Foa_Content_of_HHS-2023-ACL-AOA-ADPI-0086.pdf

Administration for Community Living

Administration on Aging

Supporting State and Community Innovations in Dementia-Specific Respite Programs and Services

HHS-2023-ACL-AOA-ADPI-0086

09/25/2023

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

I. Funding Opportunity Description

Background and Overview

Purpose, Goals and Desired Outcomes

Additional Application Elements and Considerations

Organizational Capacity

Information Dissemination

Sustainability

Performance Measurement and Project Evaluation

Data Collection and Reporting

Collaboration and Partnerships

Statutory Authority

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

Goals and Objectives

Proposed Intervention

Special Target Populations and Organizations

Outcomes

Project Management, including Equity Experience of Project Team

Evaluation

Dissemination

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:

Administration on Aging Funding Opportunity Title:

Supporting State and Community Innovations in Dementia-Specific Respite Programs and Services Funding Opportunity Number:

HHS-2023-ACL-AOA-ADPI-0086

Primary CFDA Number:

93.470 Due Date for Letter of Intent:

08/31/2023

Due Date for Applications:

09/25/2023 Date for Informational Conference Call:

08/24/2023 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

The Administration on Aging (AoA), a division of the Administration for Community Living (ACL) is committed to expanding the availability of dementia-specific respite care in support of people living with dementia (of any age) and their caregivers. Using a model of program design rooted in the issuing of sub-awards to community-based organizations, the successful grantee will be expected to further the development and testing of innovative methods of delivering community-based, dementia-specific respite models, as well as the delivery of training and technical assistance to advance the national capacity to provide such services to people living with dementia (of any age) and their caregivers.

The program is designedto support innovative models of dementia-specific respitecare through activities in two priority areas:

Priority Area 1: Advancing the delivery of innovative, community-based, dementia-specific respite care models through sub-grants to home and community-based (HCBS) organizations with the capacity to develop new or translate existing respite models for delivery at the community level. The successful grantee (i.e., the prime grantee) will be expected to use no less than 80% of each total annual budget to support this activity.

Priority Area 2: Training and Technical Assistance that supports increasing the capacity of community-based organizations (the sub-grantees funded under Priority Area 1 and the field more broadly)to implement dementia-specific respite programs and related services. All training and technical assistance activities undertaken in this initiative are expected to be coordinated with other similar activities pertaining to respite and related services. The successful grantee (i.e., the prime grantee) will be expected to use no more than 20% of each total annual budget to support this desired activity.

ACL plans to fund one (1) cooperative agreement at a federal funding level of up to $5,000,000 per year, for five years (60 months), pending the availability of federal funds.

Prospective applicants should carefully read all application requirements and submit proposals that completely address the priority areas described herein.

Highlights of additional program requirements to which applicants are subject are noted below with further information outlined in the full funding opportunity description:

https://www.grants.gov/

Grounding all work under this initiative, where appropriate, in the principles contained in the National Strategy to Support Family Caregivers.

Expected coordination and collaboration with related efforts pertaining to dementia capability, respite and family caregiver support.

Program Deliverables, resources and tools developed with grant funding (by grantee and partners) will not be proprietary in nature. All grant developed resources and tools will be delivered to ACL at the completion of the grant and will be posted on the website of ACL’s National Alzheimer’s and Dementia Resource Center for the benefit of the greater service delivery community.

Technical assistance and respite programming activities will all include impact evaluations with relevant data collection and analysis and delivery of a comprehensive report at the completion of the grant period.

A pre-application informational teleconference for interested applicants has been scheduled as follows:

Date: Thursday, August 24, 2023 Time: 2:00pm-3:00pm (eastern)

Telephone: 888-957-9844 Passcode: 3647999

A recording will be available soon after the call concludes at the following number:

Toll Free Instant Replay Number: 888-566-0452

Instant Replay will be available Until September 29th.

I. Funding Opportunity Description

Background and Overview

The role of unpaid “caregiver” is one that an estimated 11 million Americans have assumed in support the more than 6 million individuals in the United States living with Alzheimer’s disease and related dementia (ADRD). The Alzheimer’s Association estimates that those caregivers are providing more than 18 billion hours of care to people living with ADRD, valued at nearly $340 billion. [1] As the number of people living with ADRD continues to increase, so will the need to support their family caregivers, in person-centered, strengths-based ways, including though tailored approaches to the provision of respite care.

