Department of Health and Human Services

Part 1. Overview Information

Participating Organization(s)

National Institutes of Health (NIH)

Components of Participating Organizations

National Institute of Mental Health (NIMH)

National Institute on Drug Abuse (NIDA)

Applicants should carefully note which ICOs participate in this announcement and refer to NIH Institute, Center, and Office Grants & Funding Profiles for ICO-specific missions, interest areas, priorities, and funding considerations. 

Funding Opportunity Title
Advancing Real-World Effectiveness Evidence for Rapid-Acting Psychotropic Interventional Drugs (RAPIDs) (UM1 Clinical Trial Required)
Activity Code

UM1 Research Project with Complex Structure Cooperative Agreement

Announcement Type
New
Related Notices
Funding Opportunity Number (FON)
RFA-MH-27-150
Companion Funding Opportunity
None
Number of Applications

See Part 2, Section III. 3. Additional Information on Eligibility.

Assistance Listing Number(s)
93.24R, 93.DA1
Funding Opportunity Purpose

This notice of funding opportunity (NOFO) encourages applications to establish a Rapid-Acting Psychotropic Interventional Drugs - Clinical Trials Network (RAPIDs-CTN). The overarching purpose is to generate actionable, real-world evidence to guide the safe and effective implementation of RAPIDs in routine clinical practice, answering urgent questions about how these treatments can be delivered sustainably outside tightly controlled experimental settings. This NOFO utilizes a milestone-driven UM1 Cooperative Agreement mechanism structured into two operational stages: Stage 1 (Years 1–2) for network establishment and pilot studies, and Stage 2 (Years 3–5) focuses for full-scale execution of proposed pragmatic trials. This program is intended only for large-scale, coordinated network projects that could not be achieved using other, more standard grant mechanisms.

Funding Opportunity Goal(s)

The mission of the National Institute of Mental Health (NIMH) is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.

Key Dates

Posted Date
November 12, 2026
Open Date (Earliest Submission Date)
December 05, 2026
Application Due Dates Review and Award Cycles
New Renewal / Resubmission / Revision (as allowed) AIDS - New/Renewal/Resubmission/Revision, as allowed Scientific Merit Review Advisory Council Review Earliest Start Date
January 05, 2027 Not Applicable Not Applicable March 2027 May 2027 July 2027
June 10, 2027 June 10, 2027 Not Applicable November 2027 January 2028 April 2028

All applications are due by 5:00 PM local time of applicant organization. 

Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.

No late applications will be accepted for this Notice of Funding Opportunity (NOFO).

Expiration Date
June 11, 2027
Due Dates for E.O. 12372

Not Applicable

Required Application Instructions

It is critical that applicants follow the instructions in the Research (R) Instructions in the How to Apply - Application Guide, except where instructed to do otherwise (in this NOFO or in a Notice from NIH Guide for Grants and Contracts).

Conformance to all requirements (both in the How to Apply - Application Guide and the NOFO) is required and strictly enforced. Applicants must read and follow all application instructions in the How to Apply - Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the How to Apply - Application Guide, follow the program-specific instructions.

Applications that do not comply with these instructions may be delayed or not accepted for review.

There are several options available to submit your application through Grants.gov to NIH and Department of Health and Human Services partners. You must use one of these submission options to access the application forms for this opportunity.

  1. Use the NIH ASSIST system to prepare, submit and track your application online.
  2. Use an institutional system-to-system (S2S) solution to prepare and submit your application to Grants.gov and eRA Commons to track your application. Check with your institutional officials regarding availability.
  3. Use Grants.gov Workspace to prepare and submit your application and eRA Commons to track your application.

Part 2. Full Text of Announcement

Section I. Notice of Funding Opportunity Description

Background 

Intractable serious mental illnesses, treatment-resistant mental health disorders (e.g., treatment-resistant depression), and urgent suicide risk remain common and are leading causes of severe morbidity and mortality despite the availability of psychotropic medications and psychotherapies. Traditional interventions often take weeks to months to demonstrate clinical efficacy, and many patients experience varied disease trajectories that complicate acute psychiatric care.

Recent clinical advances have demonstrated that rapid-acting psychotropic interventional drugs (RAPIDs), defined as pharmacologic interventions (including FDA-approved treatments like ketamine/esketamine, as well as emerging late-stage investigational treatments such as psilocybin and 3,4-methylenedioxymethamphetamine (MDMA)) that produce clinically meaningful symptom reduction on a timescale of hours to days, can rapidly alter these disease trajectories. Within this evolving landscape, the critical scientific gap is generating actionable real-world evidence to understand how these highly controlled experimental findings translate to safe, effective, and sustainable delivery in routine practice.

NIMH seeks collaborative networks of clinical researchers, data scientists, and healthcare stakeholders with the goal of generating real-world evidence to guide the safe and effective implementation of RAPIDs in routine clinical practice. Although esketamine is currently the only FDA-approved RAPID for mental illness, the possibility exists that new treatments will come to market before or during initial year(s) of the project period. Flexibility to adapt to newly approved medicines should be a central component of the network and applications should reflect the ability to pivot to new treatments when applicable. 

Network Objectives

The primary objectives that the RAPIDs-Clinical Trial Network (RAPIDs-CTN) should aim to achieve include:

  • Establish a Data Coordinating Center (DCC) and an adaptive network infrastructure capable of implementing unified study protocols to evaluate RAPID agents singularly or concurrently across treatment arms. 
  • Conduct pragmatic clinical trials across a range of real-world care settings (including inpatient, emergency, Veterans Affairs (VA) healthcare, community mental health, and specialty clinics) to determine real-world clinical effectiveness and safety profiles.
  • Improve clinical outcomes for target populations with serious mental illnesses, treatment-resistant mental health conditions, and urgent suicide risk.
  • Produce comprehensive evidence packages that inform healthcare uptake, resource allocation and service delivery structures. This includes evaluating episode-based or bundled models, clinically necessary monitoring time, workforce models (including staffing ratios and training), optimal retreatment frequencies, the necessity of adjunctive psychosocial interventions, and downstream cost reductions (e.g., decreasing hospitalizations, emergency department use, and crisis service use).

Structure of the RAPIDs-CTN

RAPIDs-CTN sites are responsible for collaborative research to advance the real-world clinical effectiveness, safety, and sustainability of healthcare delivery of RAPIDs across representative populations. The Network is composed of a centralized DCC and a network of Federated Clinical Sites, supported by centralized research and project management activities.

Network Infrastructure and Governance

The Network will establish a unified, collaborative operational framework to ensure rigorous multi-site oversight, standardized trial governance, robust data coordination, and rapid protocol execution across real-world healthcare settings.

  • Data Coordinating Center (DCC): The DCC is expected to coordinate and monitor research, governance, and training activities across the RAPIDs-CTN. The DCC is responsible for facilitating centralized coordination and communication among clinical sites, managing site onboarding and protocol fidelity, supporting the network Steering Committee, and overseeing regulatory compliance and safety monitoring frameworks. DCCs are also expected to develop and conduct standardized training and quality assurance to ensure effective and uniform implementation of clinical site protocols and clinical delivery models.
  • Federated Clinical Sites (FCS) will provide clinical and administrative expertise as well as infrastructure to conduct clinical trial studies within the Network. Clinical sites are expected to include real-world clinical settings–such as community mental health centers (CMHCs), VA medical centers, emergency departments, inpatient psychiatric units, and outpatient specialty practice–serving clinically complex and demographically varied populations across the nation. Sites are responsible for patient recruitment, real-world protocol execution, and active participation in network-wide quality improvement.

