ADPI_0379_FAQs.docx

Frequently Asked Questions

Alzheimer’s Disease Programs Initiative (ADPI): Grants to States and Communities United States Administration for Community Living/Administration on Aging FY 2020 Funding Opportunity

HHS-2020-ACL-AOA- ADPI-0379

Last update: March 4, 2020 QUESTIONS THAT ARE NEW TO THIS VERSION OF THE DOCUMENT OR ARE UPDATED ANSWERS ARE IN BLUE FONT

1. Question: What is the difference between a grant and a “cooperative agreement”?

Answer: In the United States, federal grants are financial assistance issued by the U.S. Government. A cooperative agreement is a variation of a grant, which is awarded when a grant provider anticipates having substantial involvement with the grantee during the performance of a funded project. These grants will be issued as cooperative agreements because they are significant and multifaceted endeavors in which AoA/ACL anticipates having substantial involvement with the recipients during performance of funded activities. To ensure program success, the cooperative agreement structure allows AoA/ACL to provide a higher level of technical assistance, oversight and support than a grant relationship offers.

2. Question: Can we subcontract some or all grant activities?

Answer: Grantees, not the Federal Government, must decide whether it is in their best interest to subcontract some of the grant activities. That said, however, it is very important that the grantee realize that the administrative responsibility and oversight of all grant activities remains with the grantee. Thus, we recommend when subcontracting, the grantee retain sufficient funding to fulfill its administrative, oversight, and sustainability responsibilities under the grant.

3. Question: What are direct services?

Answer: Direct Services – we have identified six specific categories of direct services (adult day care, companion services, home health care, personal care, respite, and short-term care in health care facility).

Adult Day Care – an organized program that takes place outside of the home and provides care for the person with dementia in a congregate setting, but is not a residential setting. Services are supervised and include social engagement or health care for elders who require skilled services or physical assistance with activities of daily living. These services may be also referred to as Adult Day Services and Adult Day Health Services.

Companion Services – companion services include non-medical care, supervision and socialization provided to a participant/client. Companions may assist or supervise the individual with such tasks as meal preparation, laundry, light housekeeping, and shopping. Companion services are typically provided in a participant/client’s home but may include time spent accompanying participant/client to access services outside of the home. These services may be also referred to as Homemaker Services.

Home Health Care - in-home assistance that addresses medical needs, such as administering medications and physical therapy. These services may be also referred to as Health Maintenance Care.

Personal Care – in-home assistance with daily living activities, including bathing, dressing, eating, meal preparation, and light housekeeping. These services may be also referred to as Personal Assistance.

Respite –an interval of rest or relief OR the result of a direct dementia-specific service or supportive intervention that generates rest or relief for the caregiver and/or care recipient.

Short Term Care in Health Facility –services provided on a short/long term basis in a residential or assisted living facility, nursing home, or other long-term care institution because of the absence/need for relief of the regular caregiver.

4. Question: Can the salary of a direct service provider count towards a direct service?

Answer: Yes, if a paid position is an essential component of the direct service provision for this project, the salary for that position may count towards direct service.

5. Question: Could dementia-capability training and resulting services count toward direct service requirements?

Answer: Yes, because dementia-capability training can be necessary for providing direct services to people with dementia and their family caregivers.

6. Question: Are grantees required to participate in technical assistance activities?

Answer: Yes. Because these are cooperative agreements, we believe that the primary means of sharing information and facilitating discussions of barriers, ways to resolve barriers, and share successes among grantees is through technical assistance. Therefore, to achieve the stated programmatic goals, all grantees must participate in program technical assistance efforts, which could include individual assistance to grantees, webinars, learning collaboratives and other, similar activities.

7. Question: Does the budget have to be equally divided between the 3 years?

Answer: Applicants can choose how to divide their budgets across the three-year grant period. In other words, there is NOT a requirement that the budget be equally divided among the three years of the grant period.

8. Question: What are administrative expenses?

Answer: Administrative expenses include direct and indirect costs related to (1) routine grant administration and monitoring (for example, receipt and disbursal of program funds, preparation of routine programmatic and financial reports, and compliance with grant conditions and audit reports) and (2) contract development, solicitation review, award, monitoring, and reporting.

Administrative expenses do not include costs associated with substantive programmatic work (e.g. the costs associated with salaries, fringe and travel for a project director and other programmatic staff involved in the implementation of the program). Other examples of expenses that are not considered to be an administrative expense are: the costs of direct services (e.g., training, counseling and respite); project planning and implementation (e.g., translating evidence-based research protocols); and evaluation and information dissemination.

9. Question: Is there an upper limit on the amount of indirect costs that will be permitted?

Answer: No, but any indirect costs in excess of 10% require documentation of a negotiated rate with the US Department of Health and Human Services.