Respite is one of the cornerstones of family caregiver supports. However, according to the National Strategy to Support Family Caregivers, gaps in the availability of, and access to, respite can be significant. Moreover, respite must be meaningful to the person receiving it.[2] Respite care takes many forms in the United States and is often used as a generic description for a diverse range of services and supports that provide the family caregiver with a break from their caregiving duties. [3] The National Institute on Aging defines respite as the provision of short-term relief for primary caregivers. [4] Respite can come in many forms and be delivered in many different venues, including but not limited to, homes, churches, community centers, adult day centers or healthcare facilities. It can be arranged for just an afternoon or for several days or weeks and can be provided by volunteers, paid staff or a combination of the two. There are a variety of ways in which respite is presently delivered including adult day programs, supervised outings, in-home companion care and overnight stays in facilities. Restorative respite breaks https://nadrc.acl.gov/ https://nadrc.acl.gov/ https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf provided through respite are imperative to support ADRD caregivers in sustaining their role.

Some innovative respite providers have found success in coordinating respite opportunities with activities designed to engage caregivers as an excellent method to engage them in training and support activities.

Respite benefits are documented for both family caregivers and the person living with dementia, when the respite provider has specialized training that emphasizes preserving the dignity of the participant, building rapport with the family caregiver, and understanding the general pathology of common dementias.[5] The provision of meaningful respite activities while a caregiver participates in a supportive activity has dual benefits to the caregiver and the person living with dementia. ACL is committed to building awareness of the ways in which respite is beneficial to both ADRD caregivers and people living with dementia. Home and Community-Based Service (HCBS) providers can play a role ensuring caregivers have access to dementia-specific respite care. Respite services that are meaningful to the caregiver (i.e. what they want and need) as well as for the person living with dementia (i.e. meaningful engagement when participating in coordinated respite activities) supports keeping people living with dementia and their caregivers in their homes and communities for as long as they desire.

Respite care is expensive, with limited availability in many communities, often making it difficult to access. Traditional respite providers charge by the hour for services, with minimum hours policies per visit. It is typically not covered by insurance which results in caregivers being responsible for 100% of the costs. The costs of respite and other supportive services can be a significant source of burden and stress on ADRD caregivers. The development and delivery of cost-efficient, effective, innovative models of dementia-specific respite care are necessary to support caregivers in the community.

In the 6th Edition of their Annotated Bibliography of Respite and Crisis Care Studies, the ARCH National Respite Network and Resource Center stated that a “stronger evidence base is both desirable and necessary to recognize respite as a core component of a comprehensive strategy to support family caregivers, to merit funding for respite, demonstrate continuous quality improvement, and to identify and replicate respite best practices”.[6] The need to have stronger evidence of the benefits of respite to secure long-term financial support and quality assurance is compounded by the importance of educating caregivers in the benefits of self-care as vital for their success and resiliency and the role respite can play in their journey. It is imperative that caregiver understanding of respite, its intent and potential personal impact, as well as on the person for whom they are providing care, be expanded.

Given the need for more, high-quality support and service options for family caregivers of people living with ADRD, ACL seeks to advance the field of respite for this population. In addition to advancing the field of respite, it is anticipated this new initiative will also support Outcome 3.2 of the National Strategy to Support Family Caregivers to increase the availability of a “robust array of trained respite options available that are local, convenient, and affordable” when caregivers need a break. [7]

ACL will award one cooperative agreement to a single organization to engage and work with HCBS providers across the nation to develop, test and prepare for replication, new and innovative approaches to the delivery of meaningful respite services for family caregivers of people of all ages living with ADRD.

NOTE: The ACL will Not consider or fund research projects under this Notice of Funding Opportunity (NOFO).

1. Alzheimer’s Association. 2023 Alzheimer’s Disease Facts and Figures. Accessed June 1, 2023 at https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf .

2. Administration for Community Living, 2022 National Strategy to Support Family Caregivers. Accessed June 8, 2023 at https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers .pdf .

3. Kirk R, Kagan J. A Research Agenda for Respite Care: Deliberations of an Expert Panel of Researchers, Advocates and Funders. Chapel Hill, NC: ARCH National Respite Network and Resource Center; 2015.