Additional RAPIDs-CTN responsibilities:

Unified Protocol and Pragmatic Trial Execution

The Network is expected to develop, coordinate and oversee the implementation of unified study protocols employing an agile strategy to adapt to treatment protocol modification and newly approved pharmacotherapies. This includes designing and executing multi-site, pragmatic effectiveness trials that evaluate RAPID agents singularly or concurrently across distinct treatment arms against standard-of-care or active comparators in high-need populations (e.g., treatment-resistant conditions and acute suicide risk).

Data Management and Common Data Elements

The DCC will provide comprehensive, centralized data management, biostatistical leadership, and computational pipelines for all participating clinical sites in strict compliance with federal and regulatory standards. At a minimum, the DCC will be equipped to deliver the following core services:

  • Advanced Biostatistics and Analytics: Developing analytic plans, conducting sample size/power calculations, executing interim and final analyses, supporting adaptive trial modifications, monitoring and mitigating potential biases and confounding in real-world data streams.
  • Rigorous Clinical Data Management: Designing and maintaining centralized, secure Electronic Data Capture (EDC) systems, automated data validation, quality assurance/quality control (QA/QC) audits, and real-time adverse event reporting mechanisms.
  • Harmonization via Common Data Elements: Implementing standardized data and harmonization workflows utilizing NIMH-supported CDEs across all clinical sites to ensure interoperability and consistent clinical characteristics and outcome reporting.
  • Data Sharing and Data Deposition: Establishing automated data curation pipelines to support data deposition into the NIMH Data Archive (NDA).

Milestone-Driven UM1 Award Structure

This NOFO will support projects that include defined milestones dividing the work into two distinct stages: Stage 1 and Stage 2. See Section IV for details.

The success of the program will be facilitated by the adoption of clear, quantitative milestones with realistic and efficient timelines. Annual milestones are characterized by metrics to document progress towards the achievement of the specific aims. During the project period, the awardees will be expected to refer to these milestones in progress reports. The funding institute will use milestones and other measures of productivity and success to evaluate the progress, impact, and value of the program, and modify the milestones accordingly. 

Opportunities for Leveraging Resources

Pragmatic clinical trials in real-world settings are strengthened through collaborative partnerships across public and private sectors. Applicants are strongly encouraged to consider and propose in-kind and collaborative resources contributed by healthcare systems, community clinics, state mental health authorities, regional scientific hubs, non-profit organizations, philanthropic foundations, and industry partners (e.g., pharmaceutical, biotechnology, and healthcare technology sectors). These collaborative contributions–such as provision of therapeutic agents or comparator products, clinical observation space, specialized clinician training, patient engagement and recruitment support, dedicated electronic health record (EHR) data feeds, state registry integration, and regulatory management–can greatly facilitate embedding trials directly into routine care settings, accelerate participant recruitment, and support scalable care delivery models. Further, the program might benefit from special features in the environment or distinctive resources that will enhance the overall program. This might include any non-federal, in-kind contributions provided by participating healthcare systems, community clinics, state mental health authorities, non-profit organizations, foundations, or industry partners that will enhance network operations. 

Technical Assistance Webinar

A technical assistance webinar will be held approximately 3 weeks following publication of the NOFO, with specific details to be provided separately. This optional webinar will provide additional information and respond to questions from prospective applicants. 

Join: Microsoft Teams

Meeting ID: 284 328 052 003 917

Passcode: HV6ER3bV

Participants can submit questions in advance to NIMHRAPIDS@nih.gov 

Investigators proposing NIH-defined clinical trials may refer to the Research Methods Resources website for information about developing statistical methods and study designs.

Non-Responsive Criteria
The following types of applications are not responsive to this NOFO and will not be reviewed:
  • Applications proposing traditional, highly controlled explanatory clinical trials rather than pragmatic, real-world effectiveness trials.
  • Applications focused solely on basic neuroscience or preclinical animal models.

Applicants are strongly encouraged to refer to NIH Institute, Center, and Office Grants & Funding Profiles for ICO-specific missions, interest areas, priorities, and funding considerations. Please reach out to contacts listed in VII. Contacts.

See Section VIII. Other Information for award authorities and regulations.

Section II. Award Information

Funding Instrument

Cooperative Agreement: A financial assistance mechanism used when there will be substantial Federal scientific or programmatic involvement. Substantial involvement means that, after award, NIH scientific or program staff will assist, guide, coordinate, or participate in project activities. See Section VI.2 for additional information about the substantial involvement for this NOFO.

Application Types Allowed
New
Resubmission

The OER Glossary and the How to Apply - Application Guide provide details on these application types. Only those application types listed here are allowed for this NOFO.

Clinical Trial?

Required: Only accepting applications that propose clinical trial(s).

Funds Available and Anticipated Number of Awards

The number of awards is contingent upon NIH appropriations and the submission of a sufficient number of meritorious applications.

NIMH intends to commit up to $10M to fund at least 1 award in FY27 and in FY28. 

NIDA intends to commit up to $2M to fund 1 award in FY27. Future awards will be dependent on annual appropriations. 

Award Budget

Application budgets need to reflect the actual needs of the proposed project.

Award Project Period

The scope of the proposed project should determine the project period. 

The maximum project period is 5 years.

NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made from this NOFO.

Section III. Eligibility Information

1. Eligible Applicants

Type of Competition
Open Competition
Eligible Organizations

Higher Education Institutions - Includes all types

  • Public/State Controlled Institutions of Higher Education
  • Private Institutions of Higher Education

Nonprofits Other Than Institutions of Higher Education

  • Nonprofits with 501(c)(3) IRS Status (Other than Institutions of Higher Education)
  • Nonprofits without 501(c)(3) IRS Status (Other than Institutions of Higher Education)

For-Profit Organizations

  • Small Businesses
  • For-Profit Organizations (Other than Small Businesses)

Local Governments

  • State Governments
  • County Governments
  • City or Township Governments
  • Special District Governments
  • Indian/Native American Tribal Governments (Federally Recognized)
  • Indian/Native American Tribal Governments (Other than Federally Recognized)

Federal Governments

  • Eligible Agencies of the Federal Government
  • U.S. Territory or Possession

Other

  • Independent School Districts
  • Public Housing Authorities/Indian Housing Authorities
  • Native American Tribal Organizations (other than Federally recognized tribal governments)
  • Faith-based or Community-based Organizations
  • Regional Organizations
Applications Involving the NIH Intramural Research Program

The requests by NIH intramural scientists will be limited to the incremental costs required for participation.   As such, these requests will not include any salary and related fringe benefits for career, career conditional or other Federal employees (civilian or uniformed service) with permanent appointments under existing position ceilings or any costs related to administrative or facilities support (equivalent to Facilities and Administrative or F&A costs).  These costs may include salary for staff to be specifically hired under a temporary appointment for the project, consultant costs, equipment, supplies, travel, and other items typically listed under Other Expenses.  Applicants should indicate the number of person-months devoted to the project, even if no funds are requested for salary and fringe benefits.

If selected, appropriate funding will be provided by the NIH Intramural Program. Intellectual property will be managed in accord with established policy of NIH in compliance with Executive Order 10096, as amended, 45 CFR Part 7; patent rights for inventions developed in NIH facilities are NIH property unless NIH waives its rights.

Should an extramural application include the collaboration with an intramural scientist, no funds for the support of the intramural scientist may be requested in the application.  The intramural scientist may submit a separate request for intramural funding as described above.

Foreign Organizations/Foreign Collaborations

Non-domestic (non-U.S.) Entities (Foreign Organizations) are not eligible to apply.

Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.

Foreign components, as defined in the NIH Grants Policy Statement, are not allowed. 

NIH foreign application, collaboration, component policies do not apply as these are not allowed or eligible for this NOFO.

