FY 2013 Grant Request for Applications (RFA)

FY 2013 Cooperative Agreement for the Physician Clinical Support System - Medication Assisted Treatment
(Short Title: PCSS-MAT)

INITIAL ANNOUNCEMENT

Request for Applications (RFA) No.: TI-13-003
Posting on Grants.gov: February 13, 2013
Original Receipt date: April 1, 2013

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

Key Dates

Application Deadline Applications are due by April 1, 2013
Intergovernmental Review (E.O. 12372) Applicants must comply with E.O. 12372 if their State(s) participates. Review process recommendations from the State Single Point of Contact (SPOC) are due no later than 60 days after application deadline.
Public Health System Impact Statement (PHSIS) / Single State Agency Coordination Applicants must send the PHSIS to appropriate State and local health agencies by application deadline. Comments from Single State Agency are due no later than 60 days after application deadline.

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) is accepting applications for fiscal year (FY) 2013 Cooperative Agreement for the Physician Clinical Support System – Medication Assisted Treatment grant. The purpose of this program is to build upon the current SAMHSA-funded Physician Clinical Support System – Buprenorphine (PCSS-B), a national mentoring network offering support (clinical updates, evidence-based outcomes and training) by expanding the focus on buprenorphine to include the other two FDA approved medications for the treatment of opioid addiction, methadone and extended release naltrexone and increasing the amount of training for office based physicians and opioid treatment program medical professionals. The program will provide up to date and evidence-based information to support training of health professionals and to address complex issues of addiction.

In October 2002, the Food and Drug Administration (FDA) approved buprenorphine (Subutex ®) and buprenorphine combined with naloxone (Suboxone ®) as sublingual tablet preparations indicated for detoxification and long-term therapy in opioid dependency. These are the only two schedule III medications approved by the FDA for treatment of opioid addiction under the Drug Addiction Treatment of 2000. Subsequently, SAMHSA established the PCSS-B to (a) support physicians in the workforce who are providing buprenorphine treatment, (b) promote strategies that address practical issues in the recognition and treatment of opioid addiction through the use of multiple training formats and technologies, (c) target primary care physicians who are trying to integrate opioid addiction into their practice, and (d) provide advanced training that addresses more complex issues in the treatment of opioid use disorders.

More recently, on October 12, 2010, the FDA approved extended release injectible naltrexone (Vivitrol ®) to treat and prevent relapse after patients with opioid dependence have undergone detoxification treatment. Extended release injectible naltrexone is a non-narcotic product that provides an alternative to the two more widely used and controlled substances, methadone (schedule II) and buprenorphine. While there has been a significant increase in the number of persons who have been prescribed buprenorphine for opioid addiction treatment in the past several years, the number of people who have been inducted on extended release injectible naltrexone remains relatively low in part due to the lack of education and knowledge by primary care physicians about opioid addiction and this medication. Thus, training in the appropriate use and indications for extended release injectible naltrexone is highly needed. The overall lack of physician training, concerns over practical issues, and limited understanding of the appropriate role of medication in opioid treatment also appear to be factors in the slow adoption of newer forms of opioid treatment by the medical profession. Thus, this program is designed to carry out the training of physicians desiring to prescribe and/or dispense FDA approved products (buprenorphine, methadone and naltrexone, including extended release injectible naltrexone) for the treatment of opioid addictive disorders.

By enlisting the assistance of addiction medicine and psychiatry medical specialty organizations and other organizations that focus on opioid addiction, medication assisted treatment, and recovery from opioid addiction, the grantee will offer physicians, substance abuse specialists, and other health professions the information and consultation they need to provide safe, appropriate, and effective pharmacologic treatment for opioid dependence, thereby reducing resistance and barriers to the availability of treatment. The grantee will address medical and psychiatric co-morbidities that are highly prevalent in those with addictive disorders and which contribute to the complex nature of opioid addiction.

SAMHSA has demonstrated that prevention works, treatment is effective, and people recover from mental and substance use disorders. Behavioral health is an essential part of health service systems and community-wide strategies that work to improve health status and lower costs for families, businesses, and governments. Continued improvement in the delivery and financing of prevention, treatment, and recovery support services provides a cost effective opportunity to advance and protect the Nation's health. In order to achieve this goal, SAMHSA has identified eight Strategic Initiatives to focus the Agency's work on improving lives and capitalizing on emerging opportunities.

