HHS-2020-ACL-AOD-DNHE-0416.pdf

Administration for Community Living

Administration on Disabilities

Closing the Health Disparity Gap for People with Intellectual and Developmental Disabilities:

Strengthening the U.S. Health Care Workforce

HHS-2020-ACL-AOD-DNHE-0416

Application Due Date: 06/29/2020

Closing the Health Disparity Gap for People with Intellectual and Developmental Disabilities:

Strengthening the U.S. Health Care Workforce

HHS-2020-ACL-AOD-DNHE-0416

TABLE OF CONTENTS

I. Funding Opportunity Description II. Award Information

III. Eligibility Information

1. Eligible Applicants

2. Cost Sharing or Matching

3. Responsiveness and Screening Criteria

IV. Application and Submission Information

1. Address to Request Application Package

2. Content and Form of Application Submission

3. Submission Dates and Times

4. Intergovernmental Review

5. Funding Restrictions

6. Other Submission Requirements

V. Application Review Information

1. Criteria

2. Review and Selection Process

3. Anticipated Announcement Award Date

VI. Award Administration Information

1. Award Notices

2. Administrative and National Policy Requirements

3. Reporting

4. FFATA and FSRS Reporting

VII. Agency Contacts VIII. Other Information

Department of Health & Human Services

ACL Center: Administration on Disabilities Funding Opportunity Title: Closing the Health Disparity Gap for

People with Intellectual and Developmental Disabilities:

Strengthening the U.S. Health Care Workforce

Announcement Type: Initial Funding Opportunity Number: HHS-2020-ACL-AOD-DNHE-0416 Primary CFDA Number: 93.631 Due Date for Letter of Intent: 05/15/2020 Due Date for Applications: 06/29/2020 Date for Informational Conference Call: N/A

Applications that fail to meet the application due date will not be reviewed and will receive no further consideration. You are strongly encouraged to submit your application a minimum of 3- 5 days prior to the application closing date. Do not wait until the last day in the event you encounter technical difficulties, either on your end or, with https://www.grants.gov. Grants.gov can take up to 48 hours to notify you of a successful submission.

Executive Summary

People with Intellectual and Developmental Disabilities (ID/DD) are more likely to have a greater need for health care compared to the general population. They have an increased incidence of secondary health conditions associated with their disability, such as seizures, mental illness, cardiovascular disease, diabetes, dental diseases, and other conditions.

Physicians report a lack of experience with the ID/DD population and the training necessary to provide equitable health care to individuals with ID/DD. As a result, physicians are frequently uncomfortable providing health care to individuals with ID/DD. Medical students who do not receive any training on or experience with the ID/DD population have been found to exhibit poorer performance caring for patients with ID/DD in tasks varying from taking a medical history, conducting physical exams, and ordering laboratory tests. In an effort to fill the disability training void in medical and allied health training programs, the Administration for Community Living, Administration on Disabilities (AoD) seeks to fill this gap and improve health outcomes for the ID/DD population by funding a national consortium that will build on existing efforts to collaborate with medical and allied health schools to embed ID/DD content into their curriculum. The intended outcomes of the project will be an increase in the number of medical and allied health professional students trained in ID/DD; increased student knowledge of the health care needs of individuals with ID/DD; increased number of medical and allied health professionals reporting being prepared to provide health care to individuals with ID/DD;

and increasing the knowledge and skills of the medical and allied health care faculty to train https://www.grants.gov students on the ID/DD population.

I. Funding Opportunity Description

BACKGROUND:

Individuals with ID/DD have a lower life expectancy than their peers without disabilities as a result of many compounding factors. One persistent driver is a lack of access to routine and lifesaving care because of the limited number of qualified health care providers with training in ID/DD. People with ID/DD are more likely to have a greater need for health care. They have an increased incidence of secondary health conditions associated with their disability, such as seizures, mental illness, cardiovascular disease, diabetes, dental diseases, and other conditions.

Further, and more significantly, individuals with ID/DD are at risk of being denied lifesaving medical treatments and care as a result of medical providers making inaccurate predictions about their life expectancy and having negative perceptions about their quality of life.

A 2004 study found there are a limited number of health care providers who will accept adult patients with ID/DD. Physicians report a lack of experience with the ID/DD population and the training necessary to provide health care to individuals with ID/DD. As a result, physicians are frequently not comfortable providing health care to individuals with ID/DD (Reichard and Turnbull, 2004).

There is great variability in the extent to which disability-specific content is offered in medical and allied health education programs. At best, programs may offer disability awareness training.

