Foa_Content_of_HHS-2024-ACL-AOA-CGPS-0039 (1).pdf

Administration for Community Living

Administration on Aging

Advancing Aging Network Capacity to Support Family, Kinship and Tribal Family Caregivers:

Understanding, Testing and Evaluating Caregiver Navigator Services

HHS-2024-ACL-AOA-CGPS-0039

08/05/2024

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

Goals and Objectives

Proposed Intervention

Special Target Populations and Organizations

Outcomes

Project Management

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:

Advancing Aging Network Capacity to Support Family, Kinship and Tribal Family Caregivers:

Understanding, Testing and Evaluating Caregiver Navigator Services Funding Opportunity Number:

HHS-2024-ACL-AOA-CGPS-0039

Primary CFDA Number:

93.052 Due Date for Letter of Intent:

Date will be generated on synopsis publication Due Date for Applications:

08/05/2024 Date for Informational Conference Call:

06/10/2024 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 https://www.grants.gov/

Additional Overview Content/Executive Summary The purpose of this Notice of Funding Opportunity (NOFO) is to implement the demonstration authority in Section 373(i) of the Older Americans Act of 1965, as amended (OAA), using the framework provided by the 2022 National Strategy to Support Family Caregivers (the Strategy).

Specifically, this project seeks to: 1) better understand the extent to which caregiver navigator services outside of medical/healthcare settings can be better used by the programs and entities funded under Title III-E and VI-C of the OAA; 2) design and test approaches for delivering these services; and 3) evaluate the effectiveness and opportunities for scaling and replicating them.

ACL will award one cooperative agreement to a single entity to undertake activities of a national scope and reach. The project will last for a duration of 36 months, with three, 12-month budget periods. The amount of federal funds available will be up to approximately $882,000 per year, pending availability of federal funds.

The intended audiences for the study, scanning, technical assistance, scaling and replication of the activities developed in this project are those entities typically involved with implementing and operating programs funded by the OAA, including state units on aging (SUAs); area agencies on aging (AAAs); local aging services and family caregiver support providers; kinship, grandparent and grandfamily services providers; tribes and tribal entities, and other entities that may be part of the aging and/or tribal services networks. Additionally, given the NFCSP’s inclusion of family caregivers of individuals with early onset-dementia and older relative caregivers supporting adults with disabilities, ACL desires that proposals identify how these populations will also be included in the work.

When considering whether to apply to this NOFO, applicants should bear in mind the following factors and address them in their proposals:

1. Proposed activities must be of a national scope (i.e., proposals for local projects or initiatives limited to single geographic areas of the U.S., a state, or community, will not be considered).

2. ACL is defining “caregiver navigator services” as those that provide caregivers with “assistance in gaining access to [home and community-based] services,” as defined in the Sec. 373(b)(2) of the OAA of 1965, as amended.

3. This project will become part of ACL’s National Caregiver Support Collaborative (NCSC), focusing on strengthening and improving services delivered under Titles III-E and VI-C of the OAA of 1965, as amended.

An informational call for prospective applicants will be held as follows:

Date: June 10, 2024

Time: 3:00 pm, Eastern

Phone Number: 888-323-9921

Passcode: 6519417

I. Funding Opportunity Description Introduction https://acl.gov/CaregiverStrategy

The National Family Caregiver Support Program and the Native American Caregiver Support Program (Title III-E/NFCSP and Title VI-C/NACSP, respectively), were established by Congress in the 2000 reauthorization of the Older Americans Act of 1965. The programs fund a range of supports that assist family, kinship, and tribal caregivers to care for their loved ones at home for as long as possible. The NFCSP/NACSP requires the availability and provision of five essential services and supports:

1. Information to caregivers about available services and supports

2. Assistance to caregivers in gaining access to services and supports

3. Individual counseling, organization of support groups, and caregiver training to assist caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles

4. Respite care to enable caregivers to be temporarily relieved from their caregiving responsibilities

5. Supplemental services, on a limited basis, to complement the care provided by caregivers

Critical among the services authorized by the NFCSP/NACSP are those designed to provide caregivers with the information they need about available services and supports and to assistance them, when needed, with navigating and accessing often complex services systems and programs. Through this NOFO, ACL wishes to strengthen the “assistance” component of the NFCSP/NACSP by better understanding and supporting family caregivers with navigating the range of supports and options available to them.

