HHS-2022-ACL-AOA-CSSG-0041.pdf

Administration for Community Living

Administration on Aging

2022 Empowering Communities to Deliver and Sustain Evidence-Based Chronic Disease Self- Management Education Programs

HHS-2022-ACL-AOA-CSSG-0041

01/25/2022

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

Project Abstract

Project Relevance and Current Need

Approach

Outcomes and Evaluation

Organizational Capacity

Letters of Commitment

Work Plan

Budget Narrative/Justification

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

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:

2022 Empowering Communities to Deliver and Sustain Evidence-Based Chronic Disease Self- Management Education Programs

Funding Opportunity Number:

HHS-2022-ACL-AOA-CSSG-0041

Primary CFDA Number:

93.734

Due Date for Letter of Intent:

12/17/2021

Due Date for Applications:

01/25/2022

Date for Informational Conference Call:

12/02/2021 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

The mission of the Administration for Community Living (ACL) is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers. Through this funding opportunity, the Administration on Aging (AoA), part of the Administration for Community Living (ACL), plans to award approximately seven to nine Cooperative Agreements to domestic public or private non-profit entities.

The intent of this funding opportunity is to help communities develop or expand capacity for, deliver, and sustain evidence-based chronic disease self-management education and support programs for older adults and adults with disabilities, particularly those in underserved geographic areas and/or populations, as defined by Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government.

Applicants must request a total budget between $600,000- $700,000 in federal funds for the three-year project. All awards are subject to the availability of federal funds.

The awards will be made in the form of Cooperative Agreements to allow for substantial collaboration and involvement with ACL and the National Chronic Disease Self-Management Education Resource Center throughout the project period. These Cooperative Agreements have an anticipated start date of May 1, 2022.

An informational conference call will be held on December 2, 2021 from 1:00 PM to 2:00 PM

EST.

The dial-in information is below:

Toll Free Number: 800-369-1816 Passcode: 7194577

A recording will be available approximately one hour after the call concludes at the following number: Toll Free Playback Number: 866-487-7599

I. Funding Opportunity Description

In the United States, chronic diseases such as heart disease, cancer, stroke, and diabetes represent 7 of the top 10 causes of death, and are a leading cause of disability. [1][2] Among the rapidly increasing aging population, approximately three out of four older adults have multiple (two or more) chronic conditions which places them at greater risk for premature death, poor functional status, mental health conditions (such as depression and social isolation), unnecessary hospitalizations, adverse drug events, and nursing home placement. [3][4][5] Chronic diseases also significantly impact healthcare costs: 95% of healthcare costs for older adults in the United States can be attributed to chronic diseases. [6] [7] Additionally, adults with disabilities experience health disparities when compared with the general population. For example, adults with disabilities are more likely to have chronic health conditions such as high blood pressure, be overweight or obese, not engage in fitness activities, and receive less social-emotional support than adults without disabilities. [8]

Coping with multiple chronic diseases is a considerable challenge for older adults, their families and caregivers, which has been further complicated by ongoing COVID-19 related resource loss.

Older adults, particularly those with chronic diseases, have been disproportionately impacted by the pandemic -- accounting for more than 75% of the COVID-19 related deaths. [9] Furthermore, since March 2020, nearly one in five older adults have reported worse sleep, worse depression or sadness, 28% have reported worse anxiety or worry, and more than six in ten have reported experiencing social isolation. [10] [11]

Empowering older adults to engage in evidence-based chronic disease self-management education (CDSME) programs to better manage their conditions can help mitigate the chronic disease burden. Now more than ever we see the critical need to promote, make widely available, sustain, and integrate CDSME and support programs across sectors as the COVID-19 pandemic has significantly exacerbated existing health inequities and further exposed underserved populations to suboptimal social determinants of health.

The acronym, CDSME, is being used in this announcement as an umbrella term for community-based education programs specifically designed to enhance self-management of chronic diseases.