4. National Institute on Aging. Accessed May 18, 2023 at https://www.nia.nih.gov/health/what-respite-care#:~:text=Respite%20care%20provides%20short-term%20relief%20for%20primary%20caregivers.,healthcare%20facility%2C%20or%20a t%20an%20adult%20day%20center .

5. ACL Rapid Cycle Research and Evaluation: Review of Respite Models for Family Caregivers of Alzheimer’s Disease and Related Dementias. Accessed June 2, 2023 at https://pblob1storage.blob.core.windows.net/public/nadrc/docs/ADRD%20Respite%20R eport%20August%202022.pdf .

6. ARCH National Respite Network and Resource Center, ARCH Annotated Bibliography of Respite and Crisis Care Studies, 6th Edition, 2022, Accessed June 2, 2022 at https://archrespite.org/library/arch-annotated-bibliography-of-respite-and-crisis-care-studies-6th-edition-2022/.

7. Administration for Community Living, 2022 National Strategy to Support Family Caregivers. Accessed June 8, 2023 at https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers .pdf .

Purpose, Goals and Desired Outcomes

Through this new, five-year, national initiative, the successful applicant will develop and administer a demonstration program whereby sub-grants are made to HCBS providers to develop, test and evaluate innovative models of community-based, dementia-specific respite programs to support persons living with dementia (of all ages) and their caregivers. The prime grantee will be expected to:

1. Increase the availability of innovative, community-based dementia-specific respite care in states, communities, and tribes by supporting the development and funding of pilot programs that include coordinated activities to demonstrate the impact of the pilots on the community being served.

2. Provide technical assistance, accessible to providers across the United States and territories, to increase the capacity of HCBS providers and support their ability to design and deliver innovative dementia-specific respite services that meet the needs of caregivers and people living with dementia in the communities they serve.

https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf https://www.nia.nih.gov/health/what-respite-care#%3A~%3Atext%3DRespite%20care%20provides%20short-term%20relief%20for%20primary%20caregivers.%2Chealthcare%20facility%2C%20or%20at%20an%20adult%20day%20center https://www.nia.nih.gov/health/what-respite-care#%3A~%3Atext%3DRespite%20care%20provides%20short-term%20relief%20for%20primary%20caregivers.%2Chealthcare%20facility%2C%20or%20at%20an%20adult%20day%20center https://www.nia.nih.gov/health/what-respite-care#%3A~%3Atext%3DRespite%20care%20provides%20short-term%20relief%20for%20primary%20caregivers.%2Chealthcare%20facility%2C%20or%20at%20an%20adult%20day%20center https://www.nia.nih.gov/health/what-respite-care#%3A~%3Atext%3DRespite%20care%20provides%20short-term%20relief%20for%20primary%20caregivers.%2Chealthcare%20facility%2C%20or%20at%20an%20adult%20day%20center https://pblob1storage.blob.core.windows.net/public/nadrc/docs/ADRD%20Respite%20Report%20August%202022.pdf https://pblob1storage.blob.core.windows.net/public/nadrc/docs/ADRD%20Respite%20Report%20August%202022.pdf https://archrespite.org/library/arch-annotated-bibliography-of-respite-and-crisis-care-studies-6th-edition-2022/ https://archrespite.org/library/arch-annotated-bibliography-of-respite-and-crisis-care-studies-6th-edition-2022/

3. Demonstrate improved quality of life of caregivers and people living with dementia, by developing, delivering and documenting the impact of pilots of innovative dementia-specific respite programming in states, communities, and tribes.

Similar models for this type of demonstration program can be found in ongoing work by The Jewish Federations of North America in their establishment and operation of ACL-funded efforts such as the Center on Holocaust Survivor Care and by Oasis Institute and their Partners with the National Community Care Corps. In this regard, applicants may wish to propose programs that include a phased approach to addressing the Priority Areas outlined below. It is ACL’s expectation that while significant focus on Priority Area 2 (training and technical assistance) will likely need to occur first, the successful applicant is expected to make a significant portion of first-year funding available as sub-grants to address Priority 1, to allow community-based service providers (sub-grantees), including but not limited to existing HCBS providers, to begin developing and piloting their respite care models.

ACL expects that both Priority Areas 1 and 2 will be addressed over the entire course of the grant period, as new technical assistance, capacity building needs are identified through sub-grantee delivery of services. Applications will be scored, in part, on the extent to which applicants demonstrate intent to undertake implementation of Priority Area 1 in which they will deliver sub-awardee funding to community-based organizations in the first year of the project and throughout the duration of the grant cycle.

