Division of Clinical and Community Services

Notice of Funding Opportunity

Application due September 4, 2026

Addressing Dementia in Tribal and Urban Indian Communities: CAReS Program

Opportunity number: HHS-2026-IHS-ALZ-0001

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 7

Program description 10

Step 2: Get Ready to Apply 24

Get registered 25

Find the application package 26

Step 3: Build Your Application 27

Application checklist 28

Application contents and format 30

Step 4: Learn About Review and Award 40

Application review 41

Step 5: Submit Your Application 44

Application submission and deadlines 45

Step 6: Learn What Happens After Award 47

Post-award requirements and administration 48

Contacts and Support 50

Before you begin 3

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 September 4, 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 10

Basic information Indian Health Service (IHS)

Division of Clinical and Community Services

Supporting and expanding Tribal and Urban Indian Organization capacity for culturally responsive dementia care for American Indian and Alaska Native people, caregivers, and communities.

Have questions?

See Contacts and Support.

Key facts Opportunity name:

Addressing Dementia in Tribal and Urban Indian Communities: CAReS Program

Opportunity number:

HHS-2026-IHS-ALZ-0001

Assistance listing:

93.00J

NOFO version: Original

Key dates Application submission deadline: September 4, Expected award date:

November 1, 2026

Expected earliest start date: November 1, 2026

See other submissions for other time frames that may apply to this NOFO.

Summary This Notice of Funding Opportunity (NOFO) supports Tribal and Urban Indian communities in strengthening dementia care and services for American Indian and Alaska Native (AI/AN) people. Rooted in Indigenous values and community self-determination, the program will fund meaningful, measurable improvements that span the full dementia care continuum, from early recognition to caregiver support.

Option A – Dementia CAReS (Care Access, Resources, and Support). One national awardee will coordinate four integrated priorities:

• Mini-Project Funding to help Tribal and Urban Indian clinics launch culturally tailored services.

• A Dementia Champion Network connecting frontline leaders.

• Success Sharing through case studies and toolkits.

• Evaluation & Data using common performance measures and dashboards.

Option B – Dementia Caregiver Support and Training Center. One national awardee will deliver dementia caregiver support training, services, resources, and technical assistance. Services will support Tribes, Tribal Organizations, and Urban Indian Organizations. The awardee will develop and implement a comprehensive, culturally relevant caregiver support and training model. It will prioritize leadership, caregiver support, and knowledge and skills development.

Across both options, recipients will document emerging practices using standardized measures. These measures will guide continuous quality improvement and improve outcomes for AI/AN people and their caregivers.

Step 1: Review the Opportunity 5

Funding details Funding type: Cooperative agreement

Competition type: New

Expected total program funding: $1,050,000

Expected number of awards: 2 (1 Option A, 1 Option B)

Funding range for Option A (CAReS) per applicant for the first budget period: $500,000 to $750,000

Funding range for Option B (Caregiver Support) per applicant for the first budget period: $250,000 to $300,000

We expect to fund projects in five 1-year budget periods for a total period of performance of 5 years.

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

Step 1: Review the Opportunity 6

Eligibility Eligible applicants Per Public Law 93-638, as amended, only these types of organizations may apply:

501(c)(3) Non-profit A 501(c)(3) organization that has demonstrated expertise as follows:

• Providing a variety of services to Tribes, area health boards, and Tribal Organizations, and playing a major role in focusing attention on AI/AN care needs, resulting in improved health outcomes for Tribes.

• Promoting and supporting health care and education for AI/AN people, including improving the quality of Indian health care.

• Administering national or regional health programs.

You must provide proof of nonprofit status. See Attachments.

Federally recognized Indian Tribes An Indian Tribe as defined by 25 U.S.C. 1603(14). Read the 25 U.S.C. 1603(14) definition.

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. The Alaska Native Claims Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.] defines these entities as eligible for the special programs and services that the United States provides to Indians because of their status as Indians.