These programs focus on building multiple health behaviors and generalizable skills such as goal setting, decision making, problem solving, and self-monitoring, and are proven to maintain or improve health outcomes of older adults with chronic conditions. Similarly, a self-management support program is a community-based, behavioral change intervention that is proven to increase one or more skills or behaviors relevant to chronic disease self-management such as physical activity or medication management. [12]

The AoA has supported CDSME and other evidence-based health promotion programs for many years through grants, as well as collaborations on various federal initiatives. For example, Prevention and Public Health Fund initiatives in 2021 supported 8 CDSME grantees.

Additionally, Older Americans Act Title III-D funding supports a broader portfolio of evidence-based disease prevention and health promotion activities. To date, more than 440,000 older adults and adults with disabilities have participated in an AoA-supported CDSME program. For more information about ACL’s CDSME Program, including grantee profiles, please visit: https://www.acl.gov/programs/health-wellness/chronic-disease-self-management-education-programs.

Purpose This funding opportunity is designed for applicants to propose how they will develop capacity for, expand, deliver, and sustain evidence-based chronic disease self-management education and support programs that address the prevention and management of chronic conditions among older adults and adults with disabilities.

Goal 1: Develop or expand capacity to significantly increase the number of older adults and adults with disabilities, particularly those in underserved areas/populations, who participate in evidence-based chronic disease self-management education and self-management support programs to empower them to better manage their chronic conditions.

Goal 2: Enhance the sustainability of evidence-based chronic disease self-management education and self-management support programs through the implementation of robust sustainability strategies.

Please refer to Appendix A (Glossary of Terms) for definitions of CDSME and self-management support programs. Applicants for this funding opportunity must propose to deliver two or more CDSME programs AND at least one self-management support program. The programs proposed must be on the list of pre-approved interventions found in Appendices B and C of this funding opportunity.

All applicants must propose to implement at least one program that can be delivered in a remote format, i.e., by video conference, phone, mailed toolkit + phone, or some other format that does not have an in-person component. The National Council on Aging (NCOA) maintains a website that tracks remote program guidance (https://www.ncoa.org/news/ncoa-news/center-for-healthy-aging-news/track-health-promotion-program-guidance-during-covid-19/). All applicants should contact the program administrator(s) for any program(s) they are interested in delivering remotely to confirm that: 1) the programs are allowed for remote delivery; and 2) training is readily available for applicants who need it. Note that the NCOA website includes programs on the pre-approved list in Appendix B and C, as well as other programs not on the list.

For this funding opportunity, applicants may ONLY propose programs on the pre-approved lists in Appendix B and C.

All applicants who do not have adequate existing capacity for any in-person and/or remote program(s) they are proposing must include a letter from the program administrator(s) in their application indicating that they will be able to get training in the programs no later than three months after the start date of the grant (if selected for funding).

References [1] Centers for Disease Control and Prevention, National Center for Health Statistics. Leading causes of death. Updated March 1, 2021. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. Accessed October 8, 2021.

[2] Buttorff C, Teague R, Bauman M. Multiple chronic conditions in the United States. Santa Monica (CA): RAND Corporation; 2017. https://www.rand.org/pubs/tools/TL221.html.

Accessed October 5, 2021.

[3] Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, Basu J. Multiple Chronic Conditions Chartbook. AHRQ Publications No, Q14-0038. Rockville, MD: Agency for Healthcare Research and Quality. April 2014.

[4] Parekh, A.K., et al. 2011. Managing Multiple Chronic Conditions: A Strategic Framework for Improving Health Outcomes and Quality of Life. Public Health Rep. 126(4):460– 71.

[5] Kramarow E. et al. 2007. Trends in the Health of Older Americans,1970–2005. Health.

[6] Center for Medicare & Medicaid Services. National health expenditures 2019 highlights.

https://www.cms.gov/files/document/highlights.pdf. Accessed October 5, 2021.

[7] Centers for Disease Control and Prevention. The State of Aging and Health in America 2013.

Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013.

[8] Centers for Disease Control and Prevention (CDC), National Center for Health Statistics.