Required Registrations

Applicant Organizations

Applicant organizations must complete and maintain the following registrations as described in the How to Apply- Application Guide to be eligible to apply for or receive an award. All registrations must be completed prior to the application being submitted. Registration can take 6 weeks or more, so applicants should begin the registration process as soon as possible. Failure to complete registrations in advance of a due date is not a valid reason for a late submission, please reference the NIH Grants Policy Statement Section 2.3.9.1 Electronically Submitted Applications for additional information.

  • System for Award Management (SAM) – Applicants must complete and maintain an active registration, which requires renewal at least annually. The renewal process may require as much time as the initial registration. SAM registration includes the assignment of a Commercial and Government Entity (CAGE) Code for domestic organizations which have not already been assigned a CAGE Code. Foreign organizations must obtain a NATO Commercial and Government Entity (NCAGE) Code (in lieu of a CAGE code) in order to register in SAM.
    • Unique Entity Identifier (UEI)- A UEI is issued as part of the SAM.gov registration process. The same UEI must be used for all registrations, as well as on the grant application.
  • eRA Commons - Once the unique organization identifier is established, organizations can register with eRA Commons in tandem with completing their Grants.gov registrations; all registrations must be in place by time of submission. eRA Commons requires organizations to identify at least one Signing Official (SO) and at least one Program Director/Principal Investigator (PD/PI) account in order to submit an application.
  • Grants.gov – Applicants must have an active SAM registration in order to complete the Grants.gov registration.

Program Directors/Principal Investigators (PD(s)/PI(s))

All PD(s)/PI(s) must have an eRA Commons account.  PD(s)/PI(s) should work with their organizational officials to either create a new account or to affiliate their existing account with the applicant organization in eRA Commons. Obtaining an eRA Commons account can take up to 2 weeks.

All PD(s)/PI(s) must be registered with ORCID. The personal profile associated with the PD(s)/PI(s) eRA Commons account must be linked to a valid ORCID ID. For more information on linking an ORCID ID to an eRA Commons personal profile see the ORCID topic in our eRA Commons online help.

Eligible Individuals (Program Director/Principal Investigator)

Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director(s)/Principal Investigator(s) (PD(s)/PI(s)) is invited to work with their organization to develop an application for support. 

For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the How to Apply - Application Guide.

2. Cost Sharing

This NOFO does not require cost sharing as defined in the NIH Grants Policy Statement NIH Grants Policy Statement Section 1.2 Definition of Terms.

3. Additional Information on Eligibility

 

Number of Applications

Applicant organizations may submit more than one application, provided that each application is scientifically distinct.

The NIH will not accept duplicate or highly overlapping applications under review at the same time, per NIH Grants Policy Statement Section 2.3.7.3 Submission of Resubmission Application. This means that the NIH will not accept:

  • A new (A0) application that is submitted before issuance of the summary statement from the review of an overlapping new (A0) or resubmission (A1) application.
  • A resubmission (A1) application that is submitted before issuance of the summary statement from the review of the previous new (A0) application.
  • An application that has substantial overlap with another application pending appeal of initial peer review (see NIH Grants Policy Statement 2.3.9.4 Similar, Essentially Identical, or Identical Applications).

Section IV. Application and Submission Information

1. Requesting an Application Package

The application forms package specific to this opportunity must be accessed through ASSIST, Grants.gov Workspace or an institutional system-to-system solution. Links to apply using ASSIST or Grants.gov Workspace are available in Part 1 of this NOFO. See your administrative office for instructions if you plan to use an institutional system-to-system solution.

Instructions for Application Submission

The following section supplements the instructions found in the How to Apply – Application Guide and should be used for preparing an application to this NOFO.

2. Content and Form of Application Submission

It is critical that applicants follow the instructions in the Research (R) Instructions in the How to Apply - Application Guide except where instructed in this notice of funding opportunity to do otherwise (in this NOFO, in a policy notice, or other notice from NIH Guide for Grants and Contracts). Conformance to the requirements in the How to Apply - Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.

Page Limitations

All page limitations described in the How to Apply – Application Guide and the Table of Page Limits must be followed.

Overview

For this specific NOFO, the Research Strategy section is limited to 20 pages. The Research Strategy must consist of the following sections:

Approach

A. Network Infrastructure and Governance

B. Unified Protocol and Pragmatic Trial Execution

C. Data Management and Common Data Elements (CDEs)

D. Timeline and Milestones

SF424(R&R) Cover

All instructions in the How to Apply - Application Guide must be followed.

SF424(R&R) Project/Performance Site Locations

All instructions in the How to Apply - Application Guide must be followed.

SF424(R&R) Other Project Information

All instructions in the How to Apply - Application Guide must be followed.

Letters of Collaboration:

Applicants must include letters of collaboration for Clinical Site Commitment that demonstrate the feasibility and collaborative nature of the proposed network.

  • Clinical Site Commitment: Provide letters of collaboration from the leadership or appropriate authorized officials of the proposed real-world clinical sites (e.g., inpatient facilities, VA healthcare centers, community clinics). These letters must explicitly confirm their commitment to participating in the network, adhering to the unified study protocols, and sharing data via the DCC.

Applicants are encouraged to include Letters of Collaboration for Leveraged Resources that demonstrate the collaborative nature of the proposed network.

  • Leveraged Resources: To support the network's sustainability, applicants may include Letters of Collaboration or intent from external partners (such as institutional leadership, state health systems, philanthropy, or private-sector partners). Letters of Collaboration might address any special features in the environment or distinctive resources that will enhance the overall program.

SF424(R&R) Senior/Key Person Profile

All instructions in the How to Apply - Application Guide must be followed.

Within the biosketches, highlight expertise in designing and executing large-scale, multi-site pragmatic clinical trials or adaptive platform trials. 

R&R Budget

All instructions in the How to Apply - Application Guide must be followed.

Applicants must designate individuals for core network leadership positions. It is strongly recommended that key leadership commit the following levels of effort:

  • Contact PD/PI (Overall Network Lead): At least 2.4 person-months (20% effort) per year across all 5 years of the award to oversee cross-network governance and strategic execution.
  • DCC Director / Lead Data Scientist: At least 2.4 person-months (20% effort) per year to lead centralized data management, quality assurance procedures, CDE development, and safety monitoring frameworks.
  • Multi-PD/PIs (if applicable): Each designated PD/PI commits at least 1.8 person-months (15% effort) per year.
  • Clinical Site Lead Investigators: At least 1.2 person-months (10% effort) per year to ensure protocol fidelity, patient recruitment, and trial execution.

In Year 1, there will be a 2-day, in-person RAPID-CTN meeting in the Washington, DC area, or a relevant scientific conference as designated by NIH. The contact PD/PIs must include travel to attend such meetings in their budgets.

R&R Subaward Budget

All instructions in the How to Apply - Application Guide must be followed.

PHS 398 Cover Page Supplement

All instructions in the How to Apply - Application Guide must be followed.

PHS 398 Research Plan

All instructions in the How to Apply - Application Guide must be followed, with the following additional instructions:

In addition to the standard NIH instructions for Significance, Innovation, and Approach, applicants must explicitly address the following elements within the Approach section. We strongly recommend using the following sub-headings to organize the application:

A. Network Infrastructure and Governance

  • Data Coordinating Center (DCC): Describe the organizational structure, leadership and governance of the DCC. Detail how the DCC will manage cross-network communication, oversee unified study protocols, and implement rigorous safety and monitoring frameworks across all settings.
  • Federated Clinical Sites (FCS): Describe the initial network of real-world care settings (e.g., inpatient, emergency, VA, community mental health, and specialty clinics) participating in Stage 1.  For the pilot study proposed during Stage 1, describe the operational readiness, patient populations, clinical capacity, and specific roles of the initial sites in successfully executing the pilot. Detail the strategy and feasibility for rapidly onboarding additional sites during Stage 2. Describe strategies for meaningful community engagement, including partnerships with local clinic leadership, practicing clinicians, and patient stakeholders to support participant recruitment and study acceptability.