Tribal Organizations A Tribal Organization, as defined by 25 U.S.C. 1603(26), which refers to the definition 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

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

Step 1: Review the Opportunity 7 https://www.govinfo.gov/content/pkg/USCODE-2023-title25/html/USCODE-2023-title25-chap18-other-sec1603.htm https://www.govinfo.gov/content/pkg/USCODE-2023-title25/html/USCODE-2023-title25-chap18-other-sec1603.htm https://www.govinfo.gov/content/pkg/USCODE-2023-title25/html/USCODE-2023-title25-chap18-other-sec1603.htm https://www.govinfo.gov/content/pkg/USCODE-2023-title25/html/USCODE-2023-title25-chap46-sec5304.htm 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 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, 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 a subsequent opportunity for the same program while this award is active.

See statutory authority.

Completeness and responsiveness criteria We will review your application to make sure it meets these requirements:

• Is from an organization that meets all eligibility criteria.

• Does not request funding above the award ceiling shown in the funding range.

• Is not submitted after the deadline.

• Includes a draft or final Tribal Resolution.

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

Step 1: Review the Opportunity 8 https://www.govinfo.gov/content/pkg/USCODE-2023-title25/html/USCODE-2023-title25-chap18-other-sec1603.htm

Application limits Applicants may apply for funding from Option A, Option B, or from both.

• If you submit for both Options (A and B), you must submit a separate application for each Option.

• If you submit multiple applications for a single Option (A or B) on Grants.gov, we will only review the most recent submission.

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 our review. If you receive an award, we will include your voluntary commitment in the award, and you must report on the funds.

Step 1: Review the Opportunity 9

Program description Background Alzheimer’s disease and related dementias (ADRD; dementia) touch every Tribal and Urban Indian community. Age is the biggest risk factor for dementia, and the AI/AN population aged 65 and older will triple in coming decades, leading to a rapid rise in cases.

Other health conditions also increase dementia risk, including diabetes, heart disease, kidney disease, liver disease, smoking, and traumatic head injuries.

Many of these issues are more common among AI/AN people. When these conditions occur together, they can speed up or worsen memory loss, make daily tasks harder, and add to caregiving demands.

Dementia often goes undetected, and many people receive a late diagnosis.

Some people see memory changes as normal aging or avoid care because of stigma.

People usually receive a dementia diagnosis in a primary care office or clinic setting. However, there are still barriers to diagnosing dementia in primary care.

Primary care clinics may lack staff trained to test memory or have trouble referring patients to specialists. Primary care clinicians often face challenges in workflow, reimbursement, and access to specialty care that delay diagnosis and limit care coordination. Only special or complex cases require specialist referrals, such as neurology or neuropsychology. These cases might include dementia symptoms at a younger age, an unclear type of dementia, or dementia in people with intellectual or developmental disabilities.

These gaps mean many AI/AN people, and their caregivers, do not get early diagnosis or help. Without a diagnosis or support, people with dementia and cognitive impairment face higher risk for financial exploitation, poor health outcomes, injuries, and even death. As a result, they go without education, safety measures, and supports that improve quality of life and delay crises.

Comprehensive dementia care requires a team-based approach that links clinic, community, and cultural resources. Caregivers need training, respite, and emotional support. Patients benefit from coordinated chronic disease management, medication review, advance care planning, and culturally anchored activities.

This funding opportunity builds on these realities. It invests in Tribal and Urban Indian health systems to strengthen early recognition, diagnosis, clinical

Step 1: Review the Opportunity 10 management, referral pathways, and caregiver support, while respecting Indigenous values, languages, and community strengths.

Purpose We created this NOFO to help improve care, services, and outcomes for AI/AN people living with or at risk of cognitive impairment or dementia, their caregivers, and their communities. Rooted in Indigenous values, the program supports meaningful, measurable improvements in dementia care.

Choose between two funding tracks based on your role and experience:

1. Dementia CAReS Grant (Option A)

2. Dementia Caregiver Support and Training Center (Option B)

You must design activities to serve and respond to the needs, culture, and historical experiences of AI/AN people living with dementia and their caregivers.

You will conduct ongoing program evaluation on your project’s progress, incorporating real-world clinical and program data, and provide regular reports of your findings.

Dementia CAReS Grant (Option A) One Dementia CAReS Grant (Care Access, Resources, and Support) recipient will provide funding, training, and technical assistance to Tribal and Urban Indian communities across the country.

The CAReS grant supports local community-led actions to improve access to dementia care through mini-projects, shared learning, and culturally aligned tools.

Our goal is to expand services and build stronger, more responsive clinical systems.

