Form Attachments A-F Attachments A-F Attachments A-F

Evaluation of SAMHSA’s Minority Fellowship Program (MFP)

OMB Submission

List of Attachments:

SURVEY AND INTERVIEW PROTOCOLS

• Attachment A Survey: Current SAMHSA MFP Fellows

• Attachment B Survey: MFP Alumni

• Attachment C Survey: Current and former members of Selection and Advisory Committees

• Attachment D Interview protocol: Current and former SAMHSA MFP Staff and other SAMHSA officials involved in the MFP

• Attachment E Interview protocol: Current and former MFP Program Directors/Senior Staff in each of the four grantee programs

• Attachment F Interview protocol: Staff in each of the grantee’s host organizations (i.e. staff in the ANA, APA, ApA, and CSWE)

Attachment A

Survey: Current SAMHSA MFP Fellows

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bottom of this page

CURRENT SAMHSA MFP FELLOWS (on-line survey)

1. In which SAMHSA Minority Fellowship Program (MFP) are you participating?

   1. ___ American Nurses Association

   2. ___ American Psychiatric Association

   3. ___ American Psychological Association

   4. ___ Council on Social Work Education

2. When did you first apply to the SAMHSA MFP? Was it:

   1. ___ Prior to entering the first year of your PhD/residency training program

   2. ___ During the first year of your PhD/residency training program

   3. ___ During the second year of your PhD/residency training program

   4. ___ During the third year of your PhD/residency training program

   5. ___ Other, please sepcify:_________________________________________

3. Were you:

   1. ___ directly accepted into the MFP (and funded) the first time you applied

   2. ___ put on a wait list and then accepted into the MFP

   3. ___ not accepted the first time and successfully reapplied

   4. ___ other, please specify: ______________________________________________________

4. To date, in which years have you received a Fellowship from the SAMHSA MFP? _______________________

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 90 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

5. How did you first hear about SAMHSA’s MFP?

   1. ___ A professor in your undergraduate program

   2. ___ A professor in your graduate program

   3. ___ Another employee/faculty person in your Medical School, Graduate School or Department

   4. ___ Another university official or staffperson

      1. If yes to a-d, was this person a former Fellow in the MFP? ___ Yes ___ No ___ Don’t know

   5. ___ A current or former Fellow

   6. ___ Through a support group for students of color

   7. ___ At a professional conference

   8. ___ A SAMHSA MFP brochure obtained from ______________________________

   9. ___ Another type of print ad where: ______________________________________

   10. ___ A television or radio announcement

   11. ___ Through the internet

   12. ___ Other, please specify: _______________________________________________

6. Why did you apply to the MFP – what did you hope to get out of your experience as a Fellow? (list up to three reasons)

   1. _______________________________________________

   2. _______________________________________________

   3. _______________________________________________

7. Which of the following best describes your general area of specialization within your graduate/residency training program?

   1. ___ Mental health

   2. ___ Substance abuse

   3. ___ Co-occurring disorders

   4. ___ Other, please specify: __________________________

8. During the time you have been an MFP Fellow and you have either taken courses in your graduate program or been in the residency training program….

   1. How has your program structured its courses? In which of the following ways has it addressed ethnic and minority issues in mental health and substance abuse? (check all that apply)

___ There are entire courses (training modules) on ethnic and minority issues

___ Portions or sections of courses address ethnic and minority issues

___ Faculty offer private readings or other individualized courses on ethnic and minority issues

___ There are no resources within my graduate or residency training program for ethnic and minority issues

2. How many courses have you taken at your university/ training program that were directly related to minority mental health and/or substance abuse? ______

3. How many independent studies/private readings at your university/ training program have you taken that were directly related to minority mental health and/or substance abuse? ________________

4. How many courses have you taken at other universities, colleges or programs that have been directly related to minority mental health and/or substance abuse? ________________

5. On a scale of 1 to 5 with 1 being very unimportant to 5 being very important, to what extent was your university’s/residency program’s ability to offer these courses a factor in your applying to the university/medical institution?

Very Unimportant………….……….……..…….Very Important

1 2 3 4 5

6. On a scale of 1 to 5 with 1 being very incomprehensive to 5 being very comprehensive, how comprehensive would you say your graduate/residency coursework/seminars have been in addressing minority mental health and/or substance abuse issues?

Very Incomprehensive……………………………….Very Comprehensive

1 2 3 4 5

The SAMHSA MFP offers different types of supports to Fellows. During the time that you have been a Fellow in the program, have you:	Which of the following best describes how often you have used each of these resources: 1 = daily 2 = weekly 3 = monthly 4 = every other month (6 times/year) 5 = quarterly (4 times/year) 6 = 3 times a year 7 = twice a year 8 = once a year	On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful have each of these been to you? Very Very Unhelpful…………… Helpful
___ Been assigned a mentor from within the SAMHSA MFP program (outside of your university/ residency program) ___ Attended a national professional meeting in your discipline ___ Attended specific sessions at a national professional meeting which addressed minority issues in mental health/substance abuse ___ Participated in other educational seminars sponsored/organized/conducted by your MFP program such as the Summer Institute or Winter Institute – if so please indicate if it was: ___ On-line ___ In-person ___ Met with the (ANA/APA/ApA/CSWE) MFP staff in an in-person site visit to your university/training program ___ Participated in on-line chat groups in the MFP ___ Other________________________________________	1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8	1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

12. What types of financial support have you received from the SAMHSA MFP program?

1. ___ Fellowship stipend amount: ____________ per year for ___ years

2. ___ Tuition reimbursement amount: ____________ per year for ___ years

3. ___ Travel grant/stipend to attend a conference amount: ____________ per conference

4. ___ Dissertation support amount: ____________ per year for ___ years

5. ___ Other, please specify_____________________ amount: ____________ per time

13. Have you received financial support from your university/training program during the time that you have been an MFP Fellow?

1. ___ Yes ___ No

1. ___ Tuition reimbursement amount: ____________per year for ___ years

2. ___ Dissertation support amount: ____________per year for ___ years

3. ___ Teaching assistantship amount: ____________per year for ___ years

4. ___ Research assistantship amount: ____________per year for ___ years

5. ___ Other: ___________________ amount: ____________per year for ___ years

6. On a scale of 1 to 5 with 1 being very inadequate to 5 being very adequate, please rate the level of financial support you are receiving – considering both the SAMHSA stipend and all other financial sources.

Very Inadequate……………………………..Very Adequate

1 2 3 4 5

14. How many hours per week, on average, have you worked for pay during the academic year (training program) while you were an MFP Fellow? __________

1. During the summer did you work at a paid clinical internship? ___ Yes ___ No ___ NA – no summer yet

1. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No ___ NA – no summer yet

2. During the summer did you work at an unpaid clinical internship? ___ Yes ___ No ___ NA – no summer yet

   1. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No ___ NA – no summer yet

3. During the summer did you work as a paid research intern (or RA)? ___ Yes ___ No ___ NA – no summer yet

4. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No ___ NA – no summer yet

5. During the summer did you work as an unpaid research intern (or RA)? ___ Yes ___ No ___ NA – no summer yet

6. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No ___ NA – no summer yet

15. During the past year, has anyone from the [ANA/APA/ApA/CSWE] MFP conducted a formal site visit to your university or training program?

___ Yes	___ No	___ Don’t Know
If yes: What prompted the site visit(s)? (check all that apply): ___ You requested a visit ___ You were having academic difficulty ___ You were having other difficulties with your program’s administration ___ Some other reason: ____________________	b) In other years, has your discipline’s MFP conducted site visits to your university or training program? ___Yes ___ No ___ Don’t Know c) If yes: What prompted the site visit(s)? (check all that apply): ___ You requested a visit ___ You were having academic difficulty ___ You were having other difficulties with your program’s administration ___ Some other reason: ____________________

16. Have you ever personally met with or spoken to a staffperson in the federal SAMHSA MFP office?

1. ___ Yes ___ No

1. In what contexts? (Select all which apply.)

___ At annual meetings of the MFP

___ At a formal on-site visit

___ At other professional meetings

___ Through other one-on-one contacts (What type? ___ E-mail ___ Telephone ___ In-person)

___ Other, please specify: __________________________________________

2. For what reason(s): ___________________________________________________

___________________________________________________

17. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful would you say that your interaction with the SAMHSA MFP office has been?

Very Unhelpful ……………..………………. Very Helpful

1 2 3 4 5 Not Applicable –

Haven’t met w/ SAMHSA

18. During the time you have been a Fellow, in which of the following professional development activities have you participated? Who, if anyone, connected to the SAMHSA MFP helped you to secure that opportunity? (Select all which apply.) And, on a scale of 1 to 5, how important do you believe that this opportunity will be in helping to prepare you for your professional career?

Professional Development Activity	1 = MFP Program Director 2 = MFP Mentor/Advisor 3 = Former MFP Fellow 4 = Someone else with the MFP 5 = Someone else - NOT connected to the MFP	How important do you believe this will be in preparing you for your career? Very Very Unimportant…..…..Important
___ Authoring/ Co-authoring an article/paper ___ Authoring/ Co-authoring a policy brief ___ Making a presentation at a professional conference ___ Offering a training seminar ___ Collaborating in research as a paid assistant ___ Collaborating in research as an unpaid intern ___ Participating in a paid clinical internship ___ Participating in an unpaid clinical internship ___ Making case presentations at Grand Rounds ___ Participating in case consultation	1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA	1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA

19. Have you received any feedback from the ANA/APA/ApA/CSWE MFP about your performance?

___Yes ___No ___ I have not been in the program long enough to receive feedback but expect to (skip to Question 20)

1. If yes, was this in ___ writing or ___ verbally?

2. Who provided that feedback?

   1. ___ The MFP Program Director

   2. ___ Your mentor from the MFP

   3. ___ Other, please specify: _________________________________

3. Did the feedback … (check all that apply and rate the helpfulness of each area on a scale of 1 to 5 with 1 being very unhelpful to 5 being very helpful)

Very Unhelpful……………...Very Helpful

1. ___ Identify areas in which you could improve 1 2 3 4 5

2. ___ Make recommendations for how you could improve

your performance 1 2 3 4 5

3. ___ Identify your strengths 1 2 3 4 5

4. ___ Make recommendations for courses you could pursue 1 2 3 4 5

5. ___ Evaluate your dissertation proposal 1 2 3 4 5

6. ___ Evaluate your progress in the program 1 2 3 4 5

7. ___ Other: _______________________________________ 1 2 3 4 5

20. On a scale of 1 to 5 with 1 being very unhelpful and 5 being most helpful, please rate your experience with the following aspects of your MFP program. Note: this question asks about your experience with your discipline specific (ANA, APA, ApA or CSWE) MFP – not about the experience you are having in your university, college, or residency training program. Please select “Not applicable” if you have no experience with that particular feature of the MFP:

Very Unhelpful…….……...Very Helpful Not applicable

1. The clarity of requirements in the MFP program. 1 2 3 4 5

2. The stipend 1 2 3 4 5

3. Tuition reimbursement 1 2 3 4 5 NA

4. Travel grants 1 2 3 4 5 NA

5. Dissertation grants 1 2 3 4 5 NA

6. Accessibility of the MFP Director in the MFP Program 1 2 3 4 5

7. Guidance/feedback from the MFP Program about your

graduate work or psychiatric residency 1 2 3 4 5 NA

8. Feedback from the MFP in your discipline about

your dissertation 1 2 3 4 5 NA

9. Mentoring provided in the program 1 2 3 4 5 NA

10. The annual conference 1 2 3 4 5 NA

11. Summer Institute 1 2 3 4 5 NA

12. Winter Institute 1 2 3 4 5 NA

13. Other Seminars or opportunities to learn about the fields of

minority mental health and substance abuse 1 2 3 4 5 NA

14. Meeting other MFP students/residents 1 2 3 4 5 NA

15. Opportunities to network with other professionals in

minority mental health and substance abuse 1 2 3 4 5 NA

16. The MFP overall 1 2 3 4 5

21. Please rate how adequate you think the following resources are for the MFP. Using a scale of 1 to 5, with 1 being too little and 5 being too much, please evaluate the amount of funding for…

Too Little……………Too Much Don’t Know Not applicable

1. The Fellow’s stipend 1 2 3 4 5 DK NA

2. The amount available to reimburse tuition and fees 1 2 3 4 5 DK NA

3. The amount available in total for dissertation grants 1 2 3 4 5 DK NA

4. The amount available for individual travel awards to Fellows 1 2 3 4 5 DK NA

5. The amount available in total for travel awards to Fellows 1 2 3 4 5 DK NA

6. The amount of funding for the Summer Institute 1 2 3 4 5 DK NA

7. The amount of funding for the Winter Institute 1 2 3 4 5 DK NA

8. The amount of funding available to cover other items in the MFP budget:

i. _____________________________________ 1 2 3 4 5

ii. _____________________________________ 1 2 3 4 5

iii. _____________________________________ 1 2 3 4 5

[Note: QUESTIONS 23 TO BE ASKED ONLY FOR THOSE WITH MORE THAN 1 SEMESTER IN THE MFP]

The next set of questions will ask you to assess the [ANA/ APA/ApA/CSWE] MFP funded by SAMHSA

22. Please consider each of the goals of SAMHSA’s MFP. How engaged would you say the MFP is in addressing this goal? Would you say it is.

GOALS The [1st/2nd/3rd/etc.]goal is to:	1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged
Develop new cohorts of Fellows	1 2 3 4 5 DK
Train/mentor ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK
Increase the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK
Increase diversity in mental health/substance abuse leadership	1 2 3 4 5 DK
Increase professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK
Increase institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK
Increase mental health and substance abuse services to minority communities	1 2 3 4 5 DK

[RESUME ASKING QUESTIONS OF EVERYONE:]

23. What has been most helpful to you as a Fellow in the SAMHSA MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

24. As a Fellow, what would you most like to see improved in the SAMHSA MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

25. Have you received any reports on the SAMHSA MFP which have evaluated the performance of any of the four individual [ANA, APA, ApA or CSWE] programs? ___ Yes ___ No

1. Can you please provide the name or other identifying information about that report and rate how helpful that report was to you, on a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful?

Title/Description Very Unhelpful………………..………….Very Helpful

i. ___________________________________________ 1 2 3 4 5

ii. ___________________________________________ 1 2 3 4 5

iii. ___________________________________________ 1 2 3 4 5

iv. ___________________________________________ 1 2 3 4 5

26. Overall, what difference has the SAMHSA MFP made for minority mental health and substance abuse services?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

27. Overall, what would you identify as the MFP’s most important contributions?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

28. Have you encouraged [students /psychiatric residents] who were not already part of the MFP to apply to the program? ___ Yes ___ No

1. [If yes:] How many students have you encouraged to apply to SAMHSA’s MFP? ______

2. Did they apply to the program? ___ Yes ___ No ___ Don’t Know

3. How many were accepted? ________ ___ Don’t Know

Could you please tell us a little bit about your background?

29. Are you ___ male or ___ female?

30. How old were you when you first became an MFP Fellow? _____

31. Which of the following would best characterize the type of community in which you grew up (if more than one, please select the one which was most influential)

1. ___ Urban

2. ___ Suburban

3. ___ Rural

4. ___ Frontier area

32. Do you consider yourself Hispanic/Latino? __ Yes ___ No

33. Which of the following describes your racial background [note: participant may select all that apply]:

_____ American Indian or Alaska Native

_____ Asian

_____ Black or African American

_____ Native Hawaiian or Other Pacific Islander

_____ White

34. Is there anything else which you would like to tell us about your experience with the SAMHSA MFP?

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Thank you for participating in this survey –– we appreciate you taking the time and sharing your comments with us!

Attachment B

Survey: MFP Alumni

F

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bttom of this page

ormer SAMHSA MFP FELLOWS (on-line survey)

1. From which of SAMHSA’s Minority Fellowship Programs (MFP) did you receive a Fellowship?

   1. ___ American Nurses Association

   2. ___ American Psychiatric Association

   3. ___ American Psychological Association

   4. ___ Council on Social Work Education

2. When did you first apply to the SAMHSA MFP? Was it:

   1. ___ prior to entering the first year of your PhD/residency training program

   2. ___ during the first year of your PhD/residency training program

   3. ___ during the second year of your PhD/residency training program

   4. ___ during the third year of your PhD/residency training program

   5. ___ other:______________________________________________

3. Were you (check one):

   1. ___ directly accepted into the MFP (and funded) the first time you applied

   2. ___ put on a wait list and then accepted into the MFP

   3. ___ not accepted the first time and successfully reapplied

   4. ___ other, please specify: ______________________________________________________

4. For how many years did you receive a Fellowship from the SAMHSA MFP? _____________

5. In what year did you last receive a Fellowship from the SAMHSA MFP? ______________________________________

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 120 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

6. What year did you receive your PhD or complete your psychiatric residency training? ___________________________

   1. Check here ___ if you did not complete your PhD or did not complete your psychiatric residency training program.

   2. Can you please tell us a little bit about why did not complete your training?

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

7. How did you first hear about SAMHSA’s MFP?

   1. ___ A professor in your undergraduate program

   2. ___ A professor in your graduate program

   3. ___ Another employee/faculty person in your Medical School, Graduate School or Department

   4. ___ Another university official or staffperson

      1. If yes to a-d, was this person a former Fellow in the MFP? ___ Yes ___ No ___ Don’t know

   5. ___ A current or former Fellow

   6. ___ Through a support group for students of color

   7. ___ At a professional conference

   8. ___ A SAMHSA MFP brochure obtained from ______________________________

   9. ___ Another type of print ad where: ______________________________________

   10. ___ A television or radio announcement

   11. ___ Through the internet

   12. ___ Other, please specify: _______________________________________________

8. Why did you apply to the MFP – what did you hope to get out of your experience as a Fellow? (list up to three reasons)

1. ____________________________________________________________________________________________

2. ____________________________________________________________________________________________

3. ____________________________________________________________________________________________

9. Which of the following best describes your general area of specialization within your graduate/residency training program?

   1. ___ Mental health

   2. ___ Substance abuse

   3. ___ Co-occurring disorders

   4. ___ Other: please specify________________________________________________

9. During the time you were an MFP Fellow and you either took courses in your graduate program or were in the residency training program….

   1. how did your program structure its courses? In which of the following ways did it addressed ethnic and minority issues in mental health and substance abuse? (check all that apply)

___ There were entire courses (training modules) on ethnic and minority issues

___ Portions or sections of courses addressed ethnic and minority issues

___ Faculty offered private readings or other individualized courses on ethnic and minority issues

___ There were no resources within my graduate or residency training program for ethnic and minority issues

2. How many courses did you take at your university/ training program that were directly related to minority mental health and/or substance abuse? ___

3. How many independent studies/private readings at your university/ training program did you take that were directly related to minority mental health and/or substance abuse? ___

4. How many courses did you take at other universities, colleges or programs that were directly related to minority mental health and/or substance abuse? ___

5. On a scale of 1 to 5 with 1 being very unimportant to 5 being very important, to what extent was your university’s / residency program’s ability to offer these courses a factor in your applying to the university/medical institution?

