) Q3 as our form of evidence-based assessment. The GAIN-Q3 is a multi-purpose
tool designed for brief assessment, facilitating brief intervention, and referral to
treatment in targeted populations. The GAIN-Q3 is a standardized brief assessment that
integrates clinical and research measures into one comprehensive structured interview
with ten main sections: background, school problems, work problems, physical health,
sources of stress, risk behaviors, mental health, substance use, crime and violence, and
life satisfaction.
Dennis, M. L., Titus, J. C., White, M., Unsicker, J., & Hodgkins, D. (2003). Global
Appraisal of Individual Needs (GAIN): Administration guide for the GAIN and related
measures. (Version 5 ed.). Bloomington, IL: Chestnut Health Systems. Retrieved from
www.gaincc.org on January 17, 2012.
If you are targeting a special population or service settings in one of several areas (e.g., youth,
young adults, African American, American Indians/Alaska Natives, Hispanic, or Spanish
speaking, French speaking, GLBTQ, Deaf/Hard of Hearing, drug treatment courts, offender reentry projects), there are already workgroups of other grantees doing the same that work together
to identify resources to better meet their needs and questions they would like to get addressed
from the pooled data. If you are interested in another population or setting we can also help to
identify and link you to prior grantees with similar interests who might form a new work group.
This information can be obtained from the GAIN Coordinating Center regardless of whether you
choose to use the GAIN-Q3.
Cost of the GAIN-Q3 service package
Chestnut will provide this GAIN-Q3 service package at the following rates:
 The GAIN-Q3 service package at a fixed price of $37,600 over 3 years, billed at the rate
of $12,533 per year. Table 1 below shows the basis of this price.
 The GAIN-Q3+Motivational Interviewing service package at a fixed price of $46,334
over 3 years, billed at a rate of $15,444 per year. Table 2 below shows the basis of this
price.
GAIN Coordinating Center
gaininfo@chestnut.org
309-451-7900
3
In both cases the costs have been prorated by year to simplify budgeting; grantees can actually
use services whenever they are ready. If the applicant is already using the GAIN and has
certified staff that will be committed to work on the proposed project and/or if there is a
complicated or unusual situation, please consult with Kate Moritz at Chestnut at (309) 451-7831
to get her to provide a modified price to you prior to applying.
GAIN Coordinating Center
gaininfo@chestnut.org
309-451-7900
4
Table 1. GAIN-Q3 service package costs
Unit
Cost
Year 2
Unit Cost
Year 3
Unit Cost
2 $3,000
0 $-
0 $-
2 $3,000
$2,800
1 $2,800
0 $-
0 $-
1 $2,800
Annual GAIN ABS Account (up to 15 active users)
$1,800
1 $1,800
1 $1,800
1 $1,800
3 $5,400
Annual data submission, cleaning, analysis and reporting
Annual project coordination, monitoring, coaching and
technical assistance
$5,000
1 $5,000
1 $5,000
1 $5,000
3 $15,000
$3,800
1 $3,800
1 $3,800
1 $3,800
3 $11,400
Service
People getting GAIN-Q3 Administration and Local
Distance Training and Certification
People getting Program Management and Evaluation
Distance Training and Certification
$1,500
Total Actual
1/3 Total Cost Per Year (invoice amount each year)
GAIN Coordinating Center
Year 1
Unit Cost
$16,400
$12,533
gaininfo@chestnut.org
$10,600
$12,533
309-451-7900
$10,600
$12,533
Total
Unit Cost
$37,600
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Table 2. GAIN-Q3 + Motivational Interviewing service package costs
Unit
Cost
Year 1
Unit Cost
Year 2
Unit Cost
Year 3
Unit Cost
Total
Unit Cost
Service
People getting GAIN-Q3 Administration and Local
Distance Training and Certification
People getting GAIN Program Management and
Evaluation Distance Training and Certification
$1,500
2 $3,000
0 $-
0 $-
2 $3,000
$2,800
1 $2,800
0 $-
0 $-
1 $2,800
People getting Q3 MI Training and Certification
Person trips to attend Q3 MI training
$3,000
$1,367
2 $6,000
2 $2,734
0 $0 $-
0 $0 $-
2 $6,000
2 $2,734
Annual GAIN ABS Account (up to 15 active users)
$1,800
1 $1,800
1 $1,800
1 $1,800
3 $5,400
Annual data submission, cleaning, analysis and reporting
Annual project coordination, monitoring, coaching and
technical assistance
$5,000
1 $5,000
1 $5,000
1 $5,000
3 $15,000
$3,800
1 $3,800
1 $3,800
1 $3,800
3 $11,400
Total Actual
1/3 Total Cost Per Year (invoice amount each year)
GAIN Coordinating Center
$25,134
$15,444
gaininfo@chestnut.org
$10,600
$15,444
309-451-7900
$10,600
$15,444
$46,334
6
Below is a draft of text to put in your budget justification under Other or Contractual Costs
We are proposing to adopt as our evidence-based assessment the Global Appraisal of Individual
Needs (GAIN; www.gaincc.org) Q3, which was developed by Chestnut Health Systems in
collaboration with several Federal Agencies (CSAT, NIDA, NIAAA, OJJDP), states, local
governments and researchers. The budget therefore requests $12,533 or $15,444 per year to
cover a fixed price contract with Chestnut to provide the GAIN-Q3 Service Package used by
other grantees. This contract includes the cost of 1) Training, quality assurance/coaching,