10. Question: Are there restrictions on what an applicant can use for the non-financial contribution (match) required of grantees?

Answer: Non-financial recipient contributions may include the value of goods and/or services contributed by the grantee and any and all third parties involved in the project, including sub-grantees, contractors and consultants. Examples of non-financial recipient contributions include: salary/fringe benefits of staff devoting time to the grant and not otherwise included in the budget or derived from federal funds, applicable indirect costs, volunteer time, and use of facilities to hold meetings or conduct project activities. In- kind contributions from a third party may also be used as non-financial contributions and may include the value of the time spent by Advisory Board members in the design, development and implementation of the grant.

11. Question: What value should be assigned to volunteer services used for in-kind matching?

Answer: Volunteer hours included as in-kind matching should be valued at what you would have to pay another individual to provide the service in your area. If you do not have a current measure of the cost of an individual providing a particular service, you may consider investigating other direct service providers in your area.

12. Question: Is match calculated on the budgeted spending or actual spending?

Answer: Match is calculated on actual spending.

13. Question: Can we include maps as appendices to our application?

Answer: Yes. It may be helpful for reviewers to see, visually, how access to services and supports would be enhanced throughout the state over the project period.

14. Question: If my state encounters an obstacle to submitting the application by the deadline, will AoA/ACL accept the application after the deadline passes?

Answer: No, the application must be submitted by the deadline.

Grants.gov will automatically send applicants a tracking number and date of receipt verification electronically once the application has been successfully received and validated in grants.gov . After AoA/ACL retrieves your application form from grants.gov, a return receipt will be emailed to the applicant contact. This will be in addition to the validation number provided by grants.gov.

Unsuccessful submissions will require authenticated verification from grants.gov indicating system problems existed at the time of your submission. For example, you will be required to provide a grants.gov submission error notification and/or tracking number in order to substantiate missing the cut off date. Failure to have complied with requirements such as registration with SAMS.Gov and DUNS numbers will not be accepted as reasons for missing due date and requesting an exception.

15. Question: When will states that are awarded cooperative agreements begin receiving funds?

Answer: Projects have an anticipated start date around September 1, 2018. Shortly after the grant is awarded, grantees may begin drawing down funds through the Payment Management System. During the planning phase of the cooperative agreement, grantees will be able to access no more than 15% of total grant funding to develop their implementation plans. At the conclusion of the planning phase, the grantee must participate in a planning phase exit conference and receive approval of AoA/ACL to progress to the implementation phase and access the remaining 85% of cooperative agreement funding.

16. Question: Is it permissible for the direct service portion of the grant to propose a service/s that we're already funding in a limited way (e.g., only some AAAs in the state and/or some counties in certain AAA area, and/or in limited numbers) because there is limited funding available - and to expand the service to a different catchment area (different county) OR expand the population to whom it's available by altering/lowering the eligibility criteria in existing areas of service?

Answer: It is permissible, in implementing the direct service requirement of the grant, to use grant funds (including federal dollars and match) to expand existing programs/services to a different area or population. What you cannot do is use grant funds (including federal dollars and match) to supplant funding to maintain existing programs/services that are presently funded using other Federal sources.

17. Question: We were also told that the award was going to be forward-funded for the entire 36 month project period, and that ‘forward-funded’ meant the entire amount of funding (all 36 months of it) would be awarded at one time. The grant award will have a 36-month project period, but how will the budget period will be shown? If the entire 36 months of funding is included in the initial grant award, wouldn’t the budget period also have to reflect 36 months? And if the grant award’s budget period is 36 months, how can we consider funds to be ‘carried over’ from one 12 month budget period to another?

Answer: Each project will have a 36 month project period, which is comprised of three 12 month budget periods. 100% of the funds will be obligated all at the time of award, and all of the funds will in fact be available at that time, however they can only be drawn down as they are expended. For the proposal process, applicants are expected to present both a work plan that covers the entire 36-month project, as well as three separate and defined budget periods by which they will conduct the business over the course of the grant. “Carry overs” would not be necessary between the three 12 month budget periods within the 36-month project period.

18. Question: Can we submit our application as a Multiple-PI/PD project? Or do we need to have one PI/PD and the rest of the key personnel as Co-Investigators?

Answer: Your project should have one PI/PD – that person would be affiliated with the primary applicant and not the partners.

19. Question: Is there a particular format and page limit that we should follow when preparing each vitae for the key personnel?

Answer: No, there is no required format for each vitae

20. Question: In addition to the letters of commitment from key participating organizations and agencies, do we need to secure letters from participating individuals that we be involved in the project?

