Foa_Content_of_HHS-2025-ACL-AOA-CSSG-0010.pdf

Administration for Community Living

Administration on Aging

Advancing Strategies to Deliver and Sustain Evidence-Based Chronic Disease Self-Management Education Programs to Support Older Adult Behavioral Health

HHS-2025-ACL-AOA-CSSG-0010

02/19/2025

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

I. Funding Opportunity Description

Background

Purpose

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

Project Abstract

Project Relevance and Current Need

Approach

Outcomes and Evaluation

Organizational Capacity

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

Appendix A: Glossary of Terms

Appendix B: Listing of Evidence-Based CDSME Programs

Appendix C: Listing of Self-Management Support Programs

Appendix D: Required Data Collection Forms

Appendix E: Guidance for Administration for Community Living Chronic Disease Self- Management Education Grant Applicants: Considerations for Estimating Participation and Completion Targets

Appendix F: Resources for Competitive Grant Application Writing

ACL Center:

Administration on Aging Funding Opportunity Title:

Advancing Strategies to Deliver and Sustain Evidence-Based Chronic Disease Self-Management Education Programs to Support Older Adult Behavioral Health Funding Opportunity Number:

HHS-2025-ACL-AOA-CSSG-0010

Primary CFDA Number:

93.734 Due Date for Letter of Intent:

01/09/2025 Due Date for Applications:

02/19/2025 Date for Informational Conference Call:

12/19/2024 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

Additional Overview Content/Executive Summary The mission of the Administration for Community Living (ACL) is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers.

This funding opportunity is designed for applicants to propose how they will develop capacity for, deliver, and sustain evidence-based chronic disease self-management education (CDSME) and support programs to improve the behavioral health of older adults and adults with disabilities through a statewide initiative.

In alignment with language stated in the Final Rule to Update Older Americans Act Regulations released February 2024 to reach those of greatest economic and social need, the applicant’s targeted population for recruitment should reflect state demographics including recruitment of minority populations. This recruitment should include American Indian/Alaska Native/Native Hawaiian individuals of which nearly 70% of Native Americans live off-reservation in cities and towns across the United States. [1] Regardless of whether they are part of a federally recognized tribe, state recognized tribe, or are living in urban communities, Native American elders are geographically located in the state and shall be reflected in target reach and included in the statewide strategy.

The target population is older adults (age 60 and older) and individuals with disabilities with one or more behavioral health conditions and older adults (age 60 and older) and individuals with disabilities with one or more stressors that are negatively impacting their behavioral health. This funding opportunity has three outcomes:

• Increase the number of individuals who participate in evidence-based CDSME programs, while reaching the grant’s target population.

• Increase partnerships and collaboration between the Aging and Disability Services Network, behavioral health providers, and other key organizations.

• Increase the knowledge of the field by developing and disseminating resources and learnings from your grant for other organizations to replicate similar projects in their communities.

The Administration on Aging (AoA), part of ACL, plans to award five cooperative agreements with a three-year (36-month) project period, subject to the availability of funds. To help ensure a wider geographic reach, it is unlikely that more than one applicant per state will be funded.

Applicants must request a total budget between $1,100,000 to $1,250,000 in federal funds for the three-year project. All awards are subject to the availability of federal funds.

The awards will be made in the form of Cooperative Agreements to allow for substantial collaboration and involvement with ACL and the National Chronic Disease Self-Management Education Resource Center throughout the project period. These Cooperative Agreements have an anticipated start date of July 1, 2025.

https://www.grants.gov/ https://acl.gov/OAArule

I. Funding Opportunity Description

Background Chronic Disease and Behavioral Health Conditions Among Older Adults

Chronic conditions, such as hypertension, diabetes, and arthritis, are prevalent among older adults. Approximately 95% of older adults have at least one chronic condition, and nearly 80% have two or more. [2] Behavioral health is the promotion of mental health and well-being, the treatment of mental and substance use disorders, and the support of those who experience and/or are in recovery from these conditions. As of 2022, an estimated 9.8 million older adults (12.5%) had a mental illness in the past year, and there were 7.1 million older adults (9.1%) who had a substance use disorder (SUD) in the past year. [3] Behavioral health conditions among older adults are often underrecognized and undertreated. [4] In addition to those who have been diagnosed with a behavioral health condition, research shows that stressful life events, such as the loss of a spouse, major illness, and loss of independence, are linked to the onset of depression. [5] In the United States, 90% of adults have been exposed to at least one traumatic event, and exposure to multiple traumatic events is common. As trauma survivors age, their trauma symptoms may resurface and evolve as they face stressful life events. [6]

