Foa_Content_of_HHS-2025-ACL-CIP-AAFP-0051.pdf

Administration for Community Living

Center for Innovation and Partnership

Research to Spread and Scale the Impact of Evidence-Based Falls Prevention Programs and Interventions

HHS-2025-ACL-CIP-AAFP-0051

08/20/2025

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

I. Funding Opportunity Description

II. Award Information

III. Eligibility Information

1. Eligible Applicants

2. Cost Sharing or Matching

3. Responsiveness and Screening Criteria

IV. Application and Submission Information

1. Address to Request Application Package

2. Content and Form of Application Submission

Letter of Intent

Project Narrative

Summary/Abstract

Organizational Capability

Budget Narrative/Justification

Work Plan

Letters of Commitment from Key Participating Organizations and Agencies

3. Unique Entity Identifier and System for Award Management (SAM)

4. Submission Dates and Times

5. Intergovernmental Review

6. Funding Restrictions

7. Other Submission Requirements

V. Application Review Information

1. Criteria

2. Review and Selection Process

3. Anticipated Announcement Award Date

VI. Award Administration Information

1. Award Notices

2. Administrative and National Policy Requirements

3. Reporting

4. FFATA and FSRS Reporting

VII. Agency Contacts

VIII. Other Information

The Paperwork Reduction Act of 1995 (P.L. 104-13)

Appendix

Instructions for Completing Required Forms

Budget Narrative/Justification- Sample Format

Instructions for Completing the Project Summary/ Abstract

ACL Center:

Center for Innovation and Partnership Funding Opportunity Title:

Research to Spread and Scale the Impact of Evidence-Based Falls Prevention Programs and Interventions Funding Opportunity Number:

HHS-2025-ACL-CIP-AAFP-0051

Primary CFDA Number:

93.048 Due Date for Letter of Intent:

07/31/2025 Due Date for Applications:

08/20/2025 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.

Executive Summary

Additional Overview Content/Executive Summary Evidence suggests that it takes more than a decade for new research findings related to older adult health to be implemented in clinical or professional settings.[1] This keeps critical interventions from having practical impact for populations that need interventions that work for them. Developing health promotion and disease prevention programs and interventions delivered in a variety of settings can improve quality of life for older adults, save money to the health care delivery system, and ensure older adults can live independently in their homes and communities.

While there has been a growth in investments in research over time, fewer dollars are invested in research that facilitates the broader implementation and scaling of community-based interventions.[2] This creates a gap whereby many effective interventions are not implemented into practice and policy in a timely manner.

One pathway researchers are using to help bridge the research, practice, and policy gap is implementation research. Implementation research is the scientific study of the use of strategies https://www.grants.gov/ to adopt and integrate evidence-based health interventions into clinical and community settings to improve individual outcomes and benefit population health.[3] In short, implementation research seeks to understand the how, when, by whom, and under what circumstances; that is the spread of evidence-based health programs and interventions throughout communities, organizations, and clinical and public health services. This design is also used to study contextual factors that facilitate their adoption, implementation, sustainability, scale, and spread. Although organizations have been delivering evidence-based health promotion programs and interventions for many years, most of these programs and interventions have not been sufficiently scaled and evaluated in order to incorporate and sustain them into routine practice.

The U.S. Preventive Services Task Force recently reviewed falls prevention interventions in community-dwelling older adults and their findings state that “existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small.”[4] Practically, this means that while these interventions have demonstrated their effectiveness on a smaller scale, there is still some question of their larger impact. This funding opportunity aims to take a meaningful step to bridge the gap between smaller community-based interventions for falls prevention and use implementation science methods to test the larger public health impacts, spread, and scale of multifactorial falls prevention interventions through the Aging Network and collaborative partners.

This funding opportunity will fund implementation research that brings to scale and evaluates the impact of evidence-based multifactorial falls prevention programs on falls among older adults[5] through a collaborative approach inclusive of the Aging Network and collaborative partners, experts in falls prevention research, and experts in implementation science and research. This funding is not intended to support the development of new programs or interventions.