Answer: Assuming that participating key individual would be affiliated with participating organizations, you would only need the organizations. If key personnel proposed are not presently affiliated with the Primary applicant it would be assumed that you have been authorized by that person to include them in your application.

21. Question: Does Lewy Body Dementia and Parkinson’s Disease Dementia qualify as ‘related dementias’ under this mechanism?

Answer: Yes.

22. Question: Could we prepare a submission that would include respite care, and also a combination of dementia as it relates to elderly abuse services.

Answer: Respite care is included in the categories of approved direct services. If you meet all of the requirements that are outlined in the funding opportunity announcement, elder abuse services, as they apply to persons with dementia could be a component within your proposed project.

23. Question: The funding opportunity announcement states that sole proprietorships are not eligible applicants. Can I put add a partner to my company when I apply for this, and change my status there at this point?

Answer: Sole Proprietorship is defined as:

A business structure in which an individual and his/her company are considered a single entity for tax and liability purposes. A sole proprietorship is a company which is not registered with the state as a limited liability company or corporation. The owner does not pay income tax separately for the company, but he/she reports business income or losses on his/her individual income tax return. The owner is inseparable from the sole proprietorship, so he/she is liable for any business debts.

If the business considering application for this program falls within this definition of sole proprietorship, it would be ineligible.

Because sole proprietorship is a tax designation, simply adding the name of another person would not change that designation.

24. Question: Can applicants propose interventions that would be used in assisted living facilities? Or is this funding opportunity just for home and community-based services?

Answer: This opportunity is dedicated to keeping people in their homes and communities through home and community-based services. Once in an assisted living facilities, community-based services are no longer in play.

25. Question: Do you have examples of well-developed dementia capable systems?

Answer: Profiles of the existing ADI-SSS (predecessor to the ADPI community program) grantees that are operating within dementia-capable systems are available on the ACL/AoA’s National Alzheimer’s and Dementia Resource Center webpage at www.nadrc.acl.gov .

Dementia-capability, as defined in the funding opportunity announcement, can look very different, dependent on the kind of system you’re operating within. The State of Minnesota is always a good example of a well-developed dementia-capable system.

26. Question: The Funding Opportunity Announcement mentioned that applicants need to use an approved data collection system. What are you using as an approved data collection system?

The federal government is mandated to comply with what is called The Paperwork Reduction Act - the PRA – when information is being collected. To require collection of information from grantees, ACL must to have an OMB approved information collection tool. ACL has an approved data collection tool and that is what we require. Through the approved tool, we collect things like program demographics of the people that are receiving services, the amount of money that is spent, etc. The conditions of the grants allow us to require future approved collections as well. If you would like to see our existing data collection tool you can find it on the ACL/AoA’s National Alzheimer’s and Dementia Resource Center webpage at www.nadrc.acl.gov .

That is one piece of the program outcome information necessary to report. We would need to be informed of the results of the outcomes proposed in your work plan (for example, if your program were training people, we would want to know the kinds of training).

27. Question: Related to the reporting mechanism, this is an ACL reporting tool that is maintained by ACL, and that grantees would be reporting through this tool. It’s not a grantee implementation evaluation tool per se, is this correct?

Answer: That is correct. It is an Excel spreadsheet that has three tables on it - one for caregivers with demographic information -, one for persons with dementia to get information on the people receiving services. Then the third page has the units of direct service and the percentages of the - how the funds are being spent. All grantees report on the exact same information using this tool, it is not modified for each grant.

28. Question: Regarding the dementia capable systems, could that be part of a health system, particularly like a pioneering field? Does the health system have to be an ACO?

Answer: Yes, it could include - it could be a health system as long as you can hit those three out of those four areas with your program, depending on what kind of program that you develop. The applying system does not have to be an ACO.

29. Question: Is IRB approval required of programs.

Answer: It depends on the organization within which you are operating. We do not have an IRB approval process through ACL/AoA. However, many of our grantees through their evaluators do seek and receive IRB approval.

30. Question: With regard to budgets, this program opportunity is for up to a million dollars over a project period of three years, correct?

Answer: That is correct.

31. Question: One of the requirements within the funding opportunity announcement is the need to partner with key agencies in the state. Would an applicant become ineligible if we were to include working with existing or previous ADI-SSS state grantee that is ineligible to apply as the primary applicant in our work plan?

Answer: No, having partners on your team that are primary recipients of previous ADI-SSS grants would not make your application ineligible. Recipients of previous program grants may join other teams, but they may not be the primary recipients of ADI-SSS program resources.

32. Question: Can funding may be used for current programs? Or does it need to be for new or expanded programs? And related to that, can it support current staff salaries or new staff salaries?