Since its passage in 2000, the NFCSP and NACSP have served as catalysts for greater recognition and support of family and kinship caregivers in states, tribes, and territories and provide a range of essential services and supports (see the 2016 – 2018 Caregiver Program Evaluation). For example, in 2022, the NFCSP provided an estimated 1.5 million contacts to caregivers, assisting them in locating services from a variety of public and private agencies.

Additionally, approximately 105,000 family caregivers received some type of counseling, training, or support group services to help educate them in their roles and provide essential emotional and social connectedness.

Authorized by Congress and signed into law in January 2018, the Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act directed the Secretary of Health and Human Services to establish a Family Caregiving Advisory Council to develop the National Strategy to Support Family Caregivers (the Strategy). The Strategy, developed in collaboration with the Advisory Council to Support Grandparents Raising Grandchildren, established by the Supporting Grandparents Raising Grandchildren (SGRG) Act, was delivered to Congress and the nation in 2022. The Strategy identifies nearly 500 actions across five goals that the federal and state governments, communities, service providers, employers and many other sectors can take to better assist and support family and kinship caregivers.

When taken together, the NFCSP/NACSP, RAISE and SGRG Acts represent significant federal commitments to improving the lives of family caregivers and those they support. The Strategy is a national roadmap for improving how we can better recognize and support family caregivers, regardless of where they live or what caregiving looks like for them and their loved ones.

Goal https://acl.gov/programs/program-evaluations-and-reports#TheCaregiverOutcomeEvaluationStudyoftheNationalFamilyCaregiverSupportProgram https://acl.gov/programs/program-evaluations-and-reports#TheCaregiverOutcomeEvaluationStudyoftheNationalFamilyCaregiverSupportProgram https://acl.gov/sites/default/files/about-acl/2018-10/PLAW-115publ119%20-%20RAISE.pdf https://acl.gov/sites/default/files/about-acl/2018-10/PLAW-115publ119%20-%20RAISE.pdf https://acl.gov/CaregiverStrategy https://acl.gov/CaregiverStrategy https://acl.gov/sites/default/files/common/NatlStrategyFamCaregivers_FedActions.pdf https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyFamCaregivers_ActionsSCO.pdf

Through this NOFO, ACL wishes to emphasize the themes of “Recognizing,” “Assisting,” and “Supporting” family caregivers that are central to the RAISE and SGRG Acts. The project will undertake approaches for building capacity to offer caregiver navigator services in OAA-funded Title III-E/VI-C programs and by the entities administering them (e.g., state units on aging, area agencies on aging, tribes, local service providers). In this regard, ACL’s goals are threefold: 1) better understand the extent to which caregiver navigator services are/are not used in the programs and entities funded by Title III-E and VI-C of the OAA and where the opportunities to do so more effectively exist; 2) design and test approaches for delivering caregiver navigator services in Title III-E/VI-C programs; and 3) evaluate the effectiveness and opportunities for scaling and replicating them.

Family, Kinship and Tribal Caregiving – The Numbers and the Challenge

Each year, more than 53 million family caregivers provide most of the support that makes it possible for older people and people with disabilities to live in the community (AARP and National Alliance for Caregiving, 2020). In addition, at least 2.7 million grandparents – and an unknown number of other kin caregivers – carried the primary responsibility for caring for children whose parents were unable to do so (Annie E. Casey Foundation, 2019). Among American Indian, Alaska Natives, and Native Hawaiian (AI/AN/NH) populations, approximately one in three elders reports having a family caregiver, and nearly one in ten elders themselves are grandparents raising grandchildren (See Title VI Evaluation, Year 3 Interim Report).

As the population ages and people live longer, the need for support provided by a family member or friend will likely increase. Additionally, if the direct care workforce shortage crisis continues

– or worsens -- greater and greater responsibility for very complex care tasks could ultimately fall to family members and other informal caregivers. All too often, family caregivers do not recognize themselves as such, or they lack sufficient knowledge about the tasks they are performing, or the confidence to be sure they are doing them properly. Additionally, many continue to lack the information they need to properly understand their needs or do not understand how to navigate complex systems of support without assistance.

