HHS-2024-IHS-ALZ-0001.pdf

Notice of Funding Opportunity

Application due July 16, 2024

Division of Clinical and Community Services (DCCS)

Addressing Dementia in Tribal and Urban Indian Communities: Enhancing Sustainable Models of Care Opportunity number: HHS-2024-IHS-ALZ-0001

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 8

Step 2: Get Ready to Apply 15

Get registered 16

Find the application package 16

Step 3: Write Your Application 17

Application contents and format 18

Step 4: Learn About Review and Award 23

Application review 24

Award notices 30

Step 5: Submit Your Application 32

Application submission and deadlines 33

Application checklist 35

Step 6: Learn What Happens After Award 36

Post-award requirements and administration 37

Contacts and Support 39

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registration is active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by July 16, 2024 Applications are due by 11:59 p.m. Eastern Time on July 16, 2024.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

Jump to a step

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Basic information Indian Health Service (IHS)

Division of Clinical and Community Services (DCCS)

Supporting expansion and increasing local clinical capacity for culturally relevant dementia care and services for American Indian and Alaska Native people living with dementia, their caregivers, and their communities.

Have questions?

See Contacts and Support.

Key facts Opportunity Name:

Addressing Dementia in Tribal and Urban Indian Communities: Enhancing Sustainable Models of Care

Opportunity Number:

HHS-2024-IHS-

ALZ-0001

Federal Assistance Listing:

93.933

Statutory authority number:

25 U.S.C. 13, 42 U.S.C.

2001(a), 25 U.S.C.

1665a(c)(5)(F) and 1660e

Key dates Application deadline:

July 16, 2024

Expected award date:

September 1, 2024

Expected earliest start date:

September 1, 2024

Summary This program is designed to improve clinical care, services, and outcomes for American Indian and Alaska Native (AI/AN) people living with dementia, their caregivers, and their communities. The program supports Tribes, Tribal organizations, and Urban Indian organizations already working toward comprehensive dementia care to:

• Expand and improve their capacity to provide culturally relevant services, clinical diagnostic workflow in the primary care setting, and care coordination.

• Plan for and evaluate the long-term sustainability of comprehensive dementia care and services, including diagnostic and procedural coding and billing for clinical and community services.

• Develop, document, and disseminate local models for comprehensive dementia care and services and best practices throughout the project.

Funding details Type: Cooperative agreement

Competition type: New

Expected total program funding: $1.2 million

Expected number of awards: 6

Funding range per applicant for the first budget period: $100,000 to $200,000

The period of performance is for three years.

Continuation funding depends on the availability of funds and agency budget priorities.

Step 1: Review the Opportunity 5

Eligibility Who can apply

Eligible applicants Only these types of organizations may apply:

Federally recognized Indian Tribes An Indian Tribe as defined by 25 U.S.C. 1603(14). The term “Indian Tribe” means any Indian Tribe, band, nation, or other organized group or community, including any Alaska Native village or group, or regional or village corporation, as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.], which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.

Tribal organizations A Tribal organization as defined by 25 U.S.C. 1603(26). The term “Tribal organization” has the meaning given the term in section 4 of the Indian Self- Determination and Education Assistance Act (25 U.S.C. 5304(l)): “Tribal organization” means the recognized governing body of any Indian Tribe; any legally established organization of Indians which is controlled, sanctioned, or chartered by such governing body or which is democratically elected by the adult members of the Indian community to be served by such organization and which includes the maximum participation of Indians in all phases of its activities:

provided that, in any case where a contract is let or grant made to an organization to perform services benefiting more than one Indian Tribe, the approval of each such Indian Tribe shall be a prerequisite to the letting or making of such contract or grant.

You must submit letters of support or Tribal Resolutions from the Tribes you will serve. See attachments.

Urban Indian Organizations An Urban Indian organization as defined by 25 U.S.C. 1603(29). The term “Urban Indian organization” means a nonprofit corporate body situated in an urban center, governed by an urban Indian controlled board of directors, and providing for the maximum participation of all interested Indian groups and individuals, Step 1: Review the Opportunity 6 which body is capable of legally cooperating with other public and private entities for the purpose of performing the activities described in 25 U.S.C. 1653(a).

You must provide proof of nonprofit status. See attachments.

Eligibility exceptions

• Individuals, including sole proprietorships and foreign organizations, are not eligible.

• We do not fund concurrent projects under this program. If you get an award under this announcement, we can’t later fund you under other Addressing Dementia in Tribal and Urban Indian Communities: Enhancing Sustainable Models of Care programs while this award is active.

Other eligibility criteria You must be able to provide ambulatory care services directly or through coordination with IHS Direct Services and must be able to coordinate with elder services.