B. Unified Protocol and Pragmatic Trial Execution

  • Provide a detailed plan for designing and executing pragmatic, real-world effectiveness trials using unified study protocols.
  • Explain how the network will evaluate RAPID agents singularly or concurrently across distinct treatment arms against control groups.
  • Explain how the network will adapt if newly approved RAPIDs become available for real-world data collection. 
  • Describe the target patient populations, ensuring inclusion of individuals with serious mental illnesses, treatment-resistant psychiatric disorders, and/or urgent suicide risk. Discuss the potential generalizability of the data based upon the proposed target populations.
  • Address practical clinical implementation parameters, including concomitant medication management and protocols for individualized antidepressant tapering or washout when clinically required, and account for the impact of these clinical timelines on study feasibility and recruitment.

C. Data Management and Common Data Elements (CDEs)

  • Describe the data infrastructure and data flow from the federated clinical sites to the DCC.
  • Explicitly detail the plan to adopt and implement NIMH-supported CDEs to ensure data harmonization and facilitate future data sharing.
  • Outline how the network will generate comprehensive, actionable evidence packages regarding workforce models, healthcare costs, and retreatment frequencies to inform healthcare uptake, resource allocation, and delivery-model decisions.

D. Timeline and Milestones (Critical for UM1 Structure)

  • Provide a milestone plan that delineates Stage 1 (Years 1 and 2) and Stage 2 (Years 3 through 5).
  • Include a detailed, quantifiable table of administrative milestones mapping to specific annual milestones for Year 1 and Year 2.
  • Year 1 milestones must include: Establishment of the DCC infrastructure and governance; onboarding initial FCS and establishing community engagement workflows; standardizing NIMH CDEs, data flow pipelines, safety frameworks, and finalizing unified study protocols, and the successful launch or activation of pilot pragmatic effectiveness studies across the initial federated network.
  • Year 2 milestones must include: Delivery of initial pilot findings (safety, feasibility, utilization, and costs); the submission of a concrete Stage 2 scale-up plan and evidence package generation plan that provides a cross-functional roadmap to show how data, research, and insights are collected and distributed to make decisions. Applicants may include a summary of potential in-kind and collaborative resources (Refer to Section 1 Opportunities for Leveraging Resources). These milestones will be used by NIH program staff to evaluate the transition into Stage 2. 
  • Stage 2 (Years 3-5) focuses on full-scale execution of unified pragmatic trials, onboarding additional FCS across a broad range of real-world settings, adaptive integration of newly approved pharmacotherapies, and comprehensive data deposition to the NDA to provide actionable evidence packages for sustainable health system adoption.

Resource Sharing Plan: Individuals are required to comply with the instructions for the Resource Sharing Plans as provided in the How to Apply - Application Guide.

Other Plan(s): 

All instructions in the How to Apply - Application Guide must be followed, with the following additional instructions:

A Data Management and Sharing Plan (DMS Plan) is required for any NIH-funded or conducted research that will generate scientific data. Applicants must submit the DMS Plan at the time of application using the NIH DMS Plan Format Page. The DMS Plan must address the elements in the structured format. Where the DMS Plan Format Page requires a "Yes or No" response, no additional narrative is allowed.

  • NIMH expects investigators funded under this NOFO to collect Common Data Elements (CDEs) for mental health human subjects research. 
  • Investigators are expected to use the NIMH Data Archive (NDA) to submit data. NDA links data across research projects through its Global Unique Identifier (GUID) and Data Dictionary technology. 
  • Describe methods and systems for data collection (e.g., Case Report Forms/CRFs), data entry, data verification, and data validation. Describe the data query process and frequencies and any planned mitigation strategies in the event of noncompliance.
  • Describe the process for locking the final trial datasets and the planned procedures on data access and sharing, as appropriate.

Appendix: Only limited Appendix materials are allowed. Follow all instructions for the Appendix as described in the How to Apply - Application Guide.

  • No publications or other material, with the exception of blank questionnaires or blank surveys, may be included in the Appendix.

PHS Human Subjects and Clinical Trials Information

When involving human subjects research, clinical research, and/or NIH-defined clinical trials (and when applicable, clinical trials research experience) follow all instructions for the PHS Human Subjects and Clinical Trials Information form in the How to Apply - Application Guide, with the following additional instructions:

If you answered "Yes" to the question "Are Human Subjects Involved?" on the R&R Other Project Information form, you must include at least one human subjects study record using the Study Record: PHS Human Subjects and Clinical Trials Information form or Delayed Onset Study record.

Study Record: PHS Human Subjects and Clinical Trials Information

All instructions in the How to Apply - Application Guide must be followed.

Section 3 - Protection and Monitoring Plans

3.3 Data and Safety Monitoring Plan

Describe the locations where the monitoring will occur (e.g., participating clinical sites, data center, clinical coordinating center) and what data will be reviewed.

Provide an overall description of the monitoring plan to ensure adherence to the protocol, and the quality and consistency of the study intervention(s), including fidelity monitoring for behavioral interventions. Include methods to monitor study intervention and system to record and manage exceptions and deviations. If applicable, describe monitoring of participating facilities, such as labs or pharmacies, for adequate handling and storage of investigational product(s) and study specimens. Include a description to ensure that the investigational product(s) accountability and reconciliation are performed adequately during and at the end of the trial per applicable regulatory requirements.

Describe plans for handling any deficiencies that are uncovered, and in cases of serious deficiencies, the appropriate reporting to relevant authorities, including but not limited to the IRB of record, DSMB if one is assigned, FDA if applicable, institutional officials, and the NIH.

Section 4 - Protocol Synopsis

4.1 Brief Summary

NIH recognizes the role of both effectiveness/pragmatic versus efficacy trials and understands that all elements will not apply to all trial types (e.g., frequent patient visits, 100% source data verification, frequent site monitoring); for example, for large simple effectiveness trials. Applicants should ensure applicable elements are provided based on the type of trial planned (e.g., efficacy, effectiveness, randomized registry or pilot trials).

4.1.c Interventions

If applicable, provide a description of the dose frequency and type of administration of the intervention(s).

4.5 Will the study use an FDA-regulated intervention?

4.5.a If yes, describe the availability of Investigational Product (IP) and Investigational New Drug (IND)/Investigational Device Exemption (IDE) status

If applicable, provide FDA info available on early feasibility studies.

Section 5 - Other Clinical Trial-related Attachments

5.1 Other Clinical Trial-related Attachments

The following additional Clinical Trial-related attachments are required for applications that include a clinical trial: "Common Data Elements Applicability" and "Clinical Protocol Schedule of Events."

Common Data Elements Applicability

Applicants are required to provide a description of their plans to consider the applicability of Common Data Elements (CDEs). The filename "Common Data Elements Applicability.pdf" must be used for this attachment. If more than one set of CDEs are used, they should be combined in this attachment.

Investigators are encouraged to describe if NIH-supported CDEs will be used in the proposed clinical trial. If CDEs are not applicable, applicants are expected to explain why.

Clinical Trial applications that lack the 'Common Data Elements Applicability' attachment are considered incomplete.

Clinical Protocol Schedule of Events

The filename "Clinical Protocol Schedule of Events.pdf" must be used for this attachment. If more than one set of Clinical Protocol Schedules of Events are used, they should be combined in this attachment.

The clinical protocol schedule of events is to capture a snapshot of the time it takes for protocol procedures to be completed by an individual participant during the trial.

For example:

  • Week 1 Screening/Baseline Visit (4 hours)- eligibility criteria, obtain informed consent, screening assessment(s), labs, etc.
  • Week 2, 4, 6, 8, Study Visits (3 hours) intervention(s), assessment(s), labs, scan(s) etc.
  • Week 12 and 18 Follow-up Visits (3 hours)- assessment(s), labs, scan(s) etc.
  • Week 24 End of study visit (2 hours)- assessment(s), labs, scan(s) etc.

