Foa_Content_of_HHS-2025-ACL-AOA-FPSG-0037.pdf

Administration for Community Living

Administration on Aging

Expanding Strategies for Community Evidence-Based Falls Prevention Programming

HHS-2025-ACL-AOA-FPSG-0037

08/15/2025

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

I. Funding Opportunity Description

Background

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 Support/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: List of Evidence-Based Falls Prevention Programs

APPENDIX B: Glossary of Terms

APPENDIX C: Required Data Collection Forms

APPENDIX D: Guidance for Administration for Community Living Evidence-based Falls Prevention Program Grant Applicants: Considerations for Estimating Program Participation Targets

APPENDIX E: Resources for Competitive Grant Application Writing

APPENDIX F: Examples of Person-Centered approaches

ACL Center:

Administration on Aging Funding Opportunity Title:

Expanding Strategies for Community Evidence-Based Falls Prevention Programming Funding Opportunity Number:

HHS-2025-ACL-AOA-FPSG-0037

Primary CFDA Number:

93.761 Due Date for Letter of Intent:

08/15/2025 Due Date for Applications:

08/15/2025 Date for Informational Conference Call:

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.

https://www.grants.gov/

Executive Summary

Additional Overview Content/Executive Summary The intent of this funding opportunity is to support specific targeted partnerships and innovative strategies to reduce falls and/or falls risk among older adults (60 years and older) in greatest economic need and greatest social need (consistent with the Older Americans Act), and adults with disabilities using a person-centered approach. Awardees will implement evidence-based falls prevention programs with a person-centered approach, measure outcomes and evaluate the impact, create resources and share lessons learned for others to replicate the successful service delivery model statewide.

The benefit of this funding opportunity for older adults is to reduce falls and fall risk and increase their independence using innovative person-centered approaches. The primary outcome of this funding opportunity is to increase knowledge in the aging field of how successful partnerships and innovative person-centered approaches to delivering evidence-based falls prevention programs can be replicated statewide. Awardees will develop and disseminate resources and learnings for the aging field based on project outcome(s).

With this funding opportunity, the ACL plans to award two cooperative agreements to domestic public or private non-profit entities. A cooperative agreement allows for substantial collaboration and involvement with ACL and the National Falls Prevention Resource Center throughout the project period. This cooperative agreement has an anticipated start date of September 1, 2025.

An applicant must request a total budget of $1,250,000 in federal funds for the three-year project.

All awards are subject to availability of federal funds.

I. Funding Opportunity Description

Background The Older American Act (OAA)

The Older American Act (OAA) is carried out by the aging network in communities across the United States. The aging network includes State Units on Aging (SUAs), Area Agencies on Aging (AAAs), and local service providers (LSPs). This network provides services, referrals, and programs to older adults. The OAA focuses on older adults and family caregivers in the greatest economic need and greatest social need, consistent with the Older Americans Act. The OAA encourages providing regular physical activity, evidence-based health promotion and disease prevention programs, and nutrition services with a person-centered, trauma-informed approach to meet the needs of the target population.

Facts about Falls

Falls are the leading cause of fatal and nonfatal injuries among older adults [1] and have widespread and serious health impacts. One in four older adults report falling each year [2].

Older adults who fall have an increased risk for injury and reduced physical function which may significantly reduce their ability to remain independent. In 2021, for adults aged 65 and older, falls caused over 38,000 deaths, making it the leading cause of injury death for that group. Emergency departments recorded nearly 3 million visits for older adult falls in 2021.[3] In 2015, healthcare spending for older adult falls was $50 billion, and by 2020 rose to $80 billion. [4].

Risk Factors

Falls are preventable. Risk factors that can be changed or controlled include impaired balance, muscle weakness, gait deficits, medications, home hazards, vision problems, and improper footwear [5]. Fall risk can be addressed through risk assessment and targeted intervention. [6] Clinical and community-based program interventions include home modification, exercise, strength and balance training, and education on how to prevent falls.

Participants in evidence-based community falls prevention programs (EBFPP) have improved confidence, decreased fear of falling, and fewer falls and injurious falls [7].

History of ACL Falls Prevention Program

The AoA has built an infrastructure to increase access to and sustain evidence-based disease prevention and health promotion programs, including falls prevention programs. Between 2014 and 2024, AoA awarded 103 discretionary grants to states, community-based organizations, and tribal organizations to deliver evidence-based falls prevention programs (EBFPPs) to over 247,000 individuals. For more information about the Falls Prevention Program, including grantee profiles, visit: https://www.acl.gov/programs/health-wellness/falls-prevention.