Cost sharing This program has no cost-sharing requirement.

If you choose to include cost-sharing funds, we won’t consider it during our review. However, we will hold you accountable for any funds you add, including through reporting.

Step 1: Review the Opportunity 7

Program description Background Alzheimer’s disease and related dementias (ADRD; dementia) affect lives in every Tribal and Urban Indian community. Age is the biggest risk factor for dementia. American Indian and Alaska Native (AI/AN) people ages 65 and older are a fast-growing group. Their number is expected to triple in the next few decades.

There are many other risk factors for dementia. For example, diabetes, heart disease, kidney disease, liver disease, smoking, and traumatic head injuries increase the risk of getting dementia. AI/AN people have these diseases or conditions more often than other groups, including non-Hispanic white people. For people who have dementia and these health problems at the same time, dementia can progress faster.

Many people with dementia or impaired cognition suffer silently in their communities. Dementia is under-recognized, underdiagnosed, misdiagnosed, and undertreated in all populations, including AI/AN people. People living with dementia or cognitive changes and their families may:

• Think the changes are due to normal aging.

• Not recognize the signs and symptoms of dementia.

• Fear the stigma associated with a dementia or Alzheimer’s diagnosis.

• Not seek care out of concern for the person and family’s dignity and privacy.

• Have trouble accessing a healthcare provider who can listen to their concerns and diagnose the problem.

People with dementia and impaired cognition are at risk for financial exploitation, poor health outcomes, injuries, and death. Often, it takes a crisis like a hospital visit or illness to bring awareness to the disease.

A dementia diagnosis is most often made in primary care offices or clinics.

Medical specialty referral, for example, to neurologists or neuropsychologists, is only needed in special or complex cases. Referrals might be considered when the type of dementia is not common, when it occurs in someone younger, or when the diagnosis is unclear.

There are many barriers to making a diagnosis in primary care, including:

• Medical professionals’ lack of confidence or knowledge to diagnose or plan effective care.

Step 1: Review the Opportunity 8

• Clinical workflow or electronic health records that do not adequately support dementia screening, diagnosis, and management processes.

• Limited access to members of the clinical and community team who can support care.

• Limited clinical and community services and supports for people living with dementia and their families.

• Lack of specialists to support diagnosis and management decisions through consultation or referral.

• Underuse of available resources and reimbursement for services because of issues with complicated diagnostic and procedural coding and billing.

Effective clinical management of the care of people living with dementia requires coordination between clinical and community-based services. This care involves medical care, personal care, social services, legal and financial services, and housing. People living with dementia and their caregivers are usually left to coordinate this complex care themselves.

Comprehensive care for people with dementia must also include care and services for their caregivers and family. Unfortunately, at this time, this is not a standard of practice.

With this notice of funding opportunity (NOFO), the IHS is looking to improve care, services, and outcomes for AI/AN people living with dementia, their caregivers, and their communities. As a result, we will identify and share care models that will work in Tribal and Urban Indian communities.

Purpose This program is intended to support the following improvements to care for people living with dementia and their caregivers, families, and communities:

• Expansion and increased local capacity to provide culturally relevant, comprehensive care and services.

• New opportunities and additional services to enhance and strengthen existing care approaches in clinical settings.

• Long-term sustainability planning for and evaluation of Tribal and Urban Indian Health clinical programs, services, and systems.

• Documentation and dissemination of locally developed Tribal and Urban Indian Health emerging practices and models of comprehensive care.

In your application, you must demonstrate your existing infrastructure and how you currently provide dementia care and services in at least two of the five primary drivers of comprehensive care, which are:

Step 1: Review the Opportunity 9

• Awareness and recognition

• Accurate and timely diagnosis

• Interdisciplinary assessment

• Management and referral

• Caregiver support

Your activities must be designed to serve and respond to the needs, culture, and historical experiences of AI/AN people living with dementia and their caregivers in your local community.

This grant is designed to support the ongoing development, evolution, and evaluation of your Tribal or Urban Indian community’s comprehensive model of dementia care.

Your model, programs, and services should be informed by evidence and consider approaches to care and services adapted from existing models and interventions where interventions and approaches exist.

Current work by others at the state and national level developing dementia models of care and interventions will also shape your local efforts. Right now, there is no widely accepted standard or comprehensive model of dementia care.

However, evidence-based models of dementia care are quickly evolving.