The behavioral health crisis was exacerbated by the COVID-19 pandemic. Since March 2020:

• Nearly one in five older adults have reported worse sleep, worse depression, or sadness,

• Nearly 30% have reported worse anxiety or worry, and

• More than six in ten have reported experiencing social isolation. [7][8]

Many older adults have co-occurring chronic conditions and behavioral health conditions.

Research shows us:

• People who have a chronic condition are at a higher risk of developing depression due to anxiety, stress, or other challenges caused by the condition, brain changes, and medications.

• Individuals who have a chronic disease and depression tend to have more severe symptoms of both illnesses.

• People who have depression are at a higher risk for developing some chronic diseases like heart disease, diabetes, stroke, and osteoporosis. [9]

• As adults age, they often experience heightened sensitivity to substances, which can result in injury, complicate existing medical conditions, or interact with medications. [10]

Coping with multiple chronic diseases and worsening behavioral health conditions is a considerable challenge for older adults, their caregivers, and their families. Efforts to address chronic conditions and behavioral health are more impactful when they include the community and are part of coordinated strategies across multiple sectors that include public health, healthcare, behavioral health, and other critical stakeholders. By addressing both chronic conditions and behavioral health, we can better meet the needs of the whole person.

Chronic Disease and Behavioral Health Conditions Disparities

Racial/ethnic disparities exist in the burden of chronic disease and behavioral health conditions.

Underserved populations and communities, such as adults with disabilities, those living in rural areas, communities of color, Native American communities, members of the LGBTQ+ communities, and those adversely affected by persistent poverty, experience greater burden. The burden and management of chronic diseases among those underserved are further exacerbated by the social determinants of health (SDOH) such as their physical environment, history of trauma, economic status, access to healthcare and health-related resources, among other factors. [11] [12] Due to factors such as intergenerational trauma, discrimination, and barriers to services, American Indian and Alaska Native individuals experience disproportionately high rates of behavioral health conditions and psychiatric diagnoses such as post-traumatic stress disorder (PTSD), substance use disorder, and suicide compared to other racial and ethnic groups. [13] Older people from communities of color have also faced challenges due to racism, which has led to psychological distress and potential mistrust of health care providers. [14]

Increasing Participation in Evidence-Based Community Programs to Mitigate the Chronic Disease and Behavioral Health Burden

Empowering older adults to engage in evidence-based chronic disease self-management education (CDSME) programs to better manage their conditions can help mitigate the chronic disease and behavioral health burden. The acronym, CDSME, is used in this announcement as an umbrella term for community-based education programs specifically designed to enhance self-management of chronic diseases. These programs focus on building multiple health behaviors and generalizable skills – such as goal setting, decision-making, problem-solving, and self-monitoring – and are proven to maintain or improve health outcomes of older adults with chronic conditions. Similarly, a self-management support program is a community-based, behavioral change intervention that is proven to increase skills or behaviors relevant to chronic disease self-management, such as physical activity or medication management. [15]

Evidence-based CDSME programs supported by the Administration for Community Living have been proven to improve health and well-being and reduce disease and injury. CDSME program participants experience improved health literacy, better psychological well-being, better health-related quality of life, improved physical activity, and reduced loneliness, social role limitations, and health distress. [16] [17] [18] Research has shown that CDSME programs are also associated with long-term improvements in depression. [19] Additionally, evidence-based programs such as Healthy IDEAS (Identifying Depression & Empowering Activities for Seniors) and PEARLS (Program to Encourage Active, Rewarding Lives) (see Appendix C for more information) are designed to combat depression among older adults.