Very Unimportant…………………………Very Important

1 2 3 4 5

6. On a scale of 1 to 5 with 1 being very incomprehensive to 5 being very comprehensive, how comprehensive would you say your graduate/residency coursework/seminars were in addressing minority mental health and/or substance abuse issues?

Very Incomprehensive….……………………..Very Comprehensive

1 2 3 4 5

The SAMHSA MFP offers different types of supports to Fellows. During the time that you were a Fellow in the program, did you:	Which of the following best describes how often you have used each of these resources: 1 = daily 2 = weekly 3 = monthly 4 = every other month(6 times/year) 5 = quarterly(4 times/year) 6 = 3 times a year 7 = twice a year 8 = once a year	On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful have each of these been to you? Very Very Unhelpful…………… Helpful
___ Have an assigned mentor from within the SAMHSA MFP program (outside of your university/ residency program) ___ Attend a national professional meeting in your discipline ___ Attend specific sessions at a national professional meeting which addressed minority issues in mental health/substance abuse ___ Participate in other educational seminars sponsored/ organized/ conducted by your MFP program such as the Summer Institute or Winter Institute (please indicate if it was: ___ On-line ___ In-person ___ Meet with the (ANA/APA/ApA/CSWE) MFP staff in an in-person site visit to your university/training program ___ Participate in on-line chat groups in your MFP ___ Other________________________________________	1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8	1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

9. What types of financial support did you receive from the SAMHSA MFP program?

   1. ___ Fellowship stipend amount: ____________ per year for ___ years

   2. ___ Tuition reimbursement amount: ____________ per year for ___ years

   3. ___ Travel grant/stipend to attend a conference amount: ____________ per conference

   4. ___ Dissertation support amount: ____________ per year for ___ years

   5. ___ Other, please specify: _______________________ amount: ____________ per time

9. Did you receive any financial support from your university/medical training program when you were an MFP Fellow?

   1. ___ Yes ___ No

      1. ___ Tuition reimbursement amount: ____________ per year for ___ years

      2. ___ Dissertation support amount: ____________ per year for ___ years

      3. ___ Teaching assistantship amount: ____________ per year for ___ years

      4. ___ Research assistantship amount: ____________ per year for ___ years

      5. ___ Other, please specify: _________________ amount: ____________ per year for ___ years

2. On a scale of 1 to 5 with 1 being very inadequate to 5 being very adequate, please rate the level of financial support you received – considering both the SAMHSA stipend and all other financial sources.

Very inadequate……………………………..Very Adequate

1 2 3 4 5

9. How many hours per week, on average, did you work for pay during the academic year (training program) while you were an MFP Fellow? __________

   1. During the summer did you work at a paid clinical internship? ___ Yes ___ No

      1. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No

   2. During the summer did you work at an unpaid clinical internship? ___ Yes ___ No

      1. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No

   3. During the summer did you work at a paid research internship (or assistantship)? ___ Yes ___ No

      1. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No

   4. During the summer did you work at an unpaid research internship (or assistantship)? ___ Yes ___ No

      1. If yes: Did the MFP help identify that opportunity? ___ Yes ___ No

9. During the time you were a Fellow, did anyone from the [ANA/APA/ApA/CSWE] MFP conduct a formal site visit to your university or training program?

___ Yes	___ No	___ Don’t Know
If yes: How many times? _______ What prompted the site visit(s)? (check all that apply): ___ You requested a visit ___ You were having academic difficulty ___ You were having other difficulties with your program’s administration ___ Some other reason: ____________________

9. During the time you were a Fellow did you ever personally meet with or speak to a staffperson in the federal SAMHSA MFP office?

   1. ___ Yes ___ No

      1. In what context(s)? (Select all which apply.)

___ At annual meetings of the MFP

___ At a formal on-site visit

___ At other professional meetings

___ Through other one-on-one contacts (What type? ___ E-mail ___ Telephone ___ In-person)

___ Other, please specify: _______________________________________________

2. For what reason(s): __________________________________________________________

__________________________________________________________

9. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful would you say that your interaction with the SAMHSA MFP office was?

Very Unhelpful ……………..………………. Very Helpful

1 2 3 4 5 Not Applicable –

Haven’t met w/ SAMHSA

9. During the time you were a Fellow, in which of the following professional development activities did you participate? Who, if anyone, connected to the MFP helped you to secure that opportunity? And, on a scale of 1 to 5, how important was this in helping to prepare you for your professional career?

Professional Development Activity	1 = MFP Program Director 2 = MFP Mentor/Advisor 3 = Former MFP Fellow 4 = Someone else with the MFP 5 = Someone else – NOT connected to the MFP	. How important was this in preparing you for your career? Very Very Unimportant……....Important
___ Authoring/ Co-authoring an article/paper ___ Authoring/Co-authoring a policy brief ___ Making a presentation at a professional conference ___ Offering a training seminar ___ Collaborating in research as a paid assistant ___ Collaborating in research as an unpaid intern ___ Participating in a paid clinical internship ___ Participating in an unpaid clinical internship ___ Making case presentations at Grand Rounds ___ Participating in case consultation	1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA	1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 1 2 3 4 5 NA 2 3 4 5 NA

9. During the time you were a Fellow, did you receive any feedback from the ANA/APA/ApA/CSWE MFP about your performance?

___Yes ___No

1. If yes, was this in ___ writing or ___ verbally?

2. Who provided that feedback?

   1. ___ The MFP Program Director

   2. ___ Your mentor from the MFP

   3. ___ Other, please specify: _________________________________

3. Did the feedback … (check all that apply and rate the helpfulness of each area on a scale of 1 to 5, with 1 being very unhelpful to 5 being very helpful)

Very Unhelpful……………….Very Helpful

1. ___ Identify areas in which you could improve 1 2 3 4 5

2. ___ Make recommendations for how you could improve

your performance 1 2 3 4 5

3. ___ Identify your strengths 1 2 3 4 5

4. ___ Make recommendations for courses you could pursue 1 2 3 4 5

5. ___ Evaluate your dissertation proposal 1 2 3 4 5

6. ___ Evaluate your progress in the program 1 2 3 4 5

7. ___ Other, please specify: __________________________________ 1 2 3 4 5

The next set of questions will ask you to assess SAMHSA’s MFP, as administered by the [ANA/APA/ApA/CSWE]. Please frame your answers based on your experience with the program during those years.

24. SAMHSA began administering this program in 1992. In which years have you been directly familiar with the [ANA/APA/ApA/CSWE] MFP? _______ (year) to _______ (year)

25. Please consider the following goals contained in SAMHSA’s MFP. Then evaluate how appropriate you think those goals are for the MFP; and finally rate the degree to which the ANA’s/APA’s/ApA’s/CSWE’s program has been engaged in addressing those goals during the time you have been familiar with the program.

GOALS	Appropriateness of Goals 1 = very inappropriate to 5 = very appropriate	Degree to which the Program is engaged in addressing the Goals 1 = very disengaged to 5 = very engaged
a. Develop new cohorts of Fellows	1 2 3 4 5	1 2 3 4 5 DK
b. Train/mentor ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
c. Increase the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
d. Increase diversity in mental health/substance abuse leadership	1 2 3 4 5	1 2 3 4 5 DK
e. Increase professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5	1 2 3 4 5 DK
f. Increase institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
g. Increase mental health and substance abuse services to minority communities	1 2 3 4 5	1 2 3 4 5 DK

27. Thinking about the same goals, how much progress would you say the SAMHSA MFP has made in its contribution toward achieving those goals?

GOALS	Would you that the SAMHSA MFP has had: 1 = no influence on…. 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK
Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK
Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5 DK
Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK
Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK
Increasing mental health and substance abuse services to minority communities	1 2 3 4 5 DK

28. Overall, please rate the appropriateness of all of the goals in SAMHSA’s MFP.

Very Inappropriate………………..Very Appropriate

1 2 3 4 5

29. Please rate the degree to which the ANA/APA/ApA/CSWE MFP is engaged overall in addressing these goals.

Very Disengaged……………….Very Engaged

1 2 3 4 5

30. Please rate how adequate you think the following resources are for the MFP. Using a scale of 1 to 5, with 1 being too little and 5 being too much, please evaluate the amount of funding for…

Too Little…………………..….Too Much Not applicable

1. The Fellow’s stipend 1 2 3 4 5 NA

2. The amount available to reimburse tuition and fees 1 2 3 4 5 NA

3. The amount available in total for dissertation grants 1 2 3 4 5 NA

4. The amount available for individual travel awards to Fellows 1 2 3 4 5 NA

5. The amount available in total for travel awards to Fellows 1 2 3 4 5 NA

6. The amount of funding for the Summer Institute 1 2 3 4 5 NA

7. The amount of funding for the Winter Institute 1 2 3 4 5 NA

8. The amount of funding available to cover other items in the MFP budget:

i. _____________________________________ 1 2 3 4 5

ii. _____________________________________ 1 2 3 4 5

iii. _____________________________________ 1 2 3 4 5

31. On a scale of 1 to 5, please rate your MFP’s performance in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

31. On a scale of 1 to 5, with 1 being very unhelpful to 5 being very helpful, please rate the following resources provided by SAMHSA to the MFP. Note: please use “don’t know” (DK) if you have not been directly involved with these resources or “not applicable” (NA) if they are not available to your program.

Very Unhelpful………………………..Very Helpful

1. The direction provided by SAMHSA’s Project Officer 1 2 3 4 5 DK NA

2. The technical assistance provided through SAMHSA 1 2 3 4 5 DK NA

3. Other SAMHSA resources (please specify):

i. ______________________________________ 1 2 3 4 5

ii. ______________________________________ 1 2 3 4 5

iii. ______________________________________ 1 2 3 4 5

33. On a scale of 1 to 5 with 1 being very unhelpful and 5 being most helpful, please rate your experience with the following aspects of your MFP. Note: this question asks about your experience with your discipline specific (ANA, APA, ApA, or CSWE) MFP – not about the experience you had in your university, college, or residency training program. Please select “Not applicable” if you have no experience with that particular feature of the MFP:

Very Unhelpful………………Very Helpful Not Applicable

1. The clarity of requirements in the MFP program. 1 2 3 4 5

2. The stipend 1 2 3 4 5

3. Tuition reimbursement (from the ANA/APA/Apa/CSWE MFP) 1 2 3 4 5 NA

4. Travel grants 1 2 3 4 5 NA

5. Dissertation grants 1 2 3 4 5 NA

6. Accessibility of the MFP Director in the MFP Program 1 2 3 4 5

7. Guidance/feedback from the MFP Program about your

graduate work or psychiatric residency 1 2 3 4 5 NA

8. Feedback from your MFP program about

your dissertation 1 2 3 4 5 NA

9. Mentoring provided in the program 1 2 3 4 5 NA

10. The annual conference 1 2 3 4 5 NA

11. Summer Institute 1 2 3 4 5 NA

12. Winter Institute 1 2 3 4 5 NA

13. Other Seminars or opportunities to learn about the fields of

minority mental health and substance abuse 1 2 3 4 5 NA

14. Meeting other MFP students/residents 1 2 3 4 5 NA

15. Opportunities to network with other professionals in

minority mental health and substance abuse 1 2 3 4 5 NA

16. The MFP overall 1 2 3 4 5

1. What was most helpful to you as a Fellow?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

2. When you were a Fellow what would you most liked to have seen improved in the SAMHSA MFP?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

33. Have you received any reports on the SAMHSA MFP which have evaluated the performance of any of the four individual [ANA, ApA, APA, or CSWE] programs? ___ Yes ___ No

1. Can you please provide the name or other identifying information about that report and rate how helpful that report was to you, on a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful?

Title/Description Very Unhelpful…………………………..Very Helpful

i. ___________________________________________ 1 2 3 4 5

ii. ___________________________________________ 1 2 3 4 5

iii. ___________________________________________ 1 2 3 4 5

iv. ___________________________________________ 1 2 3 4 5

33. Overall, what difference has the SAMHSA MFP made for minority mental health and substance abuse services?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

36. Overall, what would you identify as the MFP’s most important contributions?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

36. Overall, what if anything, would you most like to see improved in the MFP?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

There are many different ways in which former Fellows have gone on to influence the fields of mental health and substance abuse treatment. The first section below asks you to consider various ways in which you have influenced the professional development of new cohorts of mental health and substance abuse professionals.

36. How many students/professionals have you encouraged to pursue careers in treating ethnic minorities for mental health and substance abuse issues? __________

    1. How many of these have been racial/ethnic minorities themselves? __________

36. How many students/professionals have you encouraged to pursue careers in researching ethnic minority mental health and substance abuse? __________

    1. How many of these have been racial/ethnic minorities themselves? __________

36. Have you encouraged [students /psychiatric residents] who were not already part of the MFP to apply to the program? ___ Yes ___ No

1. [If yes:] How many students have you encouraged to apply to SAMHSA’s MFP? ______

2. Did they apply to the program? ___ Yes ___ No ___ Don’t Know

3. How many were accepted? ________ ___ Don’t Know

4. In what capacity did you know these individuals (please indicate how many for each of the following)

___ As a professor

___ As a community member

___ Through family connections

___ As another type of mentor (please describe: ________________________________)

___ Through my role in the MFP Advisory Committee

___ Through another way (s)

Please describe: ___________________________________________________________

___________________________________________________________

5. To how many students have you provided a written reference for the MFP? __________

36. Since leaving in the Fellowship program, how many Fellows in the MFP have you mentored? __________

    1. In what capacity? Please indicate how many for each of following:

___ Through a mentorship relationship formally established by the MFP

___ As a faculty member in the Fellow’s training program

___ As a clinical supervisor or other type of clinical position connected to the Fellow’s

___ Through another type of relationship, please specify: ________________________

The next set of questions will ask about your experiences in mentoring outside of the MFP. The questions will ask you to consider your relationships with students as well as other professionals – both in mental health/substance abuse treatment and in research.

36. Have you mentored other students in mental health/substance abuse treatment (outside of the MFP)? ___ Yes ___ No

    1. If yes, how many have been Caucasian __________

       1. of these, how many have you mentored in ethnic minority issues in mental health/substance abuse __________

    2. How many have been ethnic/racial minorities __________

       1. of these, how many have you mentored in ethnic minority issues in mental health/substance abuse __________

37. Have you mentored other students in mental health/substance abuse research (outside of the MFP)? ___ Yes ___ No

    1. If yes, how many have been Caucasian __________

       1. of these, how many have you mentored in ethnic minority issues in mental health/substance abuse __________

    2. How many have been ethnic/racial minorities __________

       1. of these, how many have you mentored in ethnic minority issues in mental health/substance abuse __________

38. Have you mentored other professionals in mental health/substance abuse treatment (outside of the MFP)? ___ Yes ___ No

    1. If yes, how many have been Caucasian __________

       1. of these, how many have you mentored in ethnic minority issues in mental health/substance abuse __________

    2. How many have been ethnic/racial minorities __________

       1. of these, how many have you mentored in ethnic minority issues in mental health/substance abuse __________

The next set of questions asks you to reflect upon what you have accomplished in your professional life since leaving the MFP. While some of the questions may not apply to you, others will. At the end, we ask you if we have overlooked anything so that you may more fully tell us about your professional contributions.

36. Since being in the Fellowship program, can you please summarize your work history? In which of the following contexts have you worked and for how many years?

Context	Please list position title(s)	Number of years	Was this: 1 = a public organization; 2 = a private for profit, or 3 = a private not for profit organization?	Did this organization serve 1 = primarily minority, 2 = primarily non-minority (Caucasian), or 3 = mixed (minority /non-minority) populations?	If 1 (primarily minority): Was this an Historically Black College or University (HBCU)
Academia	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3	___yes ___no ___yes ___no ___yes ___no
Hospitals	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Community-based Clinical Services (other than a hospital)	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Private Practice	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Human Services Administration	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Mental Health and or Substance Abuse Policy	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Research Organization	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Consumer or Family-Based Organization	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3
Other (please describe): a. _________________ b. _________________ c. _________________	a. b. c.	a. b. c.	1 2 3 1 2 3 1 2 3	1 2 3 1 2 3 1 2 3

36. Were any of these positions in rural or frontier areas? ___ Yes ___ No

    1. If yes, how long did you/have you worked in rural/frontier areas? __________ years

36. Since completing your Fellowship, which of the following have you done? (select all that apply)

    1. ___ Taught at a largely minority institution (including but not limited to Historically Black Colleges and Universities)

    2. ___ Provided community-based clinical services in minority communities

    3. ___ Provided clinical services to minorities in other settings

    4. ___ Administered human service programs in minority communities

    5. ___ Held a clinical position in a hospital or medical institution serving large minority populations

    6. ___ Worked on federal policies for ethnic and racial minorities in mental health and/or substance abuse

    7. ___ Worked on state policies for ethnic and racial minorities in mental health and/or substance abuse

    8. ___ Worked on local community policies for ethnic and racial minorities in mental health and/or substance abuse

    9. ___ Had articles published in peer-reviewed publications about mental health and/or substance abuse issues which affect ethnic and racial minorities

    10. ___ Researched mental health and substance abuse issues with a focus on the experiences of ethnic and racial minorities

    11. ___ Engaged in other types of service to minority communities. Please specify: ___________________________________

36. Have you supervised clinicians who provide services to those living in predominately minority communities? ___ Yes ___ No

    1. If yes, how many years? __________

    2. Number of clinicians on average per year? __________

36. As an MFP Fellow, were you obligated to fulfill the “payback requirement”? ___ Yes ___ No

If yes:

1. In your opinion, what were the benefits of having the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. In your opinion, what were the drawbacks or limitations of having the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

3. Was there any opposition to eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

4. In your opinion, what were the benefits of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

5. In your opinion, what were the drawbacks or limitations of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

6. If the payback requirement had not existed, how likely do you think it would have been that you worked in the type of setting in which you did to fulfill the requirement? Please rate the likelihood on a scale of 1 to 5 with 1 being very unlikely to 5 being very likely.

