Foa_Content_of_HHS-2022-ACL-CIP-NWGV-0067.pdf

Administration for Community Living

Center for Innovation and Partnership

No Wrong Door System Governance: Improving Access to LTSS for Individuals and Family Caregivers

HHS-2022-ACL-CIP-NWGV-0067

07/05/2022

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

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

Letter of Intent

Project Narrative

Summary/Abstract

Problem Statement and Current Need

Goals and Objectives

Approach

Outcomes and Evaluation

Organizational Capability

Budget Narrative/Justification

Work Plan

Letters of Commitment from Key Participating Organizations and Agencies

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

4. Submission Dates and Times

5. Intergovernmental Review

6. Funding Restrictions

7. 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

The Paperwork Reduction Act of 1995 (P.L. 104-13)

Appendix

Instructions for Completing Required Forms

Budget Narrative/Justification- Sample Format

Instructions for Completing the Project Summary/ Abstract

ACL Center:

Center for Innovation and Partnership Funding Opportunity Title:

No Wrong Door System Governance: Improving Access to LTSS for Individuals and Family Caregivers Funding Opportunity Number:

HHS-2022-ACL-CIP-NWGV-0067

Primary CFDA Number:

93.048 Due Date for Letter of Intent:

05/27/2022 Due Date for Applications:

07/05/2022 Date for Informational Conference Call:

05/18/2022 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 Additional Overview Content/Executive Summary Finding and accessing the right long-term services and supports (LTSS) can be a daunting task for individuals and family caregivers. The current LTSS System involves numerous funding streams administered by multiple federal, state, and local agencies using different, and often fragmented and duplicative, access processes involving screening, intake, needs assessment, service planning, and eligibility determination. Individuals and family caregivers trying to access LTSS frequently find themselves confronted with a bewildering maze of organizations and bureaucratic requirements at a time when they are vulnerable or in crisis. This often results https://www.grants.gov/ in people making decisions based on incomplete, and sometimes inaccurate, information about their options. This can lead to the purchase and/or use of LTSS options that are less than optimal for the individual and more expensive than necessary, such as nursing facility care that can quickly exhaust an individual’s or family’s personal resources and result in their spending down to Medicaid.

In 2003, the Administration for Community Living (ACL) and federal partners came together to respond to this challenge facing our country, creating a joint funding opportunity to support state efforts to create “one-stop-shop” access programs for people seeking LTSS, known as the Aging and Disability Resource Center (ADRC) Program. This program is designed to provide individuals and caregivers needing services with “visible and trusted” sources of information, one-on-one counseling, and streamlined access to services and supports. Lessons since learned from ADRC grants and related initiatives, combined with further alignment of federal programs, created the current vision for LTSS, or No Wrong Door (NWD) Systems.

ACL will fund up to 10 states to undergo a two-year process where in the first year the states will assess individual and family caregiver access to LTSS. This includes the mapping of key coordination referral sources such as Social Health Access Referral Platforms (SHARPs) sometimes used by health care providers and payers to refer patients to CBOs for services to address their health- related social needs. Individuals’ and family caregivers’ perspectives and needs will inform the development of a strong NWD governance structure. Governance must involve a collaborative effort among multiple state agencies and key stakeholders. NWD Systems serve people who represent a variety of ages, disabilities, incomes, nationalities, citizenship statuses, cultures, gender identities and expressions, sexual orientations, or languages.

This funding will allow the State to develop NWD System governance that includes health systems (or health system state associations) to establish partnerships that enable individuals to access services to transition from hospitals and nursing homes to home and the community. After completing the access analysis in the first year of the grant, the state’s NWD System governing body will use the second year of the grant to develop a plan to address the identified individual and caregiver access challenges and service or population gaps.