Purpose This section provides details about the Target Population and Goals.

The purpose of this funding opportunity is to develop and implement multi-faceted strategies that support the delivery and sustainability of evidence-based chronic disease self-management education (CDSME) programs for older adults (age 60 and older) and individuals with disabilities with one or more behavioral health conditions and older adults and individuals with disabilities with one or more stressors that are negatively impacting their behavioral health through a statewide initiative.

Outcomes will include:

https://acl.gov/programs/health-wellness/disease-prevention

• Increase the number of individuals who participate in evidence-based CDSME programs, while reaching the grant’s target population.

• Increase partnerships and collaboration between the Aging and Disability Services Network, behavioral health providers, and other key organizations.

• Increase the knowledge of the field by developing and disseminating resources and learnings from your grant for other organizations to replicate similar projects in their communities.

Target Population

For this project, the target population is:

• Older adults (60 years and older) and individuals with disabilities who have one or more behavioral health conditions, such as:

o Depression o Anxiety disorders o Bipolar disorder o PTSD o Substance use disorder

• Older adults (60 years and older) and individuals with disabilities who have one or more stressors that are negatively impacting their behavioral health. Stressors are defined in this Notice of Funding Opportunity (NOFO) as:

o Experiencing a traumatic event o New diagnosis of a chronic condition or disability o Being a caregiver o A change in finances or work status o Loss of a loved one, including through divorce o Sudden change in housing status (i.e., homelessness)

As noted above, minority populations and American Indian/Alaska Native (AI/AN) populations are at increased risk of behavioral health conditions and behavioral health stressors. Due to that evidence and in alignment with language stated in the Final Rule to Update Older Americans Act Regulations (released February 2024), which highlights the importance of Older Americans Act programs reaching those of greatest economic and social need and to improve the health of racial and ethnic minority groups and American Indian/Alaska Native (AI/AN) populations, applicants shall ensure targeted population for recruitment and reach reflect state demographics including recruitment of minority populations and American Indians/Alaska Natives/Native Hawaiians.

Please note, nearly 70% of American Indians/Alaska Natives/Native Hawaiians live off-reservation in cities and towns across the United States. These individuals are not eligible for services under Title VI programs.

The majority focus of your grant should be older adults 60 and older, but projects may serve some individuals under 60 with disabilities.

Throughout the rest of the announcement, the term “target population” will be used to refer to these two groups, and applicants should reflect a statewide strategy to engage minority groups and American Indian/Alaska Native/Native Hawaiian individuals.

Goals

This funding opportunity has two goals:

• Goal 1: Through a statewide initiative, develop capacity (e.g., instructors, partnerships, and referral networks) to increase the number of older adults and adults with disabilities in the target population who participate in evidence-based chronic disease self-management education (CDSME) and support programs.

• Goal 2: Develop and disseminate 508-compliant resources specific to your grant learnings to enhance knowledge in serving the target population and aid in the sustainability of programs.

To be considered for funding, the application must include the following components in the proposal to accomplish the goals of this funding opportunity.

1. Applicants for this funding opportunity must propose to deliver one or more CDSME programs in Appendix B AND at least one self-management program in Appendix C.

Explain how the programs selected will help improve the behavioral health of the target population. The programs proposed MUST be on the list of pre-approved interventions found in Appendices B and C of this funding opportunity. Please refer to Appendix A (Glossary of Terms) for definitions of CDSME and self-management support programs.

o Applicants are expected to begin delivering their proposed CDSME and self-management support programs within three to six months after receiving their Notice of Award, should they be funded.

o Applicants may propose to implement one or more of the identified programs in a remote format, i.e., by video conference, phone, mailed toolkit + phone, or some other format. Applicants should contact the program developer/administrator for any program(s) they are interested in delivering remotely to confirm that: 1) the programs are allowed for remote delivery; and 2) training is readily available for applicants who need it.

o All applicants who do not have adequate existing capacity (i.e., trained leaders, licensing, etc.) for any in-person and/or remote program(s) they are proposing must include a letter from the program developer/administrator in their application indicating that they will be able to get training in the programs no later than three months after the start date of the grant (if selected for funding).

