ISP Application Instructions

Crisis Counseling Assistance and Training Program
Immediate Services Program Application
Supplemental Instructions
CCP Application Toolkit, Version 3.4
May 2012

Note: Content from the actual ISP application is in shaded boxes.

Supplemental Instructions for the
Crisis Counseling Assistance and Training Program
Immediate Services Program Application
These supplemental instructions describe the purpose of each section of the Crisis Counseling
Assistance and Training Program (CCP) Immediate Services Program (ISP) application, and
provide an explanation of how to complete the required forms and questions. These instructions
are most useful when reviewed simultaneously with the ISP application and the Crisis Counseling
Assistance and Training Program Guidance. Text in shaded boxes signifies content taken directly
from the ISP application.
Please note that throughout the ISP Supplemental Instructions, the terms “State” and “State Mental
Health Authority (SMHA)” are intended to include all qualified applicants (i.e., States, U.S.
Territories, and federally recognized Tribes).
The ISP application consists of the following:
•

Application Signature Sheet: May be used in place of a transmittal letter from the
Governor’s Authorized Representative (GAR) to the Federal Emergency Management
Agency (FEMA) Disaster Recovery Manager.

•

Forms: Standard Form 424 Request for Federal Assistance (SF–424) and Standard Form
424a Budget Information: Non-Construction Programs (SF–424a).

•

Contact Information: Preparer information, point of contact information, and alternate
point of contact information.

•

Part I. Geographic Areas and Initial Needs Assessment: Includes an estimate of the
number of disaster survivors who would benefit from crisis counseling services. It also
includes an explanation of special circumstances related to the disaster that may increase
the need for crisis counseling services.

•

Part II. Response Activities from Date of Incident: Describes State and local crisis
counseling response activities from the date of the disaster incident to the date of the
application submission.

•

Part III. State and Local Resources and Capabilities: Describes the State and local
mental health systems pre- and post-disaster, and explains why these resources cannot
meet the estimated disaster crisis counseling needs.

•

Part IV. Plan of Services: Includes a list of active service providers and a plan of services
to meet identified needs, including plans for staffing, service provision, training, and
program management.

•

Part V. Budget: Includes a required format for submitting State and individual provider
budgets and line-item budget narratives.

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Application Signature
The first box is for the director of the SMHA. The second box is for the GAR to certify that the crisis
counseling needs exceed the capacity of available State and local resources. The GAR is the only
State official authorized to represent the Governor in applying for ISP funding. The ISP application
will not be accepted by FEMA without the GAR’s signature. The director of the SMHA does not
have authority to apply for ISP funds without the GAR’s signature. This signature sheet may be
used in place of a transmittal letter. Please refer to page 3 of the ISP Application.
SF–424 and SF–424a
SF–424 and SF–424a are Federal forms required by the Office of Management and Budget on
grant applications. All States applying for ISP funds must submit an SF–424 signed by the GAR
and an SF–424a. These forms are available online at http://www.samhsa.gov/dtac/.

Contact Information
Complete the information for the application preparer, the person in the SMHA who will be the
point of contact for FEMA and the Center for Mental Health Services (CMHS) regarding the CCP (if
different from the preparer), and an alternate point of contact for the CCP. Please refer to page 4 of
the ISP Application.

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Part I. Geographic Areas and Initial Needs Assessment
Provide a brief narrative description of the disaster event and its impact on individuals and communities.

The State’s response should summarize the type, scope, and impact of the disaster event to create
a frame of reference for more specific questions that follow. Please refer to page 5 of the ISP
Application.
Use the Needs Assessment Guidance to develop an estimate of the number of people who would
benefit from services and the estimated number of people to be served through primary and
secondary services. These guidelines provide information on the use of Preliminary Damage
Assessment data, the circumstances under which Individual Assistance numbers can be used, and
the percent multipliers for primary and secondary services. It is important to consult with your
FEMA Program Specialist and SAMHSA CMHS Project Officer prior to completing the Needs
Assessment Formula Table and the Table of Estimated Number of People to be Served.
START: COPY AND PASTE SECTION FOR EACH DESIGNATED SERVICE AREA

The initial needs assessment provides the foundation for all grant program activities conducted
under the ISP. Because all services and staff proposed in the ISP must relate directly to the needs
assessment, it is very important that the State carefully complete this section. A CMHS Needs
Assessment Formula Table must be completed for each area designated in the Presidential
declaration of disaster. CCP services are limited to the areas designated in the Presidential declaration.
A. CMHS Needs Assessment Formula—Estimated Crisis Counseling Needs

A CMHS Needs Assessment Formula Table and the associated questions must be copied, pasted,
and completed for each designated service area. Because the timeframe for developing an ISP
application is very limited, applicants must rely on the best information available during the initial
aftermath of the disaster. The most reliable data on disaster damage generally will come from the
FEMA preliminary damage assessment, which can be provided by the FEMA regional office
responsible for the disaster response.
Other important sources of information on crisis counseling needs may include the State
Emergency Management Agency; voluntary agencies, such as the American Red Cross; and
media sources. In addition, any crisis counselors and other human service workers deployed by
the SMHA or other public agencies in the immediate aftermath of a disaster may provide
information on crisis counseling needs. Please refer to pages 5–6 of the ISP Application.
Identify the sources of data for the number of people identified in each loss category. If FEMA
preliminary damage assessment data has not been collected for this disaster, or were not used in
specifying the number of people for each category, please clearly identify the alternate sources of data
that were used (e.g., American Red Cross, State Emergency Management Agency, media reports).