A survey of allopathic and osteopathic American medical schools found that 52 percent reported having a disability awareness program that most often used people with disabilities or caregivers speaking in a large group setting. These programs were most likely to focus on adults with physical disabilities rather than individuals with a range of disabilities (Seidel, Erica, Crowe, and Scott, 2017).

In 2006, Iezonni published Going beyond Disease to Address Disability and cited a number of programs that were being offered in medical schools, including:

•Standardized Patient Exercise and Pediatric Clerkship at the University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ During their pediatric rotation, all third-year students spend one day at Matheny Medical and Education Center, which serves children and adults with developmental disabilities. After introductory sessions, each student performs a 20-minute interview with a standardized patient, an adult with speech disabilities who has been trained to represent common medical conditions.

After the interviews, standardized patients provide feedback using electronic communication devices or yes-or-no responses to questions.

•Caring for Adults with Disabilities at the University of South Florida College of Medicine, Tampa, FL This module is integrated into the 16-week primary-care clerkship for third-year students. It addresses older adolescents and adults with physical, sensory, and cognitive disabilities through two afternoon seminars with guests from the local community of persons with disabilities; home and community visits; service learning projects; and writing a reflection on the experience.

•Annual Disability Plenary Session, University of Illinois–Chicago College of Medicine, Chicago, IL This half-day session is part of a required Essentials of Clinical Medicine course for second year students. Presentations vary from year to year, including performances by artists with disabilities, films about living with disability, and presentations from faculty members with expertise in caring for persons with specific disabilities.

•The “Wheelchair Experience” University of Pennsylvania School of Medicine, Philadelphia, PA

This four-hour disability simulation is required of all first-year students as part of the Doctoring I Professionalism and Humanism curriculum. Students work in pairs, one using a wheelchair to perform specified day-to-day tasks while the other serves as caregiver. Students then switch roles. Afterward, students write a two-page essay about the experience. In addition, a person with a disability or a family caregiver interacts with students in small groups, describing disability-related experiences and answering students’ questions (Iezzoni, 2006).

While well-meaning, these types of training experiences point to the limited amount of time medical students spend learning about health care for people with disabilities. While this disability awareness training offers medical and allied health students some information with respect to people with disabilities, it falls well short of providing the amount of adequate training necessary to provide quality health care to people with disabilities. In addition, disability simulations, such as the “Wheelchair Experience,” may ultimately cause more harm rather than enlighten attitudes about people with disabilities. For example, participants in disability simulations have concluded that people with disabilities are less capable than the general population. (Silverman, Gwinn, & Van Boven, 2014; Nario-Redmond, Gospodinov and Cobb, 2017).

The lack of meaningful training impacts the extent to which health care providers can provide adequate care to individuals with ID/DD. Medical students who do not receive any training on or experience with the ID/DD population have been found to exhibit poorer performance caring for patients with ID/DD in tasks varying from taking a medical history, conducting physical exams, and ordering laboratory tests (Brown, Graham, Richeson, Wu, and McDermott, 2010).

Yet, there is evidence that early and frequent experiences with people with disabilities can improve medical students’ knowledge and attitudes about disability, thereby increasing their comfort level in providing care to people with disabilities (Brown, Graham, Richeson, Wu, and McDermott, 2010; Jackson, 2007; Larson McNeal, Carrothers and Premo, 2002; Long-Bellil et al., 2011; Rose, Kent and Rose, 2011; Thistlethwaite and Ewart, 2003; Tracy and Iacono, 2008).

In an effort to fill the disability training void in medical and allied health training programs, there has been a growing effort to develop training resources (e.g., competencies, curriculum, trainings) to better prepare the health care workforce to more effectively interact with and meet the health care needs of individuals with disabilities. For example, in 2016, the National Center for Birth Defects and Developmental Disabilities (NCBDDD) at the Center for Disease Control (CDC) developed competencies for the public health professionals already working in the public health field. These competencies can be adapted and embedded into new or existing public health curricula and training programs (https://disabilityinpublichealth.files.wordpress .com/2016/06/competencies-pdf-final.pdf).

https://disabilityinpublichealth.files.wordpress.com/2016/06/competencies-pdf-final.pdf https://disabilityinpublichealth.files.wordpress.com/2016/06/competencies-pdf-final.pdf

More recently NCBDDD invested in a project to develop core competencies on disability for health care education. These competencies establish broad disability standards that serve as a baseline of expertise required by health care practitioners to provide quality care to individuals with disabilities. It is intended for health care education faculty to integrate the competencies into existing curricula (https://nisonger.osu.edu/wp-content/uploads/2019/08/post-consensus- Core-Competencies-on-Disability_8.5.19.pdf).