An informational conference call will be held on May 18, 2022 from 2:00 to 3:00pm ET. Toll Free Number: 800-619-8521 Passcode: 3358777 A recording will be available approximately one hour after the call concludes at the following number: 800-597-8358

I. Funding Opportunity Description Finding and accessing the right long-term services and supports (LTSS) can be a daunting task for individuals and family caregivers. The current LTSS System involves numerous funding streams administered by multiple federal, state, and local agencies using different, and often fragmented and duplicative, access processes involving screening, intake, needs assessment, service planning, and eligibility determination. Individuals and family caregivers trying to access LTSS frequently find themselves confronted with a bewildering maze of organizations and bureaucratic requirements at a time when they are vulnerable or in crisis. This often results in people making decisions based on incomplete, and sometimes inaccurate, information about their options. This can lead to the purchase and/or use of LTSS options that are less than optimal for the individual and more expensive than necessary, such as nursing facility care that can quickly exhaust an individual's or family’s personal resources and result in their spending down to Medicaid.

The consequences of a LTSS System that makes it difficult for people to make informed decisions about their LTSS options have a direct impact on the health, well-being, and financial status of our citizens, and it also has a direct impact on our state and federal budgets. This situation will only be compounded as the number of people who need LTSS increases and more and more LTSS products come onto the market. In 2018, 14 million adults needed LTSS[1], and about 70% of all the people now turning age 65 will need LTSS.[2]

In 2003, the Administration for Community Living (ACL) and federal partners came together to respond to this challenge facing our country, creating a joint funding opportunity to support state efforts to create “one-stop-shop” access programs for people seeking LTSS. This initiative, known as the Aging and Disability Resource Center (ADRC) Program, was designed to provide individuals and caregivers needing services with “visible and trusted” sources of information, one-on-one counseling, and streamlined access to services and supports. The ADRC Program was a “system change” initiative to help states better coordinate and integrate their access functions and create a new “interface” between individuals needing services and the LTSS System in order to make it easier for people to learn about and quickly access the LTSS options that would best meet their needs. Over the next two decades, ACL and its federal partners invested in state infrastructure building and systems change initiatives to enhance and streamline access for LTSS. Lessons learned from those prior grants, combined with further alignment of federal programs, created the current vision for LTSS, or No Wrong Door (NWD) Systems.

The NWD System vision, includes national standards, tools, metrics, and best practices that all states can use to develop a single “high performing” access system to serve all populations who may need any LTSS, regardless of payer. With the adoption of a NWD System, each state has a single, coordinated statewide system where multiple agencies at the state and local level align to create a simplified process through which individuals and family caregivers can get unbiased information and one-on-one counseling on the options available in their communities. NWD Systems serve people who represent a variety of ages, disabilities, incomes, nationalities, citizenship statuses, cultures, gender identities and expressions, sexual orientations, or languages.

A state NWD System is a network of ADRCs and community-based organizations with trained staff, such as information and assistance specialists, person- centered counselors, etc., that manage access functions and processes to maintain independent living in the community.

ADRCs and their partners have unmatched expertise in understanding local culture and needs, service coordination and delivery, and securing benefits, services, and supports that maximize independence. In addition, the breadth of staff residing in a state’s NWD system are best positioned to understand a person’s preferences for community living; these preferences may differ depending on an individual’s age, race, culture, social and family support, as well as which applicable services and supports are important to a person and for a person.

The foundation of NWD Systems is supported by four key functions:

Public Outreach and Coordination with Key Referral Sources Person Centered Counseling Streamlined Access to Public LTSS Programs