The data source for each loss category in the CMHS Needs Assessment Formula Table must be
identified. FEMA preliminary damage assessment data are considered the most reliable source
and must be used, if available. Data sources for other categories added should be discussed here.
Describe any special circumstances not captured in the CMHS Needs Assessment Formula that will
affect the need for crisis counseling services.

Special circumstances might include the type of disaster, a rapid onset of disaster with little
warning, a recent history of disaster in the designated regions, or whether the disaster was human
caused.

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Specify any high-risk group or populations of special concern identified through State’s initial needs
assessment process (e.g., children, adolescents, older adults, ethnic and cultural groups, lower income
populations).

To complete an ISP application, States are required to conduct a comprehensive assessment of
need, including a detailed assessment of the needs of at-risk populations who may be especially
vulnerable to disaster effects or who may have unique needs. Children, adolescents, and older
adults may be affected most by disasters, but the State should identify what other at-risk groups
are affected by this specific disaster. Provide a brief rationale for including these additional at-risk
groups.
If “other” categories were added to the CMHS Needs Assessment Formula Table, please describe the
rationale for including these loss categories and how the Traumatic Impact Risk Ratios were
determined.

The State may include other loss categories not listed in the CMHS Needs Assessment Formula.
For each other category listed, the State must provide a traumatic impact risk ratio and the
rationale for determining the ratio. The Traumatic Impact Risk Ratio assesses the likelihood of
individual and community adverse reactions to this disaster. If FEMA IA numbers are used, the
Traumatic Impact Risk Ratio should be 100%.
Note that “other” categories are not multiplied by household size multiplier, as the State is
expected to have reliable estimates of people in any “other” category it seeks to add.
Additional comments, if any:
B. Estimated Number of People to Be Served Through Primary and Secondary Services

The State is asked to develop appropriate and reasonable targets for providing primary and
secondary services to individuals affected by the disaster. Note that individuals may be targeted to
receive both primary and secondary services, so the sum of primary and secondary services does
not need to equal the total number of people who can benefit from crisis counseling services.
However, individually, neither primary nor secondary services should exceed the number of people
identified as in need of crisis counseling services. Please refer to page 7 of the ISP Application.
Instructions for Estimating Primary and Secondary Services
Primary Services: Individual crisis counseling; group crisis counseling; assessment, referral, and
resource linkage; community networking; basic supportive/educational contacts; and public education
presentation/groups.

Primary services are typically of a higher intensity but lower volume. When determining the primary
service targets, the State should keep in mind the following factors: type and scope of disaster,
existing services available, geography, population, and operational realities such as the capacity to
hire, train, and manage high-quality crisis counseling staff.
Experience with past CCPs, consultation with the National Center for Posttraumatic Stress
Disorder (NCPTSD), and data from the Retrospective 5-year Evaluation of the Crisis Counseling
Program indicate that typical programs (of 2,500 survivors to be served) see between 60 and 80
percent of the individuals identified through the CMHS Needs Assessment Formula process.
Note that these figures are general guidelines only. The State is strongly advised to consult with its
FEMA and CMHS project officers to identify a primary percent multiplier based on the size and
scope of the disaster, the types of needs caused by the disaster, the at-risk groups affected, and
the geographic and demographic regions to be served. For example, with smaller disasters in
which the survivors are known and more readily accessible, one may expect to see more than 80
percent of people who could benefit from services. With larger disasters, or disasters in which the
ISP Supplemental Instructions, Page 5 of 22

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survivors are dispersed or difficult to reach, one may see fewer than 60 percent of people who
could benefit from services. The State is responsible for presenting a rationale for its calculations.
Secondary Services: Media/public service announcements and distribution of educational materials
(including e-mail and Web sites).

Secondary services are typically of a lower intensity but higher volume. The State must also
estimate the number of individuals who may be served through high-volume secondary services,
such as media/public service announcements and distribution of educational materials. It is
understood and appropriate that a certain number of individuals not deemed directly affected may
be exposed to distributed educational materials or media messaging. However, as the ISP is
intended for disaster survivors and at-risk populations, these individuals would not be included in
estimated service targets. Therefore, the number of people to be served through secondary
services could reach the total number of people who would benefit from services, but should not
exceed 100%.
Provide a rationale for estimating the total number of people to be served through primary and
secondary services.
END: COPY AND PASTE SECTION FOR EACH DESIGNATED SERVICE AREA

While the total number of people who would benefit from crisis counseling services is determined
by simple calculation, the estimated number of people to be served must be identified by the State.
Even the most effective program is unlikely to serve every single person identified as potentially
benefiting from services. Therefore, the State must present a rationale for estimating the number of
people the ISP will serve. The State is encouraged to confer with its FEMA or CMHS project officer
for assistance in determining this estimation.
C. Summary of Geographic Areas and Initial Needs Assessment

Please refer to page 8 of the ISP Application.
Additional comments, if any:

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Part II. Response Activities from Date of Incident
This section of the application is an opportunity to demonstrate to FEMA and CMHS that the State
and local providers carried out a timely crisis counseling response to the disaster. To be
reimbursed for costs incurred from date of incident to date of application, the State must document
and describe the crisis counseling services that have been provided and justify the costs.
Expenses incurred in providing these services must be thoroughly documented in the budget and
budget narrative section at the end of the application. The State may seek reimbursement only for
crisis counseling-type services.
Describe State and local crisis counseling activities from the date of the incident to the date of this
application. Please include information on types of crisis counseling services and number of services
provided. Enter “none” if no activities have been conducted to date.

