oppHHS-2018-ACL-AOD-PRRC-0287-cfda93.325-cidHHS-2018-ACL-AOD-PRRC-0287-instructions.pdf

Administration for Community Living

Administration on Disabilities

National Paralysis Resource Center

HHS-2018-ACL-AOD-PRRC-0287

Application Due Date: 04/17/2018

National Paralysis Resource Center

HHS-2018-ACL-AOD-PRRC-0287

TABLE OF CONTENTS

I. Funding Opportunity Description II. Award Information

III. Eligibility Information

1. Eligible Applicants

2. Cost Sharing or Matching

3. Responsiveness and Screening Criteria

IV. Application and Submission Information

1. Address to Request Application Package

2. Content and Form of Application Submission

3. Submission Dates and Times

4. Intergovernmental Review

5. Funding Restrictions

6. Other Submission Requirements

V. Application Review Information

1. Criteria

2. Review and Selection Process

3. Anticipated Announcement Award Date

VI. Award Administration Information

1. Award Notices

2. Administrative and National Policy Requirements

3. Reporting

4. FFATA and FSRS Reporting

VII. Agency Contacts VIII. Other Information

Department of Health & Human Services

ACL Center: Administration on Disabilities Funding Opportunity Title: National Paralysis Resource Center Announcement Type: Initial Funding Opportunity Number: HHS-2018-ACL-AOD-PRRC-0287 Primary CFDA Number: 93.325 Due Date for Letter of Intent: 03/02/2018 Due Date for Applications: 04/17/2018 Date for Informational Conference Call: 03/07/2018

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

Executive Summary The Independent Living Administration (ILA), a component of the Administration on Disabilities within the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS), announces the availability of Fiscal Year (FY) 2018 funds authorized under Section 301 of the Public Health Service Act (42 U.S.C. §§ 241, 247b(k)(2)).

Funds will be awarded to support a National Paralysis Resource Center (NPRC) that will improve the health and quality of life of individuals with all forms of paralysis of all ages, their families, and their support networks by raising awareness of and facilitating access to a broad range of services, tools, and opportunities available to such individuals. For purposes of this funding opportunity announcement and the activities of the NPRC, “paralysis” refers to a range of disabling conditions due to stroke, spinal cord injury, multiple sclerosis, cerebral palsy, or any central nervous system disorder and results in difficulty or inability to move the upper or lower extremities.

The NPRC will work with ACL and ACL-funded programs to remove environmental, social, and systems barriers to health and community living for individuals with paralysis, their families, and their support networks. The NPRC will provide national outreach to educate and enhance community living opportunities and share information and resources targeted to people of all ages with paralysis as well as outreach to unserved and underserved populations. A non-exhaustive list of possible underserved individuals include those who are: veterans; children and youth; older adults; incarcerated or formerly incarcerated individuals; racial and ethnic minorities; native and tribal populations; rural populations; individuals with substance use disorders; homeless individuals; persons who are lesbian, gay, bisexual and transgender (LGBT); survivors of domestic or other forms of violence; individuals who are uninsured or underinsured; and individuals with co-occurring developmental, intellectual, physical, psychiatric, sensory, or emerging disabilities.

https://www.grants.gov

All activities funded under this grant will promote greater independence, equality, choice, and control for children, adults, and older persons with paralysis and to best enable them to more fully integrate into their communities.

I. Funding Opportunity Description A. Background & Purpose:

The Administration for Community Living (ACL) was established in April 2012 to serve older adults and people with disabilities to fully engage and participate in their communities, make informed decisions, and exercise self-determination and control about their independence, well-being, and health. ACL’s mission is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, their families, and their support networks.

In 2009, Congress passed the Christopher and Dana Reeve Paralysis Act, which authorized a three-part effort within the Public Health Services Act (42 U.S.C. §§ 241, 247b(k)(2)) to address the public health challenges posed by paralysis.[1] Title I and Title II of the Act provided the National Institutes of Health (NIH) with authority to create paralysis research consortia and fund research into clinical rehabilitation intervention protocols. Title III gave the Centers for Disease Control and Prevention (CDC) in HHS the authority to fund projects to improve the quality of life of individuals with paralysis.[2] The national Paralysis Resource Center (PRC) was authorized to implement Title III of the Act. The national PRC was funded through the CDC until 2014 when Congress transferred funding from CDC to ACL.[3] Congress transferred the program from CDC to ACL in 2014 because the program better aligned with ACL’s mission and goals. Since the move, the program has been increasingly focused on the principles of Independent Living, which stresses the importance of empowering individuals with disabilities – particularly individuals with significant disabilities – to exercise full choice and control over their lives and to live independently in their communities. It is expected that the successful applicants will demonstrate how these aims will be advanced particularly through active, meaningful collaboration with individuals with paralysis and independent living, self advocacy, and other consumer as well as family controlled organizations. Successful applicants also will provide evidence that individuals with paralysis and other disabilities will be actively and meaningfully engaged throughout all funded activities, including staffing, administration, and governance.