Very Unlikely ……………..…………….…. Very Likely

1 2 3 4 5

7. What percentage of the payback requirement have you fulfilled? __________

   1. If 100%: Have you changed jobs since fulfilling your payback requirement? ___ Yes ___ No

      1. If yes, after fulfilling the requirement, did you change your position to work in:

         1. ___ The private non-profit sector

         2. ___ The public sector

         3. ___ The private for-profit sector

      2. Please rank the reasons you had for changing positions after fulfilling the payback requirement (select only those which apply to you):

         1. ___ To work with a different population(s), please specify which: _________________

         2. ___ To work in a different part of the country

         3. ___ To have greater financial opportunities

         4. ___ To gain more responsibility

         5. ___ To gain more independence/professional autonomy

         6. ___ To acquire additional skills/training

         7. ___ Other, please specify: _________________________________________________

In the next section, you will be asked about other professional activities – outside of your job – in which you have participated since leaving the MFP.

36. Since being in the Fellowship program, have you served on the MFP Advisory Committee? ___ Yes ___ No

    1. If yes, how many years: __________

36. Since being in the Fellowship program, have you served on the MFP Selection Committee? ___ Yes ___ No

    1. If yes, how many years: __________

36. Since being in the Fellowship program, have you served on a SAMHSA Review Group? ___ Yes ___ No

    1. If yes, how many times? __________

36. Since being in the Fellowship program, have you served on other federal groups? ___ Yes ___ No

Please list the titles and active dates of those groups.

Title of group Number of years participating

1. ____________________________________________________ ________________________

2. ____________________________________________________ ________________________

3. ____________________________________________________ ________________________

4. ____________________________________________________ ________________________

36. Since leaving the MFP, have you published any articles in peer-reviewed journals? ___ Yes ___ No

If yes:

1. How many articles have you published? _______________

2. How many articles have focused on minority mental health and/or substance abuse?_______

3. So that we may code additional information about your contributions to the field, without linking your identity to this survey, please e-mail (or send a hardcopy of) your current CV to:

Teresita Comacho-Gonsalves, PhD

Human Services Research Institute

2336 Massachusetts Avenue

Cambridge, MA 02140

[email protected]

36. Have you published books on minority-related issues in mental health and/or substance abuse? ___ Yes ___ No

    1. If yes: How many books? ______________

    2. How many Book chapters? _____________

36. Have you sat on the boards of any community-based organizations primarily serving minority populations? ___ Yes ___ No

    1. If yes, please indicate if this organization/ these organizations focused on (check all that apply):

___ Mental health ___ Substance abuse ___ Other area, please specify: ___________________________

2. How many years (total) have you sat on this board/these boards: __________

3. Did you take on any of the following leadership roles:

   1. ___ President

   2. ___ Vice President

   3. ___ Chair or Co-Chair

   4. ___ Secretary

   5. ___ Other, please specify: _______________________________

36. Since leaving the MFP, have you belonged to any professional associations? ___ Yes ___ No

1. If yes, please list which ones and include any offices and membership in active subcommittees, task forces, or other working groups (do not include division members which do not require active participation).

Offices held (e.g. President,

Professional Association VP, Secretary, Chair) / years ) .

2. _____________________________ (a) ______________/_________ ______________/_________ ___________________________________

3. ______________/_________ ___________________________________

2. _____________________________ (a) ______________/_________ ___________________________________

   2. ______________/_________ ___________________________________

   3. ______________/_________ ___________________________________

36. Since leaving the MFP as a Fellow, have you been in a professional position where you know that you have broadened the exposure of non-minorities (Caucasians) to professionals from ethnic and racial minority backgrounds?

1. ___ Yes, please provide a brief description: __________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

2. ___ No

36. Since leaving the MFP as a Fellow, have you made other contributions to the fields of minority mental health and substance abuse treatment which you would like to share?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

1. In what ways do you believe the MFP helped you to realize these accomplishments?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

Could you please tell us a little bit about your background?

60. Are you ___ male or ___ female?

61. How old were you when you first became an MFP Fellow? _____

62. Which of the following would best characterize the type of community in which you grew up (if more than one, please select the one which was most influential)

1. ___ Urban c) ___ Rural

2. ___ Suburban d) ___ Frontier area

63. Which of the following would best characterize the type of community in which you have professionally practiced (if more than one, please select the one in which you have practiced the longest)

    1. ___ Urban c) ___ Rural

    2. ___ Suburban d) ___ Frontier area

64. Do you consider yourself Hispanic/Latino? __ Yes ___ No

65. Which of the following describes your racial background [note: participant may select all that apply]:

_____ American Indian or Alaska Native

_____ Asian

_____ Black or African American

_____ Native Hawaiian or Other Pacific Islander

_____ White

64. Is there anything else which you would like to tell us about your experience with the MFP?

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Thank you for participating in this survey – we appreciate you sharing your experiences with the MFP and beyond with us!

Attachment C

Survey: Current and former members of

Selection and Advisory Committees

A

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bottom of this page

DVISORY COMMITTEE

1. In which SAMHSA Minority Fellowship Program (MFP) have you participated as an Advisory Committee Member?

   1. ___ American Nurses Association

   2. ___ American Psychiatric Association

   3. ___ American Psychological Association

   4. ___ Council on Social Work Education

2. On a scale of 1 to 5, with 1 being very unfamiliar to 5 being very familiar, how familiar are you with the MFP sponsored by SAMHSA?

Very Unfamiliar………………………………Very Familiar

1 2 3 4 5

3. Were you an MFP Fellow yourself? ___ Yes ___ No

   1. If yes: in what years did you receive a SAMHSA MFP Fellowship? ______ to ______ for a total of ___ years

   2. In which MFP program was your fellowship? ___ ANA ___ ApA ___ APA ___CSWE

4. When did you first become a member of the Advisory Committee? ______

5. How long have you been (or were you) a member of the Advisory Committee? ______ years

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 90 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

6. Which of the following best describes your area of expertise during the most recent time you were on the Advisory Committee?

   1. ___ Mental health

   2. ___ Substance abuse

   3. ___ Co-occurring disorders

   4. ___ Other, please specify: _________________________________________

Please consider your experiences during the time you were an Advisory Committee member when answering the remaining questions on this survey.

7. Which of the following best describes the professional context in which you work (or worked) during the time you have been (or were) on the Advisory Committee?

   1. ___ Academia

   2. ___ Hospital

   3. ___ Community-based clinical service (other than a hospital)

   4. ___ Private practice

   5. ___ Human services administration

   6. ___ Mental health and/or substance abuse policy

   7. ___ Research organization

   8. ___ Consumer- and family-based organization

   9. ___ Military

   10. ___ Other, please specify: ___________________________________

8. How often does the Advisory Committee meet?

   1. ___ Once a year: number of hours ___

   2. ___ Twice a year: number of hours (total) ___

   3. ___ Three times a year: number of hours (total) ___

   4. ___ Quarterly (4 times a year): number of hours (total) ___

   5. ___ Other: ___ number of times per year for ___ hours total

9. The next question will ask you about your involvement in specific activities. First, however, in thinking about your overall involvement in the MFP, what is the role of the Advisory Committee for the grantee’s MFP? Are Advisory Committee members …

   1. ___ Apprised of decisions

   2. ___ Consulted about programmatic decisions

   3. ___ Actively involved in making decisions

   4. ___ Other, please describe: _____________________________________

10. Please identify in which areas the Advisory Committee participates and evaluate how actively the Committee participates on a scale of 1 to 5 with 1 being very inactive to 5 being very active. Please select “don’t know” (DK) if you do not know.

		If yes: Very Inactive……………Very Active DK
In identifying goals for the MFP	___ Yes ___ No	1 2 3 4 5 DK
In selecting new Fellows	___ Yes ___ No	1 2 3 4 5 DK
In selecting returning Fellows	___ Yes ___ No	1 2 3 4 5 DK
In designing programs to support the Fellows	___ Yes ___ No	1 2 3 4 5 DK
In improving the performance of the ANA/ APA/ApA/CSWE MFP	___ Yes ___ No	1 2 3 4 5 DK
Other, please specify: _______________________	___ Yes ___ No	1 2 3 4 5 DK

11. Have you participated in any events or activities held by the ANA/APA/ApA/CSWE MFP to facilitate job searches and professional development of ethnic/racial minorities into the mental health and substance abuse professions?

___ Yes ___No

1. If yes, what event or activity was this? ___________________________________________________

2. When was the most recent time you participated? __________________________________________

3. What role did you play in that event or activity (check all that apply):

1. ___ I helped organize the event/activity through my professional affiliation with an organization other than the MFP

2. ___ I attended as an official representative of the ANA/APA/ApA/CSWE MFP

3. ___ I made a presentation or offered a seminar at one of the sessions

4. ___ I attended the event/activity out of personal interest

5. ___ Other, please specify: ________________________________________________________

12. Have you encouraged students (or psychiatric residents) who were not already part of the SAMHSA MFP to apply to the program? ___ Yes ___No

1. If yes: How many students have you encouraged to apply to SAMHSA’s MFP? ______

2. Did they apply to the program? ___ Yes ___ No ___Don’t Know

3. How many were accepted? ______ ___ Don’t Know

13. How many times during the year (on average) did you or have you spoken directly to someone in your discipline’s MFP office? ______

1. How many times during the year (on average) have you initiated the contact? ______

2. How many times during the year (on average) has someone from the MFP office contacted you? ______

3. How many times during the year (on average) do you meet in person with someone from the MFP office? ______

4. What has been (was) the purpose of the contact? (check all that apply)

1. ___ To discuss new regulations in the SAMHSA MFP

2. ___ To discuss new goals selected by my discipline’s MFP

3. ___ To answer questions that I have about the program

4. ___ To discuss suggestions that I have about the program, please specify: __________________________________

5. ___ Other, please specify: ________________________________________________________________________

14. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful would you say that your interaction with the ANA/APA/ApA/CSWE MFP office has been?

Very Unhelpful ……………………..……… Very Helpful

1 2 3 4 5 Not Applicable

15. Have you collaborated with the ANA/APA/ApA/CSWE MFP or its Fellows in any other way (outside of the activities we just spoke about)? ___ Yes ___ No

1. [If yes] What event or activity was this? ________________________________________________________________

16. Is the Advisory Committees involved in making decisions about which applicants are selected as Fellows? ___ Yes ___ No (If no, please skip to: Question 26)

1. If yes: who is included in making decisions about selecting the Fellows? (Check all that apply)

   1. ___ Advisory Committee members

   2. ___ MFP Project Directors/staff (from your discipline’s office)

   3. ___ Current Fellows

   4. ___ Other, please specify: ________________________________________________________________________

17. Are the selection criteria ___ formal (i.e. written) or ___ informal (i.e. unwritten)?

18. What are the selection criteria? (please check all that apply and rank each of these in order of importance in terms of how decisions are actually made, with 1 being most important, etc.)

Rank (1 = most important, etc)

1. ___ GPA _____

2. ___ Graduate school test scores _____

3. ___ Quality of references _____

4. ___ Appropriateness of career interests _____

5. ___ Balance in the minority background of the current

MFP cohort _____

6. ___ Relevant work experience _____

7. ___ Other, please specify: _____________________ _____

19. Are the same criteria applied to every applicant in the exact same manner? ___Yes ___No

1. If no: if there is discretion, who has authority to exert that discretion? (Select all that apply)

1. ___ Advisory Committee members

2. ___ MFP Project Directors/staff (in your discipline’s office)

3. ___ Other, please specify: ____________________________________________________________________

2. In your time on the Advisory Committee, has such discretion been exercised? ___ Yes ___ No ___DK

3. If yes: please describe briefly the circumstances under which discretion has been exercised in selecting new applicants.

______________________________________________________________________________________________

20. Is there a formal application packet for renewing the Fellowship? ___Yes ___No

21. What materials do Fellows submit to be reconsidered for subsequent years’ funding? Please check all that apply)

1. ___ Official transcript

2. ___ References from professors, department chairs or training directors

3. ___ Dissertation proposal (when written)

4. ___ Application form designed by the MFP

5. ___ Other, please specify: _________________________________________

22. Are the selection criteria for renewal applications ___ formal (i.e. written) or ___ informal (i.e. unwritten)?

23. What are the selection criteria for renewal applications? (Please check all that apply and rank the criteria in order of importance with 1 being most important, etc.)

Rank (1 = most important, etc)

1. ___ GPA _____

2. ___ Quality of references _____

3. ___ Progress in the program _____

4. ___ Participation in professional activities _____

5. ___ Appropriateness of career interests _____

6. ___ Balance in the minority background of the

current MFP cohort _____

7. ___ Other, please specify: _________________ _____

24. Are the same criteria applied to every renewal applicant in the exact same manner? ___Yes ___No

1. If no: if there is discretion, who has authority to exert that discretion? (Select all that apply)

1. ___ Advisory Committee members

2. ___ MFP Project Directors/staff (in your discipline’s office)

3. ___ Other, please specify: ____________________________________________________________________

2. In your time on the Advisory Committee, has such discretion been exercised in selecting renewal applications?

___ Yes ___ No ___DK

3. If yes: please describe briefly the circumstances under which discretion has been exercised.

______________________________________________________________________________________________

______________________________________________________________________________________________

The next set of questions will ask you to assess SAMHSA’s MFP, as administered by the [ANA/APA/ApA/CSWE] during the time you have been familiar with the program.

25. SAMHSA began administering this program in 1992. In which years have you been directly familiar with the [ANA/APA/ApA/CSWE] MFP? _______ (year) to _______ (year)

26. Please consider the following goals contained in SAMHSA’s MFP. Then evaluate how appropriate you think those goals are for the MFP; and finally rate the degree to which the ANA’s/APA’s/ApA’s/CSWE’s program has been engaged in addressing those goals during the time in which you have been familiar with the program. (Use “don’t know” (DK) if you do not have direct experience with the way in which the program addresses specific goals.)

GOALS	Appropriateness of Goals 1 = very inappropriate to 5 = very appropriate	Degree to which the Program is engaged in addressing the Goals 1 = very disengaged to 5 = very engaged
a. Develop new cohorts of Fellows	1 2 3 4 5	1 2 3 4 5 DK
b. Train/mentor ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
c. Increase the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
d. Increase diversity in mental health/substance abuse leadership	1 2 3 4 5	1 2 3 4 5 DK
e. Increase professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5	1 2 3 4 5 DK
f. Increase institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
g. Increase mental health and substance abuse services to minority communities	1 2 3 4 5	1 2 3 4 5 DK

27. Thinking about the same goals, how much progress overall would you say the SAMHSA MFP has made in all the discipline toward achieving these goals:

GOALS	Would you that the SAMHSA MFP has had: 1 = no influence on…. 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK
Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK
Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5 DK
Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK
Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK
Increasing mental health and substance abuse services to minority communities	1 2 3 4 5 DK

28. Overall, please rate the appropriateness of all of the goals in SAMHSA’s MFP.

Very Inappropriate…………………………..Very Appropriate

1 2 3 4 5

29. Please rate the degree to which the ANA/APA/ApA/CSWE MFP is engaged overall in addressing these goals.

Very Disengaged…………………………..Very Engaged

1 2 3 4 5

30. On a scale of 1 to 5, please rate the MFP’s performance, overall (that is, across all four grantee programs), in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

31. Please rate how adequate you think the following resources are for the SAMHSA MFP in your discipline. Using a scale of 1 to 5, with 1 being too little and 5 being too much, please evaluate the amount of funding for…

Too Little…………….Too Much Not Applicable

1. The Fellow’s stipend 1 2 3 4 5

2. The amount available for tuition and fees 1 2 3 4 5 NA

3. The amount available for individual dissertation grants 1 2 3 4 5 NA

4. The amount available in total for dissertation grants 1 2 3 4 5 NA

5. The amount available for individual travel awards to Fellows 1 2 3 4 5 NA

6. The amount available in total for travel awards to Fellows 1 2 3 4 5 NA

7. The amount of funding for the Summer Institute 1 2 3 4 5 NA

8. The amount of funding for the Winter Institute 1 2 3 4 5 NA

9. The amount of funding for the ANA/APA/ApA/CSWE

Director’s salary 1 2 3 4 5

10. The amount of funding for other MFP salaries in the

ANA/APA/ApA/CSWE 1 2 3 4 5

11. The amount of funding available to cover other MFP activities:

1. _____________________________________________ 1 2 3 4 5

2. _____________________________________________ 1 2 3 4 5

3. _____________________________________________ 1 2 3 4 5

32. Were you working with the [ANA/APA/ApA/CSWE]’s MFP during the time in which the payback requirement was active?

___ Yes ___ No ___Don’t Know

If yes:

1. In your opinion, what were the benefits of the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. In your opinion, what were the drawbacks or limitations of the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

3. In your opinion, what were the benefits of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

4. In your opinion, what were the drawbacks or limitations of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

33. On a scale of 1 to 5 with 1 being very unhelpful to 5 being very helpful please rate the following resources provided by SAMHSA to the MFP. Note: please use “don’t know” (DK) if you have not been directly involved with these resources or “not applicable” (NA) or if they are not available to the program.

Very Unhelpful…….Very Helpful

1. The direction provided by SAMHSA’s Project Officer 1 2 3 4 5 DK NA

2. The technical assistance provided through SAMHSA 1 2 3 4 5 DK NA

3. Other SAMHSA resources (please specify):

   1. ______________________________________ 1 2 3 4 5 DK NA

   2. ______________________________________ 1 2 3 4 5 DK NA

   3. ______________________________________ 1 2 3 4 5 DK NA

34. On a scale of 1 to 5 with 1 being very unhelpful and 5 being most helpful, please rate in your experience, how helpful each of the following aspects of the ANA, APA,ApA or CSWE) MFP has been for the Fellows. Please select “Not applicable” if you have no experience with that particular feature of the MFP:

Very Unhelpful…..Very Helpful Not Applicable

1. The clarity of requirements in the MFP program. 1 2 3 4 5 NA

2. The stipend 1 2 3 4 5

3. Tuition and fees paid for by the MFP 1 2 3 4 5 NA

4. Travel grants 1 2 3 4 5 NA

5. Dissertation grants 1 2 3 4 5 NA

6. Accessibility of the MFP Director in the MFP Program 1 2 3 4 5 NA

7. Feedback from the MFP Program about the student’s

graduate work 1 2 3 4 5 NA

8. Feedback from the MFP about the student’s dissertation 1 2 3 4 5 NA

9. The way the mentoring program is organized 1 2 3 4 5 NA

10. The annual conference 1 2 3 4 5 NA

11. Summer Institute 1 2 3 4 5 NA

12. Winter Institute 1 2 3 4 5 NA

13. Other Seminars or opportunities to learn about the fields of

minority mental health and substance abuse. 1 2 3 4 5 NA

14. Meeting other MFP students/residents 1 2 3 4 5 NA

15. Opportunities to network with other professionals in

minority mental health and substance abuse. 1 2 3 4 5 NA

16. The MFP overall 1 2 3 4 5

35. Have you received any reports on the SAMHSA MFP which have evaluated the performance of the ANA/APA/ApA/CSWE program? ___ Yes ___ No (Skip to Question 40)

1. Can you please provide the name or other identifying information about that report and rate how helpful that report was to you, on a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful?