According to the Centers for Disease Control and Prevention, family caregivers are at increased risk for having multiple chronic diseases as they may neglect their own health needs while providing support to others.[1] Data from ACL’s 2022 National Survey of OAA Participants, indicate nearly a quarter of family caregivers are assisting two or more people. More importantly, they report their caregiving tasks are growing in both number and complexity, making navigating complex systems of information, assistance, and training, particularly those provided by the NFCSP and NACSP even more of an imperative. For example:

• When asked if they knew where to go to ask for respite services, nearly 44% of family caregivers indicated they did not.

• In the previous year, 41% of family caregivers served by the NFCSP reported needing assistance applying for, or accessing, services and supports for themselves or the care recipient.

• Despite receiving supports, 38% of family caregivers indicated they had at least some difficulty accessing services on behalf of the care recipient; and

• When asked what recommendations they had for improving NFCSP services, 46% indicated they wanted to see improvements in either, information about available services https://acl.gov/sites/default/files/programs/2020-03/ACL_TitleVI_EvaluationYear3_InterimReport_1_2020_508.pdf

(19.46%), assistance gaining access to services (15.16%) and/or better counseling, training, or access to support groups (11.53%).

The OAA-funded caregiver support programs have accomplished a great deal in their nearly 24 years of implementation. They have served as catalysts for further caregiver support program development at the state and community levels. However, based on the most recent data gathered from OAA Title III-E participants (i.e., family caregivers), opportunity exists to improve their experiences obtaining the information and assistance they need and navigating service and support delivery systems.

Select Examples of Family Caregiver Navigator Practices

Family care/caregiver navigators, both as a profession and a service, can work with family caregivers to create sustainable and flexible plans for needed support along their journey. Such programs/services are intended to further person-centered and family-centered approaches to support. Family care/caregiver navigators can improve access to the most needed services and supports and assist family caregivers in managing the support needs of those to whom they provide care. The individuals offering such services can be called by a variety of titles, including caregiver navigator, care team navigator, patient navigator, community health worker, case manager, and link worker.

Care navigators can keep caregivers on track with their own self-care and support, thus helping to ensure their own physical and mental health does not decline because of their caregiving roles.

Care/caregiver navigation programs currently exist in the U.S and internationally. In one study, 20 different programs for people with dementia, their family caregivers, and members of the care team in 39 sources were identified. Programs in the United States were either statewide initiatives or concentrated in specific cities. Common offerings of these programs included education, in-person, and telephone services, and many involved care providers. Of note, there did not appear to be a standard professional title for the individuals providing navigation services across programs and the differing titles appear to be used in both community and clinical settings.[2]

Navigation services can be necessary in facilitating vital connections to long-term services and supports and could include:

• Compendia of resources that empower family caregivers in the support needs they identify

• Information and education about the care recipient’s condition and support needs

• Accessing and moving through screening and other services, as appropriate for both caregiver and care recipient

• Planning for future needs of aging family caregivers and individuals with disabilities as transitions between programs and services become necessary

• Respite and related service options for the family caregivers

• Tutorials on a range of topics to enable family caregivers to be effective advocates for those they support

Following are select examples of care/caregiver navigation programs and results from studies showing their potential for supporting family caregivers.

• The Care Ecosystem is a model of dementia care designed to provide personalized, cost-efficient care for persons with dementia (PWD) and their caregivers. The model includes positions called care team navigators (CTNs) the main point of contact for patients and caregivers in the Care Ecosystem. They are unlicensed yet trained to screen for dementia-related needs and provide support and information. Their work is guided by care protocols, and they are supported and supervised by a clinician (nurse or social worker).

In late 2022, the Administration of Community Living (ACL) awarded Alzheimer Orange County (AlzOC) a grant to promote the development and expansion of dementia-capable home and community-based services intended to improve the quality of life of people living with Alzheimer’s disease or related dementias and their caregivers.[3] As part of memory support, care team navigators (CTNs) in the Care Ecosystem model are the main point of contact for patients and caregivers. In this model, support is delivered from centralized hubs across broad geographic areas to caregivers and persons with dementia (PWDs) independently of their health system affiliations. This Telephone-based collaborative dementia care was delivered by a trained care team navigator, who provided education, support, and care coordination with a team of dementia specialists.[4]

The effectiveness of the Care Ecosystem model was studied in 1560 rural and urban regions across the U.S. When compared with other models of support, the Care Ecosystem was shown to improve the quality of life among the 780 PWD and 780 caregivers' studies, reduced emergency department visits, and decreased their reports of depression and perceived burden.

