hhs-2026-acl-aoa-fpsg-0004_rev1.pdf

Notice of Funding Opportunity

Application due Wednesday July 29, 2026

Administration on Aging (AOA)

Office of Nutrition and Health Promotion Programs (ONHPP)

Scaling Evidence-Based Falls Prevention Programs Opportunity number: HHS-2026-ACL-AOA-FPSG-0004

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 7

Program description 9

Step 2: Get Ready to Apply 24

Find the application package 25

Get registered 26

Step 3: Build Your Application 27

Application checklist 28

Application contents and format 30

Step 4: Learn About Review and Award 53

Application review 54

Award notices 56

Step 5: Submit Your Application 57

Application submission and deadlines 58

Step 6: Learn What Happens After Award 60

Post-award requirements and administration 61

Contacts and Support 63

Before you begin 3

Appendices 66

Endnotes 81

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 registrations are 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 the application due date

Applications are due by 11:59 p.m. Eastern Time on Wednesday July 29, 2026.

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/

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

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 7

Program description 9

Basic information Administration for Community Living (ACL)

Administration on Aging (AOA)

Office of Nutrition and Health Promotion Programs (ONHPP)

Scaling the Stepping On program and STEADI clinical intervention as a part of a statewide multi-factorial evidence-based falls prevention approach for older adults and people with disabilities in alignment with ACL’s strategic priorities and the Make America Healthy

Again agenda.

Have questions?

See Contacts and

Support.

Key facts

Opportunity name:

Scaling Evidence-Based Falls

Prevention Programs

Opportunity number:

HHS-2026-ACL-AOA-

FPSG-0004

Federal assistance listing:

93.761

Cost sharing: None

NOFO version: Original

Key dates

Application submission deadline:

July 29, 2026

Optional notice of intent deadline:

July 6, 2026

Expected award date:

September 30, 2026

Expected project start date:

September 30, 2026

See intergovernmental review for other submission processes that may apply to this NOFO.

Summary Reducing falls among older adults is a national priority and is in alignment with this administration’s efforts to Make America Healthy Again. The U.S. Department of Health and Human Services (HHS), through the Administration for Community Living (ACL), is coordinating a cross-agency response to significantly reduce the incidence of falls among older adults. While HHS has invested in falls prevention for decades, the work was often siloed within agencies, for specific providers, and/or in specific communities. This effort, informed by the National Falls Prevention Action Plan [PDF], seeks to bring together tools and program investments across ACL, the Centers for Disease Control and Prevention

(CDC), the Health Resources and Services Administration (HRSA), the Center for Clinical

Standards and Quality in the Centers for Medicare and Medicaid Services, and the

National Institute on Aging (NIA) to realize significant progress over the next three years.

As a part of this initiative, this funding opportunity shall expand and scale the evidence-based Stepping On program and STEADI clinical intervention for adults 60 and older, prioritizing those with the greatest social and economic need. HRSA will be working with

Federally Qualified Health Centers to screen for falls risk using STEADI as another part of this coordinated effort. This funding opportunity advances HHS’ Make America Healthy

Again (MAHA) agenda by empowering older adults to manage their own health, reducing clinical dependence, and building community infrastructure that sustains healthy behaviors. It is expected that adults between ages 60–70 will make up at least 50% of the participants, through a required partnership model using statewide reach and strong partnerships with state level organizations. Outreach and engagement efforts will prioritize populations that face barriers related to falls, ensuring meaningful reach and

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

Step 1: Review the Opportunity 5 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fassets.ncoa.org%2Fffacfe7d-10b6-0083-2632-604077fd4eca%2F8dd5d7b0-b98f-48f2-a484-989d9e339f4a%2F2025_National_Falls_Prevention_Action_Plan.pdf&data=05%7C02%7CKari.Benson%40acl.hhs.gov%7C50870fcb4f9b489d066308de90f499f0%7Cd58addea50534a808499ba4d944910df%7C0%7C0%7C639107577394452755%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=5xI0IqfrqPAglwajZol%2BEhZazU3yfnLrr63hwvNsf5c%3D&reserved=0 https://wihealthyaging.org/programs/falls-prevention-programs/stepping-on/ https://www.cdc.gov/steadi/hcp/clinical-resources/index.html participation, while maintaining inclusive program access for all eligible adults in alignment with the Older Americans Act.

This project has two goals.