Title/Description Very Unhelpful……………………………..Very Helpful

i. ___________________________________________ 1 2 3 4 5

ii. ___________________________________________ 1 2 3 4 5

iii. ___________________________________________ 1 2 3 4 5

iv. ___________________________________________ 1 2 3 4 5

36. Did any of these evaluations identify areas for improvement? ___ Yes ___ No ___ DK

    1. If yes, what areas were identified for improvement?

i. _________________________________________________________

ii. _________________________________________________________

iii. _________________________________________________________

37. Since the time the program was first evaluated, has that performance been re-assessed? ___ Yes ___ No ___ DK

    1. Has performance improved? ___ Yes ___ No ___ DK

    2. In which, if any, of the areas you identified was there improvement?

i. _________________________________________________________

ii. _________________________________________________________

iii. _________________________________________________________

38. Overall, what difference has the SAMHSA MFP made for minority mental health and substance abuse services?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

39. Overall, what would you identify as the MFP’s most important contributions?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

1. In your experience as an Advisory Committee member in the ANA/APA/ApA/CSWE MFP, what do you believe has been the most helpful to the Fellows?

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

40. Overall, what if anything, would you most like to see improved in the MFP?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

Could you please tell us a little bit about your background?

41. Are you ___ male or ___ female?

42. Are you of Hispanic/Latino background/ethnicity? ___ Yes ___ No

43. Which of the following describes your ethnic/racial background [Note: participant may select all that apply]:

___ American Indian or Alaska Native

___ Asian

___ Black or African American

___ Native Hawaiian or Other Pacific Islander

___ White

44. Is there anything else which you would like to tell us about your experience with the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Thank you for participating in this survey and sharing your experiences as an Advisory Committee Member

in the SAMHSA Minority Fellowship Program with us!

Attachment D

Interview protocol: Current and former SAMHSA MFP Staff and other SAMHSA officials involved in the MFP

(Pre-interview form also included)

S

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bottom of this page

AMHSA SENIOR STAFF (telephone administration)

Note: Participants will be asked a subset of these questions, relevant to their involvement in the MFP. Questions which collect factual information will be asked once.

As you know, in this interview, I will be asking you questions about the Minority Fellowship Program sponsored by your agency.

1. What is the title of your position? ________________________________________________

2. When were you employed in this position at SAMHSA? ______ to _____________

   1. If you have been employed in other SAMHSA positions which worked on the MFP, what positions were these and when did you hold them?

Position Years

__________________________________________ ____________

__________________________________________ ____________

__________________________________________ ____________

3. In which of SAMHSA’s agencies are you located? ___ CMHS ___ CSAP ___ CSAT

4. Can you briefly describe what it is that you do in your role as [refer to question 1] in the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

5. Which of the grantees do you oversee in the MFP? (check all that apply)

___ American Nurses Association ___ American Psychiatric Association

___ American Psychological Association ___ Council on Social Work Education

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 120 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

6. To whom do you report to (for the Minority Fellowship Program)? ________________________________________________________________________________

7. Are there other staff in [CMHS, CSAP, CSAT – see question 3] who also work on the MFP? ___ Yes ___ No

   1. [If yes:] what positions are these? _______________________________________________________________________

______________________________________________________________________________________________________

8. On a scale of 1 to 5 with 1 being extremely inadequate to 5 being extremely adequate, how adequate is the current level of SAMHSA staffing for supporting the MFP?

Very Inadequate…………………Very Adequate

1 2 3 4 5

9. Now in thinking about larger staff meetings you have within your Division at [CMHS/ CSAT/ CSAP]

a) [Ask only of the Project Officers:] How often are staff meetings held?	b) [For everyone:] In an average year, how often would you say you attend these staff meetings?
___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: __________________________________	___ Every week ___ 2-3 times per month ___ Once a monthly ___ Once every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: __________________________________

3. During the last year, how many times have you discussed the MFP during these meetings? __________________________

4. What issues have you discussed?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

10. [If the participant is a Project Officer:] Do you have regularly scheduled meetings, one-on-one with your supervisor to discuss the MFP?

___ Yes ___ No

If yes:

If no:

How often do you regularly meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: ______________________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings?

a) During an average year, how often is it that you discuss the MFP with your supervisor during other types of meetings? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Never ___ Other, specify: _______________________________ b) Are these __ in person meetings or __ telephone conferences? c) What do you discuss during those meetings?

11. [For Senior MFP staff:] Do you have regularly scheduled meetings, with senior SAMHSA officials to discuss the MFP?

___ Yes ___ No

If yes:
With whom? (person # 1) _________ How often do you meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: _________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings? _______________________________ ______________________________ _______________________________	(person # 2) _________ How often do you meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: ________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings? _______________________________ _______________________________ _______________________________	(person # 3) _________ How often do you meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: _________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings? _______________________________ _______________________________ _______________________________

12. [For Senior MFP staff:] Do you have regularly scheduled meetings, with DHHS officials, other than those in SAMHSA, to discuss the MFP?

___ Yes ___ No

If yes:
With whom? (person # 1) _________ How often do you meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: _________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings? _______________________________ ______________________________ _______________________________	(person # 2) _________ How often do you meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: ________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings? _______________________________ _______________________________ _______________________________	(person # 3) _________ How often do you meet? ___ Weekly ___ 2-3 times per month ___ Monthly ___ Every other month ___ Quarterly ___ 2-3 times per year ___ Once per year ___ Other, specify: _________________ Are these __ in person meetings or __ telephone conferences? What do you discuss during those meetings? _______________________________ _______________________________ _______________________________

SAMHSA RESOURCES

The next series of questions will ask about different ways that SAMHSA supports the MFP including the way it has structured the grant program and the priorities it has identified. I will also ask you about the RFAs which SAMHSA issues, as well as about the grant review process, and any site visits or technical assistance you may offer.

STRUCTURE OF THE GRANT PROGRAM

13. When SAMHSA funded the MFP, it decided to structure the program as a grant program rather than as a cooperative agreement or a contract. Why did SAMHSA choose this funding mechanism?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

14. In your experience, are there any federal regulations or policies which limit the ability of SAMHSA to oversee the MFP?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

15. In your experience, have there been any federal regulations or policies which limit the ability of the grantees to implement their programs?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

PRIORITIES

16. Thinking about the programmatic priorities which SAMHSA has identified for the entire agency (that is throughout SAMHSA), could you please tell me which have been explicitly included in the MFP?

1.______________________________________________________________________________________________________

2.______________________________________________________________________________________________________

3.______________________________________________________________________________________________________

4.______________________________________________________________________________________________________

Probes:

1. How, if at all, have consumer and family interests and involvement been included in the priorities for the MFP?

2. How, if at all, have issues related to substance abuse as well as mental health been included in SAMHSA’s priorities for the MFP?

3. How, if at all, have Evidenced Based Practices (EBPs) been included in SAMHSA’s priorities for the MFP?

4. How, if at all, has recovery been included in SAMHSA’s priorities for the MFP?

17. What goals has SAMHSA prioritized for the MFP?

1.______________________________________________________________________________________________________

2.______________________________________________________________________________________________________

3.______________________________________________________________________________________________________

4.______________________________________________________________________________________________________

1. Have these changed during the time you have worked on the MFP? ___ Yes ___ No

2. If yes: In what ways?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

18. In what ways have SAMHSA’s Program Priorities furthered the implementation of the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

19. In what ways have these priorities limited the implementation of the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

PROGRAM GUIDANCE

20. In designing the RFA for grantees, in what ways did SAMHSA intend to shape the programs proposed by the grantees?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

21. Thinking about the latest Program Guidance (from 2008), on a scale of 1 to 5, with 1 being very unclear to 5 being very clear, please assess how unclearly or clearly you believe the Program Guidance has expressed the goals which SAMHSA has for the MFP.

Very Unclear……………………..Very Clear

1 2 3 4 5

Comments: _____________________________________________________________________________________________

_______________________________________________________________________________________________________

22. Thinking about the latest Program Guidance (from 2008), on a scale of 1 to 5, with 1 being very unclear to 5 being very clear, please assess how unclearly or clearly you believe the Program Guidance outlined the criteria by which the grantee programs would be evaluated.

Very Unclear……………………..Very Clear

1 2 3 4 5

Comments: _____________________________________________________________________________________________

_______________________________________________________________________________________________________

23. How, if at all, have the criteria changed over the years you have worked on the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

GRANTS MANAGEMENT

Now in thinking about the grant review process, there are two stages of review: the peer review and the National Advisory Council.

24. How many people are on the peer review group? _________

25. In the peer review process of the MFP grant applications, are members of the review group ____ SAMHSA employees or _____ other external experts? (check all that apply)

    1. If SAMHSA: What positions do the SAMHSA employees hold within SAMHSA?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

26. How much continuity has there been in the membership of SAMHSA’s peer review group for the MFP over the 15 years it has operated the program?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

1. The RFAs for the grantees list general evaluation criteria. Are there additional and more specific evaluation criteria which the reviewers use? ____ Yes ___ No

1. If yes, is that: ___ formal (written) or ___ informal (not written)?

1. Is there a pre-set minimum score which grantees must meet to be funded? ___ Yes ___ No

Comments: _____________________________________________________________________________________________

_______________________________________________________________________________________________________

28. Does SAMHSA use any tracking mechanisms to track reviewers’ comments from previous grant cycles to see whether and how grantees have addressed those comments? ___ Yes ___ No

    1. What type of tracking mechanism do you use?

___ Manual review of prior applications

___ Electronic database

___ Other: _________________________________________________________________________________________

Comments: _____________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

29. In thinking of the grant review process, in your experience, what concrete changes have you seen each of the grantees make to their programs as a result of the grant review process? (Probe for which program(s) and when)

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

30. How did SAMHSA make the decision to limit grant applicants to the 4 professional disciplines for the first 15 years, and now the current 5 professions?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. Were other disciplines considered? ___ Yes ___ No

2. If yes: When did SAMHSA consider these professions? ______________________________________________________

3. What other professions were these? ______________________________________________________________________

___________________________________________________________________________________________________

4. What considerations led SAMHSA to not include these professions in the final grantee pool?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

31. In what ways has having the four professional associations – the ANA, APA, ApA & CSWE - administer the SAMHSA MFP been beneficial?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. What has been the most important benefit?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

32. In what ways has having the four professional associations – the ANA, APA, ApA & CSWE - administer the SAMHSA MFP presented challenges?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. What has been the most challenging?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

33. Have there been particular issues or decisions on which the grantees and their host organization (the ANA, APA, ApA, or CSWE) have had difficulty seeing eye-to-eye?

___ Yes ___ No ___ Don’t Know

If yes: (use additional grids as necessary)

	Issue #1	Issue #2	Issue #3
Which organization?
What was the issue?
Was the issue resolved?
How was it resolved?

34. The RFAs have required grantees to send two MFP staff members (including the Project Director) to attend one joint grantee meeting in the DC area for 2 to 3 days.

1. Have these meetings happened each year? ___ Yes ___No

   1. If no: why not? _______________________________________________________________________

____________________________________________________________________________________

2. If yes: beginning in which year? _____________

1. What has been most beneficial about these meetings?

______________________________________________________________________________________________

______________________________________________________________________________________________

3. What has been most challenging?

______________________________________________________________________________________________

______________________________________________________________________________________________

SITE VISITS

35. Turning now to other monitoring activities, does SAMHSA conduct in-person site visits with the grantees? ___ Yes ___ No

    1. How many site monitoring visits has SAMHSA made to any of the grantee programs in the last 2 years? _____________

(use additional grids as necessary)

If site visits occurred: a) When did they occur? (years)	Visit 1	Visit 2	Visit 3
b) Which grantee(s) was/were visited?
c) Which SAMHSA divisions participated?
d) What was the purpose of the site monitoring visit?
e) Did SAMHSA produce a report for the grantees detailing the site visit?
f) What, if any, concrete changes have the grantees made in the way they operate the MFP as a result of this visit?
g) What, if any, concrete changes has SAMHSA made in the way you operate the MFP as a result of this visit?

36. On a scale of 1 to 5, with 1 being very ineffective and 5 being very effective, overall how effective are the site visits?

Very Ineffective………………………………Very Effective

1 2 3 4 5

1. What is most helpful about the site visits?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. What would you most like to see improved about the site visits?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

TECHNICAL ASSISTANCE

Now in thinking about technical assistance…

37. Have any of the Minority Fellowship Programs requested any technical assistance from SAMHSA over the past 2years?

___ Yes ___ No ___ Don’t Know (DK)

[Note: this does not include answering questions about grant applications, reports or budgets.]

	TA Request #1	TA Request #2	TA Request #3	TA Request #4
On what topic or issue did grantees request TA?
When was it requested? (year)
Which grantee requested TA?
Did SAMHSA provide TA?	____ Yes _____ No ____ DK	____ Yes _____ No ____ DK	____ Yes _____ No ____ DK	____ Yes _____ No ____ DK
Which SAMHSA divisions participated?
Who provided the TA? (e.g.: SAMHSA, name of external contractor)
On what topic or issue was TA provided?
How many hours of TA were provided?
Did the TA target a particular priority area identified by SAMHSA? If yes: which?
In what way(s) could the TA have been improved?

38. Outside of the grant review process, how often does someone from the SAMHSA MFP contact each of the Program Directors in:

(Frequency)	For what reason(s)?
Nursing? Psychiatry? Psychology? Social Work?

39. How often does someone from the SAMHSA MFP meet with current Fellows in:

(Frequency)	In what context(s)? (e.g. at annual meetings of the MFP; at other professional meetings; through one-on-one contacts (e-mail, telephone, in-person); other)
Nursing? Psychiatry? Psychology? Social Work?

40. For the first time, in December 2003, SAMHSA sponsored a National Conference which included all four grantees.

41. Has SAMHSA considered hosting another conference of this type? (Probe: for what reasons has another conference not been held?)

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

42. Are there regular and recurring tasks or activities which SAMHSA’s MFP Program staff members undertake to ensure that the MFP continues? ___ Yes ___ No

a) If yes: What are these?	b) Who participates?	c) How often (in a year) do these tasks or activities occur?	d) Have these tasks/activities always been included in the SAMHSA MFP? When were they first included?
1. 2. 3.

REPORTING

43. How long have the current GPRA measures as listed in the 2008 grant announcement been used in the MFP?

Comments:______________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Note to interviewer: These are the measures as contained in the 2008 RFA (for the last 10 years):

Employment of past fellows: types of jobs esp those related to MHAS to underserved populations, public/private locations, other professional activities, etc.

Attrition of students: reported by year, sex and ethnicity – number admitted to the program, graduated, terminated before graduation, still in training, and disabled. Also historical attrition rate is required.

Current Fellows by ethnicity and gender (currently admitted and those still in training)

Evaluation of the Program (plan required)

1. What process was used to identify those measures?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

44. The RFA requires that SAMHSA provide grantees with a schedule for submitting (GPRA) data prior to awarding the grant funds. For the most recent grant award (that is for FY 2008), has SAMHSA established a GPRA reporting schedule with each of the grantees?

    1. ANA ___ Yes ___ No ___ Don’t Know

    2. APA ___ Yes ___ No ___ Don’t Know

    3. ApA ___ Yes ___ No ___ Don’t Know

    4. CSWE ___ Yes ___ No ___ Don’t Know

45. In the most recently completed fiscal year, did each of the grantees report their GPRA data by the date(s) required?

    1. ANA ___ Yes ___ No ___ Don’t Know

    2. APA ___ Yes ___ No ___ Don’t Know

    3. ApA ___ Yes ___ No ___ Don’t Know

    4. CSWE ___ Yes ___ No ___ Don’t Know

46. What barriers have grantees experienced in collecting and reporting GPRA data?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

47. Do grantees have more difficulty reporting on some of the measures than others? ___ Yes ___ No ___ Don’t Know

    1. If yes: Which measures are those and what are the difficulties?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

48. In what ways have the GPRA data been most useful to SAMHSA?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

1. Does SAMHSA use the GPRA data it receives from the grantees to put together reports on the entire MFP?

___ Yes ___ No ___ Don’t Know

Comments/ If yes: “what reports are those”? “How often are they produced?” ___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. In what ways have the GPRA data not been useful to SAMHSA?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

49. How have the GPRA data been used by the grantees? That is, in what ways has it been useful to them?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

50. During the past 3 years of the SAMHSA MFP, have you provided feedback to any of the grantees on any of the following types of reports they have provided to SAMHSA?

	Which grantee(s)	How often?	Is feedback provided: in person; on the telephone; or through a written report?
Grant applications __Yes __ No Annual Progress Reports __Yes __ No Any Special reports (record below) _________________________________ _________________________________ _________________________________	ANA APA ApA CSWE ANA APA ApA CSWE ANA APA ApA CSWE ANA APA ApA CSWE ANA APA ApA CSWE

51. One of the requirements of the MFP has been that the grantees routinely monitor their program’s performance. On a scale of 1 to 5 with 1 being very inadequate and 5 being very adequate, please rate the adequacy of the evaluation plans submitted by each of the grantees stating how they will monitor their program’s performance.

	a) ANA	b) APA	c) ApA	d) CSWE
	1 2 3 4 5	1 2 3 4 5	1 2 3 4 5	1 2 3 4 5
i) If 1 or 2: what were the weakest aspects of their evaluation plans? ii) If 4 or 5: what were the strongest aspects of their evaluation plans?

52. On a scale of 1 to 5 with 1 being very inadequate and 5 being very adequate, please rate the adequacy of the actual evaluation activities actually conducted by the four grantees

	a) ANA	b) APA	c) ApA	d) CSWE
	1 2 3 4 5	1 2 3 4 5	1 2 3 4 5	1 2 3 4 5
i) If 1 or 2: what were the weakest aspects of their evaluations? ii) If 4 or 5: what were the strongest aspects of their evaluations?

53. What reports has SAMHSA produced on the MFP? Can you please provide the name or other identifying information about that report/ those reports?

a) Title/Description	b) [Interviewer: Check which program]	c) What data (information) did the report use that was supplied by the Grantee?
i. _____________________________________________ ii. _____________________________________________ iii. _____________________________________________ iv. _____________________________________________	ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA

IMPLEMENTING THE MFP

The next set of questions will ask you to think about how the SAMHSA MFP has been administered in the grantee programs.