The AoA encourages, leverages, and complements other national efforts to reduce falls and falls risk for older adults, such as :

• The Centers for Disease Control and Prevention (CDC) and AoA support opportunities to broaden and improve the linkage between primary care providers and community EBFPPs. Related resources include:

o CDC STEADI Initiative o Older Adult Fall Prevention o CDC Compendium of Effective Fall Interventions: What Works for Community-

Dwelling Older Adults o Still Going Strong Campaign

Evidence-Based Approved Interventions

EBFPPs have direct benefits for hundreds of thousands of older adults to address fall-related risk. When properly implemented, EBFPP participant outcomes include fewer falls, reduced fear of falling, lower health care costs, and improved balance, strength, and self-rated health.

The AoA-funded National Falls Prevention Resource Center recently reported EBFPP participant outcomes that included a 30% reduction in total number of falls, and 87% reduced fear of falling.

EBFPPs also have indirect benefits for older adults. Small-group, in-person EBFPP workshops increase social support and promote social connection. Participants interact and bond over a shared purpose and engage with peers and trained lay leaders for weeks at a time.

While EBFPPs reduce fall risk, a more person-centered approach with coordinated care through community and clinical partnerships could further reduce fall risk and improve outcomes for older adults.

https://www.acl.gov/programs/health-wellness/falls-prevention https://www.acl.gov/programs/health-wellness/falls-prevention http://www.cdc.gov/steadi/index.html https://www.cdc.gov/falls/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhomeandrecreationalsafety%2Ffalls%2Findex.html https://www.cdc.gov/falls/interventions/falls-compendium.html https://www.cdc.gov/falls/interventions/falls-compendium.html https://www.cdc.gov/still-going-strong/about/index.html

Person-Centered Approach

Person-centered care allows older adults to make informed decisions about services and supports that could reduce their fall risk, increase health, and preserve their independence.[8] Guided and informed by the older adult’s goals, preferences, culture, and values, it is a personalized and coordinated approachthat treats older adults asindividuals. Everyone should be listened to and treated with respect and empathy. A person-centered approach empowers the individual, informs them of available supports and involves them in health decisions. An older adult shares their personal goals and agrees how to achieve them. [9]

Falls have many causes. A person-centered approach sees that each older adult may have a different set of fall risk factors and ways to meet their unique needs. A person may need or want to choose one or more professional, program, service, and/or intervention to support them. [9]

For this person-centered approach to succeed, organizations may need to develop partnerships across the community and acquire new skills, such as active listening and motivational interviewing.

Purpose

The intent of this Notice of Funding Opportunity (NOFO) is to support specific targeted partnerships and innovative strategies to reduce falls and/or falls risk among older adults (60 years and older) in greatest economic need and greatest social need (consistent with the OAA), and adults with disabilities using a person-centered approach. Awardees will implement evidence-based falls prevention programs (EBFPP) with a person-centered approach, measure outcomes and evaluate the impact, create resources and share lessons learned for others to replicate the successful service delivery model statewide.

This funding opportunity has two goals:

Goal 1: Develop an innovative falls prevention method that includes:

Key Deliverables for Goal 1:

• Targeted partnerships and outreach to recruit the target population into small group in-person EBFPPs.

• Community partnerships that support referral to and implementation of selected EBFPPs, along with a plan to develop further, unique partnerships as the project progresses to meet individual needs of participants.

• Delivery of two or more small-group, in-person EBFPPs. At least one program must also be offered in a remote format, e.g., by video conference or similar virtual modality.

i. These programs must be on the list of pre-approved EBFPPs found in Appendix A.

ii. EBFPP delivery will be person-centered, trauma informed and culturally appropriate. Training on these topics may be required for staff and program leaders.

• Formalized person-centered approach where participants take an active role and are involved in decisions for their continued health, well-being, and independence. (See Appendix F for examples of what this could look like.)

Goal 2: Evaluate the intervention to assess its impact on reducing falls and/or the risk of falls, and develop and disseminate Section 508-compliant program results and resources.