The logic model below shows how the program will work. It includes four strategies and the changes we expect you to achieve over time:

1. Mini-Project Program: Provides small project funding, training, and support to Tribal and Urban Indian clinics in priority areas to address direct care, service, and training needs.

2. Call to Action Network: Builds a national network of dementia champions and helps expand the reach into other Tribal and Urban Indian communities.

It helps people learn from one another and collectively work together to improve care and outcomes.

3. Sharing Local Successes: Collects and shares real-world examples from Tribal and Urban Indian communities. This increases awareness, spreads new ideas, and encourages others to act.

Step 1: Review the Opportunity 11

4. Evaluation and Data: Tracks and shares effective practices. This helps communities, program leaders, and IHS measure and evaluate progress, improve quality, and guide future efforts by using jointly developed measures.

Each strategy helps communities build awareness, take action, share what they learn, and improve dementia care in measurable, meaningful, and sustainable ways. We know it will take us working together to strengthen and grow dementia care and services that reflect the local culture and values of AI/AN communities.

Logic Model: Dementia CAReS Grant for AI/AN Communities

Strategy Short-Term Changes Medium-Term Changes Long-Term Changes

Mini-Grant Program

Provide funding, training, technical assistance, and evaluation support to Tribal health clinics (and systems) and Urban Indian Organizations to expand dementia care and caregiver services for AI/AN people.

• Identify gaps in local dementia care, services, and support.

• Increase use of funding, training, and support from the project.

• Strengthen capacity to design and implement local activities.

• More programs offer new or expanded dementia care and services in priority areas.

• More staff trained and delivering care and services.

• More programs use local clinical and evaluation data to improve services and outcomes.

• Improved access to high-quality, comprehensive dementia care.

• More people living with dementia and their caregivers receive culturally-responsive care.

• Increased number of clinics and systems sustaining programs and improvements using data and feedback.

Call to Action Network

• Build and sustain a multidisciplinary network of dementia champions.

• Promote shared learning among IHS, Tribal, and Urban Indian Organization clinical staff

• Increase number of Indian health system workers completing IHS-sponsored dementia training.

• Expand awareness of and knowledge about dementia and

• More clinics and organizations adopt effective practices for recognition, care, and services, including comprehensive models of care.

• Communities share experiences of best and emerging practices.

• More communities and clinical and community care settings adopt dementia-friendly practices.

• Reduced stigma around dementia for community members and across the Indian health workforce.

• More people with cognitive impairment are identified earlier, and people with cognitive impairment or dementia receive an accurate and timely diagnosis.

• Caregivers are regularly identified across health and community service systems, including in

Step 1: Review the Opportunity 12

Strategy Short-Term Changes Medium-Term Changes Long-Term Changes and communities.

cognitive impairment.

• More staff awareness of evidence-informed practices and tools.

• Increase number of staff identifying as dementia champions and community members identifying as Dementia Friends.

electronic health records.

• More caregivers participate in programs and services.

Sharing Local Successes

Document and promote effective IHS, Tribal, and Urban Indian dementia care services, practices, and successes to inspire innovation and wider adoption.

• Increase visibility of successful care models and stories, including IHS comprehensive models of dementia care grantees.

• Develop and share new resources and program profiles to highlight effective practices.

• More programs use culturally tailored models and resources.

• Communities adapt and adopt resources and tools that have worked elsewhere.

• Improved quality of life for people living with dementia and their caregivers.

• Faster spread and adoption of clinical and community systems innovations in dementia care and services.

Step 1: Review the Opportunity 13

Strategy Short-Term Changes Medium-Term Changes Long-Term Changes

Evaluation and Data

Develop and use performance measures to track progress, improve quality, and support national and local decision-making for IHS, Tribal, and Urban Indian Organization clinical and community services.

• Achieve consensus on shared measures to evaluate comprehensive dementia care, services, and project performance measures.

• Programs integrate clinical and program data into planning.

• Programs test, refine, and report on new performance measures.

• Grant recipient and program evaluators use data to monitor and improve care quality.

• More high-quality data is available to inform project, community, and national Alzheimer’s program evaluation and decision-making.

• Better national and local reporting on Alzheimer’s program impact.

• Sustained, data-informed improvements in dementia care and services.