Funding details Type: Cooperative agreement

Expected total program funding over the performance period: $15,521,296

Expected total program funding per budget period:

• Year 1: $5,921,296

• Years 2 to 3: Up to $4,800,000 per year (subject to available funds)

Total expected awards: 8

Funding range per applicant for budget period, year one: $600,000 to $740,162

Year two and year three budget periods, per year: $500,000 to $600,000 (subject to available funds)

We plan to fund awards in three 12-month budget periods for a three-year period of performance from September 30, 2026 to September 29, 2029, pending availability of funding.

Step 1: Review the Opportunity 6

Eligibility Eligible applicants Only these types of organizations may apply:

• State Units on Aging.

• Domestic public or private nonprofit entities, including state and local governments.

• Tribal governments or organizations (American Indian/Alaskan Native/Native

American).

• Faith-based organizations.

• Community-based organizations.

• Hospitals.

• Institutions of higher education.

Disqualifying factors We will review your application to make sure it meets these responsiveness requirements.

We won’t consider an application that:

• Is submitted after the deadline.

• Is from an individual, including a sole proprietorship, or a foreign entity.

• Is received in paper format that didn’t have a previously approved exemption from ACL.

• Does not follow the required format for project and budget narratives as outlined in the Application Contents and Format section of this NOFO, also listed below:

◦ Font: Times New Roman or Arial.

◦ Format: PDF.

◦ Size: 11-point font.

◦ Footnotes and text in graphics may be 10-point.

◦ Spacing for project narrative main content: double-spaced.

◦ Spacing for budget narrative: As needed.

◦ Spacing for project summary, tables, footnotes: Single-spaced.

◦ Margins: 1-inch.

◦ Include page numbers.

• Has a project narrative that exceeds 20 pages. Applications with a project narrative that exceeds 20 pages will be screened out and will not be further reviewed or

Step 1: Review the Opportunity 7 considered. Do not include a table of contents or cover page in your project narrative.

• Does not include an individual budget narrative/justification for each of years 1, 2, and 3 AND a combined budget narrative/justification for the proposed 36-month budget period. Forms SF424 and SF424A of your application do NOT satisfy this requirement. The proposed combined budget narrative/justification must not exceed the total federal 3-year award ceiling of $1,940,162.

• Does not include an individual project work plan for each of years 1, 2, and 3. Each year must be separate and clearly labeled.

Application limits If you submit the same application more than once under this notice of funding opportunity (NOFO), we will only acknowledge the last on-time submission.

Only one grant will be awarded in any one state.

Cost sharing This program has no cost-sharing requirement, meaning you do not need to contribute to the costs of this project.

If you choose to include cost-sharing funds, we won’t consider it during review. If you receive an award, we will include your voluntary commitment in the award.

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

Statutory authority 42 USC 3032; Older Americans Act, funded through the Patient Protection and Affordable

Care Act, 42 USC. § 300u-11 (Prevention and Public Health Fund)

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

Step 1: Review the Opportunity 8 https://uscode.house.gov/view.xhtml?req=%22chronic+disease+self-management%22&f=treesort&fq=true&num=1&hl=true&edition=prelim&granuleId=USC-prelim-title42-section3032 https://www.govinfo.gov/link/uscode/42/300u-11

Program description Background

ACL’s strategic priorities

This funding opportunity directly aligns with ACL’s strategic priorities. Falls prevention sits at the heart of ACL’s Whole-Person Health priority, which explicitly calls for scaling evidence-based falls prevention programs and supporting interventions that maximize independence and avoid unnecessary institutional care.

Make America Healthy Again (MAHA)

HHS’ Make America Healthy Again (MAHA) agenda envisions a health system built on prevention, personal empowerment, and community-based health promotion – and this funding opportunity embodies each of these principles. By targeting fall risk through exercise and strength building, home safety, and medication management, the funding allows approved grantees to intervene upstream—keeping older adults active, independent, and out of emergency rooms. Increasing the number of states that implement Stepping On and STEADI will help develop a model that can be shared broadly to directly reduce avoidable healthcare utilization and support the kind of community-level health infrastructure MAHA envisions: one that empowers individuals to protect their own health and reduces the burden on clinical systems. Applicants that propose to coordinate this effort with A Demonstration to Scale Innovative Person-Centered

Approaches to Falls Prevention through Clinical-Community Partnerships (HHS-2026-ACL-

CIP-AAFP-0017) will achieve an even greater impact through closer integration with health care providers.

The Older Americans Act

The Older American Act (OAA) is carried out by the aging network in communities across the United States. The aging network includes:

• State Units on Aging (SUAs).

• Area Agencies on Aging.

• local service providers.

This network provides services, referrals, and programs to older adults. The OAA focuses on older adults (aged 60 and over) and family caregivers in the greatest economic need and greatest social need.