The leading cause of paralysis according to a 2013 study was stroke, followed by spinal cord injury and multiple sclerosis [4]. Every year, more than 795,000 people in the United States have a stroke. More than a quarter of a million Americans are currently living with spinal cord injuries (SCI) and there are an estimated 17,500 new spinal cord injuries every year in the United States. [5] Secondary conditions from living with paralysis and other co-occurring disabilities have the potential to dramatically impact the health, emotional well-being, community participation, and the lives of individuals, families and their support networks. For example, a common secondary condition for individuals with many forms of paralysis are pressure ulcers. Pressure ulcers are difficult to detect and expensive to treat. Each year in the U.S., 2.5 million pressure ulcers are treated in acute care settings. The estimated cost of treating pressure ulcers varies between

$50,000 and $130,000 per person[6] .

The number of people who experience some form of paralysis continues to grow as a result of improved emergency and acute care. Medical advances and technology has come a long way in the last few decades with new procedures and devices that enable individuals with paralysis to live longer.

Finding and accessing the right long-term services and supports can be a daunting task for individuals with paralysis and their families – ultimately leading to increased healthcare costs and loss of independence. Individuals trying to access information on paralysis frequently find themselves confronted with a bewildering maze of organizations and scientific jargon at a time when they are the most vulnerable or in crisis. This often results in individuals and families making decisions based on incomplete, and sometimes inaccurate, information about their options. The lack of current high quality information makes it difficult for individuals to make informed decisions about both their present and their future well-being, which may result in frustration, inappropriate care or equipment, negative health impacts, and increased costs.

The purpose of the NPRC is to improve the quality of life for all people with paralysis and to leverage resources through collaboration. The NPRC currently provides comprehensive information for people with spinal cord injuries, paralysis, and other mobility-related disabilities and their families. Current resources include information and referral by phone and email in multiple languages; a peer and family support mentoring program; a military and veterans program; multicultural outreach services; quality of life subawards; and a national website. As the number of individuals who live with paralysis increases and the cost of healthcare rises, it is important to ensure that these individuals have access to the most current, relevant information so that they can make informed choices regarding their physical and emotional health and overall quality of life.

Through this funding opportunity announcement, ACL plans to award one (1) cooperative agreement for a National Paralysis Resource Center to ensure the availability of, and access to, the most comprehensive, high quality information and supports for people of all ages with paralysis, their families, and their support networks.

In an effort to ensure program efficiency, in 2018 ACL is conducting a pilot to test two approaches for making subawards to community-based organizations that provide long-term services and supports to people with paralysis, their families, and their support networks.

Specifically, as part of this funding opportunity announcement Making Subawards to Improve the Quality of Life of Americans with Paralysis is included under the Program Activities section below. Information reported about the efficiency and effectiveness of these subawards will be compared to similar activities being funded under a separate funding opportunity announcement, the new PRC State Pilot Program. Up to five (5) new PRC State Pilot Program grantees will make subawards to community-based organizations across their states that provide long-term services and supports to people with paralysis, their families, and their support networks. ACL will work closely with the PRC State Pilot Program grantees and NPRC to avoid duplication of sub awards within the pilot states.

B. PROGRAM ACTIVITIES:

NPRC applicants will describe a multifaceted approach to disseminate current accurate information related to paralysis, secondary conditions, and resources available. Applicants should describe their experience and expertise in carrying out the activities described in this funding opportunity announcement and show evidence of the support and active involvement of a wide range of stakeholders to fully achieve the desired outcomes. NPRC applicants will propose strategies and approaches to carrying out the activities – including TA modalities, partnerships and collaborations with key stakeholders from across the public and private sectors to fully address the key activities – that will ensure the greatest impact and benefit for people of all ages with paralysis, their families, and their support networks. Applicants should describe how they will incorporate the Independent Living Philosophy throughout their applications. The philosophy is built around consumer control, peer support, self-help, self-determination, equal access, and individual and system advocacy, in order to maximize the leadership, empowerment, independence, and productivity of individuals with disabilities and the integration and full inclusion of individuals with disabilities into the mainstream of American society.

Applicants will identify specific steps the project would take to help achieve two or more of the following HHS wide public health goals: reduce inappropriate use of opioid medications;

effectively treat individuals with paralysis and co-occurring serious mental illness; and/or reduce childhood obesity.