There are many academic books on disability and health, as well as specific texts on ID/DD. In addition, there are various web-based trainings and curricula available, such as a training curriculum for medical professionals on improving the quality of care for people with disabilities by the World Institute on Disability, the Special Olympics Online Learning Portal, and the Health and Disability 101 Training for Health Department Employees offered by the National Association of County and City Health Officials.

Perhaps the most concerted effort to date to include ID/DD content in medical education programs is the National Curriculum Initiative in Developmental Medicine (NCIDM). This program founded by American Academy of Developmental Medicine & Dentistry (AADMD) works with medical schools to integrate ID/DD content into the medical school curriculum.

NCIDM has partnered with 18 medical schools to embed ID/DD content into their medical school curriculum.

Despite these efforts, there is no wide scale adoption of ID/DD content into medical school curriculum. Furthermore, education programs for allied health professionals have had little exposure to these efforts. Without the health and other care needs of the ID/DD population incorporated into more training programs, the health care workforce will not have the knowledge, skills, attitudes, and competence necessary to provide high quality healthcare to the ID/DD population.

The Administration for Community Living, Administration on Disabilities (AoD) seeks to fill this gap and improve health outcomes for the ID/DD population by funding a national consortium that will build on existing efforts to collaborate with medical and allied health schools to embed ID/DD content into their curriculum. This project will be a critical activity as part of AoD’s strategic priority to decrease health disparities of individuals with ID/DD. In 2019, AoD established two key, long-term strategic priorities and has aligned resources to decrease the health disparities of individuals with disabilities (AoD’s second strategic priority is to increase opportunities for competitive, integrated employment). AoD recognizes that a leading contributor to these health disparities is the denial of routine, preventative, and life-saving care as well as limited access to qualified healthcare providers.

This project will complement the AoD funded Center for Dignity in Healthcare for People with Disabilities (CDHPD) at the University of Cincinnati Center for Excellence in Developmental Disabilities (UCCEDD), which is part of AoD’s strategic priority to reduce health disparities. In 2019, AoD funded this first of its kind Center to lead a national coalition that will develop resources for healthcare professionals to understand the civil rights and support the needs of Americans with disabilities as they access routine and lifesaving care throughout the lifespan.

The Center will also engage people with ID/DD and their families to learn more about advocacy related to healthcare discrimination. It is anticipated that resources from this Center will be utilized in this project and embedded into medical education training curriculum.

The Administration on Disabilities (AoD) seeks to fund a five-year cooperative agreement that https://nisonger.osu.edu/wp-content/uploads/2019/08/post-consensus-Core-Competencies-on-Disability_8.5.19.pdf https://nisonger.osu.edu/wp-content/uploads/2019/08/post-consensus-Core-Competencies-on-Disability_8.5.19.pdf will increase and accelerate current efforts to embed ID/DD content into medical and allied health school education programs. The goal of the project is to expand access to quality healthcare for individuals with ID/DD by increasing the ID/DD-specific knowledge, skills, attitudes, and competence of the health care workforce. By funding this project, AoD seeks to create greater health equity and increase life expectancy of the ID/DD population.

In the proposal, applicants must describe how they will incorporate the following components into the project:

Establishment of a national ID/DD health care training consortium: A key component of the project will involve the creation of a consortium of disability experts to guide all aspects of the project, including the development of an overall plan for embedding content specific to improving the health of individuals with ID/DD into the training curricula of medical and allied health education programs.

o This consortium will include:

Professionals who have experience developing disability-specific competencies, curricula, and training for medical and allied health professions;

Practitioners from medical and allied health, including faculty and national association members; and Individuals with ID/DD, families, and other relevant stakeholders in their support networks.

o The application should describe the methods planned for ensuring active and meaningful engagement of all consortium members in all aspects of the project.

o The applicant should describe a plan of operation that describes how the consortium will be managed to ensure the goals and objectives for the project are achieved, including how they will use a consensus-based, participatory process in carrying out the activities of the project.

o A signed Memorandum of Understanding (MOU) between the applicant and members of the consortium must be submitted as part of the application. The MOUs should specify expectations of consortium member participation.

