HHS--2021--ACL--AOA--ADPI--0104.pdf

Administration for Community Living

Administration on Aging

Alzheimer's Disease Programs Initiative - Dementia Capability in Indian Country

HHS-2021-ACL-AOA-ADPI-0104

07/19/2021

Table of Contents Executive Summary

Additional Overview Content/Executive Summary

I. Funding Opportunity Description

II. Award Information

III. Eligibility Information

1. Eligible Applicants

2. Cost Sharing or Matching

3. Responsiveness and Screening Criteria

IV. Application and Submission Information

1. Address to Request Application Package

2. Content and Form of Application Submission

Letter of Intent

Project Narrative

Summary/Abstract

Problem Statement

Goals and Objectives

Proposed Intervention

Special Target Populations and Organizations

Outcomes

Project Management

Evaluation

Dissemination

Organizational Capability

Budget Narrative/Justification

Work Plan

Letters of Commitment from Key Participating Organizations and Agencies

3. Submission Dates and Times

4. Intergovernmental Review

5. Funding Restrictions

6. Other Submission Requirements

V. Application Review Information

1. Criteria

Organizational Capacity (8 Points)

2. Review and Selection Process

3. Anticipated Announcement Award Date

VI. Award Administration Information

1. Award Notices

2. Administrative and National Policy Requirements

3. Reporting

4. FFATA and FSRS Reporting

VII. Agency Contacts

VIII. Other Information

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

Appendix

Instructions for Completing Required Forms

Budget Narrative/Justification- Sample Format

Instructions for Completing the Project Summary/ Abstract

ACL Center:

Administration on Aging Funding Opportunity Title:

Alzheimer's Disease Programs Initiative - Dementia Capability in Indian Country Funding Opportunity Number:

HHS-2021-ACL-AOA-ADPI-0104

Primary CFDA Number:

Due Date for Letter of Intent:

06/01/2021 Due Date for Applications:

07/19/2021 Date for Informational Conference Call:

06/03/2021 Applications that fail to meet the application due date will not be reviewed and will receive no further consideration. You are strongly encouraged to submit your application a minimum of 3-5 days prior to the application closing date. Do not wait until the last day in the event you encounter technical difficulties, either on your end or, with https://www.grants.gov. Grants.gov can take up to 48 hours to notify you of a successful submission.

Executive Summary Additional Overview Content/Executive Summary Cooperative agreements under this Alzheimer’s Disease Programs Initiative (ADPI) Funding Opportunity Announcement (FOA) are intended to support and promote the development and implementation of dementia-capable home and community-based service (HCBS) systems in https://www.grants.gov/

Indian Country. The Dementia Capability in Indian Country program is intended to support federally recognized tribes, tribal organizations, and/or consortiums representing federally recognized tribes in these target activities. The dementia-capable systems resulting from activities under this program are expected to provide quality, person-centered services and supports that help Tribal elders and other individuals living with dementia and their caregivers remain independent and safe in their communities.

Applicants for the 36-month Dementia Capability in Indian Country cooperative agreement are those entities that are presently responsible for the provision of and actively providing home and community-based services in tribal communities (i.e., tribes, tribal organizations and/or consortiums representing federally recognized tribes). Applicants will propose to enhance existing service systems with dementia services, resulting in the provision of services to Tribal elders and their caregivers through a dementia-capable system. Responsive applications will include a signed resolution(s) permitting the tribal organization to apply for the ADPI Dementia- Capability in Indian Country funding opportunity. The inclusion of the resolution will demonstrate tribal leadership support and the authority to conduct the activities proposed in the application. If the organization is applying as a consortium, a signed resolution to apply for the current grant cycle from each member of the consortium is required.

Applicants are expected to develop a three-year program that includes dementia-capable supports and services for elders living with dementia and their caregivers as well as dementia education and training of the greater tribal communities. Eligible applicants will collaborate with relevant subject matter experts and community and government entities to design and implement culturally competent quality, person-centered services and support programs.

Applicants will propose three-year programs that include project milestones that will demonstrate continued progress toward stated goals.

