**ADMINISTRATION ON AGING**

**Alzheimer's Disease Demonstration Grants to States (ADDGS) Program**

# Evidence-Based Intervention Grants to Better Serve People with Alzheimer's Disease and Related Disorders

**FY 2008 Funding Opportunity**

**[Frequently Asked Questions (FAQ)]{.underline}**

**Q. What is an evidence-based intervention under this grant
announcement?**

A. The term "evidence-based intervention" refers to a program that
closely replicates a specific intervention that has been tested through
randomly controlled experiments with results that have been published in
peer-reviewed journals. Examples of specific intervention that are known
to AoA are listed in Appendix F of the grant announcement (you may
locate and propose others). A good presentation of the concept of
"evidence-based can be found at:
<http://www.healthyagingprograms.org/captivate/module2.htm> .

**If a state is proposing an intervention in which substantial changes
have been made and those changes have not been proven through a
randomized controlled trial and/or published in a peer-reviewed journal,
is this intervention allowed?**

The goal of the "Evidence-Based Intervention Grants to Better Serve
People with Alzheimer's Disease and Related Disorders" Program
Announcement is for states to demonstrate how existing evidence-based
service interventions [that help people with ADRD]{.underline} to remain
in the community can be translated into effective programs administered
at the community level. If substantial changes to the core components of
the original intervention have not been proven through a randomized
controlled trial and/or published in a peer-reviewed journal, the
intervention does not fit AoA's definition of an evidence-based service
intervention. However, if (for example) an evidence-based intervention
originally was made with a population of persons with ADRD that were
primarily Caucasian or all men, but the state proposal was to translate
the intervention to serve an ADRD population that was of a different
race, ethnicity, gender, or a more varied ADRD population \-- that would
be allowable (and desirable) as a translation of the original
intervention. Even though an intervention may not meet the criteria for
the evidence-based Program Announcement, a state may consider applying
under our Innovations Program Announcement, which does allow states to
implement interventions that are not yet evidence-based and has less
stringent evaluation requirements.

**Q. Can a state offer services other than those services which are
essential components to the evidence-based intervention?**

A. The funds under this grant, including the federal funds and the
matching funds, may only be used for the purposes of this project as
defined in this grant announcement. A state may offer services other
than those services which are essential to the evidence-based
intervention [if]{.underline} those services are paid for with funds
outside of the ADDGS evidence-based translation grant.

**Q. If an evidence-based intervention for people with dementia and/or
their caregivers has been [accepted for publication in a peer-reviewed
journal but has not yet been published]{.underline}, is that an
acceptable intervention to propose?**

A. Yes. AoA is aware of publications that have been accepted for
publication in a peer-reviewed journal but which have not yet been
published. For example, there are a number of researchers who worked on
REACH II who have developed new interventions derivative of the REACH II
intervention. These new interventions do not meet the criteria for an
evidence-based intervention unless a new randomized controlled trial has
been published -- or approved for publication -- in a peer-reviewed
journal. If you are proposing an intervention that was not listed in
Attachment F of the Program Announcement, include a copy of the journal
article(s) that detail the original study and outcomes with your
application. If the publication is not yet available, other
documentation that substantially verifies the information in the article
to be published must be submitted with the application.

**Q. Some evidence-based interventions have already produced manuals. If
a state proposed an intervention that already has a manual, does that
state need to produce another manual, as required under "Products" in
the program announcement?**

A. If a state believes it has a manual for an evidence-based program
that is sufficient to fully replicate the program in another setting,
then they need not invest in the development of a manual. However, many
manuals produced by the original intervention are not always well-suited
to community translations. Even if a manual has been produced by the
original researcher, it would be appropriate for an applicant to propose
the development of a new manual that incorporates the new lessons will
be learned through the community translation that can better inform
future community implementation.

### General Questions

Q. What are administrative services?

A. Administrative expenses include direct and indirect costs related to
(1) routine grant administration and monitoring (for example, receipt
and disbursal of program funds, preparation of routine programmatic and
financial reports, and compliance with grant conditions and audit
reports) and (2) contract development, solicitation review, award,
monitoring, and reporting.