Dementia Caregiver Support and Training Center (Option B) One Dementia Caregiver Support and Training Center grant recipient will provide dementia caregiver support training, services, resources, and technical assistance to Tribes, Tribal Organizations, and Urban Indian Organizations. This work will help build strong, culturally grounded systems that support dementia caregivers, improve care outcomes, and enhance the well-being of elders living with dementia.

This logic model below includes the three priorities and the changes we expect you to achieve over time:

1. Leadership.

2. Caregiver Support.

3. Knowledge and Skills Development.

Funded activities will include:

• Conducting national outreach to raise awareness of dementia caregiver needs in Tribal and Urban Indian communities.

• Developing and delivering culturally relevant caregiver support training, services, resources, and technical assistance.

Step 1: Review the Opportunity 14

• Planning for long-term sustainability and evaluating the impact of your new caregiver support and training program, services, and systems.

• Documenting and sharing your lessons learned, successes, and emerging practices with Tribal and Urban Indian Health Organizations, communities, and health systems.

Activities should reflect the unique history, culture, and experiences of AI/AN people you serve, including caregivers and families.

Logic Model: Dementia Caregiver Support and Training Center

Priorities and Activities

Short-Term Changes Medium-Term Changes Long-Term Changes

Leadership

• Conduct national outreach to raise awareness of dementia caregiver needs in Tribal and Urban Indian communities.

• Facilitate partnerships between Tribal health programs, aging services, and community organizations.

• Support Tribes in developing local dementia care and caregiver policies, plans, or resource networks.

• Increase awareness of dementia and caregiver needs across Tribal and Urban Indian communities.

• Increase collaboration to support dementia caregiver needs in Tribal and Urban Indian communities.

• Sustainable caregiver support programs within Tribal and Urban Indian Organizations.

• Enhance community-level integration on dementia care.

• Caregivers report reduced stress, improved confidence, and better understanding of dementia caregiving.

• Improve access to culturally appropriate dementia care training, resources, and services.

• Improved quality of life for dementia caregivers and care recipients.

• Increased community capacity to support aging in place.

• Reduced caregiver burnout and improved caregiver well-being.

• Expanded sustainable, culturally embedded caregiver support infrastructure across Indian Country.

• Strengthened Tribal and Urban Indian health systems for dementia care.

Caregiver Support

• Strengthen the capacity

Step 1: Review the Opportunity 15

Priorities and Activities

Short-Term Changes Medium-Term Changes Long-Term Changes

• Provide direct technical assistance to Tribal and Urban Indian Organizations.

• Develop and deliver culturally relevant caregiver support services (e.g., support groups, respite models, stress-management training).

• Offer navigation assistance to connect caregivers with dementia-related services.

of Tribal and Urban Indian Organizations to provide caregiver services.

• Improve coordination among Tribal health programs and caregiver support providers.

Knowledge and Skills Development

• Develop or adapt culturally relevant training curricula.

• Conduct caregiver trainings (virtual and in-person) on dementia care,

• Increase caregiver skills in dementia care techniques, stress management, and resource navigation.

• Increase availability of culturally relevant

Step 1: Review the Opportunity 16

Priorities and Activities

Short-Term Changes Medium-Term Changes Long-Term Changes safety, communication, and behavioral symptom management.

• Train Tribal health workers, community health representatives (CHRs), caregivers, and others.

• Provide webinars, workshops, and resource toolkits.

• Maintain a resource hub with evidence-based and culturally tailored tools.

dementia care materials.

Step 1: Review the Opportunity 17

Using evidence to develop your program Your approach, model, programs, and services should be guided by evidence, and incorporate and adapt (when needed) proven approaches to care and services from existing models and interventions when available.

Ongoing efforts at the state and national levels to develop dementia care models and interventions will also help inform your local work. For example, see the CMS GUIDE Model’s Summary of Required Care Delivery Activities.

While there is no single, widely accepted standard for comprehensive dementia care, evidence-based models are quickly evolving.

Below is a list of important resources to consider when planning and writing your application:

• CDC’s Healthy Brain Initiative Road Map for American Indian and Alaska Native Peoples

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

• Alzheimer’s Association Dementia Care Practice Recommendations

• Best Practice Caregiving Online Database of Interventions

• 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 [PDF]

Required, optional, and allowable activities Option A (CAReS) requires the following activities:

• Provide subawards of up to 45% of your program budget annually beginning in Year 2.