Information about each program can be found in Appendices B and C.

2. Applicants must identify the total target number of older adults and adults with disabilities throughout the state that they will reach with this funding, define which behavioral health condition(s) and behavioral health stressor(s) listed above will be prioritized, and clearly propose how 50% of the program's total participant target will be from the target population.

3. Applicants must show a statewide approach to reach the target population noted above, that is inclusive of minority populations and American Indian/Alaska Native/Native Hawaiian elders. If partnering with state or federally recognized tribes or tribal consortiums, applicants must also establish a collaborative agreement with tribal health leaders from those tribes or tribal consortiums to offer evidence-based CDSME programs to American Indian/Alaska Native/Hawaiian Native elders.

4. The proposed project must include partnerships across the state to support this application. At a minimum two or more of those partnerships must specialize in serving older adults with behavioral health conditions and other key organizations.

5. Delivery of evidence-based CDSME and support programs needs to be person-centered, trauma-informed, and culturally appropriate. To accomplish this, the awarded organization will provide training on these topics for grant staff and program leaders.

6. Recruitment of participants for the evidence-based CDSME programs must include those older adults in greatest economic and social need consistent with the language stated in the Final Rule to Update Older Americans Act Regulations released in February 2024.

For more details, see the Glossary in Appendix A.

7. All proposed activity funded by the Administration for Community Living, or “federal financial assistance” as it is referred to, must abide by the Final Rule Implementing Section 504 of the Rehabilitation Act of 1973. The Rule defines new compliance requirements of recipients of federal funding of the Administration for Community Living that services must be provided in the most integrated setting appropriate to meet the needs of individuals with disabilities.

• To help regulated entities and community members understand the new final rule, the Office of Civil Rights (OCR), as the agency charged with implementing and enforcing Section 504, has published a fact sheet providing a summary overview of the rule’s provisions. The Section 504 of the Rehabilitation Act of 1973 Final Rule: Section by Section Fact Sheet for Recipients of Financial Assistance from HHS can be found on the OCR website.

References

[1] Urban Indian Health Commission. (2015, October 13). Invisible Tribes: Urban Indians and Their Health in a Changing World. Urban Indian Health Commission.

www2.census.gov/cac/nac/meetings/2015-10-13/invisible-tribes.pdf

[2] National Council on Aging. (2024, August 16). Get the Facts on Healthy Aging. ncoa.org.

https://www.ncoa.org/article/get-the-facts-on-healthy-aging/

[3] Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report

[4] Mental Health America. (n.d.). Depression in Older Adults. Mental Health in Older Adults.

https://mhanational.org/depression-older-adults

[5] Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005;1:607-28. doi:

10.1146/annurev.clinpsy.1.102803.144141. PMID: 17716101; PMCID: PMC2568977.

https://acl.gov/OAArule https://acl.gov/504rule https://acl.gov/504rule https://www.hhs.gov/civil-rights/for-individuals/disability/section-504-rehabilitation-act-of-1973/ocr-detailed-504-fact-sheet https://www.hhs.gov/civil-rights/for-individuals/disability/section-504-rehabilitation-act-of-1973/ocr-detailed-504-fact-sheet https://www.hhs.gov/civil-rights/for-individuals/disability/section-504-rehabilitation-act-of-1973/ocr-detailed-504-fact-sheet https://www.ncoa.org/article/get-the-facts-on-healthy-aging/ https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report https://mhanational.org/depression-older-adults

[6] Center on Aging and Trauma. (n.d.). Aging and Trauma. The Jewish Federations of North America. https://cdn.fedweb.org/fed- 42/2/AgingAndTrauma_FactSheet_CenterOnAgingAndTrauma_2fdbr.pdf

[7] Gerlach L, Solway E, Singer D, Kullgren J, Kirch M, Malani P. Mental Health Among Older Adults Before and During the COVID-19 Pandemic. University of Michigan National Poll on Healthy Aging. May 2021. Available at: http://dx.doi.org/10.7302/983.