Describe the types of crisis counseling services provided; specify who provided the services, where
the services were provided, and the number of recipients. Displaying this information in a table
may be helpful.
Unless there are unusual situations related to crisis counseling services that the State wants to
convey to FEMA and CMHS in detail, this section should be concise. The description in this section
should be limited to crisis counseling services provided during this interim period by the State and
by service providers being proposed for inclusion in the ISP.
Additional comments, if any:

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Part III. State and Local Resources and Capabilities
The CCP regulations require that the ISP application provides “a description of the State and local
resources and capabilities, and an explanation of why these resources cannot meet the need.” The
Federal Government is required to verify that the needs are beyond State and local resources and
capabilities before Federal funds may be awarded.
Describe State and local mental health systems and the clients they serve. Explain why these
resources cannot meet the disaster-related mental health needs.

As State and local mental health systems differ, please explain clearly how the SMHA is structured
within the State system, as well as the types of clients served, eligibility requirements for clients,
and usual capacity to provide services (e.g., number of clients in the system). The ISP is a
supplemental grant, so a clear description of why these resources cannot meet the disaster-related
mental health needs is essential.
Additional comments, if any:

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Part IV. Plan of Services
Complete the following Staffing Summary Table by entering information from the State and Provider
Staffing Tables

Complete the Staffing Summary Table by taking information from the State and Provider Staffing
Plan Tables (located in Part IV.B.1. and Part IV.C.2.). The State will need to complete separate
sheets for the State and for each proposed service provider.
A. Staffing Summary Table

The State must attach a comprehensive organizational chart that indicates the location of the
SMHA in the overall State system and breaks out the SMHA ISP staff, as well as each individual
provider. Clear lines of reporting from the provider to the State ISP leadership level should be
included. ISP positions listed must be consistent with those proposed in the staffing and plan of
services and those included in the budget. Please refer to page 9 of the ISP Application.
Describe the rationale for determining the number of FTEs for the program based on the total
estimated number of people to be served through primary services.

In order to identify the number of staff needed for the program, the State must determine the
subset of individuals that crisis counselors are expected to reach. The total estimated number of
people to be served through primary services is determined in the Summary of Geographic and
Initial Needs Assessment Table (See Part I.C.). However, Additional information on staffing levels
is available in Part IV.B.1. State Staffing and Part IV.C.2. Provider Staffing.
Provide a brief description of the organizational and supervisory plan for the program.

Describe how the organizational structure of the ISP will promote effective State oversight and
support clear communication and staff supervision at both the State and individual provider levels.
Additional comments, if any:
B. State Staffing Plan
Please provide information on the State staffing plan. Include State leadership positions and include
State service staff if the State is directly providing primary services.

The State staffing plan typically consists of State leadership positions such as the State CCP
Program Manager or Director, Fiscal Administrator, Administrative Assistant/Data Entry Clerk, and
Evaluation Coordinator. Large programs may have additional staff positions based on the needs of
the program. In some cases, the State may also choose to directly provide primary services. In this
case the State staffing plan would also include direct service staff such as crisis counselors and
team leaders.

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1. State Staffing Table

Please refer to page 10 of the ISP Application.
Provide a brief job description (one paragraph) for each staff position included in the program. Sample
job descriptions for typical positions are available in the ISP Supplemental Instructions and may be
modified and inserted here.

Please see sample job descriptions on pages 12 and 13 of the ISP Supplemental Instructions.
2. Services and Strategies

If the State is directly providing primary services, please answer the following service strategy
questions using the instructions on pages 13 of the ISP Supplemental Instructions. Please indicate
if the State is not directly providing primary services. Please refer to pages 10–11 of the ISP
Application.
Additional comments, if any:
Start: COPY AND PASTE SECTION FOR EACH SERVICE PROVIDER
C. Provider Staffing Plan

Selection of Service Providers
CCP service providers most often are community mental health agencies with a pre-existing
organizational relationship with the SMHA. However, because fiscal and administrative procedures
and service delivery in the CCP are substantially different from those in other State mental health
programs, specialized training and planning is crucial to ensure an effective ISP response. If service
providers have not been selected and trained prior to a disaster, the State will have to work closely
with service providers to familiarize them with the procedures and requirements of the program.
1. Contact Information