This document may be provided in a tabular format.

Clinical Trial applications that lack the 'Clinical Protocol Schedule of Events' attachment are considered incomplete.

Delayed Onset Study

Note: Delayed onset does NOT apply to a study that can be described but will not start immediately (i.e., delayed start). All instructions in the How to Apply - Application Guide must be followed.

PHS Assignment Request Form

All instructions in the How to Apply - Application Guide must be followed.

3. Unique Entity Identifier and System for Award Management (SAM)

See Part 2. Section III.1 for information regarding the requirement for obtaining a unique entity identifier and for completing and maintaining active registrations in System for Award Management (SAM), NATO Commercial and Government Entity (NCAGE) Code (if applicable), eRA Commons, and Grants.gov

4. Submission Dates and Times

Part I. contains information about Key Dates and times. Applicants are encouraged to submit applications before the due date to ensure they have time to make any application corrections that might be necessary for successful submission. When a submission date falls on a weekend or Federal holiday, the application deadline is automatically extended to the next business day.

Organizations must submit applications to Grants.gov (the online portal to find and apply for grants across all Federal agencies). Applicants must then complete the submission process by tracking the status of the application in the eRA Commons, NIH's electronic system for grants administration. NIH and Grants.gov systems check the application against many of the application instructions upon submission. Errors must be corrected and a changed/corrected application must be submitted to Grants.gov on or before the application due date and time.  If a Changed/Corrected application is submitted after the deadline, the application will be considered late. Applications that miss the due date and time are subjected to the NIH Grants Policy Statement Section 2.3.9.2 Electronically Submitted Applications.

Applicants are responsible for viewing their application before the due date in the eRA Commons to ensure accurate and successful submission.

Information on the submission process and a definition of on-time submission are provided in the How to Apply – Application Guide.

5. Intergovernmental Review (E.O. 12372)

This initiative is not subject to intergovernmental review.

6. Funding Restrictions

All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Pre-award costs are allowable only as described in the NIH Grants Policy Statement Section 7.9.1 Selected Items of Cost.

7. Other Submission Requirements and Information

Applications must be submitted electronically following the instructions described in the How to Apply - Application Guide. Paper applications will not be accepted.

Applicants must complete all required registrations before the application due date. Section III. Eligibility Information contains information about registration.

For assistance with your electronic application or for more information on the electronic submission process, visit How to Apply – Application Guide. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Dealing with System Issues guidance. For assistance with application submission, contact the Application Submission Contacts in Section VII.

Important reminders:

All PD(s)/PI(s) must include their eRA Commons ID in the Credential field of the Senior/Key Person Profile form. Failure to register in the Commons and to include a valid PD/PI Commons ID in the credential field will prevent the successful submission of an electronic application to NIH. See Section III of this NOFO for information on registration requirements.

The applicant organization must ensure that the unique entity identifier provided on the application is the same identifier used in the organization's profile in the eRA Commons and for the System for Award Management. Additional information may be found in the How to Apply - Application Guide.

See more tips for avoiding common errors.

Upon receipt, applications will undergo an administrative check for completeness, compliance, and responsiveness requirements prior to peer review. Any application that does not meet these requirements will not be accepted for peer review and will be returned.

Mandatory Disclosure

Recipients or subrecipients must submit any information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. See Mandatory Disclosures, 2 CFR 200.113 and NIH Grants Policy Statement Section 4.1.36.

Send written disclosures to the NIH Chief Grants Management Officer listed on the Notice of Award for the IC that funded the award and to the HHS Office of Inspector Grant Self Disclosure Program at grantdisclosures@oig.hhs.gov. 

Post Submission Materials

Applicants are required to follow the instructions for post-submission materials, as described in the policy

Section V. Application Review Information

1. Criteria

Only the review criteria described below will be considered in the review process.  Applications submitted to the NIH in support of the NIH mission are evaluated for scientific and technical merit through the NIH peer review system.

A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Additionally, the results of the clinical trial may indicate that further clinical development of the intervention is unwarranted or lead to new avenues of scientific investigation.

Overall Impact

Reviewers will provide an overall impact score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).

Scored Review Criteria

Reviewers will consider each of the review criteria below in the determination of scientific merit and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.

 

Does the project address an important problem or a critical barrier to progress in the field? Is the prior research that serves as the key support for the proposed project rigorous? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?

In addition, for applications involving clinical trials

Are the scientific rationale and need for a clinical trial to test the proposed hypothesis or intervention well supported by preliminary data, clinical and/or preclinical studies, or information in the literature or knowledge of biological mechanisms? For trials focusing on clinical or public health endpoints, is this clinical trial necessary for testing the safety, efficacy or effectiveness of an intervention that could lead to a change in clinical practice, community behaviors or health care policy? For trials focusing on mechanistic, behavioral, physiological, biochemical, or other biomedical endpoints, is this trial needed to advance scientific understanding?

Specific to this NOFO:

  • To what extent will the network advance actionable evidence to safely transition RAPIDs from explanatory trial settings into routine practice for clinically complex, high-need populations?
  • To what extent will the evidence generated by the network inform clinical care standards, workforce delivery models, and sustainable health system adoption across healthcare settings?

 

Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or those in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD/PI, do the investigators have complementary and integrated expertise; are their leadership approach, governance and organizational structure appropriate for the project?

In addition, for applications involving clinical trials

With regard to the proposed leadership for the project, do the PD/PI(s) and key personnel have the expertise, experience, and ability to organize, manage and implement the proposed clinical trial and meet milestones and timelines? Do they have appropriate expertise in study coordination, data management and statistics? For a multicenter trial, is the organizational structure appropriate and does the application identify a core of potential center investigators and staffing for a coordinating center?

Specific to this NOFO:

  • To what extent do the investigative team have the necessary expertise in designing and executing large-scale, multi-site pragmatic clinical trials or adaptive platform trials?
  • Is the proposed level of effort sufficient for accomplishing the activities proposed?

 

Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?

In addition, for applications involving clinical trials

Does the design/research plan include innovative elements, as appropriate, that enhance its sensitivity, potential for information or potential to advance scientific knowledge or clinical practice?


 

Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Have the investigators included plans to address weaknesses in the rigor of prior research that serves as the key support for the proposed project? Have the investigators presented strategies to ensure a robust and unbiased approach, as appropriate for the work proposed? Are potential problems, alternative strategies, and benchmarks for success presented? If the project is in the early stages of development, will the strategy establish feasibility and will particularly risky aspects be managed? Have the investigators presented adequate plans to address relevant biological variables, such as sex, for studies in vertebrate animals or human subjects?

If the project involves human subjects and/or NIH-defined clinical research, are the plans to address 1) the protection of human subjects from research risks, and 2) inclusion (or exclusion) of individuals on the basis of sex, race, and ethnicity, as well as the inclusion or exclusion of individuals of all ages (including children and older adults), justified in terms of the scientific goals and research strategy proposed?

Does the application adequately address the following, if applicable?

Study Design

Is the study design justified and appropriate to address primary and secondary outcome variable(s)/endpoints that will be clear, informative and relevant to the hypothesis being tested? Is the scientific rationale/premise of the study based on previously well-designed preclinical and/or clinical research? Given the methods used to assign participants and deliver interventions, is the study design adequately powered to answer the research question(s), test the proposed hypothesis/hypotheses, and provide interpretable results? Is the trial appropriately designed to conduct the research efficiently? Are the study populations (size, sex, age, demographic group), proposed intervention arms/dose, and duration of the trial, appropriate and well justified?

