HHS-2017-ACL-AOA-ADSG-0212 508c.pdf

Image Description: Administration for Community Living

Administration for Community Living

Administration on Aging

Alzheimer's Disease Supportive Services Program (ADSSP): Creating and Sustaining Dementia-Capable Service Systems for People with Dementia and their Family Caregivers

HHS-2017-ACL-AOA-ADSG-0212

Application Due Date: 05/12/2017

Alzheimer's Disease Supportive Services Program (ADSSP): Creating and Sustaining Dementia-Capable Service Systems for People with Dementia and their Family Caregivers

HHS-2017-ACL-AOA-ADSG-0212

TABLE OF CONTENTS

Funding Opportunity Description I.

Award Information II.

Eligibility Information

Eligible Applicants 1.

Cost Sharing or Matching 2.

Responsiveness and Screening Criteria 3.

III.

Application and Submission Information Address to Request Application Package 1.

Content and Form of Application Submission 2.

Submission Dates and Times 3.

Intergovernmental Review 4.

Funding Restrictions 5.

Other Submission Requirements 6.

IV.

Application Review Information Criteria 1.

Review and Selection Process 2.

Anticipated Announcement Award Date 3.

V.

Award Administration Information Award Notices 1.

Administrative and National Policy Requirements 2.

Reporting 3.

FFATA and FSRS Reporting 4.

VI.

Agency Contacts VII.

Other Information VIII.

Department of Health & Human Services

ACL Center: Administration on Aging Funding Opportunity Title: Alzheimer's Disease Supportive Services Program (ADSSP):

Creating and Sustaining Dementia-Capable Service Systems for People with Dementia and their Family Caregivers

Announcement Type: Initial Funding Opportunity Number: HHS-2017-ACL-AOA-ADSG-0212 Primary CFDA Number: 93.051 Due Date For Letter of Intent: 03/27/2017 Due Date for Applications: 05/12/2017 Date for Informational Conference Call:

04/03/2017

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.

Executive Summary

There are two parts to the cooperative agreements available under the Alzheimer's Disease Supportive Services Program (ADSSP) funding opportunity announcement (FOA). The first opportunity (PART A) is for new three year, forward funded grants to states that have not benefited from the program since 2011 and the second (PART B) is a program expansion opportunity through which existing grantees that are not presently benefitting from expansion grants, can apply to receive 18 month expansion grants to build upon a successful component within the ACL ADSSP project they are presently implementing. Applicants eligible for the ADSSP program would be eligible for either Part A OR Part B, there would be no applicant eligible to apply for both opportunties.

The cooperative agreements under the ADSSP are designed to ensure that people with dementia and their family caregivers have access to a sustainable home and community-based services (HCBS) system that is dementia-capable. Such a system meets the unique needs of each person with dementia by 1) identifying those with a possible dementia and recommending follow up with a physician, 2) ensuring that the staff encountered by consumers of the system have appropriate training, understand their unique needs and the services available, as well as knowledge of how to effectively communicate with them, and 3) providing quality, person-centered services that help them remain independent and safe in their communities. A dementia-capable HCBS system also includes services and supports for family caregivers.

Eligible applicants for both Part A and Part B must be the designated state agency for dementia-capability and have working relationships with their state Medicaid agencies that enable creating and sustaining a dementia-capable HCBS System that meets two key objectives:

Objective 1: Create and sustain a dementia-capable HCBS system that includes Single Entry Point/No Wrong Door (SEP/NWD) access for people with dementia and their family caregivers.

Objective 2: Ensure access to a comprehensive, sustainable set of quality HCBS that are dementia capable http://www.grants.gov and provide innovative services to the population with dementia and their family caregivers.

A model dementia-capable HCBS system would:

Identify people with possible dementia and recommend that they see a physician for a timely, accurate diagnosis and to rule out reversible causes of dementia or conditions that resemble it.

1.

Ensure that program eligibility and resource allocation take into account the impact of cognitive disabilities.

2.

Ensure that staff communicate effectively with people with dementia and their caregivers and provide services that are person- and family-centered, offer self-direction of services, and are culturally appropriate.

3.

Educate workers to identify possible dementia, and understand the symptoms of dementia and appropriate services.

4.

Educate the public about brain health, including information about the risk factors associated with developing dementia, first signs of cognitive problems, management of symptoms if individuals have dementia, support programs, and opportunities to participate in research.