• Although not available in every state, kinship navigator programs are often cited as a recognized and proven best practice for supporting kinship families and grandfamilies.

Federal law defines kinship navigator programs as programs that assist kinship caregivers in learning about, finding, and using programs and services to meet the needs of the children they are raising and their own needs, and promote effective partnerships among public and private agencies to ensure kinship caregiver families are served. The Advisory Council to Support Grandparents Raising Grandchildren’s initial Report to Congress described a successful example of a kinship navigator effort underway with SHARE New Mexico, a resource directory on New Mexico community health resources, social services, initiatives, and counties. Kinship navigators programs can be examined as for possibilities for translation to other populations of family caregivers.

• In the mental health services space, Mental Health Navigators have specific experience in navigating the mental health system and have been highlighted as promising partners in efforts to improve overall engagement in mental health services.[5] In Idaho, the Caregiver Alliance employs family caregiver navigators who conduct evidence-based assessments to identify the most critical needs and stressors of family caregivers and then connect them with resources throughout Idaho to improve their quality of life.[6]

• In 2020, the Community Memorial Health System in Ventura, California, partnered with Channel Islands University to create a caregiver navigator program. It leverages the role of hospitals in assisting caregivers and patients, provides resources and access to programs to support positive outcomes, including reducing hospital readmissions, caregiver burden, depression, and patient depression. Most important, the program integrates family caregivers into the healthcare team to improve communication with the provider. The program has served over 200 family caregivers since it began.[7] https://sharenm.org/kinship-navigation https://sharenm.org/kinship-navigation https://caregivernavigator.org/support-for-caregivers/

• The Ryan White HIV/AIDS Program (RWHAP) is administered by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB). In this program, providers have been building Community health worker (CHW) programs to achieve positive health outcomes for their patients while building strong ties to the community. CHWs and patient/peer navigators are uniquely able to engage with people living with HIV (PLWH), and help them understand the complex healthcare system, educate them, and ensure that they receive HIV care.

The peer navigators in the RWAP are traditionally persons living with HIV (PLWH), who are treatment adherent and share similar experiences and live within the same communities as the people they mentor. This model could also be applied to what caregiver navigators can offer caregivers. Like these Patient Navigators who work one-on-one with clients to encourage continued commitment and adherence to medical treatment, access to social services, improved communication, and prompt re-engagement in care, this framework holds promise for possible translation and replication in other program areas.

• In a recent study conducted by Health Management Associates for the state of Minnesota, researchers noted that the state’s “caregiver support services are more extensive and well-developed than almost any other state.” Among the recommended actions the state could take to further strengthen its caregiver support infrastructure, improving navigation services was noted, including training curricula for caregiver consultants, increasing the caregiver consultant workforce, thereby allowing for greater numbers of referrals to these professionals; and implementing caregiver navigator forums to promote learning and best-practice information at the fore.

According to an article in the BMC Health Services Research Journal in PubMed, primary outcomes and benefits for care/caregiver navigation programs appear to have both cost-benefits and outcomes related to positive impact on social determinants of health. Additionally, the article states “System navigation can be facilitated by an individual or team of lay and/or healthcare professionals to reduce barriers and facilitate access to continuous, effective, and efficient care for patients, caregivers, and providers”.[8]

Priority Areas and Desired Activities

ACL has identified the following priority areas as critical to better understanding and deploying caregiver navigators in OAA-funded Title III-E/VI-C programs. Applicants should consider these priority areas as a starting point for their proposals and work, as opposed to a definitive and complete listing. Applicants are encouraged to construct their proposals to comprehensively address ACL’s desire to expand the understanding and use of caregiver navigators in OAA-funded Title III-E/VI-C programs.