Key Deliverables for Goal 2:

• Create resources based on outcomes for statewide use and applicability. To include lessons learned (i.e., successes and challenges) process documents, and best practices that can assist others in replicating service delivery, program development and /or policy making to foster innovation and accelerate future implementation.

• Design an assessment using at least three (3) questions that focus on goal identification, goal follow-up, and goal achievement, to determine whether person-centered supports added beyond the EBFPP lowers the risk of falls and increases older adults’ independence.

• Develop Section 508-compliant resources to disseminate project results and lessons learned to inform practice, service delivery, program development and policy making for organizations statewide, as described above, to replicate the service delivery model.

• Create a complete list of partnerships and prepare a report for the agency evaluating partnerships effectiveness.

REFERENCES

1. WISQARS. Web-based Injury Statistics Query and Reporting System (WISQARS).

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention 2021 [cited 2021 June]; Accessed October 11, 2024, from:

www.cdc.gov/injury/wisqars

2. Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged ≥65 Years— United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:993–998.

Accessed October 11, 2024, from:

https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm?s_cid=mm6537a2_w

3. Centers for Disease Control and Prevention. (2024) About Older Adult Fall Prevention.

Accessed October 11, 2024, from https://www.cdc.gov/falls/about/index.html

4. Haddad Y, Miller G, Kakara R, Florence C, Bergen G, Burns E R, Atherly A, Healthcare Spending for non-fatal falls among older adults, USA, 2024 July, Accessed October 11, 2024 from Healthcare spending for non-fatal falls among older adults, USA | Injury Prevention (bmj.com)

5. Bergen G. Stevens MA. Kakara R. Burns EA. Understanding Modifiable and Unmodifiable Older Adult Fall Risk Factors to Create Effective Prevention Strategies.

American Journal of Lifestyle Medicine. October 2019, Accessed October 11, 2024 form DOI:10.1177/1559827619880529Gillespie LD, Robertson MC,

6. U.S. Centers for Disease Control and Prevention. (2015). Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults, accessed October 11, 2024 from:

https://www.cdc.gov/homeandrecreationalsafety/pdf/falls/cdc_falls_compendium-2015-a.pdf http://www.cdc.gov/injury/wisqars https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm?s_cid=mm6537a2_w https://www.cdc.gov/falls/about/index.html https://injuryprevention.bmj.com/content/30/4/272.info https://injuryprevention.bmj.com/content/30/4/272.info https://www.cdc.gov/falls/pdf/CDC_Falls_Compendium-2015-a.pdf https://www.cdc.gov/falls/pdf/CDC_Falls_Compendium-2015-a.pdf

7. Brach JS, Juarez G, Perera S, Cameron K, Vincenzo JL, Tripken J. Dissemination and Implementation of Evidence-Based Falls Prevention Programs: Reach and Effectiveness.

The Journals of Gerontology: Series A, Volume 77, Issue 1, January 2022, Pages 164– 171, Accessed October 11, 2024, from: https://doi.org/10.1093/gerona/glab197

8. Person-Centered Care, Centers for Medicare and Medicaid Services, Accessed October 12, 2024 from https://www.cms.gov/priorities/innovation/key-concepts/person-centered-care#:~:text=Person%2Dcentered%20care%20includes%3A,Managing%20chronic%20a nd%20complex%20conditions

9. Coulter A, Oldham J. Person-centered care: what is it and how do we get there? Future Hosp J. 2016 Jun;3(2):114-116. doi: 10.7861/futurehosp.3-2-114. PMID: 31098200;

PMCID: PMC6465833. Accessed October 12, 2024 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465833/

Statutory Authority The statutory authority for grants under this Notice of Funding Opportunity is contained in the Older Americans Act, Title IV; Section 411.

II. Award Information

Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$2,500,000 Expected Number of Awards:

Award Ceiling:

$1,250,000 Per Project Period

Award Floor:

$1,250,000 Per Project Period

Length of Project Period:

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

Cooperative Agreement 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 grant requirements outlined in this NOFO, as well as carry out project activities as reviewed, approved, and awarded.

https://doi.org/10.1093/gerona/glab197 https://www.cms.gov/priorities/innovation/key-concepts/person-centered-care#%3A~%3Atext%3DPerson%2Dcentered%20care%20includes%3A%2CManaging%20chronic%20and%20complex%20conditions https://www.cms.gov/priorities/innovation/key-concepts/person-centered-care#%3A~%3Atext%3DPerson%2Dcentered%20care%20includes%3A%2CManaging%20chronic%20and%20complex%20conditions https://www.cms.gov/priorities/innovation/key-concepts/person-centered-care#%3A~%3Atext%3DPerson%2Dcentered%20care%20includes%3A%2CManaging%20chronic%20and%20complex%20conditions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465833/

2. Engage approximately 25% of your target participants by the end of Year 1, 50% of target participants by the end of Year 2, and 100% of target participants by the end of Year 3.