Priority Area 1: Advancing the delivery of innovative, community-based, dementia-specific respite care models through grants with home and community-based (HCBS) organizations in the position to develop new or translate existing respite models for delivery at the community level. (Not less than 80% of each annual budget)

In this priority area, ACL seeks to foster innovations at the community level whereby the prime grantee makes sub- awards to community-based entities to develop and implement innovative models of dementia-specific respite to support people living with dementia (of all ages) and their caregivers. The desired models of dementia-specific respite will be responsive to unmet respite needs in communities. Sub-awards shall not supplant, sustain, or replace existing programs and funding streams. Rather, the sub-grant program should fund new or expanded efforts to increase and sustain the availability of innovative models of dementia-specific respite.

Applicants to this Notice of Funding Opportunity (NOFO) are encouraged to consider a broad range of possible approaches, while ensuring that local dementia-specific respite models are:

Delivered in a variety of settings, by established organizations with the sufficient capacity to provide respite services;

Designed to ensure that those providing services are trained in the provision of dementia-capable care and address the needs of people living with dementia (of all ages) and their caregivers;

Models of care that include meaningful activities for the people living with dementia (of all ages) intended to benefit from the services;

Support the ability of people living with dementia and their caregivers to remain in their homes and communities for as long as they desire;

Targeting historically underserved populations: including those of greatest economic and social need, with particular attention to low-income individuals, including low-income https://holocaustsurvivorcare.jewishfederations.org/ https://www.communitycarecorps.org/ minority individuals, individuals with limited English proficiency, and individuals residing in rural areas, and Not providing medical, administrative, or financial services.

In proposing approaches in this priority area, applicants should describe the process by which they will develop and administer a sub-grant program to make funds available to local-level organizations to establish innovative dementia-specific respite programs.

Applicants should thoroughly describe the process they will competitively solicit, objectively evaluate, select and make sub-awards to community-based organizations with the capacity to deliver dementia-specific respite. Program plan descriptions should include:

1. A proposed timeline detailing the competition solicitation, application review and awarding process;

2. A description of the entities that are eligible for funding;

3. The range of respite services eligible for funding;

4. The ways in which the anticipated services will enhance or expand community-based, dementia-specific respite for people living with dementia (at all ages) and their caregivers; and

5. The ways in which the grantee and its sub awardee(s) will evaluate the impact of funded services on the people living with dementia (of all ages)and their caregivers, as well as the communities in which they are being implemented.

For the proposed sub-grant program, priority shall be given to community-based entities with existing infrastructure and the ability to expand and or/enhance existing capacity to support people living with dementia (of all ages) and their caregivers through the provision of an innovative model of dementia-specific respite. ACL envisions that a broad range of not-for-profit entities will be eligible for sub-grant funding, including, but not limited to, local aging services organizations as defined in 102(5) of the Older Americans Act of 1965, disability service providers with the capacity to support people living with Intellectual and Developmental Disabilities (IDD) and ADRD, dementia-specific service providers, faith-based entities, and other community-based not for profit entities with demonstrated capacity and existing infrastructure to support people living with dementia (of all ages) and their caregivers. In the program planning and application process the prime grantee shall make clear that all sub-grantee funded programs will include planning for project sustainability beyond the Federal funding period.

The successful grantee AND sub-grantees shall not be permitted to use project funds for construction and/or rehabilitation of buildings; basic research; medical or institutional care;

income maintenance; or equipment purchases, unless such equipment is demonstrated to be necessary to carry out an activity otherwise fundable under Title IV of the Older Americans Act.

IMPORTANT: The prime grantee selected from this NOFO and all sub-grantees are subject to adherence to all requirements, including those for making and monitoring sub-awards, as outlined in 45 CFR Part 75.

Grantees and sub-grantees should understand that programs and deliverables funded through this grant will not be proprietary in nature. Program deliverables (tools, training, resources, manuals, etc.) created with grant dollars shall remain in the public domain, with promising practices, resource materials and tools posted on the website of ACL’s National Alzheimer’s and Dementia ResourceCenter (NADRC), for the benefit of the broader dementia respite delivery community.