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

Step 1: Review the Opportunity 9 https://www.grants.gov/search-results-detail/360505 https://www.grants.gov/search-results-detail/360505

The OAA encourages:

• Providing regular physical activity.

• Evidence-based health promotion and disease prevention programs.

• Nutrition services with a person-centered, trauma-informed approach to meet the needs of the older adult population.

Facts about falls

Falls are the leading cause of fatal and nonfatal injuries among older adults and have widespread and serious health impacts.[1]

• One in four older adults report falling each year[2] and many falls go unreported, suggesting the actual number is much higher.[3]

• Older adults who fall have an increased risk of injury and reduced physical function which may significantly reduce their ability to remain independent.

• In 2021, for adults aged 65 and older, falls caused over 38,000 deaths, making it the leading cause of injury death for that group.

• Emergency departments recorded nearly 3 million visits for older adult falls in

2021.[4]

• In 2015, healthcare spending for older adults falls was $50 billion, and by 2020 rose to $80 billion.[5]

Falls are not a normal part of aging and are preventable.[6] Risk factors that can be changed or controlled include impaired balance, muscle weakness, gait deficits, medications, home hazards, vision problems, and improper footwear.[7] Multiple factors contribute to fall risk, particularly behavioral health conditions (e.g. depression, anxiety, substance use disorder) and chronic conditions or multiple complex conditions (e.g.

multiple sclerosis, Parkinson’s disease, traumatic brain injury), with fall risk increasing as the number of co-occurring conditions rises. Social isolation affects half of older adults and is linked to both increased fall risk and behavioral health conditions, as socially isolated individuals have less support to take preventive action.

Adults ages 60–70 represent a critical and underserved population in fall prevention efforts.[8] This cohort experiences high rates of chronic disease, polypharmacy, and fall-risk medications (antihypertensives, sedatives, antidepressants), along with elevated behavioral health factors and social isolation.[9] These clinical, behavioral, and social factors interact and compound fall risk, requiring a comprehensive approach that includes coordinated clinical screening, medication review, behavioral health awareness, and strategies addressing social determinants of health—not balance and strength training alone.

Step 1: Review the Opportunity 10

ACL falls prevention program

ACL has built an infrastructure to increase access to and sustain evidence-based disease prevention and health promotion programs, including falls prevention programs.

• Between 2014 and 2024, ACL awarded 103 discretionary grants to states, community-based organizations, and tribal organizations to deliver EBFPPs to over

247,000 individuals.

• Participants in EBFPPs have fewer falls and injurious falls, improved confidence, and decreased fear of falling.[10]

• Group Falls prevention classes can help address social isolation.

• Small-group, in-person EBFPP workshops increase social support and promote social connection.

• Participants interact and bond over a shared purpose and engage with peers and trained leaders for weeks at a time.[11]

Gaps in participation

Although evidence-based falls prevention programs demonstrate positive outcomes and broader reach, participation gaps persist among populations with elevated risks for falls.

Falls are multifactorial and associated with multiple chronic conditions, polypharmacy, balance and gait impairments, and functional limitations. However, current participation data suggests that some high risk groups, including adults 60-70 and individuals managing multiple chronic conditions and/or complex health conditions, are under-represented.

Applicants are encouraged to analyze local, state, and national data and trends to identify participation gaps among populations at increased risk for falls and to propose strategies to improve access and engagement with complex risk profiles-including those with multiple chronic conditions, behavioral health needs, and functional limitations and propose whole person strategies to improve engagement.

Tools, resources and national efforts

ACL wants to help prepare the aging network to serve populations that would benefit from EBFPPs. As older adults’ expectations, preferences, and needs from programs and services evolve, the aging network should have tools and resources to broaden the reach of EBFPPs to populations who have a high risk for falls but have not historically participated in EBFPPs.

ACL encourages, leverages, and complements other national efforts to reduce falls and falls risk for older adults.

Step 1: Review the Opportunity 11

These include collaborations to broaden and improve the linkage between health care providers and evidence-based community falls prevention programs. Cross-sector initiatives are also a part of this.

This funding opportunity integrates:

• CDC’s STEADI (Stopping Elderly Accidents, Deaths & Injuries) clinical framework.

• The Stepping On program as the required evidence-based falls prevention program.

• State-level approach requiring State Units on Aging as part of the strategy.

• Active collaboration with healthcare providers.

• Technology-enabled engagement strategies.

• Advancing public awareness around falls prevention.

• Use of data and evaluation to show impact.

• A whole-person approach to fall risk reduction that aligns with the age-friendly framework and addresses specific behavioral, clinical, and social factors that are based on data-informed evidence that leads to increased falls.