3. Develop resources based on learnings throughout the grant with 25% developed by the end of Year 1, 50% by the end of Year 2, and 100% by the end of Year 3.

4. Commit to send two project staff to the annual falls prevention professional development conference hosted by the National Falls Prevention Resource Center. Attendance is expected annually for the project period (including any no-cost extension period, if applicable). Applicants must budget each year for two people to attend the conference in the Washington, D.C. area.

5. Have expertise in person-centered thinking, planning, and practice and its application to older adults and/or adults with disabilities and falls prevention programs or programs of similar scope.

6. Meet all training, licensing, fees, or other requirements associated with the selected falls prevention programs to comply with program developer/administrator requirements.

7. Project Investigator/Director must attend all regularly scheduled calls and communicate with the AoA Project Officer monthly (or another agreed time), to improve project effectiveness.

8. Collect required data for all program participants using ACL’s specific data collection forms (see Appendix C). Within 30 days of participants’ completion of the program, successful applicants must compile and report the data to the National Falls Prevention Database. Data include de-identified participant demographic and health status information, attendance information, and workshop type and location. Successful applicants should plan to train workshop leaders on data collection practices and use of these forms.

9. Participate in any ACL/National Falls Prevention Resource Center sponsored research and/or evaluations.

10. Participate in relevant ACL/National Falls Prevention Resource Center education (e.g., webinars, workgroups, etc.), with reasonable notice from ACL/National Falls Prevention Resource Center of the subject, date, and time of the event.

11. Comply with all other reporting requirements, as outlined in Section VI of this Funding Opportunity and the Notice of Award.

12. Include the following disclaimer on all products produced using this grant funding:

HHS 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 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 successful applicant to ensure that minimum grant requirements are met.

2. Work with the successful applicant to clarify program and budget issues and, as necessary, mutually agree upon how to solve or meet any needs identified by the grantee or ACL.

3. Help the successful applicant understand 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. With the National Falls Prevention Resource Center, provide technical assistance to you for program support and tasks related to fulfilling grant goals and objectives.

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

6. Communicate with the ACL project director monthly, or other agreed time, to improve project effectiveness.

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 if 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 Domestic public or private non-profit entities including state governments, Native American tribal organizations (other than Federally recognized tribal governments), public housing authorities/Indian housing authorities, special district governments, nonprofits having a 501(C)(3) status with the IRS other than institutions of higher education, city or township governments, public and state controlled institutes of higher education, independent school districts, private institutions of higher education, Native American tribal governments (Federally recognized), nonprofits that do not have a 501(c)(3) status with the IRS other than institutions of higher education, county governments, faith based organizations, and community organizations.

https://www.ncoa.org/professionals/health/center-for-healthy-aging/national-falls-prevention-resource-center/

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:

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

2. The Project Narrative section of the Application must be double-spaced, on 8.5” x 11” plain white paper with 1" margins on all sides, and a standard font size of no less than 11 point, Times New Roman or Arial.

3. The Project Narrative (defined below) must not exceed 20 pages. NOTE: The Project Work Plan, Letters of Support/Commitment, Project Map, Organizational Chart, Budget Narrative/Justification, Vitae of Key Project Personnel, and reference list are not counted as part of the Project Narrative for purposes of the 20-page limit.

4. Applications must include a Budget Narrative/Justification for years 1, 2, and 3 along with a combined Budget Narrative/Justification for the proposed 36-month budget period.

The proposed combined Budget Narrative/Justification for federal funds listed in the budget must not exceed the total federal 3-year award ceiling of $1,250,000.

5. 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.

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

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

IV. Application and Submission Information

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

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

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

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

Eastern Time.

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

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

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

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.