Here is a list of important resources you might consider when planning and writing your application:

• CMS’ Guiding an Improved Dementia Experience (GUIDE) Model

• CDC’s Health Brain Initiative Road Map for Indian Country

• Evidence-Based Models of Dementia Care

• Alzheimer’s Association Dementia Care Practice Recommendations

• Best Practice Caregiving Online Database of Interventions

• Dementia Friendly America

• Report: Meeting the Challenges of Caring for Persons Living with Dementia and their Care Partners and Caregivers

• Implementation of the REACH model of dementia caregiver support in American Indian and Alaska Native communities

Required activities You will be required to carry out the following activities:

• Use existing and new evidence to address all five primary drivers of care by the end of the period of performance.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.cms.gov/priorities/innovation/innovation-models/guide https://www.cdc.gov/aging/healthybrain/indian-country-roadmap.html https://www.ndcc.edc.org/six-models-of-ndcc https://academic.oup.com/gerontologist/article/58/suppl_1/S1/4816759 https://bpc.caregiver.org/#searchPrograms https://www.dfamerica.org/ https://nap.nationalacademies.org/catalog/26026/meeting-the-challenge-of-caring-for-persons-living-with-dementia-and-their-care-partners-and-caregivers https://nap.nationalacademies.org/catalog/26026/meeting-the-challenge-of-caring-for-persons-living-with-dementia-and-their-care-partners-and-caregivers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645288/pdf/13142_2017_Article_505.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5645288/pdf/13142_2017_Article_505.pdf

• Expand your current dementia care and services to include a comprehensive approach to clinical care and services for people living with dementia and their caregivers.

• Increase the number of people you can serve who are living with dementia and their caregivers and families.

• Increase coordination of local care and services and improve community-clinical linkages. This includes clinical care, aging services, public health, home and community-based services, and other Tribal or jurisdictional health and human services programs.

• Develop a sustainability plan to support care and services after the award ends. This plan must include:

◦ Business planning for existing and new services that include public, Tribal, and private reimbursement options.

◦ Plans for increased scalability or service reach.

◦ Plans to implement new and emerging evidence-based care and services.

• Create tools, resources, and presentations in collaboration with the IHS Alzheimer’s Grant Program. This can include stories about best and promising practices, clinical support tools, patient and caregiver resources, and community and clinical presentations. These resources will be shared with federal, Tribal, and Urban Indian health programs as they plan and implement programs.

• Plan, implement, and share findings from your project evaluation that include both process and outcome measures.

• Develop and submit an updated Driver Diagram (action-oriented logic model) that will be shared publicly by the end of your final project year.

• Work with the IHS on an expected program evaluation that will include creating and testing common data elements to track program implementation and support program improvement nationally.

• Participate in regular (not more than monthly) web-based opportunities to share your experience and expertise.

• Budget for two people to attend at least one annual, two-day in-person meeting in a location to be determined.

Other optional training and technical assistance opportunities will be offered.

Step 1: Review the Opportunity 11

Cooperative agreement terms Cooperative agreements use the same policies as grants. The difference is that the IHS will have substantial involvement in the project during the entire period of performance. Below is a detailed description of our level of involvement.

Both you and the IHS will have a role in the project. Throughout the life of your project, IHS staff will be there to help you and work with you.

IHS role The IHS will have overall programmatic responsibility for monitoring the project’s conduct and progress. The IHS will collaborate with you to:

• Provide technical assistance and subject matter expert advice on planning and implementation.

• Review and refine your proposed annual work plan and evaluation plan at the start of each year.

• Help identify and recommend useful tools, training, resources, and presentations.

• Revise, provide technical advice about, and approve any co-branded work products.

• Review and approve materials developed for dissemination to other Tribal, IHS, and Urban Indian health programs.

• Help as needed with evaluation plan implementation and developing a sustainability plan.

• Convene meetings, not more often than monthly, to share ideas, strategies, and tools to accelerate your program design and implementation.

• Make recommendations for possible federal agencies and non-governmental organization partners who can work with you to improve care.

• Coordinate, review, approve, and analyze project reporting templates and tools (for example, identified metrics utilized, achieved goals, and identified best practices).

• Review and approve all key personnel and major budget changes.

Your role

• Comply with general and program terms and conditions of the award.

• Successfully complete and submit updated work plans and evaluation plans, within three months after the start of the annual period.

Step 1: Review the Opportunity 12

• Submit performance measures data and all required performance assessments, evaluations, and financial reports.

• Immediately notify the IHS of needed or anticipated changes to the work plan or evaluation plan.

• Collaborate with the IHS to create Driver Diagrams and sustainability plans.

• Attend and actively participate in monthly calls, virtual meetings, and annual in-person gatherings.

• Share project-related and project-funded information, data, tools, resources, reports, and presentations with the IHS and others.

• Assist the IHS in actively disseminating emerging and best practices about your Model of Care grant.

Funding policies and limitations Limitations

• Pre-award costs are allowable up to 90 days before the start date of the award, provided the costs are otherwise allowable if awarded. Pre-award costs are incurred at the risk of the applicant.