Finally, applicants should identify specific steps the project would take to help achieve two or more of the five ACL pillars and goals: Better connect older persons and individuals with disabilities of all ages to resources; Protect the rights and prevent the abuse of such individuals;

Support families and caregivers; Enhance the employment opportunities of people with disabilities and older workers; and Strengthen the reach, capacity, and business acumen of community based organizations.

There are 6 areas of allowed activity for the NPRC:

A. Operating and Enhancing a National Resource and Information Center B. Making Subawards to Improve the Quality of Life of Americans with Paralysis C. Conducting Promotional Activities and Outreach D. Increasing Support and Resources Available to People with Paralysis, their Families and Caregivers E. Collaborating and Partnering with Other Organizations, Agencies, and Programs F. Measuring Performance A) Operating and Enhancing a National Resource and Information Center: Individuals with paralysis should have a reliable entity from which to acquire needed information specific to their situation at any time. The NPRC will gather, translate, organize, and make publicly available readily accessible, high-quality information and resources about paralysis, spinal cord injuries, and secondary conditions; services that support and improve independent living;

promotion of community-based opportunities and experiences; and evidence-based interventions. Other activities may include the development of informational products, resource mapping, and making available any toolkits or software that might be helpful to people with paralysis. The NPRC will also make use of on-line support communities such as blogs, webinars, and other opportunities available via social media in order to reach across the nation with useful information.

B) Making Subawards to Improve the Quality of Life of Americans with Paralysis: The lack of current opportunities to increase independence and self-confidence or to improve environmental access for people with paralysis can be challenging. The NPRC will provide at least 40 percent of the total awarded federal funds as Quality of Life subawards to nonprofit community-based organizations that provide long-term services and supports to people with paralysis and other disabilities, their families, and their support networks.

The purpose of these subawards is to promote greater independence and increased choice and control for individuals with paralysis to help them more fully integrate into their communities and enhance full participation, independent living, self-sufficiency, and equality. This activity is intended to recognize and support organizations that assist individuals with paralysis, their families and support networks in ways that increase independence, provide social and education opportunities, and access to needed services and or supports. The NPRC will focus its efforts on at least 4 priority areas of need for people with paralysis across the country.

Examples of priority areas of need are but not limited to:

• improving accessibility to services and supports;

• providing assistive technology;

• expanding career path employment opportunities;

• facilitating nursing home transitions;

• equipping children, youth and young adults with the knowledge, skills, resilience, opportunities and supports to succeed in school, college, careers, and life;

• investing in identifying and meeting the needs of individuals with paralysis who are unserved or underserved, including those highlighted previously;

• establishing creative transportation options; • supporting families and support networks; and

• facilitating access to integrated or specialized recreation.

NOTE: In an effort to ensure program efficiency, in 2018 ACL is conducting a pilot to test two approaches for making subawards to community-based organizations that provide long-term services and supports to people with paralysis, their families, and their support networks.

Information reported about the efficiency and effectiveness of these subawards will be compared to similar activities being funded under a separate funding opportunity announcement, the new PRC State Pilot Program. Up to five (5) new PRC State Pilot Program grantees will make subawards to community-based organizations across their states that provide long-term services and supports to people with paralysis, their families, and their support networks. ACL will work closely with the PRC State Pilot Program grantees and NPRC to avoid duplication of sub awards within the pilot states.

B.1 Subaward Strategy Requirements Applicants for the NPRC should describe in detail how they will conduct a national competitive subaward program that incorporates the following criteria:

• At least 40 percent of the total federal funds awarded will be issued through a competitive national subaward process.

• The proposed subaward process should describe how the approach will ensure that funds are used for programmatic capacity building activities that further subawardees’ ability to improve or increase their services and/or supports to individuals with paralysis, their families, and their support networks.

• The proposed subaward process should describe how the subaward application process will be completely open without any projects being pre-selected or otherwise given a competitive advantage or discriminated against.

• The proposed subaward process should describe how the proposed outreach activities for subaward applications will be broad and inclusive of a range of organizations that serve people with paralysis, including both secular and faith-based nonprofit organizations.

• Applicants should describe how they will provide follow up technical assistance to the organizations to which they issue subawards in order to maximize the impact of the subawards.

• The proposed subaward process should describe how subaward amounts will be appropriate to the projects and needs expressed by the subaward applicants. ACL expects most subaward amounts will generally be between $10,000 and $25,000.

• Applicants should describe how subawards will be made available to organizations with a history of providing services and supports to individuals with paralysis and their families and support networks in order to help them live more independently, to more fully integrate into their communities (for example, through transitions from institutions back into the community or by providing transportation and employment opportunities), and to alleviate burnout on the part of their families and others that assist them.