You can read more about ACL’s Falls Prevention Program, including grantee profiles.

Purpose This funding opportunity awards cooperative agreements to scale the in-person Stepping

On program with the STEADI clinical intervention, as a part of a statewide multi-factorial falls prevention approach for older adults and people with disabilities.

Applicants must demonstrate how these components will be operationalized in an integrated model.

As part of the cooperative agreements:

• You will develop and put in place a strong statewide strategy, with a focus on populations with both:

◦ A high risk for falls.

◦ Historically low participation in evidence-based falls prevention programs.

• The statewide strategy will include:

◦ Identifying older adults and people with disabilities at high risk for falls.

◦ Conducting individualized risk assessments.

◦ Connecting people to resources (including evidence-based programs) to address their specific fall risk factors.

• Efforts will include:

◦ Ensuring collaboration with partners.

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

Step 1: Review the Opportunity 12 https://www.cdc.gov/steadi/hcp/clinical-resources/index.html https://wihealthyaging.org/programs/falls-prevention-programs/stepping-on/ https://www.acl.gov/programs/health-wellness/falls-prevention https://wihealthyaging.org/programs/falls-prevention-programs/stepping-on/ https://www.cdc.gov/steadi/hcp/clinical-resources/index.html

◦ Creating and disseminating resources and education.

◦ Capturing best practices and learnings.

• You will also design an evaluation to assess the impact on reducing falls or the risk of falls.

For this funding opportunity, the Stepping On program and STEADI clinical intervention must be included in all applications. Applicants are encouraged to propose how the efforts funded through this NOFO would be coordinated with proposed efforts under A

Demonstration to Scale Innovative Person-Centered Approaches to Falls Prevention through Clinical-Community Partnerships (HHS-2026-ACL-CIP-AAFP-0017) to achieve greater impact.

Main population

This funding serves adults 60 and older, prioritizing those with the greatest social and economic need. Programs may also serve adults under 60 with disabilities, provided that older adults remain the majority of participants and at least 50% are ages 60-70—an underrepresented population identified in the data. This focus aligns with the Older

Americans Act.

Select sub-populations

You may also select a sub-population of older adults. If selecting a sub-population, further identify the specifics.

• You should identify a select sub-population(s) of interest from the main population that has/have historically low participation in EBFPPs, but a high risk for falls.

• You should ensure that the program reaches the population specified by the

Stepping On program fidelity guidelines.

• You should provide a thorough and data-driven rationale for choosing this select sub-population(s).

• Include how you will market to and recruit this select sub-population(s) to participate in the Stepping On program and STEADI intervention.

Examples:

• You may want to reach a select sub-population(s) of older adults with behavioral health conditions such as depression, fear of falling, anxiety disorders, or substance use disorder as part of your whole person strategy.

• You may choose a select sub-population(s) of older adults with multiple and complex chronic conditions such as traumatic brain injury, multiple sclerosis, or

Parkinson’s disease.

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

Step 1: Review the Opportunity 13 https://wihealthyaging.org/programs/falls-prevention-programs/stepping-on/ https://www.cdc.gov/steadi/hcp/clinical-resources/index.html https://www.grants.gov/search-results-detail/360505 https://www.grants.gov/search-results-detail/360505 https://www.grants.gov/search-results-detail/360505 https://www.ncoa.org/page/falls-prevention-evidence-based-programs-fidelity-hub/#Stepping%20On

Goals

This program has two goals.

Goal 1:

• On a statewide level, increase participation among older adults and adults with disabilities in the Stepping On program and the STEADI clinical screening tool while also building the capacity and resources needed to effectively serve the participants.

◦ Examples of capacity include instructors, partnerships, and referral networks.

Goal 2:

• Develop and disseminate section 508-compliant resources based on what the grant activities show.

◦ These resources will help increase knowledge, improve services for older adults and help sustain EBFPPs.

To be considered for funding, your application must include the following components to accomplish the goals of this funding opportunity.

1. Pair Stepping On with STEADI

• Demonstrate formal partnership(s) with physicians, health systems, and other key players across the state.

◦ For example, Federally Qualified Health Centers, the National Association of

County and City Health Officials, Association of State and Territorial Health

Officials, Rural Health Centers, Veteran’s Administration, Emergency

Management Services (EMS), falls prevention coalitions, behavioral health networks, and other key organizations.

◦ Partnerships with organizations that specialize in reaching your identified select sub-population(s) (if any were selected) are encouraged.

• Implement STEADI-based screening, referral, and follow-up processes.