The U.S. Department of Health and Human Services (HHS) anticipates awarding up to three grants to domestic public or private non-profit entities who have:

• significant expertise in implementation research in the health and/or social sciences; and

• demonstrated experience conducting research with the Aging Network and/or community care hubs

Successful applicants must demonstrate their capacity to conduct several activities including, but not limited to, the following:

• Finalize research questions and methods for conducting research to reduce falls and falls risk using an implementation science approach, with structured (quantitative) data and unstructured (qualitative) data collection;

• Ensure a secure, dynamic system to house the data collected and evidence developed by community-based organizations, complying with the HHS public access plan and policy regarding scientific or research data collected as a result of this funding;

• Foster collaboration with the Aging Network and other partners involved in the delivery of the falls prevention programs and interventions and report implementation and participant data in order to understand and measure the extent to the program/intervention reduces falls and falls risk factors;

• Provide technical assistance to sub-awardees on the program/intervention delivery and structured data collection using a relational database or some other technically appropriate data warehouse;

https://acl.gov/programs/aging-and-disability-networks https://acl.gov/programs/aging-and-disability-networks https://acl.gov/programs/aging-and-disability-networks https://www.healthaffairs.org/content/forefront/improving-health-and-well-being-through-community-care-hubs https://www.healthaffairs.org/content/forefront/improving-health-and-well-being-through-community-care-hubs

• Conduct both predictive and statistical analysis on research findings, and disseminate findings through peer-reviewed research and other appropriate media; and

• Develop a dissemination plan to initiate and participate in broader sustainability efforts to achieve further scaling of the program/intervention and public health impact for community-based multifactorial falls prevention programs.

Applicants may request a total budget of up to $4.65 million for the four-year project period. At a minimum, the budget and budget narrative should include funds for personnel, programming, indirect costs (using off campus rates research, if applicable). The organization(s) selected will be fully funded for a 48-month project period and budget period.

The grant has an anticipated start date of September 1, 2025.

[1]Ploeg J, Markle-Reid M, Davies B, Higuchi K, Gifford W, Bajnok I, et al. Spreading and sustaining best practices for home care of older adults: a grounded theory study. Implement Sci.

2014;9:162.

[2]National Science Board (2024). Research and Development: U.S. Trends and International Comparison, 6, 2025 fromhttps://ncses.nsf.gov/pubs/nsb20246

[3] National Institutes of Health (2025). Center for Translation Research and Implementation Science, accessed May 6, 2025 at https://www.nhlbi.nih.gov/about/divisions/center-translation-research-and-implementation-science

[4] U.S. Preventative Services Task Force (2024). Final Recommendation Statement

Falls Prevention in Community-Dwelling Older Adults: Interventions, accessed May 6, 2025 at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-community-dwelling-older-adults-interventions

[5] For the purpose of this FOA and consistent with the definition in the Older Americans Act (42 U.S.C. §3002(8)), we are defining an older adult as an individual who is 60 years of age or older. For tribes and tribal organizations, the age of older Indians is defined by the tribe and may vary.

I. Funding Opportunity Description Background

Falls in later life can have a significant impact on health and well-being of older adults, people with disabilities, their families, and their communities. Unfortunately, older adult falls are common, with approximately one in four older adults falling each year[1], and costly, with an estimated $80 billion in annual healthcare costs attributable to non-fatal falls.[2] Each year, there are about 3 million emergency department visits[3] and 1 million hospitalizations[4] related to older adult falls. Fortunately, rigorous research has shown that older adult falls are preventable.

In alignment with its mission, the Administration on Aging (AoA) invests in the delivery of evidence-based community health promotion programs, as well as related technical assistance through the National Falls Prevention Resource Center. Between October 1, 2014 – September 30, 2023, AoA formula grantees supported the delivery of health promotion programs and https://ncses.nsf.gov/pubs/nsb20246 https://www.nhlbi.nih.gov/about/divisions/center-translation-research-and-implementation-science https://www.nhlbi.nih.gov/about/divisions/center-translation-research-and-implementation-science https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-community-dwelling-older-adults-interventions https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-community-dwelling-older-adults-interventions https://acl.gov/programs/falls-prevention/national-falls-prevention-resource-center-and-resources-available https://acl.gov/programs/health-wellness/disease-prevention activities to over 10 million older adults across the nation.[5] During this same period, AoA falls prevention competitive grantees reached over 268,468 older adults and adults with disabilities with evidence-based falls prevention programs specifically, with 42.13% of program participants reporting decreased social isolation and loneliness and 21.25% reporting improvements in self-rated health.[6]