• Priority Area 1 – Develop an understanding of the extent to which care/caregiver navigator services are being, or could be used, in the delivery of OAA Title III-E/VI-C programs and services. ACL’s interest in this area includes, but is not limited to:

o The models and types of caregiver navigator support currently in use within OAA-funded family caregiver support programs.

o The interplay between caregiver assessment, assistance, and caregiver navigation o Available resources to support caregiver navigator programs

• Priority Area 2 – Based on the outcome of activities in Priority Area 1, design, develop, and test approaches to providing technical assistance and capacity building to OAA-funded caregiver programs to promote the use of care/caregiver navigator services.

ACL’s interest in this area includes, but is not limited to:

o Substantive input from, and engagement with, target audiences in the study, design and testing of technical assistance.

o The development of technical assistance modes and methods intended to build capacity to deliver care/caregiver navigator services.

o Testing of new models in a variety of settings and across multiple and diverse populations of family caregivers

• Priority Area 3 – Evaluate and package for replication and scaling the most successful models and approaches for implementing and sustaining care/caregiver navigator services in OAA Title III-E/VI-C programs. ACL’s interest in this area includes, but is not limited to:

o Robust third-party evaluation of newly developed technical assistance modes and models o Identification of the most successful and/or promising models for replication and scaling o Materials and resources to support greater uptake and use of care/caregiver navigator services in the OAA-funded NFCSP/NACSP.

The grantee (including any partners) is expected to undertake activities in response to this NOFO that are not duplicative of any existing efforts, particularly those focusing on ensuring family caregivers are included in care teams typically seen in healthcare and similar settings. In that regard, the grantee will be expected to closely coordinate their work with the five grantees previously funded to form the National Caregiver Support Collaborative (NCSC), launched in late 2023, particularly the University of California, San Francisco who is addressing strengthening inclusion of family caregivers in health care delivery teams.

IMPORTANT: Given the specificity of the topic to be addressed, ACL anticipates that the entity to be funded will be one that possesses and demonstrates the understanding of, and capacity to address, the range of issues associated with care/caregiver navigation programs and services.

Additional Application Elements and Considerations

The following additional application elements and considerations will be incorporated by reference into the terms and conditions of each Cooperative Agreement and their associated Notices of Award (NOAs). Applicants should be aware of, and discuss in their applications (where appropriate), the following additional elements and considerations for their projects:

Using the 2022 National Strategy to Support Family Caregivers as a Framework

The National Strategy to Support Family Caregivers (the Strategy) envisions a “whole of society approach” for more effectively recognizing, assisting, including, supporting, and engaging family caregivers as essential partners in the support of those who wish to maintain their independence and autonomy. The Strategy is an important first step towards that goal and should be used as the organizing framework and guide for applicants to this NOFO. Applications will be scored, in part, on the degree to which proposed approaches to technical assistance and capacity building are grounded in, and help to advance, the principles and concepts contained in the Strategy.

Organizational Capacity and a National Scope

Applicants must demonstrate the organizational expertise and capacity to apply multi-faceted, comprehensive approaches in achieving the goals of this initiative. Most importantly, applicants must demonstrate (and commit to) conducting their work on a national level. Further, applicants should demonstrate expertise, either directly or by partnering with subject matter experts and/or awarding sub-contracts, and sub-grants, to carry out the desired activities outlined in this funding opportunity. Applicants will be reviewed and scored, in part, on how well they demonstrate such expertise and/or how they propose to ensure it is available throughout the life of the project, and:

• Ensure expeditious startup of project activities upon notice of award;

• Work effectively with all other grantees/contractors on this project, as well as the stated target audiences, to achieve desired outcomes;

• Employ efficient and effective strategies that maximize available resources, including technology, while ensuring measurable reach and impact of technical assistance; and

• Ensure sustainability of all activities once federal funding ends.

Sub-grants and/or subcontracts

Provision of funding for sub-grantees or subcontracts to carry out specific activities is expected, as ACL believes this project will have a greater likelihood of success when a range of organizations, or individual subject matter experts, undertakes the work and/or the applicant identifies a gap in expertise necessary to fully complete project goals and objectives. Applicants should describe their rationale and criteria for selecting sub-grantees/subcontractors, including their approaches for monitoring sub-grantee/subcontractor progress, and ensuring successful completion of all tasks. In particular, when undertaking activities in response to Priority Area 2, applicants should consider the extent to which sub-awards are a viable mechanism for achieving this objective. The successful grantee, and any sub-grantees, shall adhere to all requirements, including those for making and monitoring sub-awards, as outlined in 45 CFR Part 75.