Policies

• Total award funds include both direct and indirect costs.

• Each applicant can receive only one award through this announcement.

Indirect costs Indirect costs are those for a common or joint purpose across more than one project and that cannot be easily separated by project. Learn more at 45 CFR 75.414, Indirect Costs.

To charge indirect costs, you can select one of two methods:

Method 1 — Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency.

Usually, IHS recipients negotiate their rates with the U.S. Department of Health and Human Services (HHS) Division of Cost Allocation or the Department of the Interior, Interior Business Center. For questions regarding the indirect cost policy, please write to the IHS Division of Grants Management at DGM@IHS.gov.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 13 https://www.ecfr.gov/current/title-45/section-75.414 https://www.ecfr.gov/current/title-45/section-75.414 https://www.hhs.gov/about/agencies/asa/psc/indirect-cost-negotiations/index.html https://ibc.doi.gov/ICS/indirect-cost

Method 2 — De minimis rate. Per 45 CFR 75.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you are awaiting approval of an indirect cost proposal, you may also use the de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is 10% of modified total direct costs (MTDC). See 45 CFR 75.2 for the definition of MTDC. You can use this rate indefinitely.

Statutory authority This program is authorized under the Snyder Act, 25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001(a); and the Indian Health Care Improvement Act, 25 U.S.C.

1665a(c)(5)(F) and 1660e.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 14 https://www.ecfr.gov/current/title-45/part-75#p-75.414(f) https://www.ecfr.gov/current/title-45/part-75#p-75.2(Modified%20Total%20Direct%20Cost) https://www.govinfo.gov/link/uscode/25/1665a https://www.govinfo.gov/link/uscode/25/1665a https://www.govinfo.gov/link/uscode/25/1660e

Step 2:

Get Ready to Apply

In this step

Get registered 16

Find the application package 16

Get registered SAM.gov You must have an active account with SAM.gov. This includes having a Unique Entity Identifier. SAM.gov registration can take several weeks. Begin that process today.

To register, go to SAM.gov Entity Registration and click Get Started. From the same page, you can also click on the Entity Registration Checklist for the information you will need to register.

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants.

Need Help? See Contacts and Support.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number

HHS-2024-IHS-ALZ-0001.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 16 https://sam.gov/content/entity-registration http://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://grants.gov/search-grants

Step 3:

Write Your Application

In this step

Application contents and format 18

Application contents and format Applications include five main components. This section includes guidance on each. Make sure you include each of these:

Component Submission format Page limit

Project abstract Use the Project Abstract Summary form 1 page

Project narrative Use the Project Narrative Attachment form 10 pages

Budget narrative Use the Budget Narrative Attachment form 5 pages

Attachments Insert each in a single Other Attachments form None

Other required forms Upload using each required form None

We will provide instructions on document formats in the following sections.

Project abstract Provide a self-contained summary of your proposed project, including the purpose and expected outcomes. Do not include any proprietary or confidential information. We use this information when we receive public information requests about funded projects.

Required format for project narrative and budget narrative

Font size: 12-point font. Footnotes, tables, and text in graphics may be 10-point.

Font color: Black

Spacing: Single-spaced

Margins: 1-inch

Size: 8.5 by 11 inches

Include consecutive page numbers

Formats: While the forms for project and budget narratives are PDF, you may upload Word, Excel, or PDF files to those forms. PDF file formats are recommended to make sure you meet page limits.

Step 3: Write Your Application 18

Project narrative Page limit: 10 pages

Filename: Project Narrative

To create your project narrative:

• Follow the headings in the table below in order.

• Use the merit review criteria to determine what you need to include.

• Describe your proposed project and activities for the full period of performance.

• Stay within the page limit, or we will remove pages beyond that. We recommend some page limits for subsections below, but they are guidance only.

Table: Project narrative components

Heading Recommended page length

Introduction and need for assistance 2 pages

Project objectives, work plan, and approach 4 pages

Program evaluation 2 pages

Organizational capabilities, key personnel, and qualifications

2 pages

Budget narrative Page limit: 5

Filename: Budget Narrative

The budget narrative supports the information you provide in Standard Form 424-A. See other required forms.

It includes added detail and justifies the costs you ask for. As you develop your budget, consider:

• If the costs are reasonable and consistent with your project’s purpose and activities.

• Restrictions on spending funds. See funding policies and limitations.

Step 3: Write Your Application 19

To create your budget narrative:

• Show each line item in your SF-424A, organized by budget category.

• Provide the information for the entire period of performance, broken down by year.

• For each line item, describe:

◦ How the costs support achieving the project’s proposed objectives.

◦ How you calculated or arrived at the cost.

• Be sure to explain each item in the “other” category and why you need it.

• Do not use the budget narrative to expand your project narrative.