Use of a consensus-based, participatory process to conduct background research, identify core ID/DD competencies, and establish a plan for embedding ID/DD content:

The applicant should describe how they will working through the consortium:

o Complete an environmental scan that will identify and inventory existing ID/DD training resources that can be used by medical and allied health schools to embed ID/DD content into the curriculum. This should include any training resources developed by the Center for Human Dignity in Healthcare for Individuals with Disabilities. The environmental scan may include broader disability training resources that could be adapted to include ID/DD content in medical and allied health curriculum. The applicant should describe how the environmental scan will guide the creation of a gap analysis to identify information that is needed to ensure medical and allied health professionals have the training resources needed to provide health care to individuals with ID/DD.

o Complete a survey of the medical and allied health schools regarding their use of

ID/DD and other disability training resources, including but not limited to how many students have completed the trainings, the level of interest in embedding ID/DD content into their existing curriculum, and barriers to embedding ID/DD content into their existing curriculum.

o Complete a survey of individuals with ID/DD, their families, and others in their support network on their health care experiences, needs, and outcomes and the competencies they think are important for health care providers.

o Use the information from the environmental scan and the surveys to identify the core competencies that medical and allied health professional students should know and be able to be able to do to provide health care to people with ID/DD and standards for embedding ID/DD content into medical and allied health curriculum.

o Develop a plan for partnering with medical and allied health schools to embed ID/DD content based on the core competencies into their curriculum. The plan should include how training resources inventoried in the environmental scan or developed as a result of the gap analysis can be used to assist with embedding ID/DD content into the curriculum.

Partnership to embed ID/DD content into healthcare workforce training programs: The applicant will describe how the consortium will utilize their plan to establish partnerships with medical and allied health education training programs to promote the adoption of and assist with the integration of ID/DD content into their education programs, including how they may partner early on in the project with healthcare workforce training programs.

Dissemination of materials: Applicants will describe how they will utilize the consortium and their partners in making the information developed under this project available to the general public, including medical and allied health schools not involved as a partner. The applicant should also provide a plan to disseminate findings from this project for implementation in other sites and/or states.

Evaluation to assess progress and determine outcomes from the project. The applicant will describe how process evaluation techniques will be used to analyze delivery of project activities to determine, among other things: (a) the extent to which the project is implemented as planned, (b) how the project activities are being received by the schools and allied health, (c) the barriers to implementation, and (d) areas for project improvements/refinements. The applicant will also describe how summative evaluation techniques will be used to determine project success in meeting the intended outcomes of the project in terms of an increase in the:

o Number of medical and allied health professional students trained in ID/DD;

o Student knowledge of the health care needs of individuals with ID/DD;

o Number of medical and allied health professionals reporting being prepared to provide health care to individuals with ID/DD; and o The knowledge and skills of the medical and allied health care faculty to train students on the ID/DD population.

Sustainability: An expected outcome of this project will be sustainability in terms of health care workforce training programs embedding ID/DD content into their training curriculum. During the course of the project, efforts should be made to generate the sufficient resources and strategies for organizational and financial sustainability to ensure work remains viable and current.

Statutory Authority The Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act of 2000),Section 161(2) (D) (v) (42U.S.C. 15081)

II. Award Information Funding Instrument Type: Cooperative Agreement Estimated Total Funding: $350,000 Expected Number of Awards: 1 Award Ceiling: $350,000 Per Budget Period Award Floor: $300,000 Per Budget Period Length of Project Period: 60-month project period with five 12-month budget periods

The ACL project officer agrees to execute the responsibilities of the cooperative agreement outlined below:

1. Perform the day-to-day federal responsibilities of managing a grant initiative and work with the grantee to ensure that the minimum requirements for the grant are met. Conduct monthly conference calls to ensure goals and objectives are being met.

2. Work cooperatively with the grantee to clarify the programmatic and budgetary issues to be addressed by the grantee’s project, and, as necessary, collaborate with grantee to achieve a mutually agreed upon solution to any needs identified by the grantee or ACL.

3. Share information with the grantee about other federally sponsored projects and other activities relevant to the interests of the grantee and their activities.

4. Work with the grantee on the development and implementation of performance measures and quality assurance systems to ensure that performance is measured and continuous improvement occurs.

5. Provide technical advice on grantee work products to ensure they are accurate, objective, unbiased, and of high professional quality, and that they do not violate federal, departmental, or agency grant rules.

6. Attend and participate in major project events as appropriate.

The grantee will agree to execute the responsibilities of the cooperative agreement outlined below:

1. Fulfill all of the requirements of the grant initiative as detailed in this program announcement.

2. Collaborate with ACL in any in-scope modifications and execution of the work plan initially within 45 days of the award.

3. Document the impact of overall project activities and ensure quality assurance systems are in place.

4. Share information with ACL, the ID/DD network, national, state and local partner organizations, and other entities as appropriate.

5. Work with the ACL Projects of National Significance project officer to evaluate performance results reported semi-annually and jointly develop strategies to address those areas requiring improvement.

6. Submit resumes of potential key staff hires as detailed under HHS grants prior approval requirements.

7. Report semi-annually on project accomplishments, challenges, and progress towards measurable objectives.

8. Work with the ACL Projects of National Significance program project officer to brand this work in such a way that appropriately recognizes and acknowledges ACL’s financial contributions to its activities.