• Use and promote existing and new evidence-based approaches to address dementia.

• Plan, implement, and share findings from your project evaluation.

Option B (Caregiver Support) requires the following activities:

• Incorporate findings and recommendations from the IHS Caregiver Workgroup [PDF].

• Build a comprehensive, culturally relevant caregiver support and training center to support people living with dementia and their caregivers.

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

Step 1: Review the Opportunity 18 https://www.cms.gov/priorities/innovation/innovation-models/guide https://www.cms.gov/priorities/innovation/innovation-models/guide https://www.alz.org/professionals/public-health/models-frameworks/hbi-road-map-american-indian-alaska-native https://www.alz.org/professionals/public-health/models-frameworks/hbi-road-map-american-indian-alaska-native https://www.cms.gov/priorities/innovation/innovation-models/guide https://academic.oup.com/gerontologist/article/58/suppl_1/S1/4816759 https://bpc.caregiver.org/#searchPrograms https://doi.org/10.17226/26026 https://doi.org/10.17226/26026 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 https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/ihsdementiacaregivingreport.pdf https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/ihsdementiacaregivingreport.pdf

• Increase the number of caregivers, Tribes, Tribal Organizations, and Urban Indian Organizations with access to caregiver support and training.

• Support an increase in coordination among local care and service providers and improvements in 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.

Both Option A and B require the following activities:

• Hire and maintain at least one full-time employee who functions as a project director, manager, or coordinator.

• Participate in monthly calls with the IHS Elder Health and Alzheimer’s Program staff to review and update work and evaluation plans.

• 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.

• Collaborate with and promote existing IHS dementia training and workforce development programs, such as ECHOs and the Geriatric Nurse Fellowship, Models of Care grants, and communications activities.

• Create tools, resources, and presentations in cooperation with the IHS Alzheimer’s Grant Program. This can include stories about best and promising practices, clinical support tools, patient and caregiver training and 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.

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

• Present your activities and findings publicly at least once a year.

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

Other optional training and technical assistance opportunities will be available.

Pre-conference award requirements If you receive an award, you must follow the Department of Health and Human Services (HHS) Policy on Promoting Efficient Spending: Use of Appropriated Funds for Conferences and Meeting Space, Food, Promotional Items, and Printing and Publications. This policy applies to funded conferences.

You will also provide additional information in your budget narrative. See budget justification for conferences.

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

Step 1: Review the Opportunity 19 https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/alzevaltemplatesample.docx https://www.hhs.gov/grants/contracts/contract-policies-regulations/efficient-spending/index.html?language=es.

Cooperative agreement terms Cooperative agreements follow the same policies as grants. The difference is that the IHS will have substantial involvement in the project during the entire period of performance. The next section describes our level of involvement.

Substantial agency involvement description for cooperative agreement 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 and work with you.

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

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

• Review and refine your proposed priorities, annual work and evaluation plans at the beginning of each budget year.

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

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

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

• Help as needed with evaluation plan implementation and sustainability plan development.

• Hold monthly meetings to share ideas, strategies, and tools to advance your program design and implementation.

• Recommend possible Federal agencies and non-governmental organizations that can work with you to improve care.

• Coordinate, review, approve, and analyze project reporting templates and tools, including metrics, goals achieved, and best practices.

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

Step 1: Review the Opportunity 20

Your role

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

• Successfully complete and submit updated work plans and evaluation plans within 3 months of the start of the annual period.

• Submit performance measure 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.

• 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 from your project.

Funding policies and limitations Pre-award costs allowed Pre-award costs are allowable up to 90 days before the award start date, provided the costs are otherwise allowable if awarded. If you pay pre-award costs, you do so at your own risk.

For guidance on some types of costs that we restrict or do not allow, see 2 CFR part 200 subpart E, General Provisions for Selected Items of Cost. See also program-specific limitations.

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.

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

Step 1: Review the Opportunity 21 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#subpart-E

Policies

• The issuance of awards under this Notice of Funding Opportunity is subject to the availability of funds and the receipt of sufficient appropriations by Congress. The agency reserves the right to proceed with, delay, or forego the review and award process based on funding availability.

• Total award funds include both direct and indirect costs.