Additional Application Elements

Highlights of additional program requirements to which applicants are subject are noted below with further information outlined in the full funding opportunity description:

Inclusion of a signed resolution(s) permitting the tribal organization to apply for the ADPI Dementia-Capability in Indian Country funding opportunity;

Propose implementation of a minimum of one dementia-specific evidence-based or evidence-informed intervention during the course of the grant (Administration for Community Living (ACL)/Administration on Aging (AoA) definitions of evidence-based and evidence informed are provided in this FOA);

10% cost sharing/match;

Dedication of a percentage of TOTAL grant funds to the provision of direct services as defined in the announcement (Year 1: 25%, Year 2: 35%, Year 3:

45%);

Phased program implementation including program milestones for each year;

No single program partner may receive more than 20 percent of funding (Note: pass-through or conduit projects are prohibited);

Participation by primary grantee and partners in an initial and then annual Dementia Capability Assessment;

Robust, third-party, program evaluation, including anticipated program outcomes and measures to demonstrate program impact on persons living with dementia and their caregivers;

Compliance with program-specific, OMB-approved data collection activities, and

Participation in technical assistance opportunities.

Emailed Letters of Intent are requested (but not required) to be submitted 10 days after the FOA posting date.

ACL will host an informational conference call in relation to this FOA; the call will be recorded and made available to the public immediately following the call.

Call Date: June 3, 2021 Call Time: 3:00-4:00 pm (Eastern) Conference Line #: 888-790-3545 Participant Code: 8559592 Instant Replay available until July 4, 2021 at 800-835-5808, passcode 88747

Please direct any questions about this FOA to erin.long@acl.hhs.gov.

I. Funding Opportunity Description The National Institute on Aging defines dementia, a major cause of impairment among older adults, as the loss of cognitive functioning, thinking, remembering, and reasoning and behavioral abilities, to the extent that it interferes with a person’s daily life and activities. Dementia is an umbrella term under which many different types of cognitive impairment fall. Alzheimer’s disease is the most common form of dementia; vascular dementia is the second most common.

Estimates of the percentage of older persons with dementia vary, but its prevalence increases with age. Impairment, resulting from dementia, ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.

A study in 2016 revealed that American Indians, Native Alaskans (AI/AN), and African Americans are at the highest risk of developing dementia. Age is the most common risk factor for dementia, as the number of Native Americans reaching older ages continues to increase the expectation is that there will be more tribal elders with dementia. Other risk factors for dementia include, but are not limited to, diabetes, high blood pressure, and heart disease, all of which are common in AI/AN communities. [1] There are 573 federally recognized tribes across the United States, each with unique cultures, traditions and languages. Some tribes do not have a term that translates to dementia. [2] The Centers for Disease Control and Prevention estimates that between 2014 and 2060 the number of AI/AN 65 and older will grow to five times its current size. [3] Tribes would benefit from culturally competent supports and services and educational resources to support tribal elders and their caregivers.

mailto:erin.long@acl.hhs.gov

A number of conditions cause dementia-like symptoms, including dehydration, malnutrition, hearing loss, and depression. Medication mismanagement can also result in the appearance of dementia. People with dementia and their caregivers use a broad range of home and community-based services (HCBS) available from public and private sector programs.

People living in the community with Alzheimer’s disease and related dementias (ADRD) are at an increased risk of unmet needs, malnutrition, injury, and various forms of neglect and exploitation. [4] Caring for people with advanced dementia is defined by the severity of their functional and cognitive impairment and their reliance on other trusted individuals to make their decisions as well as their inability to live alone and increased burden on families and caregivers.

Elders demonstrate dementia thru certain behaviors, including repetitive speech, wandering, and sleep disturbances all of which are core clinical features of ADRD. 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. [5]

Alzheimer's disease is responsible, at least in part, for an estimated 60 percent of cases of dementia. [6] The CDC reports that one in six AI/ANs aged 45 and older has reported difficulties in memory or thinking. [7] Individuals are living longer because of advances in medicine and technology, as well as social and environmental conditions [8] and thus advancing to ages at which they are at increased risk of developing ADRD.

Estimates are that about half of older persons with dementia do not have an accurate diagnosis or any diagnosis. [9] CDC estimates that only one in three AI/ANs that have experienced memory loss have talked to their doctors about it. [10] It is critically important to identify these conditions correctly to provide for appropriate referrals to dementia-capable services that are supportive of individuals living with dementia and their family caregivers. Given the impact of the dementia on people and communities, the HCBS service systems that wish to be dementia- capable should consider adopting key aspects of a dementia-capable HCBS model.

A dementia-capable HCBS system should:

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 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.

Information on how HCBS providers can become dementia-capable, thus increasing their ability to help people with dementia and their caregivers can be found in ACL’s paper entitled Dementia Capable States and Communities: Lessons Learned from Administration on Aging Grantees.

