Foa_Content_of_HHS-2025-ACL-AOA-ADPI-0012 (Revised) (2).pdf

Administration for Community Living

Administration on Aging

Alzheimer's Disease Programs Initiative (ADPI) - Developing Dementia-Capable Community Health Worker Programs in the National Aging Network

HHS-2025-ACL-AOA-ADPI-0012

07/30/2025

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:

Alzheimer's Disease Programs Initiative (ADPI) - Developing Dementia-Capable Community Health Worker Programs in the National Aging Network Funding Opportunity Number:

HHS-2025-ACL-AOA-ADPI-0012

Primary CFDA Number:

93.470 Due Date for Letter of Intent:

Due Date for Applications:

07/30/2025 Date for Informational Conference Call:

07/09/2025 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 This Notice of Funding Opportunity (NOFO) introduces a new Administration on Community Living (ACL) initiative and provides instructions for how to apply. Through the Alzheimer’s https://www.grants.gov/

Disease Program Initiative (ADPI), ACL seeks to enhance workforce capacity in the National Aging Network with the inclusion of dementia-capable Community Health Workers (CHWs).

CHWs work to improve conditions for health in communities with the highest rates of disease, disability, and death. ADPI supports dementia-capable home and community-based services for people living with dementia and their caregivers. As a result of this initiative, ACL seeks to strengthen relationships with rural and underserved communities and address barriers to care for people living with dementia and their caregivers.

ACL’s goal for this new initiative is to develop and strengthen a person-centered workforce capable of increasing the quality and quantity of dementia services. This initiative will result in more older adults with dementia living well in the community. More specifically this initiative will:

1. Identify how CHWs can increase early detection and engagement in dementia care.

2. Demonstrate how CHWs can help reduce barriers to care when delivering EBI/EII.

3. Evaluate impact of programs on people living with dementia, caregivers, and CHWs for sustaining and scaling best practices.

ACL will award up to twelve cooperative agreements to Area Agencies on Aging (AAA) or any State which has been designated a single planning and service area under section 305(a)(1)(E) of Title III in the Older Americans Act (OAA). Projects will be fully funded for 36 months, with three, 12-month budget periods up to a total of $750,000 in federal funding. Products created with this funding will be available for reuse in the public domain and may be posted on the ACL’s National Alzheimer’s and Dementia Resource Center (NADRC) website.

When considering whether to apply to this NOFO, applicants should keep in mind the following:

• Projects must include a dementia-specific intervention that is either an evidence-based intervention (EBI) or an evidence-informed intervention (EII), and that can be delivered by CHWs.

o This means the intervention has already been tested and shown to be effective. It does not need more testing (i.e. research). See section VIII, Other Information – Glossary of Key Terms for full definition of evidence based and evidence informed.

o Each project will be expected to allocate the following minimum portions of their total annual budgets to the provision of direct services:

o Year 1: A minimum of 25% of the total budget must be allocated to the delivery of direct services.

o Year 2: A minimum of 35% of the total budget must be allocated to the delivery of direct services.

o Year 3: A minimum of 45% of the total budget must be allocated to the delivery of direct services.

• Pass through projects are prohibited. No project partner may receive more than 20% of total Federal funds received by the primary grantee.

• All projects must meet a 25% cost sharing (match) requirement.

Emailed Letters of Intent are requested (but not required) and should be submitted 10 days after the notice of funding opportunity posting date.

https://nadrc.acl.gov/home

The call will be recorded and made available to the public immediately following the call.

Wednesday, July 9, 2025 from 1:00 pm – 1:45 pm eastern time

The dial-in information is below:

Toll Free Number: 877-716-4291 Passcode: 3330445

For security reasons, the passcode and the leader's name will be required to join your call.

Leader: STEPHANIE BOSTIC

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

Toll Free Instant Replay Number: 866-490-2538

I. Funding Opportunity Description Introduction

America is aging and the needs of this growing demographic are complex. This is especially true for individuals with memory loss, where formal (paid) and informal (unpaid) supports are needed to continue living at home and in community. However, the needs for services are often more than or do not match what is available, creating a challenge for the National Aging Services Network to develop new and better ways of providing care to people at risk for moving into an institution (e.g., nursing home).