State Governance and Administration

Each of these functions are described in detail in the [NWD Key Elements document]. The federal vision recognizes there is no one agency or network that has the capacity, expertise, or authority to effectively carry out all the NWD System functions for all the different populations served by the NWD System. The NWD System is governed by a multi-agency leadership team, responsible for coordinating the System’s on-going development, implementation, financing, evaluation, and continual improvement. The governing body includes representatives from the State Medicaid Agency, the State Unit on Aging, and the state agencies that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, and the state authorities administering mental health or behavioral services. States may involve other state agencies, such as the housing agency, budget office, the agency administering programs for Veterans, or the University Centers for Excellence in Developmental Disabilities Education, Research, and Service (UCEDDs), as members of its NWD System governing body. Multiple agencies and organizations at the state and local level need to be formally involved in the operations of a state’s NWD System, all with clearly defined roles and responsibilities including healthcare stakeholders such hospital associations. A key function of the NWD System is to serve as a bridge for the health system to the community and to facilitate the transition of individuals with LTSS needs who are being discharged from acute care settings and nursing homes back to their own homes. Organizations within a NWD System also help these individuals to arrange for the community services and supports they need to remain at home and avoid unnecessary hospital readmissions. As a result, state NWD systems help ensure that NWD partners have formal agreements with acute care entities that define the role of the NWD staff in facilitating hospital-to-home transitions for people with LTSS needs.

Integration of RAISE Goals and National Family Caregiving Strategy in NWD Governance

The number of caregivers is expected to grow significantly, as the population of people living with multiple chronic conditions and disabilities increases in the coming decades and more complex care shifts to community-based care. In addition to more traditional tasks such as personal care or assistance, caregivers also take on responsibilities related to medical tasks, emotional and mental health support, administration management, transportation coordination, advocacy assistance, and education. Almost a quarter of family caregivers are caring for more than one person, also known as “multiple caregiving.” Furthermore, the COVID-19 pandemic has exposed an increasing number of young people caring for family members, also known as “caregiving youth”, who are children, teens, and young adults who care for parents, grandparents, and/or siblings. In addition, the pandemic has overall identified increased challenges for caregivers including gaps in childcare, need for PPE and burnout risk. ADRCs across the country have responded through continued or newly implemented supports to caregivers.

The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act of 2017 (Public Law 115-119) was signed into law in January 2018 and directs the Secretary of Health and Human Services to develop a National Family Caregiving Strategy. To inform that work, the RAISE Act also directed the establishment of the Family Caregiving Advisory Council providing recommendations on effective models of both family caregiving and support to family https://nwd.acl.gov/pdf/NWD-National-Elements.pdf https://www.ta-community.com/t/m1hz2mk/acl-state-strategies-for-supporting-caregivers https://www.ta-community.com/t/m1hz2mk/acl-state-strategies-for-supporting-caregivers https://www.ta-community.com/t/m1hz2mk/acl-state-strategies-for-supporting-caregivers https://www.ta-community.com/t/m1hz2mk/acl-state-strategies-for-supporting-caregivers https://acl.gov/sites/default/files/about-acl/2018-10/PLAW-115publ119%20-%20RAISE.pdf caregivers, as well as improving coordination across federal government programs. The Administration for Community Living is leading the implementation of the RAISE Act and facilitates the work of the RAISE Family Caregiving Advisory Council.[3] On September 22, 2021, the RAISE Family Caregiving Advisory Council released its initial report outlining the challenges faced by family caregivers, and federal programs currently available to support them.

The report also provides 26 recommendations for better supporting family caregivers.

To support the implementation of RAISE, ACL will fund up to 10 states to assess individual and family caregiver access to the statewide NWD System, the formal “point of entry” into the state’s LTSS system. States will identify inequities, fragmentation, duplication, and other challenges individuals and family caregivers face trying to access LTSS. Analyzing access to LTSS will identify strategies to align with the first three of the five recommended priority areas or RAISE Goals:

Goal 1: Family caregivers’ physical, emotional, and financial well-being will meaningfully improve as a result of expanded awareness, outreach, and education.

Goal 2: Family caregivers are recognized, engaged, and supported as key partners with providers of health care and long-term services and supports.

Goal 3: Family caregivers have access to an array of flexible person- and family-centered programs, supports, goods, and services that meet the diverse and dynamic needs of family caregivers and people receiving support.

Goal 4: Family caregivers’ lifetime financial and employment security is protected and enhanced.

Goal 5: Family caregivers are engaged stakeholders in a national research and data gathering infrastructure that documents their experiences, translates evidence into best practices, develops person-and family-centered interventions, and measures progress toward the National Family Caregiving Strategy.