Answer: Funding must for new programs or expansion of existing programs. It cannot be to continue something that you are already doing without expansion. For example, let us say you have a program and you have never been able to serve individuals with intellectual and developmental disabilities, you make a plan to expand the services that you’re already providing to include that underserved population. You could do that. The funding from this program cannot be a sustainability plan for something you are already doing.

The second answer is yes, grant funds can be used to pay for staff.

33. Question: Can a portion of current staff that would work on the project plus that new staff member that would likely implement?

Answer: Yes. For example, if you have a staff member that was 20% of their time is dedicated to this new project and 80% of their time is dedicated to other projects within the organization, that would work.

34. Question: In the funding opportunity announcement it states that it’s critical the grantees build dementia capability into their current programs and partnerships with key agencies in their states including but not limited to Medicaid and the veterans’ health system. Is that applicable to every proposal?

Answer: No, necessary partnerships would dependent on the applicant organization, whatever is appropriate for the community you serve. Because this is open to everyone, not only government entities, each organization has different resources and organizations that would be appropriate for partnership.

35. Question: As a university, we would be the evaluative arm working with the dementia capable system. Should the dementia capable system be the ones who submit the proposal and we are the subcontractor or vice versa? Or does it not matter?

Answer: The announcement states that applicants must be working within a dementia-capable system. If the university can demonstrate that they are working within a dementia-capable system, it would be possible. Presently one of our grantee organizations is an institute within a university, the official grantee being the university, but they are dementia capable. Then we have others, they use the universities as the evaluators. The structure of the partnerships in grant applications would be whatever applicant deem appropriate that fits within the guidance provided in the funding opportunity announcement.

36. Question: We are a 501C3. We are not ourselves a dementia capable program but we will be collaborating with one that is. Would it matter who was the primary person asking for the grant? Would it have to be the dementia capable organization? Or could we be the ones to do that? We would be providing the community services.

Answer: The applicant organization needs to be the existing dementia-capable system within which the project is operating. The applicant must be able to demonstrate the existing dementia-capable system in which the project will operate.

37. Question: Is there a limit to how many collaborative partners there can be?

Answer: No.

38. Question: We are reviewing the application guidelines and noticed that the responsive ADPI project application will not propose conduit or pass-through funding for another agency to lead the project. Does this mean that we could not pass any of the funding to the organization that we would like to partner with? We submitted the letter of intent but if the answer is yes, would it be possible to change the applicant on the letter of intent to the organization that we would like to partner with?

Answer: You can have partners, what we are saying is that you cannot apply for the grant and then turn the majority of the resources over to another organization to conduct the bulk of the work.

As to your question about changing the name on the letter of intent, no, that would not be possible.

39. Question: Can you tell us the number/ number range of LOIs received for this opportunity.

Answer: We cannot provide the number of LOIs received for this opportunity, we can however say it will be very competitive.

40. Question: Can you provide any resources that might help with development of proposals?

Answer:

· Writing Effective Proposals: Tips for a Strong Application http://nadrc.acl.gov/node/48

· Evaluation of Dementia Programs http://nadrc.acl.gov/node/64

· Evaluation Measures Resource List http://nadrc.acl.gov/sites/default/files/uploads/docs/Evaluation%20Measures%20Resource%20List%20FINAL%20February%202016.pdf

41. Question: Can our proposal count the State dementia-capable home and community based system as the “existing dementia capable HCBS system” within which the applicant is operating?

Answer:

Yes, if the applicant is a State entity and the entity is operating a dementia capable system that complies with the requirements of the FOA No, if the applicant is not a state entity. All primary applicants must be operating directly within an existing dementia-capable system dedicated to the population that they serve and that complies with the requirements of this FOA.

42. Question: Can the multiple components of a team make up an eligible existing dementia capable system?

Answer: The primary applicant must be operating directly within an existing dementia-capable system dedicated to the population that they serve and that complies with the requirements of this FOA.

The combination of a variety of systems within a single application to create a dementia capable system would not constitute an eligible existing dementia capable system.

43. Question: Is there an implied emphasis on Alzheimer’s, or is the word Alzheimer’s being used as a generic for all dementias?

Answer: Throughout the funding opportunity announcement are references to the program’s support of those with Alzheimer’s disease and related dementias (ADRD) and their caregivers.

44. Question: The grant contains a prohibition against lobbying but does that prevent proposing State or Federal legislation that would mandate dementia training or other ways to raise the level of training for anyone who works with dementia care?

Answer: Program funds cannot be used for lobbying. The restriction is clearly outlined in the funding opportunity announcement.

45. Question: There is a requirement to include data sources and other references. Do they count against the 20 page limit?

Answer: Data sources and references may be included as Appendices to the Project Narrative. If included as an Appendix, it would not count toward the 20-page limit.