As the proportion of older Americans grows, so does the gap between workforce capacity and demand for direct care service (Administration for Community Living [ACL], 2024; National Academies of Sciences, Engineering, and Medicine [NASEM], 2021). One estimate predicts the need for direct care workers to increase by 48% between 2015 and 2030 (U.S. Department of Health and Human Services [HHS], 2017). Yet, acceptance rates for home health services continue to decline, dropping from an already low 48% in 2019 to 36% in just two years (Harootunian et al., 2023). High turnover of direct care workers contributes to this shortage, where the average length of employment for direct care workers is only 5 months and fewer than one third of those who leave a position in direct care move to another in direct care services (Baughman & Smith, 2012).

Within this growing population of older adults, studies also show increasing complexity in economic and social circumstances. For example, in 2022 nearly one in 10 older adults lived below poverty, and out-of-pocket healthcare costs increased by nearly 50% since 2012 (ACL, 2024). In 2023, approximately 28% of older Americans living in the community lived alone, with the percent increasing to 42% as age increased to 75 years of age and better (ACL, 2024).

Living alone in community can be challenging for individuals with memory loss and other health conditions effecting their abilities to perform critical, everyday tasks.

As people are living longer, researchers expect an increase in the number of people with dementia and the percent to be higher in communities experiencing barriers to care (Assistant Secretary for Planning Evaluation [ASPE], 2018; Centers for Disease Control [CDC], 2019; Chi et al., 2019; Liu et al., 2022; NASEM, 2021). Additionally, poor economic and social conditions

(i.e., barriers to care) may lead to delays in the diagnosis and treatment of dementia symptoms, ultimately leading to worse health outcomes (Liu et al., 2022; NASEM, 2021). For example, fewer health and social care resources in low-income and rural communities reduce access to care, while bad experiences with healthcare systems and/or care providers damage trust and lower engagement in care (NASEM, 2021).Understanding the role barriers to care play in health outcomes can lead to more effective, person-centered services and supports (see section VIII, Other Information – Glossary of Key Terms for a definition and examples of barriers to care).

As described above, we are headed in a direction of more people living with dementia, with more barriers to care, and less available support. However, Community Health Workers (CHWs) can help address these issues in the following ways:

• The CHW profession is fast growing, expected to surpass the average occupational growth rate of 14% between 2022 and 2032. As more CHWs enter the workforce, they will fill new roles as well as replace workers who move to new occupations (U.S.

Department of Labor [DOL], 2024).

• CHWs have unique skills and abilities. As members of the communities they serve, CHWs understand the challenges and have personal experience overcoming the same barriers to care they help others address.

• CHWs are effective and efficient in linking underserved communities to vital resources.

They bring services into the community, advocate for community identified issues, and improve quality of care through persona-centered interventions (Schaaf et al., 2020;

Thompson & Borson, 2021; HHS, 2017).

CHWs and ADPI

CHWs are defined in many ways, under a variety of titles. Common to most descriptions, CHWs are trusted members of the communities they serve and work to reduce barriers to care in communities with the highest rates of disease, disability, and death. (Berthold, 2016; Schaaf et al., 2020; Verhagen et al., 2014). Examples of barriers to care include being socially and/or geographically isolated, poverty, and low educational attainment (CDC, 2019; ASPE, 2018;

Kosteniuk, 2024; Liu et al., 2022; NASEM, 2021). CHWs work with individuals, families, neighborhoods, and institutions to overcome the effects of barriers to care and to build capacity for new resources (Berthold, 2016; Schaaf et al., 2020).

ADPI cooperative agreements use a dementia capable home and community-based services model to support people living with dementia and their caregivers. ADPI activities are a good match for CHW skills and expertise and include community outreach, training professionals, providing community education, and developing new resources to support people living with dementia. CHWs may also offer non-clinical individualized care. While it is beyond the CHW scope of practice to operate as a home health provider, they can extend health services with home visits for routine assessment, social support, and self-management skill building.