The RAISE Family Caregiving Advisory Council has been working with a Congressionally mandated Advisory Council to Support Grandparents Raising Grandchildren (SGRG) to develop the National Family Caregiving Strategy. As further described SGRG initial report to Congress, the National Family Caregiving Strategy is a collection of 22 recommendations to identify actions that community, providers, government and others may take to recognize and support family caregivers. As with the RAISE Act Goals, this ACL funding opportunity supports the National Family Caregiving Strategy’s many recommendations. Such recommendations include:

Recommendation 1.2: Improve outreach to kinship families and grandfamilies to help them to identify their critical role as primary caregivers so they seek access to appropriate services and supports.

Recommendation 1.3: Increase kinship families and grandfamilies’ awareness of, and access to, the full range of available information, services, and supports to help them meet their needs and the needs of the children in their care.

Recommendation 2.2: Increase the use of comprehensive assessments to determine caregiver and family strengths and needs when identifying appropriate services for kinship families and grandfamilies who are seeking help.

https://acl.gov/RAISE/report https://acl.gov/SGRG/report

Recommendation 3.1: Increase kinship families and grandfamilies’ access to information, services, and supports.

Recommendation 3.3: Increase the availability and types of culturally competent, trauma-informed counseling, training, and education for kinship families and grandfamilies, including best practices, model approaches, and evidence-based interventions.

Recommendation 3.4: Increase the availability of supports and services that specifically meet the needs of the caregiver.

Funding Application Requirements To best assess individuals and family caregivers’ access of a NWD System, a strong NWD governance structure is needed. As detailed further in the NWD System Key Elements, the NWD governing body leads the design, implementation, and ongoing administration of the NWD System. Governance and administration must involve a collaborative effort among multiple state agencies, since no one state agency has the authority or expertise to carry out all the functions involved in a NWD System. The NWD System is a critical component of any well-developed, person-centered state LTSS System, and therefore, its governance and oversight should be lodged in a Cabinet level body - either a new or existing one - and should be part of the state's oversight of its LTSS System. It must include representatives from the State Medicaid Agency, the State Unit on Aging, and the state agencies that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, and the state authorities administering mental health services. Senior staff from these agencies should be designated as full partners in managing the on-going development and implementation of the NWD System.

The NWD System governing body should be responsible for coordinating the on-going development, implementation, financing, evaluation and continual improvement of the state's NWD System. Once established, some initial responsibilities for a NWD System governing body would include:

Setting up a process that will ensure key stakeholders have meaningful contributions into the ongoing development and implementation of the states’ NWD System. Stakeholders should include individuals, their advocates including family caregivers, Area Agencies on Aging, Centers for Independent Living, key statewide healthcare stakeholders (e.g., State Hospital Association), state housing agencies and/or local/regional housing agencies, local affordable housing providers, local Medicaid agencies, local organizations that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, individuals with mental/behavioral health needs, Veteran Service Organizations, service providers, and other relevant public and private entities;

Developing criteria and/or process to determine what organizations at the state and local level should play a formal role in carrying out NWD system functions;

Designating and developing formal agreements and funding arrangements with the state and local organizations that are selected to carry out NWD System functions;

Developing a communications strategy and process that will facilitate on-going communication among the many different agencies and organizations playing formal roles in the NWD System; Identifying the existing public resources currently being used https://nwd.acl.gov/pdf/NWD-National-Elements.pdf to support access functions across the multiple state administered programs that provide LTSS, and determining how these resources can best be coordinated and integrated to align their operation and performance with the NWD System functions outlined in the NWD Key Elements; and, Making recommendations to the Governor on key aspects of the NWD System’s design, development, financing, and on-going administration.