Between 2020-2024, HHS funded independent studies to examine successes, challenges, and opportunities related to evidence-based health promotion programs, each of which indicated that program sustainability has been an ongoing challenge.[7],[8],[9],[10] Although some communities have had success in securing grants for program training and delivery, this funding is often time-limited and/or otherwise insufficient for long-term sustainability. Despite recognition of the growing human and financial cost of falls, there has been a dearth of investment – particularly by healthcare – in community-based falls prevention programs.

The U.S. Preventative Services Task Force (USPSTF) plays an important role in making evidence-based recommendations about clinical preventive services, which often impacts insurance coverage for these services. Highly recommended (A and B grade) services, those with high or moderate net benefit, are typically covered by federal and private insurers without copay or cost-sharing. Grade C recommendations are made by the USPSTF when the net benefit is found to be small.

In 2024, the USPSTF updated two recommendations on interventions to prevent falls among community-dwelling older adults. The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls (B recommendation). The USPSTF recommends that clinicians individualize the decision to offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (C recommendation) The USPSTF found existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small.

The USPSTF identified several evidence gaps related to interventions to prevent falls among community-dwelling older adults (see the USPSTF Evidence Gaps Research Taxonomy Table), including the need for research to:

• develop and validate primary care risk assessment tools that accurately predict risk for falls in community-dwelling older adults;

• compare the benefits and harms of exercise plus multifactorial interventions with exercise interventions alone;

• identify methods to improve the availability and accessibility of effective fall prevention interventions; and

• examine the effectiveness and harms of interventions in different functional and risk groups

Interventions and implementation strategies proposed for this funding opportunity should address at least one of the research gaps noted by the USPSTF, using one of the following approaches:

• implementing at one least evidence-based multifactorial falls prevention program compared to exercise alone (comparison group); or https://acl.gov/programs/health-wellness/falls-prevention-program https://www.uspreventiveservicestaskforce.org/uspstf/document/falls-prevention-older-adults-evidence-gaps-research-taxonomy-table/falls-prevention-community-dwelling-older-adults-interventions

• implementing at one least evidence-based multifactorial falls prevention program plus exercise compared to no intervention (comparison group)

• implementing at least one evidence-based multifactorial falls prevention program compared to no intervention (comparison group)

Applicant study designs should ensure their proposed interventions are available and accessible to a variety of populations. All programs must meet the Older Americans Act Title III-D criteria for evidence-based (see Appendix A). A list of programs that meet the criteria is included in Appendix B. Applicants may propose an evidence-based multifactorial falls prevention program(s) that is not on the list as long as they indicate and provide clear evidence in their application that the program meets the Title III-D criteria.

Program Goals

This grant opportunity intends to fund research to address these evidence gaps and assess the benefits of incorporating evidence-based multifactorial falls prevention programs to prevent falls among older adults into routine practice, either alone or in combination with exercise. Studies must employ an implementation research approach to increasing the uptake and demonstrating the impact of their proposed interventions in the community. This funding is not intended to support the development of new programs or interventions.

Applicants must describe their comprehensive approach in detail, including the following:

• providing the theoretical basis, conceptual model, and/or logic model for the overall approach to dissemination and implementation with an explanation of how individual strategies and techniques fit within the theory or model and are expected to contribute to its success;

• identifying potential challenges and barriers to executing the dissemination and implementation approach and proposed mitigation strategies;

• describing how the strategy will address barriers to risk assessment in the proposed population;

• describing the evaluation approach, data sources, data collection (including how and from where data will be collected), and analysis plan; and

• describing whether and how the implementation strategies will be sustained once the grant funding ends. Sustainability may involve both helping programs and interventions implement lasting change and building infrastructure that can be leveraged in future projects.