DATA 2010 [Internet database]. Hyattsville, MD: CDC; 2010 [9] Centers for Disease Control and Prevention. National Center for Health Statistics. COVID-19 Mortality Overview. Accessed October 5, 2021. https://www.cdc.gov/nchs/covid19/mortality-overview.htm [10] Gerlach L, Solway E, Singer D, Kullgren J, Kirch M, Malani P.Mental Health Among Older Adults Before and During the COVID-19 Pandemic. University of Michigan National Poll on Healthy Aging. May 2021. Available at: http://dx.doi.org/10.7302/983 [11] NIHCM Foundation. Aging & COVID-19: Vaccination, Mental and Physical Health, and isolation. February 2021. https://nihcm.org/publications/aging-covid-19-vaccination-mental-and-physical-health-and-isolation [12] Brady, Teresa. “Strategies to Support Self-Management in Osteoarthritis.” AJN, American Journal of Nursing, vol. 112, no. 3, 2012, pp. 54–60., doi: 10.1097/01.naj.0000412653.56291.ab.

Statutory Authority

The statutory authority for grants under this Notice of Funding Opportunity is contained in the Older Americans Act, Title IV; and the Patient Protection and Affordable Care Act, 42 U.S.C. § 300u-11 (Prevention and Public Health Fund).

II. Award Information

Funding Instrument Type:

CA (Cooperative Agreement)

Estimated Total Funding:

$6,000,000

Expected Number of Awards:

Award Ceiling:

$700,000 Per Project Period

Award Floor:

$600,000 Per Project Period

Length of Project Period:

Other

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

Current or previous ACL CDSME grantees are not excluded from this funding opportunity, but must provide a strong rationale for the need for additional funding. This must include an explanation for how this proposal significantly differs from previous projects. This proposal may not be a continuation of current efforts/activities supported by previously awarded ACL CDSME grants (particularly because sustainability without additional federal funding has been a goal of all previous ACL CDSME funding opportunities). Applicants must propose an innovative approach that addresses the goals of this funding opportunity that features new partnerships and/or programs. Repeat awardees will be expected to meet the discrete reach (participant/completer) and sustainability goals that they included in each of their awards.

Cooperative Agreement Terms

This is a new Cooperative Agreement with the following terms. As provided by the terms of the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224), this Cooperative Agreement provides for the substantial involvement and collaboration of AoA in activities that the recipient organization will carry out in accordance with the provisions of the approved grant award.

The grantee agrees to execute the responsibilities outlined below:

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

2. Reach 25% of your target completers (for CDSME programs) and participants (for self-management support programs) by the end of Year 1, 50% by the end of Year 2, and 100% by the end of Year 3.

3. Commit to sending two project staff to the annual CDSME professional development conference hosted by the National CDSME Resource Center. Attendance is expected annually for the duration of your grant activities (including any no-cost extension period, if applicable). Although it remains unknown if future conferences will be in-person or remote (not requiring travel), all applicants must include funds for each budget year for two people to attend a conference in the Washington, D.C. area. Awardees will be able to reallocate unused travel funds to a different grant-related activity that is mutually agreed upon by the grantee and the ACL Project Officer.

4. Meet all training, licensing, fees, or other requirements associated with the selected CDSME and self-management support program(s) to ensure compliance with all the requirements stipulated by the authorizing entity/program administrator.

5. Communicate with the AoA project officer monthly, or at such other times as are agreed upon, to improve the effectiveness of the activities carried out under this Agreement.

6. Collect required program data for all program participants by way of ACL’s specific data collection forms (see Appendix D). Within 30 days of participants’ completion of the program, grantees are responsible for compiling and reporting the data to the CDSME National Database. Data include de-identified participant demographic and health status information, attendance information, and workshop type and location. Grantees should plan to train workshop leaders on data collection practices and use of these forms.

7. Participate in any ACL/National CDSME Resource Center sponsored research and/or evaluations.

8. Participate in relevant ACL/National CDSME Resource Center education (e.g., webinars, workgroups, etc.) provided that ACL/ National CDSME Resource Center provides reasonable notice of the subject, date, and time of the event.

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

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

This project was supported by the Administration for Community Living (ACL), U.S.

Department of Health and Human Services (HHS) as part of a financial assistance award totaling $XX with XX percentage funded by ACL/HHS and $XX amount and XX percentage funded by non-governmental source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor are an endorsement, by ACL/HHS, or the U.S. Government.

