Opportunity Information: Apply for HRSA 16 068

The Nurse Education, Practice, Quality and Retention - Interprofessional Collaborative Practice Program: Behavioral Health Integration (NEPQR-IPCPBHI) is a two-year FY 2016 cooperative agreement opportunity from the Health Resources and Services Administration (HRSA) designed to bring behavioral health services into routine, nurse-led primary care. The central focus is improving access, coordination, and outcomes for people in vulnerable communities, including underserved and rural populations, by embedding interprofessional, collaborative behavioral health care into everyday primary care workflows led by advanced practice registered nurses (APRNs). The opportunity is grounded in longstanding national priorities to treat primary care as a key entry point for mental health and substance use assessment and treatment, reflecting recommendations from the New Freedom Commission on Mental Health, Healthy People 2020, and the Affordable Care Act's push to expand coverage for mental health and substance use services and, as a result, expand the workforce able to deliver integrated care.

At its core, the program expects applicants to operate (and strengthen) a team-based model where primary care and behavioral health are delivered in a coordinated way at the community level. Applicants must already be providing nurse-led primary care and then expand that team by adding at least one onsite, full-time equivalent licensed behavioral health provider. HRSA specifies the minimum integrated team composition: an APRN primary care provider, a behavioral health provider, a care coordinator, and access to a consulting psychiatric provider. The psychiatric consultant role can be supported through approaches like telebehavioral health, which is particularly relevant for rural areas that struggle to recruit specialty clinicians.

A major requirement is that applicants clearly describe where they currently stand on the SAMHSA-HRSA Center for Integrated Health Solutions six-level framework for integrated care, and then lay out a realistic plan to move to higher levels of integration over the project period. In practice, that means applicants need to show they understand integration as a continuum (from minimal collaboration to fully integrated teams and systems) and that they have an actionable strategy to deepen coordination, shared workflows, and shared accountability for outcomes.

The clinical approach is not left open-ended. HRSA requires the use of specific evidence-based tools to identify and treat common behavioral health needs in primary care. For unhealthy alcohol and substance use, applicants must implement Screening, Brief Intervention, and Referral to Treatment (SBIRT). For depression, applicants must implement the IMPACT model (Improving Mood-Promoting Access to Collaborative Treatment), a well-established collaborative care approach that structures how depression is identified, treated, monitored, and stepped up when patients are not improving. Beyond simply naming these approaches, applicants must propose an efficient and innovative implementation plan that explains how SBIRT and IMPACT will be built into everyday primary care operations, including screening processes, follow-up, and treatment workflows.

The program places strong emphasis on infrastructure that makes integrated care workable and measurable. Applicants must use an interoperable health information technology system that supports real-time exchange of clinical data between primary care and behavioral health, with a shared patient record accessible to the care team. The intent is to support accountable care by enabling the team to track patient progress, coordinate interventions, and evaluate outcomes using consistent, up-to-date information rather than fragmented documentation across separate systems.

Continuous improvement is another required element. Applicants must describe a rapid cycle quality improvement (RCQI) method they will use to identify issues, test changes, measure results, and refine workflows to improve performance. This expectation signals that HRSA is not only funding service expansion, but also wants grantees to actively manage implementation challenges (for example, screening rates, referral completion, follow-up adherence, and clinical outcome tracking) through an iterative improvement process.

Competitive applications are expected to demonstrate clear community need for behavioral health services and to show that the project will close real service gaps. Applicants must explain how they will systematically identify individuals who need behavioral health services and deliver comprehensive, culturally competent, integrated care. They must also show how they will leverage existing behavioral health resources in and around the community, which typically means building referral pathways, coordinating with local mental health and substance use providers, and addressing shortages by using strategies like telepsychiatry or shared-care arrangements.

HRSA outlines how award funds are expected to be used. Funded projects should create more efficient, integrated practices that improve patient- and population-centered outcomes and that can inform interprofessional education models. They must expand the nurse-led team to include the required roles, and they must function as an integrated primary care and behavioral health practicum site that supports interprofessional training for nursing students and learners from other health professions. Grantees are expected to implement universal screening for depression and unhealthy alcohol and drug use using IMPACT and SBIRT, then provide education, brief interventions, ongoing monitoring, and follow-up as needed. Because not every patient can be treated fully within primary care, projects must also establish effective referral arrangements for patients needing more intensive or ongoing specialty treatment.

The opportunity also requires formal evaluation and dissemination. Grantees must collect program data, evaluate effectiveness, and share findings with appropriate audiences, which supports broader replication of successful integrated care models. In addition, each project must develop a sustainable business model, signaling that HRSA expects the integrated services to continue beyond the two-year award through reimbursement strategies, partnerships, or operational redesign. Finally, applicants must secure a formal arrangement for technical assistance specifically aimed at increasing the level of behavioral health integration and improving care delivery, with at least $25,000 per year dedicated to that technical support.