Completing the Staffing Plan
The staffing plan must be based on the estimated provider service targets. In other words, the
number of staff that each provider hires is based on the number of people to be served. Please
refer to page 11 of the ISP Application.
Step 1: The State must determine the percentage of total people who would benefit from services
and whom it expects to reach with primary CCP services. The State must then develop a ratio of
direct-service staff to number of people targeted for primary services. Direct-service staff are
defined as crisis counselors, team leaders, community liaisons, and resource linkage coordinators.
These calculations may vary by region, with justification. Experience with past CCPs, consultation
with the National Center for Posttraumatic Stress Disorder, and data from the Retrospective 5-Year
Evaluation of the Crisis Counseling Program indicate that typical programs (of 2,500 survivors to
be served) see between 60 and 80 percent of the individuals identified through the CMHS Needs
Assessment Formula process. Furthermore, typical programs have had approximately one directservice staff person to every 300 individuals served with primary services.
Using the above figures as a guideline, if 3,000 individuals were identified as benefiting from
services and the State expects to see 70 percent of those identified, then 2,100 people would be
targeted for services. The number of people targeted for services (2,100) divided by 300 equals 7
direct service staff for the ISP (i.e., [3,000 x .70]/300=7).

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Note that these figures are general guidelines only. The State is strongly advised to consult with its
FEMA and CMHS project officers to identify an appropriate ratio, or ratios, based on the size and
scope of the disaster, the types of needs caused by the disaster, the at-risk groups affected, and
the geographic and demographic regions to be served. For example, with smaller disasters in
which the survivors are known and more readily accessible, one may expect to see more than 80
percent of people who could benefit from services. With larger disasters, or disasters in which the
survivors are dispersed or difficult to reach, one may see fewer than 60 percent of people who
could benefit from services. The State is responsible for presenting a rationale for its calculations.
Step 2: The second step in the process is to determine the ratio of team leaders to crisis
counselors. Team leaders typically supervise between four and eight crisis counselors. Team
leaders are within the total FTE available for direct service staff. For example, if 7 FTE of direct
service staff are identified for the CCP, then the applicant might choose to have 1 FTE team leader
supervise the remaining 6 FTE crisis counselors (for a ratio of 1 team leader to 6 crisis counselors).
Step 3: The third step is to determine the FTE amount of nondirect-service staff (e.g., managerial,
administrative, evaluation, and fiscal staff) appropriate for the provider. The CCP is a basic
supportive program that emphasizes face-to-face contact with survivors and at-risk individuals.
Therefore, CCP grant funded nondirect-service staff should not exceed 15 to 20 percent of the total
grant-funded FTE workforce. Some applicants may opt to allocate in-kind personnel resources to
support nondirect-service functions. Larger providers may have a need for a provider project
manager, fiscal coordinator, or administrative assistants; however, smaller providers may not have
a need for these roles, as team leaders can devote part of their time to performing these functions.
The role of State CCP program manager/director and evaluation coordinator is reserved for the
SMHA level. Nondirect-service staff are calculated in addition to the direct service FTE.
For example, an applicant proposes to hire 7 direct-service FTE and 1.5 nondirect-service FTE.
The total grant-funded workforce is 8.5 FTE (7+1.5=8.5). The nondirect-service FTE comprise 17.6
percent of the total workforce (1.5 is 17.6 percent of 8.5). As the nondirect-service FTE is under the
20 percent limit, it could be approved if the applicant includes appropriate written justification.
The Provider Staffing Table must be copied, pasted, and completed for the State and for each
service provider.
2. Provider Staffing Table

Please refer to page 12 of the ISP Application.
Provide a brief job description (one paragraph) for each staff position included in the program. Sample
job descriptions for typical positions are available in the ISP Supplemental Instructions and may be
modified and inserted here.

Sample job descriptions are provided on the following page. The State may modify these, as
needed. CCPs typically use a mix of mental health professionals (often in team leader roles) and
trained paraprofessional staff (often in crisis counselor roles). If professional staff are used as crisis
counselors, they should be paid at the State’s customary rates for a similar paraprofessional
position. Paraprofessional staff with experience in disaster mental health or crisis counseling may
also serve as team leaders.