5.

Implement quality assurance systems that measure how effectively providers serve people with dementia and their caregivers.

6.

Encourage development of dementia-friendly communities, which include key parts of dementia-capability.

7.

Additional information on dementia-capable systems is found in the issue brief entitled Dementia-capable States and Communities: the Basics ( https://nadrc.acl.gov/node/93 ).

In addition to implementing a program designed to result in dementia-capable HCBS system that meets objectives 1 and 2 above and moving toward the outlined model system, applicants MUST identify at least one evidence-based or evidence-informed service/intervention designed to support individuals with dementia or their caregivers that will be implemented over the course of their proposed project. Applicants are required to comply with statutorily imposed cost sharing/match and direct service requirements as outlined in the FOA.

Please direct any questions about the programmatic goals and objectives of this FOA to erin.long@acl.hhs.gov.

Please note that letters of intent are requested; please see Section IV.3 of this FOA

An informational conference call will be held on April 3, 2017 from 2:30pm – 3:30 pm EST.

The dial-in information is below:

Toll Free Number: 877-918-2312

Passcode: 7962346

A recording will be available approximately 48 hours after the call concludes at the following number:

Toll Free Playback Number: 800-947-6935

I. Funding Opportunity Description

The national consensus is that our home and community-based service (HCBS) system must be https://nadrc.acl.gov/node/93

The national consensus is that our home and community-based service (HCBS) system must be person-centered, that is, more responsive to the unique needs and preferences of each individual utilizing the system. It is critical that every person-centered HCBS system consider the needs and preferences of people with cognitive impairment, as they represent a substantial proportion of those in the system. For example, 15 percent of older adults living in the community with at least one activity of daily living (ADL) or instrumental activity of daily living (IADL) limitation have a cognitive impairment. [1] Such an impairment is also attributable to about 25 percent of older adults with severe disabilities, people with three or more limitations in ADLs. It is also worth noting that about 24 percent of people of all ages who receive Medicare or Medicaid-funded home health care have moderate to severe cognitive impairment.[2]

Dementia, the loss of cognitive functioning, thinking, remembering, and reasoning and behavioral abilities to the extent that it interferes with a persons daily life and activities, is the major cause of impairment among older adults. Impairment as a result of dementia ranges in severity from the mildest stage, when it is just beginning to affect a persons functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. Estimates of the percentage of older persons with dementia vary, but the prevalence of the disease increases with age. Alzheimer's disease is responsible, at least in part, for about 60 percent of cases of dementia.

Estimates are that about half of older persons with dementia do not have an accurate diagnosis or any diagnosis at all. [3] It is critically important to correctly identify these conditions to enable appropriate referral. A number of conditions can mimic dementia, including dehydration, malnutrition, hearing loss, and depression. Medication mismanagement can result in the appearance of dementia. People with dementia (70 percent of whom live in the community) and their caregivers use the full spectrum of HCBS available from a variety of public and private sector programs. Creating a dementia-capable HCBS system involves building upon and integrating existing programs from the private sector and those that AoA and its partners offer.

Public sector partners include, but are not limited to, tribes or tribal organizations, the Administration for Intellectual and Developmental Disabilities (AIDD); the Centers for Medicare & Medicaid Services (CMS);

and the Department of Veterans Affairs. Among the innovative programs that AoA and its partners have implemented are those listed in the Appendix. It is critical that grantees build dementia capability into their current programs in partnership with key agencies in their states, including, but not limited to, Medicaid and the Veterans Health System. Inclusion of dementia capability in existing and future efforts (i.e.

Medicare-Medicaid integration demonstrations, the State Innovation Models, and other Affordable Care Act initiatives) will foster better quality, coordinated care and improve population health at lower cost.

Funding Opportunity Requirements

Applicants for Part A of this cooperative agreement funding must describe their current system as related to this FOAs goal, objectives, and core components including but not limited to the identification of a lead state agency for dementia capability, and implementation of a partnership between the State Unit on Aging and the State Medicaid Agency.

Applicants for Part B must describe their current system and the activities in which they are engaged through the ADSSP cooperative agreement they are in the process of implementing, including the program component targeted for expansion.