• Applicants should describe how all subawards will promote greater independence, equality, choice, and control for individuals with paralysis and help them more fully integrate into their communities.

• Applicants should ensure that there will be no requirement for subaward applicants to provide matching funds and no preference given in the selection process if any offer matching funds in their applications. • Applicants should describe how they will make subawards to nonprofit organizations that serve people with paralysis living in the United States.

• Applicants should describe how they will not provide subaward recipients a second subaward for the duration of the funded period. Such organizations may continue to receive technical assistance provided by the grantee.

• Applicants should describe how they will require subawardees to expend their subawards within a 12-month period and not allow subawards to be used to provide medical services, direct services, nor direct fundraising activities.

Applicants for the NPRC funding should understand that the NPRC grantee is accountable for all federal funds received including all subawards provided under the grant program. Applicants should describe how they will ensure the subawards are used for the intended purposes of this program and that expenditures comply with both program and federal regulations. Applicants should also discuss how they will monitor, provide TA, and report on subaward activities.

C) Conducting Promotional Activities and Outreach: Individuals and service providers need to know where they can find and access services and supports for individuals with paralysis, their families, and their support networks. Applicants should describe how they will co-brand the NPRC jointly with ACL and develop and carry out a marketing plan to increase awareness and usage of the NPRC among professionals in the field of paralysis, individuals with paralysis, families, support networks, and the general public by: a) Promoting awareness and usage of the NPRC among service providers within the disability and aging networks and other community-based organizations.

b) Identifying opportunities and submitting proposals for presentations at national and local major meetings/conferences for disabilities and aging services professionals and people with paralysis and other disabilities, relevant to the specific goals / outcomes of the project.

c) Ensuring the marketing plan and its implementation includes a strategy to promote and market the NPRC to consumers from traditionally unserved or underserved individuals and communities. A non-exhaustive list of possible underserved individuals include those who are:

veterans; children and youth; older adults; incarcerated or formerly incarcerated individuals;

racial and ethnic minorities; native and tribal populations; rural populations; individuals with substance use disorders; homeless individuals; persons who are lesbian, gay, bisexual and transgender (LGBT); survivors of domestic or other forms of violence; individuals who are uninsured or underinsured; and individuals with co-occurring developmental, intellectual, physical, psychiatric, sensory, or emerging disabilities.

D) Increasing Support and Resources Available to People with Paralysis, their Families and Caregivers: Finding the right supports and resources can be challenging to individuals and their families seeking information. Peer mentoring has proven positive outcomes and provides the most direct and beneficial way to assist those living with paralysis, their families and caregivers. The assistance and guidance from someone who “been there and done that” and has a similar type of paralysis does much to encourage and empower the newly paralyzed, as well as for the person transitioning through the various stages of living with paralysis.

Applicants should propose how they will operate a peer program to provide support, information and resources to those living with paralysis, their family members and caregivers nationally.

Applicants should also describe how they will measure the impact of the peer program on both the peer mentors and those living with paralysis, their families and caregivers.

E) Collaborating and Partnering with Other Organizations, Agencies, and Programs:

Collaboration and partnership will be critical for the success of the NPRC. NPRC applicants should have strong partnerships with agencies and organizations vested in paralysis. Applicants should describe who they are partnering with and how they will reach out to, partner, and collaborate with other agencies and organizations that have similar goals, policy initiatives, and social practice. ACL funds many initiatives that naturally work together and could be strong community partners for the applicant. ACL houses the Administration on Aging, the Administration on Intellectual and Developmental Disabilities and the Independent Living Administration. Applicants should describe their collaborative efforts with ACL’s disability and aging programs and as well as other federally funded programs such as but not limited to the ones listed below.

• ACL's Assistive Technology program provides funds to each state and territory to support state efforts to improve the provision of assistive technology to individuals with disabilities.

People with paralysis usually rely on durable medical equipment for mobility needs. Assistive technology (AT) comes in a variety of forms that include low tech AT devises such as a https://www.acl.gov/programs/assistive-technology/assistive-technology magnifier or Easy Reacher to high tech devises such as complex rehabilitation equipment.

Partnering with these agencies can help connect options or needed equipment to those seeking assistance.

• The Centers for Independent Living (CILs) Program: There are 354 federally funded centers across the country that are consumer-controlled, community-based, cross-disability, nonresidential, private nonprofit agencies that provide Independent Living services. CILs are required to provide the core services of information and referral, peer support, individual and system advocacy, independent living skills trainings, and transition or diversion services from institutional setting and post-secondary transition higher education and/or employment. Many CILs also offer: sign language interpreters, support groups, assistance in securing housing or shelter, personal assistance services, transportation referral and assistance, mobility training, rehabilitation technology, recreation, and other services necessary to improve the ability of individuals with significant disabilities to live independently in their homes and communities.