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TYPICAL CCP POSITIONS AND JOB DESCRIPTIONS
State CCP Program Manager/Director
• Acts as lead coordinator for State crisis counseling response and is main point of contact for FEMA.
• Oversees staffing, training, reporting, and fiscal monitoring.
• Works with other disaster service agencies to ensure nonduplication of services.
• Conducts regular site visits to providers and accompanies crisis counselors as an observer to ensure
appropriate services are delivered.
• In some cases, often with smaller CCPs, may be the State Disaster Mental Health Coordinator, i.e., the
individual identified by the SMHA as responsible for State disaster mental health preparedness and
response.
Team Leader
• Leads a team of crisis counselors in the field.
• Is usually an experienced disaster mental health worker or mental health professional who supervises
paraprofessional or less experienced crisis counselors.
• May help to assess people who require traditional mental health or substance abuse treatment.
• Depending on the size and scope of the disaster, providers may have more than one leader on staff.
Crisis Counselor
• Works with individuals, families, and groups to provide outreach, basic support, individual and group
crisis counseling, public education and referral.
• Is synonymous with term “outreach worker.”
Administrative Assistance/Data Entry Clerk
• Provides a full range of administrative support to the CCP and enters evaluation data.
Consultant/Trainer
• Hired by the CCP to train program staff or provide consultation to program leadership.
• Should be experienced in the CCP model.
• Must be approved by FEMA and CMHS to conduct the trainings specified by the State.
Evaluation Coordinator
• Implements and oversees the CCP evaluation plan.
• Collects and analyzes data, collects provider and participant surveys, supervises data entry clerks,
reports data to FEMA and CMHS, and provides data analysis and feedback to State and provider
leadership staff to improve program services.
Fiscal Coordinator
• Tracks and monitors funds, reviews and submits requests for program budget modifications to FEMA
and CMHS, and prepares fiscal reports.
• Works closely with CCP leadership staff to ensure that funds are accessible to providers and are being
appropriately used for crisis counseling services.
ADDITIONAL POSITIONS ENCOUNTERED IN THE CCP
Provider Project Manager
• Often found in larger provider components.
• Acts as lead coordinator for the crisis counseling response at the provider agency and is main point of
contact for the State CCP program manager/director.
• Oversees staffing, training, reporting, and fiscal monitoring for the provider.
• Sometimes serves as a team leader.
Community Liaison
• Facilitates entry on behalf of CCP into local communities and works with community organizations.
• May serve as a cultural broker and as liaison between the CCP and a cultural group.
Media Liaison
• Develops public information press releases.
• Coordinates media events.
• Develops informational and educational literature consistent with CCP programming and services.
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Resource Linkage Coordinator
• Provides intensive resource linkage for survivors struggling to access disaster relief assistance.
• Networks with community resources to identify referral mechanisms.
• Provides training to crisis counselors and other service providers regarding referral resources and
mechanisms.

3. Services and Strategies

The CCP funds services described in the table on page 14 of the ISP Supplemental Instructions. A
description of the services is included on page 14. Note that individuals may be targeted to receive
both primary and secondary services.
Providers should check the services they intend to provide during the ISP. It is common for
providers to check all primary services listed. The State is encouraged to tailor these services to
meet special needs of survivors and at-risk populations, but they must stay within the outlined
parameters. Note that the CCP does not support critical incident stress debriefing or management,
traditional mental health or substance abuse treatment, medications, and hospitalization. Please refer
to page 13 of the ISP Application.
How will you organize and deploy crisis counseling teams?

CCP staff are typically deployed in teams, with a team leader available to coordinate deployment
and provide guidance if severe reactions are encountered. The CCP is an outreach-oriented
program. Most services should take place in the community rather than in the provider’s office.
Describe your plan to reach those identified as in need of services. Include any special population
groups that are identified in the needs assessment.
Describe the staff support mechanisms that will be available.

By its very nature, crisis counseling entails stress risks to staff. Providers should demonstrate how
they will support their staff (e.g., careful supervision, reasonable workload, and opportunities for
stress management activities).
Community stakeholders often include community mental health and substance abuse centers, schools,
faith-based organizations, first responders, law enforcement, community-based cultural organizations,
and local elected officials. With what organizations and community stakeholders will you network?

The State is encouraged to select providers indigenous to the communities they will serve.
Providers should describe how they will target both directly affected survivors and members of
special (at-risk) populations in their community. The State should ensure that any targeted at-risk
populations are also identified in the needs assessment section.
Additional comments, if any:
END: COPY AND PASTE SECTION FOR EACH SERVICE PROVIDER

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PRIMARY CCP SERVICES
Brief Educational or Supportive Contact
• Is less than 15 minutes in duration.
• Provides basic educational or emotional support to individuals or groups.
Individual Crisis Counseling
• Is greater than 15 minutes in duration.
• Helps disaster survivors understand their situation and reactions, review their options, and connect with
other individuals and agencies that may assist them.
• Includes working with the family as a unit.
• Staff are active listeners who provide emotional support.
Group Crisis Counseling
• Provides group members with emotional support and helps them to understand their situation and
reactions and to review their options.
• Assists group members with referral to other services and provides them with skills to cope with their
situation and reactions.
• Group members do most of the talking.
Public Education
• Provides general educational information to survivors on disaster services available and key concepts
of disaster mental health.
• Common activities include public speaking at community forums, in-service group meetings, and local
government meetings.
• Crisis counselor does most of the talking.
Assessment, Referral, and Resource Linkage
• Assessment determines the need for referral to additional services, such as disaster relief or traditional
mental heath or substance abuse treatment.
• Referral directs survivors to formal mental health or substance abuse treatment if they are experiencing
severe reactions.
• Referral may also direct survivors to other disaster relief resources that meet a wide range of physical,
structural, or economic needs.
• Resource linkage connects disaster survivors with health and behavioral health services, disaster
recovery resources, and tangible goods.
Community Networking and Support
• Networking allows for stronger community coalitions to promote recovery and access to services.
• Crisis counselors may be available at community events to provide a compassionate presence and
crisis counseling services.
SECONDARY CCP SERVICES
Distribution of Educational Materials
• Typically includes flyers, brochures, tip sheets, guidance documents, or Web site content.
• Includes topics such as basic disaster information, key concepts of disaster mental health, disaster
reactions and coping skills, and individual or community recovery or resilience.
• Should include materials that address the needs of at-risk populations and are available in multiple
languages.
Media and Public Service Announcements
• Refers to activities and public messaging conducted in partnership with media, State and local
governments, charitable organizations, or other community brokers of information.
• Activities and messaging are designed to reach a large number of people in order to promote access to
CCP services or to provide basic information concerning disaster, key concepts of disaster mental
health, disaster reactions and coping skills, and individual or community recovery and resilience.
• Venues for this messaging are varied and might include media interviews with CCP spokespeople,
television or radio public service announcements, use of Web sites or e-mail, or advertising.