Dementia-capable services within a home- and community-based system (HCBS) are those that build upon and integrate existing programs from both private and public sectors. Public sector partners/programs include, but are not limited to, tribes or tribal organizations, Area Agencies on Aging, Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), and the Department of Veterans Affairs (VA).

The ACL’s Alzheimer’s Disease Programs Initiative (ADPI) is informed by the work and recommendations of National Alzheimer's Project Act Advisory Council and is dedicated to filling gaps in services, through the provision of HCBS to both targeted special populations and targeted training at both the State and Community levels. The ADPI is implemented with authority contained within Title IV of the Older Americans Act.

The ADPI is not intended as a program funding "research"; in fact, “research” projects will not be funded. The program is designed to pilot much-needed dementia-capable HCBS programs to communities, evaluate program outcomes and using program outcome data to garner support to sustain successful initiatives beyond the Federal program period. The ADPI grant program is intended to advance non-clinical, social models of HCBS in support of persons with dementia and their 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.

1. Centers for Disease Control and Prevention. Healthy Brain Initiative: Road Map for Indian Country. Accessed March 29, 2021 at https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf.

2. Winchester, Blythe. Dementia in Indian Country. Accessed March 29, 2021 at https://www.ihs.gov/newsroom/ihs-blog/november2018/dementia-in-indian-country/.

3. Centers for Disease Control and Prevention. Healthy Brain Initiative: Road Map for Indian Country. Accessed March 29, 2021 at https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country- 508.pdf .

4. Gould, E., Maslow,K.,LePore,M.,et al. Identifying and Meeting the Needs of Individuals With Dementia Who Live Alone. Accessed April 2, 2021 at https://nadrc.acl.gov/details?search1=79#result .

https://nadrc.acl.gov/details?search1=93#result https://nadrc.acl.gov/details?search1=93#result https://aspe.hhs.gov/national-alzheimers-project-act https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf https://www.ihs.gov/newsroom/ihs-blog/november2018/dementia-in-indian-country/ https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf https://nadrc.acl.gov/details?search1=79#result

5. Gitlin LN, Kales HC, Lyketsos CG. Non-pharmacologic Management of Behavioral Symptoms in Dementia. JAMA. 2012;308(19):2020-2029.oi:10.1001/jama.2012.36918.

6. Alzheimer’s Association. 2021 Alzheimer’s Disease Facts and Figures. Accessed March 29, 2021 at https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf .

7. Centers for Disease Control and Prevention. Healthy Brain Initiative: Road Map for Indian Country. Accessed March 29, 2021 at https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf.

8. Alzheimer’s Association. 2021 Alzheimer’s Disease Facts and Figures. Accessed March 29, 2021 at https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf .

9. Alzheimer’s Association. 2021 Alzheimer’s Disease Facts and Figures. Accessed March 29, 2021 at https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf .

10. Centers for Disease Control and Prevention. Healthy Brain Initiative: Road Map for Indian Country. Accessed March 29 2021 at https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf.

Funding Opportunity Requirements

GENERAL PROGRAM REQUIREMENTS/COMPONENTS

All applicants to this FOA are subject to the General program items listed below and must consider and include all of them in the development of their application, work, and evaluation plans.

Phased Implementation

Successful applicants will propose a phased approach for implementation of their projects. A description of the phases follows:

Planning Phase: The period during which the grantee refines their proposed program Work Plan and Evaluation Plan, based on the plans contained in their original application. The resulting plans will be the ACL/AoA approved roadmap for the grantee to accomplish the goals, objectives, and relevant milestone of the ACL/AoA funded program. During the planning phase, and prior to entering the implementation phase, all grantees and their partners will complete ACL's Dementia-Capability Assessment Tool to establish a baseline for program evaluation activities. Grantees will work with the National Alzheimer’s and Dementia Resource Center (NADRC) staff to disseminate the assessment to their partners. The NADRC will compile results and deliver them to the grantee, the assessment activity is not expected to be part of the required 3rd party evaluation activities.

Applicants are to propose a planning phase of an estimate of 6 months from the notification date of the grant award. During this planning phase, grantees will be able to access no more than 15 percent of year one grant funding to refine and expand on the work and evaluation plans submitted with their applications. ACL/AoA will be actively involved during the planning phase of the grant to ensure that all ACL program objectives outlined in the Funding Opportunity Announcement are addressed. To conclude the planning phase the grantee must have received ACL/AoA’s approval of https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf https://nadrc.acl.gov/details?search1=117#result their work and evaluation plans and uploaded those plans into the reporting system, the grantee and all relevant partners will have completed the initial Dementia-Capability Assessment Tool and participated in a “Planning Phase Exit Conference.”