The AoA Project Officer agrees to execute the responsibilities outlined below:

1. Perform the day-to-day Federal responsibilities of managing a Cooperative Agreement and work with 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 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.

6. Communicate with the grantee project director monthly, or at such other times as are agreed upon, to improve the effectiveness of the activities carried out under this Agreement.

Once a Cooperative Agreement is in place, requests to modify or amend the Agreement or the work plan may be made by ACL or the awardee at any time as long as the request stays within the scope of work. Major changes may affect the integrity of the competitive review process.

Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the execution of an award notice, unless ACL is authorized under the Terms and Conditions of award, 45 CFR Part 75, or other applicable regulation or statute to make unilateral amendments. When an award is issued, the Cooperative Agreement terms and conditions from the program announcement are incorporated by reference.

III. Eligibility Information

1. Eligible Applicants

For FY 2022 the below guidance is provided to advance the Administration’s policy, as stated in E.O. 13985, to “pursue a comprehensive approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.” This guidance is intended to begin to address inequities in HHS programs, processes, and policies that may serve as barriers to equal opportunity. By advancing equity in our NOFOs, we can “create opportunities for the improvement of communities that have been historically underserved, which benefits everyone.”

Domestic public or private non-profit entities including state governments, county governments, city or township governments, special district governments, independent school districts, public and state controlled institutions of higher education, Native American tribal governments, public housing authorities/Indian housing authorities, Native American tribal organizations, nonprofits having a 501(c)(3) status, private institutions of higher education, faith-based organizations, and community-based organizations.

2. Cost Sharing or Matching

Cost Sharing / Matching Requirement:

No 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.

3. Responsiveness and Screening Criteria

Application Responsiveness Criteria Not Applicable.

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

In order for an application to be reviewed, it must meet all of the following screening requirements:

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

2. The Project Narrative section of the Application must be double-spaced, on 8.5” x 11” plain white paper with 1” margins on 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 twenty (20) pages. NOTE: The Project Work Plans, Letters of Commitment, Project Map, Organizational Chart, Budget Narrative/Justifications and Vitae of Key Project Personnel are not counted as part of the Project Narrative for purposes of the 20-page limit.

4. Applications must include a proposed Budget Narrative/Justification for years 1, 2, and 3, along with a combined Budget Narrative/Justification for the proposed 36-month budget period. The proposed combined Budget Narrative/Justification must not exceed the award ceiling of $700,000.

5. Applications must include a Project Workplan for years 1, 2 and 3. Project Workplans must be consistent with the proposed Project Narrative and Budget Narrative/Justifications.

Unsuccessful submissions will require authenticated verification from https://www.grants.gov indicating system problems existed at the time of your submission.

For example, you will be required to provide an https://www.grants.gov submission error notification and/or tracking number in order to substantiate missing the application deadline.

IV. Application and Submission Information

1. Address to Request Application Package

Application materials can be obtained from https://www.grants.gov or https://www.acl.gov/grants/applying-grants.

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

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

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

Eastern Time.

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

All applicants must have a 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.

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.

Contact person regarding this Notice of Funding Opportunity:

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

Administration on Aging Office of Nutrition and Health Promotion Programs Lesha Spencer-Brown, MPH Email: Lesha.spencer-brown@acl.hhs.gov

2. Content and Form of Application Submission Letter of Intent

Due Date for Letter Of Intent 12/17/2021

12/17/2021

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:

U.S. Department of Health and Human Services Administration for Community Living Administration on Aging Lesha Spencer-Brown, MPH Office of Nutrition and Health Promotion Programs Email: Lesha.spencer-brown@acl.hhs.gov

Project Narrative

The Project Narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins on both sides, and a standard font size of not less than 11, preferably Times New Roman or Arial. The entirety of the Project Narrative, including tables, graphics, and headings must be double-spaced. You can use smaller font sizes to fill in the Standard Forms and Sample Formats outside of the Project Narrative section, such as the Project Work Plans and Budget Narrative/Justifications. Twenty (20) pages is the maximum length allowed.