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Note: Content from the actual ISP application is in shaded boxes.

D. Program Management Plan

The following section should be used by the State to describe the SMHA’s overall plan for program
administration, monitoring, and oversight.

Describe the State’s plan for oversight of the entire program.

While local service providers typically conduct ISP services, the State is expected to maintain clear
oversight of program operations. The State will be the main contact for FEMA/CMHS, and will be
responsible for program reporting and sharing information from FEMA/CMHS with service
providers. Describe the mechanisms the State will use to maintain contact with service providers to
share program information and updates, provide training and direction regarding CCP procedures,
and gather information from providers for ongoing needs assessment and required reporting to
FEMA/CMHS. Describe how the State’s oversight will ensure a cohesive program identity for the
ISP.
Describe the State’s plan for monitoring fiscal activity and fiscal accountability. Include financial
documentation procedures.

The State is ultimately responsible for the Federal funds received. Describe what mechanisms the
State will use to ensure that funds are properly used and accounted for at both the State and local
provider levels. While routine State financial documentation procedures should be highlighted here,
also include any specific mechanisms that will be put into place for the ISP.
Describe the State’s plan for quality control methods to assure appropriate services reach disaster
survivors.

Describe how the State will ensure that high-quality services consistent with the CCP model are
delivered across providers.
Data collection and evaluation must be consistent with the guidelines provided by FEMA and CMHS.
Data should be collected using the data collection tools approved by the Office of Management and
Budget (OMB). These tools are available in Evaluating and Monitoring the Reach, Quality, and
Consistency of Crisis Counseling Programs Manual and Toolkit, which is included with the application
materials packet that SAMHSA DTAC sends to States, and through the CCP Online Data Collection
and Evaluation System.

By checking the box, the State agrees to use the OMB-approved data collection tools and conduct
evaluation activities consistent with FEMA and CMHS guidelines.

There are specific required forms and procedures for data collection. These are detailed in the
previously referenced manual. Please review this document to ensure that the State is able to
comply with these requirements. Note that crisis counselors are required to use three of the seven
reporting forms during the ISP phase. In addition to required forms, CCP data are used in national
evaluation. Regular submission of databases is required as part of program reporting.
Describe and justify any additional process or program evaluation that may be conducted during the
ISP.

States may opt to conduct additional evaluation during the ISP. Such evaluation should be
consistent with FEMA and CMHS guidelines. Describe and justify any additional evaluation here,
including any associated costs or in-kind contributions to the program.

ISP Supplemental Instructions, Page 15 of 22

Note: Content from the actual ISP application is in shaded boxes.

If an evaluation consultant will be used for other evaluation activities, explain why this consultant was
selected and attach a résumé to the application.

If a consultant (rather than evaluation coordinator staff included in direct personnel charges) will be
used for evaluation, justify selection of this consultant here and attach a résumé to the application.
Will the State be providing, in addition to oversight, direct crisis counseling services to survivors?
Yes

No

If yes, the State must include in Part IV.B.1–2. detailed information concerning the direct services to be
provided.

Some States choose to use direct State personnel, either funded through the ISP or in-kind, to
carry out only administrative services such as oversight, fiscal management, training, or
educational materials development. If the State personnel will be providing only these types of
services, then check “No”; however, if any direct State employees will be providing crisis
counseling services to survivors, then the State must details of direct service staffing information
and service strategy information in Part IV.B.1–2. In this case, the State is essentially treated as a
service provider, while maintaining its oversight and administrative responsibilities.
Additional comments, if any:

E. Consultants (Excluding Trainers)

Consultants are individuals who have extensive experience in the CCP and who provide guidance
to State and service provider leadership staff regarding program administration, services, fiscal
management, or evaluation. Consultants are distinct from trainers, who train crisis counselors and
team leaders to carry out CCP services or address special issues related to the disaster or at-risk
populations. Consultants must be approved by FEMA and CMHS to be funded. As a basic supportive
program, the CCP does not fund professional mental health consultation on individual cases. Please
refer to page 15 of the ISP Application.
Additional comments, if any:

ISP Supplemental Instructions, Page 16 of 22

Note: Content from the actual ISP application is in shaded boxes.

F. Training

Trainers teach crisis counselors and team leaders to carry out CCP services or address special
issues related to the disaster or at-risk populations. Trainers providing the required CCP trainings
must have extensive experience in the CCP. All trainers must be approved by FEMA and CMHS to
be funded. Trainers are distinct from consultants, who are individuals with extensive experience in
the CCP and provide guidance to State and service provider leadership staff regarding program
administration, services, fiscal management, or evaluation.
Note: Enter only people who are trainers; list consultants in the previous section (E). All program staff
must receive training in the FEMA crisis counseling requirements. Please refer to pages 15–16 of the
ISP Application.

Attach résumés for any proposed trainers who have not been FEMA/CMHS approved.