Upon completion of those steps, grantees will progress to the Implementation Phase and access the remaining 85 percent of cooperative agreement funding.

Implementation Phase: The period during which the grantees implement their approved plan for accomplishing the goals, objectives, and relevant milestones, as well as the evaluation of planned program activities. All grantees and their partners will complete annual Dementia-Capability Assessments, each fall, over the course of the grant period.

The grantee may not advance to the Implementation Phase without ACL/AoA staff approved work and evaluation plans, initial dementia-capability assessments completed by the grantee and each partner, as well as a “Planning Phase Exit Conference.” Upon ACL/AoA approval of the aforementioned documents and completion of the assessments and the exit conference, the grantee will begin the implementation phase of the grant period.

Milestone Model

The three-year grant program uses a program milestones model to demonstrate program progress and support program continuation. For this program, milestones are the points in the project where targeted project outcomes are occurring and signaling program progress. Each applicant will include at least one milestone for each budget year and include the steps toward achieving those milestones in their work plan. In addition to the availability of funding, progress in achieving milestone targets will be included in the considerations for funding program continuation years. Examples of program milestones include:

Year 1 (Focus on Capacity Building):

Develop or adapt existing dementia training and education program to create culturally competent program designed to build awareness of dementia in Indian Country;

Train program partners to conduct trainings;

Train home and community based service providers, family caregivers and community members.

Year 2 (Focus on Intervention Implementation):

Select evidence-based or evidenced informed intervention for delivery;

Train staff in intervention delivery;

Enroll participants in intervention and conduct trainings.

Year 3 (Focus on Program Sustainability):

Sustain education and intervention programs;

Implement program sustainability plan.

Use of Evidence-Based/Evidence-Informed Intervention

All programs must identify, by name, and describe the dementia specific evidence-based or evidence-informed intervention they propose to implement, how it fits into their proposed overall program and the intended beneficiaries. The chosen intervention must fit the definitions outlined below.

Evidence-based programs or interventions: These are interventions that 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: These are interventions that 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, an evidence- informed intervention is one that has: 1) been tested by at least one quasi-experimental design with a comparison group, with at least 50 participants; OR 2) is an adaptation or translation of a single evidence-based intervention.

Evidence-based dementia specific interventions adapted for cultural competency are considered evidence-informed. Examples of culturally competent evidence-informed dementia specific interventions would include REACH Community, which was modified to create REACH into Indian Country and The SAVVY Caregiver in Indian Country. The state of Wisconsin has used the evidence-informed Music and Memory programs to support elders living with dementia and their caregivers.

Examples of dementia-specific evidence-based and evidence informed services/interventions implemented through ACL state and community grant programs can be found in ACL's NADRC's paper entitled Grantee-Implemented Evidence-Based and Evidence-Informed Interventions . Best Practice Caregiving, a free online database of proven dementia programs for family caregivers, is another excellent resource for identifying dementia specific evidence-based interventions.

Evidence –based and evidence informed interventions implemented through the program should have positive impact/outcomes for persons living with dementia and their caregivers. Applicants must identify in the project narrative and in the project evaluation plan the intended, measurable outcomes (i.e. increased knowledge, improved quality of life, reduced depression and stress/burden) of the proposed dementia-specific intervention, as well as providing estimates of persons served by each programmatic component. ACL's National Alzheimer's and Dementia Resource Center (NADRC) created a compendium of Evaluation Measures Resources that could https://www.uthsc.edu/preventive-medicine/mcc.php https://www.nicoa.org/elder-resources/savvy-caregiver/ https://nadrc.acl.gov/details?search1=140#result https://nadrc.acl.gov/details?search1=140#result https://bpc.caregiver.org/ https://nadrc.acl.gov/details?search1=70#result provide assistance in identifying desired measurable outcomes of program activities.

Direct Service Requirement

All successful applicants are required to dedicate a portion of the total program budget to the provision of direct services to persons living with dementia and caregivers. All funded projects will dedicate the following percentage of the total program budget to direct services: Year 1:

25%, Year 2: 35%, Year 3: 45%.