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

Applicants must document all source materials. If any text, language, and/or materials are from another source, the applicant must make it clear the material is being quoted and where the text comes from. The applicant must also cite any sources when they include numbers, ideas, or other material that are not their own.

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

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

1. Project Abstract

2. Project Relevance and Current Need

3. Approach

4. Outcomes and Evaluation

5. Organizational Capacity

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

Project Abstract

This section should include a brief description of the proposed project, including goals, objectives, and outcomes. Detailed instructions for completing the summary/abstract are included in the Instructions for Completing the Project Summary/Abstract (see Appendix).

In your abstract, clearly specify:

1. Goals, objectives, and outcomes of the proposed project;

2. Two or more proposed CDSME programs and at least one self-management support program you plan to implement/disseminate; (reference Appendix B and C for the approved programs)

3. Projected number of program completers (CDSME programs) and participants (self-management support program[s]) for your proposed programs (reference Appendix E).

4. Key partners;

5. Target population(s); and

6. Targeted/impacted geographic area(s).

Project Relevance and Current Need

This section should describe, in both quantitative and qualitative terms, the nature and scope of the particular problem or issue the proposed project is designed to address.

In this section:

1. Briefly describe and cite (using reliable and relevant local/state/national data sources) the impact of chronic conditions (as relevant to your proposed programs) in your state/region/tribe, and how your proposed project will address this impact.

2. Describe the gap between the current availability of your proposed CDSME and self-management support programs and the ideal situation where the programs are readily available. This should include a description of the current delivery status of CDSME and self-management support programs, sustainability efforts, geographic/population reach of the proposed programs in your state/region/tribe, and the extent to which a network exists for systematically delivering and sustaining the programs.

3. Include a Project Map of your state/region/tribe that shows where your proposed programs are already being offered (if applicable), and which areas are being selected for this project. Provide data to support why you are targeting those areas (e.g., the number of older adults or adults with disabilities with chronic condition, the lack of available programs, etc.). The map should be included as an appendix to your application.

4. If you are a current or past ACL CDSME grantee, you must describe how this proposed project significantly differs from your current or previously funded work. Please describe the status of your CDSME program delivery and sustainability efforts, summarize your key outcomes from that project (including what your completer/participant targets were and if you met them, the extent to which you met other key project goals), and your rationale for requesting additional funding (i.e. how this proposal significantly differs from previous projects or provides significant enhancement of the network developed with prior funding). Note that this proposal should not simply be a continuation of current efforts, but rather an innovative approach that features new partnerships and programs.

Approach

A. Capacity Building and Program Implementation

In this sub-section, the applicant should describe how they will develop or expand capacity to deliver CDSME and self-management support programs to older adults and adults with disabilities, including any key partners, and underserved populations to be served as defined by Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government.

In this section:

1. State the project’s goals and major objectives that align with Goal 1 of this funding opportunity.

Goal 1: Develop or expand capacity to significantly increase the number of older adults and adults with disabilities, particularly those in underserved areas/populations, who participate in evidence-based chronic disease self-management education and self-management support programs to empower them to better manage their chronic conditions.

2. Identify two or more evidence-based CDSME and at least one self-management support program you propose to implement and a rationale for selecting the programs. The rationale should relate to the project relevance and current need of the target population(s) and geographic area(s) identified. Do not propose programs that are not included in Appendix B and Appendix C.

3. Propose to implement at least one program from the pre-approved list that can be delivered in a remote format, i.e., by video conference, phone, mailed toolkit + phone, or some other format that does not have an in-person component. The National Council on Aging (NCOA) maintains a website that tracks remote program guidance (https://www.ncoa.org/news/ncoa-news/center-for-healthy-aging-news/track-health-promotion-program-guidance-during-covid-19/). All applicants should contact the program administrator(s) for any programs they are interested in delivering remotely to confirm that: 1) the programs are allowed for remote delivery; and 2) training is readily available for applicants who need it. Note that the NCOA website includes programs on the pre-approved list in Appendix B and C, as well as other programs not on the list. For this funding opportunity, applicants may ONLY propose programs on the pre-approved lists in Appendix B and C.