For this program, CHWs will be operating as both service provider and service connector. CHW directed activities MUST include but are not limited to: 1) providing community-based dementia screenings and referrals for early detection and support; 2) delivering a dementia specific EBI/EII; and, 3) addressing barriers to care as they effect access, engagement, and quality of dementia services and supports. Additional activities may be performed to build on current resources and/or to address gaps in community needs. However, activities must fit inside a CHW scope of practice. Common CHW roles and responsibilities include:

• Care extender: Conduct screenings and person-centered assessments, support goal development, facilitate action plans, and monitor progress; Collaborate with an interdisciplinary team of professionals by participating in care planning, case consulting, and/or care team huddles.

• Capacity builder: Develop social networks to support a common cause; Advocate for resources and investment in community.

• Liaison to institutions: Facilitate dementia capable training to professionals, emphasizing cultural preferences and practices of underserved populations.

• Health promoter: Deliver person-centered, relevant dementia education to people living with dementia and/or caregivers; Train individuals, families, and groups in behavior-management and self-care techniques.

• Health navigator: Connect individuals and families to dementia related health and social services; Ensure services are appropriate and meeting need.

• Peer coach: Provide informal counseling and social support; Model dementia capable behaviors and attitudes.

• Outreach: Disseminate dementia resource information; Engage and retain participants in dementia relevant health and social services.

• Evaluation support: Distribute and collect surveys; Participate as a key informant in community strengths/ needs assessments.

(Berthold, 2016; Rosenthal et al., 2016).

In this program, ACL expects to see positive outcomes for people living with dementia, caregivers, and CHWs. While personal experience and interpersonal skills are what make CHWs so effective, training and certification programs can improve CHW impact. Training and certification also support CHWs interested in pursuing advanced or specialized roles. For these reasons, comprehensive and continuous professional development of the CHW(s) are key components of this program and must include: 1) CHW core competencies training and/or certification; 2) training in implementing a validated dementia screening tool and protocols for referral and linkage to follow-up services; 3) training to deliver EBI/EII; and, 4) dementia and other aging specific trainings.

While career development opportunities may appeal to new and/or younger workers, CHW positions are also attractive options for aging and older adults, as evident by a 2021 national survey showing 29% of CHWs are 55 years of age and better (National Association of Community Health Workers [NACHW], 2022). Meaningful, high reward employment has shown to positively impact mental, social, financial, and physical health in older adults, and CHW programs offer just that (Baxter, 2021; National Research Council & Institute of Medicine, 2004). With access to resources and influence in service design and delivery, CHWs are empowered to make real change in the communities they serve and live in (Kane et al., 2016).

Program Goal and Objectives

ACL’s goal for this new initiative is to develop and strengthen a person-centered workforce capable of increasing quality and quantity of dementia services for communities in greatest need.

Applicants should focus their proposals on this goal and the following objectives, as they relate to the communities in which their projects will operate:

1. Identify how CHWs can expand reach and improve Aging Network operations for early detection and engagement in dementia care.

2. Demonstrate how CHWs can leverage community resources to counter barriers to care when delivering EBI/EII.

3. Evaluate impact of programs on people living with dementia, caregivers, and CHWs for sustaining and scaling best practices.

References

Administration for Community Living. (2024, May). 2023 profile of older Americans.

https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.p df.

Baughman, R. A., & Smith, K. E. (2012, December). Labor mobility of the direct care workforce: implications for the provision of long-term care. Health Economics. DOI:

10.1002/hec.1798. Pubmed, https://pubmed.ncbi.nlm.nih.gov/22025403/.

Baxter, S., Blank, L., Cantrell, A., & Goyder, E. (2021, July 9). Is working in later life good for your health? A systematic review of health outcomes resulting from extended working lives.

BMC Public Health. https://doi.org/10.1186/s12889-021-11423-2.

Berthold, T. (Ed.). (2016). Foundations for Community Health Workers. Jossey-Bass & Pfeiffer Imprints, Wiley.

Bureau of Labor Statistics, U.S. Department of Labor. (2024, April 17). Occupational Outlook Handbook, Community Health Workers. https://www.bls.gov/ooh/community-and-social-service/community-health-workers.html.

Centers for Disease Control. (2019, August 20). Minorities and women are at greater risk for Alzheimer's disease. Alzheimer's Disease and Healthy Aging.

https://www.cdc.gov/aging/publications/features/Alz-Greater-Risk.html.