• An Area Agency on Aging (AAA) is a public or private nonprofit agency designated by a state to address the needs and concerns of all older persons at the regional and local levels. AAAs coordinate and offer services that help older adults remain in their homes, if that is their preference, aided by services such as home-delivered meals, homemaker assistance, and whatever else it may take to make independent living a viable option. By making a range of supports available, AAAs make it possible for older individuals to choose the services and living arrangements that suit them best.

• The No Wrong Door (NWD) System initiative is a collaborative effort of ACL, the Centers for Medicare & Medicaid Services (CMS), and the Veterans Health Administration (VHA). The development, implementation, and oversight of a state’s NWD System has the support of the Governor and active involvement of the multiple state agencies that administer programs that effect LTSS populations. The NWD System initiative builds upon the Aging and Disability Resource Center (ADRC) program and supports efforts to streamline access to long-term services and support (LTSS) options by providing the infrastructure to promote the collaboration of local service organizations, making service delivery more efficient and person-centered. NWD Systems simplify access to LTSS, and are a key component of LTSS systems reform. These entities are made up of community agencies and partner on many HHS initiatives collectively.

• The Veteran's Directed Home and Community Based Services (VD-HCBS) Program is a partnership between ACL and the Veteran’s Health Administration (VHA) to serve veterans of all ages. The VD-HCBS program provides veterans with opportunities to self-direct their LTSS and continue living independently at home. Eligible Veterans manage their own flexible budgets, decide what mix of goods and services best meet their needs, and hire and supervise their own workers. Person-centered counselors within Aging & Disability Network Agencies provide facilitated assessment and care/service planning, arrange fiscal management services, and provide ongoing counseling and support to veterans, their families, and support networks.

• NIDILRR's Model Systems programs in spinal cord injury (SCIMS), traumatic brain injury (TBIMS), and burn injury (BMS) provide coordinated systems of rehabilitation care and conduct research on recovery and long-term outcomes. In addition, these centers serve as platforms for collaborative, multi-site research, including research on interventions using randomized controlled approaches. The programs also track Model Systems patients over time https://www.acl.gov/programs/aging-and-disability-networks/centers-independent-living https://www.acl.gov/programs/aging-and-disability-networks/area-agencies-aging https://nwd.acl.gov/ https://nwd.acl.gov/VD-HCBS.html https://www.acl.gov/about-acl/about-national-institute-disability-independent-living-and-rehabilitation-research in large databases.

Provision of funding for subcontracts to carry out specific activities is permissible, if the applicant identifies a gap within its organization’s expertise necessary to fully complete project goals and objectives.

F) Measuring Performance: The NPRC will collect information to document and describe output and outcomes for all activities described in this funding announcement opportunity.

Applications to this announcement should include a brief description of expected sources for output and outcome data and methods for data collection (e.g., surveys of consumers, reviews of administrative records).

Applications should include a separate description for the quality of life program (see Section I.B.). Applicants should discuss how, as the NPRC, they will measure the efficiency of the subaward making process as well as the efficacy of subawards (individually and in combination) on individuals with paralysis, their families, and their support networks.

Specifically, the NPRC will measure the costs of administering the subawards, the award rate (i.e., the number of subawards divided by the number of applications received), the percentage of the subawards that are completed on time and on budget, the level of satisfaction of the subawardees with the application / award process, the number of people proposed to be served throughout the life of the subaward compared to how many are served, and the level of satisfaction of the beneficiaries (i.e., individuals with paralysis, their families, and their support networks) with the outcome of the subaward.

Referrences:

1.United States. Congress. House. Committee on Energy and Commerce. Christopher and Dana Reeve Paralysis Act: Report (To Accompany H.R. 1727) (Including Cost Estimate of the Congressional Budget Office). Volume 110, Issue 378 of Report. U.S. Government Printing Office, http://www.gpo.gov/fdsys/pkg/CRPT-110hrpt937/html/CRPT-110hrpt937.htm; 2007.

Accessed 09.07.13.

2. Christopher and Dana Reeve Paralysis Act. Centers for Disease Control and Prevention:10.

Disability and Health Program. Available at: http://www.cdc.gov/ncbddd/disabilityandhealth /programs.html; 2013. Accessed 09.07.13.