Applicants for Part A and Part B must either agree to implement dementia-capable HCBS systems that meet this FOAs two objectives and their core components, or already be in the process of implementing programs meeting those requirements.

Objective 1: Create and sustain a dementia-capable HCBS system that includes Single Entry Point/No Wrong Door (SEP/NWD) access for people with Alzheimer's disease and related dementias (ADRD) and their caregivers.

In such systems, people with ADRD and their family caregivers have streamlined access to the full array of person-centered, public and private sector HCBS that promote community living and independence.

Applicants for Part A must fully describe how they plan to implement the following four core components of Objective 1 by the end of the cooperative agreement period.

Applicants for Part B must be in the process of implementing the core components of an existing ADSSP grant and identify a specific area of the grant targeted for expansion. The Part B application would fully describe the component proposed for expansion as it relates to their overall existing project, the rationale for the expansion, the target consumers, the methodology and the desired outcomes for the proposed expansion.

The core components include:

1.a. Information, Referral and Access

This component requires that the grantee have a highly visible and trusted place for people with ADRD and their family caregivers to seek objective information on HCBS that maximizes their ability to remain independent in the community. Applicants must fully describe their method(s) for achieving this and providing access to a full range of services, which may include, but are not limited to person-centered home and community-based services; care transitions; and family caregiver support programs. Applicants must provide measurable targets for achieving maximum population coverage of dementia capable information, referral and access for each year of the cooperative agreement period. For example, applicants might propose to have a dementia capable HCBS system available in geographic areas where 25% of the state's population lives in the first year, 35% in the second year and 50% in the third year.

Applicants for Part A must fully describe their methods for achieving this core component of the grant.

Applicants for Part B must be in the process of implementing a project that includes this component.

1.b. Options Counseling and Assistance

Options counseling enables persons with dementia and their family caregivers to understand and use the services available in their communities by assisting in:

Identification of the person with dementias strengths, values, needs, and preferences;

Person-centered service plan development;

Enrollment in self-directed programs or seamless transfer into this process, as appropriate Service initiation;

On-going assistance and follow-up.

Applicants for Part A must fully describe their methods for achieving this core component of the grant.

Applicants for Part B must be in the process of implementing a project that includes this component.

Applicants must provide measurable targets for achieving maximum population coverage for Options Counseling each year of the cooperative agreement period. For example, applicants might propose to have options counseling available in geographic areas where 25% of the states population lives in the first year, 35% in the second year and 50% in the third year.

1.c. Person-Centered Care Transitions Across Multiple Settings

Care transitions is a person-centered, interdisciplinary approach to integrating health care and social support services for individuals and their caregivers as they move across settings, such as hospitals, nursing homes, and home. Care transition services identify individual needs and preferences, develop and activate comprehensive service plans, empower people to take an active role in their health care, and connect them to resources provided by options counselors or staff with similar responsibilities. Care transitions can involve self-direction of services for those with dementia and their caregivers. Examples of evidence-based care transition programs for the general population appear in the definition of care transitions in the Appendix. By the end of the third grant year period, successful applicants must offer person-centered care transitions that are dementia capable in at least two geographic areas of the state.

Applicants for Part A must fully describe their methods for achieving this core component of the grant.

Applicants for Part B must be in the process of implementing a project that includes this component.

1.d. Streamlined Eligibility Determinations for Public Programs and Assistance in Applying for These Programs

Applicants must fully describe how they plan to make Streamlined Eligibility Determination an integral part of their state and local HCBS systems and these systems Options Counseling functions. These processes must be both administratively efficient and easy-to-use for persons with dementia, their family caregivers or their legal representatives, regardless of the program or type of service.

Applicants for Part A must fully describe their methods for achieving this core component of the grant.

Applicants for Part B must be in the process of implementing a project that includes this component.

Objective 2: Ensure access to a comprehensive, sustainable set of quality services/interventions that are dementia-capable and provide innovative services to the population with dementia and their family caregivers.

Applicants for Part A must describe the dementia-capable services/interventions proposed to meet Objective

2. At least one of the proposed services/interventions must be evidence-based or evidence-informed and designed for implementation with individuals living with or at risk of developing Alzheimer's or a related dementia and/or their family caregivers. Applicants must identify, by name, and describe the evidence based or evidence informed intervention they are proposing to implement and how it fits into their proposed program .