46. Question: The instructions it state “Successful applicants under this program will be leaders or partners in existing dementia-capable systems designed to improve the quality and effectiveness of programs and services.” Could you clarify this? For example, if existing organizations (partners) have banded together to form a dementia capable system – who should file the application?

Answer: Please refer to the funding opportunity announcement for a description of an existing dementia-capable system.

The primary applicant must be operating directly within an existing dementia-capable system dedicated to the population that they serve and that complies with the requirements of this funding opportunity announcement.

The combination of a variety of systems within a single application to create a dementia capable system would not constitute an eligible existing dementia capable system.

47. Question: What resources are available that specify exactly what constitutes “evidenced based” and “evidence-informed” as they relate to this initiative?

Answer: Definitions of what constitutes evidence-based and evidence-informed interventions are provided in the “definitions” section of the funding opportunity announcement.

48. QUESTION: On the Prevention and Public Health Fund page (http://www.hhs.gov/open/prevention/), it describes this grant's "Planned Uses of Funds" as:

· To fund new grants to states that expand specialized services and supports targeting certain categories of individuals living with Alzheimer’s disease or related disorders.

· To initiate a new public awareness campaign to encourage consumers experiencing memory loss to seek medical advice and to address the stigma associated with dementia.

The second component – the public awareness piece – is not well spelled out in HHS-2016-ACL-AOA-ALGG-0152 instructions. Could you please expand on how this ‘planned use’ relates to the ADI grant? Or is there going to be a separate grant for the awareness campaign?

Answer: The PPHF funded public awareness campaign is in the form of a contract that is administered by the ACL Office of External Affairs. The public awareness campaign and the associated dedicated resources have no direct relationship to the ADI-SSS (predecessor to the ADPI community program), however many existing ADI-SSS projects do include outreach and awareness components.

49. QUESTION: One of the issue about home based services is the existence of lead based paint and plumbing in many older homes. Would lead testing and/or removal be a direct service under this grant?

Answer: The six specific categories for direct services are referenced in the definitions section of the FOA and are outlined, including examples, in question #3 of this document. Testing for and/or removal of lead based paint would not qualify as a direct service, based on the definitions provided.

50. QUESTION: What reasons have been used successfully (or not) to justify match waivers in the past?

Answer: Since the inception of the ADI-SSS (predecessor to the ADPI community program) program, zero requests for waivers have been received and zero waivers have been granted.

51. Question: How are funds disbursed to awardees throughout the period of the grant?

Answer: Grant funds are disbursed through drawdowns from the HHS Division of Payment Management through the payment management system (PMS).

52. Question: As a cooperative agreement, what kinds of involvement has ACL experienced historically on previous awards?

Answer: A description of “AoA/ACL's Anticipated Substantial Involvement Under the Cooperative Agreement” is included in the FOA. Cooperative Agreement is subject to terms provided for in the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224). Please refer to the Planning Phase description within the FOA for one way in which the Cooperative Agreement involvement plays out in the ADPI program.

53. Question: I am having difficulty reconciling what appears to be your definition of a dementia-capable system.

Answer: In addition to the explanations provided in the FOA, you may also review the paper referenced in the FOA, located at http://nadrc.acl.gov/node/40 . There are also many other resources/tools that may be of assistance on the National Alzheimer’s and Dementia Resource Center at www.NADRC.ACL.GOV .

54. Question: My entity has never received a negotiated indirect cost rate. Can we request indirect charges in the budget?

Answer: Any non-Federal entity that has never received a negotiated indirect cost rate, except for those non-Federal entities described in Appendix VII to Part 200—States and Local Government and Indian Tribe Indirect Cost Proposals, paragraph D.1.b, may elect to charge a de minimis rate of 10% of modified total direct costs. Costs must be consistently charged as either indirect or direct costs, but may not be double charged or inconsistently charged as both. If chosen, this methodology once elected must be used consistently for all Federal awards until such time as a non-Federal entity chooses to negotiate for a rate, which the non-Federal entity may apply to do at any time. (see 45 CFR 75.414 (f).

55. Question: May we use indirect costs as a part of the required match?

Answer: Per the Funding Opportunity Announcement, Indirect Costs can only be claimed on Federal funds, more specifically, they are to only be claimed on the Federal share of your direct costs. Any unused portion of the grantee’s eligible Indirect Cost amount that are not claimed on the Federal share of direct charges can be claimed as un-reimbursed indirect charges, and that portion can be used towards meeting the recipient match. (see 45 CFR 75.306 (c)).

56. Question: How do you define lobbying?

Answer: Lobbying Disclosure Act of 1995 LOBBYING ACTIVITIES.-The term "lobbying activities" means lobbying contacts and efforts in support of such contacts, including preparation and planning activities, research and other background work that is intended, at the time it is performed, for use in contacts, and coordination with the lobbying activities of others.