[8] NIHCM Foundation. Aging & COVID-19: Vaccination, Mental and Physical Health, and isolation. February 2021. https://nihcm.org/publications/aging-covid-19-vaccination-mental-and-physical-health-and-isolation

[9] National Institute of Mental Health. (2024). Understanding the Link Between Chronic Disease and Depression. National Institute of Mental Health.

https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health

[10] Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Treating Substance Use Disorder in Older Adults. SAMHSA.

https://store.samhsa.gov/sites/default/files/tip-26-pep20-02-01-011.pdf

[11] Boersma P, Black LI, Ward BW. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis 2020;17:200130. DOI: http://dx.doi.org/10.5888/pcd17.200130.

[12] Shaw KM, Theis KA, Self-Brown S, Roblin DW, Barker L. Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013. Prev Chronic Dis 2016;13:160088. DOI: http://dx.doi.org/10.5888/pcd13.160088.

[13] Kwon SC, Kabir R, Saadabadi A. Mental Health Challenges in Caring for American Indians and Alaska Natives. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL):

StatPearls Publishing; 2024 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK570587/

[14] Jimenez DE, Park M, Rosen D, Joo JH, Garza DM, Weinstein ER, Conner K, Silva C, Okereke O. Centering Culture in Mental Health: Differences in Diagnosis, Treatment, and Access to Care Among Older People of Color. Am J Geriatr Psychiatry. 2022 Nov;30(11):1234- 1251. doi: 10.1016/j.jagp.2022.07.001. Epub 2022 Jul 8. PMID: 35914985; PMCID:

PMC9799260.

[15] Brady, Teresa. “Strategies to Support Self-Management in Osteoarthritis.” AJN, American Journal of Nursing, vol. 112, no. 3, 2012, pp. 54–60., doi: 10.1097/01.naj.0000412653.56291.ab.

[16] Smith ML, Chen E, Lau C, Davis D, Simmons J, Merianos AL. Effectiveness of chronic disease self-management education (CDSME) programs to reduce loneliness. Chronic Illness.

2022. DOI: 10.1177/17423953221113604

[17] Kennedy A, Reeves D, Bower P, et al. The effectiveness and cost effectiveness of a national lay-led self-care support programme for patients with long-term conditions: a pragmatic randomised controlled trial. Journal of Epidemiology & Community Health 2007;61:254-261.

[18] Muscat DM, Song W, Cvejic E, Ting JHC, Medlin J, Nutbeam D. The impact of the chronic disease self-management program on health literacy: A pre-post study using a multi-dimensional health literacy instrument. Int J Environ Res Public Health. 2019 Dec 19;17(1):58. doi:

10.3390/ijerph17010058. PMID: 31861752; PMCID: PMC6982295.

https://cdn.fedweb.org/fed-42/2/AgingAndTrauma_FactSheet_CenterOnAgingAndTrauma_2fdbr.pdf https://cdn.fedweb.org/fed-42/2/AgingAndTrauma_FactSheet_CenterOnAgingAndTrauma_2fdbr.pdf http://dx.doi.org/10.7302/983 https://nihcm.org/publications/aging-covid-19-vaccination-mental-and-physical-health-and-isolation https://nihcm.org/publications/aging-covid-19-vaccination-mental-and-physical-health-and-isolation https://store.samhsa.gov/sites/default/files/tip-26-pep20-02-01-011.pdf http://dx.doi.org/10.5888/pcd17.200130 http://dx.doi.org/10.5888/pcd13.160088

[19] Ritter PL, Ory MG, Laurent DD, Lorig K. Effects of chronic disease self-management programs for participants with higher depression scores: secondary analyses of an on-line and a small-group program. Transl Behav Med. 2014 Dec;4(4):398-406. doi: 10.1007/s13142-014-

0277-9. PMID: 25584089; PMCID: PMC4286546.

Statutory Authority The statutory authority for grants under this Notice of Funding Opportunity is contained in the Older Americans Act, Title IV; and the Patient Protection and Affordable Care Act, 42 U.S.C. § 300u-11 (Prevention and Public Health Fund).