Are potential ethical issues adequately addressed? Is the process for obtaining informed consent or assent appropriate? Is the eligible population available? Are the plans for recruitment outreach, enrollment, retention, handling dropouts, missed visits, and losses to follow-up appropriate to ensure robust data collection? Are the planned recruitment timelines feasible and is the plan to monitor accrual adequate? Has the need for randomization (or not), masking (if appropriate), controls, and inclusion/exclusion criteria been addressed? Are differences addressed, if applicable, in the intervention effect due to sex and race/ethnicity?

Are the plans to standardize, assure quality of, and monitor adherence to, the trial protocol and data collection or distribution guidelines appropriate? Is there a plan to obtain required study agent(s)? Does the application propose to use existing available resources, as applicable?

Data Management and Statistical Analysis

Are planned analyses and statistical approach appropriate for the proposed study design and methods used to assign participants and deliver interventions? Are the procedures for data management and quality control of data adequate at clinical site(s) or at center laboratories, as applicable? Have the methods for standardization of procedures for data management to assess the effect of the intervention and quality control been addressed? Is there a plan to complete data analysis within the proposed period of the award?

Specific to this NOFO:

Network Infrastructure & Governance:

  • To what extent are the organizational, leadership, and operational structures of the DCC capable of managing multi-site trial governance, quality assurance, and centralized safety monitoring?
  • To what extent does the network include real-world healthcare settings, and how feasible is the plan for rapidly onboarding additional clinical sites for Stage 2?

Unified Protocols & Pragmatic Trial Execution:

  • To what extent are the unified study protocols scientifically rigorous, pragmatic, and capable of evaluating RAPID agents singularly or concurrently across distinct treatment arms against standard-of-care or active comparators?
  • How viable and agile is the plan to adapt trial protocols if newly approved pharmacotherapies emerge during the project period?
  • To what extent will the proposed patient cohorts include clinically complex, high-need populations (e.g., serious mental illnesses, treatment-resistant conditions, urgent suicide risk) to ensure broad generalizability?

Data Management & Common Data Elements (CDEs):

  • To what extent are the data management pipelines, EDC systems, and quality control procedures adequate to support multi-site pragmatic trials?
  • How effectively does the application incorporate NIMH-supported Common Data Elements (CDEs) to ensure data harmonization and timely deposition to the NIMH Data Archive (NDA)?

Timeline, Milestones & Sustainability:

  • To what extent are the proposed Stage 1 (Years 1and 2) administrative milestones quantifiable, well-defined, and appropriate for determining readiness for Stage 2? 

 

Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?

If proposed, are the administrative, data coordinating, enrollment and laboratory/testing centers, appropriate for the trial proposed?

Does the application adequately address the capability and ability to conduct the trial at the proposed site(s) or centers? Are the plans to add or drop enrollment centers, as needed, appropriate?

If international site(s) is/are proposed, does the application adequately address the complexity of executing the clinical trial?

If multi-sites/centers, is there evidence of the ability of the individual site or center to: (1) enroll the proposed numbers; (2) adhere to the protocol; (3) collect and transmit data in an accurate and timely fashion; and, (4) operate within the proposed organizational structure?

Specific to this NOFO:

  • To what extent do the proposed real-world clinical sites (e.g., emergency, VA healthcare, community clinics) provide appropriate environments to ensure the pragmatic trials generate highly generalizable effectiveness data?

Additional Review Criteria

As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact score, but will not give separate scores for these items.

 

Is the study timeline described in detail, taking into account start-up activities, the anticipated rate of enrollment, and planned follow-up assessment? Is the projected timeline feasible and well justified? Does the project incorporate efficiencies and utilize existing resources (e.g., CTSAs, practice-based research networks, electronic medical records, administrative database, or patient registries) to increase the efficiency of participant enrollment and data collection, as appropriate?

Are potential challenges and corresponding solutions discussed (e.g., strategies that can be implemented in the event of enrollment shortfalls)?


 

For research that involves human subjects but does not involve one of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate the justification for involvement of human subjects and the proposed protections from research risk relating to their participation according to the following five review criteria: 1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety monitoring for clinical trials.

For research that involves human subjects and meets the criteria for one or more of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Guidelines for the Review of Human Subjects.


 

When the proposed project involves human subjects and/or NIH-defined clinical research, the committee will evaluate the proposed plans for inclusion. For additional information on review of the Inclusion section, please refer to the Guidelines for the Review of Inclusion in Clinical Research. 


 

The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following three points: (1) a complete description of all proposed procedures including the species, strains, ages, sex, and total numbers of animals to be used; (2) justifications that the species is appropriate for the proposed research and why the research goals cannot be accomplished using an alternative non-animal model; and (3) interventions including analgesia, anesthesia, sedation, palliative care, and humane endpoints that will be used to limit any unavoidable discomfort, distress, pain and injury in the conduct of scientifically valuable research. Methods of euthanasia and justification for selected methods, if NOT consistent with the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals, is also required but is found in a separate section of the application. For additional information on review of the Vertebrate Animals Section, please refer to the Worksheet for Review of the Vertebrate Animals Section.


 

Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.


 

For Resubmissions (as applicable), the committee will evaluate the application as now presented, taking into consideration the responses to comments from the previous scientific review group and changes made to the project.


 

For Renewals (as applicable), the committee will consider the progress made in the last funding period.


 

For Revisions (as applicable), the committee will consider the appropriateness of the proposed expansion of the scope of the project. If the Revision application relates to a specific line of investigation presented in the original application that was not recommended for approval by the committee, then the committee will consider whether the responses to comments from the previous scientific review group are adequate and whether substantial changes are clearly evident.


Additional Review Considerations

As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact score.

 

Reviewers will assess whether the project presents special opportunities for furthering research programs through the use of unusual talent, resources, populations, or environmental conditions that exist in other countries and either are not readily available in the United States or augment existing U.S. resources.


 

Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).


 

Reviewers will comment on whether the Resource Sharing Plan(s) (e.g., Sharing Model Organisms) or the rationale for not sharing the resources, is reasonable.


 

For projects involving key biological and/or chemical resources, reviewers will comment on the brief plans proposed for identifying and ensuring the validity of those resources.


 

Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.


2. Review and Selection Process

Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by CSR, in accordance with NIH peer review policies and practices, using the stated review criteria. Assignment to a Scientific Review Group will be shown in the eRA Commons.

As part of the scientific peer review, all applications will receive a written critique.

Applications may undergo a selection process in which only those applications deemed to have the highest scientific and technical merit (generally the top half of applications under review) will be discussed and assigned an overall impact score.

Requests for reconsideration of initial peer review will not be accepted for applications submitted in response to this NOFO. 

Applications will be assigned on the basis of established referral guidelines to the appropriate NIH Institute or Center. Applications will compete for available funds with all other recommended applications submitted in response to this NOFO. Following initial peer review, recommended applications will receive a second level of review by the appropriate national Advisory Council or Board. Funding decisions are based on the core tenets of a unified funding strategy, see ICO Funding Policies and Considerations. Applicants are strongly encouraged to also refer to the ICO-specific funding policies and considerations pages linked therein that build upon the agency-wide framework.

Awarding institutes, centers, and offices may give priority to applications in the following areas:

Not Applicable

If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant as described in the NIH Grants Policy Statement Section 2.5.1. Just-in-Time Procedures. This request is not a Notice of Award nor should it be construed to be an indicator of possible funding.

Prior to making an award, NIH reviews an applicant's federal award history in SAM.gov to ensure sound business practices. An applicant can review and comment on any information in the Responsibility/Qualification records available in SAM.gov.  NIH will consider any comments by the applicant in the Responsibility/Qualification records in SAM.gov to ascertain the applicant's integrity, business ethics, and performance record of managing Federal awards per 2 CFR Part 200.206 "Federal awarding agency review of risk posed by applicants."  This provision will apply to all NIH grants and cooperative agreements except fellowships.