• Each applicant can receive only one award for each option under this program.

• Support beyond the first budget year 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.

Salary rate limitation The salary rate limitation in the current appropriations act applies to this program.

As of January 2026, the salary rate limitation is $228,000.

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.

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.

Usually, IHS recipients negotiate their rates with the HHS Division of Cost Allocation or the Department of the Interior, Interior Business Center. For questions about the indirect cost policy, write to DGM@ihs.gov.

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/section-200.307 https://www.hhs.gov/about/agencies/asa/psc/indirect-cost-negotiations/index.html https://www.hhs.gov/about/agencies/asa/psc/indirect-cost-negotiations/index.html https://ibc.doi.gov/ICS/indirect-cost mailto:DGM@ihs.gov

Method 2 — De minimis rate. If you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate (see 2 CFR 200.414(f)). This rate is 15% of modified total direct costs (MTDC). See the definition of MTDC (2 CFR 200.1). You can use this rate indefinitely.

If you choose this method, you must not charge costs included in the indirect cost pool as direct costs.

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.

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

Step 6: Learn What Happens After Award

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/section-200.414 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/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC))

Step 2:

Get Ready to Apply

In this step

Get registered 25

Find the application package 26

Get registered You must be registered in both SAM.gov and Grants.gov to apply. You can review the requirements and get started on developing your application before your registrations are complete.

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 25 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

Find the application package The application package has all the forms you need to apply. You can find it at this NOFO’s Grants.gov opportunity page.

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

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 26 https://www.grants.gov/support https://www.grants.gov/support

Step 3:

Build Your Application

In this step

Application checklist 28

Application contents and format 30

Application checklist This checklist includes every component you will need to submit a complete application:

Narratives Component Grants.gov form Required or optional Page limit

Project summary Use the Project Abstract Summary Form.

Required 1 page

Project narrative Use the Project Narrative Attachment form.

Required 10 pages

Budget narrative Use the Budget Narrative Attachment form.

Required 5 pages

Attachments Insert each in a single Other Attachments form.

Attachments Required or optional Page limit

Tribal Resolution Draft required, if applicable None

Work plan Required, does not have to be in the template provided

None

Evaluation plan table Required, does not have to be in the template provided

None

Proof of nonprofit status Required, if applicable None

Indirect cost agreement Required None

Biographical sketches Required None

Letters of support Required None

Audit documentation Required None

Optional attachments Optional None

Step 3: Build Your Application 28

Other required forms Upload using each required Grants.gov form.

Other required forms Required or optional Page limit

Application for Federal Assistance

(SF-424)

Required None

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

Required None

Project/Performance Site Location Required None

Grants.gov Lobbying Form Required None

Key Contacts Required None

Disclosure of Lobbying Activities (SF-

LLL)

Required, if applicable None

Step 3: Build Your Application 29

Application contents and format Applications include narratives, attachments, and other required forms. This section includes guidance on each.

Your organization’s authorized official must certify your application.

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

If you don’t provide the required documents, your application is incomplete. See completeness and responsiveness criteria to understand what may disqualify your application from consideration.

Project summary 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 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.

Step 3: Build Your Application 30

Project narrative Page limit: 10 pages

Filename: Project narrative

To create your project narrative:

• Follow the headings in the project narrative components table in order.

• Use the scoring criteria in this section to determine what you need to include.

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

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

Table: Project narrative components

Heading Recommended page limit Points

Introduction and need for assistance 2 pages 25 points

Project objectives, work plan, and approach

4 pages 25 points

Program evaluation 2 pages 25 points

Organizational capabilities, key personnel, and qualifications

2 pages 15 points

Project narrative scoring criteria 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 how well you do the following:

Needs

• Identify gaps in currently available services and provide data on the unmet needs of people with dementia and their caregivers using quantitative (numbers) or qualitative (stories) data.

Dementia-related activities and accomplishments

• Identify and describe your existing dementia clinical or community programs.

Step 3: Build Your Application 31

• Describe your major activities and accomplishments within the past 5 years related to implementing clinical or community dementia care and dementia caregiver support.

Other funded initiatives

• Provide information on other dementia-related activities that you participate in or plan to participate in during the same project period that are funded by an outside organization, Federal grant, or contract. 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 overall project plan, objectives, and approach sections of your project narrative. Reviewers will assess how well you do the following:

Approach

• Provide a detailed Year 1 work plan narrative and a high-level plan narrative for Year 2 through Year 5.