The Government retains all rights to all data and reports compiled as a result of this grant. No information furnished to or generated by the grantee in the performance of this grant shall be released to the public by the grantee without the prior approval of the project officer.

Once a cooperative agreement is in place, requests to modify or amend it or the work plan may be made by ACL or the awardee at any time as long as it stays within the original confines of the proposed project description. Major changes may affect the integrity of the competitive review process. Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the execution of an award notice. When an award is issued the cooperative agreement terms and conditions from the program announcement are incorporated by reference unless ACL is authorized under the Terms and Conditions of award, 45 CFR Part 75, or other applicable regulation or statute to make unilateral amendments.

III. Eligibility Information

1. Eligible Applicants Domestic public or private non-profit entities including state and local governments, Indian tribal governments and organizations (American Indian/Alaskan Native/Native American), faith-based organizations, community-based organizations, hospitals, and institutions of higher education.

2. Cost Sharing or Matching

Cost Sharing / Matching Requirement: No

3. Responsiveness and Screening Criteria

Application Responsiveness Criteria The successful applicant will be an organization that meets the following criteria:

Provided signed letters of commitment from key partners and collaborators named in the proposal and identify their specific role in the project; and

Included a 5-year budget narrative/justification.

Application Screening Criteria All applications will be screened to assure a level playing field for all applicants. Applications that fail to meet the three screening criteria described below will not be reviewed and will receive no further consideration.

In order for an application to be reviewed, it must meet the following screening requirements:

1. Applications must be submitted electronically via http://www.grants.gov by 11:59 p.m., Eastern Time, by due date listed in section IV.3 Submission Dates and Times.

2. The Project Narrative section of the Application must be double-spaced, on 8.5” x 11” plain white paper with 1” margins on both sides, and a standard font size of no less than 11 point, preferably Times New Roman or Arial.

3. The Project Narrative must not exceed 45 pages. Project Narratives that exceed 45 pages will have the additional pages removed and only the first 45 pages of the Project Narrative will be provided to the merit reviewers for funding consideration. NOTE: The Project Work Plan, Letters of Commitment, and Vitae of Key Project Personnel are not counted as part of the Project Narrative for purposes of the 45-page limit.

Unsuccessful submissions will require authenticated verification from http://www.grants.gov indicating system problems existed at the time of your submission. For example, you will be required to provide an http://www.grants.gov submission error notification and/or tracking number in order to substantiate missing the application deadline.

IV. Application and Submission Information

1. Address to Request Application Package Address to Request Application Package Application materials can be obtained from http://www.grants.gov or https://www.acl.gov/grants/applying-grants.

Please note, ACL requires applications for all announcements to be submitted electronically through http://www.grants.gov in Workspace. Grants.gov Workspace is the standard way for organizations and individuals to apply for federal grants in Grants.gov. An overview and training on Grants.gov Workspace can be found here at:

https://www.grants.gov/web/grants/applicants/workspace-overview.html The Grants.gov registration process can take several days. If your organization is not currently registered, please begin this process immediately. For assistance with http://www.grants.gov, please contact them at support@grants.gov or 800-518-4726 between 7:00 a.m. and 9:00 p.m.

Eastern Time.

At the http://www.grants.gov website, you will find information about submitting an application electronically through the site, including the hours of operation. ACL strongly recommends that you do not wait until the application due date to begin the application process because of the time involved to complete the registration process.

All applicants must have a DUNS number (http://fedgov.dnb.com/webform/) and be registered with the System for Award Management (SAM, www.sam.gov) and maintain an active SAM registration until the application process is complete, and should a grant be made, throughout the life of the award. Effective June 11, 2018, when registering or renewing your registration, you must submit a notarized letter appointing the authorized Entity Administrator. Please be sure to read the FAQs located at www.sam.gov to learn more. Applicants should allot sufficient time prior to the application deadline to finalize a new, or renew an existing registration. This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award.

Maintain documentation (with dates) of your efforts to register or renew at least two weeks before the deadline. See the SAM Quick Guide for Grantees at: https://www.sam.gov /sam/ transcript/ SAM_Quick_ Guide_Grants_ Registrations-v1.6. ;pdf.

Note: Once your SAM registration is active, allow 24 to 48 hours for the information to be available in Grants.gov before you can submit an application through Grants.gov. This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award.

Note: Failure to submit the correct EIN Suffix can lead to delays in identifying your organization and access to funding in the Payment Management System.