Applicants for Part B must be in the process of implementing the core components of an existing ADSSP grant and identify a specific component of the grant that would benefit from expansion.

Applicants for Part A must fully describe how they plan to implement the following three core components of Objective 2 by the end of the cooperative agreement period. These components include the following:

2.a Comprehensive set of services

Applicants for Part A must fully describe how people with ADRD and their family will have access to a wide range of person-centered HCBS that promote independence in the community. These services must be responsive to the individuals needs and preferences, and have self-direction opportunities. The comprehensive set of services must include and identify at least one evidence-based or evidence informed service/intervention, as well as HCBS supports for family caregivers, and related supportive services.

2.b Quality assurance system

Applicants for both Part A and Part B must fully describe their implementation and use of a quality assurance and improvement process that will help ensure delivery of quality, dementia capable services.

Quality measurement and data collection are integral parts of quality assurance. Applicants must propose measurable performance goals and indicators related to the quality assurance systems visibility, ease of access, responsiveness to persons with dementia and their family caregivers, efficiency and effectiveness.

2.c Sustainable service system

Applicants for both Part A and Part B must fully describe how they plan to ensure sustainability of the grantees dementia capable HCBS system. Sustainability involves leveraging existing traditional Federal and State level resources, as well as innovations underway as part of the Affordable Care Act such as the Medicare-Medicaid integration demonstrations, the State Innovation Models, and other Affordable Care Act initiatives.

Grantees must maintain the infrastructure and capacity to deliver programs throughout the state including partnerships that have effectively embedded dementia capability within HCBS systems, and an adequate number of delivery sites and workforce to deliver the programs in geographic areas containing half of the states population. Applicants for both Part A and Part B will identify program outcomes as well as measures to demonstrate program impact and evaluation strategies that will document progress toward implementing and sustaining a comprehensive, dementia capable system.

Please see the dementia-capability issue brief for more information on this type of system at: https://nadrc.acl .gov/node/93 .

Evidence-based or Evidence-informed Services

In addition to implementing and evaluating a dementia capable HCBS system that meets objectives 1 and 2 above, applicants for Part A must identify and fully describe how they plan to provide at least one evidence-based or evidence-informed intervention in the provision of service. The chosen intervention(s) must be designed to assist persons with dementia and their caregivers in maintaining their health and independence while remaining in their communities.

The evidence-based or evidence-informed services of the grantees choosing must be pilot-tested and evaluated in at least one geographic area of the state. Applicants must specify services chosen, summarize the evidence base for those services and the methods the applicants propose to use in developing, pilot testing and evaluating the services. The application must also describe how the service(s) will be sustained and expanded, if proven successful.

Evidence-based programs or interventions have been tested through randomized controlled trials and are: 1) effective at improving, maintaining, or slowing the decline in the health or functional status of older people or family caregivers; 2) suitable for deployment through community-based human services organizations and involve non-clinical workers and/or volunteers in the delivery of the intervention; 3) the research results have been published in a peer-reviewed scientific journal; and 4) the intervention has been translated into practice and is ready for distribution through community-based human services organizations.

Evidence-informed interventions have substantive research evidence that demonstrates an ability to improve, maintain, or slow the decline in the health and functional status of older people or family caregivers. For the purposes of this announcement, evidence-informed interventions:1) have been tested by at least one quasi-experimental design with a comparison group, with at least 50 participants; OR 2) have been adapted from evidence-based interventions.

By the end of the cooperative agreement period, successful applicants must agree to implement, and sustain the core components of dementia-capable HCBS and the successful evidence-based or evidence informed services implemented under this FOA.

Evaluation

Applicants for both Part A and Part B must fully include a robust, independent evaluation plan. The evaluation plan must describe the method(s), techniques and tools that will be used to: 1) determine whether or not the proposed dementia-capability efforts achieved their anticipated outcome(s), and 2) document the lessons learned both positive and negative from the project that will be useful to people interested in replicating it, if it proves successful.

SPECIAL REQUIREMENTS FOR USE OF FUNDS AND MATCHING REQUIREMENTS UNDER

THIS FUNDING OPPORTUNITY ANNOUNCEMENT

States must use these Alzheimer's Disease Supportive Services Program (ADSSP) funds, which are provided under the Public Health Services Act, to implement dementia-capable HCBS systems and at least one evidence-based or evidence-informed service under this FOA.

The Public Health Services Act has specific requirements that shape the use of funds:

The statute governing the ADSSP requires that grantees provide a 25% match (cash and/or in-kind) during the first year, 35% during the second year, and 45% during the third and subsequent years of the grant period. Waivers to these match requirements are not permitted under the Public Health Services Act.

Applicants for Part A are subject to the escalating match over the course of the three year grant.

Applicants for Part B are subject to the Year Three match rate of 45%.

Applicants to both Part A and Part B are subject to the statute governing the ADSSP which states, the State agrees to expend not less than 50 percent of the federal grant funds for the provision of [direct] services to persons with Alzheimer's disease or related dementias and their families.

All ADSSP funded projects are subject to the 50% direct service requirement.

Those services which are listed as direct services in the programs statute are: "...home health care, personal care, [adult] day care, companion services, short-term care in health facilities, and other respite care to individuals with Alzheimer's disease or related disorders that are living in single family homes or congregate settings.

For this FOA, respite is defined as an interval of rest or relief OR the result of a direct service intervention that generates rest or relief for the person with dementia and/or their family caregiver. For example, if people with dementia and/or their family caregivers receive counseling or training through an intervention, the intervention will be considered to have generated respite for the participants. This may be considered part of the direct service requirement.

Applicants to both Part A and Part B are subject to the statute governing the ADSSP which states that the State agrees that not more than 10 percent of the grant will be expended for administrative expenses with respect to the grant.

There are no age restrictions on who may be served through the ADSSP. Any person with Alzheimer's disease or a related dementia or their caregiver, regardless of age, is eligible to benefit from the services provided through the AdSSP program.

In the ADSSP statute, there is a particular focus on providing access to services to individuals, who are members of racial or ethnic minority groups, who have limited proficiency in speaking the English language, or who live in rural areas. Reviewers will be encouraged to give favorable consideration to applicants that propose robust efforts to serve these populations.

Funding Opportunity Requirements

Projects awarded under the Part A cooperative agreement will have two phases:

1. Planning Phase during which the grantee develops a plan acceptable to AoA that will result in accomplishing the goal, objectives, and core components of these objectives and pilot testing of at least one evidence-based or evidence-informed service under this FOA.

2. Implementation Phase that carries out the grantees plan for accomplishing the goal, objectives, and core components of these objectives and pilot testing of at least one evidence-based or evidence-informed service under this FOA.

Projects awarded under the Part B cooperative agreement will be expanding an element of an existing ADSSP program that is well into the implementation stage.

Planning Phase:

Part A applicants are to propose a planning phase of no more than 6 months from the notification date of the grant award. During this planning phase, grantees will be able to access no more than 15% of total grant funding to develop their implementation plan. During the planning phase of the grant, AoA will be actively involved. At the conclusion of the planning phase, the grantee must participate in a Planning Phase Exit Conference and receive the approval of AoA to progress to the Implementation Phase and access the remaining 85 percent of cooperative agreement funding.

During the planning phase the grantee must conduct a dementia capability assessment of the system within they are operating and through which they intend to implement their program.

Implementation Phase:

Part A grantees may not advance to the Implementation Phase without a Planning Phase Exit Conference and AoA staff approval of their implementation plan. Upon AoA approval of the implementation plan the State grantee may begin the Implementation Phase of the grant period. During the implementation phase the grantee must commit to periodic reassessment of their dementia capability to allow them to report on systems change over time.

Part B applicants would be well into the implementation phase of their program they are proposing to expand.

Data Collection

Applicants receiving awards under Part A and Part B will be required to collect OMB approved data (OMB approval # 0985-0022) for the Alzheimer's Disease Supportive Services Program services and any subsequent OMB-approved data during the grant period.

Technical Assistance:

Successful applicants are to draw on the expertise of AoA program staff and existing AoA-sponsored resources, including the National Alzheimer's and Dementia Resource Center (NADRC), to develop, implement, and sustain their strategic plans. All grantees will be expected to participate in technical assistance activities as they pertain to the program development, management and integration. This includes, but is not limited to, participation in regularly scheduled technical assistance conference calls, web casts, and one-on-one technical assistance opportunities initiated by ACL/AoA staff, technical assistance resource center staff or the grantees.

Please see the Appendix for a list of existing resource centers.

At any time after a cooperative agreement is in place, requests to modify or amend it or the work plan may be made by AoA or the awardee. Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the mutual agreement of both parties, except where AoA is authorized under the Terms and Conditions of award, 45 CFR 75, or other applicable regulation or statute to make unilateral amendments.

[1 ] Johnson, R. W., &Wiener, J. M. (2006). A Profile of Frail Older Americans and their Caregivers.

Washington, DC: The Urban Institute. Available at http://www.urban.org/UploadedPDF/311284_older_americans.pdf.

[2 ] U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. (No date).

Unpublished data from rollup summary reports, case mix means and episode counts, national values for the 12-month period from March 2003February 2004, Baltimore MD.

[3 ] Boustani M, Peterson B, Hanson L, Harris R, Lohr, KN. Screening for dementia in primary care: A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2003;

138(11):927-37.

Statutory Authority Pub.L. 78-410; 42 U.S.C. §280c-3. Amended by Pub.L. 101-557 and by Pub.L. 105-392

II. Award Information

Funding Instrument Type: Cooperative Agreement Estimated Total Funding: $3,758,933 Expected Number of Awards: 7 Award Ceiling: $650,000 Per Project Period Award Floor: $300,000 Per Project Period Average Projected Award Amount: $550,000 Per Project Period Length of Project Period: Other

Seven to nine grants. The Part A grant distribution is anticipated to be approximately five traditional ADSSP grants forward-funded for up to three years (floor of $450,000 and ceiling of $650,000) and Part B is approximately three ADSSP expansion grants for 18 months (floor of $300,000 and ceiling of $325,000).

This program is subject to a statutorily mandated escalated cost sharing/matching requirement. The cost sharing/match escalation schedule is as follows 25% in year one, 35% in year two and 45% in year three.

Part A Cooperative Agreements will be a 36 month project period within a 36 month budget period.

Part B Cooperative Agreements will be a 18 month project period within an 18 month budget period.

All awards will be forward-funded for the entire grant project period: Part A - 36 month project period; Part B - 18 month project period, The ACL/AoA plans to fund approximately five Part A Cooperative Agreements with a federal funding level of up to $600,000 and approximately three Part B Cooperative Agreements with a Federal funding level of up to $325,000. The final number of awards will vary based on the following factors: 1) appropriation levels, and 2) the number of applications funded under the FOA.

The size of each award will vary, as dictated by the nature and scope of the projects proposed by applicants.

ACL/AoA reserves the right to offer a lower level of funding than that requested in the application.

Funding decisions are at the discretion of the Administrator for ACL/Assistant Secretary for Aging. Only those applications ranking the highest in a third party review will be recommended for funding by the ACL/AoA Program Officer. It is anticipated that not all applications will be funded.

Description of ACL's Anticipated Substantial Involvement Under the Cooperative Agreement

Once a cooperative agreement is in place, requests to modify or amend it or the work plan may be made by ACL/AoA or the awardee at any time. Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the mutual agreement of both parties, except where ACL is authorized under the Terms and Conditions of award, 45 CFR Part 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.

The ACL/AoA plans to fund approximately eight awards. Part A grants with a federal funding level of up to $600,000 per three year project period and Part B with a federal funding level of up to $325,000. The number of awards will vary based on the following factors: 1) appropriation levels, and 2) the number of applications received under the FOA.

The size of each award will vary, as dictated by the nature and scope of the projects proposed by applicants.

ACL/AoA reserves the right to offer a lower level of funding than that requested in the application.

Funding decisions are at the discretion of the Administrator for ACL/Assistant Secretary for Aging. Only those applications ranking the highest in a third party review will be recommended for funding by the ACL/AoA Program Officer. It is anticipated that not all applications will be funded.

Description of ACL's Anticipated Substantial Involvement Under the Cooperative Agreement

Once a cooperative agreement is in place, requests to modify or amend it or the work plan may be made by ACL or the awardee at any time as long as it stays within the original confines of the proposed project description. 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. When an award is issued the cooperative agreement terms and conditions from the program announcement are incorporated by reference 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.

The grantee agrees to execute the responsibilities outlined below:

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

2. Communicate with the AoA project officer and/or the assigned technical assistance liaison regularly to improve the effectiveness of the activities carried out under this Agreement.

3. Conduct a baseline assessment of the dementia capability in collaboration with Project Officer and technical assistance team.

4. Produce and submit to the AoA/ACL Project Officer, at the conclusion of the project, a summary report or manual describing how the project was conducted and goals were achieved. The report would also include ways in which barriers to goal achievement were addressed.

5. Cooperate with any federal evaluation efforts and comply with the timeline, content and format of all required data collection and reporting requirements (see Section VI-3 for more detail). Submit to the AoA/ACL project officer a final, clean copy of all data developed or supported with these grant funds, in the format in which it was developed or produced, as provided for in the HHS Grants Policy Statement http ://www .hrsa .gov /grant s /hhsgr antsp olicy .pdf ) and referenced in the Notice of Award.

The HHS Grants Policy Statement defines “data” as: “recorded information, regardless of the form or media on which it may be recorded, and includes writings, films, sound recordings, pictorial reproductions, drawings, designs or other graphic representations, procedural manuals, forms, diagrams, work flow charts, equipment descriptions, data files, data processing or computer programs (software), statistical records, and other research data” (p. II-69, Footnote 18).

6. Participate in Learning Collaborative activities as organized by the AoA/ACL Project Officer and the technical assistance team. Collaborative participants will mentor one another in their efforts to fulfill the aims of the ADI-SSS program.

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

"This (report/document/etc.) was supported in part by a cooperative agreement (No. XXX) from the Administration on Aging (AoA), Administration for Community Living (ACL), U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official AoA, ACL, or DHHS policy."

The AoA/ACL project officer agrees to execute the responsibilities outlined below:

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

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

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

3. Provide technical advice to the grantee on the provision of technical support and associated tasks related to the fulfillment of the goals and objectives of this grant.

4. Attend and participate in major project events as appropriate.

5. Communicate with the grantee project director regularly to improve the effectiveness of the activities carried out under this Agreement.

III. Eligibility Information

1. Eligible Applicants The Administration for Community Living/Administration on Aging (ACL/AoA) will award up to $3,758,933 in competitive cooperative agreements to eligible State Units on Aging through this Funding Opportunity Announcement (FOA) entitled: Creating and Sustaining Dementia-Capable Systems to serve Persons with Alzheimer's Disease and Related Dementias and their Family Caregivers.

There are two parts to this funding opportunity, Part A and Part B, both opportunities are extended to eligible state governments and also subject to the following limitations.

Part A, "traditional" ADSSP three year cooperative agreements, is for states that have not already received ADSSP systems integration grants (2011, 2013, 2014, 2015 and 2016). The states are Alabama, Alaska, Arkansas, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Indiana, Kansas, Kentucky, Louisiana, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, U.S. Territories, Utah and Vermont.

Part B, 18 month expansion grants, is extended to those states that received ADSSP systems integration grants in 2011, 2013, 2014, 2015 and 2016 and desire to expand on a specific component of their program.

The states that already have expansion grants in place may not apply for a second one. The expansion grants provide the opportunity for the existing ADSSP grantees to build on a specific component of their ongoing project that shows potential but for which expansion would otherwise not be feasible. These States are Arizona, Colorado, Florida, Illinois, Iowa, Maine, Michigan, New York, Ohio, Oregon, Texas, Washington and West Virginia.

Individuals, foreign entities, and sole proprietorship organizations are not eligible to compete for, or receive, awards under this announcement.

2. Cost Sharing or Matching

Cost Sharing / Matching Requirement: Yes Grantees are required to meet a non-federal share of the project cost, in accordance with Pub.L. 78-410; 42 U.S.C. §280c-3, as amended by Pub.L.101-557 and by Pub.L. 105-392.

There are two types of match: 1) non-federal cash and 2) non-federal in-kind. In general, costs borne by the applicant and cash contributions of any and all third parties involved in the project, including sub-grantees, contractors and consultants, are considered matching funds. Volunteered time and use of facilities to hold meetings or conduct project activities may be considered in-kind (third party) donations. Budgetary funds provided from the applicant agencys budget for costs associated with the project is an example of a non-federal cash match . ACL encourages you to not exceed the minimum match requirement.

Applications with a match greater than the minimum required will not receive additional consideration under the review. Match is one of the responsiveness criteria as noted in Section III, 3 Application Disqualification Factors.

The statute governing the ADSSP requires that grantees provide a 25% match (cash and/or in-kind) during the first year, 35% during the second year, and 45% during the third and subsequent years of the grant period. Waivers to these match requirements are not permitted under the Public Health Services Act.

Applicants for Part A cooperative agreements are subject to the escalated match outlined above. Applicants for Part B cooperative agreements are subject to the year three 45% match rate throughout the entirety of the program expansion project.

Refer to Section IV.2 for Information on pre-application submissions.

3. Responsiveness and Screening Criteria

Application Responsiveness Criteria Applications will be reviewed to establish responsiveness to the following criteria. Those applications that do not meet the required criteria, listed below, will be administratively eliminated and will not be reviewed.

All applications will go through an initial programmatic screening to verify that the applicant meets the following criteria:

Is an eligible State Unit on Aging;1.

Does not propose conduit or pass-through funding for another entity to lead the project;2.

Meets the statutory defined cost sharing/match requirements;3.

Meets statutory defined direct service requirements;4.

Includes quality assurance/outcome measures in their program plan;5.

Identifies and describes an evidence-based/evidence-informed intervention to be implemented over the course of the proposed project;

6.

Does not propose a research project;7.

Does not propose a brick and mortar project;8.

Applications that fail to meet all of the above criteria 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 three 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 the following screening requirements:

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

1.

The Project Narrative section of the Application must be double-spaced, on 8 ½ x 11 plain white paper with 1 margins on both sides, and a standard font size of not less than 11, preferably Times New Roman or Arial.

2.

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

3.

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

IV. Application and Submission Information

1. Address to Request Application Package http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.acl.gov/Funding_Opportunities/Announcements/Index.aspx

Application materials can be obtained from http://www.grants.gov or http://www.acl.gov/Funding_Opportu nities/ Announcements/Index.aspx.

Please note, ACL is requiring applications for all announcements to be submitted electronically through http ://www.grants.gov. The Grants.gov (http://www.grants.gov) registration process can take several days. If your organization is not currently registered with http://www.grants.gov , please begin this process immediately. For assistance with http://www.grants.gov, please contact them at support@grants.gov or 1-800-518-4726 between 7 a.m. and 9 p.m. Eastern Time.

At the http://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 through http://www.grants .gov ;because of the time involved to complete the registration process.

All applicants must have a DUNS number (http://fedgov.dnb.com/webform/) 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.

Applicants should finalize a new, or renew an existing, registration at least two weeks before the application deadline. 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: https://www.sam.gov /sam/ transcript/ SAM_Quick_ Guide_Grants_ Registrations-v1.6. ;pdf .

The agency is prohibited from making an award until an applicant has complied with these requirements. At the time an award is ready to be made, if the intended recipient has not complied with these requirements, the agency:

May determine that the applicant is not qualified to receive an award; and May use that determination as a basis for making an award to another applicant.

Note: Once your SAM registration is active, you will need to 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 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 be:

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

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

2.

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

An award cannot be made until the applicant has complied with these requirements. At the time an award is ready to be made, if the intended recipient has not complied with these requirements, the OPDIV/STAFFDIV:

May determine that the applicant is not qualified to receive an award; and May use that determination as a basis for making an award to another applicant.

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

Since October 1, 2003, The Office of Management and Budget has required applicants to provide a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when applying for http://www.grants.gov/ http://www.acl.gov/Funding_Opportunities/Announcements/Index.aspx http://www.acl.gov/Funding_Opportunities/Announcements/Index.aspx http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ mailto:support@grants.gov?subject=Support http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://fedgov.dnb.com/webform/ http://www.sam.gov/ https://www.sam.gov/sam/transcript/SAM_Quick_Guide_Grants_Registrations-v1.6.pdf https://www.sam.gov/sam/transcript/SAM_Quick_Guide_Grants_Registrations-v1.6.pdf

Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when applying for Federal grants or cooperative agreements. It is entered on the SF 424. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities. The DUNS number is free and easy to obtain.

Organizations can receive a DUNS number at no cost by calling the dedicated toll-free DUNS Number request line at 1-866-705-5711 or by using this link to access a guide: http://www. ;white house.gov/ sites/default/files/omb/grants/duns _num_guide.pdf.

You must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications.

Your application must comply with any page limitation requirements described in this Program Announcement.

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

U.S. Department of Health and Human Services

Erin Long…