54. Were you working within SAMHSA’s MFP during the time in which the payback requirement was active?

___ Yes ___ No ___Don’t Know

If yes:

1. In your opinion, what were the benefits of having the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. In your opinion, what were the drawbacks or limitations of having the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

3. Why was the payback requirement eliminated? [What reasons were given for eliminating it?]

___________________________________________________________________________________________________

___________________________________________________________________________________________________

4. How was the payback requirement eliminated? [probe for process: who initiated/supported the effort; how long did it take to be recognized/enacted]

___________________________________________________________________________________________________

___________________________________________________________________________________________________

5. Did the elimination of the payback requirement occur along with other policy changes? That is, was the elimination part of other shifts in policy?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

6. Was there any opposition to eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

7. In your opinion, what were the benefits of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

8. In your opinion, what were the drawbacks or limitations of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

55. SAMHSA’s MFP has several goals. For each of the following, please tell me if that particular goal applies equally to all four grantees (ANA, APA, ApA, and CSWE) or it is more applicable to some.

a) Developing a new cohort of Fellows	ALL ANA APA ApA CSWE
b) Training/ mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	ALL ANA APA ApA CSWE
c) Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	ALL ANA APA ApA CSWE
d) Increasing diversity in mental health/substance abuse leadership	ALL ANA APA ApA CSWE
e) Increasing professional contributions in mental health/substance abuse treatment for minority populations	ALL ANA APA ApA CSWE
f) Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	ALL ANA APA ApA CSWE
g) Increasing mental health and substance abuse services to minority communities	ALL ANA APA ApA CSWE

56. Overall, please rate the appropriateness of all of the goals in SAMHSA’s MFP. Would you say they are very inappropriate, somewhat inappropriate, neither inappropriate or appropriate, somewhat appropriate, or very appropriate:

Very Inappropriate…………………………..Very Appropriate Don’t Know

1 2 3 4 5 DK

Next, I will ask you to consider each of the grantee programs separately, starting first with the American Nurses Association, the ANA.

57. What, if any, barriers has the ANA encountered in implementing the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

[Probe:] what have been the most significant? (3 maximum)

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

58. In your experience, what, if anything, would you identify as the ANA’s most important contributions to the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

59. In your experience, what if anything, would you most like to see improved in the ANA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Next, think about the American Psychiatric Association, the ApA.

60. What, if any, barriers has the ApA encountered in implementing the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

[Probe:] what have been the most significant? (3 maximum)

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

61. In your experience, what, if anything, would you identify as the ApA’s most important contributions to the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

62. In your experience, what if anything, would you most like to see improved in the ApA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Now, in thinking about the American Psychological Association, the APA…

63. What, if any, barriers has the APA encountered in implementing the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

[Probe:] what have been the most significant? (3 maximum)

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

64. In your experience, what, if anything, would you identify as the APA’s most important contributions to the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

65. In your experience, what if anything, would you most like to see improved in the APA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Finally, please consider the Council on Social Work Education, the CSWE.

66. What, if any, barriers has the CSWE encountered in implementing the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

[Probe:] what have been the most significant? (3 maximum)

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

67. In your experience, what, if anything, would you identify as the CSWE’s most important contributions to the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

68. In your experience, what if anything, would you most like to see improved in the CSWE’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

69. In thinking about the SAMHSA MFP overall, which of its programmatic goals has SAMHSA had the most success addressing in the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

70. Overall, what, if anything, would you identify as the MFP’s most important contributions?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

71. Which of its programmatic goals has SAMHSA had the least success addressing in the MFP? Why?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

72. In your experience, what if anything, would you most like to see improved in the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

73. As you know, this will be the first time that SAMHSA’s MFP will be evaluated.

    1. What prompted SAMHSA to fund the current evaluation?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

74. Why was the program not evaluated in prior years in which SAMHSA has overseen the MFP? [Probe: Were there no regulations requiring an evaluation? Were there no funds available?]

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

BACKGROUND

Could you please tell us a little bit about your background?

75. [Interviewer, please check whether the participant is ___ male or ___ female.]

76. Have you yourself participated in the MFP in any other way besides being on staff at SAMHSA? ___ Yes ___ No

If yes: In which of the following ways have you been involved? [Note: participant may select all that apply]

Did you receive a Minority Fellowship through SAMHSA? Have you acted as a formal (assigned) advisor to a Fellow? Were you a supervisor in a training program where you supervised a Fellow? Outside of your role as a SAMHSA [Project Officer/ staffperson], have you made presentations at conferences/professional meetings organized by the SAMHSA MFP? Outside of your role as a SAMHSA [Project Officer/ staffperson], have you made presentations or offered seminars at other types of meetings organized by the MFP? Have you participated in some other way?

__ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No

During which years? _________ to __________ for a total of _____years In what way(s)? ____________________________________ __________________________________________________

77. Which of the following best describes your area of expertise?

1. ___ Mental health

2. ___ Substance abuse

3. ___ Co-occurring disorders

4. ___ Some other area: What is that? ___________________________________________________________

78. Are you of Hispanic/Latino background/ethnicity? ___ Yes ___ No

79. Which of the following describes your ethnic/racial background [Note: participant may select all that apply]:

___ American Indian or Alaska Native

___ Asian

___ Black or African American

___ Native Hawaiian or Other Pacific Islander

___ White

80. Is there anything else which you would like to tell us about your experience with SAMHSA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Thank you for participating in this survey and sharing your experiences working

with SAMHSA’s Minority Fellowship Program.

Pre-Interview Form: SAMHSA Staff

S

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bottom of this page

AMHSA Minority Fellowship Program

1. Which of the following resources within SAMHSA but outside of the Minority Fellowship Program are used by the MFP Program staff?

a) Other SAMHSA staff? ___ Yes ___ No	If yes: for what purpose? __________________________________________________________________ __________________________________________________________________
b) Other grantee programs within SAMHSA’s portfolio? ___ Yes ___ No	If yes: for what purpose? __________________________________________________________________ __________________________________________________________________

2. HSRI already has copies of the 20 year and 30 year reports as well as the Conference Proceedings from the First MFP Conference. In addition to these reports, has SAMHSA released any other reports about the MFP since 1992?

___ Yes ___ No

1. If so, what reports are these? (use additional sheets, as necessary)

1. _________________________________________________________________________________________________

2. _________________________________________________________________________________________________

3. _________________________________________________________________________________________________

Please return copies of any reports along with this form. (Note: We do NOT need additional copies of the Conference Proceedings from the First MFP Conference, or the 20 year and the 30 year reports.)

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 90 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

3. During the past 15 years, as SAMHSA has overseen the MFP, have you communicated any changes to the goals of the MFP in the Report to Congress? (check one)

___ Yes (see below) ___ No, the goals have not changed ___ No, the Report did not contain this information

1. (If yes): What changes to the goals did you communicate? And when?

Change in Goal (briefly describe)	Date (year) of Report
1. 2. 3. 4. (use additional space as necessary)

Please fill out the following form for each fiscal year for which SAMHSA has operated the program.

4. What level of support has SAMHSA received internally for the MFP, over the years?

	How many staff (FTEs) at SAMHSA has the program had in each fiscal year?	How much funding has SAMHSA allocated internally to operate the MFP each fiscal year?
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

The next set of questions will ask you to evaluate each of the grantee programs separately, during the time you have been familiar with the program.

5. SAMHSA began administering this program in 1992. In which years have you been directly familiar with the SAMHSA MFP? _______ (year) to _______ (year)

6. Please rate how engaged the (American Nursing Association’s) ANA’s MFP has been in addressing the following goals and assess how much progress that organization has made.

GOALS	How engaged would you say the ANA’s MFP has been in addressing this goal? Would you say it is: 1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged	Would you say that the ANA’s MFP has had: 1 = no influence on… 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
a) Developing a new cohort of MFP Fellows	1 2 3 4 5 DK
b) Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
c) Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
d) Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5 DK	1 2 3 4 5 DK
e) Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK	1 2 3 4 5 DK
f) Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
g) Increasing mental health and substance abuse services to minority communities	1 2 3 4 5 DK	1 2 3 4 5 DK

7. Please rate the degree to which the ANA has been engaged overall in addressing these goals.

Very Disengaged…………………………..Very Engaged Don’t Know

1 2 3 4 5 DK

8. On a scale of 1 to 5, please rate the quality of the ANA’s performance in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the ANA’s MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

9. Consider the following types of professional activities for which the MFP prepares its Fellows. Then rate the degree to which you believe the ANA’s MFP has prepared its Fellows.

Very Very Don’t Unprepared……..……….Prepared Know

Offering clinical services in mental health treatment Understanding ethnic/racial minority issues in mental health Offering clinical services in substance abuse treatment Understanding ethnic/racial minority issues in substance abuse Supervising mental health treatment Supervising substance abuse treatment Networking in the profession Mentoring other ethnic/racial minorities in the profession Working with community-based organizations relevant to ethnic/racial minorities Working with consumers and families with ethnic/racial backgrounds Authoring an article/paper for publication in a peer-reviewed journal Authoring a policy brief Making a presentation at a professional conference Offering a training seminar Conducting quantitative research Understanding statistics Conducting qualitative research

1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK

10. Next, please rate the degree to which the American Psychiatric Association (the ApA) is engaged in addressing these same goals and assess how much progress that organization has made.

GOALS	How engaged would you say the ApA’s MFP has been in addressing this goal? Would you say it is: 1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged	Would you say that the ApA’s MFP has had: 1 = no influence on… 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
a) Developing a new cohort of MFP Fellows	1 2 3 4 5 DK
b) Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
c) Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
d) Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5 DK	1 2 3 4 5 DK
e) Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK	1 2 3 4 5 DK
f) Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
g) Increasing mental health and substance abuse services to minority communities	1 2 3 4 5 DK	1 2 3 4 5 DK

11. Please rate the degree to which the ApA is engaged overall in addressing these goals.

Very Disengaged…………………………..Very Engaged Don’t Know

1 2 3 4 5 DK

12. On a scale of 1 to 5, please rate the quality of the ApA’s performance in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the ApA’s MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

13. Consider the following types of professional activities for which the MFP prepares its Fellows. Then rate the degree to which you believe the ApA’s MFP has prepared its Fellows.

Very Very Don’t Unprepared……..……….Prepared Know

Offering clinical services in mental health treatment Understanding ethnic/racial minority issues in mental health Offering clinical services in substance abuse treatment Understanding ethnic/racial minority issues in substance abuse Supervising mental health treatment Supervising substance abuse treatment Networking in the profession Mentoring other ethnic/racial minorities in the profession Working with community-based organizations relevant to ethnic/racial minorities Working with consumers and families with ethnic/racial backgrounds Authoring an article/paper for publication in a peer-reviewed journal Authoring a policy brief Making a presentation at a professional conference Offering a training seminar Conducting quantitative research Understanding statistics Conducting qualitative research

1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK

14. Next, consider how engaged the American Psychological Association (APA) has been in addressing these same goals and assess how much progress that organization has made toward achieving those goals.

GOALS	How engaged would you say the APA’s MFP has been in addressing this goal? Would you say it is: 1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged	Would you say that the APA’s MFP has had: 1 = no influence on… 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
a) Developing a new cohort of MFP Fellows	1 2 3 4 5 DK
b) Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
c) Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
d) Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5 DK	1 2 3 4 5 DK
e) Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK	1 2 3 4 5 DK
f) Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
g) Increasing mental health and substance abuse services to minority communities	1 2 3 4 5 DK	1 2 3 4 5 DK

15. Please rate the degree to which the APA is engaged overall in addressing these goals.

Very Disengaged…………………………..Very Engaged Don’t Know

1 2 3 4 5 DK

16. On a scale of 1 to 5, please rate the quality of the APA’s performance in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the APA’s MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

17. In considering the following types of professional activities, please rate the degree to which you believe the APA’s MFP has prepared its Fellows.

Very Very Don’t Unprepared……..……….Prepared Know

Offering clinical services in mental health treatment Understanding ethnic/racial minority issues in mental health Offering clinical services in substance abuse treatment Understanding ethnic/racial minority issues in substance abuse Supervising mental health treatment Supervising substance abuse treatment Networking in the profession Mentoring other ethnic/racial minorities in the profession Working with community-based organizations relevant to ethnic/racial minorities Working with consumers and families with ethnic/racial backgrounds Authoring an article/paper for publication in a peer-reviewed journal Authoring a policy brief Making a presentation at a professional conference Offering a training seminar Conducting quantitative research Understanding statistics Conducting qualitative research

1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK

18. Finally, please consider how engaged the Council on Social Work Education (CSWE) has been in addressing these same goals and assess how much progress that organization has made toward achieving those goals.

GOALS	How engaged would you say the CSWE’s MFP has been in addressing this goal? 1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged	Would you say that the CSWE’s MFP has had: 1 = no influence on… 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
a) Developing a new cohort of MFP Fellows	1 2 3 4 5 DK
b) Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
c) Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
d) Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5 DK	1 2 3 4 5 DK
e) Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 DK	1 2 3 4 5 DK
f) Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 DK	1 2 3 4 5 DK
g) Increasing mental health and substance abuse services to minority communities	1 2 3 4 5 DK	1 2 3 4 5 DK

19. Please rate the degree to which the CSWE is engaged overall in addressing these goals.

Very Disengaged…………………………..Very Engaged Don’t Know

1 2 3 4 5 DK

20. On a scale of 1 to 5, please rate the quality of the CSWE’s performance in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the CSWE’s MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

21. Please rate the degree to which you believe the CSWE’s MFP has prepared its Fellows through each of the following types of activities.

Very Very Don’t Unprepared……..……….Prepared Know

Offering clinical services in mental health treatment Understanding ethnic/racial minority issues in mental health Offering clinical services in substance abuse treatment Understanding ethnic/racial minority issues in substance abuse Supervising mental health treatment Supervising substance abuse treatment Networking in the profession Mentoring other ethnic/racial minorities in the profession Working with community-based organizations relevant to ethnic/racial minorities Working with consumers and families with ethnic/racial backgrounds Authoring an article/paper for publication in a peer-reviewed journal Authoring a policy brief Making a presentation at a professional conference Offering a training seminar Conducting quantitative research Understanding statistics Conducting qualitative research

1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK

22. Finally on a scale of 1 to 5, please rate the MFP’s performance, overall (that is, across all four grantee programs), in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

Please mail or FAX this completed form by: _________________ which is 10 days before your scheduled telephone interview with HSRI.

Completed forms may be sent to:

Debbie Potter, PhD

MFP Project Manager/HSRI Project Director

2336 Massachusetts Avenue

Cambridge, MA 02140

FAX: 617 4497-1762

Thank you and we look forward to speaking with:

(NAME) on (date) (time)

(NAME) on (date) (time)

Attachment E

Interview protocol: Current and former MFP Program Directors/ Senior Staff

(Pre-interview form also included)

P

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bttom of this page

ROJECT DIRECTORS (and/or SENIOR STAFF) (telephone administration)

As you know, in this interview, I will be asking you questions about the Minority Fellowship Program (MFP) sponsored by SAMHSA. [Interviewer: check which program and read any additional introductory material to the participant.]

___ American Nurses Association

___ American Psychiatric Association: “Please note that I will not be asking you questions about Astrazeneca’s Fellowship Program. I am only interested in the clinical program funded by SAMHSA.”

___ American Psychological Association: “Please note that although the APA houses 2 Minority Fellowship Programs, I will not be asking you questions about the research Fellowship sponsored by NIH. I am only interested in the clinical program funded by SAMHSA.”

___ Council on Social Work Education

1. Interviewer: check if ___ Project Director; If not, ask: What is the title of your position? _____________________________

2. When were you hired for your current position at the [ANA/ APA/ ApA/ CSWE]? ______ (years)

   1. How long have you been/were you in this position? ______ (number of years)

   2. Have you held other positions in the MFP? __ Yes ___ No (if yes: what position was that? _______________________)

3. Are you on any task forces, committees, or other types of work groups in the [ANA/ APA/ ApA/ CSWE]? ___ Yes ___ No

If yes: What task force, committee, workgroup?	What role do you have? (member, chair, etc)	How long have you been in this group? (years)
1. 2. 3. 4.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 120 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

4. Have you yourself participated in the SAMHSA MFP in any other way besides being on staff? ___ Yes ___ No

[If yes:]

In which of the following ways have you been involved? [Note: participant may select all that apply]

Did you receive a Minority Fellowship through SAMHSA? Have you acted as a formal (assigned) advisor to a Fellow? Were you a supervisor in a training program where you supervised a Fellow? Have you participated in some other way?

___ Yes ___ No ___ Yes ___ No ___ Yes ___ No ___ Yes ___ No

During which years? _________ to __________ for a total of _____years During which years? _________ to __________ for a total of _____years During which years? _________ to __________ for a total of _____years In what way(s)? _____________________________________ __________________________________________________ __________________________________________________ __________________________________________________

THE RFA PROCESS AND GRANT PROGRAM REQUIREMENTS

The next set of questions asks about the requirements for your program contained in the grant announcements issued by SAMHSA.

5. The RFA for the MFP has routinely required each of the grantees to report performance measures (i.e. GPRA data) cumulatively over the last 10 years. For the past year, that is for FY2008, was your program able to report the following data::

   A list of the types of jobs secured by Past Fellows Whether those jobs were in mental health and addiction services to underserved populations Whether or not those jobs were public, private Other professional activities of Past Fellows The number of students admitted to the program The number graduating from the program The number terminating before graduating The number of Fellows still in training The number of Fellows who have been disabled A list of Fellows’ names from the past 10 years Ethnicity of Fellows over the past 10 years Gender of Fellows over the past 10 years A list of current Fellows’ names Ethnicity of current Fellows Gender of current Fellows

   (if yes) For approximately what percent of Fellows from the required reporting period of 10 years were you able to report this data? _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________

   (if yes) Are you able to report this data by (circle all that apply): a) year; b) sex; and c) ethnicity of the Fellows? a b c a b c a b c a b c a b c

6. What types of challenges have you faced in order to be able to report these data?

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

7. Outside of reporting the data to SAMHSA, how has your program used the GPRA data?

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

8. The RFA requires that SAMHSA provide you with a schedule for submitting (GPRA) data prior to awarding the grant funds. For your most recent grant award (that is for FY 2008), did SAMHSA provide you with a reporting schedule? ___ Yes ___ No ___ Don’t Know

   1. Did your program report data by the date(s) required? ___ Yes ___ No ___Don’t Know

Comments: ____________________________________________________________________________________

______________________________________________________________________________________________

9. In what years have you formally evaluated your program? _________________________________

   1. What types of evaluation activities have you conducted?

______________________________________________________________________________________________

______________________________________________________________________________________________

2. Briefly, what have been the results of this/these evaluation(s)?

______________________________________________________________________________________________

______________________________________________________________________________________________

3. [If available in the budget the interviewer will ask:]

According to your grant application, you expected to spend $__________ or ___ % of your budget on evaluation and data collection activities. Was that estimate accurate? ___ Yes ___ No ___ Don’t Know

1. If “no”: what was the correct amount/percent? spend $__________ or ___ % of the budget

[OR if the budget does not contain sufficient detail, the interviewer will ask]:

Approximately what percent of your budget have you devoted to evaluation and data collection activities? ____ % So that would be $___________________?