3.Consolidated Appropriations Act of 2014

4. Research & Practice; Prevalence and Causes of Paralysis—United States, 2013 Brian S.

Armour, PhD, Elizabeth A. Courtney-Long, MA, MSPH, Michael H. Fox, ScD, Heidi Fredine, MPH, and Anthony Cahill, PhD (Am J Public Health. Published online ahead of print August 23, 2016: e1–e3. oi:10.2105/AJPH.2016.303270) accessed 12-8, 2017

5. National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance. Birmingham, AL: University of Alabama at Birmingham, 2017.

6. Brem, H, Maggi, J, Nierman, D, et al. (2010). The high cost of stage IV pressure ulcers. The American Journal of Surgery. 200(4): 473-477.

Statutory Authority Section 301 of the Public Health Service Act (42 U.S.C. §§ 241, 247b(k)(2)).

http://www.gpo.gov/fdsys/pkg/CRPT-110hrpt937/html/CRPT-110hrpt937.htm http://www.cdc.gov/ncbddd/disabilityandhealth/programs.html http://www.cdc.gov/ncbddd/disabilityandhealth/programs.html

II. Award Information Funding Instrument Type: Cooperative Agreement Estimated Total Funding: $5,487,654 Expected Number of Awards: 1 Award Ceiling: $5,487,654 Per Budget Period Award Floor: $5,000,000 Per Budget Period Length of Project Period: 36-month project period with three 12-month budget periods

The ACL project officer agrees to execute the responsibilities of the cooperative agreement outlined below:

1. Perform the day-to-day federal responsibilities of managing a grant initiative and work with the grantee to ensure that the minimum requirements for the grant are met. Conduct monthly conference calls to ensure goals and objectives are being met.

2. Work cooperatively with the grantee to clarify the programmatic and budgetary issues to be addressed by the grantee’s project, and, as necessary, collaborate with grantee to achieve a mutually agreed upon solution to any needs identified by the grantee or ACL.

3. Share information with the grantee about other federally sponsored projects including the new PRC State Pilot Program projects and other activities relevant to the interests of the NPRC grantee and their activities.

4. Work with the grantee on the development and implementation of performance measures and quality assurance systems to ensure that performance is measured and continuous improvement occurs.

5. Provide technical advice on grantee work products to ensure they are accurate, objective, unbiased, and of high professional quality, and that they do not violate federal, departmental, or agency grant rules.

6. Attend and participate in major project events as appropriate.

The grantee will agree to execute the responsibilities of the cooperative agreement outlined below:

1. Fulfill all of the requirements of the grant initiative as detailed in this program announcement.

2. Collaborate with ACL in any in-scope modifications and execution of the work plan initially within 45 days of the award.

3. Document the impact of overall project activities and ensure quality assurance systems are in place.

4. Share information with ACL, the paralysis network, national, state and local partner organizations, and other entities as appropriate.

5. Work with the ACL NPRC program project officer to evaluate performance results reported semiannually and jointly develop strategies to address those areas requiring improvement.

6. Submit resumes of potential key staff hires as detailed under HHS grants prior approval requirements.

7. Work with ACL to provide TA materials and resources to the PRC State Pilot Program grantees.

8. Report semi-annually on project accomplishments, challenges and progress towards measurable objectives.

9. Work with ACL NPRC Project Officer to brand the NPRC in such a way that appropriately recognizes and acknowledges ACL’s financial contributions to NPRC activities.

10. The Government retains all rights to all data and reports compiled as a result of this grant.

No information furnished to or generated by the grantee in the performance of this grant shall be released to the public by the grantee without the prior approval of the project officer.

Once a cooperative agreement is in place, requests to modify or amend it or the work plan may be made by ACL or the awardee at any time as long as it stays within the original confines of the proposed project description. Major changes may affect the integrity of the competitive review process. Modifications and/or amendments of the Cooperative Agreement or work plan shall be effective upon the execution of an award notice. When an award is issued the cooperative agreement terms and conditions from the program announcement are incorporated by reference unless ACL is authorized under the Terms and Conditions of award, 45 CFR Part 75, or other applicable regulation or statute to make unilateral amendments.

III. Eligibility Information

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

2. Cost Sharing or Matching

Cost Sharing / Matching Requirement: No

3. Responsiveness and Screening Criteria

Application Responsiveness Criteria The successful applicant will be an organization that meets the following criteria:

1. Demonstrated ability to disseminate SCI and paralysis related information and education.

2. Documented commitment to solicit, select, and make subawards totaling at least 40% of the total federal annual award.

3. Included letters of support from partnering agencies and or organizations.

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

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

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

2. The Project Narrative section of the Application must be double-spaced, on 8.5” x 11” plain white paper with 1” margins on both sides, and a standard font size of no less than 11 point, preferably Times New Roman or Arial.