certification and on-going monitoring of 2 people to get GAIN-Q3 Local Trainer Certification;
2) Distance training, quality assurance/coaching, certification and on-going monitoring of 1
person to get Program Manager and Evaluator Certification; 3) Distance training of the person
acting as the local GAIN Data Manager; 4) Review and technical assistance to the above staff as
they train, coach, certify and monitor other local staff using the GAIN; 5) GAIN ABS web
account to support conducting the assessment, generating and editing the bio-psychosocial
narrative report, other interpretative reports, the GPRA reports, if required, and ability to export
the data to for analysis (or local IT system depending on what it is and/or someone doing the
work to link them outside of this subcontract); 6) Data cleaning, analysis, and reporting,
including providing the grantee with clean analytic files to use for local evaluation on a
quarterly basis; 7) Project coordination, monitoring, coaching and technical assistance,
including the cost of calls and teleconferences, to implement and use the data to support both
individual level clinical decision making and program level evaluation and program
improvement; 8) The GAIN license (unlimited use across the agency for 5 years); 9) This
includes the cost to cover accessing pooled data from other grantees to support our monitoring,
evaluation and program planning, and adding our data to the pooled data.
Description for performance assessment and data sections
Where performance assessment and/or data sections are required in a grant, it is recommended
that you include a section like the following:
Performance Assessment. By using the GAIN-Q3 service package we are agreeing
to participate in independent monitoring by Chestnut Health Systems of our
implementation relative to the funder’s general goals general goals under the as well as
to be compared to the performance of other grantees in the same cohort. Chestnut will
provide a) individual level feedback on each trainee’s progress toward certification, b)
monthly feedback on the overall implementation, c) quarterly feedback on client
characteristics once there are at least 20 clients, and d) a review of norms and internal
consistency of our data overall. They will also use coaching calls to focus on any
emerging issues, help us brainstorm about how to address and link us as necessary to
technical assistance (directly or via other contractors). The key performance indicators
Chestnut will provide to the project director in monthly monitoring in the monthly report
include:
1. Staff Measures like: Number of staff trained and completing certification for GAINQ3 Administration, Local Trainer, Program Management and Evaluation
GAIN Coordinating Center
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2. Data Collection Measures like: a) Recruitment Rate (GAIN Recruitment Rate (GAIN
N recruited/Prorated N expected), b) Treatment Satisfaction Index (TxSI) at session
Completion Rate (Done/Due) and On-time Rate (On-time status/N done), c) 3, 6, and
12 Month Completion (GAIN completion number (Done/(Due-Dead)), d) Data
Quality Information), e) Total unresolved GAIN Edits
3. Simple Treatment Process Measures like: a) Treatment Initiation Rate (Admitted -14
to +7 days from GAIN N recruited), b) Treatment Engagement (N where Index
Length of stay (LOS)>=42)/N of unique persons, c) Continuing Care: (N where any
Tx at 90-180 days post admission/N of unique persons), and d) Linkage rate to
continuing care after release from a controlled environment (n linked within 14 days /
n released)
The quarterly reports give detailed data tables and over 50 charts provide
detailed information on the grant site alone and relative to the grant cohort
overall. This comparison can be changed to another grantee that is in a similar
service setting or has a similar population (e.g., high percent of Hispanics). The
charts cover client characteristics (e.g., gender, race groups, age groups,
environment), cross domain measures (e.g., life impact measures, cost to
society/cohort, treatment planning needs), common problems (e.g., mental health,
school, work, physical health, sources of stress, risk behavior, substance use,
crime and violence).
Analytic data files will be provided to the local evaluators to look at additional
questions. When there is sufficient sample size (across or within sites) this data
can also be used to look at the effects associated with the program overall as well
as the extent to which these outcomes are associated with specific background or
context factors, individual factors, how durable the effects were. Grantee staff will
be able to compare the above measures to what is proposed to address other key
process questions including: how closely did we implement as planned? What and
why did deviations occur? What impact (if any) did deviations have on outcomes?
Note: If you are using an evidence-based treatment practice, you should also have paragraphs
describing how you will monitor the implementation of those services and what was received.