LOBBYING CONTACT.- (A) DEFINITION.-The term "lobbying contact" means any oral or written communication (including an electronic communication) to a covered executive branch official or a covered legislative branch official that is made on behalf of a client with regard to- (i) the formulation, modification, or adoption of Federal legislation (including legislative proposals); (ii) the formulation, modification, or adoption of a Federal rule, regulation, Executive order, or any other program, policy, or position of the United States Government;

57. Question: Can ACL/AoA Grant Funds be used in support of lobbying activities?

Answer: No, ACL/AoA grantees may not use federal funds in support of lobbying activities.

58. Question: I understand that applicants are required to dedicate certain percentages of our program budget to direct services and see that the FAQ’s list six categories of direct services. We are wondering if the following services would be considered direct services:

a. navigation services that help individuals with ADRD and their families find care options, make decisions (including optional family consultations to assist family members in problem solving and decision making when they have a difference of opinion regarding the best care options), and plan ahead for future needs

b. education, training, and support for family caregivers with loved ones with ADRD

Answer: Yes, the services identified in a & b would qualify as direct services in the 2018 ADPI program.

59. Question: We are a faith-based 501(c)(3) that restricts our free services to members of a specific religious/cultural/ethnic group. Are we able to receive funding to provide dementia-related services to one specific sub-population?

Answer: No, ADPI grantees are not allowed to restrict provision of grant funded services to a specific religious/cultural/ethic group.

It is a public policy requirement of HHS that no person otherwise eligible will be excluded from participation in, denied the benefits of, or subjected to discrimination in the administration of HHS programs and services based on non-merit factors such as age, disability, sex, race, color, national origin, religion, gender identity, or sexual orientation. Recipients must comply with this public policy requirement in the administration of programs supported by HHS awards. ( 45 CFR 75.300(c) ) The special population targets included in this funding opportunity encourage the inclusion of underserved/disadvantaged populations and those with the most need, not exclusion of groups based on religion, culture or ethnicity.

60. Question: We have looked into this opportunity further and are wondering if there is a preference given to non-profits over for profit companies. It seems as though most of the 2017 awardees were either not-for-profits or universities. Is this simply because of who applied, or is it related to how funding decisions are made?

Answer: Every applicant is reviewed using the same criteria, no organization is given preference.

61. Question: Can a HCBS system partner with other HCBS systems in adjacent geographic areas and each system focus on different gap areas? The majority of the funds would stay with the applicant (not a pass through) and less than 50% of the funds would be allocated to the partners. Also, while the proposed scope of work would cover all three gap areas amongst the partners, the implementation of services may not necessarily cover all three gap areas across all geographic areas.

Answer: Yes, a dementia capable HCBS making an application may partner with any organizations they choose to work with in the implementation of their program. It is up to the primary dementia capable HCBS applicant to determine the activities of themselves and their partners.

Each project must address each of the gap areas. It is up to the primary dementia capable HCBS applicant to determine the coverage of the service implementation and which partners are engaged in addressing the necessary gaps. All of the proposed activities must be new to the organization or community receiving the services or an demonstrable expansion of existing activities/services.

62. Question: We are seeking confirmation that the DICE method is considered an evidence informed treatment. We feel that based on previous grant{s} experience with ACL that it was but it did not show up on the Grantee-Implemented Evidence-Based and Evidence Informed Interventions (June 2018).

Answer: At this time, ACL does not consider DICE an evidence informed intervention.

While the DICE approach is informed by several existing evidence-based interventions, it is a synthesis of many interventions rather than an adaptation of a single evidence-based intervention. ACL is aware that the DICE developers have published information on the process by which the University of Michigan Program for Positive Aging in collaboration with the Johns Hopkins Alzheimer’s Disease Research Center and the Center for Innovative Care in Aging convened experts in the field to evaluate the existing interventions. As we understand, the DICE approach was developed based on recommendations “developed using existing evidence and…clinical experience” and that the supporting material for DICE comes from the panel’s systematic reviews and meta-analyses

ACL does have an existing cooperative agreement that is implementing the DICE approach. However, the DICE approach is not serving as that project’s response to the evidence-based or evidence-informed intervention requirement.

Implementing the DICE approach could be part of the direct services provided in an ACL Alzheimer’s Disease Programs Initiative (ADPI) but would not meet the evidence-based or evidence-informed intervention criteria set forth in the 2018 funding opportunity announcement.

It is our understanding that there is an ongoing clinical trial currently funded by NIA that, in the future, may provide the evidence base for this intervention.