Effective October 1, 2010, HHS requires all entities that plan to apply for and ultimately receive federal grant funds from any HHS Operating/Staff Division (OPDIV/STAFFDIV) or receive subawards directly from the recipients of those grant funds to:

1. Register in SAM prior to submitting an application or plan;

2. Maintain an active SAM registration with current information at all times during which it has an active award or an application or plan under consideration by an OPDIV; and

3. Provide its DUNS number in each application or plan to submit to the OPDIV.

Additionally, all first-tier subaward recipients must have a DUNS number at the time the subaward is made.

Since October 1, 2003, The Office of Management and Budget has required applicants to provide a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when applying for federal grants or cooperative agreements. It is entered on the SF-424. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities.

The DUNS number is free and easy to obtain.

Organizations can receive a DUNS number at no cost by calling the dedicated toll-free DUNS Number request line at 866-705-5711 You must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications.

After you electronically submit your application, you will receive an automatic acknowledgement from http://www.grants.gov that contains http://www.grants.gov tracking number. The Administration for Community Living will retrieve your application form from http://www.grants.gov

U.S. Department of Health and Human Services

Elizabeth Leef Administration on Disabilities Phone Number: (202) 475-2482 E-mail: Elizabeth.leef@acl.hhs.gov

2. Content and Form of Application Submission

Letter of Intent

Due Date for Letter of Intent: 05/15/2020

Project Narrative The Project Narrative must be double-spaced, on 8.5” x 11” paper with 1” margins on both sides, and a standard font size of no less than 11 point, preferably Times New Roman or Arial.

You can use smaller font sizes to fill in the Standard Forms and Sample Formats. The suggested length for the Project Narrative is 30 to 45 pages; 45 pages is the maximum length allowed.

Project Narratives that exceed 45 pages will have the additional pages removed and only the first 45 pages of the Project Narrative will be provided to the merit reviewers for funding consideration. The Project Work Plan, Letters of Commitment, and Vitae of Key Personnel are not counted as part of the Project Narrative for purposes of the 45-page limit, but all of the other sections noted below are included in the limit.

The sample components of the Project Narrative counted as part of the 45 page limit include:

Summary/Abstract

Challenges and Opportunities http://www.grants.gov/ http://www.grants.gov/ mailto:Elizabeth.leef@acl.hhs.gov

Goal(s) and Objective(s)

Approach

Special Target Populations and Organizations

Outcomes

Project Management

Evaluation

Dissemination

Organizational Capability

The Project Narrative is the most important part of the application, since it will be used as the primary basis to determine whether your project meets the minimum requirements for grants under the authorizing statutes. The Project Narrative should provide a clear and concise description of your project. ACL recommends that your project narrative include the following components:

Summary/Abstract All applications for grant funding must include a summary/abstract that concisely describes the proposed project, including goals, objectives, overall approach (including target population and significant partnerships), anticipated outcomes, products to be developed, and duration. It should be written for an audience that includes the general public. To ensure uniformity, please limit the length to 265 words or less on a single page with a font size of not less than 11, doubled-spaced.

More detailed instructions for completing the summary/abstract, including simple descriptions of terms and a sample abstract, are included in the “Instructions for Completing the Project Summary/Abstract" in Section VIII of this funding opportunity announcement.

Challenges and Opportunities This section should describe, in both quantitative and qualitative terms, the nature and scope of the particular problem or issue the proposed intervention is designed to address, including how the project will potentially affect older adults and /or people with disabilities, their families and caregivers and the health care and social services systems.

Goals and Objectives This section should consist of a description of the project's goal(s) and major objectives. Unless the project involves multiple, complex interventions, we recommend you only have one overall goal.

Approach This section should provide a clear and concise description of the intervention you are proposing to use to address the problem described in the "Problem Statement". You should also provide the rationale for using the particular intervention, including factors such as: "lessons learned" for similar projects previously tested in your community, or in other areas of the country; factors in the larger environment that have created the "right conditions" for the intervention (e.g., existing social or economic factors that you'll be able to take advantage of, etc.). Also note any major barriers you anticipate encountering, and how your project will be able to overcome those barriers. Be sure to describe the role and makeup of any strategic partnerships you plan to involve in implementing the intervention, including other organizations, supporters, and/or consumer groups.

Special Target Populations and Organizations This section should describe how you plan to involve organizations in a meaningful way in the planning and implementation of the proposed project. This section should also describe whether, and if so, how the proposed intervention will target disadvantaged populations, including limited-English speaking populations, those of greatest economic need and those of greatest social need.