The applicant is required to have demonstrated experience conducting research collaboratively within the Aging Network. The Older Americans Act of 1965 (OAA) established a national network of federal, state, and local agencies to plan and provide services that help older adults to live independently in their homes and communities. This interconnected structure of agencies is known as the Aging Network. The National Aging Network is headed by the Administration on Aging, which sits within the Department of Health and Human Services. The network includes 56 State Agencies on Aging, approximately 615 Area Agencies on Aging, and more than 280 Title VI Native American aging programs. Further, the network is supported by tens of thousands of service providers, community-based organizations, and hundreds of thousands of volunteers.

Community care hubs, also funded through Older Americans Act Aging and Disability Resource Center/No Wrong Door funding, are a model to align health care and social services to meet the needs of older adults and people with disabilities who may have unmet social needs that impact their health. The model is meant to provide “whole person care” by funding networks of community-based organizations that have one “hub” to contract with health plans, payors, and health systems. Community care hubs provide infrastructure to provide higher quality care, including evidence-based interventions at scale.

All applicants must ensure delivery partners implement at least one evidence-based multifactorial falls prevention program across delivery partners, capturing core outcome measures across participants and organizations. All programs must meet the Older Americans Act Title III-D criteria for evidence-based (see Appendix A). A list of programs that meet the criteria is included in Appendix B. Applicants may propose an evidence-based multifactorial falls prevention program(s) that is not on the list as long as they indicate and provide clear evidence in their application that the program meets the Title III-D criteria.

[1]Kakara R, Bergen G, Burns E, Stevens M. Nonfatal and Fatal Falls Among Adults Aged ≥65 Years—United States, 2020–2021. MMWR Morbidity and Mortality Weekly Report.

2023;72:938–943. DOI: 10.15585/mmwr.mm7235a1.

[2] Healthcare spending for non-fatal falls among older adults, USA (2024)

Haddad, Yara K; Miller, Gabrielle F; Ramakrishna Kakara; Curtis, Florence; Bergen, Gwen ; et

al. Injury Prevention; London Vol. 30, Iss. 4,:

[3] Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online].

Accessed March 11, 2024.

[4] Moreland B, Legha J, Thomas K, Burns ER. Hip Fracture-related Emergency Department Visits, Hospitalizations, and Deaths by Mechanism of Injury Among Adults Aged 65 and Older, United States 2019. (2023). Journal of Aging and Health. 35(5–6):345–s355. DOI:

10.1177/08982643221132450.

[5] Older Americans Act State Program Report. (FY2014-2023). Accessed from the Older Americans Act Performance System on March 25, 2025.

[6] National Council on Aging. (2025). Falls Outcomes Dashboard. Healthy Aging Integrated Programs Database. Accessed March 24, 2025.

[7]Fidelity Evaluation of ACL’s Evidence-Based Programs: https://acl.gov/news- and-events/announcements/fidelity-evaluation-acls-evidence-based-programs

[8] Evidence-Based Health Promotion Programs Among American Indian, Alaska Native, and Native Hawaiian Communities: A Call to Action to Improve Cultural Relevance and Accessibility: https:/www.nicoa.org/wp-content/uploads/2021/03/1-FINAL- REPORT- Evidence-Based-Health-Promotion-Among-AIANNH-Communities.pdf

[9] Analysis of Evidence-Based Health Promotion and Disease Prevention Program Review Processes: https://acl.gov/sites/default/files/programs/2023- 10/ACLEBPFinalReport.pdf https://acl.gov/programs/strengthening-aging-and-disability-networks/improving-business-practices

[10] State Units on Aging Survey of Title III-D Evidence-Based Program Delivery and Review Process (https://www.ncoa.org/article/evidence-based-programming-results- of- a-state-units-on-aging-title-iii-d-survey)

Statutory Authority Special Programs for the Aging, Title IV, and Title II, Discretionary Projects, Older Americans Act of 1965, Title IV, Public Law 89-73, 79 Stat. 218, as amended; Public Law 97-115, 95 Stat.

1595; Public Law 98-459, 98 Stat. 1767; Public Law 100-175; Public Law 100-628, 42 U.S.C.

3031-3037b; Public Law 102-375; Public Law 106-501.