3. Anticipated Announcement and Award Dates

After the peer review of the application is completed, the PD/PI will be able to access his or her Summary Statement (written critique) via the eRA Commons. Refer to Part 1 for dates for peer review, advisory council review, and earliest start date.

Information regarding the disposition of applications is available in the NIH Grants Policy Statement Section 2.4.4 Disposition of Applications.

Section VI. Award Administration Information

1. Award Notices

A Notice of Award (NoA) is the official authorizing document notifying the applicant that an award has been made and that funds may be requested from the designated HHS payment system or office. The NoA is signed by the Grants Management Officer and emailed to the recipient's business official.

In accepting the award, the recipient agrees that any activities under the award are subject to all provisions currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.

Recipients must comply with any funding restrictions described in Section IV.6. Funding Restrictions. Any pre-award costs incurred before receipt of the NoA are at the applicant's own risk.  For more information on the Notice of Award, please refer to the NIH Grants Policy Statement Section 5. The Notice of Award and NIH Grants & Funding website, see Award Process.

Individual awards are based on the application submitted to, and as approved by, the NIH and are subject to the IC-specific terms and conditions identified in the NoA.

ClinicalTrials.gov: If an award provides for one or more clinical trials. By law (Title VIII, Section 801 of Public Law 110-85), the "responsible party" must register and submit results information for certain "applicable clinical trials" on the ClinicalTrials.gov Protocol Registration and Results System Information Website (https://register.clinicaltrials.gov). NIH expects registration and results reporting of all trials whether required under the law or not. For more information, see https://grants.nih.gov/policy/clinical-trials/reporting/index.htm

Institutional Review Board or Independent Ethics Committee Approval: Recipient institutions must ensure that all protocols are reviewed by their IRB or IEC. To help ensure the safety of participants enrolled in NIH-funded studies, the recipient must provide NIH copies of documents related to all major changes in the status of ongoing protocols.

Data and Safety Monitoring Requirements: The NIH policy for data and safety monitoring requires oversight and monitoring of all NIH-conducted or -supported human biomedical and behavioral intervention studies (clinical trials) to ensure the safety of participants and the validity and integrity of the data. Further information concerning these requirements is found at http://grants.nih.gov/grants/policy/hs/data_safety.htm and in the application instructions (SF424 (R&R) and PHS 398).

Investigational New Drug or Investigational Device Exemption Requirements: Consistent with federal regulations, clinical research projects involving the use of investigational therapeutics, vaccines, or other medical interventions (including licensed products and devices for a purpose other than that for which they were licensed) in humans under a research protocol must be performed under a Food and Drug Administration (FDA) investigational new drug (IND) or investigational device exemption (IDE).

2. Administrative and National Policy Requirements

The following Federal wide and HHS-specific policy requirements apply to awards funded through NIH:

All federal statutes and regulations relevant to federal financial assistance, including those highlighted in NIH Grants Policy Statement Section 4 Public Policy Requirements, Objectives and Other Appropriation Mandates.

By applying for or accepting federal funds from HHS, recipients certify compliance with all federal antidiscrimination laws and these requirements and that complying with those laws is a material condition of receiving federal funding streams. Recipients are responsible for ensuring subrecipients, contractors, and partners also comply.

Applicants and recipients are strongly encouraged to refer to the NIH Director's Statement of Priorities, entitled "Advancing NIH's Mission Through a Unified Strategy." 

Recipients are responsible for ensuring that their activities comply with all applicable federal regulations. Pursuant to 2 CFR 200.340, by accepting an NIH award, the recipient agrees that continued funding for the award is contingent upon the availability of appropriated funds, recipient satisfactory performance, compliance with the Terms and Conditions of the award, and may also otherwise be terminated, to the extent authorized by law, if the agency determines that the award no longer effectuates the program goals or agency priorities, in line with 2 CFR 200.340(a)(4).

Pursuant to the Cybersecurity Act of 2015, Div. N, § 405, Pub. Law 114-113, 6 USC § 1533(d), the HHS Secretary has established a common set of voluntary, consensus-based, and industry-led guidelines, best practices, methodologies, procedures, and processes.

Successful recipients under this NOFO agree that:

When recipients, subrecipients, or third-party entities have:

  • ongoing and consistent access to HHS owned or operated information or operational technology systems; and
  • receive, maintain, transmit, store, access, exchange, process, or utilize personal identifiable information (PII) or personal health information (PHI) obtained from the awarding HHS agency for the purposes of executing the award.

Cybersecurity plans and procedures must at minimum include the following:

  • Develop cybersecurity plans and procedures, modeled after the NIST Cybersecurity framework, to protect HHS systems and data:
    • Identify:
      • Develop an inventory of all assets and accounts with access to HHS owned and operated information or operational technology systems or which obtain PII or PHI for the purposes of the award.
    • Protect:
      • Limit access to HHS owned and operated systems to only those in need of access to complete reward activities.
      • Require all staff to complete annual cybersecurity and privacy awareness training. Visit 405(d): Knowledge on Demand (hhs.gov) to obtain free trainings, if needed.
      • Enable multifactor authentication for all employees, subrecipients, and third-party entities to access HHS owned and operated information or operational technology systems.
      • Regularly backup sensitive data and test backups.
    • Detect:
      • Install anti-virus or anti-malware software on all devices, servers, and accounts used to connect to HHS owned and operated systems.
    • Respond:
      • Develop an incident response plan. See Incident-Response-Plan-Basics_508c.pdf (cisa.gov) to learn about developing incident response plans.
      • Have cybersecurity incident reporting procedures that ensure the relevant HHS awarding agencies are notified of a cybersecurity incident within 48 hours of discovery. A cybersecurity incident is defined as an unplanned interruption to a technology service or reduction in the quality of a technology service, or an occurrence that actually or potentially jeopardizes the confidentiality, integrity, or availability of an information system or the information the system processes, stores, or transmits.
    • Recover:
      • Investigate incidents and plug any security gaps identified. 

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings.  Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate; racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety.  If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

For applications involving substance abuse, the application must not support harm reduction. Please see Updated Funding Guidance for Recipients on Supplies and Services.

For applications involving funding Medication-Assisted Treatment (MAT) or medications for opioid use disorder (MOUD), this funding should be used to provide comprehensive treatment and recovery support services rather than medication-only models for opioid use disorder. Services should include medications, where clinically indicated, in conjunction with psychosocial and other treatment and recovery support services. Funding can also be used to support individualized tapering and discontinuation of medications when clinically indicated. Please see Updated Funding Guidance for Recipients on  MAT/MOUD.

Recipients of both Clinical Trial Required and Clinical Trial Optional awards subject to this term shall report standardized clinical trial activation and enrollment performance data for any interventional clinical trial supported under the award. These metrics are intended to assess trial startup efficiency, site activation, and post-activation performance and to support continuous quality improvement in clinical trial operations (see supplemental guidance). Recipients shall report required data annually at the time of Research Performance Progress Report (RPPR) submission on clinical trial activation and enrollment performance milestone dates as calendar dates; NIH will calculate standardized interval metrics from these dates.

Institutions are expected to maintain capabilities that support efficient clinical trial startup, participant enrollment, and performance monitoring, including streamlined workflows and systems for electronic tracking of milestones.  Recipients are encouraged to implement and evaluate approaches that improve trial efficiency and the participant experience.

As of October 1, 2025, HHS has adopted 2 CFR Part 200, with some modifications included in 2 CFR Part 300. These regulations replace those in 45 CFR Part 75. However, for NIH, under the Consolidated Appropriations Act for FY 2026, (P.L. 119-75, Division B, Title II, Sec. 224), the provisions relating to indirect costs in 45 CFR 75 continue to apply to NIH awards. Consistent with the statute, NIH will not apply updated thresholds outlined within 2 CFR Part 200, at this time.