Direct services come in many forms, in addition to training and education other direct services include, but are not limited to, respite, home health aides and companion services. A definition of direct service is provided in the FOA Appendix. Budget narratives included in the program application must include clear identification of the lines within the budget where the funds for the required direct services will reside.

Data Collection

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

Evaluation

All successful grant applications MUST include a plan for a robust, third-party evaluation. A third-party entity is one that is not engaged in proposed program activities beyond development and implementation of the program's evaluation plan and reports. Individuals or organizations involved in the development or implementation of any component of the proposed program would not qualify as "third party" evaluator.

At the beginning of funded projects, grantees and their partners are required to conduct a baseline assessment of the dementia-capability of their existing systems. The National Alzheimer’s and Dementia Resource Center's (NADRC) developed the Dementia Capability Assessment Tool to measure the dementia capability of grantees and their partners. Grantees will work with the NADRC staff to disseminate the assessment to their partners. The NADRC will compile results and deliver them to the grantee, the assessment activity is not expected to be part of the required 3rd party evaluation activities.

The assessment gives grantees and their partners the opportunity to create measures they can use in future program evaluations. It also helps to refine program goals, objectives and milestones, as well as monitoring and reporting. The baseline information will provides a basis to track program progress toward enhanced dementia-capability and document progress.

Grantees will agree to conduct annual follow-up assessments in each year of program funding throughout the duration of the program. Grantees submit the annual follow-up assessment with each Fall Semi-Annual Report, and a final assessment at the end of the grant period. Use of a progressive assessment model will ensure that, at the conclusion of the grant 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 are scored on the inclusion of a robust, third-party, project evaluation plan.

Evaluations should, at a minimum, determine the effectiveness and impact of program strategies and the processes used to execute project goals at both the systems development and consumer (service provision) level. Applicants should include outcome measures that demonstrate the impact of the program on persons living with dementia and caregivers in the proposed program and evaluation plans (ACL will NOT fund any project that does not include measurable outcomes). All proposed projects will include at least one project component through which they will demonstrate impact on the quality of life of persons living with dementia.

More information on evaluation expectations are in Section V of this FOA.

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, resource center staff or the grantees.

Statutory Authority Title IV of the Older Americans Act

II. Award Information Funding Instrument Type:

CA (Cooperative Agreement) Estimated Total Funding:

$ 1,000,000 Expected Number of Awards:

Award Ceiling:

$ 250,000 Per Budget Period

Award Floor:

$ 200,000 Per Budget Period

Length of Project Period:

36-month project period with three 12-month budget periods Additional Information on Project Periods and Explanation of 'Other'

The projects will be 36-month awards with three 12-month budget periods. Funded three-year programs will be designed in single year increments with well-defined required milestones.

Continuation funding for each year is contingent upon both the achievement of annual program milestones and the availability of Federal funding.

Awards made are subject to terms provided for in the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224). The 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/AoA 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/AOA 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 ACL/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 project dementia-capability (grantee and all relevant partners) in collaboration with Project Officer and technical assistance team, with annual reassessments to be conducted each fall in alignment with semi-annual report submission through the duration of the project;

4. Produce and submit to the ACL/AoA Project Officer, at the conclusion of the project, a program report/manual and an independent evaluation report describing how the project was conducted and goals, program outcomes that were achieved, as well as program components sustained beyond the program funding period. 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 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, http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf equipment descriptions, data files, data processing or computer programs (software), statistical records, and other research data” (p. II-69, Footnote 18);

6. 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 ADPI program; and

7. 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 Domestic public or private non-profit entities including state and local governments, Indian tribal governments and organizations (American Indian/Alaskan Native/Native American), faith-based organizations, community-based organizations, hospitals, and institutions of higher education.

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

Yes For awards that require matching or cost sharing by statute, recipients will be held accountable for projected commitments of non-federal resources (at or above the statutory requirement) in their application budgets and budget justifications by budget period, or by project period for fully funded awards. The applicant will be held accountable for all proposed non-federal resources as shown in the Notice of Award (NOA). A recipient's failure to provide the statutorily required matching or cost sharing amount (and any voluntary committed amount in excess) may result in the disallowance of federal funds. Recipients will be required to report these funds in the Federal Financial Reports.

For awards that do not require matching or cost sharing by statute, recipients are not expected to provide cost sharing or matching. However, recipients are allowed to voluntarily propose a commitment of non-federal resources. If an applicant decides to voluntarily contribute non-federal resources towards project costs and the costs are accepted by ACL, the non-federal resources will be included in the approved project budget. The applicant will be held accountable for all proposed non-federal resources as shown in the Notice of Award (NOA). A recipient's failure to meet the voluntary amount of non-federal resources that was accepted by ACL as part of the approved project costs and that was identified in the approved budget in the NOA, may result in the disallowance of federal funds. Recipients will be required to report these funds in the Federal Financial Reports.