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

5. State the projected total number of participants and completers that you expect to reach through your proposed CDSME and self-management support programs. For any group series program, provide a target number of completers and a specific target completion rate. Provide a rationale for these targets, e.g., by referencing your previous experience delivering CDSME and/or self-management support programs, the number of older adults and adults with disabilities in your state/region/tribe you may be able to reach, saturation of target participant population (i.e. “low hanging fruit”), partner commitments, referral systems, and other factors. Targets should be realistic and achievable. In developing your participant/completer targets, please reference the Guidance for Administration for Community Living 2020 Chronic Disease Self- Management Education Grant Applicants: Considerations for Estimating Participation and Completer Targets in Appendix E.

a. Describe how your approach will engage approximately 25% of your completer target (CDSME programs) and participant target (self-management support programs) by the end of Year 1, 50% by the end of Year 2, and 100% of your target by the end of Year 3.

6. Identify a comprehensive strategy for implementing/disseminating the proposed CDSME and self-management support programs (including relevant integration with other aging and disability programs/services and specific involvement of key partners). Describe any existing CDSME, self-management support, and other evidence-based prevention initiatives in your area and how you plan to coordinate with and leverage these efforts.

This should include a description of any existing capacity to deliver the proposed programs, i.e., the number of host sites, implementation sites, and delivery personnel (such as trainers and leaders/coaches).

7. Describe whether your existing infrastructure for the proposed programs is adequate. If not, describe and provide a rationale for any proposed trainings. If you require training, you must include a Letter of Commitment from the program administrator(s) and/or entity that will provide training with your application. The letter should state that the training will be provided no more than three months after the applicant receives the Notice of Award from ACL. Letter(s) should be submitted as an appendix. See Letters of Commitment.

8. Describe how you intend to identify, market to, and recruit participants for your proposed programs.

9. Describe any major challenges and barriers you anticipate encountering, and how your project will address those challenges and barriers.

Special Target Populations

1. Describe any underserved population(s) to be served by the proposed CDSME and self-management support programs as defined by Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, dated January 20, 2021.

2. Provide a rationale (citing relevant data) for selecting the target population(s), how the target population(s) will be engaged, and the organizations (if applicable) that would be collaborating in reaching the proposed population(s).

Key Partners

1. Describe your key partners and their role in the dissemination of your proposed programs. Note that a Letter of Commitment must be obtained from each of the key partners described and provided as an appendix. See Letters of Commitment.

B. Sustainability

In this sub-section, the applicant should describe how they will establish or strengthen and enhance the sustainability of their proposed CDSME and self-management support programs.

The goal of sustainability is to integrate and embed evidence-based programs into a community’s network of coordinated health and social services so that they become a routine and integral component of the network services, and are available and easily accessible over time.

Sustainability strategies can include a combination of approaches including funding from healthcare entities, other federal funding, philanthropy, public funding, Older Americans Act Title IIID, development of referral partnerships, etc. For more information on business planning and financial sustainability, please visit https://www.ncoa.org/professionals/health/center-for-healthy-aging/community-integrated-health-care and https://www.ncoa.org/article/sustainability.

In this section:

1. State the project’s goals and major objectives that align with Goal 2 of this funding opportunity.

Goal 2: Enhance the sustainability of evidence-based chronic disease self-management education and self-management support programs through the implementation of robust sustainability strategies.

2. Describe your sustainability strategies to support the proposed programs during and beyond the grant period, including:

a. Any proposed or current centralized and coordinated processes to promote a unified and consistent approach across your state/region/tribe to achieve the goal of an integrated, sustainable evidence-based prevention program network (i.e.

Community Integrated Health Network or Hub). If these strategies are already being implemented, describe how they will be enhanced by this proposal.

b. Who your sustainability partners are, the role they will play, and how you plan to engage them on a regular basis. Note that a Letter of Commitment must be obtained from each key partner described and provided as an appendix. See Letters of Commitment.

c. Any other business planning efforts to be undertaken (e.g., infrastructure, health IT, etc.); and

d. Any major challenges and barriers you anticipate encountering (or are encountering), and how your project will address those challenges and barriers.