Cross-collaboration and coordination with other technical assistance efforts

As a new, high-visibility initiative to operationalize the principles and actions outlined in the Strategy, all parties in this initiative (e.g., grantees, sub-grantees/contractors, and their partners) will become key resources in further development and strengthening of programs and services in both the NFCSP and NACSP. Therefore, close collaboration between the five previously funded grantees under the NCSC, ACL, the Technical Assistance and Coordinating Center associated with this initiative, as well as other partners to the project, should be anticipated throughout the life of the project. Such collaboration and alignment will be achieved and maintained through regular communication and information sharing.

Additionally, given the range of considerations for effective recognition and support of family caregivers, it is expected that all parties to this initiative will align their efforts and look to foster collaborations with other technical assistance initiatives (both ACL-funded and non-ACL-funded), including (but not limited to):

• The Direct Care Workforce Technical Assistance Center

• The Technical Assistance Center for Kinship and Grandfamilies

• Center on Holocaust Survivor Care/Jewish Federations Institute on Aging and Trauma

• Older Adults Equity Collaborative (OAEC)

• National Center for Advancing Person-Centered Planning and Services

• Bridging Aging and Disabilities Networks at NACDD;

• The National Information and Referral (I&R) Support Center;

• Resource centers for Older Indians, Alaska Natives, and Native Hawaiians; and

• Administration on Disabilities (AoD)-funded Projects of National Significance (PNS) activities, as appropriate.

Applicants should further familiarize themselves and align their efforts with two current technical assistance initiatives to: 1) support the implementation of the Strategy; and 2) better support kinship and grandfamily caregivers:

• In support of the FCAC’s work, the National Academy for State Health Policy (NASHP) with funding from The John A. Hartford Foundation established the RAISE Act Family Caregiver Resource and Dissemination Center. NASHP supports the council’s work by providing resources, convening experts, and supporting states as they develop policies.

• With funding from the 2021 American Rescue Plan Act, ACL established the Grandfamilies and Kinship Support Network: A National Technical Assistance Center, (the Network). Led by Generations United in collaboration with key partners, the TA Center is increasing the capacity and effectiveness of states, territories, tribes/tribal organizations, nonprofits, and other community-based organizations to serve and support grandfamilies and kinship families.

Use of advisory/steering committee and subject matter experts

A steering committee and other subject matter experts (SMEs) can be effective additions to any project and can help to ensure that diverse ideas are considered in the planning and implementation of any new project. Applicants for this opportunity should explain how they will use a steering committee to assist their efforts and include a listing of the backgrounds of individuals (e.g., consumers, professionals, and organizations) that will be invited to participate.

As this is a cooperative agreement, ACL anticipates ongoing and substantial involvement in the identification and engagement of steering committee members and other subject matter experts over the life of the project. The grantee is permitted to provide stipends to steering committee members and other SMEs, as necessary, to appropriately reimburse for their time and expertise on work directly related to this project. Such expenses should be appropriately accounted for in the applicant’s budget and budget narrative.

Methods of technical assistance, capacity building, and information dissemination

The strongest proposals will be those offering a variety of approaches to delivering technical assistance and supporting capacity building within the chosen priority area and with the intended audiences. Technical assistance modalities should be varied with respect to their design and delivery and may include (but are not limited to):

• Learning collaboratives https://acl.gov/programs/direct-care-workforce https://www.gksnetwork.org/ https://holocaustsurvivorcare.jewishfederations.org/ https://acl.gov/programs/diversity-and-cultural-competency/oaec https://ncapps.acl.gov/ https://nacdd.org/bridging-aging-disability/ https://www.advancingstates.org/initiatives/national-information-referral-support-center http://ruralhealth.und.edu/projects/nrcnaa/ http://elders.uaa.alaska.edu/ http://manoa.hawaii.edu/hakupuna/ https://acl.gov/programs/strengthening-aging-and-disability-networks/projects-national-significance https://www.johnahartford.org/dissemination-center/view/four-new-grants-totaling-nearly-5-million-approved-by-jahf-board-of-trustee https://nashp.org/policy/aging-and-disabilities/family-caregiving/ https://nashp.org/policy/aging-and-disabilities/family-caregiving/ https://www.gksnetwork.org/ https://www.gu.org/ https://www.gksnetwork.org/partners/

• E-learning programs, discussion platforms, self-directed learning programs

• Webinars, online/web-based materials

• Resource hubs and information clearinghouse

• Listening sessions, focus groups, town halls, etc.