Priority Area 2: Training and Technical Assistance that supports increasing the capacity of community-based organizations (the sub-grantees funded under Priority Area 1 and the field more broadly) to implement dementia-specific respite programs and related services.

(Not to exceed 20% of each annual budget)

A community-based organization’s ability to develop and deliver sustainable dementia-specific respite is dependent upon the availability of a broad range of technical supports. Under Priority Area 2, ACL anticipates that the successful grantee and partners will undertake a variety of approaches for supporting the development and implementation of meaningful and innovative dementia-specific respite programming. This initiative is intended to strengthen existing dementia-capable HCBS systems, with a primary focus on the availability of respite services.

Program-developed resources might include foundational materials and guidance to communities and organizations interested in establishing or expanding their ability to deliver innovative, dementia-specific respite programs. Program Deliverables, training, resources and tools developed with grant funding (by grantee and partners) will not be proprietary in nature. All grant developed resources and tools will be delivered to ACL at the completion of the grant and will be posted on the website of ACL’s National Alzheimer’s and Dementia Resource Center for the benefit of the greater service delivery community.

To the greatest degree possible, all activities under this initiative should leverage existing national, state, and community-level partnerships, develop new partnerships, and share best practices to enhance program development and service delivery. Examples of possible focus areas for such efforts include, but are not limited to:

The development, testing and dissemination of education and training programs in support of the delivery of community-based, dementia-specific respite in a broad range of community-based settings;

Identification of promising models of innovative, cost-efficient, community-based, dementia-specific respite, including support in selection of sustainable models determined by community capacity;

Enhanced workforce capacity, through the development and dissemination of training for respite providers in the delivery of community-based culturally competent, person-centered, strengths-based, dementia-specific respite services to address unmet community needs;

Development and delivery of training of respite staff to deliver person-centered, strengths-based supports with a focus on the strengths, goals, preferences, needs, and desired outcomes of the services for people living with dementia (of all ages) and their caregivers;

Development and implementation innovative dementia-specific respite programming;

Establishment of community partnerships and collaborations in support of dementia-specific respite care; and Administration of local programs, including sustaining dementia-specific respite programming.

Additional Application Elements and Considerations https://nadrc.acl.gov/ https://nadrc.acl.gov/

It is the expectation of ACL that projects of this scope and intent require that prospective grantees come to the application process possessing the infrastructure and organizational capacity necessary to expedite startup of project activities (specifically a grant-making infrastructure) and to complete all stated goals and objectives in an efficient, effective and sustainable manner through the use of sound business practices.

Applications must include a comprehensive project work plan and associated budget/budget justification that reflect the applicants best estimates of the range of permissible grant activities that will be undertaken, the level of resources necessary for each, and reflect that information in a detailed manner. Applications will be scored, in part, on the extent to which resource allocation across priority areas reflects an understanding of the needs to be addressed and the approaches to be taken.

Proposed approaches in response to the priority areas described above, should incorporate descriptions of the following key elements within their application narratives:

Alignment with the National Strategy to Support Family Caregivers

The release of the 2022 National Strategy to Support Family Caregivers (the Strategy), presents an opportunity to advance how respite services are designed and delivered, particularly for specific populations of family caregivers. Applicants to this NOFO should be familiar with the relevant components and actions contained in the Strategy. For example, under Outcome 3.2:

Family caregivers can obtain respite services that meet their unique needs, it states, “High-quality respite is one of the most requested needs of caregivers, but gaps in the availability and affordability of access are significant.” This and other relevant outcome should be clearly addressed in proposals.

Organizational Capacity

To meet ACL’s expectations for this initiative, the successful grantee will be one that possesses the organizational capacity to apply multi-faceted and comprehensive approaches in support of their proposed efforts. Applicants should fully describe their capacity to:

Ensure the expeditious startup of project activities upon notice of award, including the establishment and execution of a sub-award/grant program;

Work effectively at the national, state, and local levels to achieve desired outcomes;

Use efficient and effective strategies that maximize limited resources while ensuring measurable impact of both service provision, workforce training and TA activities;

Embed all efforts in targeted networks to ensure ownership and long-term sustainability;

Qualitatively and quantitatively measure program/service impact and effectiveness; and Use technology where possible to maximize project reach and impact.