Workforce diversity and cultural competence are explicit priorities. Applicants are expected to show commitment to increasing diversity in health professions programs and the health workforce, and to building competencies for cross-cultural understanding and cultural fluency. The guidance frames diversity broadly, including but not limited to race, ethnicity, sex, sexual orientation and gender identity, nationality, religion, age, socioeconomic status, disability, and language. The underlying expectation is that integrated care teams should be prepared to deliver respectful, effective services to diverse communities and that workforce development should help the provider pipeline better reflect the populations served.

Eligibility is limited to accredited schools of nursing, health care facilities, or partnerships between a school of nursing and a health care facility, as long as the applicant has the capacity to deliver high-quality, integrated, team-based, nurse-led primary care and behavioral health services in community-based settings. Foreign entities are not eligible for HRSA awards under this opportunity (with narrow statutory exceptions that generally do not apply here). Administrative details in the source data identify this as a discretionary HRSA opportunity (Funding Opportunity Number HRSA-16-068) using a cooperative agreement mechanism, with an original closing date of January 22, 2016, and an anticipated 16 awards listed in the announcement.

  • The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Nurse Education, Practice, Quality and Retention- Interprofessional Collaborative Practice Program: Behavioral Health Integration" and is now available to receive applicants.
  • Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.359.
  • This funding opportunity was created on 2015-10-16.
  • Applicants must submit their applications by 2016-01-22. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
  • The number of recipients for this funding is limited to 16 candidate(s).
  • Eligible applicants include: Others.
Apply for HRSA 16 068

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NEPQR-IPCPBHI (HRSA-16-068) Grant Opportunity FAQs

1) What is the NEPQR-IPCPBHI program?

The Nurse Education, Practice, Quality and Retention - Interprofessional Collaborative Practice Program: Behavioral Health Integration (NEPQR-IPCPBHI) is a two-year FY 2016 HRSA cooperative agreement designed to bring behavioral health services into routine, nurse-led primary care.

2) What is the main goal of this funding opportunity?

The central goal is to improve access, coordination, and outcomes for people in vulnerable communities (including underserved and rural populations) by embedding interprofessional, collaborative behavioral health care into everyday primary care workflows led by advanced practice registered nurses (APRNs).

3) Why does HRSA emphasize integrating behavioral health into primary care?

The opportunity reflects national priorities that treat primary care as a key entry point for mental health and substance use assessment and treatment, consistent with recommendations from the New Freedom Commission on Mental Health, Healthy People 2020, and the Affordable Care Act focus on expanding mental health and substance use coverage and workforce capacity.

4) What type of award mechanism is this?

This opportunity uses a cooperative agreement mechanism under HRSA, which generally indicates substantial federal involvement compared to a standard grant.

5) What is the Funding Opportunity Number for this program?

The Funding Opportunity Number (FON) is HRSA-16-068.

6) How long is the project period?

The opportunity is described as a two-year FY 2016 cooperative agreement.

7) Who is eligible to apply?

Eligibility is limited to accredited schools of nursing, health care facilities, or partnerships between a school of nursing and a health care facility, as long as the applicant has capacity to deliver high-quality, integrated, team-based, nurse-led primary care and behavioral health services in community-based settings.

8) Are foreign entities eligible to apply?

No. Foreign entities are not eligible for HRSA awards under this opportunity, with narrow statutory exceptions that generally do not apply here.

9) Do applicants need to already be providing nurse-led primary care?

Yes. Applicants must already be providing nurse-led primary care and are expected to expand and strengthen a team-based model by integrating behavioral health into that existing primary care setting.

10) What is the minimum required integrated care team composition?

HRSA specifies a minimum integrated team that includes: (1) an APRN primary care provider, (2) a behavioral health provider, (3) a care coordinator, and (4) access to a consulting psychiatric provider.

11) Does the program require adding behavioral health staff?

Yes. Applicants must expand the nurse-led team by adding at least one onsite, full-time equivalent (FTE) licensed behavioral health provider.

12) Is a psychiatric provider required on-site?

The requirement is access to a consulting psychiatric provider. The psychiatric consultant role may be supported through approaches like telebehavioral health, which can be especially helpful in rural settings.

13) What integrated care framework must applicants address in the application?

Applicants must describe their current position on the SAMHSA-HRSA Center for Integrated Health Solutions six-level framework for integrated care and provide a realistic plan to move to higher levels of integration during the project period.

14) What does it mean to move to higher levels of integration?

Integration is treated as a continuum, from minimal collaboration to fully integrated teams and systems. Applicants are expected to propose an actionable strategy to deepen coordination, shared workflows, and shared accountability for outcomes over time.

15) Are specific evidence-based clinical models required?

Yes. HRSA requires applicants to implement specific evidence-based tools for common behavioral health needs in primary care: SBIRT for unhealthy alcohol and substance use, and the IMPACT model for depression.