• Be sure to budget for the cost of two people attending at least one annual, two-day in-person meeting in a location to be determined.

If you like, you can also include a spreadsheet that provides more detail than in the SF-424A. If you do provide a spreadsheet, we won’t count it against the page limit.

Attachments You will upload attachments in Grants.gov using a single Other Attachments Form.

Tribal Resolution If you are a Tribal or Tribal Organization applicant, you must submit an official, signed Tribal Resolution with your application. If you cannot provide a final resolution with your application, you can submit a draft. But we must have a final resolution before we can make an award.

If you propose serving more than one Tribe, you must submit a resolution from each.

If your organization has a governing structure other than a Tribal council, you may substitute an equivalent document such as a letter of support or letter of commitment. Please include documentation explaining and justifying the substitution.

Driver Diagram table Attach a Driver Diagram table that identifies the five primary drivers of care, secondary drivers, activities, and measures.

You must use the Driver Diagram template.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 3: Write Your Application 20 https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/alzdriverdiagrammoctemplate.docx

Work plan table Attach a work plan table that includes your key activities organized by the five drivers of care, due dates, staff assigned, and outcomes.

The work plan should include activities for the entire period of performance.

You may use the work plan sample template as a reference and resource.

Evaluation plan table Attach an evaluation plan that includes a table with information outlined in the program evaluation section of this document.

The evaluation plan should include activities for the entire performance period.

You may use the evaluation plan sample template as a reference and resource.

Proof of nonprofit status If your organization is a nonprofit, you need to attach proof. We will accept any of the following:

• A copy of a current tax exemption certificate from the IRS.

• A letter from your state’s tax department, attorney general, or another state official saying that your group is a nonprofit and that none of your net earnings go to private shareholders or others.

• A certified copy of your certificate of incorporation. This document must show that your group is a nonprofit.

• Any of the above for a parent organization. Also include a statement signed by an official of the parent group that your organization is a nonprofit affiliate.

Indirect cost agreement If you include indirect costs in your budget using an approved rate, include a copy of your current agreement approved by your cognizant agency for indirect costs. If you use the de minimis rate, you do not need to submit this attachment.

Biographical sketches For key personnel, attach biographical sketches or resumes and position descriptions for positions that are filled. If a position isn’t filled, attach a short description of the position and qualifications.

Be sure to identify, at a minimum, one full-time (100%) staff person that is responsible for program coordination and management.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 3: Write Your Application 21 https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/alzworkplantemplatesample.docx https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/alzevaltemplatesample.docx https://www.ecfr.gov/current/title-45/part-75#p-75.2(Cognizant%20agency%20for%20indirect%20costs)

Letters of support Attach letters of support from your organization’s Board of Directors, if relevant, and for any key partners collaborating and named in your proposal.

Audit documentation You must provide documentation of required audits. You can submit:

• E-mail confirmation from the Federal Audit Clearinghouse (FAC) showing that you submitted the audits.

• Face sheets from audit reports. You can find these on the FAC website.

Optional attachments You can attach additional supporting documents, including:

• Consultant or contractor proposed scope of work and letter of commitment.

• Organizational chart.

• Map of area showing project location(s).

Other required forms You will need to complete some required forms. Upload the standard forms listed below at Grants.gov. You can find them in the NOFO application package or review them and their instructions at Grants.gov Forms.

Forms Submission requirement

Application for Federal Assistance (SF-424) With application

Budget Information for Non-Construction Programs

(SF-424A)

With application

Assurances for Non-Construction Programs

(SF-424B)

With application

Grants.gov Lobbying Form With application

Disclosure of Lobbying Activities (SF-LLL) If applicable, with the application

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 3: Write Your Application 22 https://facdissem.census.gov/ https://www.grants.gov/web/grants/forms/sf-424-family.html

Step 4:

Learn About Review and

Award

In this step

Application review 24

Award notices 30

Application review Initial review We review each application to make sure it meets basic requirements. We won’t consider an application that:

• Is from an organization that doesn’t meet all eligibility criteria.

• Is incomplete.

• Requests funding above the award ceiling shown in the funding range.

• Requests a period of performance longer than this NOFO allows.

• Is submitted after the deadline.

Also, if you don’t follow page limit or formatting requirements, we will remove any pages over the page limit from your application before it goes to the merit review.

Merit review The Review Committee reviews all applications that pass the initial review. The members use the criteria below.

We will send your authorized official an Executive Summary Statement within 30 days after we complete reviews. This statement will outline the strengths and weaknesses of your application.