The governing body actively and publicly promotes the philosophy, values, concepts, and practices of person-centeredness throughout the NWD System. It defines performance measures and leads continuous quality improvement, including ensuring adequate training and workforce capacity. One example is from Virginia’s NWD System, which has a dedicated No Wrong Door Virginia website and page describing their governance structure. Virginia has also created a series of videos sharing insights about NWD from individuals, providers, communities and investors. Grantees of this funding opportunity will be expected to establish a clear governance structure if one is not already in place. States may reference the NWD Business Case Toolkit: Section 1: Getting Started: A Focus on Governance for initial steps and resources for securing a state’s governance structure around the NWD System.

Each state NWD System governing body will lead a mapping analysis from the lens of individuals and family caregivers. In the first year of the two-year grant, states will analyze:

Key coordination referral sources such as Social Health Access Referral Platforms (SHARPs)

Public outreach and education activities for caregivers and those who need caregiving support

Activities to support obtaining and sustaining housing Existing and potential key caregiving referral sources Transitions across hospital and institutional settings and opportunities to support caregivers with transitions or coordination Youth transitions to postsecondary life and gaps of services filled by caregivers Access for caregivers of Veterans, including through formal agreements with VA

Medical Centers.

The analysis process must involve multiple state agencies and input from key stakeholders including family caregivers and care recipients, Area Agencies on Aging, Centers for Independent Living, state and local Medicaid agencies, key statewide healthcare stakeholders (e.g., State Hospital Association), local organizations that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, and individuals with mental/behavioral health needs, Veteran Service Organizations, state housing agencies and/or local/regional housing agencies, local affordable housing providers, as well as service providers and other relevant public and private entities. At a minimum, the following state agencies must be involved as full partners in co-leading this planning process: the State Medicaid Agency, the State Unit on Aging, and the state agencies that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, the state authorities administering mental health services and key statewide healthcare stakeholders (e.g., State Hospital Association). States may involve other state agencies in the process, such as the budget office or the agency administering programs for https://www.nowrongdoorvirginia.org/about.htm https://www.nowrongdoorvirginia.org/about.htm https://www.ta-community.com/t/q6hjvwl/virginia-no-wrong-door-virginia-video-series https://www.ta-community.com/t/q6hjvwl/virginia-no-wrong-door-virginia-video-series https://www.ta-community.com/t/83h8z8a/acl-section-1-getting-started-a-focus-on-governance https://www.ta-community.com/t/83h8z8a/acl-section-1-getting-started-a-focus-on-governance

Veterans. To address housing stability, partnerships with State Housing or other appropriate housing agencies are highly encouraged.

After completing the access analysis in the first year of the grant, the state’s NWD System governing body will use the second year of the grant to develop a plan to address the identified caregiver access challenges and service or population gaps. The plan may be specifically for the NWD System or as an integrated component within another plan for statewide implementation. For example, a Master Plan for Aging is a strategic blueprint for state-level, cross-sector planning efforts to meet the needs of older adults, people with disabilities and family caregivers over a period of 10 years or more. The Center for Health Care Strategies is hosting a multi-state learning collaborative for states interested in developing a Master Plan for Aging. Whether NWD System specific or a larger encompassing aging statewide plan, the plan should include a detailed strategy, work plan, and budget that the state will use, pending the availability of this grant / federal support, to address gaps in access to LTSS for family caregivers within the functionality and operational capacity of a NWD System that serves for all populations and all payers. Budgets may include how states are blending and braiding other public funds such as NWD Medicaid Administrative Claiming, Money Follows the Person or American Rescue Plan Act 9817 funding.

The awards under this funding opportunity will be issued as Cooperative Agreements. Successful applicants must agree to work with ACL and its technical assistance partners on all aspects of the state's planning process.