Ensure that enhancement of the Quality of Life for people living with dementia and caregivers is an identified key outcome of funded efforts;

Applicants must possess direct, in-house experience and expertise to carry out the desired activities outlined in this NOFO. Applications will be reviewed and scored based, in part, on the applicants' demonstration of key subject-matter expertise, as well as organizational experience, and capacity to carry out the proposed tasks.

file://AOAFS01/common/AoA_OSCS/Lifespan%20Respite%20Program/FOAs/FY%202023/acl.gov/caregiverstrategy

The use of sub-grant award process to carry out Priority Area #1 activities is expected. The sub-grants awards will facilitate the piloting of community-based, dementia specific respite models.

The use of sub-grants/contracts are also permissible in Priority Area #1, as appropriate, when needs are identified to support specified programmatic goals and objectives. Applicants should keep in mind that all administrative functions, including sub-grant administration and evaluation, will be included in Priority Area #1 budget lines. Applicants should specify the rationale and criteria for selecting sub-grantees/subcontractors, as well as their approach for managing the activities of all sub-grantees/contractors to ensure successful efficient and effective completion of all tasks in both Priority Areas.

Information Dissemination

Given this project's orientation as a demonstration program, ACL anticipates that the grantee will develop a robust and far-reaching dissemination strategy designed to ensure that project information, best practices and other information are available and shared broadly. Applicants should describe their dissemination plans and articulate the methods (e.g., peer-reviewed journal publications, presentations at national conferences, etc.) by which such activities are to occur.

The successful applicant will include in their proposal the intent, at the completion of the grant period, to deliver to ACL a compendium of dementia-specific respite models implemented through the funding which will include relevant program information (implementation description/steps, costs, staffing, related research, etc.) and lessons learned through the pilot funded program.

Sustainability

Through this funding opportunity, ACL expects to identify and support implementation of innovative models of dementia-specific respite. The program funded activities will include comprehensive evaluation/outcome analysis to support local capacity to sustain the provision of dementia-specific respite programs beyond this Federal funding opportunity. Applications will be scored, in part, on the extent to which a feasible plan for the project’s sustainability beyond the period of Federal funding is articulated. Applicants are encouraged to consider and propose a range of potential approaches for ensuring sustainability of project sub-grantee efforts beyond the period of Federal funding.

Performance Measurement and Project Evaluation

Performance measurement and project evaluation are necessary components of any new project.

Such activities support monitoring progress towards stated goals and objectives, as well as opportunities to identify and address project weaknesses, ensuring continuous program improvement for funders, grantees and sub-grantees. Performance measurement and project evaluation are necessary components in both priority areas of this NOFO.

Applicants to this NOFO should include a comprehensive plan for evaluating and reporting project performance and impact, as well as the delivery a final evaluation report ,containing impact analysis, at the conclusion of the grant period. This plan should include measurable outcomes that demonstrate the impact of increasing the availability (scope, reach, breadth and/or types) of community-based, dementia-specific respite programs to people living with dementia (of all ages) and their caregivers. Evaluation plans will extend far beyond satisfaction and willingness to refer individuals to the program, to demonstrate program impact, including Quality of Life for caregivers and people living with dementia. Process evaluations are acceptable in the development of new programs; however, they should be secondary to the impact evaluation data collected. Financial sustainability of programs implemented will also be included as an outcome of the evaluation. Examples of grantee program impact variables (outputs and outcomes) would include but not be limited to:

Outcomes

Caregiver stress, anxiety;

Caregiver isolation, loneliness;

Organizational and individual staff knowledge and confidence working with people living with dementia and their caregivers;

Emergency room visits and hospital readmission;

Workforce capacity to deliver dementia-specific respite, and Intent to place.

Outputs

Numbers of Caregivers and People living with dementia served;

Hours of dementia-specific respite delivered;

Number of different models of dementia-specific innovative respite delivered;

Numbers of dementia caregivers provided access to respite and uptake in the service, and Availability and types of dementia specific respite services offered and/or range of clients served (e.g., geographic locations, demographic diversity).

The NADRC has developed a compendium of evaluation tools to assist grantees in identification of development of outcomes for their evaluation plans, Evaluating Dementia Services and Supports: Instrument Resource List, 3rd Edition.