10. Outside of the mandatory GPRA measures, has your program collected other measures you routinely use to monitor your performance? ___ Yes ___ No ___ Don’t Know

    1. (if yes): What measures do you routinely use?

______________________________________________________________________________________________

2. How long has your program been collecting these data? ______ (years – use fraction for months)

3. Are these data (check all):

   1. ___ in hardcopy format

   2. ___ in an electronic database

1. How have you used the evaluation data to provide feedback to your MFP program?

__________________________________________________________________________________________________

__________________________________________________________________________________________________

1. In which of the following ways did your MFP use these results? (select all that apply)

i. ___ To establish new activities and opportunities for Fellows

ii. ___ To modify existing activities and opportunities for Fellows

iii. ___ To change administrative procedures

iv. ___ To inform participants and other stakeholders about the program

v. ___ In some other way (please specify):

______________________________________________________________________________________________

12. The RFAs have required grantees to send two MFP staff members (including the Project Director) to attend one joint grantee meeting in the DC area for 2 to 3 days. Has your program sent representatives to attend these meetings in the past?

___ Yes ___ No ___ Don’t Know ____ Meetings have not been held

1. [If yes]: What has been most beneficial about these meetings?

______________________________________________________________________________________________

______________________________________________________________________________________________

2. What has been most challenging?

______________________________________________________________________________________________

______________________________________________________________________________________________

13. In 2005, SAMHSA issued a supplemental grant award which permitted grantees to enhance their program. For what purposes did your MFP use those funds?

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

1. [Probe if not addressed above]As part of that supplemental award, did you evaluate your program? ___ Yes ___ No

   1. If yes: Can you tell me about the evaluation?

Probe for goals; scope of inquiry; methods used; data obtained; any reports available

______________________________________________________________________________________________

______________________________________________________________________________________________

2. [Probe if not addressed above] As part of the 2005 supplement, did you add or modify your IT capabilities? ___ Yes ___ No

   1. If yes: What did you add or change? Probe for new data elements; new reports; sharing of data

______________________________________________________________________________________________

______________________________________________________________________________________________

14. Have your program’s priorities changed during the time it has been funded by SAMHSA? ___ Yes ___ No

    1. [If yes:] In what ways?

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

Probes:

1. In particular, how, if at all, have consumer and family interests and involvement been evidenced in SAMHSA’s priorities for the MFP?

2. How, if at all, have issues related to substance abuse as well as mental health been evidenced in SAMHSA’s priorities for the MFP?

3. How, if at all, have Evidenced Based Practices (EBPs) been evidenced in SAMHSA’s priorities for the MFP?

4. How, if at all, has the idea of recovery been evidenced in SAMHSA’s priorities for the MFP?

15. How have the priorities established by SAMHSA affected your program?

    1. In what ways have SAMHSA’s Program Priorities furthered your program?

______________________________________________________________________________________________________

______________________________________________________________________________________________________

2. In what ways have these priorities limited the implementation of your MFP?

______________________________________________________________________________________________________

______________________________________________________________________________________________________

16. Overall, on a scale of 1 to 5, with 1 being very unclear to 5 being very clear, please assess how unclearly or clearly you believe the latest RFA (2007) has expressed the goals which SAMHSA has for the MFP.

Very Unclear …………………………………..Very Clear

1 2 3 4 5

Comments: _____________________________________________________________________________________________

_______________________________________________________________________________________________________

17. Overall, on a scale of 1 to 5, with 1 being very unclear to 5 being very clear, please assess how unclearly or clearly you believe the latest RFA (2007) outlined the criteria by which your program would be evaluated.

Very Unclear …………………………………..Very Clear

1 2 3 4 5

Comments: _____________________________________________________________________________________________

_______________________________________________________________________________________________________

18. Over the years, in what ways has the RFA helped grantees? That is, in what ways has the RFA expressed the goals of SAMHSA and the criteria by which the grantees would be judge?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

19. Over the years, in what ways has the RFA hindered the application processes of grantee organizations? That is, in what ways, has the RFA not been clear in expressing the goals of SAMHSA and the criteria by which the grantees would be judged?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. Have there been particular grant requirements which have hindered the ability to implement your program? __ Yes ___ No

Comments______________________________________________________________________________________________

_______________________________________________________________________________________________________

20. In FY2007, several new requirements were added to the application (including using logic models and organizational charts) and to the MFP grant program (such as modifying the reporting requirements and requiring grantees to secure external funding). Do you or your program have any comments you would like to make about the latest RFA and/or the requirements?

______________________________________________________________________________________________

______________________________________________________________________________________________

1. What will be the most significant challenges for your program in the coming year?

______________________________________________________________________________________________

______________________________________________________________________________________________

2. What strategies do you expect to use to address these challenges?

______________________________________________________________________________________________

______________________________________________________________________________________________

SAMHSA RESOURCES

The next series of questions will ask about different ways that SAMHSA supports the MFP including the grant review process and site visits it conducts, and any technical assistance it may offer to your program.

21. In thinking about how SAMHSA reviews your grant applications….On a scale of 1 to 5, with 1 being very unsupportive to 5 being very supportive, please rate the degree to which the SAMHSA grant review process supports your efforts to improve your program.

Very Unsupportive ……………………….…Very Supportive

1 2 3 4 5

22. After your grant has been reviewed, do you receive feedback either from the Review Group or from SAMHSA? ___Yes ___No

    1. [If yes:] From which? ___Review Group ___ SAMHSA ___ Both

1. Can you briefly summarize the type of comments you have received?

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

2. In what, if any, ways does the review process incorporate concerns specific to your program (i.e. as distinct from the other three grantees)?

______________________________________________________________________________________________________

______________________________________________________________________________________________________

3. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful have those comments been to your program?

Very Unhelpful………………………….…..Very Helpful

1 2 3 4 5

23. On a scale of 1 to 5, with 1 being very ineffective and 5 being very effective, how would you rate the ability of the grant review process in encouraging your program to meet your own program goals?

Very Ineffective………………………….…..Very Effective

1 2 3 4 5

24. On a scale of 1 to 5, with 1 being very ineffective and 5 being very effective, how would you rate the ability of the grant review process in encouraging your program to meet SAMHSA’s program goals?

Very Ineffective………………………….…..Very Effective

1 2 3 4 5

25. In what concrete ways has the grant review process affected the way in which your program operates? (Probe: What changes have you made to your program as a result of the grant review process?)

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

26. How many site monitoring visits has SAMHSA made to your Program (in the last 2 years)? ______

If site visits have occurred: a) When did they occur? (years)	b) What was the purpose for the site monitoring visits?	c) As a result of the site visit did you receive a report from SAMHSA?
1. 2. 3.

4. What, if any, concrete changes have you made in the way you operate the MFP as a result of these visits?

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

4. On a scale of 1 to 5, with 1 being very ineffective and 5 being very effective, how effective are the site visits?

Very Ineffective………………………….…..Very Effective

1 2 3 4 5

4. What is most helpful about the site visits?

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

4. What would you most like to see improved about the site visits?

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

29. Has your MFP requested any technical assistance from SAMHSA over the past 2 years?

___ Yes ___ No ___ Don’t Know

[Note: this does not include answering questions about grant applications, reports or budgets]

[If yes:] On what topic or issue did you request TA? [note: record topics in grid below] _____________________________________ _____________________________________ _____________________________________

Did SAMHSA provide TA on these topics? ___ Yes ___ No ___ Don’t Know ___ Yes ___ No ___ Don’t Know ___ Yes ___ No ___ Don’t Know

[If yes:]	TA topic #1	TA topic #2	TA topic #3
Who provided the TA? (Probe: SAMHSA, external contractor)
How many hours of TA were provided?
Did the TA target a particular priority area identified by SAMHSA? [If yes:] Which?
In what way did the TA meet your needs?
In what way could the TA have been improved?

29. In terms of each of the following resources, please rate the level of support has SAMHSA provided the MFP over the years. Using a scale of 1 to 5, with 1 being very inadequate to 5 being very adequate, how would you rate

	Very………………………….……..………Very Inadequate Adequate	21. What has been most helpful?	22. What would you most like to see changed?
…the staff performance from SAMHSA has been? …direction provided by SAMHSA’s Project Officer …technical assistance has been? …funding has been? …formal support for the grantees to collaborate has been? Other SAMHSA resources (please specify): ________________________ ________________________	1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5	__________________ __________________ __________________ __________________	__________________ __________________ __________________ _________________

RELATIONSHIP OF THE MFP TO THE ANA/ APA/ ApA/ CSWE

Now I am going to ask about your MFP’s relationship to the [ANA/ APA/ ApA/ CSWE].

29. Has the [ANA/APA/ApA/CSWE] had any formal responsibilities or duties to perform as the sponsoring organization for your MFP? ___ Yes ___ No ___ Don’t Know

    1. If yes: What were these?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

29. Are any of the MFP staff physically located in the same offices as the [ANA/ APA/ ApA/ CSWE]? ___ Yes ___ No

[If yes:] ___ All MFP staff ___ Only the following staff: ______________________________________________________

Comments: ____________________________________________________________________________________________

[Interviewer: Clear up any questions from the “Resources” Section of the Project Director Form.]

29. To whom do you [does the MFP Project Director] report to in the [ANA/ APA/ ApA/ CSWE]? __________________________

29. How much autonomy do you [the MFP Project Director] have in making decisions for the SAMHSA MFP in your discipline?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Based on what you’ve said, would it be fair to say that you [the Project Director]:

1. ___ Make(s) independent decisions with no review by [ANA/ APA/ ApA/ CSWE]

2. ___ Make(s) independent decisions with major issues/ decisions needing to be reviewed by [ANA/ APA/ ApA/ CSWE]

3. ___ Consult(s) with the [ANA/ APA/ ApA/ CSWE] before making decisions

4. ___ Other: _________________________________________________________________________________________

29. How does the MFP and the rest of the [ANA/ APA/ ApA/ CSWE] work together? Do you: [Probe for detail on each]

    1. Work together in established groups within the [ANA/ APA/ ApA/ CSWE]? ______________________________________

___________________________________________________________________________________________________

2. Share in putting together special events? __________________________________________________________________

___________________________________________________________________________________________________

3. Collaborate in job development seminars or other career related workshops? _____________________________________

___________________________________________________________________________________________________

4. Co-author articles or policy briefs which are published by the [ANA/ APA/ ApA/ CSWE]? ___________________________

___________________________________________________________________________________________________

5. Co-author articles or policy briefs which are published in peer-review journals? __________________________________

___________________________________________________________________________________________________

6. Make presentations at professional meetings? _____________________________________________________________

___________________________________________________________________________________________________

7. Conduct research together? ____________________________________________________________________________

___________________________________________________________________________________________________

8. Other, please specify: _________________________________________________________________________________

___________________________________________________________________________________________________

29. Has the [ANA/ APA/ ApA/ CSWE] helped your MFP program to network within the profession?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Probes: For what purpose/ activities? To recruit Fellows? For job development for Fellows?

For career services/ job placement for Fellows? To advocate for minority mental health/substance abuse services?

29. Has the [ANA/ APA/ ApA/ CSWE] collaborated with your MFP Program in any other way (outside of the activities to which we just spoke about)?

___ Yes ___ No

1. [If yes:] What event or activity was this? __________________________________________________________________

29. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful would you say the [ANA/ APA/ ApA/ CSWE] has been to your MFP?

Very Unhelpful ..……………………………. Very Helpful

1 2 3 4 5

29. How well do the goals of the [ANA/ APA/ ApA/ CSWE] align with those of the MFP? Are there sources of overlap or conflict?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

29. In what ways has having the [ANA/ APA/ ApA/ CSWE] administer the SAMHSA MFP been beneficial?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. [If more than 1 benefit]: What has been the most important benefit of having the [ANA/ APA/ ApA/ CSWE] administer the SAMHSA MFP? __________________________________________________________________________________________________

___________________________________________________________________________________________________

29. In what ways has having the [ANA/ APA/ ApA/ CSWE] administer the SAMHSA MFP presented challenges?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. [If more than 1 challenge]: What has been the most challenging in having in the [ANA/ APA/ ApA/ CSWE] administer the SAMHSA MFP?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Have there been particular issues or decisions on which the MFP and the rest of the [ANA/ APA/ ApA/ CSWE] have had difficulty seeing eye-to-eye? ___ Yes ___ No ___ Don’t Know

    1. [If yes:] Was the issue resolved?

___________________________________________________________________________________________________

2. How was it resolved?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

ADVISORY BOARD/COMMITTEE

29. How many Advisory Board (Advisory Committee) members does your MFP have? ______

30. Who is the chair of the Advisory Board/Committee? _______________________ (relationship to the MFP Program)

31. Which of the following describes the type of background these members have: (check all that apply)

    1. ___ Some of them are former Fellows

    2. ___ Some are MFP staff from our organization

    3. ___ Some work elsewhere in the [ANA/ APA/ ApA/ CSWE]

    4. ___ Some are other professionals in our discipline

    5. ___ Other, please specify: ____________________________

29. How is the Advisory Board/Committee for the MFP selected?

    1. Who selects the Board/Committee? ______________________________________________________________________

    2. Are members selected from among those who served previously in other groups in the [ANA/APA/ApA/CSWE]? ___ Yes ___ No Comments: ______________________________________________________________________________

30. How many years do Advisory Board/Committee members typically serve? ______ years

29. Do Advisory Board/Committee members receive any compensation for their service? ___ Yes ___ No ___ Don’t Know

    1. [If yes:] What do they receive?

$_______ (amount) per ___ hour ___ meeting ___ year ___other, specify: _____________________

29. Select which of the following which best describes how Advisory Board/Committee members are involved in decision-making. They are …

    1. ___ Apprised of decisions

    2. ___ Consulted about programmatic decisions

    3. ___ Actively involved in making decisions

    4. ___ Other, please describe: ____________________________________________________________________________

29. Please identify in which areas the Advisory Board participates and evaluate how actively the Board/Committee participates on a scale of 1 to 5 with 1 being very inactive to 5 being very active. Please select “not applicable” (NA) if you do not know or if the Advisory Panel does NOT participate in that area.

Very Inactive……………………Very Active

1. ___ In identifying goals for the MFP 1 2 3 4 5 NA

2. ___ In selecting new Fellows 1 2 3 4 5 NA

3. ___ In selecting returning Fellows 1 2 3 4 5 NA

4. ___ In designing programs to support the Fellows 1 2 3 4 5 NA

5. ___ In improving the performance of the [ANA/

APA/CSWE MFP] 1 2 3 4 5 NA

6. ___ Other, please specify: _______________________ 1 2 3 4 5 NA

RECRUITING FELLOWS

29. Does your program assist potential applicants in choosing a graduate institution or residency program? ___ Yes ___ No

    1. If yes: What do you do to help applicants select a program?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. When the [ANA/ APA/ ApA/ CSWE] reviews the applications for the SAMHSA MFP, are the selection criteria ___ formal (i.e. written) or ___ informal (i.e. unwritten)?

30. What are the selection criteria? (Please check all that apply.) Can you please rank the criteria in order of how important they are in this decision-making process? (with 1 being most important, etc.) [Note: clarify that this is how important the criteria are to the decision-making process, not to the respondent themselves.]

Rank (1 = most important, etc)

1. ___ GPA _____

2. ___ Graduate school test scores _____

3. ___ Quality of references _____

4. ___ Appropriateness of career interests _____

5. ___ Balance in the minority backgrounds of

the current MFP cohort _____

6. Relevant work experience _____

7. ___ Other, please specify: ________________ _____

29. Are the same criteria applied to every applicant in the exact same manner? ___Yes ___No

4. [If no:] If there is discretion, who has authority to exert that discretion? (check all that apply)

1. ___ Advisory Committee members

2. ___ MFP Project Directors/staff

3. ___ Other, please specify: _________________________________________________________________________

5. In your time on the MFP staff, has such discretion been exercised? ___ Yes ___ No ___ Don’t Know

6. [If yes:] Please describe briefly the circumstances under which discretion has been exercised in selecting new applicants:

___________________________________________________________________________________________________

29. Is there a formal application packet for renewing the Fellowship? ___ Yes ___ No

30. What materials do Fellows submit to be reconsidered for subsequent years’ funding? (Please check all that apply)

6. ___ Official transcript

7. ___ References from professors, program directors or training directors

8. ___ Dissertation proposal (when written)

9. ___ Application form designed by the MFP

10. ___ Other, please specify: _____________________________________________________________________________

29. Are the selection criteria for renewal applications ___ formal (i.e. written) or ___ informal (i.e. unwritten)?

30. What are the selection criteria for renewal applications? Can you please rank the criteria in order of how important they are in this decision-making process? (with 1 being most important, etc.) [Note: clarify that this is how important the criteria are to the decision-making process, not to the respondent themselves.]

Rank (1 = most important, etc)

1. ___ GPA _____

2. ___ Quality of references _____

3. ___ Progress in the program _____

4. ___ Participation in professional activities _____

5. ___ Appropriateness of career interests _____

6. ___ Balance in the minority backgrounds of

the current MFP cohort _____

7. ___ Other, please specify: ______________ _____

29. Are the same criteria applied to every renewal applicant in the exact same manner? ___Yes ___No

1. [If no:] If there is discretion, who has authority to exert that discretion?

1. ___ Advisory Committee members

2. ___ MFP Project Directors/staff

3. ___ Other, please specify: _______________________________________________________

2. In your time on the MFP staff, has such discretion been exercised in selecting renewal applications?

___ Yes ___ No ___Don’t Know

3. [If yes:] Please describe briefly the circumstances under which discretion has been exercised.