II. Award Information

Funding Instrument Type:

G (Grant) Estimated Total Funding:

$4,650,000 Expected Number of Awards:

Award Ceiling:

$4,650,000 Per Project Period

Award Floor:

$1,450,000 Per Project Period

Length of Project Period:

Other Additional Information on Project Periods and Explanation of 'Other' 48-month project and budget period, forward funded

III. Eligibility Information

1. Eligible Applicants 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.

Foreign entities are not eligible to compete for, or receive, awards made under this announcement.

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 All applications must include letters of commitment from Aging Network partners based on their selected approach, such as letters from State Units on Aging, Area Agencies on Aging, community care hubs, and tribes/tribal organizations. Applications that fail to meet this requirement will not be reviewed and will receive no further consideration.

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

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 under 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, preferably Times New Roman or Arial.

3. The Project Narrative (inclusive of the Workplan) must not exceed thirty (20) double-spaced pages. NOTE: The page limit for the Project Narrative does not apply to the Application for Federal Assistance, application table of contents, budget narrative/justification, vitae/ biosketches, the letters of commitment from key participating organizations and agencies, and references.

4. Applications must include a proposed Budget Narrative/Justification for years 1, 2, 3, and 4 as well as a combined Budget Narrative/Justification for the proposed 48-month budget period. The proposed combined Budget Narrative/Justification must not exceed the total federal 4- year award ceiling of $4,650,000 and may not be below the floor of $1,450,000.

5. Applications must include a Project Work Plan for years 1, 2, 3, and 4 as a part of the Project Narrative. Project Work Plans must be consistent with the proposed Project Narrative 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 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

Lauren Solkowski

202-795-7440 lauren.solkowski@acl.hhs.gov

2. Content and Form of Application Submission

Letter of Intent Number of Days from Publication 10

07/31/2025 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

Contact: Lauren Solkowski https://www.grants.gov https://www.grants.gov https://www.grants.gov

Email Address: lauren.solkowski@acl.hhs.gov

Project Narrative The Proposal Narrative portion of your application is where you describe your proposed project.

The Narrative should include the information below, and must use the following section headings:

o Section 1: Significance of Research o Section 2: Approach o Section 3: Organizational Capacity and Expertise

It is highly unlikely one organization can meet all the narrative criteria provided, therefore HHS expects applicants will use a collaborative approach.

Each applicant must limit the Project Narrative to the equivalent of no more than 20 pages using the following standards:

• A page is 8.5" x 11" on one side only with 1" margins at the top, bottom, and both sides

• Double-space (no more than three lines per vertical inch) all narrative text in the project narrative. You are not required to double space titles, headings, footnotes, references, captions, or text in charts, tables, figures, and graphs. Applicants who unnecessarily place narrative text in tables to avoid the double-spacing requirement run the risk of exceeding the page limit

• Use a font that is not less than size 12 and is Times New Roman, Courier, Courier New, or Arial

• Include all critical information, including the Work Plan, in the Project Narrative, minimizing the need for additional appendices

• Number the pages

For Project Narratives that exceed 20 double-spaced pages, reviewers will be instructed to disregard all of the content on the pages beyond the 20th page.

NOTE: The page limit for the Project Narrative does not apply to the Application for Federal Assistance, application table of contents, budget narrative/justification, vitae/ biosketches, the letters of commitment from key participating organizations and agencies, and references.

The Project Narrative must include the following:

• Section 1: Significance of Research o Understanding of the problem of falls and risk of falls in older adults o Research gaps to be addressed through scientific and systematic study of existing multifactorial interventions for older adults, examining outcomes, context, cost, innovations, replication potential, and resources o Anticipated benefits of implementation science research to public health, communities, and the field

▪ addressing health issues, such as chronic conditions, and social factors impacting falls and falls risk, using approaches, programs, and interventions that are grounded in evidence;

▪ strengthening established partnerships between research, the Aging Network, and other partners in communities; and

▪ knowledge generated that advances research, may influence funders/decision makers, and demonstrates value of the Aging Network with an emphasis on the network’s ability to implement evidence-based falls prevention programs at scale o Interventions and implementation strategies addressing at least one of the research gaps noted by the USPSTF, using at least one of the following approaches:

1. implementing at least one evidence-based multifactorial falls prevention program compared to exercise alone (comparison group); or

2. implementing at one least evidence-based multifactorial falls prevention program plus exercise compared to no intervention (comparison group)

3. implementing at least one evidence-based multifactorial falls prevention program compared to no intervention (comparison group) o Aging Network delivery partner characteristics and capacity required (costs, other resources, credentials) o Proposed reach (population characteristics, impact expected, etc.)