63. Question: With regard to the criteria of being a provider of direct services. We believe we meet this criteria as we would be providing training delivered to families, caregivers, home health aides and other professionals and after listening to the Grants to Communities podcast, we feel that our organization meets the criteria ( "certain trainings also can be counted toward program direct service requirements"). We would just like confirmation before we go deeper into the process. Our behavior professionals also work directly with consumers in their natural homes, assisted living facilities, etc. providing behavioral assessment, treatment plans, and ongoing training and supports.

Answer: The primary applicant must be operating within an “existing dementia capable home and community based service system”. In your message you indicate that you “would be” providing many things, the eligible applicant is one that is already providing services and is expanding to address the gap areas outlined in the funding opportunity announcement (FOA). I would direct you to the dementia-capability basics document that is referenced in the FOA and is located at www.nadrc.acl.gov to determine if your organization is dementia capable.

These programs are limited to home and community based initiatives, programs within assisted living facilities are not eligible for funding under this opportunity.

64. Question: (1) Can we use grant monies from other organization as the match, if they fund us, and (2) should I mention in the grant that we may apply for such funding?

Answer: (1) If an applicant has grant funds from another organization that are dedicated to activities of the funded project, they may use those funds in their calculation of match. All matching funds (both cash and in-kind) must be calculated in relation to program activities. An applicant may not count grant funds from another organization that are not committed to the activities conducted under the funded program.

(2) Matching funds (in-kind and cash) must be reflected in the budget and budget justification submitted as part of an application both documents must reflect the required 25% match, in its entirety. If the applying organization does not have a commitment for matching funds (either in-kind or match), they cannot be included in the application budget. Should applicants receive matching funds to dedicate to program activities, over the course of the grant period, they are able to amend their budget to reflect the addition of the new match resource.

65. Question: Am I reading the information on page 50 of the RFP for line 6j correctly to say that we can count all waived indirect costs on the federal share of the budget as part of the required cost match, but that indirect costs are not allowable on the match portion of the budget?

Answer: No, the interpretation of the language in 6j of page 50 is not correct. There is no restriction from including indirect costs related to a negotiated rate in the match portion of the budget. For example, if an organization has a 50% negotiated rate and only asked for 10% in federal fund budget, they could include the remaining 40% in the match budget resulting in the total 50% negotiated rate being accounted for.

66. Question: The bottom of page 62 and top of page 63 of the RFP provide a sample activities matrix, and page 23 (beginning of the second paragraph under the “Evaluation” heading) of the RFP references an evaluation matrix. Is the activities matrix the same as the evaluation matrix, or are these supposed to be two separate documents? They appear to have the same fields.

Answer: They are not the same, but do include some of the same information.

67. Question: We are considering using the TCARE assessment tool as our intervention. This tool provides a detailed assessment of the care recipient and caregiver, and then generates a customized care plan that links to community resources. Would the setup fee and/or the annual subscription fee for the TCARE system be considered direct services?

Answer: The setup fee and annual subscription fees would be program costs, but not attributable to direct services.

68. Question: We are considering using the Trualta e-learning platform as an education resource for use with and by family caregivers. Would the subscription cost of the Trualta system be considered a direct service cost?

Answer: Subscription costs for the e-learning platform would not be attributable to direct services

69. Question: If we were to include the Trualta e-learning platform as a training resource in our project, would this simply be considered a community resource, or would this need to be included as an evidence-informed intervention? If the latter, can you tell us whether or not ACL has made any sort of ruling on this system as to whether or not it can be considered “evidence-informed”?

Answer: There would be no requirements that the e-learning platform be evidence-informed – unless you are presenting it as your program component to meet that requirement. ACL’s definition of evidence-informed, for the purposes of this program, is included in the funding opportunity announcement.

70. Question: On page 2 of 63 of the FOA it says that the proposed projects must address the “improvement and quality and effectiveness of programs and services dedicated to individuals aging with intellectual and developmental disabilities with ADRD or those at high risk of developing ADRD.” Could you please clarify if this means that all patients served must have an intellectual and developmental disability? Or can the program focus on patients with ADRD or at risk for ADRD, who may or may not have had a pre-existing intellectual or developmental disability Answer: All proposed community projects must address each of the three gap areas noted on page 2. There is no requirement that “all patients served must have an intellectual and developmental disability”.

71. Question: Does item 55 mean that federal funding can only be used for indirect costs related to the federal direct costs but that federal funds cannot be used to cover indirect costs related to cost match items?

Answer: No

72. Question: Am I reading item 65 correctly that indirect costs are allowable on the federal funds regardless of whether the applicant has a negotiated indirect rate (i.e. applicants can use either a negotiated rate or the de minimis 10% rate) but that indirect costs are allowable on the cost match funds only if the applicant has a negotiated rate (i.e., applicants without a negotiated rate may not apply the de minimis 10% rate to cost matched expenses)?