Chi, W., Graf, E., Hughes, L., Hastie, J., Khatutsky, G., Shuman, S. B., Jessup, E. A., & Karon, S. (2019, January). Older adults with dementia and their caregivers: key indicators from the National Health and Aging Trends Study. The Office of the Assistant Secretary for Planning and Evaluation. https://aspe.hhs.gov/reports/community-dwelling-older-adults-dementia-their-caregivers-key-indicators-national-health-aging-0.

National Association of Community Health Workers. (2022). Diversity of CHW respondents by geography, ethnicity, race and cultures. https://nachw.org/nationalchwsurvey/.

Harootunian, L., Buffett, A., O’Gara, B., Perry, K., Serafini, M. W., & Hoagland, G. W. (2023, June 13). A multipronged approach to alleviating the direct care workforce shortage. Health Affairs Forefront. DOI: 10.1377/forefront.20230608.815571.

https://www.healthaffairs.org/content/forefront/multipronged-approach-alleviating-direct-care-workforce-shortage.

HHS Office of the Assistant Secretary for Planning and Evaluation Office of Disability, Aging and Long-Term Care Policy. (2018, September). A profile of older adults with dementia and https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf https://pubmed.ncbi.nlm.nih.gov/22025403/ https://doi.org/10.1186/s12889-021-11423-2 https://www.cdc.gov/aging/publications/features/Alz-Greater-Risk.html https://nachw.org/nationalchwsurvey/ their caregivers. ASPE. https://aspe.hhs.gov/reports/profile-older-adults-dementia-their-caregivers-issue-brief.

Kane, S., Kok, M., Ormel, H., Otiso, L., Sidat, M., Namakhoma, I., Nasir, S., Gemechu, D., Rashid, S., Taegtmeyer, M., Theobald, S., & de Koning, K. (2016). Limits and opportunities to Community Health Worker empowerment: A multi-country comparative study. Social Science & Medicine. https://doi.org/10.1016/j.socscimed.2016.07.019.

Kosteniuk, J., Osman, B. A., Osman, M, Quail, J., Islam, N., O'Connell, M. E., Kirk, A., Stewart, N., Karunanayake, C., Morgan, D. (2024). Rural-urban differences in use of health services before and after dementia diagnosis: a retrospective cohort study. BMC Health Services Research. https://doi.org/10.1186/s12913-024-10817-3.

Liu, C. C., Liu, C. H., Sun, Y., Lee, H. J., Tang, L. Y., & Chiu, M. J. (2022). Rural-urban Disparities in the prevalence of mild cognitive impairment and dementia in Taiwan: a door-to-door nationwide study. Journal of Epidemiology. https://doi.org/10.2188/jea.JE20200602.

National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Board on Behavioral, Cognitive, and Sensory Sciences; Committee on the Decadal Survey of Behavioral and Social Science Research on Alzheimer's Disease and Alzheimer's Disease-Related Dementias. (2021, July 26). Reducing the impact of dementia in America: a decadal survey of the behavioral and social sciences. National Academies Press (US).

Doi: 10.17226/26175. https://www.ncbi.nlm.nih.gov/books/NBK574341/.

National Research Council (US) and Institute of Medicine (US) Committee on the Health and Safety Needs of Older Workers. Wegman, D. H., McGee, J.P. (Eds.). (2004). Health and safety needs of older workers. National Academies Press (US).

https://www.ncbi.nlm.nih.gov/books/NBK207719/.

Rosenthal, E. L., Rush, C., & Allen, C. (2016, July). Understanding scope and competencies: a contemporary look at the United States Community Health Worker field. The Community Health Worker Core Consensus Project. https://www.c3project.org/resources.

Schaaf, M., Warthin, C., Freedman, L., & Topp, S. M. (2020, June). The community health worker as service extender, cultural broker and social change agent: a critical interpretive synthesis of roles, intent and accountability. BMJ Global Health. DOI:10.1136/bmjgh-2020- 002296. https://gh.bmj.com/content/5/6/e002296.

Thompson, K., & Borson, S. (2021, May 5). Community Health Workers and care of older adults: How to learn what we need to know. Journal of the American Geriatrics Society.

https://doi.org/10.1111/jgs.17186.

U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. (2017). Long-term services and supports: direct care worker demand projections, 2015-2030. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/hrsa-ltts-direct-care-worker-report.pdf.