• Tie these requirements back to the Stepping On program fidelity and evidence-based standards.

• Any program implementation should include consultation with the program developer to ensure fidelity, appropriateness, and feasibility.

• If you do not have adequate existing capacity (trained leaders, licensing, program supplies, etc.) for the Stepping On program, you must include a letter from the program developer/administrator(s) that indicates that you will be trained no later than three months after the start date of the grant.

• Establish bidirectional communication between clinical providers and community program staff.

Step 1: Review the Opportunity 14

2. Implement a whole-person approach to fall risk reduction that aligns with the age-friendly framework and addresses specific behavioral, clinical, and social factors based on data-informed evidence

• Address whole-person health, including factors such as fear of falling, depression, anxiety, substance use, as contributors to overall risk.

• Include medication risk awareness and coordination with prescribing providers.

• Incorporate innovative strategies to identify and mitigate social factors that influence overall health, independence, and daily functioning.

3. Utilize technology

• Incorporate technology to help older adults track activities that complement existing services (i.e. track exercise, medications, etc.).

• Leverage digital tools to disseminate health information and engage/connect participants with programs.

• Facilitate communication between older adults, caregivers, and providers that supports adherence and wellness goals.

4. Target adults ages 60–70 (while not exclusive to only this population)

• Explain how your outreach, engagement, and partnership efforts are designed for this age group.

• Describe how messaging will resonate with adults who may not self-identify as

“older adults”.

• Demonstrate how your strategy will expand reach among adults ages 60–70.

5. Elevate falls prevention awareness

• Clearly describe strategies specific to raising awareness of both risk of falls and successful impacts to make a difference.

• Explain how this awareness will result in increased engagement and participation in your programs.

Step 1: Review the Opportunity 15

Section 508 compliance requirements

This is a core requirement of your proposal.

All project materials must meet federal accessibility standards (Section 508).

Required accessibility features

Webinars and videos

• Live captioning for all webinars.

• American Sign Language (ASL) interpreters available upon request.

• Professional captioning for technical or jargon-heavy content.

• Edited captions in final recordings if using automatic captioning tools.

• Accurate captions on all videos.

Documents and files

• All PDFs, Word documents, and PowerPoint presentations must be:

◦ Screen reader compatible.

◦ High contrast (meets accessibility standards).

Cultural and linguistic accessibility

• All materials must meet the cultural and linguistic needs of your target audience.

Approval and deliverables

• ACL reserves the right to review and approve deliverables prior to public release.

You will work with your project officer during the grant to decide which deliverables need review.

• You must provide us with all developed resources at project end.

Budget and planning

• Include time and costs for accessibility work in your:

◦ Annual Work plan.

◦ Budget.

◦ Dissemination section.

◦ Budget Justification section.

Resources

For detailed Section 508 guidance, visit: ACL Accessibility Resources

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

Step 1: Review the Opportunity 16 https://acl.gov/Site_Utilities/Accessibility.aspx

Cooperative agreement terms Cooperative agreements require substantial ACL project involvement after an award is made. There are specific roles for both you and ACL.

Your responsibilities

You must execute the activities as noted in the program description and the responsibilities of the cooperative agreement listed here:

• Fulfill all grant requirements outlined in this NOFO, as well as carry out project activities as reviewed, approved, and awarded.

• On a statewide level, 1) commit to engage partnerships to help implement the proposal, with two or more organizations that serve the main population and sub-population(s) (if any) 2) commit to establish a statewide approach to reach those in greatest economic need and greatest social need (consistent with the OAA) and 3) serve older adults and adults with disabilities in the main population and your identified select sub-population(s) (if any selected).

• Demonstrate formal partnership(s) with physicians or health systems to implement

STEADI-based screening, referral, and follow-up processes with established bidirectional communication between clinical providers and community program staff.

• Include your State Unit on Aging as an active part of the statewide strategy and partnership model.

• Engage approximately 25% of your target participants by the end of Year 1, 50% of target participants by the end of Year 2, and 100% of target participants by the end of Year 3

• Develop a statewide strategy, as defined above, to ensure that by the end of the project period, at least 50% of the program participants are ages 60-70.

• Develop resources based on learnings throughout the grant with 25% developed by the end of Year 1, 50% by the end of Year 2, and 100% by the end of Year 3.

• Collaborate with the National Falls Prevention Resource Center throughout the project period.

• Commit to the full participation of two project staff (one who is the PI/PD) in an annual falls prevention professional development opportunity, as directed by ACL.

Attendance is expected annually for the project period (including any no-cost extension period, if applicable).