• 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 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

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

• You must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications. In accordance with the Federal Government’s efforts to reduce reporting burden for recipients of federal financial assistance, the general certification and representation requirements contained in the Standard Form 424B (SF-424B) – Assurances – Non-Construction Programs, and the Standard Form 424D (SF-424D) – Assurances – Construction Programs, have been standardized federal-wide. Effective January 1, 2020, the updated common certification and representation requirements will be stored and maintained within SAM.

Organizations or individuals applying for federal financial assistance as of January 1, 2020, must validate the federally required common certifications and representations annually through SAM located at SAM.gov.

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

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

Kari Benson

AOA.OAA@acl.hhs.gov

2. Content and Form of Application Submission

Letter of Intent Number of Days from Publication 18

08/15/2025 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

Administration on Aging https://www.grants.gov https://www.grants.gov https://www.grants.gov mailto:AOA.OAA@acl.hhs.gov

Kari Benson

Email: AOA.OAA@acl.hhs.gov

Project Narrative The Project Narrative must be double-spaced, on 8.5” x 11” paper with 1” margins on all sides, and a standard font size of no less than 11 point, Times New Roman or Arial. The entire Project Narrative, including tables, graphics, and headings must be double-spaced. You can use smaller font sizes to complete 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.

The Project Work Plan, Letters of Support/Commitment, Vitae of Key Personnel, Project Map, Organizational Chart, Budget Narrative/Justification, and reference list are not counted as part of the Project Narrative for purposes of the 20-page limit.

Applicants must document all source material. 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 E for resources on writing a grant application.

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

1. Project Abstract

2. Project Relevance and Current Need

3. Approach

4. Outcomes and Evaluation

5. Organizational Capacity

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

Project Abstract This section should include a brief (265 words maximum) description of the proposed project, including: goal(s), objectives, outcomes, and products to be developed. 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 your proposed project;

2. The two or more EBFPPs (at least one offered remotely) you plan to implement from the selected approved programs for FY25. (Reference Appendix A);

3. Projected number of program participants, broken down for each of your proposed

EBFPPs by year (Reference Appendix D);

mailto:AOA.OAA@acl.hhs.gov

4. Key partnerships you will establish to build the capacity to implement this project statewide to develop further unique partnerships as identified by EBFPP participants;

5. Target population with focus on older adults (60 years and older) in greatest economic need and/or greatest social need, consistent with the OAA, and adults with disabilities;

and,

6. Targeted project geographic area.

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 population-based, state, and local data sources) the impact of falls in your state/region/tribe specifically highlighting needs of those older adults (60 years and older) in greatest economic need and/or greatest social need (consistent with the OAA), and adults with disabilities, and how your proposed EBFPPs will address this impact.

2. Describe the gap in availability of your proposed EBFPPs and current delivery status of falls prevention programs by your organization or by other organizations in the targeted geographic area and statewide. Include reach to older adults in greatest economic need and greatest social need (consistent with the OAA), sustainability efforts, geographic/population reach of the proposed programs in your state/region/tribe, the extent of the network to deliver and sustain these programs and why your organization can fill the gap.

3. Include a Project Map of your state/region/tribe that shows where your proposed EBFPPs are already offered (if applicable), and which areas are being selected for this project.

Provide data to support why you will target those areas (e.g., the number of older adults, the lack of available programs, etc.). The map should be included as an appendix to your application.

Approach Capacity Building and Program Implementation

In this sub-section, the applicant must describe how they will help develop statewide capacity to deliver EBFPPs to older adults in greatest economic need and greatest social need (consistent with the OAA) and/or adults with disabilities, using person-centered, trauma informed and culturally appropriate practices.

In this sub-section the applicant should clearly describe:

The project’s goals and major objectives that align with Goal 1 described in this NOFO:

Goal 1: Develop an innovative fall prevention method that includes:

1. Targeted partnerships and outreach to recruit older adults in greatest economic need and/or greatest social need, consistent with the OAA, and adults with disabilities, into small group in-person evidence-based falls prevention programs.

• The proposed project will include initial community partnerships to support referral to and implementation of the selected EBFPPs along with a plan to develop further, unique partnerships as the project progresses to meet the individual needs of participants.

2. The two or more EBFPPs (at least one offered in remote format) that you propose to implement and a rationale for the programs selected. The rationale should relate to the project relevance and current need of the population(s) and target area(s) identified.

• EBFPP delivery will be person-centered, trauma informed and culturally appropriate.