Verhagen, I., Steunenberg, B., de Wit, N. J., & Ros, W. J. (2014). Community health worker interventions to improve access to health care services for older adults from ethnic minorities: a systematic review. BMC Health Services Research. https://doi.org/10.1186/s12913-014-0497-1.

https://doi.org/10.1016/j.socscimed.2016.07.019 https://doi.org/10.1186/s12913-024-10817-3 https://doi.org/10.2188/jea.JE20200602 https://www.ncbi.nlm.nih.gov/books/NBK574341/ https://www.ncbi.nlm.nih.gov/books/NBK207719/ https://www.c3project.org/resources https://gh.bmj.com/content/5/6/e002296 https://doi.org/10.1111/jgs.17186 https://doi.org/10.1186/s12913-014-0497-1.

Funding and Application Requirements

Applicants should articulate how each of the following expectations will be addressed throughout the life of their proposed projects:

Use of dementia specific Evidence-Based and/or Evidence-Informed Interventions (EBI/EII)

In keeping with the long history of the ADPI’s use of EBI/EII, this funding opportunity requires CHW training in, and delivery of, dementia-specific EBI/EII. It is ACL’s expectation that CHW delivery will engage and retain hard to reach populations in high quality programs and services.

• Projects must include a dementia-specific EBI/EII. Please make clear how implementation of the EBI/ EII will fit into the larger project and who the beneficiaries will be.

• The chosen EBI/EII must meet the definition for an EBI or EII as described in the glossary (see section VIII, Other Information) of this NOFO.

• Examples of approved, dementia-specific EBI/EIIs can be found in ACL's NADRC's paper entitled Grantee-Implemented Evidence-Based and Evidence-Informed Dementia Interventions. Best Programs for Caregiving, a free online database of dementia programs for family caregivers, is another excellent resource for identifying dementia-specific

EBI/EII.

• When choosing an EBI/EII, you should consider factors such as feasibility, scalability, costs, and sustainability. ACL developed a tool, Choosing an Evidence-Based or Evidence-Informed Intervention: Considerations to Inform Decision-Making to assist applicants in the selection of an EBI/EII.

• In addition to discussing the dementia specific EBI/EII in the project narrative, you must submit a separate attachment: 1) naming the proposed EBI/ EII; 2) providing an overview of the EBI/ EII; and 3) confirming how the chosen program meets the definition of an EBI/EII as described in the glossary (see section VIII, Other Information) of this NOFO.

If adaptations to an EBI are proposed (i.e., EII), include a description of planned modifications with permission from the program developer (if applicable).

CHW Training

Personal experience overcoming barriers to care make CHWs effective in engaging hard to reach populations and problem- solving challenges keeping individuals from achieving health goals.

However, formal training can enhance these skills and boost CHW confidence when working in multidisciplinary organizations and institutions. Ongoing professional development also creates a path to increased wages and career advancement. For these reasons, grantees must develop annual professional development plans for each CHW. Plans should be created with the CHW, personalized to their needs and interests.

• If the CHW(s) has not yet been recruited and hired, discuss what training resources will be available to them. Provide an example orientation and training schedule to be adapted when the CHW(s) is onboarded.

• If the CHW(s) are already employed, describe what training they have taken, including any certifications they have, and what additional professional development opportunities they will participate in during the project. Include schedules of training events, if available.

https://nadrc.acl.gov/details?search1=20221214043701 https://nadrc.acl.gov/details?search1=20221214043701 https://bpc.caregiver.org/pro/index.html#home https://nadrc.acl.gov/details?search1=20210126080816 https://nadrc.acl.gov/details?search1=20210126080816

• Example or real training plan(s) should be submitted with your application as a separate attachment and must include training in the following areas: 1) CHW core competencies training and/or certification; 2) training in a validated dementia screening tool and protocols for referral and linkage to follow-up services; 3) training to deliver EBI/EII;

and, 4) dementia and other aging specific trainings.

• CHW participation in training counts as direct service.

• The National Association of Community Health Workers was established 2019 to develop and professionalize the CHW occupation. The organization and associated website are excellent resources for CHW training and professional development programs. The CHW Core Consensus Project has developed a set of standard CHW core competencies and evaluation tools for CHW proficiency.