• Section 2: Approach o Identify a study design – experimental or quasi-experimental – appropriate for the identified target population, contextual factors, balancing rigor and inclusive of feasibility, practicality, and cost of design. This should include realistic power calculations that account for a range of effect sizes and do not exaggerate effect sizes and may include strengths and limitations of their proposed design.

o Implementation approach (theory/models/framework) and relevant research methods o Plans for collection and analysis of implementation strategies and outcomes, which may include:

▪ Acceptability

▪ Adoption

▪ Appropriateness

▪ Costs, including per person costs, cost per outcome, and cost of the intervention

▪ Feasibility

▪ Penetration

▪ Sustainability o Plans for collection and analysis of service and quality improvement outcome using the measures in Appendix C covering the domains below:

▪ Activities of Daily Living/Instrumental Activities of Daily Living

▪ Fear of Falling

▪ Falls Efficacy

▪ History of Falls

▪ Self-Rated Health

▪ Physical Activity

▪ Loneliness and Social Isolation

Applicants may also include project specific outcome measures but should provide an explanation and rationale for any measures proposed. Examples of additional outcomes may include falls related injuries, fractures, emergency room visits, and hospitalizations.

• Plans for collection and analysis of implementation and participant level data, as well as for relevant analysis that align with study goals, including:

o A description of the data you will collect for your project, including how you will maintain security, privacy, and confidentiality of any PII or PHI.

o A description of how you will organize, store, and preserve your project data.

o A description of the metadata to be provided for useful analysis of the data by others. Metadata include descriptions and labels for variables and values in your dataset.

o A description of the data repository that you will use to make your data available to the public at the end of your grant.

o A description of the informed consent process that will enable data sharing and using data collected for secondary analyses.

o Identified possible risks that could hinder study success, efficiency, and outcome and proposed plans to mitigate them.

o Plans for project submission to and approval by Institutional Review Board.

o Dissemination and next steps/sustainability strategies after the project concludes.

• Section 3: Organizational Capacity and Expertise o Proficient in designing and conducting implementation research with community health and/or social service organizations using mixed methods.

▪ Quantitative (describe)

▪ Qualitative (describe) o Expertise and partnerships necessary to scale screenings, programs, and interventions for older adults and measure public health impact.

o Current and previous engagement and proposed collaboration with Aging Network and other relevant stakeholders that utilize the strengths and unique features of these partners.

o Expertise in developing clear, informative, effective, high quality, innovative, creative, concise, accurate, timely, and user-friendly materials to disseminate study findings that are consistent with HHS policies regarding attribution, plain language, accessibility, and related areas.

o Investigator and institutional commitments to initiating and/or participating in broader sustainability efforts to achieve public health impact using the study results.

o Ability to identify possible risks that could hinder project and develop a plan to mitigate them.

o Familiarity with Section 508, and any other relevant requirements associated with collection of information, accessibility, confidentiality, and privacy.

o Commit to sending two project staff to at least one aging or falls-related conferences annually to share project findings and form relationships that support sustainability beyond the conclusion of federal funding.

Summary/Abstract Applicants must provide a one-page abstract, which should be a comprehensive description of the whole project (all years) and not a description of the competency of the institution or Project Director/PI.

Organizational Capability Vitae or biosketches of key project personnel should include information that is specifically pertinent to the applicant’s proposed project. Applicants are encouraged to use the National Institute of Health’s biosketch format, which provides reviewers with a concise description of training, expertise, and productivity that is relevant to the proposed project.