Recommendations for approved FEMA/CMHS trainers are available via SAMHSA DTAC. If the
State chooses to use trainers who have not been prequalified by FEMA/CMHS, they must attach
résumés of these individuals in order to seek approval.
Additional comments, if any:

G. Facilities

The CCP provides most services in the communities where survivors live or work. However,
reasonable office space for program administrative operations is necessary. Specify whether this
space will be available as an in-kind contribution.
If the space is not available as an in-kind contribution to the CCP, carefully justify why funding is
necessary; include the type, intended use, and cost of the space. Please refer to page 16 of the
ISP Application.

ISP Supplemental Instructions, Page 17 of 22

Note: Content from the actual ISP application is in shaded boxes.

Part V. Budget
The final element of the ISP application required by the CCP regulations is the budget. CCP
regulations require “a detailed budget, showing the cost of proposed services separately from the
cost of reimbursement for any eligible services provided prior to application.” Note that the budget
for proposed services must be separate from reimbursement (interim) costs and must be detailed.
Technical Assistance
Before completing the budget, applicants should do the following:
•

Review the table titled “Instructions for the Budget Narrative” included at the end of these
supplemental instructions.

•

Review the Crisis Counseling Assistance and Training Program Guidance for a more
indepth discussion of budgeting.

•

Contact their FEMA or CMHS project officer for technical assistance.

In-Kind Resources
While there are no requirements for State or local governments matching CCP fund requirements,
regulations require the “identification of the resources the State and local governments will commit
to both services and training.” States have provided in-kind resources such as personnel; overhead
or administrative costs (e.g., office and meeting space, utilities, equipment—computers, printers,
mobile phones); transportation; advertising; and public service announcements. Communities or
groups (e.g., voluntary organizations active in disaster, local faith-based organizations) may donate
in-kind resources as well (e.g., meals, refreshments for program-related meetings or support
groups, toys, meeting space, recreational items).
Indirect Costs
As a supplemental program, the CCP does not fund a line-item category for indirect costs. All
charges must be direct.
Interim Costs
States may seek reimbursement for costs associated with crisis counseling services from the date
of incident to the date of the ISP application. States must document crisis counseling services that
have been provided and must justify the costs. States may seek reimbursement only for crisis
counseling services allowable under the CCP and not for any other type of behavioral health
response. For a description of allowable crisis counseling services, please see page 14 of the ISP
Supplemental Instructions. Please consult with your FEMA ad CMHS project officer regarding
reimbursement for interim costs. Documentation should include the following:
•

Types of crisis counseling services provided.

•

Location of service provision.

•

Types of staff who provided the services.

•

Hourly rates of staff who provided the services.

•

Number of hours staff worked.

•

Types and number of recipients who received services.

ISP Supplemental Instructions, Page 18 of 22

Note: Content from the actual ISP application is in shaded boxes.

Budgeting
An accurate budget allows for successful implementation, management, and operation of program
services and activities. CCP funds can be used to provide services for survivors and at-risk
populations identified in the needs assessment. The needs assessment identifies who should be
served; the plan of services, how they will be served; and the budget, how the services will be
funded. These three elements should be related to provide a clear picture of how CCP funding will
be used. Anything included in the plan of services must also appear in the line-item budget.
Anything included in the line-item budget must also appear in the plan of services.
The ISP application requires several specific budget formats:
•

Individual provider budgets.

•

State budget

•

Estimated funding section on the main SF–424.

•

SF–424a (serves as a total budget for the program).

The individual State, provider, and SF–424a budgets must have consistent line-item rates and
costs. As the SMHA oversees the development of the application, it should work closely with
providers to assist them in developing consistent individual provider budgets. The budgets must be
in accordance with CCP expectations, part of a cohesive program, and reflective of the needs
identified in each provider’s service area. The SMHA must ensure that all fundable expenses
detailed in the plan of services are included in the budget (e.g., FTE staff, supplies, and
consultants/trainers).
The process for completing the budgets is as follows:
1. The individual provider line-item figures must be totaled and rolled into the State budget Those
States that contract with service providers must roll individual service provider budgets into the
Provider Contractual Costs line item of the State budget. Those States that do not contract with
service providers must reflect all costs by line item in the State budget.
2. The State budget is then entered in SF–424a.
3. The SF–424a lines should then be collapsed further and included in the estimated funding
section on the main SF–424.
The budget must be integrated with the needs assessment and the program plan. A separate budget
must be provided for the SMHA and each service provider. A line-item budget narrative justifying costs
is required for both State and service provider budgets.

•

Note that SF–424a is a required form and represents the total budget for the program.

•

The applicant should review the detailed guidance on budgeting in the ISP Supplemental
Instructions and the Crisis Counseling Assistance and Training Program Guidance.

A. Budget Summary Table (Includes State and Provider Costs)

Please refer to page 17 of the ISP Application.
B. Budget Narrative Table (Includes State and Provider(s) Costs)

Please refer to page 18 of the ISP Application.

ISP Supplemental Instructions, Page 19 of 22

Note: Content from the actual ISP application is in shaded boxes.