Outcomes and Evaluation

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

In this section:

Project Outcomes

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

2. List measurable outcomes in the Work Plan grid under “Measurable Outcomes” in addition to any discussion included in the narrative.

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

Quality Assurance

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

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

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

c. Ensure the ACL-required dataset (see Appendix D) is being collected and accurately reported by the implementation sites and how you will identify and troubleshoot any potential problems.

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

Dissemination

1. Describe the method(s) that will be used to disseminate the project’s results and findings in a timely manner and in easily understandable formats, to parties who might be interested in using the results to inform practice, service delivery, program development, and/or policy-making, including and especially those parties who would be interested in replicating the project.

2. Clearly state your commitment to cooperating with any broader efforts led by ACL and/or the National CDSME Resource Center to help others understand how they could replicate the project activities in their communities.

3. Clearly state your commitment to participating in any ACL/National CDSME Resource Center sponsored research and/or evaluations.

Organizational Capacity

This section should describe the capabilities of your agency and any contractual organization(s), as appropriate.

In this section:

1. Describe how your agency is organized, the nature and scope of its work, and/or the capabilities it possesses. Include an organizational chart as an appendix to your application. Also include information about any contractual organization(s) that will have a significant role in implementing project and achieving project goals.

2. Describe any experience delivering health promotion programs (particularly those that are evidence-based) to older adults/adults with disabilities and how you will leverage this experience to integrate your proposed CDSME and self-management support programs within your organization.

3. Describe the project management, including the roles and responsibilities of project staff, consultants, and partner organizations, as well as how they will contribute to achieving the project’s objectives and outcomes. You should:

a. Provide a description of the qualifications and experience of the key personnel for this proposed project, including for the Project Director. Application must include resumes or CVs as an appendix.

b. Specify who will have day-to-day responsibility for key tasks such as: leadership of project, monitoring the project’s on-going progress, preparation of reports, and communications with other partners and ACL.

c. Detail the approach that will be used to monitor and track progress on the project’s tasks and objectives.

Letters of Commitment

Applicants must include Letters of Commitment as an appendix to the application and use a Table of Contents to clearly describe which letters represent which partners. Note that any organization that is specifically named to have a significant role in carrying out the project should be considered a key partner.

1. Key Partners: You must provide letters of commitment describing and confirming support from key partners, such as collaborating organizations and agencies that were named in the project abstract and approach sections. These letters should describe the specific role of each partner in the project.

2. State Unit on Aging: It is expected that the State Unit on Aging (SUA) will provide a letter affirming their support of your proposed project. If the SUA(s) declines to provide a letter, you must provide documentation indicating this (e.g., an email). If you are a SUA applicant, include a letter from your SUA director. Note that applicants proposing a multi-state effort, must obtain a letter from the SUA in each state involved in the project.

This requirement is applicable for all applicants except tribes/tribal entities. You can locate applicable SUA information using the search feature on https://eldercare.acl.gov/Public/Index.aspx.

a. If you are a tribe or tribal entity, you must include a tribal resolution that states the reasons you are applying for the grant, and your commitment to executing the grant activities (should it be awarded).

3. Area Agency on Aging: It is expected that relevant Area Agencies on Aging will provide a letter affirming their support of your proposed project. Include a letter from each Area Agency on Aging (AAA) that reaches/covers your target geographic area (a letter from the state AAA association is not permissible in lieu of this requirement). If you are an applicant from a Single State Authority (Alaska, Delaware, Nevada, New Hampshire, North Dakota, Rhode Island, South Dakota, Washington DC, and Wyoming) or tribe/tribal entity, this requirement is not applicable). You can locate applicable AAA information using the search feature on https://eldercare.acl.gov/Public/Index.aspx.

4. Program Administrator: Applicants are expected to begin delivering their proposed CDSME and self-management support programs within three to six months after receiving their Notice of Award. If you require training for the evidence-based programs you propose before you can begin delivery of the programs, your application must include letters of support from the program administrators that will be providing training.

The letter(s) should state that the training will be provided within three months of award notification. ACL encourages applicants to have a thorough discussion with the program administrator(s) to ensure that applicants: 1) fully understand the requirements and length of the training/certification process; 2)…