Administrative expenses do not include costs associated with substantive
programmatic work. For example, the costs associate with salaries,
fringe and travel for a project director and other programmatic staff
involved in the implementation of the program. Other examples of
expenses that are not considered to be an administrative expense are:
the costs of direct services (e.g., training, counseling and respite);
project planning and implementation (e.g., translating evidence-based
research protocols); evaluation and information dissemination.

Under this grant, no more than 10% of the federal funds can be spent on
administrative expenses. However, there are no restrictions on the use
of non-federal funds (including the matching funds that are used for
this grant) for administrative purposes.

**Q. The Program Announcement states that: "States must implement
community-level projects under this Announcement, and approximately 75%
of the federal grant funds must be spent on community-level activities.
The community-level activities include the 50% direct service
requirement." What is a community-level activity?**

A. States need to exercise reasonable judgment in attributing costs to
the state or to the community-level. However, the following guidelines
help to illustrate our intent on this question:

> A community level activity includes:

-   All direct project service activities that take place in AAAs, aging
    services community provider organizations, research partners
    operating at the community-level, and Alzheimer's Association
    chapters, and other local partners are included as community-level
    activities (for example, the community-level activities include the
    50% direct service requirement activities).

-   State expenditures for activities that take place in the PSAs and/or
    state expenditures that are directly related to operations in the
    PSA, such as state sponsored training of local project staff or
    licenses to operate a copyrighted program.

**Q. Does evaluation count as a community-level activity?**

A. Evaluation activities that take place at the community-level can be
included in the 75% that must be utilized at the community level.
Evaluation activities that take place at the state level are not
community-level activities.

**Q. Can the salary of a direct service provider count towards a direct
service?**

A. Yes, if a paid position is an essential component of direct service
provision for this project, the salary for that position may count
towards direct service.

**Q. The Program Announcement states that, "These demonstrations should
aim to serve a substantial number of persons with ADRD during the
three-year period..." What does AoA define as a substantial number of
persons?**

A. AoA does not define what a substantial number of persons served is.
Due to state, regional, and local variations in population, and
differing costs of various interventions and services, each state will
need to determine the maximum number of people it is likely to serve.

### Eligible Applicants

**Q. Who may apply?**

A. Only an agency of state government, including state universities, may
apply for this opportunity. If the State Unit on Aging is not the
applicant, they must be included as a substantive and active partner, as
demonstrated by a [letter]{.underline} from the SUA detailing their
willingness and the extent of their participation in the proposed grant.

**Q. Are Tribal Organizations eligible to apply for an ADDGS grant?**

A. Since Tribal Organizations are not agencies of state government, they
are not eligible applicants. However, they may participate in projects
as a partner.

**Q. If a state already has an Evidence-Based ADDGS grant, are they
eligible to apply for a new Evidence-Based ADDGS grant?**

A. Yes, they are eligible to apply for new funding. States that choose
to do this have the option of starting an entirely new evidence-based
effort or building upon the translation work that is currently being
implemented. If a state chooses to build on the current effort and is
awarded funding, a budget offset may occur if there are unobligated
funds in the old grant. If a state with a current Evidence-Based ADDGS
grant is awarded a new grant, match for the new grant will be 25%.

### Funding 

**Q. Can a state receive more than one ADDGS grant?**

A. Yes. If scored highly by reviewers, it is possible that a state may
receive one "Innovations" award and one "Evidence-Based" award. Final
award decisions will be made by the Assistant Secretary for Aging (ASA).
In making these decisions, the ASA will take into consideration:
recommendations of the review panel; reviews for programmatic and grants
management compliance; the reasonableness of the estimated cost to the
government considering the available funding and anticipated results;
geographic distribution; the type of intervention being implemented; the
possible receipt of other ADDGS funds, and the likelihood that the
proposed project will result in the benefits expected.