Focus on Expanding Services and Infrastructure

To accomplish ACL’s goal of more services serving more people, grantees must dedicate a minimum amount of the total project budget to the delivery of direct services. Additionally, grantees must use funds to develop new and/or expand programming to address gaps in existing dementia-capable home and community-based services. In this regard, ACL seeks to support ongoing improvements in established dementia service systems.

• Direct service provision is a focus of this initiative. Each project will be expected to allocate the following minimum portions of their total annual budgets to the provision of direct services:

o Year 1: A minimum of 25% of the total budget must be allocated to the delivery of direct services.

o Year 2: A minimum of 35% of the total budget must be allocated to the delivery of direct services.

o Year 3: A minimum of 45% of the total budget must be allocated to the delivery of direct services.

• CHW led direct service activities MUST include, but are not limited to:

o Community-based dementia screening and referral for early detection and support o Delivering dementia specific EBI/EII; and, o Screening for and addressing the consequences of barriers to care, as they influence access to, engagement in, and/or quality of dementia care (find barriers to care in glossary for definition and examples).

• A complete definition of direct service, as well as a list of qualifying services, is provided in this NOFO’s glossary (see section VIII, Other Information).

• It is ACL’s intention to support the development of infrastructure in the National Aging Network, prohibiting distinct, time-limited and/or pass-through projects. The CHW(s) should be fully integrated into the home and community-based services organization.

Participation in Technical Assistance (TA)

The NADRC has a long history of providing TA to ADPI cooperative agreement grantees.

NADRC staff have expertise in dementia specific EBI/EII, supportive services, and many other dementia-capable topics. The NADRC can consult with grantees as subject matter experts as https://nachw.org/ https://www.c3council.org/ well as offer guidance with data collection, reporting, and program evaluation. The goal of TA is to ensure success and excellence with ADPI program implementation.

• TA is provided through a variety of activities including, but not limited to, conference calls, webinars, learning collaboratives, and one-on-one consultation.

• Participation in routine TA activities is expected, while TA functions to support a specific need must be requested.

Using a Phased Approach to Project Implementation

ADPI cooperative agreements support new and/or expansion projects closing gaps in dementia care. To adequately prepare and optimize work plans, project implementation takes a phased approach. The Administration on Community Living/ Administration on Aging (ACL/AoA) and NADRC staff offer consultation, guidance, and resource connection during each phase.

• Planning Phase: The grantee will be responsible for refining and expanding upon the work plan and the evaluation plan originally proposed in the application, incorporating feedback given by ACL/AoA and NADRC staff. The final work plan and evaluation plan must be approved by ACL/AoA staff, and the grantee must upload this version into the grant record system before moving to the next phase.

• Implementation Phase: In this phase, the grantee takes actions described in the approved work and evaluation plans to deliver the program. During technical assistance activities, the grantee will discuss successes, challenges, and proposed adaptations for meeting goals, objectives, and core components of these objectives. ACL/AoA Program Officers will be actively involved in program implementation, sharing decision making responsibilities and providing resources, as needed.

• Project Conclusion: Grantees must have robust, third-party evaluation of project outcomes, and are encouraged to share project results through presentations. At the conclusion of projects, grantees are required to manualize implementation tools and processes for distribution to the broader community, made available on the NADRC website.

Evaluation

ADPI projects must create a plan for robust, third-party evaluation. Applications should provide detail on how outcomes of direct services will be measured. This preliminary evaluation plan should describe anticipated outcomes for direct service activities to: 1) people living with dementia, 2) caregivers, and 3) the CHW(s) assigned to the project.

• Third-party evaluation requires an objective, independent evaluation of program outcomes. The evaluator’s efforts are limited to the scope outlined in the evaluation plan.

They should not be affiliated with the grantee organization or the project (intervention development and/or implementation) outside of the contracted evaluation role. Applicants should name and include a letter of commitment from their proposed evaluator. One resource for identifying qualified evaluation services is the American Evaluation Association.