3. The Project Narrative must not exceed 50 pages. Project Narratives that exceed 50 pages will have the additional pages removed and only the first 50 pages of the Project Narrative will be provided to the merit reviewers for funding consideration. NOTE: The Project Work Plan, Budget, Budget Narrative/Justification, Letters of Commitment, and Vitae of Key Project Personnel are not counted as part of the Project Narrative for purposes of the 50-page limit.

Unsuccessful submissions will require authenticated verification from http://www.grants.gov indicating system problems existed at the time of your submission. For example, you will be required to provide an http://www.grants.gov submission error notification and/or tracking number in order to substantiate missing the application deadline.

IV. Application and Submission Information

1. Address to Request Application Package Application materials can be obtained from http://www.grants.gov or https://www.acl.gov/grant s/applying-grants.

Please note, ACL is requiring applications for all announcements to be submitted electronically through http://www.grants.gov. The Grants.gov (http://www.grants.gov) registration process can take several days. If your organization is not currently registered, please begin this process immediately. For assistance with http://www.grants.gov, please contact them at support@grants .gov or 800-518-4726 between 7:00 a.m. and 9:00 p.m. Eastern Time. •At the http://www.grants .gov website, you will find information about submitting an application electronically through the site, including the hours of operation. ACL strongly recommends that you do not wait until the application due date to begin the application process because of the time involved to complete the registration process. •All applicants must have a DUNS number (http://fedgov.dnb .com/webform/) and be registered with the System for Award Management (SAM, www.sam .gov) and maintain an active SAM registration until the application process is complete, and should a grant be made, throughout the life of the award. Applicants should finalize a new, or renew an existing, registration at least two weeks before the application deadline. This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award.

Maintain documentation (with dates) of your efforts to register or renew at least two weeks http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov https://www.acl.gov/grants/applying-grants https://www.acl.gov/grants/applying-grants http://www.grants.gov http://www.grants.gov http://www.grants.gov mailto:support@grants.gov mailto:support@grants.gov http://www.grants.gov http://www.grants.gov http://fedgov.dnb.com/webform/ http://fedgov.dnb.com/webform/ http://www.sam.gov http://www.sam.gov before the deadline. See the SAM Quick Guide for Grantees at: https://www.sam.gov /sam/ transcript/ SAM_Quick_ Guide_Grants_ Registrations-v1.6. pdf.

Note: Once your SAM registration is active, allow 24 to 48 hours for the information to be available in Grants.gov before you can submit an application through Grants.gov. This action should allow you time to resolve any issues that may arise. Failure to comply with these requirements may result in your inability to submit your application or receive an award. •Note:

Failure to submit the correct EIN Suffix can lead to delays in identifying your organization and access to funding in the Payment Management System. •Effective October 1, 2010, HHS requires all entities that plan to apply for and ultimately receive federal grant funds from any HHS Operating/Staff Division (OPDIV/STAFFDIV) or receive subawards directly from the recipients of those grant funds to: 1.Register in SAM prior to submitting an application or plan;

2.Maintain an active SAM registration with current information at all times during which it has an active award or an application or plan under consideration by an OPDIV; and 3.Provide its DUNS number in each application or plan to submit to the OPDIV.

Additionally, all first-tier subaward recipients must have a DUNS number at the time the subaward is made. •Since October 1, 2003, The Office of Management and Budget has required applicants to provide a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when applying for federal grants or cooperative agreements. It is entered on the SF-

424. It is a unique, nine-digit identification number, which provides unique identifiers of single business entities. The DUNS number is free and easy to obtain. •Organizations can receive a DUNS number at no cost by calling the dedicated toll-free DUNS Number request line at 866- 705-5711 •You must submit all documents electronically, including all information included on the SF424 and all necessary assurances and certifications. •After you electronically submit your application, you will receive an automatic acknowledgement from http://www.grants.gov that contains http://www.grants.gov tracking number. The Administration for Community Living will retrieve your application form from http://www.grants.gov.

U.S. Department of Health and Human Services

Elizabeth Leef Administration on Disabilities Phone Number: (202) 475-2482 E-mail: elizabeth.leef@acl.hhs.gov

2. Content and Form of Application Submission

Letter of Intent

Due Date for Letter of Intent: 03/02/2018 Applicants are requested, but not required, to submit a letter of intent to apply for this funding opportunity to assist ACL in planning for the application independent review process. The purpose of the letter of intent is to allow our staff to estimate the number of independent reviewers needed and to avoid potential conflicts of interest in the review. The deadline for https://www.sam.gov http://www.grants.gov http://www.grants.gov http://www.grants.gov mailto:elizabeth.leef@acl.hhs.gov submission of the letter of intent is two weeks after the posting of the FOA.