Budget Narrative/Justification The applicant must submit an itemized budget breakdown for each project year and the basis for estimating the costs of personnel salaries, benefits, project staff travel, materials and supplies, consultants and subcontracts, indirect costs, and any other projected expenditures. The Budget Narrative/Justification can be provided using the “Budget Narrative/Justification – Sample Format” included in this document. Applicants are encouraged to pay particular attention to this document, which provides an example of the level of detail sought. A combined multi year Budget Narrative/Justification as well as a detailed Budget Narrative/Justification for each year of potential grant funding is required. This information will be uploaded in the "Budget Narrative/Justification" section under the "Optional" category.

Work Plan Applicants must provide a project Work Plan for Years 1, 2, 3, and 4. Each Work Plan should reflect and be consistent with the Project Narrative and Budget Narrative/Justification. Each Work Plan should include a statement of the project’s overall goals, anticipated outcomes, key objectives, and the major tasks/action steps that will be pursued to achieve the results-oriented goals and outcomes. Applicants should identify timeframes involved (including start- and end-dates) and the lead person responsible for completing the task. Provide each Work Plan formatted according to the guidelines below in Project Work Plan – Sample Template section.

Letters of Commitment from Key Participating Organizations and Agencies Applicants must include Letters of Support/Commitment and use a Table of Contents to clearly identify which letters represent which partners. Note that any organization that is specifically named to have a significant role in carrying out the project should be considered a key partner.

Applicants must provide letters of commitment from Aging Network partners based on their selected approach, including – but not limited to – State Units on Aging, Area Agencies on Aging, community care hubs, and tribes/tribal organizations and/or organizations representing these organizations. Applicants that do not provide letters of support demonstrating substantive collaboration with Aging Network organizations will not be considered.

The quality of the letter content (i.e., specificity with respect to the role of that partner) is more important than the quantity of letters submitted with your application. Signed letters of https://grants.nih.gov/grants-process/write-application/forms-directory/biosketch https://grants.nih.gov/grants-process/write-application/forms-directory/biosketch commitment should be scanned and included as attachments. Letters of Support/Commitment must be uploaded as part of the applicant package via Grants.gov. Hard copies will not be accepted.

3. Unique Entity Identifier and System for Award Management (SAM) 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 number 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

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 mailto:support@grants.gov https://www.fsd.gov/sys_attachment.do?sys_id=54e0016fdb3bbd90a8cb4a3913961934 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. They will no longer have to go to a third-party website to obtain their identifier. This transition allows the government to streamline the entity identification and validation process, making it easier and less burdensome for entities to do business with the federal government. If your entity is registered in SAM.gov today, your Unique Entity ID (SAM) has already been assigned and is viewable in SAM.gov. This includes inactive registrations. The Unique Entity ID is currently located below the DUNS Number on your entity registration record. Remember, you must be signed in to your SAM.gov account to view entity records. To learn how to view your Unique Entity ID (SAM) go to this help article.

• 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.

4. Submission Dates and Times 08/20/2025 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 http://www.grants.gov. Grants.gov can take up to 48 hours to notify you of a successful submission.

In addition, if you are submitting your application via Grants.gov, you must (1) be designated by your organization as an Authorized Organization Representative (AOR) and (2) register yourself with Grants.gov as an AOR. Details on these steps are outlined at the following Grants.gov web page: http://www.grants.gov/web/grants/register.html.

After you electronically submit your application, you will receive from Grants.gov an automatic notification of receipt that contains a Grants.gov tracking number. (This notification indicates receipt by Grants.gov only)

If you are experiencing problems submitting your application through Grants.gov, please contact the Grants.gov Support Desk, toll free, at 1-800-518-4726. You must obtain a Grants.gov Support Desk Case Number and must keep a record of it.

https://www.fsd.gov/gsafsd_sp?id=gsafsd_kb_articles&sys_id=a05adbae1b59f8982fe5ed7ae54bcbba https://www.grants.gov https://www.grants.gov https://www.grants.gov http://www.grants.gov/ http://www.grants.gov/web/grants/register.html

If you are prevented from electronically submitting your application on the application deadline because of technical problems with the Grants.gov system, please contact the person listed under For Further Information Contact in section VII of this notice and provide a written explanation of the technical problem you experienced with Grants.gov, along with the Grants.gov Support Desk Case Number. ACL will contact you after a determination is made on whether your application will be accepted.

Note: We will not consider your application for further review if you failed to fully…