Criteria

Criterion Total number of points =

1. Introduction and need for assistance 25 points

2. Project objectives, work plan, and approach 25 points

3. Program evaluation 25 points

4. Organizational capabilities, key personnel, and qualifications

15 points

5. Budget narrative 10 points

Most of the merit review criteria assess the information you include in your project narrative. Your project narrative should be written in a manner that is clear to outside reviewers unfamiliar with your organization or prior related activities.

Step 4: Learn About Review and Award 24

It should be well organized, succinct, and contain all information necessary for reviewers to understand the project fully. Attachments requested in the criteria do not count toward the page limit for the narratives.

Introduction and need for assistance Maximum points: 25

These criteria evaluate the introduction and need for assistance section of your project narrative. Reviewers will assess the extent to which your application does the following:

Needs

• You identify gaps in current available services and provide data about the unmet needs of people with dementia and their caregivers in your community. You use quantitative (numbers) or qualitative (stories) data.

Dementia-related activities and accomplishments

• You identify and describe your existing programs or model of dementia care.

You tell us how each of your program(s) and services fit into at least two of the five primary drivers of comprehensive dementia care. Proposals demonstrating significant activities and services in more than two drivers of care will receive more points, up to the maximum in this category.

• You describe your major activities and accomplishments within the past five years related to implementing clinical or community dementia care and support.

Other funded initiatives

• You provide information about other dementia-related activities that you are or will be participating in that are paid for by an outside organization, federal grant, or contract during the same project period as this one. This includes any other HHS grants addressing dementia (for example, the Dementia Capability in Indian Country Grant program of the Administration for Community Living or CDC BOLD funding) that may have the same project period.

Project objectives, work plan, and approach Maximum points: 25

These criteria evaluate your work plan attachment and the project objectives, work plan, and approach section of your project narrative. Reviewers will assess the extent to which your application does the following:

Step 4: Learn About Review and Award 25

Approach and Driver Diagram

• You provide a separate Driver Diagram attachment, which is required as part of your attachments and does not count toward the project narrative page limits. Your Driver Diagram will be assessed in this category for completeness and clarity. You outline your rationale and a plan clearly showing how the care and services you provide will come together to form a sustainable, comprehensive approach to dementia care.

• You describe your approach to creating and implementing an expanded comprehensive model of care for people living with dementia and their caregivers. Your plan must reflect up-to-date knowledge of evidence-based or evidence-informed practices, interventions, and models. You must:

◦ Describe your vision, goals, objectives, proposed major activities, and outcomes designed to address the problem that you identified in your Driver Diagram.

◦ Include SMART (Specific, Measurable, Achievable, Relevant, and Time-based) objectives.

◦ Describe planning activities and assessment of need, if not already available.

◦ Describe how you will address the five drivers of care.

◦ Clearly identify new and expanded opportunities, services, and programs.

◦ Identify potential partners including aging services, public health, home and community-based services, and other relevant Tribal or jurisdictional health and human services.

◦ Identify funding and billing streams that will support service delivery or explain how you will develop these funding streams during your project period.

◦ Describe the approach and timeline for developing your sustainability plan.

◦ Describe your approach and plan for developing and sharing tools, resources, reports, and presentations to support the development of dementia programs by other Tribes, Tribal organizations, or Urban Indian health programs.

Work plan attachment

• You provide a separate work plan chart, which is required as part of your attachments and does not count toward the project narrative page limits. The work plan should:

Step 4: Learn About Review and Award 26

◦ Be an extension of your Driver Diagram.

◦ Provide additional details about activities, due dates, and staff responsible for accomplishing items listed in your Driver Diagram and any related major budget items.

◦ Respond to the most urgent and pressing gaps in the availability and quality of care and services for people living with dementia and their families you discussed in the narrative.

◦ Include the provision of clinical services, either directly or through coordination with an IHS Service Unit(s).

◦ Include the engagement of elder services programs and other relevant community-based organizations or community services.

◦ Include developing tools, resources, reports, and presentations to support the development of programs by other Tribes, Tribal organizations, or Urban Indian health programs.

Services and coordination

• You demonstrate that you are able to provide ambulatory care services directly or through coordination with IHS Direct Services.

• You show that you will coordinate with elder services.

• You describe what you will do to increase coordination of care and services and improve community-clinical linkages and collaborations.

Program evaluation Maximum points: 25

These criteria evaluate the evaluation plan table attachment and the program evaluation section of your project narrative. You can use third-party evaluators.

Reviewers will assess the extent to which your application does the following:

• You describe the methods, approach, and data sources you will use to monitor and guide project progress.

• Your evaluation plan includes real-world clinical and program data.

• You plan to begin tracking and reporting no later than the first quarter of the project period.

• You describe how you will use evaluation activities to:

◦ Determine your effectiveness in implementing your plan over time.

◦ Track progress towards achievement of your outcomes and goals.