Applicants should describe their plans to evaluate the anticipated program impact, identification and collection of information necessary to document and describe both outputs and outcomes for all activities undertaken in both priority areas of this cooperative agreement, including the work of the sub-grantees. It is anticipated that the grantee (and its subgrantees) will collect evaluation data on a set of agreed upon performance measures, outlined in the application, as part of the cross-site evaluation. Sub-grantees will collect data on additional measures specifically related to the implementation of their respite program and its impact on participants. The evaluation of the subgrantees delivery of respite should include at least two outcome data points collected across all sub-grantee funded projects (using the same questions/tool as identified by the grantee evaluation team) to demonstrate the impact of dementia-specific respite of caregivers and the person living with dementia. Caregiver burden should be a consideration when developing the non-research evaluation tools to be applied to sub-grantee programs. Applications should include examples of ways in which the collection of output and outcome data will occur (electronic, paper, interviews, etc.), its analysis and evaluation reporting. ACL has an approved data collection tool approved by the Office of Management and Budget (OMB), Alzheimer's and Dementia Program Data Reporting Tool (OMB 0985-0022). Applicants will agree to use this data collection tool to report a broad range of data (basic demographic information on caregivers and people living with dementia served, numbers and types of professionals trained, hours of direct service) in relation to program funded activities.

https://nadrc.acl.gov/details?search1=70

Should the collection of information require the use of an information technology system (45 CFR 75), the grant recipient and sub-recipient(s) will be expected to adhere to the NIST Cybersecurity Framework to help ensure the security of any system used or developed by the grant recipient or sub-recipient(s). In particular, if the data to be collected includes Personally Identifiable Information (PII, 45 CFR 75) or Protected PII (45 CFR 75), the grant recipient and sub-recipient(s) must apply the appropriate security controls required to protect the privacy and security of the collected PII and/or Protected PII. There is no expectation of the need for the grantee or it’s sub-grantees to collect PII in the implementation of the respite program or its evaluation.

Data Collection and Reporting

The prime grantee shall be responsible for designing and administering a data collection and reporting process for all sub-grantees. Applicants to this NOFO should describe the information collection processes and mechanisms by which sub-grantee activities and services delivered will be tracked and monitored.

Collaboration and Partnerships

To most effectively accomplish the goals and objectives outlined in this NOFO, ACL anticipates that the successful grantee will demonstrate the commitment to broad collaboration with other national and local organizations to ensure maximized cultural competency, geographical coverage and workforce availability. Applications should describe the partner organizations and the role of each in the planning, development and implementation of the proposed project.

Letters of commitment from partnering organizations should be included as part of the application package and should reflect the unique contributions of each entity. Letters of commitment will be reviewed and evaluated to determine likely value of each named partner and its relative impact to the proposed project.

Volunteer advisory committees are proven to be effective methods of ensuring that diverse ideas are considered in the planning and implementation of any new project. Applicants for this opportunity should explain if, and how, they will use an advisory committee to assist their efforts and include a listing of some of the individuals (including people living with dementia and their caregivers) or organizations that will be invited to participate.

Statutory Authority

The statutory authority for grants under this NOFO is contained in Title IV, Section 411 of the OAA (42U.S.C. 3032), as amended by the OAA Amendments of 2006, P.L. 109-365. (Catalog of Federal Domestic Assistance 93.048, Title IV Discretionary Projects).

Statutory Authority Older Americans Act Title IV

II. Award Information

Funding Instrument Type:

CA (Cooperative Agreement)

Estimated Total Funding:

$5,000,000 Expected Number of Awards:

Award Ceiling:

$5,000,000 Per Budget Period

Award Floor:

$4,500,000 Per Budget Period

Length of Project Period:

60-month project period with five 12-month budget periods Additional Information on Project Periods and Explanation of 'Other' The award made under this NOFO is subject to terms provided for in the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224). The Cooperative Agreement provides for the substantial involvement and collaboration of ACL/AoA in activities that the recipient organization will carry out in accordance with the provisions of the approved award. 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.

The AoA will carry out the following activities for the cooperative agreement noted above:

Perform the day-to-day Federal responsibilities of grants management while working with the grantee to ensure that the minimum requirements for the grant are met.

Assist the grantee project leadership in understanding the policy concerns and/or priorities of AoA by conducting periodic briefings and by carrying out ongoing consultations.

Work cooperatively with the grantee to clarify the programmatic and budgetary issues to be addressed by the project.

Provide guidance to the grantee, as necessary, in making sub-awards (i.e., sub-grants/contracts) as permitted in this NOFO.