• Designate key award personnel to present at one or more stakeholder conferences, in consultation with ACL. Provide abstract and presentation materials (slides, handouts) related to grant activities to ACL PO in advance of presenting at any conferences, for review and approval. Following the event, grantee will disseminate

Step 1: Review the Opportunity 17 key insights, resources, and broader learnings from the conference with the network. Attendance is expected annually for the project period (including any no-cost extension period, if applicable).

• Meet all training, licensing, fees, or other requirements associated with the

Stepping On program to comply with program developer/administrator requirements, including attending regular facilitator meetings and technical assistance support provided by developer

• Project Investigator/Director must attend all regularly scheduled calls and communicate with the AoA Project Officer monthly (or another agreed time), to improve project effectiveness.

• Collect required data for all program participants using ACL’s specific data collection forms (see Appendix B). Within 30 days of participants’ completion of the program, you must compile and report the data to the National Falls Prevention Database.

Data includes de-identified participant demographic and health status information, attendance information, and workshop type and location. You should plan to train workshop leaders on data collection practices and use of these forms.

• Participate in any ACL/National Falls Prevention Resource Center sponsored research and/or evaluations.

• Participate in relevant ACL/National Falls Prevention Resource Center education

(e.g., webinars, work groups, etc.), with reasonable notice from ACL/National Falls

Prevention Resource Center of the subject, date, and time of the event.

• Comply with all other reporting requirements, as outlined in Step 6 of this Funding

Opportunity and the Notice of Award.

• If sub-awarding, you are expected to use a transparent and open process to solicit, review, select, and make required subawards to organizations. You should describe how the process will be designed and administered.

• Recipients are required to collaborate, which includes coordination with other ACL falls prevention efforts. Close coordination with ACL’s Office of Nutrition and Health

Promotion Programs (the funding office) is essential to ensure program fidelity and compliance with applicable OAA statutory requirements.

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

◦ HHS Grant or Cooperative Agreement that is NOT funded with other non-governmental sources:

▪ “This [project/publication/program/website, etc.] [is/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 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.”

Step 1: Review the Opportunity 18

◦ The HHS Grant or Cooperative Agreement that IS partially funded with other nongovernmental sources:

▪ “This [project/publication/program/website, etc.] [is/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- government source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.”

Our responsibilities

The ACL project officer agrees to execute the following responsibilities:

• Perform the day-to-day federal responsibilities of managing a Cooperative

Agreement and work with you to ensure that minimum grant requirements are met.

• Work with you to clarify program and budget issues and, as necessary, mutually agree how to solve or meet any needs identified by you or AoA.

• Help you understand 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.

• With the National Falls Prevention Resource Center, provide technical assistance to the grantee on the provision of programmatic support and associated tasks related to fulfilling grant goals and objectives.

• Attend and participate in major project events, as appropriate.

• Communicate with your project director monthly, or other agreed times, to improve project effectiveness.

Once a Cooperative Agreement is in place, requests to modify or amend the agreement or the work plan may be made by ACL or you at any time if 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.

Step 1: Review the Opportunity 19

Funding policies and limitations

Changes in HHS regulations

As of October 1, 2025, HHS adopted 2 CFR 200, with some exceptions included in

2 CFR 300. These regulations replace those in 45 CFR 75.

Policies

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations, and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate: racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety.

If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

• We will only make awards if this program receives funding. If Congress appropriates funds for this purpose, we will move forward with the review and award process.

• Support beyond the first budget period will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting your project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If we receive more funding for this program, we will consider:

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

• You may not use funds from this NOFO for any diversity, equity, inclusion, and accessibility (DEI and DEIA) activities. This includes:

◦ DEI- or DEIA-related research.

◦ Activities that discriminate based on race, color, religion, sex, national origin, or other protected traits.

• Under this NOFO, you can’t continue existing projects without expansion or new and innovative approaches.

• Meals are allowed only in limited circumstances linked to program activities, like during travel or when approved in advance by ACL. See Allowable Costs and

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

Step 1: Review the Opportunity 20 https://www.ecfr.gov/current/title-2/part-200 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-300

Activities, Exhibit 4: Selected Items of Cost, Meals in the HHS Grants Policy

Statement.

• There are restrictions on certain telecommunications and video surveillance equipment. See 2 CFR 200.216 to make sure this does not apply to any proposed equipment in your application.

Unallowable costs

• Construction or major rehabilitation of buildings.

• Basic research, such as scientific or medical experiments.

• For guidance on other types of costs that we restrict or do not allow, see General

Provisions for Selected Items of Costs of the Uniform Guidance, 2 CFR 200.420.