◦ Provide insights into how to change your clinical and service delivery and operations.

Step 4: Learn About Review and Award 27

◦ Document data and lessons learned that will be useful to people interested in replicating your model in their own communities.

• You describe:

◦ How you will develop or acquire, manage, track, and report data.

◦ Any new data collection measures and methods that you will develop.

◦ Who will be responsible for data collection, analysis, and reporting.

• Your measures include:

◦ At least one outcome and performance measure for each of the five drivers of care.

◦ The number of persons newly diagnosed with dementia.

◦ The number of persons living with a pre-existing dementia diagnosis.

◦ Screening and diagnostic process and outcome measure(s) of efforts to detect unrecognized cognitive impairment and dementia.

◦ At least one measure to assess the project’s impact on people living with dementia and/or their caregivers. Consider metrics such as:

▪ Avoidance of crisis-driven care (for example, hospitalization, emergent transfers, or undesired out-of-home placement).

▪ Processes of care that contribute to better outcomes (for example, reduction of medications that impair cognition).

Organizational capabilities, key personnel, and qualifications Maximum points: 15

These criteria evaluate the organizational capabilities, key personnel, and qualifications section of your project narrative. Reviewers will assess the extent to which your application does the following:

• You demonstrate that your program staff has the necessary skill, time, and expertise to successfully execute your proposed project.

• Your key personnel include, at a minimum, one full-time (100%) staff person that is responsible for program coordination and management.

• You have staff or partners with clinical knowledge or experience with care of people living with dementia.

Organizational overview and accomplishments You describe:

• Examples or evidence that demonstrate your ability to execute the program activities within the period of performance.

Step 4: Learn About Review and Award 28

• Other related major program activities and accomplishments within the past five years.

• Any partners and their related major program activities and accomplishments.

Organizational structure and staffing You describe:

• Organizational structure and planned approach to project staffing, management, and integration with other existing programs or departments.

• A picture of how staff will work together to meet goals and deliver services.

• Complete list of key staff for the project, their role and level of effort, and qualifications for the work.

• Current staff expertise related to the project. If staff with expertise in dementia are not currently employed, describe your plan to fill this gap and the anticipated timeframe for doing so.

• For key staff, include short biographical sketches and position descriptions in your attachments (they do not count towards the project narrative page limit).

• Any partners or collaborators and how they will help implement the work plan. Include letters of support or intent to coordinate or collaborate in your attachments.

Sharing with other Tribes, Tribal Organizations, and Urban Indian Organizations You describe:

• Your experience developing and sharing best and promising dementia and caregiving practices.

• Tools, resources, reports, and presentations you have shared across the Tribal health system including Tribal and Urban Indian health partners.

Budget narrative Maximum points: 10

Reviewers will assess the extent to which your budget narrative:

• Includes a multi-year budget covering the entire project period (not just the first year).

• Clearly defines items of cost that are consistent with objectives and scope of activities proposed in the project narrative, work plan, and evaluation plan.

• Ensures appropriate time commitment for key and other project personnel to assure proper direction, management, and completion of the project.

Step 4: Learn About Review and Award 29

Risk review Before making an award, we review the risk that you will not prudently manage federal funds. We need to make sure you’ve handled any past federal awards well and demonstrated sound business practices. We use SAM.gov Responsibility / Qualification to check this history for all awards likely to be over $250,000. You can comment on your organization’s information in SAM.gov. We’ll consider your comments before making a decision about your level of risk.

If we find a significant risk, we may choose not to fund your application or to place specific conditions on the award.

For more details, see 45 CFR 75.205.

Selection process When making funding decisions, we consider:

• Merit review results. These are key in making decisions but are not the only factor.

• The larger portfolio of agency-funded projects, including the diversity of project types and geographic distribution.

• The past performance of the applicant. We may choose not to fund applicants with management or financial problems.

We may:

• Fund applications in whole or in part.

• Fund applications at a lower amount than requested.

• Decide not to allow a prime recipient to subaward if they may not be able to monitor and manage subrecipients properly.

• Choose to fund no applications under this NOFO.

Award notices After we review and select applications for the award, we will let you know the outcome.

Unsuccessful applications We will email you or write you a letter if your application is disqualified or unsuccessful.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 4: Learn About Review and Award 30 https://sam.gov/content/entity-information https://www.ecfr.gov/current/title-45/section-75.205

Approved but unfunded applications It is possible that we could approve your application, but don’t have enough funds to support it. If so, we will hold your application for one year. If funding becomes available during the year, we may reconsider funding.

Approved applications If you are successful, we will create a Notice of Award (NoA). You will need a GrantSolutions user account to retrieve your NoA.

The NoA is the only official award document. The NoA tells you about the amount of the award, important dates, and the terms and conditions you need to follow.