The PCSS-MAT program addresses the Prevention of Substance Abuse and Mental Illness Strategic Initiative. One of the goals of this Strategic Initiative, which is consistent with the intent of PCSS-MAT, is to reduce prescription drug misuse and abuse through the education of current and future prescribers regarding appropriate prescribing practices for pain and other medications subject to abuse and misuse.

More information is available at the SAMHSA website: www.samhsa.gov/about/strategy.aspx.

The PCSS-MAT grant program is authorized under Section 509 of the Public Health Service Act, as amended. This announcement addresses Healthy People 2020 Substance Abuse Topic Area HP 2020-SA.

Eligibility

Eligibility is limited to the national professional medical organizations authorized by the Drug Addiction Treatment Act of 2000 (DATA) to carry out the training of physicians desiring to prescribe and/or dispense FDA approved schedule III medications for the treatment of addictive disorders. These are the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, and the American Psychiatric Association. Any of these entities may apply individually; they may also apply as a consortium comprised of all or several of the eligible organizations. If a consortium is formed for this purpose, a single organization in the consortium must be the legal applicant, the recipient of the award, and the entity legally responsible for satisfying the grant requirements. If a consortium submits an application, the application must include a written agreement outlining the roles and responsibilities of each participating national professional medical organization. This agreement must be signed by an authorized official of each member of the consortium and attached to the application in Attachment 3 of this RFA "Roles and Responsibilities of Participating National Professional Medical Organizations."

There is a serious public health issue involving the abuse, misuse, non-medical use and concomitant morbidity and mortality associated with the increased availability of opioids for the treatment of acute pain, chronic pain and opioid-related addiction. While these medications are mainly obtained legally through prescriptions, SAMHSA surveys indicate significant amounts are obtained through theft and other forms of diversion.

In addition, SAMHSA recognizes the difficulty in assessing patients for appropriate opioid prescribing and the limited training that physicians, psychiatrists, and dentists may receive during their formal, specialized training. Moreover, licensed physicians, who have completed their formal training, lack adequate mentoring, continuing medical education, and other resources to evaluate patients and prescribe opioid analgesics appropriately. To address this public health problem in a timely manner, SAMHSA is limiting eligibility for this cooperative agreement to the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, and the American Psychiatric Association. These organizations have extensive experience in providing educational and other support services to their members. As such, SAMHSA believes they are uniquely qualified to meet the requirements outlined in this announcement because they have the experience, infrastructure and capacity in place to expeditiously begin program activities.

The statutory authority for this program prohibits grants to for-profit agencies.

Award Information

Funding Mechanism: Cooperative Agreement
Anticipated Total Available Funding: $1 million
Anticipated Number of Awards: One
Anticipated Award Amount: Up to $1 million
Cost Sharing/Match Required? No
Length of Project Period: Up to 3 years

Proposed budgets cannot exceed $1,000,000 in total costs (direct and indirect) in any year of the proposed project. Funding estimates for this announcement are based on an annualized Continuing Resolution and do not reflect the final FY 2013 appropriation. Applicants should be aware that funding amounts are subject to the availability of funds.

This award will be made as a cooperative agreement.

Contact Information

For questions about program issues contact

Anthony Campbell, D.O.
Medical Officer
Division of Pharmacologic Therapy
Center for Substance Abuse Treatment
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Room 2-1067
Rockville, Maryland 20857
(240) 276-2702
anthony.campbell@samhsa.hhs.gov

For questions on management and budget issues contact:

Eileen Bermudez
Office of Financial Resources, Division of Grants Management
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Room 7-1091
Rockville, Maryland 20857
(240) 276-1412
eileen.bermudez@samhsa.hhs.gov

Documents Needed to Complete a Grant Application

1. REQUEST FOR APPLICATIONS (RFA)

YOU MUST RESPOND TO THE REQUIREMENTS IN THE RFA IN PREPARING YOUR APPLICATION.

2. GRANT APPLICATION PACKAGE

YOU MUST USE THE FORMS IN THE APPLICATION PACKAGE TO COMPLETE YOUR APPLICATION.

Additional Materials

For further information on the forms and the application process, see Useful Information for Applicants.

Additional materials available on this website include:


Last updated: 02/13/2013