In administering programs under this and all funding announcements, NIH prioritizes: 

  • Research involving rigorous scientific methods, including for studies related to children and adolescents, where NIH is committed to approaches that reflect the highest standards of clinical care and child safety. 
  • Biological and physiological integrity: Recognizing the relevance of biological sex to health outcomes, NIH encourages applicants to account for sex-based health factors in program design, data collection, and service delivery where scientifically appropriate.
  • NIH will implement these priorities consistent with applicable laws, regulations, court orders, and all required administrative procedures. Applicants are encouraged to describe how their proposed programs align with these priorities in their project narratives. Funded activities must advance NIH's vision of protecting and improving the health and well-being of Americans. The particular focus is on those who are medically vulnerable, or live in areas with limited access to care. NIH's duty is to serve wisely, effectively, and with measurable results that justify every taxpayer dollar invested. 
Cooperative Agreement Terms and Conditions of Award

The following special terms of award are in addition to, and not in lieu of, otherwise applicable U.S. Office of Management and Budget (OMB) administrative guidelines, U.S. Department of Health and Human Services (HHS) grant administration regulations at 2 CFR Part 200, and other HHS, PHS, and NIH grant administration policies.

The administrative and funding instrument used for this program will be the cooperative agreement, an "assistance" mechanism (rather than an "acquisition" mechanism), in which substantial NIH programmatic involvement with the recipients is anticipated during the performance of the activities. Under the cooperative agreement, the NIH purpose is to support and stimulate the recipients' activities by involvement in and otherwise working jointly with the recipients in a partnership role; it is not to assume direction, prime responsibility, or a dominant role in the activities. Consistent with this concept, the dominant role and prime responsibility resides with the recipients for the project as a whole, although specific tasks and activities may be shared among the recipients and NIH as defined below.

The PD(s)/PI(s) will have the primary responsibility for:

  • Establishing and directing the Data Coordinating Center (DCC) and overseeing the federated clinical site network.
  • Defining the research agenda, approaches, and potential leveraged resources. Develop processes for evaluating and revising the research agenda as scientific priorities evolve.
  • Ensuring all unified study protocols and Common Data Elements (CDEs) are finalized and implemented across all sites.
  • Providing clinical site monitoring, centralized data management and statistical analysis, primary research biospecimen storage, medical monitoring and pharmacovigilance plans, resources to ensure consistent standards for the protection of human subjects, and safety oversight committees for clinical trials.
  • Milestone Reporting: Annual submission of progress details for the specific aims and progress towards administrative milestones for stage 1 and stage 2.  
  • Recipients will retain custody of and have primary rights to the data and software developed under these awards, subject to Government rights of access consistent with current HHS, PHS, and NIH policies.

NIH staff have substantial programmatic involvement that is above and beyond the normal stewardship role in awards, as described below:

The role of the NIMH Project Scientist will be to facilitate and not to direct the activities. It is anticipated that the NIMH Project Scientist will offer advisory input. The NIMH Project Scientist will:

  • Provide guidance and support in the design of research activities.
  • Serve as a resource for protocol design and development.
  • Advise in the development of the protocol.
  • Participate as a voting member in the Steering Committee (SC). Regardless of the number of Project Scientists, NIH will only have one vote. 

The NIMH Program Official will be responsible for the normal scientific and programmatic stewardship of the award and will be named in the award notice. The NIMH Program Official will also:

  • Advise in management and technical performance.
  • Prior to award, negotiate final milestones with the PD/PIs that will be incorporated in the Notice of Award.
  • NIMH will serve as a liaison between NIH, the HHS, and clinical trials network(s) investigator(s) and/or partners.

Areas of Joint Responsibility include:

  • A Steering Committee will be established to serve as the main governing body of the RAPIDs-CTN. The Steering Committee will be composed of the PD/PI(s), core clinical site leads, and the NIH Project Scientist(s). The Steering Committee will be responsible for finalizing unified study protocols, evaluating network performance, reviewing quality control metrics and making iterative changes to the adaptive trial design. It is expected that most of the decisions on the activities of the Steering Group will be reached by consensus. If a vote is needed, each awardee will have one vote, and the Project Scientist(s) collectively will have one vote. The NIMH Project Scientist will serve as the voting member on behalf of NIH on the Steering Committee. Additional details and responsibilities of the Steering Committee will be negotiated at the time of award or post-award.
  • For the Program Official:
    • Protocol Harmonization and Evolution: Jointly reviewing, refining, and approving unified study protocols, protocol amendments, and the prioritization of newly approved RAPID agents or treatment arms to ensure scientific rigor and responsiveness to emerging public health needs.
    • Clinical Safety Oversight and DSMB Coordination: Coordinating with the independent Data and Safety Monitoring Board (DSMB) including the joint review of DSMB recommendations, adverse event reports, and safety protocol updates.
    • Stage Transition and Milestone Evaluation: Jointly monitoring progress toward Stage 1 administrative milestones to ensure operational readiness for Stage 2.

Dispute Resolution:

Any disagreements that may arise in scientific or programmatic matters (within the scope of the award) between recipients and NIH may be brought to Dispute Resolution. A Dispute Resolution Panel composed of three members will be convened: a designee of the Steering Committee chosen without NIH staff voting, one NIH designee, and a third designee with expertise in the relevant area who is chosen by the other two; in the case of individual disagreement, the first member may be chosen by the individual recipient. This special dispute resolution procedure does not alter the recipient's right to appeal an adverse action that is otherwise appealable in accordance with PHS regulation 42 CFR Part 50, Subpart D and HHS regulation 45 CFR Part 16.

3. Data Management and Sharing

A Data Management and Sharing Plan (DMS Plan) is required for any NIH-funded or conducted research that will generate scientific data. Applicants must submit the DMS Plan at the time of application using the NIH DMS Plan Format Page. The DMS Plan must address the elements in the structured format. Where the DMS Plan Format Page requires a "Yes or No" response, no additional narrative is allowed.

A Data Management and Sharing Plan is not applicable for this NOFO.

4. Reporting

When multiple years are involved, recipients will be required to submit the Research Performance Progress Report (RPPR) annually and financial statements as required in the NIH Grants Policy Statement Section 8.4.1 Reporting. To learn more about post-award monitoring and reporting, see the NIH Grants & Funding website, see Post-Award Monitoring and Reporting.

A final RPPR, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement Section 8.6 Closeout. NIH NOFOs outline intended research goals and objectives. Post award, NIH will review and measure performance based on the details and outcomes that are shared within the RPPR, as described at 2 CFR Part 200.301.

5. Evaluation

Section VII. Agency Contacts

We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants. When contacting the email addresses below please add the NOFO number to the subject line to assist routing.

Application Submission Contacts

eRA Service Desk - Questions regarding ASSIST, eRA Commons, application errors and warnings, documenting system problems that threaten submission by the due date, and post-submission issues.

Grants.gov Support Center - Questions regarding Grants.gov registration and services (e.g., Workspace, subscriptions).

Scientific/Research Contact(s)

National Institute of Mental Health (NIMH)
NIMHRAPIDS@nih.gov 

DTMC Program Staff
National Institute on Drug Abuse (NIDA)
Email: NIDADTMCprogram@mail.nih.gov

Peer Review Contact(s)

Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).

Financial/Grants Management Contact(s)

Grants Management Office
National Institute of Mental Health (NIMH)
Email: NIMHNOFOGrantsManagement@mail.nih.gov  

Chief Grants Management Officer
National Institute on Drug Abuse (NIDA)
Email: nidagmbemail@nida.nih.gov

Section VIII. Other Information

Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.

Authority and Regulations

Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 2 CFR Part 200.