• The preliminary evaluation plan, submitted at time of application, should be logical and comprehensive, providing a solid foundation to be expanded upon once the third-party evaluator is in place.

https://www.eval.org/ https://www.eval.org/

• A comprehensive evaluation plan includes measurable outcomes and outputs along with methods to ensure implementation quality.

o Outcomes are the impact of outputs (e.g. change in knowledge, quality of life, wellbeing). Recipients of the intervention are evaluated for impact. Who received the intervention, what changed, and by how much did they change?

o Outputs are the effort (i.e. services and supports included in the work plan). Effort is evaluated for quality. What was done, how much was done, how well was it done?

o Quality assurance processes monitor how services and supports are delivered, ensuring standards are met for consistent, effective program delivery. Quality standards may be set by best practices or, in the case of EBI, a program developer’s fidelity monitoring protocol. Quality assurance monitoring should occur during the intervention so timely adaptations can be made if issues arise.

Satisfaction surveys at the conclusion of a program or service will NOT meet this requirement.

o Evaluation should measure outcomes of all direct service components of your project.

• Outcome measurement should be relevant to your project’s goals and may be developed by your evaluator. Alternatively, grantees may consider tools used by previous projects, made available by ACL’s NADRC – Evaluating Dementia Services and Supports:

Instrument Resource List.

• Documentation of “lessons learned” – both positive and negative - are a required component of the evaluation final report.

• Writing an Effective Work Plan and Evaluation Plan – is a resource for developing your plan. Guidance for developing an evaluation plan and a sample template can be found on the NADRC website. More information on evaluation expectations can be found in Section V of this notice of funding opportunity.

Additionally, grantees are required to work with AoA/ACL to comply with OMB approved data reporting requirements and to submit reports according to the required schedule.

Statutory Authority OAA/Title IV/Sec. 411

II. Award Information

Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$9,000,000 Expected Number of Awards:

Award Ceiling:

$750,000 Per Project Period https://nadrc.acl.gov/details?search1=70 https://nadrc.acl.gov/details?search1=70 https://nadrc.acl.gov/details?search1=91

Award Floor:

$700,000 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' Additional Information on Project Periods and Explanation of 'Other'

New applications are sought for an anticipated project start of September 1, 2025. Awards made in connection with this funding opportunity will be for three-year (36-month) fully funded projects. In other words, the funding, in its entirety, will be made available at the time of award.

The planning phase will last for approximately 6 months post grant award notification but may take longer. Grantees will have access to no more than 15 percent of total grant funding during this phase. Upon completion of this phase (i.e., ACL approval of workplan, evaluation plan, budget), grantees will progress to the implementation phase and will gain access to 100 percent of cooperative agreement funding. Minimum anticipated award amount is $650,000, with a maximum award amount of $750,000, for 36 months.

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.

Awards for this funding opportunity are subject to terms provided for in the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224), which include substantial involvement from ACL/AoA in recipient activities.

Once in place, requests to modify or amend the cooperative agreement (or associated 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 this announcement are incorporated into the Notice of Award by reference. The grantee agrees to execute the responsibilities of the cooperative agreement as outlined below:

1. Fulfill all the requirements of the grant initiative as outlined in this notice of funding opportunity, as well as carry out project activities as reviewed, approved, and awarded;

2. Communicate with the AoA Project Officer and/or the assigned technical assistance liaison regularly to improve the effectiveness of the activities carried out under this agreement;

3. Produce and submit to the ACL/AoA Project Officer:

a. Program reports describing lessons learned, including challenges and how they were addressed.

b. Implementation manual(s)

c. Final independent evaluation report describing how the project was conducted and goals, program outcomes that were achieved, as well as program components sustained beyond the program funding period. The report would also include ways in which barriers to goal achievement were addressed;

4. Cooperate with any federal evaluation efforts and comply with the timeline, content, and format of all required OMB data collection and reporting requirements. 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. 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”.

5. All materials developed with program funding. These products (e.g. tools, resources, manuals) will not be proprietary and will remain in the public domain to be shared with the broader community. This may include resource publication on ACL’s NADRC website;

6. 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.

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

The ACL/AoA Project Officer agrees to execute the responsibilities of the cooperative agreement as outlined below:

1. 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.

2. Assist 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.

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

4. Provide guidance to the grantee, as necessary, in making sub-awards (i.e., subgrants/contracts) as permitted in this funding opportunity announcement.

5. 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.

6. Review and provide technical advice to the grantee on all work products and project deliverables.

7. 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.