Outcomes This section of the project narrative must clearly identify the measurable outcome(s) that will result from the project. (NOTE: ACL will not fund any project that does not include measurable outcomes). This section should also describe how the project’s findings might benefit the field at large, (e.g., how the findings could help other organizations throughout the nation to address the same or similar problems.) List measurable outcomes in the optional work plan grid (“Project Work Plan – Sample Template”) under “Measurable Outcomes” in addition to any discussion included in the narrative along with a description of how the project might benefit the field at large.

A “measurable outcome” is an observable end-result that describes how a particular intervention benefits consumers. It demonstrates the functional status, mental well-being, knowledge, skill, attitude, awareness or behavior.) It can also describe a change in the degree to which consumers exercise choice over the types of services they receive, or whether they are satisfied with the way a service is delivered. Additional examples include: a change in the responsiveness or cost-effectiveness of a service delivery system; a new model of support or care that can be replicated in the ACL network; new knowledge that can contribute to the field of community living; a measurable increase in community awareness; or a measurable increase in persons receiving services. A measurable outcome is not a measurable “output”, such as: the number of clients served; the number of training sessions held; or the number of service units provided.

You should keep the focus of this section on describing what outcome(s) will be produced by the project. You should use the Evaluation section noted below to describe how the outcome(s) will be measured and reported.

Your application will be scored on the clarity and nature of your proposed outcomes, not on the number of outcomes cited. It is totally appropriate for a project to have only ONE outcome that it is trying to achieve through the intervention reflected in the project’s design.

Project Management This section should include a clear delineation of the roles and responsibilities of project staff, consultants and project organizations, and how they will contribute to achieving the project's objectives and outcomes. It should specify who would have the day-to-day responsibility for key tasks such as leadership of project; monitoring the project's on-going progress (i.e., measure of performance towards the goals stated in the funding opportunity announcement and for your specific intervention/activities), preparation of reports; communications with other partners and

ACL. It should also describe the approach that will be used to monitor and track progress on the project's tasks and objectives.

Evaluation This section should describe the specific outcomes (e.g., changes in clients, organizations, and/or communities) expected as a result of this funding as well as method(s), techniques and tools that will be used to: 1) determine whether the proposed intervention achieved its anticipated outcome(s), and 2) document the "lessons learned" - both positive and negative -from the project that will be useful to people interested in replicating the intervention, if it proves successful.

Dissemination This section should describe the method that will be used to disseminate the project's results and findings in a timely manner and in easily understandable formats, to parties who might be interested in using the results of the project to inform practice, service delivery, program development, and/or policy-making, including those partied who would be interested in replicating the project.

Organizational Capacity Statement Each application should include an organizational capability statement and vitae for key project personnel. The organizational capability statement should describe how the applicant agency (or the particular division of a larger agency which will have responsibility for this project) is organized, the nature and scope of its work and/or the capabilities it possesses. It should also include the organization’s capability to sustain some or all project activities after federal financial assistance has ended.

This description should cover capabilities of the applicant agency not included in the program narrative, such as any current or previous relevant experience and/or the record of the project team in preparing cogent and useful reports, publications, and other products. If appropriate, include an organization chart showing the relationship of the project to the current organization.

Please attach short vitae for key project staff only. Neither vitas nor an organizational chart will count towards the narrative page limit. Also include information about any contractual organization(s) that will have a significant role(s) in implementing project and achieving project goals.

Other

Budget Narrative/Justification The Budget Narrative/Justification can be provided using the format included in the document, “Budget Narrative/Justification – Sample Format.” Applicants are encouraged to pay particular attention to this document, which provides an example of the level of detail sought. A combined multi-year Budget Narrative/Justification, as well as a detailed Budget Narrative/Justification for each year of potential grant funding is required Below you will find standard language that can be used, or modified as needed, for a one year grants program.

Work Plan

The Project Work Plan should reflect and be consistent with the Project Narrative and Budget and should cover all five (5) years of the project period. It should include a statement of the project’s overall goal, anticipated outcome(s), key objectives, and the major tasks / action steps that will be pursued to achieve the goal and outcome(s). For each major task/action step, the work plan should identify timeframes involved (including start- and end-dates), and the lead person responsible for completing the task. Please use the “Project Work Plan - Sample Template” format as a reference and resource, if desired.

Letters of Commitment from Key Participating Organizations and Agencies

Include confirmation of the commitments to the project (should it be funded) made by key collaborating organizations and agencies in this part of the application. Any organization this is specifically named to have a significant role in carrying out the project should be considered an essential collaborator. For applications submitted electronically via http://www.grants.gov, signed letters of commitment should be scanned and included as attachments.

3. Submission Dates and Times Due Date for Applications: 06/29/2020 Applications that fail to meet the application due date will not be reviewed and will receive no further consideration. You are strongly encouraged to submit your application a minimum of 3- 5 days prior to the application closing date. Do not wait until the last day in the event you encounter technical difficulties, either on your end or, with http://www.grants.gov.