• Training materials and curricula

• Research synthesis and translation to technical assistance

• White papers, implementation guides and other printed materials as appropriate

ACL anticipates that the grantee will develop and employ a robust and far-reaching dissemination strategy designed to ensure that project information, existing federal resources, best practices, and other information are available and shared broadly. Applicants should describe their dissemination plans and articulate the methods (e.g., electronic/web-based, in-person, print, etc.) by which such activities will occur.

Website and Web presence

While the grantee is welcome to develop its own web presence for purposes of housing their project activities, ACL expects all products and related materials developed and disseminated by the grantee to remain widely available and indefinitely, once federal funding ends. In that regard, ACL has designed and is hosting the website dedicated to this initiative. This site is the primary vehicle for presenting and organizing public-facing information. The grantee is expected to collaborate with ACL and other partners and contractors in the initiative by making available for posting of all products developed by their project to the ACL-hosted web site.

Accessibility and 508 Compliance Requirements

ACL requires that all information and materials developed by the grantee and partners for dissemination, regardless of method, will be fully accessible (i.e., 508-compliant), and meet the cultural and linguistic needs of the intended audience.

Project Outcomes

ACL expects to see outcomes proposed which seek to advance the capacity of the 56 state and territorial agencies on aging, tribes and tribal entities, area agencies on aging, local aging services providers and, where appropriate and resources permit, state developmental disabilities networks, to address the objectives of this NOFO. Applicants should carefully consider the outcome (or outcomes) they intend to propose and ensure they are both specific and measurable.

Project Evaluation

Projects of this scope, visibility, and reach are expected to achieve measurable results and have lasting impact. Therefore, the grantee should anticipate substantial involvement by the ACL program officer, with input from the ACL Office of Performance and Evaluation in the finalization of their evaluation, per the terms of the cooperative agreement. In this regard, applicants should focus on developing a broad evaluation framework, with the understanding that it will be finalized during the post-award project planning and alignment period (described above) and with considerable input from ACL.

Project Sustainability

ACL expects to realize tangible, measurable and sustainable outcomes from grantee and their partners. Proposals should contain a plan for sustaining the project’s work after federal funding ends. Applicants will be scored, in part, on the extent to which a plan for the project’s sustainability beyond the period of federal funding is included and appears feasible and likely.

[1] https://www.cdc.gov/aging/agingdata/docs/caregiver-brief-508.pdf

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578521/#R32

[3] https://www.alzoc.org/acl-grant-empowers-innovative-programming-at-leisure-world-seal-beach/

[4] https://memory.ucsf.edu/research-trials/professional/care-ecosystem

[5] https://pubmed.ncbi.nlm.nih.gov/30877145/

[6] https://caregivernavigator.org/

[7] https://www.mycmh.org/programs-services/supportive-care/caregiver-navigator/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165767/

Statutory Authority Older Americans Act (OAA) of 1965, as amended, Section 373(i)

II. Award Information

Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$882,000 Expected Number of Awards:

Award Ceiling:

$882,000 Per Project Period

Award Floor:

$600,000 Per Project Period

Length of Project Period:

36-month project period with three 12-month budget periods Additional Information on Project Periods and Explanation of 'Other' The ACL will carry out the following activities for the cooperative agreement:

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

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

https://www.cdc.gov/aging/agingdata/docs/caregiver-brief-508.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578521/#R32 https://www.alzoc.org/acl-grant-empowers-innovative-programming-at-leisure-world-seal-beach/ https://www.alzoc.org/acl-grant-empowers-innovative-programming-at-leisure-world-seal-beach/ https://memory.ucsf.edu/research-trials/professional/care-ecosystem https://pubmed.ncbi.nlm.nih.gov/30877145/ https://caregivernavigator.org/ https://www.mycmh.org/programs-services/supportive-care/caregiver-navigator/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10165767/

• 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., subgrants/contracts) as permitted in this funding opportunity announcement.