III. Eligibility Information

1. Eligible Applicants Eligible applicants include entities designated to plan and coordinate a network of OAA programs, services, and supports at a local level, including AAAs and any State which has been designated a single planning and service area under section 305(a)(1)(E) of Title III in the OAA functioning as an AAA.

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.

For this ACL program, awardees do have a required match of 25%. ACL will fund no more than 75% of the project’s total cost, with awardees responsible for identifying non- For this ACL program, awardees do have a required match of 25%. ACL will fund no more than 75% of the project’s total cost, with awardees responsible for identifying non-Federal resources for at least 25% of total project costs. 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] multiplied by (x) [Match Percentage] divided by (/) [Inverse Match Percentage] Below are examples of this formula at 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%)/ (75%) $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 incurred by the awardee and cash contributions of any and all third parties involved in the project (e.g. sub-grantees, contractors, consultants) are considered matching funds. Applications with a match greater than the minimum required will not receive more favorable consideration under the review.

All proposed matching funds must be directly connected to proposed program activities and cannot come from other federal resources.

3. Responsiveness and Screening Criteria Application Responsiveness Criteria Applications that fail to meet the responsiveness criteria described below will not be reviewed and will receive no further consideration.

Application Screening Criteria All applications will go through an initial screening verify responsiveness to application requirements. Additionally, applications will go through an initial programmatic screening to verify the applicant meets this notice of funding opportunity program requirements. Those applicants that do not meet the minimum responsiveness criteria outlined below will be "screened out" and will not be forwarded for panel review. In the Appendix of this NOFO is an

Application Submission Package Checklist to support grantees in ensuring all required application components are submitted.

Initial Application Screening Criteria:

• 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 8.5” x 11” plain white paper with 1” margins on both sides, and a standard font size of no less than 11 point, preferably Times New Roman or Arial

• The Project Narrative must not exceed 20 pages. Project Narratives that exceed 20 pages will have the additional pages removed and only the first 20 pages of the Project Narrative will be provided to the merit reviewers for funding consideration. NOTE: The Project Work and Evaluation Plans, Letters of Commitment, and Vitae of Key Project Personnel, etc. are not counted as part of the Project Narrative for purposes of the 20 page limit

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

Initial Programmatic Screening Criteria:

• Applicant must be an AAA or a State which has been designated a single planning and service area under section 305(a)(1)(E) of Title III in the OAA functioning as an AAA

• Application includes required match in the application budget documents

• Application includes an attachment describing at least one dementia-specific EBI/ EII

(meeting the ACL provided definition; see section VIII, Other Information – Glossary of Key Terms), and demonstrates intent to implement said intervention in the application project narrative, work plan, and evaluation plan

• Application includes a CHW training plan attachment.

IV. Application and Submission Information

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

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

https://www.grants.gov/web/grants/applicants/workspace-overview.html

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

Eastern Time.

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

• All applicants must have a UEI and be registered with the System for Award Management (SAM, www.sam.gov) and maintain an active SAM registration until the application process is complete, and should a grant be made, throughout the life of the award. Effective June 11, 2018, when registering or renewing your registration, you must submit a notarized letter appointing the authorized Entity Administrator. Please be sure to read the FAQs located at www.sam.gov to learn more. Applicants should allot sufficient time prior to the application deadline to finalize a new, or renew an existing registration.

This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award. Maintain documentation (with dates) of your efforts to register or renew at least two weeks before the deadline. See the SAM Quick Guide for Grantees at:

SAM.GOV Quick Start Guide for Financial Assistance Registrations.

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

https://www.grants.gov/ https://www.acl.gov/grants/applying-grants http://www.grants.gov/ https://www.grants.gov/web/grants/applicants/workspace-overview.html https://www.grants.gov/ mailto:support@grants.gov https://www.grants.gov/ http://www.sam.gov/ https://www.fsd.gov/sys_attachment.do?sys_id=54e0016fdb3bbd90a8cb4a3913961934

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

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

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

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

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

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

• The Federal Government will transition from the DUNS Number to the New Unique Entity Identifier. As of April of 2022, the federal government stopped using the DUNS number to uniquely identify entities. At that point, entities doing business with the federal government will use a Unique Entity Identifier (SAM) created in SAM.gov. It is entered on the SF-424.