Your program planner or local evaluator should also add text on how they will help you use the
data, address local questions, increase the focus on special service settings or populations. If you
are participating in a workgroup related to the latter, you may also want to mention that you will
work with them on data across sites to further address the needs of your target setting/population.
Frequently asked questions
Below are answers to some frequently asked questions. For more information on using GAIN
services for this grant, visit www.gaincc.org or contact Kate Moritz, MA, GAIN Projects
Manager, at (309) 451-7831.
Q1. Do we have to use the GAIN-Q3 on everyone?
GAIN Coordinating Center
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No, we generally recommend using a screener and only doing the GAIN-Q3 on people who you
believe will become part of the project and for whom you will do follow-up. The GAIN website
has a 2-page GAIN Short Screener (GAIN-SS) that might be useful in this regard. There are no
additional costs to using the GAIN-SS, if the GAIN-Q3 service package is purchased.
Q2. Which instruments do I use and when do I use them?
There are three versions of the GAIN-Q3 that grantees can choose from: Lite, Standard, or MI.
For a complete description of the GAIN-Q3 and its three versions, please visit our website.
The recommended timeline:
 At treatment intake: GAIN-Q3 Standard or GAIN-Q3+MI
 At the 2nd treatment session (3rd – 5th sessions are considered late): Treatment Satisfaction
Index (TxSI)
 If collecting follow-up (3, 6, 9, or 12-month waves): GAIN-Q3 follow-up
Should you choose to conduct follow-up, Chestnut can provide preliminary training on setting up
follow-up via a coaching call as part of the service package.
Q3. Does the GAIN help with GPRA reporting?
For those grantees that need to report on GPRA (Government Performance Results Act),
Chestnut has a version that includes additional questions to complete CSAT’s GPRA reporting
requirements (which change approximately every 2 to 3 years). Grantees will still have still have
to enter responses into the GPRA system, but this will save time during administration.
Q4. What software and equipment will be needed?
Your site must use the online web application, GAIN ABS, which was developed by and is
managed by Chestnut. The cost of the agency’s account for 15 active users is included in the
package costs, but you will need high speed internet access, the latest Internet Explorer or
Firefox browser, and a screen resolution of 1024 x 768 or higher. The GAIN can be administered
on paper and later data entered into your GAIN ABS web account or it can be administered
interactively using GAIN ABS. Once the interview is conducted and entered in GAIN ABS, you
can generate reports immediately and print to any available printer. GAIN ABS is a high security
storage site and will automatically back up your data at no additional costs. Your account can
also be configured to conform with the privacy and security policies of most agencies and we’d
be happy talk to you about what it would take to incorporate GAIN ABS into an existing EHR
utilized at your site.
Q5. What responsibilities do we have for data management?
Your site will be responsible for maintaining the contents of your GAIN ABS account, including
entering all treatment and follow-up information as well as administered GAIN records. These
records will be pulled each month by the Chestnut’s Data Management Team on the designated
pull date. Any information not entered in GAIN ABS will not be counted towards performance
rates. After review from the Data Management Team, your site will receive a GAIN Edits Excel
GAIN Coordinating Center
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file listing any data anomalies identified in GAIN ABS. As part of the service packages, your
site’s assigned Data Manager will be responsible for reconciling any data anomalies identified in
this Excel file (or say that they cannot be resolved).
Q6. What are the GAIN-Q3 training and certification processes/requirements
GAIN Local Trainer certification process begins with a GAIN Administration Distance Training.
The Local Trainer candidate must successfully complete the GAIN Administration Training and
become a certified GAIN Administrator before starting on the GAIN Local Trainer process.
GAIN Local Trainer certification is achieved by successfully training other staff members at the
Local Trainer’s agency and demonstrating the ability to provide feedback and recognize mastery
level of GAIN administration.
The role of GAIN Local Trainer is intended to offer an opportunity for agencies to sustain and
grow quality use of the GAIN assessment within their agency without having to incur ongoing
costs associated with sending staff to Chestnut Health Systems to be trained and achieve
certification. Therefore, to implement the standard service package according to Chestnut’s best
practices, the grantee should maintain two certified GAIN Local Trainers.
To achieve GAIN-Q3 Administration Certification, you must:
 Successfully complete a distance training course
 Submit digitally recorded interviews to the GAIN Administration Quality Assurance
(QA) Team and receive feedback on each submission.
 The deadline for submission of the recorded interviews to the GAIN Administration QA
Team and receiving certification is 3 months from the completion of the training process.