[1] Hado, Edem, and Harriet Komisar. Long-Term Services and Supports. Washington, DC:

AARP Public Policy Institute, August 2019. https://doi.org/10.26419/ppi.00079.001 [2] Office of the Assistant Secretary for Planning and Evaluation. “What Is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports?” Accessed February 2022:

https://aspe.hhs.gov/reports/what-lifetime-risk-needing-receiving-long-term-services-supports [3] https://acl.gov/news-and-events/announcements/news-release-raise-family-caregiving-advisory-council-report-congress

Statutory Authority The statutory authority for grants under this funding opportunity is contained in Title IV of the Older Americans Act (OAA) (42U.S.C. 3032), as amended by the Older Americans Act Amendments of 2006, P.L. 109-365. Title II Section 202b of the OAA (Public Law 109-365) specifically authorizes the Assistant Secretary for Aging to work with the Administrator of the Centers for Medicare & Medicaid Services to: “implement in all states Aging and Disability Resource Centers –

(A) to serve as visible and trusted sources of information on the full range of long-term care options that are available in the community, including both institutional and home and community-based care;

(B) to provide personalized and person friendly assistance to empower people to make informed decisions about their care options;

(C ) to provide coordinated and streamlined access to all publicly supported long-term care options so that individuals can obtain the care they need through a single intake, assessment and eligibility determination process;

(D) to help people to plan ahead for their future long-term care needs; and

(E) to assist, in coordination with the State Health Insurance Assistance Program, Medicare https://www.chcs.org/resource/getting-started-with-a-master-plan-for-aging-eight-strategies-to-build-buy-in-within-states/ https://www.chcs.org/soliciting-interest-in-a-multi-state-learning-collaborative-on-creating-a-master-plan-for-aging/ https://nwd.acl.gov/sustaining-a-nwd-system.html https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person/index.html https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person/index.html https://www.medicaid.gov/medicaid/home-community-based-services/guidance/strengthening-and-investing-home-and-community-based-services-for-medicaid-beneficiaries-american-rescue-plan-act-of-2021-section-9817-spending-plans-and-narratives/index.html https://acl.gov/news-and-events/announcements/news-release-raise-family-caregiving-advisory-council-report-congress https://acl.gov/news-and-events/announcements/news-release-raise-family-caregiving-advisory-council-report-congress beneficiaries in understanding and accessing the Prescription Drug Coverage and prevention health benefits available under the Medicare Modernization Act.”

II. Award Information Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$4,000,000 Expected Number of Awards:

Award Ceiling:

$450,000 Per Project Period

Award Floor:

$350,000 Per Project Period

Length of Project Period:

Other Additional Information on Project Periods and Explanation of 'Other' 24-month project and budget period. Forward funding.

III. Eligibility Information

1. Eligible Applicants For FY 2022 the below guidance is provided to advance the Administration’s policy, as stated in E.O. 13985, to “pursue a comprehensive approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.” This guidance is intended to begin to address inequities in HHS programs, processes, and policies that may serve as barriers to equal opportunity. By advancing equity in our NOFOs, we can “create opportunities for the improvement of communities that have been historically underserved, which benefits everyone.”

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 For awards that require matching or cost sharing by statute, recipients will be held accountable for projected commitments of non-federal resources (at or above the statutory requirement) in their application budgets and budget justifications by budget period, or by project period for fully funded awards. The applicant will be held accountable for all proposed non-federal resources as shown in the Notice of Award (NOA). A recipient's failure to provide the statutorily required matching or cost sharing amount (and any voluntary committed amount in excess) may result in the disallowance of federal funds. Recipients will be required to report these funds in the Federal Financial Reports.

For awards that do not require matching or cost sharing by statute, recipients are not expected to provide cost sharing or matching. However, recipients are allowed to voluntarily propose a commitment of non-federal resources. If an applicant decides to voluntarily contribute non-federal resources towards project costs and the costs are accepted by ACL, the non-federal resources will be included in the approved project budget. The applicant will be held accountable for all proposed non-federal resources as shown in the Notice of Award (NOA). A recipient's failure to meet the voluntary amount of non-federal resources that was accepted by ACL as part of the approved project costs and that was identified in the approved budget in the NOA, may result in the disallowance of federal funds. Recipients will be required to report these funds in the Federal Financial Reports.

Matching funds are not required. Please disregard any reference to "ACL Required Match" found in the Attachments. Please note, applications that include any form of match will not receive additional consideration under the review. Match is not one of the Responsiveness or Application Screening criteria.