II. Award Information

Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$6,203,143 Expected Number of Awards:

Award Ceiling:

$1,250,000 Per Project Period

Award Floor:

$1,100,000 Per Project Period

Length of Project Period:

Other Additional Information on Project Periods and Explanation of 'Other' 36-month project and 36-month budget periods (fully funded)

Cooperative Agreement Terms This is a new Cooperative Agreement with the following terms. As provided by the terms of the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224), this Cooperative Agreement provides for the substantial involvement and collaboration of AoA in activities that the recipient organization will carry out in accordance with the provisions of the approved grant award.

The grantee agrees to execute the responsibilities outlined below:

1. Fulfill all requirements of the grant initiative as outlined in this program announcement, as well as carry out project activities as reviewed, approved, and awarded.

2. Through a statewide initiative, 1) commit to engaging partnerships to assist in the implementation of the proposal, with two or more organizations specializing in behavioral health 2) commit to establishing a statewide approach to reach those in greatest social and greatest economic need including minority groups and American

Indian/Alaska Native/Native Hawaiian elders and 3) serving older adults and adults with disabilities, prioritizing those with at least one behavioral health and at least one behavioral health stressor.

3. Reach 25% of your target completers (for CDSME programs), participants (for self-management support programs), and resources developed by the end of Year 1, 50% by the end of Year 2, and 100% by the end of Year 3.

4. Develop a strategy to ensure that 50% of the program's total participant target by the end of the project period will be from the target population (older adults and adults with disabilities with at least one behavioral health condition and older adults and adults with disabilities with at least one behavioral health stressor).

5. Commit to sending two project staff to the annual CDSME professional development conference hosted by the National CDSME Resource Center in the Washington, D.C.

area. Attendance is expected annually for the duration of your grant activities (including any no-cost extension period, if applicable). All applicants must include funds for each budget year for two people to attend this conference.

6. Provide person-centered, trauma-informed, and culturally appropriate training for all grant staff and program leaders.

7. Meet all training, licensing, fees, or other requirements associated with the selected CDSME and self-management support programs to ensure compliance with all the requirements stipulated by the program developer/administrator.

8. The grant Project Investigator/Director must attend all regularly scheduled calls and communicate with the AoA Project Officer monthly, or at such other times as agreed upon, to improve the effectiveness of the activities carried out under this Agreement.

9. Collect required program data for all program participants by way of ACL’s specific data collection forms (see Appendix D). Within 30 days of participants’ completion of the program, grantees are responsible for compiling and reporting the data to the CDSME National Database. Data include de-identified participant demographic and health status information, attendance information, and workshop type and location. Grantees should plan to train workshop leaders on data collection practices and the use of these forms.

10. Participate in any ACL/National CDSME Resource Center sponsored research and/or evaluations.

11. Participate in relevant ACL/National CDSME Resource Center education (e.g., webinars, workgroups, symposiums) provided that ACL/ National CDSME Resource Center provides reasonable notice of the subject, date, and time of the event.

12. Comply with all other reporting requirements, as outlined in Section VI (Award Administration Information) of this Funding Opportunity and the Notice of Award.

13. If sub-awarding, the applicant is expected to use a transparent and open process for soliciting, reviewing, selecting, and making required sub-awards to organizations.

Applicants should describe how the process will be designed and administered.

14. Include the following disclaimers on all products produced using this grant funding:

HHS Grant or Cooperative Agreement that is NOT funded with other non-governmental sources:

"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 100 percent funding by ACL/HHS. 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.”

The HHS Grant or Cooperative Agreement that IS partially funded with other nongovernmental sources:

"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.”

The AoA Project Officer agrees to execute the responsibilities outlined below:

1. Perform the day-to-day Federal responsibilities of managing a Cooperative Agreement and work with the grantee to ensure that the minimum requirements for the grant are met.

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

3. Assist the grantee project leadership in understanding the strategic goals and objectives, policy perspectives, and priorities of AoA, ACL, and the U.S. Department of Health and Human Services; and about other federally-sponsored projects and activities relevant to activities funded under this announcement.