______________________________________________________________________________________________

29. Do you have a set timeline for selecting and funding new and returning applicants? ___ Yes ___ No ___Don’t Know

    1. If yes: By what date are Fellows selected? ______________

    2. When do Fellows receive their first stipend check? __________________

SUPPORTING AND MONITORING FELLOWS

29. Which of the following formal supports and enrichment activities does the [ANA/ APA/ ApA/ CSWE] provide the Fellows? Does the MFP provide Fellows with:

Supports		Is this a formal requirement of your program?	Check if respondent says it is not a formal requirement but is strongly encouraged
___ Assigned mentors from within MFP program ___ Opportunities to attend national professional meetings in your discipline ___ Opportunities to attend specific sessions at national professional meetings which address minority issues in mental health/substance abuse Opportunities to participate in other educational seminars sponsored/organized/conducted by your MFP program such as: i. __ The Summer Institute ii. __ The Winter Institute iii. __ Other:_________________ (__ On-line ___ In-person) ___ Opportunities to meet with the [ANA/ APA/ ApA/ CSWE] MFP staff in an in-person site visit to their university/ training program ___ On-line chat groups for the MFP Fellows ___ Other:___________________________________	__ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No	__ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No	__ Strongly encouraged __ Strongly encouraged __ Strongly encouraged __ Strongly encouraged __ Strongly encouraged __ Strongly encouraged __ Strongly encouraged __ Strongly encouraged __ Strongly encouraged

29. [for the ANA/APA/CSW]:What procedures do you use for monitoring the topics Fellows choose for their dissertations?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Has your training program for Fellows involved consumers? ___ Yes ___ No ___ Don’t Know

    1. If yes: How? In what activities, what roles did they play?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Has your training program for Fellows involved family members? ___ Yes ___ No ___ Don’t Know

    1. If yes: How? In what activities, what roles did they play?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Has your training program for Fellows involved community-based organizations? ___ Yes ___ No ___ Don’t Know

    1. If yes: How? In what activities, what roles did they play?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Has your MFP provided any formal supports or activities to Fellows which address SAMHSA’s priority to include substance abuse/treatment in the MFP?

___ Yes ___ No ___Don’t Know

1. Can you tell me what supports or activities you provided?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Has your MFP provided any formal supports or activities to Fellows which address SAMHSA’s priority to train Fellows in Evidence-Based Practices?

___ Yes ___ No ___Don’t Know

1. Can you tell me what supports or activities you provided?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Were you employed by the [ANA/APA/ApA/CSWE]’s MFP during the time in which the payback requirement was active?

___ Yes ___ No ___Don’t Know

If yes:

1. In your opinion, what were the benefits of the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. In your opinion, what were the drawbacks or limitations of the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

3. How was the payback requirement eliminated? [probe for process: who initiated/supported the effort; how long did it take to be recognized/enacted]

___________________________________________________________________________________________________

___________________________________________________________________________________________________

4. Was there any opposition to eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

5. Why was the payback requirement eliminated? [What reasons were given for eliminating it?]

___________________________________________________________________________________________________

___________________________________________________________________________________________________

6. In your opinion, what were the benefits of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

7. In your opinion, what were the drawbacks or limitations of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

REPORTING

29. During the past 3 years of the SAMHSA MFP, have you received feedback from the SAMHSA Project Officer (or other SAMHSA staff) on any of the following types of reports you have done for your MFP:

	[If yes:] On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful were these comments? Very Unhelpful …….… Very Helpful	As a result of these comments, did you modify your program? If yes, how?
Grant applications __ Yes __ No Annual Progress Reports __ Yes __ No Any Special reports (Interviewer will complete using the PD form) ________________________________ __ Yes __ No ________________________________ __ Yes __ No ________________________________ __ Yes __ No	1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5	__ Yes __ No __________________ __ Yes __ No __________________ __ Yes __ No __________________ __ Yes __ No __________________ __ Yes __ No __________________

29. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful have you found SAMHSA’s feedback overall to be for your MFP?

Very Unhelpful……………….………….…..Very Helpful

1 2 3 4 5

1. What has been most helpful about SAMHSA’s feedback for your program?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. What would you most like to see improved in SAMHSA’s feedback for your program?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

29. Does SAMHSA use GPRA data it receives from your program and the other MFP’s to put together reports on the entire MFP? ___ Yes ___ No ___ Don’t Know

    1. [If yes:] Have you received a copy/copies of these reports? ___ Yes ___ No ___ Don’t Know

Comments: ________________________________________________________________________________________

__________________________________________________________________________________________________

2. On a scale of 1 to 5 with 1 being very unhelpful and 5 being very helpful, how helpful would say this/these report(s) has/have been?

Very Unhelpful……………….………….…..Very Helpful

1 2 3 4 5

29. Have you received any other reports on the SAMHSA MFP which have evaluated the performance of any of SAMHSA’s other MFPs? ___ Yes ___ No

Can you please provide the name or other identifying information about that report?

a) Title/Description	b) [Interviewer: Check which program]
i. ___________________________________________________________ ii. ___________________________________________________________ iii. ___________________________________________________________ iv. ___________________________________________________________	ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA

IMPLEMENTING THE MFP

The next set of questions will ask you to assess the SAMHSA MFP during the time you have been familiar with the program.

29. In which years, since SAMHSA began administering the MFP, have you been directly familiar with the [ANA/APA/ApA/CSWE]’s MFP? _______ (year) to _______ (year)

29. While there are several goals in the MFP, how does your program prioritize the following goals? On a scale of 1 to 5, would you say that this is a low priority for your program or a high priority?

	Low……………………………………High
a) ___Developing a new cohort of Fellows	1 2 3 4 5
b) ___Training/ mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5
c) ___Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5
d) ___Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5
e) ___Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5
f) ___Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5
g) ___Increasing mental health and substance abuse services to minority communities	1 2 3 4 5

29. Next, I will ask you to rate the degree to which SAMHSA’s MFP in the [ANA/ APA/ ApA/ CSWE] is engaged in addressing those goals and assess how much progress the SAMHSA MFP has made toward achieving those goals during the time in which you have been familiar with the program?

GOALS	How engaged would you say the MFP is in addressing this goal? Would you say it is: 1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged	Would you that the SAMHSA MFP has had: 1 = no influence on… 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
a) Develop a new cohort of Fellows	1 2 3 4 5 Don’t Know
b) Train/mentor ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5 Don’t Know	1 2 3 4 5
c) Increase the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5 Don’t Know	1 2 3 4 5
d) Increase diversity in mental health/substance abuse leadership	1 2 3 4 5 Don’t Know	1 2 3 4 5
e) Increase professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5 Don’t Know	1 2 3 4 5
f) Increase institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5 Don’t Know	1 2 3 4 5
g) Increase mental health and substance abuse services to minority communities	1 2 3 4 5 Don’t Know	1 2 3 4 5

29. Overall, please rate the appropriateness of all of the goals in SAMHSA’s MFP. Would you say it is very inappropriate, somewhat inappropriate, neither inappropriate or appropriate, somewhat appropriate, or very appropriate:

Very Inappropriate…………………………..Very Appropriate Don’t Know

1 2 3 4 5 DK

29. Please rate the degree to which SAMHSA’s MFP is engaged overall in addressing these goals.

Very Disengaged…………………………..Very Engaged Don’t Know

1 2 3 4 5 DK

29. On a scale of 1 to 5, please rate your MFP’s performance in each of the following areas, with 1 being very poor and 5 being very good.

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

29. Consider the following types of professional activities for which the MFP prepares its Fellows. Then rate the degree to which you believe the [ANA/ APA/ ApA/ CSWE] MFP is preparing its Fellows. Use a scale of 1 to 5, with 1 being very unprepared and 5 being very prepared. Select “Don’t Know” (DK) if you have no basis on which to assess this area.

Very Very Don’t Unprepared……..……….Prepared Know

Offering clinical services in mental health treatment Understanding ethnic/racial minority issues in mental health Offering clinical services in substance abuse treatment Understanding ethnic/racial minority issues in substance abuse Supervising mental health treatment Supervising substance abuse treatment Networking in the profession Mentoring other ethnic/racial minorities in the profession Working with community-based organizations relevant to ethnic/racial minorities Working with consumers and families with ethnic/racial backgrounds Authoring an article/paper for publication in a peer-reviewed journal Authoring a policy brief Making a presentation at a professional conference Offering a training seminar Conducting quantitative research Understanding statistics Conducting qualitative research

1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK

29. On a scale of 1 to 5, with 1 being very difficult and 5 being very easy, please rate your experience in implementing the SAMHSA MFP.

Very Difficult………………………….Very Easy

1 2 3 4 5

29. What, if any, barriers has your program encountered?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Probe: What have been the most significant? (3 maximum)

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

29. What has your program done to try to address those barriers?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

29. Overall, what difference has the SAMHSA MFP made for minority mental health and substance abuse services?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

29. In your experience, what would you identify as the [ANA/ APA/ ApA/ CSWE’s] MFP’s most important contributions?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

29. In your experience, what, if anything, would you most like to see improved in the [ANA/ APA/ ApA/ CSWE’s] MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

29. In your experience, what, if anything, would you most like to see improved in the way SAMHSA administers the MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

BACKGROUND

Could you please tell us a little bit about your background?

29. [Interviewer, please check whether the participant is ___ male or ___ female.]

30. Which of the following best describes your area of expertise?

1. ___ Mental health

2. ___ Substance abuse

3. ___ Co-occurring disorders

4. ___ Some other area: What is that? _____________________________________________________________________

29. Are you of Hispanic/Latino background/ethnicity? ___ Yes ___ No

30. Which of the following describes your ethnic/racial background [Note: participant may select all that apply]:

1. ___ American Indian or Alaska Native

2. ___ Asian

3. ___ Black or African American

4. ___ Native Hawaiian or Other Pacific Islander

5. ___ White

29. Is there anything else which you would like to tell us about your experience with SAMHSA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Thank you for participating in this survey and sharing your experiences working with SAMHSA’s Minority Fellowship Program.

P

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bttom of this page

reInterview Form: OVERVIEW OF YOUR PROGRAM

(Form to be completed by SAMHSA MFP Project Directors at the ANA/APA/ApA/CSWE)

1. We have taken some of the information you already provided HSRI and filled out part of the grid below for each academic year your program has received funding from SAMHSA for the MFP. Please complete the form and revise as necessary: note that this table asks you to provide information beginning in the FALL OF EACH YEAR for the upcoming academic year.

(fall – summer)	Number of new Fellows funded through SAMHSA	Number of renewal Fellowships funded through SAMHSA	Number of Fellows completing their PhD or psychiatric residency	Number of Fellows withdrawing from the academic or training program
1992-3
1993-4
1994-5
1995-6	TO BE FILLED
1996-7
1997-8	IN PRIOR TO
1998-9
1999-2000	DISTRIBUTING
2000-1
2001-2	TO PARTICIPANTS
2002-3
2003-4
2004-5
2005-6
2006-7
2007-8

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 90 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

2. During the current year, how many SAMHSA Fellows has your Program funded in mental health? ______

How many in substance abuse? ______ Both/co-occurring? ______

1. Are there any “open” positions (slots for Fellows which have not been filled)?

___ Yes – how many? ______ ___ No

3. How many Fellows do you expect/hope to fund next year? ______ (total)

4. In recruiting and selecting new Fellows, are there particular minority or ethnic groups which you currently are targeting in order to have a more balanced cohort? ___ Yes ___ No ___ Don’t Know

   1. If yes: which groups (check all that apply)

Racial groups:

___ American Indian or Alaska Native

___ Asian

___ Black or African American

___ Native Hawaiian or Other Pacific Islander

___ White

Ethnic groups:

___ Hispanic/Latino background/ethnicity

5. In the past, when you were recruiting and selecting Fellows, were there particular minority or ethnic groups which you targeted in order to have a more balanced cohort? ___ Yes ___ No ___ Don’t Know

   1. If yes: which groups (check all that apply)

Racial groups:

___ American Indian or Alaska Native

___ Asian

___ Black or African American

___ Native Hawaiian or Other Pacific Islander

___ White

Ethnic groups:

___ Hispanic/Latino background/ethnicity

6. Has your program ever not met your goal for filling your allotted SAMHSA MFP slots? That is, has your MFP ever faced the situation where you did not have enough qualified applicants? ___ Yes ___ No ___ Don’t Know

   1. If yes: when? ______ (year(s))

   2. How many slots were unfilled? ______

7. Has your program ever had to reduce the number of anticipated slots in the SAMHSA MFP? ___ Yes ___ No ___ Don’t Know

   1. If yes: when? ______ (year(s))

   2. By how many slots did you reduce your program? ______

8. How many full-time equivalents (FTE’s) on the MFP staff are funded through SAMHSA? ______

9. Please list the current staff you have on the SAMHSA Minority Fellowship Program, along with their percent effort on the MFP.

POSITION TITLE EFFORT (Full-time= 100%)

__________________________________________________________________________ _________________

__________________________________________________________________________ _________________

__________________________________________________________________________ _________________

__________________________________________________________________________ _________________

__________________________________________________________________________ _________________

10. Please list any open positions for which you are hiring: or: (check) ___ We are not currently hiring.

TITLE OF OPEN POSITION EFFORT (Full-time= 100%)

__________________________________________________________________________ _________________

__________________________________________________________________________ _________________

11. From your most recently completed grant year, please indicate how much your MFP spent on:

    1. Total Salaries (without fringe benefits included) $ ________________

    2. Fringe $ ________________

    3. Consultants (do not include under “salaries”) $ ________________

    4. Stipends for Fellows $ ________________ total = $ _____________ per Fellow

    5. Tuition and fees for Fellows $ ________________ total = $ _____________ per Fellow

    6. Travel for Fellows $ ________________

    7. Travel for staff $ ________________

    8. Dissertation grant support for Fellows $ ________________

    9. Events for Fellows (if necessary, approximate these amounts)

       1. Summer Institute $ ________________

       2. Winter Institute $ ________________

       3. Other: ____________________________ $ ________________

    10. Other line items for Fellows

        1. ____________________________________ $ ________________

        2. ____________________________________ $ ________________

        3. ____________________________________ $ ________________

        4. ____________________________________ $ ________________

    11. Other direct costs $ ________________

    12. Administrative overhead (G&A), including any fees $ ________________

THE MFP and THE ANA/ APA/ ApA/ CSWE

12. Which of the following resources does the [ANA/APA/ApA/CSWE] contribute to or share with your MFP?

___ We share paid staff	Position #1: _________________ Percent effort [ANA/APA/ApA/CSWE]: ____ Percent effort MFP: ____	Position #2: _________________ Percent effort [ANA/APA/ApA/CSWE]: ____ Percent effort MFP: ____
___ We share volunteer staff	Position #1: _________________ Percent effort [ANA/APA/ApA/CSWE]: ____ Percent effort MFP: ____	Position #2: _________________ Percent effort [ANA/APA/ApA/CSWE]: ____ Percent effort MFP: ____
___ We share Information Technology	Check which apply: ___ MIS data are used to improve the MFP’s Performance ___ MIS Data are used for some other purpose; please specify what: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
___ We share office space	How many square feet does the MFP have in the [ANA/APA/ApA/CSWE]? _______________
___ We share overhead or operating expenses	Which do you share: ___ Insurance ___ Taxes ___ Rent ___ Utilities
___ We share other resources	What? ______________________________________________________________________ ______________________________________________________________________

13. For which of the following do you use funds from your SAMHSA MFP grant to provide financial reimbursement to the [ANA/ APA/ ApA/ CSWE]?

    1. Paid staff ___ Yes ___ No

    2. Volunteer staff ___ Yes ___ No

    3. Information Technology ___ Yes ___ No

    4. Office space ___ Yes ___ No

    5. Meeting space ___ Yes ___ No

    6. Overhead ___ Yes ___ No

    7. Other: _________________ ___ Yes ___ No

RECRUITING FELLOWS

14. Which of the following recruiting sources does your program use to recruit fellows into the MFP? (select all that apply)

___ Print ads

___ Special sessions at the professional meetings in your clinical discipline

___ Mass mailing of brochures

___ E-mailing deans, faculty members, admissions offices, etc (for ApA: residency supervisors)

___ Personal contact/involvement of former Fellows

___ Other, please specify: ___________________________________

Comments:

SUPPORTING AND MONITORING THE FELLOWS

15. During the past year, has anyone from within your office at the [ANA/APA/ApA/CSWE] MFP conducted a formal site visit to a university or training program in which a Fellow was enrolled?

___ Yes	___ No	___ Don’t Know
If yes: How many site visits did your program conduct this past year? ______ What prompted you to conduct the site visit(s)? Did (check all that apply): ___ The Fellow(s) requested a visit ___ The Fellow(s) was having academic difficulty ___ The Fellow(s) was having other difficulties with their program’s administration ___ Some other reason: ____________________ In other years, has your program typically conducted site visits to Fellows? ___Yes ___ No ___ Don’t Know If yes: On average, how many site visits does your program conduct per year? ______ (times)	a) In other years, has your program typically conducted site visits to Fellows? ___Yes ___ No ___ Don’t Know b) If yes: When was the last time your program conducted a site visit? ____ (year) c) How many site visits did you conduct that year? _____ What prompted you to conduct the site visit (s)? Did (check all that apply): ___ The Fellow(s) request a visit ___ The Fellow(s) have academic difficulty ___ The Fellow(s) have other difficulties with their program’s administration ___ Some other reason: ____________________

16. During the past year, has anyone from within your office at the [ANA/APA/ApA/CSWE] MFP met informally with Fellows either on or near their university or training program?