To achieve GAIN Local Trainer Certification, you must achieve GAIN-Q3 Administration
Certification and pass both Stage 1 and Stage 2 of the Local Trainer certification process:
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Stage 1 consists of reviewing a recorded interview of a GAIN-Q3 interviewer trainee not
ready to be certified and providing detailed written feedback on issues found within the
interview. The reviewed recording is submitted to the GAIN Administration QA Team
for a blind review. A member of the GAIN Administration QA Team compares the
feedback written by the Local Trainer candidate with the feedback written by the GAIN
Administration QA Team. Once the GAIN Administration QA Team has determined that
the Local Trainer candidate is proficient in giving specific, detailed, evaluative feedback
to GAIN Administration trainees, the Local Trainer candidate passes Stage 1.
Stage 2 consists of the same process outlined for Stage 1 except the Local Trainer
candidate must submit a recording of someone they feel has reached mastery level of
GAIN-Q3 administration. The GAIN Administration QA Team evaluates the Local
Trainer’s ability to write feedback and determine whether a trainee is ready to be a GAIN
certified site interviewer.
Note: The time allotted to complete the entire GAIN Local Trainer Certification process is three
months from when administration certification is achieved.
GAIN Coordinating Center
gaininfo@chestnut.org
309-451-7900
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Q7. What are the Program Management and Evaluator training (PMET) and certification
processes and requirements?
PMET is designed to provide program managers and evaluators with an understanding of:
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the need for evidence based practice and how the GAIN supports it.
the goals of program management and evaluation.
the typical questions that program managers and evaluators have when evaluating
evidence based practice.
the benefits of using GAIN data for program planning and evaluation.
the similarities between using the GAIN for clinical and evaluation purposes.
the usefulness of the GAIN Coordinating Center's resources for program managers and
evaluators.
the importance of an Implementation Plan
the benefits of aggregate data for program planning from a clinical perspective.
the benefits of accessing and using the National GAIN dataset for evaluation and research
purposes.
the benefits of PMET Certification.
The PMET certification process begins after completion of distance.
For certification, you will develop a program management or evaluation plan for the
implementation of evidence-based practices at your agency based on the information you wrote
and information you received during PMET. Once your plan is written, you will submit it to
Chestnut. Your plan is reviewed by GCC evaluation experts (using specific, standard criteria)
and detailed, written feedback is given to you within 2 weeks. You are expected to review the
feedback given and incorporate the feedback into your plan and re-submit it for review. The
process continues until you receive a rating of Better or Best on all major sections of your Plan.
Achievement of Better or Best in all review areas is considered by GCC experts as
demonstrating mastery of the knowledge and skills necessary to conduct comprehensive program
management or evaluation of a substance abuse treatment program using GAIN data and will
meet all the requirements for PME Certification. Note: The time allotted to complete the entire
PMET course and certification process is four months from registration confirmation.
Q8 - What are the Q3 MI Training and Certification processes/requirements?
The GAIN-Q3 version of MI is called the CHOICE (Compassionate Helpers Openly Inviting
Client Empowerment) Model. CHOICE Model Q3 MI certification process begins at a 2.5 day
CHOICE Model Q3 MI National training in Normal, Illinois. These "Train the Supervisor”
events are designed to train individuals on how to teach other staff how to perform CHOICE
Model Q3 MI to competency. The CHOICE Model Q3 MI Local Supervisor candidate must
successfully complete the CHOICE Model Q3 MI Training and become a Certified CHOICE
Model Q3 MI interviewer. CHOICE Model Q3 MI Local Supervisor Certification is achieved by
successfully training other staff members at the Local Supervisor’s agency and demonstrating the
ability to provide feedback and recognize competency level of CHOICE Model Q3 MI
administration.
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For sites that choose to use the GAIN-Q3 Enhanced (with MI) service package model, they must
have two designated staff achieve certification as CHOICE Model Q3 MI Local Supervisors.
Although the criteria used to judge a CHOICE Model session are different from those used to
judge the quality of a GAIN-Q3 assessment, the process is largely the same. Certification
involves practicing the CHOICE Model, submitting audio recorded sessions for review by an
experienced supervisor, and receiving feedback until the clinician has met the competency
standards.
It should be noted that meeting the competency standards for the CHOICE Model does not in
any way mean that a clinician is an expert in MI.
CHOICE Model Q3 Quality assurance reviewers will listen to your recordings and code your
adherence to tasks that are included in each of the five CHOICE model steps (i.e., Overview,
Brief Review of Non-Problem Areas, Agenda Setting, Using MI to Review Concerns, and
Session Closure). Once competency has been met, the trainee will be certified. Note: The time
allotted to complete CHOICE Model Q3 MI Local Supervisor Certification is 6 months from the
last day of training.
Q9 – Can I use the GAIN-Q3 with other treatment approaches?
Yes. In particular it has been used with adults and adolescents using the Community
Reinforcement Approach (CRA and A-CRA respectively) and for Assertive Continuing Care
(ACC) (see http://www.chestnut.org/LI/acra-acc/).
GAIN Coordinating Center
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