3. Responsiveness and Screening Criteria Application Responsiveness Criteria

1. Letter of Support from state NWD System lead agency or Office of the Governor if not the applicant

2. Provide list of designated NWD/ADRC organizations in your state

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 https://www.grants.gov by 11:59 p.m., Eastern Time, by the 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 12 pages. Project Narratives that exceed 12 pages will have the additional pages removed and only the first 12 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 12-page limit.

Unsuccessful submissions will require authenticated verification from https://www.grants.gov indicating system problems existed at the time of your submission.

For example, you will be required to provide an https://www.grants.gov submission error notification and/or tracking number in order to substantiate missing the application deadline.

http://www.grants.gov/ http://www.grants.gov/

IV. Application and Submission Information

1. Address to Request Application Package Application materials can be obtained from https://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 https://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 https://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 UEI 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/pages/public/help/samQUserGuides.jsf.

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;

https://www.grants.gov/ https://www.acl.gov/grants/applying-grants http://www.grants.gov/ https://www.grants.gov/web/grants/applicants/workspace-overview.html https://www.grants.gov/ mailto:support@grants.gov https://www.grants.gov/ http://www.sam.gov/ https://www.sam.gov/SAM/pages/public/help/samQUserGuides.jsf

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 UEI number in each application or plan to submit to the OPDIV.

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

The Federal Government will transition from the DUNS Number to the New Unique Entity Identifier. By April of 2022, the federal government will stop using the DUNS number to uniquely identify entities. At that point, entities doing business with the federal government will use a Unique Entity Identifier (SAM) created in SAM.gov. It is entered on the SF-424. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities.

You must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications. In accordance with the Federal Government’s efforts to reduce reporting burden for recipients of federal financial assistance, the general certification and representation requirements contained in the Standard Form 424B (SF-424B) – Assurances – Non-Construction Programs, and the Standard Form 424D (SF-424D) – Assurances – Construction Programs, have been standardized federal-wide.

Effective January 1, 2020, the updated common certification and representation requirements will be stored and maintained within SAM. Organizations or individuals applying for federal financial assistance as of January 1, 2020, must validate the federally required common certifications and representations annually through SAM located at SAM.gov.

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

U.S. Department of Health and Human Services Administration for Community Living

Ami Patel, Office of Network Advancement Phone Number: (202) 795-7376 E-mail: ami.patel@acl.hhs.gov

2. Content and Form of Application Submission Letter of Intent Number of Days from Publication 21

05/27/2022 Applicants are requested, but not required, to submit a letter of intent to apply for this funding opportunity to assist ACL in planning for the application independent review process. The purpose of the letter of intent is to allow our staff to estimate the number of independent https://www.grants.gov https://www.grants.gov https://www.grants.gov mailto:ami.patel@acl.hhs.gov reviewers needed and to avoid potential conflicts of interest in the review. Letters of intent should be sent to:

U.S. Department of Health and Human Services Administration for Community Living Attention: Ami Patel, Office of Network Advancement NoWrongDoor@acl.hhs.gov

Project Narrative The Project Narrative must be double-spaced, on 8 ½” X 11” paper and 1” margins on both sides, and a standard font size of not less than 11, preferably Times New Roman or Arial.

Smaller font sizes can be used to fill in the Standard Forms and Sample Forms. The maximum length allowed for the Project Narrative is 12 pages. Project Narratives that exceed 12 pages will have the additional pages removed and only the first 12 pages will be provided to the merit reviewers for funding consideration. Additional documentation can be added as attachments and will not be counted as a part of the Project Narrative for purposes of the 12-page limit.

The Project Narrative is the most important part of the application, 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 the narrative include the following components:

Summary / Abstract Problem Statement and Current Need Goals and Objective Approach Outcomes and Evaluation Organizational Capacity

Budget Narrative/Justification, Project Work Plan and Letters of Commitment should be attached to your application as appendices.