Letters of intent should be sent to:

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

Elizabeth Leef, Administration on Disabilities Email: elizabeth.leef@acl.hhs.gov or Fax: 202-205-0402

Project Narrative The Project Narrative is the most important part of the application, since it will be used as the primary basis to determine whether or not your project meets the minimum requirements for grants under the authorizing statutes. The Project Narrative should provide a clear and concise description of your project. The Project Narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins on both sides, and a standard font size of not less than 11, preferably Times New Roman or Arial. You can use smaller font sizes to fill in the Standard Forms and Sample Formats.

The Project Abstract must not exceed one page. Pages submitted beyond one page will not be considered during the panel review. The Project Narrative must not exceed 50 pages. Pages submitted beyond the first 50 in the application's Project Narrative section will not be considered during the panel review. The Appendix must not exceed 50 pages. The Appendix documents should include the Project work plan, Letters of Commitment, Vitae of Key Personnel, Budget, Narrative Budget Justification, Standard Forms for Assurances, Certifications, and Disclosures which are not counted towards the 50 page project narrative.

Any other appendix documents will not be considered during the panel review. All pages of the application must be sequentially numbered. Applicants should not send pamphlets, brochures, or other printed material along with their applications. These materials, if submitted, will not be included in the review process. In addition, applicants should not submit any additional letters of endorsement beyond any that may be required.

The sample components of the Project Narrative counted as part of the 50 page limit include:

•Summary/Abstract •Problem Statement •Goal(s) and Objective(s) •Proposed Intervention •Special Target Populations and Organizations •Outcomes •Project Management •Evaluation •Dissemination •Organizational Capability mailto:firstname.lastname@acl.hhs.gov

Summary/Abstract This section should include a brief - no more than 265 words maximum - description of the proposed project, including: goal(s), objectives, outcomes, and products to be developed.

Detailed instructions for completing the summary/abstract are included in the “Instructions for Completing the Project Summary/Abstract.”

Problem Statement This section should describe, in both quantitative and qualitative terms, the nature and scope of the particular problems or issues the proposed activities are designed to address, including how the project will potentially affect the paralysis population and/or their families and support networks (including specific subgroups within those populations), and possibly the health care and social services systems (e.g., the use of health care and/or nursing home services.)

Goals and Objectives This section should consist of a description of the project’s goal(s) and major objectives. A work plan with a timeline of activities should be included.

The Project Work Plan should reflect and be consistent with the Project Narrative and Budget and should cover all three (3) years of the project period. It should include a statement of the project’s overall goal, anticipated outcome(s), key objectives, and the major tasks / action steps that will be pursued to achieve the goal and outcome(s). For each major task / action step, the work plan should identify timeframes involved (including start- and end-dates), and the lead person responsible for completing the task. Please use the “Project Work Plan - Sample Template” format as a reference and resource, if desired.

Proposed Intervention This section should provide a clear and concise description of the activities you are proposing to use to address the problems described in the “Problem Statement”. You should also describe the rationale for using the particular intervention/activity, including factors such as: “lessons learned” for similar projects previously tested in your community, or in other areas of the country; factors in the larger environment that have created the “right conditions” for the intervention and activities (e.g., existing social, economic or political factors that you’ll be able to take advantage of, etc.). Also note any major barriers or challenges you anticipate encountering, and how your project will be able to overcome those barriers and address the challenges. Be sure to describe the role and makeup of staff and any strategic partnerships you plan to involve in implementing the intervention or activity, including other organizations, supporters, and/or consumer groups.

Special Target Populations and Organizations This section should describe how you plan to involve national, state and community-based organizations in a meaningful way in the planning and implementation of the proposal project.

This section should also describe how the proposed intervention and activities will target disadvantaged populations, including limited-English speaking populations and Veterans.

Outcomes This section of the project narrative must clearly identify the measurable outcome(s) that will result from the project. (NOTE: ACL will not fund any project that does not include measurable outcomes). This section should also describe how the project’s findings might benefit the field at large, (e.g., how the findings could help other organizations throughout the nation to address the same or similar problems.) List measurable outcomes in the optional work plan grid (“Project Work Plan – Sample Template”) under “Measurable Outcomes” in addition to any discussion included in the narrative along with a description of how the project might benefit the field at large.

A “measurable outcome” is an observable end-result that describes how a particular intervention benefits consumers, communities, organizations, and/or systems Possible outcomes relevant to this award include, but are not limited to, increased awareness of services among people with paralysis, their support networks, service providers and the general public; improved access to services; increased ability, among the target population, to make informed choices regarding their health and quality of life; reductions in barriers to health; expanded base of knowledge about health promotion strategies for those with paralysis; improved physical and emotional health among those served; and increased…