___ Yes	___ No	___ Don’t Know
If yes: How many Fellows did your or someone else from your program visit informally? ______ What prompted you to conduct the site visit(s)? Did (check all that apply): ___ The Fellow(s) requested a visit ___ The Fellow(s) was having academic difficulty ___ The Fellow(s) was having other difficulties with their program’s administration ___ Some other reason: ____________________ In other years, have you or someone else from your program typically visited Fellows on an informal basis? ___Yes ___ No ___ Don’t Know If yes: On average, how many informal visits does your program conduct per year? ______ (times)	e) In other years, have you or someone else from your program typically visited Fellows on an informal basis? ___Yes ___ No ___ Don’t Know f) If yes: When was the last time either you or someone else from your program visited a Fellow on an informal basis? ____ (year) g) How many informal visits did you conduct that year? _____ h) What prompted you or someone else from your program to informally visit the Fellow(s): (check all that apply) ___ The Fellow(s) requested a visit ___ The Fellow(s) was having academic difficulty ___ The Fellow(s) was having other difficulties with their program’s administration ___ Some other reason: ____________________

REPORTING

17. Since SAMHSA has funded the MFP, has your Minority Fellowship Program conducted an internal evaluation?

    1. If yes: When? _______ (year)

    2. Was this (check one):

___ A one-time evaluation ___ Part of a limited series of evaluation activities ___ An ongoing evaluation process

3. How much funding did you allocate for the evaluation in total? $_______________ over __________ years

4. Which of the following types of individuals/groups performed the evaluation(s) (check all that apply):

   1. ___ Staff employed directly by the MFP

   2. ___ An individual consultant hired by the MFP

   3. ___ An organization subcontracted by our MFP

   4. ___ Some other individual or group, please specify: ______________________________

      1. Were they hired: ___ directly by your MFP or ___ through SAMHSA?

5. Why was this evaluation/ these evaluations conducted? (check all that apply)

   1. ___ To identify needs (a needs assessment)

   2. ___ To identify and assess the types of procedures being used in our MFP (a process evaluation)

   3. ___ To assess how well our MFP was doing in achieving our goals (an outcome evaluation)

   4. ___ For some other reason, please specify: __________________________________________

6. Briefly, what were the findings of the evaluation(s)?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

(Please forward a copy of the evaluation(s) to HSRI)

7. How did your MFP use the results from this/these evaluation(s)? (check all that apply)

___ To establish new programs for fellows, please specify: ___________________________________________________

___ To change administrative procedures, please specify: ____________________________________________________

___ To improve how our MFP operates in some other way, specifically, what did you change?

______________________________________________________________________________________________

______________________________________________________________________________________________

___ To provide information to SAMHSA

___ To provide information to other stakeholders (check all that apply):

___ Our Advisory Board ___ Current Fellows

___ Our Selection Committee ___ Universities/ medical institutions

___ Former Fellows ___ Other individuals or groups, please specify: ________________________________________________________

18. Since the time that SAMHSA has funded the MFP, what reports has your program produced? (Check all that apply)

___ Our Annual Report to SAMHSA ___ The 20 Year Report

___ The 30 Year Report ___ Other routine, ongoing reports, please specify:

TITLE FREQUENCY

_________________________________________ ___ quarterly ___biannually ___ annually ___other, specify: _________

_________________________________________ ___ quarterly ___biannually ___ annually ___other, specify: _________

_________________________________________ ___ quarterly ___biannually ___ annually ___other, specify: _________

___Other ad hoc (one time only) reports, please specify:

TITLE YEAR(S)

____________________________________________ _______________________

____________________________________________ _______________________

____________________________________________ _______________________

Please mail or FAX this completed form by: _________________ which is 10 days before your scheduled telephone interview with HSRI. Please include copies of current CVs/resumes for all staff and consultants in the SAMHSA Minority Fellowship Program.

Completed forms may be sent to:

Debbie Potter, PhD

MFP Project Manager/HSRI Project Director

HSRI

2336 Massachusetts Avenue

Cambridge, MA 02140

FAX: 617 497-1762

Thank you and we look forward to speaking with:

(NAME) on (date) (time)

(NAME) on (date) (time)

Attachment F

Interview protocol: Staff in each of the grantee’s host organizations (i.e. staff in the ANA, APA, ApA, and CSWE)

H

Form Approved

OMB NO. 0930-XXXX

Exp. Date MM/DD/YY

See burden statement at the bttom of this page

OST ORGANIZATION (telephone administration)

In this interview, I will be asking you questions about the Minority Fellowship Program (MFP) sponsored by SAMHSA which is operated out of your organization This program supports Fellowships in clinical training for graduate students and psychiatric residents. The interview is expected to take approximately 1 hour. [Interviewer: check which program and read any additional introductory material to the participant.]

___ American Nurses Association

___ American Psychiatric Association: “Please note that I will not be asking you questions about Astrazeneca’s Fellowship Program. I am only interested in the clinical program funded by SAMHSA.”

___ American Psychological Association: “Please note that although the APA houses 2 Minority Fellowship Programs, I will not be asking you questions about the research program sponsored by NIH. I am only interested in the clinical program funded by SAMHSA.”

___ Council on Social Work Education

1. How long have you worked at the [ANA/APA/ApA/CSWE]? _____________

2. What is your position there now and how long have you held that position? ________________________________________

_____________________________________________________________________________________________________

3. On a scale of 1 to 5, with 1 being very unfamiliar to 5 being very familiar, how familiar are you with the MFP sponsored by SAMHSA?

Very Unfamiliar………………………………Very Familiar

1 2 3 4 5

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-xxxx.  Public reporting burden for this collection of information is estimated to average 60 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

4. [If participant was involved at the beginning of the MFP]:Can you tell me a little bit about why the [ANA/APA/ApA/CSWE] as an organization decided to sponsor and apply for the SAMHSA MFP?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

5. Under the RFA, are there any requirements which the [ANA/APA/ApA/CSWE] as the sponsoring organization must fulfill in order to receive the grant from SAMHSA for the Minority Fellowship Program? ___ Yes ___ No ___ Don’t Know

   1. [if yes]: What are you required to do? ____________________________________________________________

_______________________________________________________________________________________

2. Thinking about the time since SAMHSA has overseen the program – that is beginning in 1992 – has the [ANA/APA/ApA/CSWE] had any difficulty fulfilling those requirements? ___ Yes ___ No ___ Don’t Know

   1. If yes: What were those difficulties? And how did you resolve them?

____________________________________________________________________________________

____________________________________________________________________________________

6. To whom does the MFP Program Director report in the [ANA/APA/ApA/CSWE]? ______________________________________

7. Which of the following best describes how the Program Director for the MFP was hired?

   1. ___ The Executive Director of the [ANA/APA/ApA/CSWE] made the hiring decision

   2. ___ The Advisory Committee for the [ANA/APA/ApA/CSWE] made the hiring decision

   3. ___ Another search committee made the hiring decision

   4. ___ Some other process was used

      1. Can you please describe that process? ____________________________________________________________

8. Were you involved in hiring (any of) the Program Director(s)? ___ Yes ___ No

   1. If yes: What criteria were used to select the Program Director?

________________________________________________________________________________________________

2. Was the [ANA/APA/ApA/CSWE] looking for someone who had already worked in the organization? ___ Yes ___ No

9. What level of autonomy does the MFP Program Director have in making decisions for the MFP?

[Record answer] _______________________________________________________________________________________

_____________________________________________________________________________________________________

1. Based on what you’ve said, would it be fair to say that the Program Director:

   1. ___ Makes independent decisions with no review by [ANA/APA/ApA/CSWE]

   2. ___ Makes independent decisions with major issues/ decisions needing to be reviewed by the [ANA/APA/ApA/CSWE]

   3. ___ Consults with the [ANA/APA/ApA/CSWE] before making decisions

   4. ___ Other, please specify: ________________________________________________________________________

1. How is the Advisory Board/Committee for the MFP selected?

   1. Who selects the Board/Committee? ______________________________________________________________________

   2. Are members selected from among those who served previously in other groups in the [ANA/APA/ApA/CSWE]? ___ Yes ___ No Comments: ______________________________________________________________________________

2. Outside of having the SAMHSA MFP for [nursing/ psychology/psychiatry/ social work], in what ways does the [ANA/APA/ApA/CSWE] address issues of diversity through its program?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

12. How does the MFP and the rest of the [ANA/APA/ApA/CSWE] work together? Do you… [Probe for detail on each]

    1. Work together in established groups within the [ANA/APA/ApA/CSWE]? _______________________________________

______________________________________________________________________________________________________

2. Share in putting together special events? __________________________________________________________________

______________________________________________________________________________________________________

3. Collaborate in job development seminars or other career related workshops? _____________________________________

______________________________________________________________________________________________________

4. Co-author articles or policy briefs which are published by the [ANA/APA/ApA/CSWE} ___________________________

______________________________________________________________________________________________________

5. Co-author articles or policy briefs which are published in peer-review journals ___________________________________

______________________________________________________________________________________________________

6. Make presentations at professional meetings ______________________________________________________________

______________________________________________________________________________________________________

7. Conduct research together _____________________________________________________________________________

______________________________________________________________________________________________________

8. Other______________________________________________________________________________________________

______________________________________________________________________________________________________

13. Have you helped [ANA/APA/ApA/CSWE]’s MFP through contacts or networks which you have in any of the following ways?

1. ___ Providing the MFP with names of other professionals in the fields of minority mental health or substance abuse

2. ___ Providing the MFP with the names or other identifying information for organizations relevant to minority mental health or substance abuse

3. ___ Telling other professionals in the fields of minority mental health or substance abuse about ways in which they could contribute to the MFP

4. ___ Helping the MFP recruit Fellows

5. ___ Assisting in job development for Fellows

6. ___Providing career services/ job placement for Fellows

7. ___ Advocating for minority mental health/substance abuse services

8. In some other way

1. What was that? _______________________________________________________________________________

14. As part of your work with the [ANA/ APA/ApA/ CSWE] MFP, have you directly contacted academic institutions to inform them about the MFP? ___ yes ___ no

    1. If yes: Can you tell me more about that? ___________________________________________________________________

____________________________________________________________________________________________________

15. As part of your work with the [ANA/ APA/ApA/ CSWE] MFP, have you directly contacted your discipline’s licensing and/or credentialing bodies to discuss issues related to professional training in minority mental health? ? ___ yes ___ no

    1. If yes: Can you tell me more about that? ___________________________________________________________________

____________________________________________________________________________________________________

16. Has the [ANA/ APA/ApA/ CSWE] collaborated with the SAMHSA MFP in any other way (outside of the activities which we just spoke about)? ___ Yes ___ No

1. [If yes:] What event or activity was this? __________________________________________________________________

17. On a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful, how helpful would you say that having SAMHSA’s MFP has been to your profession?

Very Unhelpful …………………………… Very Helpful

1 2 3 4 5

18. Have you yourself participated in SAMHSA’s MFP in any way? ___ Yes ___ No

If yes: In which of the following ways have you been involved? [Note: participant may select all that apply]

Have you received a Minority Fellowship through SAMHSA? Have you acted as a formal (assigned) advisor to a Fellow? Were you a supervisor in a training program where you supervised a Fellow? Did you hold formal positions within any of SAMHSA’s MFP grantee programs? Have you made presentations at conferences/professional meetings organized by the SAMHSA MFP? Have you made presentations or offered seminars at other types of meetings organized by the MFP? Have you participated in some other way?

___ Yes ___ No ___ Yes ___ No ___ Yes ___ No ___ Yes ___ No ___ Yes ___ No ___ Yes ___ No ___ Yes ___ No

During which years? ______ to ______ for a total of ___ years Can you tell me what that position was? _______________________________________________ In what way(s)?: _________________________________ _______________________________________________

19. Have you personally encouraged [students /psychiatric residents] who were not already part of the MFP to apply to the program? ___ Yes ___ No

1. [If yes:] How many students have you encouraged to apply to SAMHSA’s MFP? _______

2. Did they apply to the program? ___ Yes ___ No ___ Don’t Know

3. How many were accepted? ______ ___ Don’t Know

The next set of questions will ask you to assess SAMHSA’s MFP, as administered by the [ANA/APA/ApA/CSWE] during the time you have been familiar with the program.

20. SAMHSA began administering this program in 1992. In which years have you been directly familiar with the [ANA/APA/ApA/CSWE] MFP? _______ (year) to _______ (year)

21. The next question has two parts. First, please evaluate how appropriate you think each of the goals are for the MFP. Then rate the degree to which SAMHSA’s MFP in the [ANA/APA/ApA/CSWE] is engaged in addressing those goals.

GOALS	How appropriate would you say this goal is for the MFP? Would you say it is: 1 = very inappropriate 2 = somewhat inappropriate 3 = neither inappropriate or appropriate 4 = somewhat appropriate 5 = very appropriate	How engaged would you say the MFP is in addressing this goal? Would you say it is: 1 = very disengaged 2 = somewhat disengaged 3 = neither disengaged nor engaged 4 = somewhat engaged 5 = very engaged
Developing new cohorts of Fellows	1 2 3 4 5	1 2 3 4 5 DK
Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5	1 2 3 4 5 DK
Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5	1 2 3 4 5 DK
Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5	1 2 3 4 5 DK
Increasing mental health and substance abuse services to minority communities	1 2 3 4 5	1 2 3 4 5 DK

23. Thinking about the same goals, how much progress would you say the SAMHSA MFP has made in its contribution toward achieving those goals?

GOALS	Would you that the SAMHSA MFP has had: 1 = no influence on…. 2 = very little influence on… 3 = some influence on… 4 = a fair amount of influence on… 5 = a great deal of influence on…
Training/mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5
Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5
Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5
Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5
Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5
Increasing mental health and substance abuse services to minority communities	1 2 3 4 5

24. Overall, please rate the appropriateness of all of the goals in SAMHSA’s MFP. Would you say they are very inappropriate, somewhat inappropriate, neither inappropriate or appropriate, somewhat appropriate, or very appropriate?

Very Inappropriate…………………………..Very Appropriate Don’t Know

1 2 3 4 5 DK

25. Please rate the degree to which SAMHSA’s MFP is engaged overall in addressing these goals.

Very Disengaged……………………………..Very Engaged Don’t Know

1 2 3 4 5 DK

26. Please consider the federal SAMHSA MFP program overall, that is, across all the discipline. Then on a scale of 1 to 5, with 1 being very poor and 5 being very good please tell me how you rate the MFP’s work in:

	Very Very Poor………Good
Developing and administering an MFP program that supports doctoral-level training in mental health and substance abuse prevention and treatment services to minorities with an emphasis on supporting evidence-based treatment and prevention in managed behavioral health care settings.	1 2 3 4 5
Establishing an advisory committee for the MFP, including minority consumers, to provide consultation and guidance to the MFP.	1 2 3 4 5
Working with accredited professional graduate schools to recruit ethnic minority students who are committed to serving minorities with mental health and substance abuse disorders, with particular attention given to bilingual/bicultural individuals.	1 2 3 4 5
Collaborating with other professional organizations and educational institutions to increase the pool of available qualified MFP applicants and to facilitate information dissemination concerning the MFP and its program goals and outcomes.	1 2 3 4 5
Encouraging doctoral students in schools of behavioral health to specialize in areas where personnel shortages frequently occur within minority communities.	1 2 3 4 5
Providing training opportunities to MFP Fellows in settings that involve ethnic minority consumers and families in the planning and implementation of treatment and prevention service programs and involve training in evaluation to improve services.	1 2 3 4 5

27. Consider the following types of professional activities and rate the degree to which you believe the SAMHSA MFP is preparing its Fellows. Use a scale of 1 to 5, with 1 being very unprepared and 5 being very prepared. Select “Don’t Know” if you have no basis on which to assess this area.

Very Very Don’t Unprepared……..……….Prepared Know

Offering clinical services in mental health treatment Understanding ethnic/racial minority issues in mental health Offering clinical services in substance abuse treatment Understanding ethnic/racial minority issues in substance abuse Supervising mental health treatment Supervising substance abuse treatment Networking in the profession Mentoring other ethnic/racial minorities in the profession Working with community-based organizations relevant to ethnic/racial minorities Working with consumers and families with ethnic/racial backgrounds Authoring an article/paper for publication in a peer-reviewed journal Authoring a policy brief Making a presentation at a professional conference Offering a training seminar Conducting quantitative research Understanding statistics Conducting qualitative research

1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK 1 2 3 4 5 DK

28. Has the [ANA/APA/ ApA/CSWE] formally evaluated the SAMHSA-funded MFP sponsored by its organization? ___ Yes ___ No ___DK

    1. [f yes:] Was this a… ___ One time evaluation ___ An ongoing process which occurs __________ (e.g. annually)

    2. Briefly, what were the results?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

3. In which of the following ways were the results used in the MFP?

   1. ___ To establish new activities and opportunities for fellows

   2. ___ To modify existing activities and opportunities for fellows

   3. ___ To change administrative procedures

   4. ___ Other, please specify:

______________________________________________________________________________________________

______________________________________________________________________________________________

29. Were you working with the [ANA/APA/ApA/CSWE] during the time in which the SAMHSA MFP payback requirement was active?

___ Yes ___ No ___Don’t Know

If yes:

1. In your opinion, what were the benefits of the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

2. In your opinion, what were the drawbacks or limitations of the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

3. In your opinion, what were the benefits of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

4. In your opinion, what were the drawbacks or limitations of eliminating the payback requirement?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

30. Have you received any other reports on the SAMHSA MFP which have evaluated the performance of any of SAMHSA’s MFP grantees? ___ Yes ___ No

(If yes): Can you please provide the name or other identifying information about that report and rate how helpful that report was to you, on a scale of 1 to 5, with 1 being very unhelpful and 5 being very helpful?

a) Title/Description	b) [Interviewer: Check which program]
_________________________________________________________ _________________________________________________________ ________________________________________________________ _______________________________________________________	ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA ANA APA ApA CSWE SAMHSA

31. Please rate how closely aligned each of the following goals in SAMHSA’s MFP are to your organization’s goals, with 1 being very different from your goals to 5 being very similar to your goals:

	Very Different…………………Very Similar
a) Training/ mentoring ethnic/racial minority students and professionals in mental health/substance abuse treatment	1 2 3 4 5
b) Increasing the number of ethnic/racial minority professionals in mental health/substance abuse treatment	1 2 3 4 5
c) Increasing diversity in mental health/substance abuse leadership	1 2 3 4 5
d) Increasing professional contributions in mental health/substance abuse treatment for minority populations	1 2 3 4 5
e) Increasing institutional involvement of ethnic/racial minority professionals in the areas of mental health and substance abuse treatment	1 2 3 4 5
f) Increasing mental health and substance abuse services to minority communities	1 2 3 4 5

32. In what ways has having the SAMHSA MFP associated with the [ANA/APA/ApA/ CSWE]? been beneficial for the [ANA/APA/ApA/ CSWE]?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. What has been the most important benefit of having SAMHSA’s MFP housed in your organization?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

33. In what ways has having the SAMHSA MFP presented challenges for the [ANA/APA/ApA/CSWE]?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

1. What has been the most challenging in having SAMHSA’s MFP housed in your organization?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

34. Have there been particular issues or decisions on which the MFP and the rest of the [ANA/APA/ApA/CSWE] have had difficulty seeing eye-to-eye?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

If yes:

1. Was the issue resolved?

___________________________________________________________________________________________________

2. How was it resolved?

___________________________________________________________________________________________________

___________________________________________________________________________________________________

35. Overall, what difference has the SAMHSA MFP made for minority mental health and substance abuse services?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

36. In your experience, what would you identify as the most important contributions of SAMHSA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

37. In your experience, what if anything, would you most like to see improved in the SAMHSA MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Could you please tell us a little bit about your background?

38. [Interviewer, please check whether the participant is ___ male or ___ female.]

39. Which of the following best describes your area of expertise?

1. ___ Mental health c) ___ Co-occurring disorders

2. ___ Substance abuse d) ___ Some other area:

   1. What is that? _____________________________________________________

40. Are you of Hispanic/Latino background/ethnicity? ___ Yes ___ No

41. Which of the following describes your ethnic/racial background [Note: participant may select all that apply]:

___ American Indian or Alaskan Native

___ Asian

___ Black or African American

___ Native Hawaiian or Other Pacific Islander

___ White

42. Is there anything else which you would like to tell us about your experience with SAMHSA’s MFP?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Thank you for participating in this survey and sharing your experiences working with SAMHSA’s Minority Fellowship Program

27