Until you receive the NoA, you don’t have permission to start work.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 4: Learn About Review and Award 31 https://www.grantsolutions.gov/home/getting-started-request-a-user-account/

Step 5:

Submit Your Application

In this step

Application submission and deadlines 33

Application checklist 35

Application submission and deadlines See find the application package to make sure you have everything you need.

Make sure you are current with SAM.gov and UEI requirements. See get registered. You will have to maintain your registration throughout the life of any award.

Application deadline You must submit your application by July 16, 2024 at 11:59 p.m. ET.

Grants.gov creates a date and time record when it receives the application. If you submit the same application more than once, we will accept the last on-time submission.

The grants management officer may extend an application due date based on emergency situations such as documented natural disasters or a verifiable widespread disruption of electric or mail service.

Application submission You must submit your application through Grants.gov. See get registered.

For instructions on how to submit in Grants.gov, see the Quick Start Guide for Applicants. Make sure that your application passes the Grants.gov validation checks or we may not get it. Do not encrypt, zip, or password protect any files.

The link above will also help you learn how to create PDFs.

See Contacts and Support if you need help.

Exemptions If you cannot submit through Grants.gov, you must request a waiver before the application due date. Send your waiver request to DGM@ihs.gov. Include clear justification for the need to deviate from the required application submission process. Failure to register in SAM.gov or Grants.gov in a timely way is not cause for a waiver. We will not accept applications outside of Grants.gov without an approved waiver.

We will email you if we approve your waiver. This notification will include submission instructions. If approved, we must receive your application by 5 p.m.

ET on the application deadline.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 5: Submit Your Application 33 http://www.grants.gov/quick-start-guide/applicants http://www.grants.gov/quick-start-guide/applicants mailto:DGM@ihs.gov

Other submissions Intergovernmental review This NOFO is not subject to executive order 12372, Intergovernmental Review of Federal Programs. No action is needed.

Mandatory disclosure You must submit any information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. See Mandatory Disclosures, 45 CFR 75.113.

Send written disclosures to the IHS at DGM@ihs.gov and to the Office of Inspector General at grantdisclosures@oig.hhs.gov. Include “Mandatory Grant Disclosures” in the subject line.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 5: Submit Your Application 34 https://www.ecfr.gov/current/title-45/section-75.113 mailto:DGM@ihs.gov mailto:grantdisclosures@oig.hhs.gov

Tribal resolution

Driver Diagram

Work plan chart

Evaluation plan

Proof of nonprofit status

Indirect cost agreement

Biographical sketches

Letter(s) of support or commitment

Audit documentation

Optional attachments

Application for Federal Assistance

(SF-424)

Budget Information for Non- Construction Programs (SF-424A)

Assurances for Non-Construction Programs (SF-424B)

Grants.gov Lobbying Form

Disclosure of Lobbying Activities

(SF-LLL)

Application checklist Make sure that you have everything you need to apply:

Component How to Upload Page limit

Project abstract Use the Project Abstract Summary Form. 1 page

Project narrative Use the Project Narrative Attachment form. 10 pages

Budget narrative Use the Budget Narrative Attachment form. 5 pages

Attachments Insert each in a single Other Attachments form.

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Other required forms (5 total) Upload using each required form.

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Step 5: Submit Your Application 35

Step 6:

Learn What Happens After

Award

In this step

Post-award requirements and administration 37

Post-award requirements and administration Administrative and national policy requirements There are important rules you need to know if you get an award. You must follow:

• All terms and conditions in the Notice of Award.

• The rules listed 45 CFR part 75, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards.

• The HHS Grants Policy Statement (GPS). This document has terms and conditions tied to your award. If there are any exceptions to the GPS, they’ll be listed in your Notice of Award.

• All federal statutes and regulations relevant to federal financial assistance, including those highlighted in the HHS Administrative and National Policy Requirements.

Reporting If you are successful, you will have to submit financial and performance reports and possibly reports on specific types of activities. Your NoA outlines the specific requirements and deadlines. To learn more about reporting, see:

• Performance Progress Reports

• Progress Report Requirements

• Financial Reporting

• If your award includes funds for a conference, you must submit a report for all conferences.

If you don’t submit your reports on time, we could:

• Suspend or terminate your award.

• Withhold payments.

• Move you to a reimbursement payment method.

• Withhold future awards.

• Take other enforcement actions.

• Impose special award conditions if the situation continues.

1. Review 2. Get Ready 3. Write 4. Learn 5. Submit 6. Award Contacts

Step 6: Learn What Happens After Award 37 https://www.ecfr.gov/current/title-45/part-75 https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf https://www.hhs.gov/sites/default/files/hhs-administrative-national-policy-requirements.pdf…