Program-specific limitations and policies

A recent Government Accountability Office (GAO) report has raised considerable concerns about grantees and contractors charging the federal government for additional meals outside of the standard allowance for travel subsistence known as per diem expenses. Executive Orders on Promoting Efficient Spending (E.O. 13589) and Delivering

Efficient, Effective and Accountable Government (E.O. 13576) have been issued and instruct federal agencies to promote efficient spending.

Therefore, if meals are to be charged in your proposal, applicants should understand such costs must meet the following criteria outlined in the Executive Orders and HHS Grants

Policy Statement: Meals are generally unallowable except for the following:

• For subjects and patients under study (usually a research program).

• Where specifically approved as part of the project or program activity, e.g., in programs providing children’s services (e.g. Head Start).

• When an organization customarily provides meals to employees working beyond the normal workday, as a part of a formal compensation arrangement.

• As part of a per diem or subsistence allowance provided in conjunction with allowable travel.

• Under a conference grant, when meals are necessary and integral part of a conference.

◦ Provided that meal costs are not duplicated in participants’ per diem or subsistence allowances.

◦ Conference grant means the sole purpose of the award is to hold a conference.

Pre-award costs are not allowed to be requested.

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

Step 1: Review the Opportunity 21 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.ecfr.gov/current/title-2/section-200.216 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRed1f39f9b3d4e72

Indirect costs

Indirect costs are those shared across multiple projects and not easily separated.

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

Method 1 — Approved rate. If you currently have an indirect cost rate approved by your cognizant federal agency, you may use that rate.

Method 2 — De minimis rate. If you do not have a negotiated indirect cost rate, you may elect to charge a de minimis rate (see 2 CFR 200.414(f)). This rate may be up to 15% of modified total direct costs (MTDC). See the definition of MTDC (2 CFR 200.1). You can use this rate indefinitely.

You may not charge costs included in your indirect cost pool as direct costs.

Subawards

As the prime recipient, you must maintain a substantive role in the project. This means that you conduct funded activities and provide services necessary and integral to completing the project.

Monitoring your subrecipient’s activities alone as described in 2 CFR 200.332 is not a substantive role.

We do not fund awards where your role is primarily a conduit for passing funds to other organizations unless that arrangement is authorized by statute.

All subrecipients must have a Unique Entity Identifier (UEI) through the System for Award

Management (SAM.gov).

Subrecipients must meet the eligibility requirements of this NOFO.

Salary rate limitation

The salary rate limitation in the current appropriations act applies to this program. You may not use awarded funds to pay a salary at a higher rate than the rate for Executive

Level II.

For the Executive Level II salary, please see the Office of Personnel Management information on executive and senior level employee pay.

The salary limitation reflects a person’s base salary (including any portion of the salary that is paid with indirect costs). It does not include fringe benefits or any income the person is allowed to earn outside of the duties of the applicant organization.

This salary limitation also applies to subawards, contracts, and subcontracts under an ACL grant or cooperative agreement.

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

Step 1: Review the Opportunity 22 https://www.ecfr.gov/current/title-2/part-200/section-200.414#p-200.414(f) https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#200.332 https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/ https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/

Program income

If you earn any money from your award-supported project activities (known as program income), you must use it for the purposes and under the conditions of the award. Find more about program income at 2 CFR 200.307.

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

Step 1: Review the Opportunity 23 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#200.307

Step 2:

Get Ready to Apply

In this step

Find the application package 25

Get registered 26

Find the application package The application package has all the forms you need to apply. You can search for it at

Grants.gov using opportunity number HHS-2026-ACL-AOA-FPSG-0004. Then select the

Package tab.

We recommend that you select the Subscribe button from the View Grant Opportunity page for this NOFO to get updates.

You can also find materials at Applying for Grants on ACL’s website.

If you can’t use Grants.gov to download application materials or have other technical difficulties, including issues with application submission, contact Grants.gov for assistance.

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

Step 2: Get Ready to Apply 25 https://grants.gov/search-grants https://acl.gov/grants/applying-grants https://www.grants.gov/support

Get registered SAM.gov You must have an active account with SAM.gov to apply. SAM.gov registration can take several weeks. Begin that process today.

To register:

• Go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist for the information you will need to register.

• You must agree to the financial assistance general certifications and representations

[PDF] specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier (UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

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.

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

Step 2: Get Ready to Apply 26 https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants

Step 3:

Build Your Application

In this step

Application checklist 28

Application contents and format 30

Application checklist Make sure that you have everything you need to apply. You will find the forms in

Grants.gov.