The awarded organization will need to consider the qualifications of staff and program leaders and whether training on these topics will be required.

Formalized person-centered approach where participants take an active role and are involved in decisions for their continued health, well-being, and independence. (See Appendix F for examples of what this could look like.)

3. The programs must be on the list of pre-approved interventions in Appendix A. Do not select programs that are not included on this list. Use the guidelines in the Evidence- Based Falls Prevention Program Risk Continuum to select the proposed falls prevention programs.

• How you will implement at least one of the identified programs in a remote format, e.g., by video conference or similar virtual modality. The National Council on Aging (NCOA) maintains a website that tracks remote program guidance:

(https://www.ncoa.org/evidence-based-programs/). All applicants should contact the program developer/administrator(s) for any program(s) you want to deliver remotely to confirm that: 1) the programs are allowed for remote delivery; and 2) training is available. Note that the NCOA website includes programs on the pre-approved list in Appendix A, and other programs not on the list. For this funding opportunity, applicants MUST propose programs on the pre-approved list in Appendix A.

• Describe the IT equipment and support required to deliver the proposed remote program(s) and provide a detailed plan for how you will meet these equipment and support needs.

4. The projected total number of participants (older adults and adults with disabilities),with focus on greatest economic need and/or greatest social need, consistent with the OAA, that are expected to be reached through the proposed EBFPPs, broken down by program and year, and explain how the target numbers are developed for each of the programs.

• For any proposed programs, specify a target number of completers and a target completion rate for each year. Provide a rationale for these targets, e.g., by referencing any previous experience delivering falls prevention programs, the number of older adults and adults with disabilities in your state/region/tribe that you may be able to reach, partner commitments, referral systems, and other factors.

• Targets should be realistic and achievable. To develop your participant/completer targets, please reference Appendix D Guidance for Administration for Community Living Evidence-based Falls Prevention Program Grant Applicants: Considerations for Estimating Program Participation Targets.

https://ncoa.org/article/evidence-based-falls-prevention-programs-risk-continuum-guidance-for-program-selection https://ncoa.org/article/evidence-based-falls-prevention-programs-risk-continuum-guidance-for-program-selection https://www.ncoa.org/evidence-based-programs/

• Describe how your approach will engage approximately 25% of your target participants by the end of Year 1, 50% by the end of Year 2, and 100% of your target participants by the end of year 3.

5. Your comprehensive strategy to implement/disseminate the proposed EBFPPs, in collaboration with aging and disability programs/services and other relevant initial innovative partners. You must include a Letter of Commitment from each of the key initial partners and organizations described and attach as an appendix. See Letters of Support/Commitment section.

6. How you intend to identify, market to, and recruit participants for your proposed programs. Consider what specific marketing strategies would effectively reach your target population, including any brand messaging, referral systems, media platforms, and partner involvement.

7. The innovative method that will be developed to offer a person-centered delivery pathway using a bi-directional referral process to address the individual needs and choices of each older adult beyond the EBFPP to reduce their risk of falls, including the strategy to meet with, assess, and conduct follow-up with each participant.

8. How unique partnerships will be developed to meet the participant’s individual needs and choices as the project progresses.

9. Any existing falls prevention and/or other evidence-based prevention initiatives in your area and how you plan to coordinate with and leverage these efforts. This should include a description of any existing capacity to deliver the proposed programs, i.e., the number of host sites, implementation sites, and delivery personnel (such as trainers and leaders/coaches).

10. Whether your existing infrastructure to implement and disseminate the proposed programs is adequate, i.e., the number of host sites, implementation sites, and delivery personnel (such as trainers and leaders/coaches). If not adequate, describe and provide a rationale for any proposed trainings. If you require training for any of the proposed EBFPPs, you must include a Letter of Commitment in your application from the program developer/administrator that will provide training. The letter should state that the training will be provided no more than three months after you receive the Notice of Award. Letter(s) should be submitted as an appendix. See Letters of Support/Commitment section.

11. How EBFPP delivery will be person-centered, trauma informed and culturally appropriate, what staff currently exist with this skill-set, and what training will be provided on these topics for grant staff and program leaders.