Summary/Abstract This section should include a brief description of the proposed project, including goal(s), objectives, and outcomes.

Problem Statement and Current Need Briefly describe, in both quantitative and qualitative terms, the difficulties family caregivers of older adults or individuals with disabilities currently face in understanding and accessing the LTSS options that are available to them in your state.

Briefly describe how an analysis of the NWD access system will potentially affect family caregivers of older adults and /or people with disabilities 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 have only one overall goal.

Approach Describe the NWD governance structure and oversight of the process o If applicable, describe how the NWD System governance structure will be established and which agencies will be part of the governing body. Senior level representatives on the governing body must be staff from: State Medicaid Agency, State Unit on Aging, state agencies that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, and the state authorities administering mental health services and key statewide healthcare stakeholders (e.g., State Hospital Association). Senior staff from these agencies should be full partners in managing the ongoing development and implementation.

Provide a clear and concise description of the approach you are proposing to use to address the problem described in the “Problem Statement and Current Need”. You should also describe the rationale for using the particular approach, 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, economic or political factors that you’ll be able to take advantage of, etc.).

Briefly describe the role and makeup of any strategic partnerships involved in the project, including other organizations, supporters, and/or consumer groups.

o If applicable, describe how the approach is part of a statewide Master Plan for Aging process or other statewide plan for aging or LTSS

Note any major barriers you anticipate encountering, and how your project will be able to overcome those barriers.

Outcomes and Evaluation Outcomes

This section must clearly identify the outcomes that will result from your comprehensive strategy to implement this project. Any proposed outcomes should:

o address the goals of this funding opportunity; and o be quantifiable, measurable, and likely to be achieved during the project period.

List measurable outcomes in the Work Plan grid under “Measurable Outcomes,” in addition to any discussion included in the narrative.

Evaluation

This section should describe the method(s), techniques and tools that will be used to: 1) determine whether or not the proposed approach 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 approach, if it proves successful.

Organizational Capability Describe how the applicant agency is organized, the nature and scope of its work, and the capabilities it possesses Describe the project management, including the roles and responsibilities of project staff.

You should:

o Provide a description of the qualifications and experience of the key personnel for this proposed project, including for the Project Director. Applicants must include resumes or CVs as an attachment (upload all resumes/CVs as one attachment to your application if possible).

o Specify who will have day-to-day responsibility for key tasks such as: leadership of project, monitoring the project’s on-going progress, preparation of reports, and communications with other partners and ACL.

Budget Narrative/Justification Applicants are required to provide a detailed Budget Narrative/Justification. Your budget should be aligned with the proposed activities in your Project Narrative and Work Plan.

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.

Work Plan This Work Plan should include a statement of the project’s overall goals, anticipated outcomes, key objectives, and the major tasks/action steps that will be pursued to achieve the results-based goals and outcomes. It should also include tasks/action steps taken to evaluate progress toward goals and outcomes and effectiveness of relevant strategies.

Applicants should identify timeframes involved (including start- and end-dates) and the lead person responsible for completing the task.

The Work Plan should be attached to your application as an appendix. 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 The application must include letter of support from the Office of the Governor designating all of the state agencies and/or entities that will be involved in the development and implementation of its NWD System, including the entity that will be responsible for coordination of the overall initiative and/or letters from the heads of each State agency or entity involved in the development and implementation of the state’s NWD System. In their letters, the State agency heads must state their commitment to be full partners in co-leading the analyses and include the name and title of the senior staff from their agency who will represent the agency on the interagency group that will support implementation.

The quality of the letter content (i.e., specificity with respect to the role of that partner) is more important than the quantity of letters submitted with your application. Signed letters of commitment should be scanned and included as attachments. Letters of commitment must be uploaded as part of the applicant package via Grants.gov – hard copies will not be accepted.

3. Unique Entity Identifier and System for Award Management (SAM) The Grants.gov registration process can take several days. If your organization is not currently registered, please begin this process immediately. For assistance with https://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 https://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 UEI number 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.