• Describe how the strategies and activities will build upon existing programs, priorities, and infrastructure.

• Option A applicants - Describe how you will make subawards, using up to 45% of the annual award beginning in Year 2.

• Describe your approach to addressing required priority areas.

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

• Provide a separate Year 1 work plan, which is required as part of your attachments and does not count toward the project narrative page limits. The work plan should:

◦ Use our logic model and explain how you will carry out the strategies and accomplish the short, medium, and long-term changes. Review the Option A Logic Model and the Option B Logic Model.

◦ Provide additional details about activities, due dates, and staff responsible for accomplishing activities and any related major budget items. Make sure these match the strategies and changes the IHS provided.

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

Step 3: Build Your Application 32 https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/alzworkplantemplatesample.docx

◦ 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, as discussed in the narrative.

◦ Include the engagement of potential partners.

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

Program evaluation Maximum points: 25

These criteria evaluate your use of the evaluation plan table attachment and the program evaluation section of your project narrative. You can use third-party evaluators. Reviewers will assess how well you do the following:

• Describe the methods, approaches, and data sources you will use to monitor and guide project progress.

• Include real-world clinical and program data.

• Include the beginnings of tracking and reporting no later than the first quarter of the project period.

• Describe how you will use evaluation activities to:

◦ Determine your effectiveness in implementing your plan over time.

◦ Track and share progress toward achieving your outcomes and goals.

◦ Strengthen Tribal and Urban Indian health systems for dementia care.

◦ Strengthen capacity of Tribal and Urban Indian organizations to provide caregiver services.

• Also 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.

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

These criteria evaluate the organizational capabilities, key personnel, and qualifications sections of your project narrative. Reviewers will assess how well you do the following:

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

Step 3: Build Your Application 33 https://www.ihs.gov/sites/alzheimers/themes/responsive2017/display_objects/documents/alzevaltemplatesample.docx

• Show that your program staff has the necessary skill, time, and expertise to successfully carry out your proposed project.

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

• Include staff or partners with clinical knowledge or experience in the care of people living with dementia.

Organizational overview and accomplishments

• Provide examples or evidence that show your ability to carry out program activities within the period of performance.

• Describe other related major program activities and accomplishments within the past 5 years.

• Outline any organizations and their related major program activities and accomplishments.

Organizational structure and staffing

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

• Clearly describe how staff will work together to meet goals and deliver services.

• Include a complete list of key staff for the project, including their roles, levels of effort, and qualifications for the work.

• Describe current staff expertise related to the project. If you do not currently employ staff with expertise in dementia, describe your plan to fill this gap and the expected timeframe for doing so.

• Include short biographical sketches and position descriptions for key staff in your attachments. They do not count toward the project narrative page limit.

• Describe any partners or participating organizations and how they will help carry out the work plan. Include letters of support or intent to coordinate in your attachments.

Sharing with other Tribes, Tribal Organizations, and Urban Indian Organizations Describe your experience developing and sharing best and promising dementia and caregiving practices.

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

Step 3: Build Your Application 34

Budget narrative Page limit: 5

Maximum points: 10

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.

• The restrictions on spending funds. See funding policies and limitations.

• The scoring criteria in this section.

Be sure to do the following in your budget narrative:

• Do not exceed the funding range. We will not consider applications that exceed the funding range.

• 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.

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

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

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

Budget justification for conferences You must provide a separate detailed budget justification for each conference you anticipate, addressing the following cost categories:

• Contract or planner.

• Meeting space or venue.

• Registration website.

• Audiovisual.

Step 3: Build Your Application 35

• Speakers’ fees.

• Non-federal attendee travel.

• Registration fees.

• Other.

Budget scoring criteria Categorical budget and budget justification Maximum points: 10

Reviewers will assess whether your budget narrative includes:

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

• Defined items of cost that are consistent with the objectives and scope of activities you propose in the narrative, work plan, and evaluation plan.

• Appropriate time commitments for key and other project personnel to assure proper direction, management, and completion of the project.

• Key support personnel, along with their names, titles, position descriptions, salaries, and fringe benefits.

Attachments You will upload attachments in…