Answer: No

73. Question: Would I calculate the indirect costs on the first $25,000, all, or none of the cost match expenses for this subaward?

Answer: Indirect costs are calculated by applying the approved rate to the total direct costs. If the approved agreement requires exclusion of the first $25,000 then that amount must not be included in the total to which you apply the indirect rate.

74. Question: Is our organization eligible to apply based on the requirement for an evidence-based program that is currently conducted?

Answer: All applicants must demonstrate their existing dementia-capability in their project narrative. Whether or not the organization is presently implementing evidence-based programs is not one of the criteria for program eligibility.

Question: Our organization is in the process of obtaining its new rate. If we don’t receive final word, would we submit using the default rate of 10%?

Answer: In order to receive any amount in excess of the deminimus 10% rate documentation of the negotiated rate for the type of proposed project activity (i.e. a negotiated rate for “research” would not be applicable to this program) , in the form of a letter, would have to be included in the application package. All applicants are eligible to receive the 10% deminimus indirect cost rate.

75. Question: Please clarify what is an “existing” dementia-capable HCBS system.”

Answer: Please see question 25.

76. Question: If we have 1 or 2 supervisors trained in an evidenced based model, can they train aide staff on the model to then administer to caregivers or does each aide need to hold a certification in the evidenced based model?

Answer: The developer of each evidence-based intervention determines certification and delivery criteria, whether to offer a train the trainer component, and who can be a trainer. Applicants should consult on these issues with the developer of the intervention they would like to deliver.

77. Question: Does training professional staff (nurses, aides, coaches, care coordinators) so that they, in turn, train caregivers count as a direct service?

Answer: Yes, training professionals that work with caregivers does count toward direct service Master trainings, by which a master trainer trains others to be trainers, are an exception. Time spent on master trainings does not count as direct service.

78. Question: Does training the caregiver in an evidence-based model (NYUCI) count as direct service?

Answer: Working with caregivers through dementia specific evidence-based intervention model protocols (models being offered in new target areas or not previously offered by the grantee) may be counted toward direct service requirements.

79. Question: Does coaching a caregiver in CTI and arranging necessary support services (when needed) count as a direct service?

Answer: If the implementation of the CTI for persons with dementia and their caregivers is part of the funded program, coaching and case management for those individuals would count toward direct service requirements.

80. Question: Are people certified in the Coleman Care Transitions Intervention model and NYUCI model considered eligible to provide caregiver training?

Answer: The developer of each evidence-based intervention determines certification and delivery criteria, whether to offer a train the trainer component, and who can be a trainer. Applicants should consult on these issues with the developer of the intervention they would like to deliver.

81. Question: If a state agency or community is awarded this grant and contracts with an organization that provides a program such as art or music to fulfill the grant, does that organization that provides the program have to be a nonprofit or can it be a for-profit organization?

Answer: Grantees may partner with both for-profit or nonprofit organizations.

82. Question: Our State received a similar grant award on September 1, 2010, but has received no similar grants since. With that, would we apply under Option A.1 (New Grants to States) or Option A.2 (Expansion Grants to States)?

Answer: Your state should apply under Option A.1.

83. Question: Per the definition of direct service under the grant, would a caregiver assessment, conducted directly with the family caregiver of a person with ADRD, be considered a direct service?

Answer: Yes.

84. Question: We tried to download the document that lists your current Alzheimer’s Disease Programs Initiative grantees and were not able to do so.

Answer: There is no one list of current grantees, but rather profiles of many of our state and community projects at https://nadrc.acl.gov/ .

85. Question: We also were not able to find the webinar that you referenced during the call on Tuesday that outlines the evidence based programs current grantees are working on. Would you be able to share this information in an accessible link?

(broken link - http ://www.nadrc.acl.gov)

Answer: There was not a webinar outlining evidence-based programs of grantees, but rather a document that was hyperlinked in multiple places within the funding opportunity announcement. The compendium of interventions can be found at: https://nadrc.acl.gov/node/140

86. Question: We, as the area agency on aging, fund agencies in our area to provide OAA direct services to clients. We provide some direct services in house, such as answering Information and Assistance calls. We also fund 21 memory cafes across our PSA at congregate dining sites and are directly involved in the implementation of two of these memory cafes. However, we do not provide dementia-related direct services, such as memory cafes, in house and would thus be funneling some of these grant funds to our contracted funded agencies. In this case, we want to be clear as to whether or not it would be appropriate for us to apply for this grant.

Answer: ACL’s program only funds NEW activities – no entity would receive funding to continue existing direct services whether in-house or through partnerships (i.e. memory café program as described).