**Q. The grant announcement says that "an average federal share of
approximately \$800,000 per award for a 3-year project period" is
planned for these grants. Does that mean that \$800,000 is the ceiling
on what we could request?**

A. You may request more than \$800,000 for this grant and some grants
may exceed this amount. We suggest that no state propose more than a 50%
additional amount to the average that we have targeted.

**Q. What is the difference between a grant and a "cooperative
agreement"?**

A. In the United States Federal grants are economic aid issued by the
U.S. Government out of the general federal revenue. A cooperative
agreement is a variation of a grant, which is awarded when a grant
provider anticipates having substantial involvement with the grantee
during the performance of a funded project. The ADDGS grants will be
issued as cooperative agreements because they are significant and
multifaceted endeavors in which AoA anticipates having substantial
involvement with the recipients during performance of funded activities.
Therefore, throughout the project period of the grant award, AoA will
furnish technical assistance, oversight and support to each grantee to
ensure program success. The cooperative agreement structure will allow
AoA to provide a higher level of technical assistance, oversight and
support than a grant relationship offers.

**Q. What type of involvement does AoA anticipate as part of this
cooperative agreement?**

A. As stated in the program announcements, "the grantee's involvement in
the cooperative agreement will consist of:

-   Maintain regular contact with AoA and the ADDGS Resource Center.

-   Attendance and active participation of 3 project or partner staff at
    AoA sponsored training each year of the cooperative Agreement.

-   Participate in work groups with other grantees to develop consensus
    approaches to major program issues.

-   Participate in training and learning networks developed and paid for
    by AoA through the National Resource Center

-   Collaborating and sharing information with other grantees who are
    implementing the same or similar interventions

-   Assist AoA in disseminating lessons learned at national conferences.

-   Collaborate with AoA and the ADDGS Resource Center on the
    identification and collection of date AoA and the grantee agree on
    as being essential to the successful evaluation of the grantee's
    project, including the measurable outcomes that will be used to
    track the project's progress and success.

-   Cooperate with the AoA Resource Center's technical assistance
    efforts, including data collection.

-   Respond to major AoA priorities and initiatives that impact or
    enhance the goals of the project."

**Q. Are grantees required to participate in technical assistance
activities?**

A. Yes. Because these are cooperative agreements, we believe that the
primary means of sharing information and facilitating discussions of
barriers, ways to resolve barriers, and share successes among grantees
is through a technical assistance provider. Therefore, in order to
attain the stated programmatic goals, all grantees must participate in
ADDGS technical assistance efforts.

**Q. Are there restrictions on what an applicant can use for the
non-financial contribution (match) required of grantees?**

A. Non-financial recipient contributions may include the value of goods
and/or services contributed by the grantee and of any and all third
parties involved in the project, including sub-grantees, contractors and
consultants. Examples of non-financial recipient contributions include:
salary/fringe benefits of staff devoting time to the grant and not
otherwise included in the budget or derived from federal funds,
applicable indirect costs, volunteer time, and use of facilities to hold
meetings or conduct project activities. In-kind contributions from a
third party may also be used as non-financial contribution and may
include the value of the time spent by Advisory Board members in the
design, development and implementation of the grant.

**Q. Is there an upper limit on the amount of indirect costs that will
be permitted? Would an indirect cost rate of 45% be permitted?**

A. A ten percent (10%) administrative limit is required by statute. This
limit applies to indirect costs.

**Q. Should the budget include funds for traveling to grantee meetings
or conferences**?

A. Yes. The budget should include funds to cover attendance of project
leadership at one 3-day meeting in Washington, DC. Applicants of the
Evidence-Based announcement must include funds for three (3) people to
attend, one of whom must be the State Project Director and one of whom
must be a research partner.

**Q. Can we subcontract some or all grant activities?**

A. Grantees, not the Federal Government, must decide whether it is in
their best interest to subcontract some of the grant activities. That
said, however, it is very important that the grantee realize that the
administrative responsibility and oversight of all grant activities
remains with the grantee. