HHS-2017-ACL-AOA-ALGG-0227 revised.pdf

Administration for Community Living

Administration on Aging

Alzheimer's Disease Initiative - Specialized Supportive Services (ADI-SSS) Project Financed

Solely by 2017 Prevention and Public Health Funds (PPHF 2017)

HHS-2017-ACL-AOA-ALGG-0227

Application Due Date: 07/14/2017

Alzheimer's Disease Initiative - Specialized Supportive Services (ADI-SSS) Project Financed

Solely by 2017 Prevention and Public Health Funds (PPHF 2017)

HHS-2017-ACL-AOA-ALGG-0227

TABLE OF CONTENTS

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

3. Submission Dates and Times

4. Intergovernmental Review

5. Funding Restrictions

6. 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

Department of Health & Human Services

ACL Center: Administration on Aging Funding Opportunity Title: Alzheimer's Disease Initiative -

Specialized Supportive Services (ADI- SSS) Project Financed Solely by 2017 Prevention and Public Health Funds

(PPHF 2017)

Announcement Type: Modification Funding Opportunity Number: HHS-2017-ACL-AOA-ALGG-0227 Primary CFDA Number: 93.763 Due Date For Letter of Intent: 05/25/2017 Due Date for Applications: 07/14/2017 Date for Informational Conference Call: 05/22/2017

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 Cooperative agreements under this funding opportunity announcement, Alzheimer’s Disease Initiative: Specialized Supportive Services (ADI-SSS) project, are financed solely by 2017 Prevention and Public Health Funds (PPHF-2017). The project is designed to fill gaps in established dementia-capable home and community-based service systems (HCBS) for persons living with or those at high risk of developing Alzheimer’s disease and related dementias (ADRD) and their caregivers by providing quality, person-centered services that help them remain independent and safe in their communities. A model dementia-capable HCBS system would:

1. 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.

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

3. 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.

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

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

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

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

Additional information on dementia-capable systems is found in the issue brief entitled, “Dementia-Capable States and Communities: the Basics.”

The intent of ADI-SSS program cooperative agreements is to fill service gaps identified in the following four areas. Eligible applicants will address a minimum of three of the four gap areas:

1. Provision of effective supportive services to persons living alone with ADRD in the community;

2. Provision of effective care/supportive services to persons living with moderate to severe impairment from ADRD and their caregivers;

3. Improvement of the quality and effectiveness of programs and services dedicated to individuals aging with intellectual and developmental disabilities with ADRD or those at high risk of developing ADRD; and

4. Delivery of behavioral symptom management training and expert consultation for family caregivers.

Eligible applicants are those private and/or public community-based entities that are able to: 1) demonstrate their operation within an existing dementia-capable system dedicated to the population that they serve; and 2) articulate opportunities and additional services in the targeted gap areas that would enhance and strengthen the existing system. Project applicants must identify and propose services that are evidence-based or evidence-informed. Eligible applicants will be those community-based entities that are presently operating within an existing dementia-capable system and not those in the beginning of development of such a system.

The Administration on Aging within the Administration for Community Living (ACL/AoA) plans to award up to twelve cooperative agreements to community-based public or private entities with awards ranging between $800,000 and $1,000,000 with a three-year, thirty-six month, project and budget period. The awards, made in the form of cooperative agreements to ensure ACL/AoA's substantial involvement, have an anticipated start date of September 1, 2017.

I. Funding Opportunity Description An estimated 5.5 million individuals in the United States are living with Alzheimer’s disease, that number is projected to triple by 2050[1]1. The anticipated increase is attributed to individuals living longer as a result of advances in medicine and technology, as well as social and https://nadrc.acl.gov/node/40 environmental conditions[2]2 and thus advancing to ages at which they are at increased risk of developing ADRD. Medical and technological advances are prolonging the lives of individuals living with disabilities of which an estimated 6% are affected by some form of dementia after the age of 60 and increasing with age[3]3. Of the community dwelling individuals with ADRD, approximately one-third live alone, putting them at an increased risk of, among other things, unmet needs, malnutrition and injury and various forms of neglect and exploitation[4]4. The complexity of care of persons with advanced dementia is defined by the severity of functional and cognitive impairment, reliance on surrogate decision-making, inability to live alone and tremendous family/caregiver burden[5]5. Behavioral symptoms such as repetitive speech, wandering, and sleep disturbances are a core clinical feature of Alzheimer disease and related dementias. If untreated, these behaviors can accelerate disease progression, worsen functional decline and quality of life, cause significant caregiver distress, and result in earlier nursing home placement[6]6.

In 1992 the Congress created the Alzheimer’s Disease Demonstration Grants to States (ADDGS) program to improve home and community-based services for persons living with ADRD and their families. As the number of people with Alzheimer’s disease grows, it is increasingly important that service delivery and health care systems are responsive to persons with dementia and are effectively coordinated. In 2008, the ADDGS program evolved into the Alzheimer’s Disease Supportive Services Program (ADSSP), with expanded goals of increased availability of services for persons with ADRD, their families and caregivers and improved responsiveness of the home and community-based service (HCBS) system. In 2011, the ADSSP expanded its scope to focus on ensuring the availability of dementia-capable community-based social and health care service through the coordination and incorporation of ADRD into these broader systems.

Despite the broad reach of the ADSSP, service and support gaps remain. In an effort to fill some existing gaps, in 2014 the Alzheimer’s Disease Initiative – Specialized Supportive Services (ADI- SSS) program was financed for the first time using resources from the Prevention and Public Health Fund (PPHF).

ADI-SSS is dedicated to filling identified services gaps through the provision of home and community-based services to both targeted special populations and targeted training and is implemented with authority contained within Title IV of the Older Americans Act.

Specifically, successful applicants will engage in activities, in support of individuals with ADRD that address a minimum of three of the following four identified service gap areas below:

1. Develop and deliver supportive services to persons living alone with ADRD in communities;

2. Promote and provide person- and family-centered care and training to improve care for and prepare individuals living with moderate to severe impairment and their caregivers for the future;

3. Improve the quality and effectiveness of programs and services dedicated to individuals aging with intellectual and developmental disabilities with ADRD or those at high risk of developing ADRD; and

4. Deliver behavioral symptom management training and expert consultation to family caregivers.

It is through programs such as this that the Administration for Community Living (ACL) demonstrates its commitment to its mission to maximize the independence, well-being, and health of older adults, people with disabilities, and their families and caregivers[7]7.

The expanded availability of specialized services under this announcement will be provided within an existing dementia-capable home and community-based service system by public and/or private community-based organizations. Eligible organizations are those which are able to both demonstrate their operation within an existing dementia-capable system dedicated to the population they serve, and articulate opportunities and additional services that would enhance and strengthen the existing system. Successful applicants under this program will be leaders in existing dementia-capable systems designed to improve the quality and effectiveness of programs and services.

The necessity of these specialized services is exemplified by the aging of the Baby Boom generation which is resulting in increased numbers of people with dementia living alone with no family caregivers available. The appropriate response to such an increase is an effective supportive service system that is capable of provision of services to persons living alone with ADRD in the community. Promotion and provision of person- and family-centered care and training for individuals living with moderate to severe impairment from ADRD and their caregivers are essential in efforts to prevent hospitalizations and burdensome transitions. Medical and technological advances have resulted in an increase in the number of individuals living with intellectual and developmental disabilities living long enough to become consumers of aging network services. Behavioral symptoms occur in almost everyone with dementia and symptom management is very difficult for an untrained caregiver, without assistance from experts.

Behavioral symptom management training and expert consultation for family caregivers (broadly defined to include close friends and partners) is an integral piece of the ADI-SSS project.

Behavioral interventions may include: provision of caregiver education and support, training in problem solving, and targeted therapy directed at the underlying causes for specific behaviors (e.g. implementing nighttime routines to address sleep disturbances)[8]8. The system within which such individuals and their caregivers operate should be capable of addressing their unique needs and the provision of effective services.

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. Successful applicants would demonstrate the used of person-centered practices in all of the required service areas listed above. For example, an individual may be experiencing and reacting to pain, and through a person-centered approach the cause of the pain may be identified and removed, thereby alleviating the pain and the resulting behavior. A person-centered approach affords systems the opportunity to address previously unmet needs of persons with ADRD and their caregivers. People with dementia (70% 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 system involves building upon and integrating existing programs from the private sector and those that ACL/AoA and its partners offer. Public sector partners include the Administration for Intellectual and Developmental Disabilities (AIDD); the Centers for Medicare & Medicaid Services (CMS); and the Department of Veterans Affairs. Innovative programs that ACL/AoA and its partners have implemented are those listed in the Appendix of this funding opportunity announcement. 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, the Veterans Health System and Indian Health Services and Tribal Organizations. Inclusion of dementia capability in existing and future efforts (i.e., Medicare- Medicaid integration demonstrations, the State Innovation Models, and other relevant initiatives) will foster better quality, coordinated care and improve population health at lower cost.

Funding Opportunity Requirements The cooperative agreement will have two phases:

1. Planning phase during which the grantee develops a work plan, based on the work plan contained in the original application, acceptable to ACL/AoA that will result in accomplishing the goal, objectives, and core components of these objectives.

2. Implementation phase that carries out the grantee’s plan for accomplishing the goal, objectives, and core components of these objectives.

Planning Phase 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. ACL/AoA will be actively involved during the planning phase of the grant. At the conclusion of the planning phase, the grantee must participate in a “Planning Phase Exit Conference” and receive the approval of ACL/AoA to progress to the Implementation Phase and access the remaining 85 percent of cooperative agreement funding.

Implementation Phase The grantee may not advance to the Implementation Phase without a “Planning Phase Exit Conference” and ACL/AoA staff approval of their implementation plan. Upon ACL/AoA approval of the implementation plan the grantee may begin the implementation Phase of the grant period.

Direct Service Requirement The successful applicants will be required to dedicate 30% of its first-year budget, 40% of its second-year budget and 50% of its third-year budget to the provision of direct services. Budget narratives included in the program application should include clear identification of the lines with the budget where the funds for the required direct services will reside.

In light of the service area priority of this funding opportunity, applicants whose budget reflects low administrative expenses will receive a more favorable rating.

Data Collection

Grantees will be required to collect information on services provided under the authority of existing or future approved data collections.

Evaluation All successful grant applications will include a plan for a robust, independent evaluation.

At the onset of the project, grantees will be required to conduct a baseline assessment of the dementia capability of their existing systems, using either the Community-Based Entities Dementia Capability Quality Assurance Assessment Tool created by the National Alzheimer’s and Dementia Resource Center ( https://nadrc.acl.gov/node/43 ) or another tool approved by ACL program staff. The assessment will afford grantees the opportunity to create metrics for use in future service program evaluations, as well as a basis for setting goals, objectives and milestones for program monitoring and reporting throughout the program period. In an effort to track program progress toward enhanced dementia-capability and document progress toward systems change, grantees will agree to conduct annual follow-up assessments in each year of program funding throughout the duration of the program. Use of a progressive assessment model will ensure that, at the conclusion of the program period, programs will be able to document their progress by reporting on the aspects of their project that were successful and those that were not, as well as the lessons learned.

Applications will be scored on the extent to which a robust, independent project evaluation is undertaken. Evaluations should, at a minimum, determine the effectiveness and impact of the strategies and processes used for execution of project goals at both the systems development and consumer (service provision) level. More information on evaluation expectations can be found in Section V of this funding opportunity announcement.

Technical Assistance Successful applicants are to draw on the expertise of ACL/AoA program staff and existing AoA-sponsored resources to develop, implement, and sustain their strategic work plans. All grantees are required 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, learning collaboratives and one-on-one technical assistance opportunities initiated by ACL/AoA staff, technical assistance resource center staff or the grantees.

[1]Alzheimer’s Association. 2017 Alzheimer’s Disease Facts and Figures. Accessed March 27, 2017 at https://www.alz.org/documents_custom/2017-facts-and-figures.pdf.

[2] Vincent, GK, Velkof, VA. The Next Four Decades: The Older Population in the United States: 2010-2050. Washington, DC. US Census Bureau, 2010. Accessed March 27, 2017 at https://www.census.gov/library/publications/2010/demo/p25-1138.html.

[3] National Task Group on Intellectual Disabilities and Dementia Practice. My Thinker’s Not Working. January2012.AccessedMarch 28, 2017at http://aadmd.org/ntg/thinker.

[4] Gould, E., Maslow,K.,LePore,M.,etal.Identifying and Meeting the Needs of Individuals With Dementia Who Live Alone. Accessed March 28, 2017 at https://nadrc.acl.gov/sites/default/files https://nadrc.acl.gov/node/43 file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref1 https://www.alz.org/documents_custom/2017-facts-and-figures.pdf file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref2 https://www.census.gov/library/publications/2010/demo/p25-1138.html file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref3 http://aadmd.org/ntg/thinker file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref4 https://nadrc.acl.gov/sites/default/files/uploads/docs/PWD_Living_Alone%202015.pdf

/uploads/docs/PWD_Living_Alone%202015.pdf.

[5]National Alzheimer Project Act Advisory Council on Alzheimer's Research, Care, and Services Meeting #15: Advanced Dementia Expert Panel Summary and Key Recommendations.

(2015,January26). January 26, 2015 In-Person Meeting. Accessed March 27, 2017 at https://aspe.hhs.gov/experts-advanced-dementia-january-2015-meeting.

[6 ]GitlinLN,KalesHC,LyketsosCG.NonpharmacologicManagementofBehavioralSymptomsinDeme ntia. JAMA. 2012;308(19):2020-2029.oi:10.1001/jama.2012.36918.

[7]Administration for Community Living. ACL Strategic Plan 2013-2018. Accessed March 28, 2017 at http://acl.gov/About_ACL/StrategicPlan/docs/ACL_Strategic_Plan.pdf.

[8]Gitlin LN, Kales HC, Lyketsos CG. Nonpharmacologic Management of Behavioral Symptoms in Dementia. JAMA. 2012;308(19):2020-2029. doi:10.1001/jama.2012.36918.

Statutory Authority Title IV of the Older Americans Act as reauthorized in 2016 and with funding provided for in the Patient Protection and Affordable Care Act, Prevention and Public Health Fund (PPHF)(42 U.S.C. § 300u-11). Authority for the transfer of PPHF resources for Alzheimer’s Disease Prevention Education and Outreach is contained within the Consolidated Appropriations Act, 2014, Pub. L. 113-76, Div. H., Title II, § 219(a).

II. Award Information Funding Instrument Type: Cooperative Agreement Estimated Total Funding: $10,050,746 Expected Number of Awards: 12 Award Ceiling: $1,000,000 Per Project Period Award Floor: $800,000 Per Project Period Length of Project Period: Other

36 month project and budget period All awards will be fully funded for the entire 36 month project period.

ACL/AoA plans to forward fund up to twelve cooperative agreements with a federal funding level of up to $1,000,000 per project period with one three-year budget period. The 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 highest in a third-party panel review will be https://nadrc.acl.gov/sites/default/files/uploads/docs/PWD_Living_Alone%202015.pdf file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref5 https://aspe.hhs.gov/experts-advanced-dementia-january-2015-meeting https://aspe.hhs.gov/experts-advanced-dementia-january-2015-meeting file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref6 file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref6 file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref7 http://acl.gov/About_ACL/StrategicPlan/docs/ACL_Strategic_Plan.pdf file:///U:/Alzheimers/2017%20ADI-SSS/ALGG_AoA_FOA_4-23-17_Alz-Dis-Initative-SSS%20(2)_JB%20edits%20FINAL%20revisions%20for%20upload.docx#_ftnref8 recommended for funding by the ACL/AoA Program Officer. It is anticipated that not all applications will be funded.

Description of ACL/AoA 's Anticipated Substantial Involvement in the Cooperative Agreement This Cooperative Agreement is subject to terms provided for in the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224). This Cooperative Agreement provides for the substantial involvement and collaboration of ACL/AoA in activities that the recipient organization will carry out in accordance with the provisions of the approved award.

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. Subsequent to the baseline assessment, conduct annual assessments of the program dementia capability through the duration of the project;

5. Produce and submit to the ACL/AoA 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;

6. 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 ACL/AoA project officer a final, clean copy of all data developed or supported with these grant funds, in the format in which it was developed or produced, as provided for in the HHS Grants Policy Statement (http://www.hhs.gov /sites/default/files/grants/grants/policies-regulations/hhsgps107.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), http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf statistical records, and other research data” (p. II-69, Footnote 18);

7. Participate in program collaborative activities as organized by the ACL/AoA Project

Officer and the technical assistance team. Collaborative program activity participants will mentor one another in their efforts to fulfill the aims of the ADI-SSS program; and

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

"This project was supported, in part by grant number 90XXXX####, from the U.S.

Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy."

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

1. 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;

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

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

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

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

6. 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 competitive cooperative agreements to eligible domestic community-based public and/or private entities. In order to extend sophisticated dementia-capable services to the special populations targeted with this funding opportunity announcement, entities that are able to 1) demonstrate their operation within an existing community-based dementia-capable system dedicated to the population that they serve, and 2) articulate opportunities and additional services that would enhance and strengthen the existing dementia-capable system in which they are operating may apply to receive grant resources.

This funding opportunity is not extended to entities that are unable to 1) demonstrate their operation within an existing community-based dementia-capable system dedicated to the population that they serve, and 2) articulate opportunities and additional home and community-based services that would enhance and strengthen the existing system in which they are operating.

This funding opportunity is not extended to entities not operating within an existing dementia-capable community-based system or those organizations that received awards as a result of the following funding opportunity announcements in 2014, 2015 and 2016 (HHS-2014-ACL-AOA- AL-0090, HHS-2015-ACL-AOA-AL-0104 and HHS-2016-ACL-AOA-ALGG-0152). The entities excluded from eligibility because they received awards under this program in 2014, 2015 or 2016 are: Alzheimer's & Dementia Alliance of Wisconsin, Alzheimer's Association of Greater Michigan, Alzheimer's Greater Los Angeles, Alzheimer's San Diego, Alzheimer's Community Cares, Board of Regents University of Wisconsin System, County of San Diego, Delaware Department of Health and Social Services, District of Columbia Office on Aging, Georgia Southwestern University, Family Services of Westchester, Florida Atlantic University, Greenville Health Systems, Illinois Department on Aging Division of Older America, Jewish Family & Children's Services of Sarasota, FL, Jewish Family Service of San Diego, Lehigh Valley Hospital, Inc., Lutheran Services of Puerto Rico, Minnesota Board on Aging, Neighborhood Centers, Inc., Nevada Aging and Disability Service Division, Orange County Department on Aging, Regents of the University of California - San Francisco, San Francisco Human Services Agency, Senior Citizen's Council of Sheridan, WY, Seven Hills Rhode Island, Inc., Southern Maine AAA, United Way of Tarrant County, University of Hawaii, University of Kansas Medical Center Research Institute, Virginia Department for Aging and Rehabilitative Services, Wisconsin Department of Health Services.

States, 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 The federal match required for the ADI-SSS program is 25% (cash and/or in-kind). All applicants are required to comply with the 25% match requirement outlined in the funding opportunity announcement (FOA). Applicants have the opportunity to apply for waivers of a portion of the match. Waivers to match requirements under this program will not result in requirements below 15%.

Applicants desiring to apply for a match waiver should include their desire for the waiver in their application. Applicants requesting match waiver must provide a compelling reason for the necessity of the desired waiver. There are no guarantees that an applicant requesting a match waiver will receive one. Applicants desiring a match waiver should plan their budget using the 25% full match and include in their application package a letter outlining their waiver request which includes a compelling rationale for a match waiver.

The match waiver application would include the proposed percentage of the match to be waived, as well as the compelling reason for the request. The desired waiver request should not result in a match level that falls below 15%. If the grant application that includes a waiver request is successful and the waiver request is also approved, the appropriate budget modification will occur during the budget negotiation period.

If a match waiver request included in a successful grant application is not approved, there will not be an opportunity for a budget revision and the grantee will be expected to supply the full 25% match provided in the original application budget.

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 agency’s budget for costs associated with the project are 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.

3. Responsiveness and Screening Criteria

Application Responsiveness Criteria All applications will go through an initial programmatic screening to verify that the applicant meets the minimal responsiveness criteria.

Applications will be reviewed to establish responsiveness to the following criteria. Those that do not meet the required criteria will be administratively eliminated and will not be reviewed.

The responsive ADI-SSS project application will:

1. Demonstrate operation within an existing dementia-capable home and community-based service system;

2. Identify at least the minimum number of required targeted gap areas that the program will address (including a well-articulated implementation work plan in each target area);

3. Demonstrate the intent to meet program direct service requirements;

4. Include outcome measures in their program plan (ACL will NOT fund any project that does not include measurable outcomes);

5. Name at least one evidence-based or evidence informed dementia specific intervention directed at persons with dementia and/or caregivers and demonstrate the intent to implement it in their proposed program;

6. Demonstrate preparedness and agree to conduct a baseline assessment of the dementia capability of the existing system with the intent of creating metrics for use in future service program evaluations, as well as a basis for setting goals, objectives and milestones for program monitoring and reporting throughout the program period;

7. Demonstrate capacity to serve persons of all ages with dementia, including those with intellectual and developmental disabilities;

8. Develop and implement strong collaboration among entities serving individuals living with ADRD and their caregivers, including but not limited to, the state’s Agencies for Aging, Medicaid, Tribal Organizations and agencies that serve persons living with intellectual and developmental disabilities;

9. Build on existing access points for services relevant to these agencies;

10. Agree to participate in collaborative learning and technical assistance activities devoted to dementia capability and specialized services;

11. Include a sustainability plan for program elements that are deemed successful;

12. Include a robust, independent evaluation plan;

13. Meet match requirements;

14. Include a work plan, budget and budget justification;

15. Not propose conduit or pass-through funding for another agency to lead the project;

16. Not propose a brick and mortar project;

17. Not propose a research project; and

18. Not be a state, individual, foreign entity, or sole proprietorship organization.

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:

1. 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.

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

3. 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 are not counted as part of the Project Narrative for purposes of the 20-page limit.

Unsuccessful submissions will require authenticated verification from http://www.grants.gov indicating system problems existed at the time of your submission. For example, you will be required to provide 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 Application materials can be obtained from http://www.grants.gov or https://www.acl.gov/grant http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ https://www.acl.gov/grants/applying-grants s/applying-grants.

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, please begin this process immediately. For assistance with http://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 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 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.

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

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 federal grants or cooperative agreements. It is entered on the SF-424. It is a unique, nine-digit identification number, which provides unique https://www.acl.gov/grants/applying-grants http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ mailto:support@grants.gov?subject=Support mailto:support@grants.gov?subject=Support 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 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 866-705-5711 or by using this link to access a guide: http ://www. ;whitehouse.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.

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 Office of Supportive and Caregiver Services E-mail: erin.long@acl.hhs.gov

2. Content and Form of Application Submission

Letter of Intent

Due Date for Letter of Intent: 05/25/2017 Letters of intent should be emailed to:

Erin Long Office of Supportive and Caregiver Services Administration for Community Living

Email: erin.long@acl.hhs.gov .

Project Narrative The Project Narrative must be double-spaced, on 8.5” x 11” paper with 1” margins on both sides, and a standard font size of no less than 11-point, preferably Times New Roman or Arial.

You can use smaller font sizes to fill in the Standard Forms and Sample Formats. The suggested length for the Project Narrative 10 to 20 pages; 20 pages is the maximum length allowed.

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. The Project Work Plan, Letters of Commitment, and Vitae of Key Personnel are not counted as part of the Project Narrative for purposes of the 20-page limit, but all of the other http://www.whitehouse.gov/sites/default/files/omb/grants/duns_num_guide.pdf http://www.whitehouse.gov/sites/default/files/omb/grants/duns_num_guide.pdf http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ mailto:erin.long@acl.hhs.gov mailto:erin.long@acl.hhs.gov sections noted below are included in the limit.

The components of the Project Narrative counted as part of the 20-page limit include:

Summary/Abstract Problem Statement Goal(s) and Objective(s) Proposed Intervention Special Target Populations and Organizations Outcomes Project Management

Summary/Abstract This section should include a brief (265 words maximum) description of the proposed project, including: goal(s), objectives, outcomes, and products to be developed. Detailed instructions for completing the summary/abstract are included in the “Instructions for Completing the Project Summary/Abstract.”

Problem Statement This section should describe, in both quantitative and qualitative terms, the nature and scope of the particular problem or issue the proposed intervention is designed to address, including how the project will potentially affect older adults and/or people with disabilities, their families, and caregivers as well as the health care and social services systems.

In this section:

Describe the impact of ADRD on the population that you serve;

Describe existing service gaps;

Describe the dementia capability of the existing system within which the applicant organization will operate and how it pertains to the target populations;

Describe the trainings and services presently available to address behavioral symptom management, and

Describe the management, systems, financial or other challenges requiring attention in order to implement and sustain programs funded under this opportunity.

Goals and Objectives This section should consist of a description of the project’s goal(s) and major objectives. Unless the project involves multiple, complex interventions, we recommend you have only one overall goal.

Identify your proposed project goal(s) and major objectives, including the projected total number of individuals who will benefit from services provided under this funding announcement;

How you plan to address the major challenges identified in the problem statement;

Description of partnerships, collaborations and innovative activities that will take place in support of goal/objective achievement;

Explanation of how program activities will be marketed and participants identified; and

Description of the sustainability plan for program elements that are deemed successful.

Proposed Intervention This section should provide a clear and concise description of the intervention you are proposing to use to address the problem described in the “Problem Statement.” You should also describe the rationale for using the particular intervention, including factors such as: “lessons learned” for similar projects previously tested in your community, or in other areas of the country; factors in the larger environment that have created the “right conditions” for the intervention (e.g., existing social or economic factors that you’ll be able to take advantage of, etc.). Also note any major barriers you anticipate encountering, and how your project will be able to overcome those barriers. Be sure to describe the role and makeup of any strategic partnerships you plan to involve in implementing the intervention, including other organizations, supporters, and/or consumer groups.

Special Target Populations and Organizations This section should describe how you plan to involve organizations in a meaningful way in the planning and implementation of the proposed project. This section should also describe whether, and if so, how the proposed intervention will target hard-to-reach populations, such as limited-English speaking populations, those of greatest economic need, and those of greatest social need.

Outcomes This section of the project narrative must clearly identify the measurable outcome(s) that will result from the project. (NOTE: ACL will not fund any project that does not include measurable outcomes.) This section should also describe how the project’s findings might benefit the field at large, (e.g., how the findings could help other organizations throughout the nation to address the same or similar problems.), List measurable outcomes in the optional work plan grid (“Project Work Plan – Sample Template”) under “Measurable Outcomes,” in addition to any discussion included in the narrative along with a description of how the project might benefit the field at large.

A “measurable outcome” is an observable end-result that describes how a particular intervention benefits consumers. It demonstrates the functional status, mental well-being, knowledge, skill, attitude, awareness, or behavior. It can also describe a change in the degree to which consumers exercise choice over the types of services they receive, or whether they are satisfied with the way a service is delivered. Additional examples include: a change in the responsiveness or cost-effectiveness of a service delivery system; a new model of support or care that can be replicated in the aging network; new knowledge that can contribute to the field of aging; a measurable increase in community awareness; or a measurable increase in persons receiving services. A measurable outcome is not a measurable “output”, such as: the number of clients served;

the number of training sessions held; or the number of service units provided.

You should keep the focus of this section on describing what outcome(s) will be produced by the project. You should use the Evaluation section noted below to describe how the outcome(s) will be measured and reported.

Your application will be scored on the clarity and nature of your proposed outcomes, not on the number of outcomes cited.