16) What is required for alcohol and substance use care?

Applicants must implement SBIRT (Screening, Brief Intervention, and Referral to Treatment) to identify and address unhealthy alcohol and substance use in the primary care setting.

17) What is required for depression care?

Applicants must implement the IMPACT model (Improving Mood-Promoting Access to Collaborative Treatment), a collaborative care approach for identifying depression, treating it, monitoring progress, and stepping up care when patients are not improving.

18) Does HRSA require universal screening?

Yes. Grantees are expected to implement universal screening for depression and unhealthy alcohol and drug use using IMPACT and SBIRT, and then provide appropriate education, brief interventions, monitoring, and follow-up.

19) What does HRSA expect regarding implementation of SBIRT and IMPACT?

Applicants must propose an efficient and innovative implementation plan that explains how SBIRT and IMPACT will be embedded into everyday primary care operations, including screening processes, follow-up, and treatment workflows.

20) What health IT capabilities are required?

Applicants must use an interoperable health information technology system that supports real-time exchange of clinical data between primary care and behavioral health, with a shared patient record accessible to the care team.

21) Why is an interoperable, shared patient record emphasized?

The shared record is intended to support accountable care by enabling the team to track patient progress, coordinate interventions, and evaluate outcomes using consistent, up-to-date information rather than fragmented documentation across separate systems.

22) What quality improvement approach is required?

Applicants must describe a rapid cycle quality improvement (RCQI) method they will use to identify issues, test changes, measure results, and refine workflows to improve performance.

23) What kinds of operational challenges does RCQI help address in this program?

RCQI is positioned as a way to manage implementation issues such as screening rates, referral completion, follow-up adherence, and clinical outcome tracking through iterative testing and refinement.

24) What does HRSA expect regarding demonstration of community need?

Competitive applications are expected to demonstrate clear community need for behavioral health services and explain how the project will close real service gaps in the community.

25) How should applicants plan to identify individuals who need behavioral health services?

Applicants must explain how they will systematically identify individuals who need behavioral health services and deliver comprehensive, culturally competent, integrated care.

26) Are partnerships or referral pathways with community behavioral health resources expected?

Yes. Applicants must show how they will leverage existing behavioral health resources in and around the community, typically by building referral pathways and coordinating with local mental health and substance use providers.

27) How does the opportunity address workforce shortages, especially in rural areas?

The opportunity highlights strategies such as telebehavioral health and telepsychiatry for accessing psychiatric consultation and addressing challenges in recruiting specialty clinicians in rural areas.

28) What should funded projects use award funds to do?

Funded projects are expected to create more efficient, integrated practices that improve patient- and population-centered outcomes, expand the nurse-led team to include required roles, and inform interprofessional education models.

29) Is interprofessional education or training part of the program expectations?

Yes. Projects must function as an integrated primary care and behavioral health practicum site that supports interprofessional training for nursing students and learners from other health professions.

30) What happens when patients need specialty behavioral health treatment beyond what primary care can provide?

Because not every patient can be fully treated within primary care, projects must establish effective referral arrangements for patients who need more intensive or ongoing specialty treatment.

31) Are evaluation and dissemination required?

Yes. Grantees must collect program data, evaluate effectiveness, and share findings with appropriate audiences to support broader replication of successful integrated care models.

32) Is sustainability planning required?

Yes. Each project must develop a sustainable business model, indicating that HRSA expects integrated services to continue beyond the two-year award through reimbursement strategies, partnerships, or operational redesign.

33) Is technical assistance (TA) required as part of the project?

Yes. Applicants must secure a formal arrangement for technical assistance specifically aimed at increasing the level of behavioral health integration and improving care delivery.

34) Is there a minimum budget requirement for technical assistance?

Yes. The opportunity requires at least $25,000 per year dedicated to technical assistance.

35) What are the program priorities related to workforce diversity and cultural competence?

Applicants are expected to demonstrate commitment to increasing diversity in health professions programs and the health workforce, and to building competencies for cross-cultural understanding and cultural fluency.

36) How broadly does the program define diversity?

The guidance frames diversity broadly, including (but not limited to) race, ethnicity, sex, sexual orientation and gender identity, nationality, religion, age, socioeconomic status, disability, and language.

37) What is the original closing date listed for this opportunity?

The original closing date identified in the source data is January 22, 2016.

38) How many awards were anticipated?

The announcement lists an anticipated 16 awards.

39) What kinds of settings are emphasized for service delivery?

The program emphasizes community-based settings and focuses on vulnerable communities, including underserved and rural populations.

40) What does HRSA mean by "integrated" in this program?

In this opportunity, integrated care means primary care and behavioral health services are delivered in a coordinated, team-based way at the community level, supported by shared workflows, shared accountability, and interoperable health IT that allows real-time information exchange and a shared patient record.

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