4. In collaboration with the National Chronic Disease Self-Management Education Resource Center, provide technical advice to the grantee on the provision of technical support and associated tasks related to the fulfillment of the goals and objectives of this grant.

5. Attend and participate in major project events, as appropriate.

6. Communicate with the grantee project director monthly, or at such other times as are agreed upon, to improve the effectiveness of the activities carried out under this Agreement.

Once a Cooperative Agreement is in place, requests to modify or amend the Agreement or the work plan may be made by ACL or the awardee at any time as long as the request stays within the scope of work. Major changes may affect the integrity of the competitive review process. Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the execution of an award notice. Unless ACL is authorized under the Terms and Conditions of award, 45 CFR Part 75, or other applicable regulation or statute to make unilateral amendments. When an award is issued, the Cooperative Agreement terms and conditions from the program announcement are incorporated 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 https://www.ncoa.org/professionals/health/center-for-healthy-aging/national-cdsme-resource-center/ https://www.ncoa.org/professionals/health/center-for-healthy-aging/national-cdsme-resource-center/ 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.

Domestic public or private non-profit entities including state governments, county governments, city or township governments, special district governments, independent school districts, public and state controlled institutions of higher education, Native American tribal governments, public housing authorities/Indian housing authorities, Native American tribal organizations, nonprofits having a 501(c)(3) status, private institutions of higher education, faith-based organizations, and community-based organizations.

2. Cost Sharing or Matching Cost Sharing / Matching Requirement:

No 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.

3. Responsiveness and Screening Criteria Application Responsiveness Criteria Not Applicable

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

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

• Applications must be submitted electronically via https://www.grants.gov by 11:59 p.m., Eastern Time, by the due date listed in section IV under 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 all sides, and a standard font size of no less than 11 point, preferably Times New Roman or Arial.

http://www.grants.gov/

• The Project Narrative must not exceed twenty (20) pages. NOTE: The Project Work Plans, Letters of Support/Commitment, Project Map, Organizational Chart, Budget Narrative/Justifications and Vitae of Key Project Personnel are not counted as part of the Project Narrative for purposes of the 20-page limit.

• Applications must include a proposed Budget Narrative/Justification for years 1, 2, and 3, as well as a combined Budget Narrative/Justification for the proposed 36-month budget period. The proposed combined Budget Narrative/Justification must not exceed the total federal 3- year award ceiling of $1,250,000.

• Applications must include a Project Work Plan for years 1, 2, and 3. Project Work Plans must be consistent with the proposed Project Narrative and Budget Narrative/ Justifications.

• You can use smaller font sizes to fill in the Standard Forms and Sample Formats outside of the Project Narrative section, such as the Project Work Plans and Budget Narrative/Justifications.

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 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/ 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.

1.

• 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:

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

3. 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

4. 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. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities.

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

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

• After you electronically submit your application, you will receive an automatic acknowledgment from https://www.grants.gov that contains https://www.fsd.gov/sys_attachment.do?sys_id=54e0016fdb3bbd90a8cb4a3913961934 https://www.grants.gov https://www.grants.gov tracking number. The Administration for Community Living will retrieve your application form from https://www.grants.gov.

Contact person regarding this Program Announcement:

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

Laura Plunkett

Email: Laura.Plunkett@acl.hhs.gov

Administration on Aging

Office of Nutrition and Health Promotion Programs

2. Content and Form of Application Submission

Letter of Intent Due Date for Letter Of Intent 01/09/2025

01/09/2025 Applicants are requested, but not required, to submit a letter of intent to apply for this funding opportunity to assist ACL in planning for the application independent review process. The purpose of the letter of intent is to allow our staff to estimate the number of independent reviewers needed and to avoid potential conflicts of interest in the review. Letters of intent should be sent to:

U.S. Department of Health and Human Services

Administration for Community Living

Laura Plunkett

Administration on Aging

Office of Nutrition and Health Promotion Programs

Email Address:

Laura.Plunkett@acl.hhs.gov

Project Narrative The Project Narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins on all sides, and a standard font size of no less than 11, Times New Roman or Arial. The entirety of the Project Narrative, including tables, graphics, and headings must be double- spaced. You can use smaller font sizes to fill in the Standard Forms and Sample Formats outside of the Project Narrative section, such as the Project Work Plans and Budget Narrative/Justifications. Twenty

(20) pages is the maximum length allowed.