Grants.gov can take up to 48 hours to notify you of a successful submission.

In addition, if you are submitting your application via Grants.gov, you must (1) be designated by your organization as an Authorized Organization Representative (AOR) and (2) register yourself with Grants.gov as an AOR. Details on these steps are outlined at the following Grants.gov web page: http://www.grants.gov/web/grants/register.html.

After you electronically submit your application, you will receive from Grants.gov an automatic notification of receipt that contains a Grants.gov tracking number. (This notification indicates receipt by Grants.gov only.) If you are experiencing problems submitting your application through Grants.gov, please contact the Grants.gov Support Desk, toll free, at 1-800-518-4726.

You must obtain a Grants.gov Support Desk Case Number and must keep a record of it.

If you are prevented from electronically submitting your application on the application deadline because of technical problems with the Grants.gov system, please contact the person listed under For Further Information Contact in section VII of this notice and provide a written explanation of the technical problem you experienced with Grants.gov, along with the Grants.gov Support Desk Case Number. ACL will contact you after a determination is made on whether your application will be accepted.

Note: We will not consider your application for further review if you failed to fully register to submit your application to Grants.gov before the application deadline or if the technical problem you experienced is unrelated to the Grants.gov system.

http://www.grants.gov/web/grants/register.html

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once prior to the application due date, ACL will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

Unsuccessful submissions will require authenticated verification from http://www.grants.gov indicating system problems existed at the time of your submission. For example, you will be required to provide an http://www.grants.gov submission error notification and/or tracking number in order to substantiate missing the cut off date.

Grants.gov (http://www.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 http://www.grants.gov.

4. Intergovernmental Review This funding opportunity announcement is not subject to the requirements of Executive Order 12372, "Intergovernmental Review of Federal Programs."

5. Funding Restrictions The following activities are not fundable:

Construction and/or major rehabilitation of buildings Basic research (e.g. scientific or medical experiments) Continuation of existing projects without expansion or new and innovative approaches

Note: A recent Government Accountability Office (GAO) report has raised considerable concerns about grantees and contractors charging the Federal Government for additional meals outside of the standard allowance for travel subsistence known as per diem expenses. Executive Orders on Promoting Efficient Spending (E.O. 13589) and Delivering Efficient, Effective and Accountable Government (E.O. 13576) have been issued and instruct Federal agencies to promote efficient spending. Therefore, if meals are to be charged in your proposal, applicants should understand such costs must meet the following criteria outlined in the Executive Orders and HHS Grants Policy Statement:

Meals are generally unallowable except for the following:

o For subjects and patients under study (usually a research program);

o Where specifically approved as part of the project or program activity, e.g., in programs providing children’s services (e.g. Head Start);

o When an organization customarily provides meals to employees working beyond the normal workday, as a part of a formal compensation arrangement, o As part of a per diem or subsistence allowance provided in conjunction with allowable travel; and o Under a conference grant, when meals are necessary and integral part of a conference, provided that meal costs are not duplicated in participants' per diem http://www.grants.gov/ http://www.grants.gov/ or subsistence allowances. (Note: conference grant means the sole purpose of the award is to hold a conference.)

6. Other Submission Requirements Letters of intent should be emailed to:

Elizabeth.leef@acl.hhs.gov

Elizabeth Leef

V. Application Review Information

1. Criteria Applicants must document all of their source material. If any text, language and/or materials are from another source, the applicant must make it clear the material is being quoted and where the text comes from. The applicant must also cite any sources when they obtain numbers, ideas, or other material that is not their own. If the applicant fails to comply with this requirement, regardless of the severity or frequency of the plagiarism, the reviewers shall reduce their scores accordingly even to the degree of issuing no points at all.

Applications are scored by assigning a maximum of 100 points across the desired review criteria:

a. Project Relevance & Current Need (15 points)

b. Approach (45 points)

c. Program Evaluation (15 points)

d. Dissemination (10 points)

e. Organizational Capacity (10 points)

f. Budget (5 points)

Project Relevance & Current Need Maximum Points:15

Clearly establishes the need to develop an ID/DD curriculum for medical and allied health professional schools to embed within their training programs using relevant and current research and data that identifies the health-care needs of individuals with ID/DD and their current healthcare disparities as a result of a lack of trained health care providers. (4 points)

Describes how individuals with ID/DD and their family members were consulted in the development of the application and provides evidence that feedback from such representatives was utilized in developing the project proposal, including the goals and goal-related activities. (2 points)

Shows a direct relationship between the needs identified based on research, data and planning studies and feedback…