Narratives

Item Grants.gov form Page limit

Project narrative Use the Project Narrative Attachment form. 20 pages

Budget narrative Use the Budget Narrative Attachment form. None

Attachments Insert each in a single Other Attachments Form.

Item Page limit

Indirect cost agreement None

Commitment letters None

Proof of nonprofit status None

Resumes and job descriptions None

Organizational chart None

Project map None

References None

Work plan None

Step 3: Build Your Application 28

Other required forms Use each required form in Grants.gov.

Item Page limit

Application for Federal Assistance (SF-424) None

Budget Information for Non-Construction Programs (SF-424A) None

Assurances for Non-Construction Programs (SF-424B) None

Key Contacts form None

Grants.gov Lobbying form (Certification Regarding Lobbying) None

Project/Performance Site Location form None

Step 3: Build Your Application 29

Application contents and format This section includes guidance on each component found in the application checklist.

Application page limit: No limit on total number of pages.

Submit your information in English and express whole number budget figures using

U.S. dollars.

Required format Required format for project and budget narratives.

Font: Times New Roman or Arial

Format: PDF

Size: 11-point font

Footnotes and text in graphics may be 10-point.

Spacing for project narrative main content: Double-spaced

Spacing for budget narrative: As needed

Spacing for project summary, tables, footnotes: Single-spaced

Margins: 1-inch

Include page numbers.

Project narrative Page limit: 20

The project narrative is the most important part of the application. We use it as the primary basis to decide whether your project meets the statutory requirements and to review its merit. The project narrative should give a clear and concise description of your project.

Be sure to cite all your sources. Merit reviewers may lower your score if you do not.

Also study the merit review criteria under each section to make sure you answer all questions and cover all topics reviewers will look at.

Step 3: Build Your Application 30

Project summary

Provide a brief project summary of no more than 265 words. Write it for the general public. You will need to include:

• Goals: Broad overall purpose, like a mission statement that says what you want to do and where you want to be.

• Objectives: Narrow, specific, and clear steps toward the goals. These are the “hows” to achieve the goals.

• Overall approach: General overview of what you will do.

• Outcomes: These are the measurable results of a project. Include expected changes among those served, such as clients, systems, organizations, and communities.

These should tie directly to your goals and those of this funding.

• Products: The materials and other deliverables you expect to generate through the project.

• Duration: The anticipated start and end dates of the period of performance.

Project relevance and current need

Problem statement

This section should describe, in both quantitative and qualitative terms, the nature and scope of the problem or issue your proposed project will address.

In this section:

• Provide a concise description, supported by reliable state and local population-based data, of the impact of falls on adults aged 60 and older and adults with disabilities, emphasizing older adults with greatest economic need and greatest social need and relevant sub-populations (if any selected).

◦ Explain how the Stepping On program and STEADI clinical intervention will address these impacts.

• Specifically address the needs and fall risk factors of adults ages 60–70, including data on chronic disease prevalence, medication use, polypharmacy, behavioral health factors, and social isolation in this age group within your service area.

• Describe the gap in availability of the Stepping On program and STEADI clinical intervention statewide.

◦ Include details on the current delivery status of falls prevention programs offered by your organization or others across the state, ongoing sustainability efforts, the geographic/population reach of the Stepping On program and

STEADI intervention, and the capacity of the network to be able to deliver and maintain this program and intervention.

Step 3: Build Your Application 31

• Describe how and why your organization is well-positioned to fill the existing gap.

◦ You may include your experience partnering with organizations that serve the main population and your select sub-population(s) (if any), reaching individuals in those populations, and working with other key organizations.

• Describe your organization’s existing or planned partnerships with healthcare providers, health systems, active falls prevention coalitions (if available), and State

Units on Aging.

• Include a Project Map of your state that shows where the Stepping On program and

STEADI intervention are already being offered (if applicable), and which areas are being selected for this project.

◦ Provide data to support why you will target those areas (e.g., the number of older adults, the lack of available programs, etc.).

◦ The map should be included as an attachment to your application.

Goals and objectives

Applicants shall provide SMART goals and specific objectives aligned with the award’s purpose as outlined above.

Table: Scoring criteria

Reviewers will evaluate the extent to which the applicant provides:

Project Relevance and Current Need (Maximum points: 4)

Point value

• A concise description, supported by reliable state and local population-based data, of the impact of falls on adults aged 60 and older and adults with disabilities. (1 point)

◦ Emphasis should be on older adults with greatest economic need and greatest social need and relevant sub-populations (if any selected).

• Did applicant explain how the Stepping On program and STEADI intervention will address these impacts?

• Did applicant…