NOTE: The Project Work Plans, Letters of Support/Commitment, Vitae of Key Project Personnel, Project Map, Organizational Chart, and Budget Narrative/Justifications are not counted as part of the Project Narrative for purposes of the 20-page limit.

mailto:Laura.Plunkett@acl.hhs.gov mailto:Laura.Plunkett@acl.hhs.gov

Applicants must document all source materials. If any text, language, and/or materials are from another source, the applicant must make it clear the material is being quoted and where the text comes from. The applicant must also cite any sources when they include numbers, ideas, or other material that are not their own.

The Project Narrative is the most important part of the application since it will be used as the primary basis to determine whether your project meets the minimum requirements for grants under the authorizing statutes. The Project Narrative should provide a clear and concise description of your project. See Appendix F for resources on writing a grant application.

Your Project Narrative must include the following components and be clearly labeled:

• Project Abstract

• Project Relevance and Current Need

• Approach

• Outcomes and Evaluation

• Organizational Capacity

To assist reviewers in scoring your application, applicants are required to organize their proposals using the headings above.

Project Abstract This section should include a brief description (no more than 265 words) of the proposed project.

Detailed instructions for completing the summary/abstract are included in the “Instructions for Completing the Project Summary/Abstract.”

In your abstract, clearly specify:

1. The objectives and outcomes of the proposed project;

2. One or more proposed evidence-based CDSME program(s) and at least one self-management support program you plan to implement/disseminate, with reasoning for why you selected the program and how it will positively impact the behavioral health of the target population:

o Programs proposed MUST be on the list of pre-approved interventions found in Appendices B and C of this funding opportunity.

o Applicants may propose to implement one or more of the identified programs in a remote format.

o Applicants are expected to begin delivering their proposed CDSME and self-management support programs within three to six months after receiving their Notice of Award.

3. Projected number of program completers (CDSME programs) and participants (self-management support program[s]) for your proposed programs (reference Appendix E) broken down by program and grant year;

4. Number of key partners, clearly identifying which partnerships are across the state and a minimum of two or more of those partnerships who specialize in serving older adults with behavioral health conditions and other key organizations (as described in the Approach, Capacity Building and Program Implementation section);

5. A statewide strategy that reaches the target population, clearly defining which behavioral health condition(s) and behavioral health stressor(s) of special interest to ACL will be prioritized. Affirmation that the targeted project geographic area is statewide.

Project Relevance and Current Need This section should describe, in both quantitative and qualitative terms, the nature and scope of the problem or issue the proposed project is designed to address.

In this section:

1. Briefly describe and cite (using reliable and relevant data sources) the impact of chronic conditions and behavioral health conditions in your state among older adults and adults with disabilities, especially from the target population (older adults and adults with disabilities with at least one behavioral health condition and with at least one behavioral health stressor being inclusive of minority groups and American Indian/Alaska Native/Native Hawaiian elders), and how your proposed evidence-based CDSME programs will address this impact.

2. Describe the gap that exists in the availability of your proposed CDSME and self-management programs across the state. This should include the extent to which a network exists, or doesn’t exist, for systematically delivering and sustaining CDSME and self-management support programs across the state. This should include the current delivery status of CDSME and self-management support programs by your organization or other organizations across the state, and program sustainability efforts.

3. Describe why your organization is well-positioned to fill the existing gap. Include your experience partnering with behavioral health organizations, experience reaching individuals in the target population, and experience working with other key organizations (including those serving minority groups and American Indian/Alaska Native/Native Hawaiian elders).

4. Include a Project Map of your state that shows where your proposed programs are already being offered (if applicable), and where programming will be offered for this grant.