12. Major challenges and barriers you expect, and how your project will address them.

13. How the approach will help develop capacity for statewide implementation and dissemination.

Target Populations

Applicants are required to engage older adults (60 years and older) and adults with disabilities, with the majority focus being older adults in greatest economic need and/or greatest social need, consistent with the OAA. In this subsection applicants should:

1. Describe the older adult (60 years and older) and adult with disabilities population served by the EBFPPs.

2. Provide the rationale (citing relevant data) for selecting the population, how they will be engaged, and the organizations that you will collaborate with to reach the identified population(s). See Appendix D, Section III of this NOFO for information about selecting and reaching your identified population.

3. Describe how EBFPP participant recruitment will include older adults in greatest economic need and/or greatest social need (consistent with the OAA) and adults with disabilities.

Sustainability

In this sub-section the applicant should identify and describe how they will implement one or more strategies to sustain strategies for their proposed EBFPPs. The goal is to integrate and embed evidence-based programs into a network of coordinated health and social services so that they are readily available and easily accessible over time.

Sustainability strategies can combine approaches, including development of referral partnerships, philanthropy, public funding, Older Americans Act Title IIID funding (for those participants 60 and older only), other federal funding, funding from healthcare entities, etc. For more information on business planning and financial sustainability, please visit:

• Sustainability

• Business Planning and Sustainability

• Maximizing Data and Partnerships to Enhance Evidence-Based Program Sustainability

• Community Integrated Health Care

This sub-section should describe:

1. Description of sustainability strategies to support the proposed programs during and beyond the grant period, including:

• One or more robust strategies to be implemented and how you will lead or integrate these efforts.

• How you’ll foster and maintain sustainability if your person-centered approaches are costly or resource-intensive.

• Emerging or established efforts to centralize and coordinate health and social services in your area. For example, business and marketing planning efforts to be undertaken (e.g., infrastructure, health IT, partnerships, community care HUBS, etc.).

• Current partnerships and how your plans for additional key partnerships will help sustain programs put in place beyond this grant period.

Outcomes and Evaluation This section should clearly identify and describe measurable outcome(s) from your proposed project and how you will establish and maintain quality assurance, evaluate impact, and disseminate your findings to the field at large.

Project Outcomes

In this section you must:

https://www.ncoa.org/article/sustainability https://www.ncoa.org/article/business-planning-sustainability https://www.ncoa.org/article/maximizing-data-and-partnerships-to-enhance-evidence-based-program-sustainability https://www.ncoa.org/page/the-roadmap-to-community-integrated-health-care/

1. Describe the quantifiable and measurable outcomes that will be achieved during the project period. Note that the outcomes must address the two goals of this funding opportunity.

2. List measurable outcomes in the Work Plan grid under "Measurable Outcomes".

• A “measurable outcome” is an observable end-result that describes how a particular intervention will benefit participants. It demonstrates the functional status, mental well- being, knowledge, skill, attitude, awareness, or behavior. A measurable outcome is not a measurable “output”, such as the number of clients served, or the number of training sessions held.

Quality Assurance

Describe your plans for maintaining quality assurance including methods, techniques, and tools that will be used to:

1. Monitor and track progress on the project’s tasks and objectives;

2. Monitor whether the proposed programs are being implemented with fidelity*, as well as identify processes for corrective actions;

3. Ensure the ACL-required dataset (see Appendix C) is being collected and accurately reported by delivery partners and how you will identify and troubleshoot any potential problems.

* Fidelity is the extent to which delivery of the evidence-based program consistently adheres to the program’s intent and design. In other words, the extent to which you are delivering the program exactly how it is meant to be implemented. Maintaining fidelity to the program is essential to ensure that your participants receive the intended health benefits from the program.

Evaluation and Dissemination

1. State your project’s goals and major objectives that align with Goal 2 described in this funding opportunity:

Goal 2: Evaluate the intervention to assess its impact on reducing falls and/or the risk of falls, and develop and disseminate Section 508-compliant program results and resources.

Key Deliverables:

• Create resources based on outcomes for statewide use and applicability, lessons learned (i.e., successes and challenges), process documents, and best practices that can assist other in replicating service delivery, program development and / or policy making to foster innovation and accelerate future implementation.

• Design an assessment using at least three (3) questions that focus on goal identification, goal follow-up, and goal achievement, to determine whether person-centered supports added beyond the EBFPP lowers the risk of falls and increases older adults’ independence.

• Develop Section 508-compliant resources to disseminate project results and lessons learned to inform practice, service delivery, program development and policy making for organizations statewide, as described above, to replicate the…