Provide guidance to the grantee on the provision of technical support and associated tasks related to the fulfillment of the goals and objectives of this grant.

Review and provide technical advice to the grantee on work products and other project deliverables and processes.

Provide consultation to the grantee in identifying emerging issues as they relate to the goals and objectives of this grant program.

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

Attend and participate in program events as appropriate.

The grantee will execute the responsibilities of the cooperative agreement as listed below:

Immediately inform, and collaborate with, the AoA on any in-scope modification of the work plan.

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

Share program information with AoA, national and local organizations, and other entities as appropriate.

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

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

Work with the AoA program officer to evaluate performance results reported semiannually and jointly develop strategies to address those areas requiring improvement.

Cooperate with any federal evaluation efforts and comply with the timeline, content and format of all required data collection and reporting requirements (see Section VI-3 for more detail). Submit to the ACL/AoA project officer a final, clean copy of all data developed or supported with these grant funds, in the format in which it was developed or produced, as provided for in the HHS Grants Policy Statement (http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf) and referenced in the Notice of Award. The HHS Grants Policy Statement defines “data” as: “recorded information, regardless of the form or media on which it may be recorded, and includes writings, films, sound recordings, pictorial reproductions, drawings, designs or other graphic representations, procedural manuals, forms, diagrams, work flow charts, equipment descriptions, data files, data processing or computer programs (software), statistical records, and other research data” (p. II-69, Footnote 18);

Submit program deliverables, resources and tools developed with grant funding (by grantee, partners and sub-grantees) to ACL through their grant reporting system, as none of which will be proprietary in nature; and

Include the following disclaimer language when issuing statements, press releases, requests for proposals, bid solicitations, and other ACL supported publications and forums describing projects or programs funded in whole or in part with ACL funding:

This [project/publication/program/website, etc.] [is/was] supported by the Administration for Community Living (ACL ), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $XX with XX percentage funded by ACL/HHS and $XX amount and XX percentage funded by non- government source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.

http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf) http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf)

AoA will assist the grantee in understanding the strategic goals and objectives, policy perspectives, and priorities of the Administrator/Assistant Secretary for Aging and the Department of Health and Human Services, by sharing such information via email, conference calls, briefings, memos, and other consultations. The AOA project officer will provide technical assistance and guidance on issues related to grant management and implementation, including the execution of the Cooperative Agreement. The project officer will also share information with the grantee about other federally sponsored projects and activities relevant to activities funded under this announcement.

III. Eligibility Information

1. Eligible Applicants

For FY 2023 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.

For the purposes of this competition, eligible “national organizations” are the domestic public and private non-profit entities (outlined above) with demonstrated capacity to support a program of this scope across the nation, meeting the technical assistance and grant-making requirements described throughout the NOFO. That organization will have the capacity deliver a program designed to improve the delivery of dementia-specific respite for a major, nationwide segment of the older adult and persons with disabilities population.

Applications that do not meet the responsiveness criteria outlined in Section III.3below will be administratively eliminated and will not be reviewed.

2. Cost Sharing or Matching

Cost Sharing / Matching Requirement:

Yes 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.

The federal match required for the Supporting State and Community Innovations in Dementia-Specific Respite Programs and Services program is 25% (cash and/or in-kind). All applicants are required to comply with the 25% match requirement outlined in the Notice of Funding Opportunity (NOFO).

Match Calculation: For every three (3) dollars received in Federal funding, you must contribute at least one (1) dollar in non-Federal resources toward the project's total cost. This three-to-one ratio is reflected in the following formula which you can use to calculate your minimum required match:

Example of varying match levels: $888,812.83 (Federal funds)*25%(match)/.75 = $296,270.94

There are two types of match: 1) non-federal cash and 2) non-federal in-kind. In general, costs borne by the applicant and cash contributions of any and all third parties involved in the project, including sub-grantees, contractors and consultants, are considered matching funds. Volunteered time and use of facilities to hold meetings or conduct project activities may be considered in-kind (third-party) donations. Budgetary funds provided from the applicant agency’s budget for costs associated with the project are an example of a non-federal cash match. All proposed matching funds must be directly connected to proposed program activities and cannot come from other Federal sources. ACL discourages applicant agencies exceeding the minimum match requirement. A recipient's failure to provide the 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.

3. Responsiveness…