The Federal match required for the Dementia Capability in Indian Country program is 10% (cash and/or in-kind). All applicants are required to comply with the 10% match requirement outlined in FOA.

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.

All proposed matching funds must be directly connected to proposed program activities and cannot come from other Federal sources.

ACL discourages applicant agencies exceeding the minimum match requirement. Applications with a match greater than the minimum required will not receive more favorable consideration under the review.

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

Applications will be reviewed to establish responsiveness to the following criteria.

All applications will go through an initial programmatic screening to verify that the applicant meets the FOA criteria. Those applicants that do not meet the minimum responsiveness criteria outlined below will be "screened out" and will not be forwarded for panel review.

The responsive project applicant:

1. Is presently responsible for the provision of and actively providing home and community services in the tribal community the applicant proposes to support with dementia services;

2. Include a signed resolution(s) permitting the tribal organization to apply for the ADPI Dementia-Capability in Indian Country funding opportunity. The inclusion of the resolution will demonstrate tribal leadership support and the authority to conduct the activities proposed in the application. If the organization is applying as a consortium, a signed resolution to apply for the current grant cycle from each member of the consortium is required.

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 https://www.grants.gov or https://www.acl.gov/grants/applying-grants.

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

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

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

Eastern Time.

http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ https://www.grants.gov/ https://www.acl.gov/grants/applying-grants http://www.grants.gov/ https://www.grants.gov/web/grants/applicants/workspace-overview.html mailto:support@grants.gov

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

All applicants must have a DUNS number (https://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. Effective June 11, 2018, when registering or renewing your registration, you must submit a notarized letter appointing the authorized Entity Administrator. Please be sure to read the FAQs located at www.sam.gov to learn more. Applicants should allot sufficient time prior to the application deadline to finalize a new, or renew an existing registration. This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award. Maintain documentation (with dates) of your efforts to register or renew at least two weeks before the deadline. See the SAM Quick Guide for Grantees at:

https://www.sam.gov/SAM/pages/public/help/samQUserGuides.jsf.

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 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.

https://www.grants.gov/ https://fedgov.dnb.com/webform/ http://www.sam.gov/ https://www.sam.gov/SAM/pages/public/help/samQUserGuides.jsf

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

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

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

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

2. Content and Form of Application Submission Letter of Intent Due Date for Letter Of Intent 06/01/2021

06/01/2021 Applicants are requested, but not required, to submit a letter of intent to apply for this funding opportunity to assist ACL in planning for the application independent review process. The purpose of the letter of intent is to allow our staff to estimate the number of independent reviewers needed and to avoid potential conflicts of interest in the review. Letters of intent should be sent to:

Applicants are requested, but not required, to submit a letter of intent to apply for this funding opportunity to assist ACL in planning for the application independent review process. The purpose of the letter of intent is to allow our staff to estimate the number of independent reviewers needed and to avoid potential conflicts of interest in the review. The letter need only indicate intent to apply for program funding, no additional application details are necessary.

The deadline for submission of the letter of intent is 14 days after the publication of the FOA.

Letters of intent should be sent to:

Erin Long, U.S. Department of Health and Human Services, Administration for Community Living, Administration on Aging at 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 https://www.grants.gov/ https://www.grants.gov/ use smaller font sizes to fill in the Standard Forms and Sample Formats. The suggested length for the Project Narrative is 20 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 sections noted below are included in the limit.

The sample 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 Evaluation Dissemination Organizational Capability

The Project Narrative is the most important part of the application, since it will be used as the primary basis to determine whether your project meets the minimum requirements for grants under the authorizing statutes. The Project Narrative should provide a clear and concise description of your project. ACL recommends that your project narrative include the following components:

Summary/Abstract This section should include a brief (265 words maximum) description of the proposed project, including: goal(s), milestones, 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 In this section eligible applicants should describe, in both quantitative and qualitative terms, the nature and scope of the particular problem or issue the proposed program is designed to address in the community you serve, 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 home and community-based service system within which they are operating.

Problem Statements must include descriptions of:

The impact of Alzheimer's disease and related dementias (ADRD) on the community and population that you serve;

The trainings and services presently…