• 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 all work products and other project deliverables and processes.

• Establish and maintain the website for the curation, dissemination and maintenance of all products and deliverables associated with this project.

• Establish branding for the collective project and lead development of branding of public-facing materials and activities.

• 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 major project events as appropriate.

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

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

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

• In collaboration with the ACL program officer, the other grantees funded under this

NOFO, and other entities as determined by the ACL program officer, participate in, and successfully complete a post-award planning period, as described in “Mandatory Post- Award Project Planning and Alignment Period” section of the NOFO

• Participate in (at least) monthly meetings with the ACL program officer, and/or the other grantees and partners to this initiative (more frequent meetings will be expected during the post-award project planning and alignment period);

• Provide drafts of all press releases and social media announcements prior to release;

• Provide preliminary and other working drafts of all products and deliverables to the ACL program officer for review;

• Ensure that all materials and products are fully accessible and developed in accordance with 508 compliance standards;

• Prior to dissemination, provide final drafts of all products and deliverables to the ACL program officer for accessibility and 508-compliance review and remediate any issues identified;

• Use the ACL-developed website as the primary means by which all project-related materials, information, resources, etc., are disseminated and made available for use by the public;

• Collaborate with ACL on the identification and selection of steering committee (if established) members and any subject matter experts/advisory consultants to the project;

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

• Share information with ACL, national and local organizations, and other entities as appropriate.

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

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

ACL will assist the grantee in understanding the strategic goals and objectives, policy perspectives, and priorities of the ACL 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 ACL program officer will provide technical assistance and guidance on issues related to grant management and implementation, including the execution of the cooperative agreement. The program officer will also share information with the grantee about other federally sponsored projects and activities relevant to activities funded under this announcement. 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. Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the mutual agreement of both parties, except where ACL is authorized under the Terms and Conditions of award, 45 CFR Part 74 or 92, or other applicable regulation or statute to make unilateral amendments. When an award is issued, the cooperative agreement terms and conditions from the program announcement are incorporated into the Notice of Award by reference.

III. Eligibility Information

1. Eligible Applicants For FY 2024 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.

This is a full and open competition. 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 are eligible to apply.

Priority will be given to national organizations (including faith and community-based organizations and tribal organizations that demonstrate the capacity to work at the national level), with demonstrated understanding and expertise in the priority areas identified in this

NOFO, including family, tribal and kinship family caregivers (as defined in the Older Americans Act of 1965, as amended) and those whom they support. For the purposes of this competition, national organizations are defined as those entities established with headquarters and administration for an organized group of bodies (local chapters, affiliates, faith- and community-based and tribal organizations).

Applicants must demonstrate that they have experience and a capacity for developing and providing technical assistance related to care/caregiver navigator programs and initiatives and partnering with key national stakeholder groups involved in the matters related to this NOFO.

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.

Under this ACL program, ACL will fund no more than 75% of the project’s total cost, which means the applicant must cover at least 25% of the project’s total cost with non-federal resources. In other words, for every three (3) dollars received in federal funding, the applicant 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 the minimum required match.

(Federal Funds Requested) times (Match Percentage) divided by (Inverse Match Percentage)

Here are examples of varying match levels

Federal Funds Requested X Match Percentage / Inverse Match Percentage

Minimum Match Requirement

($100,000 X 5%) / (95%) $5,263 ($100,000 X 25%) / (75%) $33,333 ($100,000 X 35%) / (65%) $53,846 ($100,000 X 45%) / (55%) $81,818

A common error applicants make is to match 25% of the Federal share, rather than 25% of the project’s total cost.

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 all third parties involved in the project, including sub-grantees, contractors and consultants, are considered matching funds.

3. Responsiveness and Screening Criteria

Application Responsiveness Criteria Applications that fail to meet each of the responsiveness criteria described below will not be reviewed and will receive no further consideration:

• The project’s proposed activities focus on each of the priority area described in the NOFO; and

• The project’s proposed activities are of national in scope.

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

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

• The Project Narrative section of the Application must be double-spaced, on 8 ½” x 11” plain white paper with 1” margins on both sides, and a font size of not less than 11 point.

• The Project Narrative must not exceed 30 pages. 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 30-page limit.

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