State Budget Narrative
A detailed line-item narrative is critical for budget review and approval. Every line in the budget
must have a detailed narrative. There are specific requirements for what to include in the narrative.
These are detailed in the table titled “Instructions for the Budget Narrative” at the end of this
document. Itemize all benefits included in the fringe line item. Please refer to pages 18–19 of the
ISP Application.
Optional Interim Budget Narrative (Includes State and Provider Costs)

If applying to be reimbursed for interim costs, include a detailed line-item narrative in the ISP Line ItemBudget Narrative–Interim Costs table. Please review the detailed guidance on interim costs included in
the ISP Supplemental Instructions and in the Crisis Counseling Assistance and Training Program
Guidance.
In addition to entering itemized costs, please enter a detailed narrative justification for all line-items at
the end of each budget table.

States may seek reimbursement for costs associated with crisis counseling services it provided
from the date of the incident to the date of the ISP application. States must document crisis
counseling services that have been provided and must justify the costs. States may seek
reimbursement only for crisis counseling services allowable under the CCP and not for any other
type of behavioral health response. For a description of allowable crisis counseling services,
please see page 14 of the ISP Supplemental Instructions. Please consult with your FEMA and
CMHS project officer regarding reimbursement for interim costs. Please refer to pages 19–20 of
the ISP Application.
START: COPY AND PASTE SECTION FOR EACH SERVICE PROVIDER

C. Individual Provider Budgets

Complete an Individual Service Provider Budget for each service provider. Please refer to page 21 of
the ISP Application.

Provider Budget Narrative
A detailed line-item narrative is critical for budget review and approval. Every line item in the
budget must have a detailed narrative. There are specific requirements for what to include in the
narrative. These are detailed in the table titled “Instructions for the Budget Narrative” at the end of
this document. Itemize all benefits included in the fringe line item.
In the ISP Line-Item Budget Narrative for the Individual Service Provider—Projected Costs table,
include a detailed line-item narrative for the projected period (45 days). Please review the detailed
guidance on the budget narrative included in the ISP Supplemental Instructions and in the Crisis
Counseling Assistance and Training Program Guidance.
In addition to entering itemized costs, please enter a detailed narrative justification for all line-items at
the end of each budget table. Please refer to pages 22–23 of the ISP Application.

ISP Supplemental Instructions, Page 20 of 22

Note: Content from the actual ISP application is in shaded boxes.

Optional Interim Provider Budget Narrative
On behalf of providers, States may seek reimbursement for costs associated with crisis counseling
services provided from the date of the incident to the date of the ISP application. States must
document crisis counseling services that have been provided and must justify the costs. States
may seek reimbursement only for crisis counseling services allowable under the CCP and not for
any other type of behavioral health response. For a description of allowable crisis counseling
services, please see page 14 of the ISP Supplemental Instructions. Please consult with your FEMA
and CMHS project officer regarding reimbursement for interim costs. Please refer to pages 23–25
of the ISP Application.
END: COPY AND PASTE SECTION FOR EACH SERVICE PROVIDER

ISP Supplemental Instructions, Page 21 of 22

Budget
Category
Salaries and
Wages

Fringe Benefits

INSTRUCTIONS FOR THE BUDGET NARRATIVE
Key Points for Each Line Item

o Within the budget narrative table, list each position type and all relevant details, including the corresponding number of FTEs,
hours, weeks, rates of pay, and total cost.

o Indicate how rates of pay were determined. List sources used to make such determinations (e.g., U.S. Department of Labor).
o If rates differ from usual and customary rates for comparable positions in the local area, justify why pay rates differ.
o
o
o
o

Provide the rate of fringe for each provider.
Indicate whether the fringe benefits are based on usual and customary rates in the local area.
If the fringe rates are not comparable to the usual and customary rates for the local area, describe why the fringe rates differ.
Itemize individual benefits that constitute the fringe benefits package.

o Provide the following list of travel expenses for program staff: number of estimated miles per week, number of weeks, and
Travel

Equipment

established State mileage rate.

o Provide details on in-State airfare costs, lodging, and per diem rates.
o Consultant or trainer travel costs must be included in the consultants/trainers category.
o Itemize equipment and provide justification of equipment costs.
o Expenses less than $5,000 (e.g., mobile phones or computers) must be included in the supplies category.
Note: This line is reserved for individual equipment purchases exceeding $5,000.

Supplies

o Itemize all supplies not normally stocked in a typical business office or covered by the negotiated indirect rate agreement
(e.g., mobile phones, computers, pagers).

o Include a justification for each item.
Consultants/
Trainers

o Itemize all consultant and trainer costs by identifying person, role, daily rate, and number of days.
o Identify the type of consultation or training that the individuals are providing.
o Provide a breakdown of transportation, lodging, and per diem rates (some travel costs may need to be estimated).
Note: Ensure all compensation complies with FEMA policy and established rates of pay.

Media/Public
Information

o Provide a breakdown of expenses for pamphlets, flyers, educational materials, advertising expenses for staff recruitment, and
educational media and public information efforts.
Note: The State is encouraged to seek donated or matching media and marketing activities.

Other

o List all other costs, and provide justification for these costs.
Note: Ensure all other costs are directly supported within the plan of services.

Note: As a supplemental program, the CCP does not fund a line-item category for indirect costs. All charges must be direct.

ISP Supplemental Instructions, Page 22 of 22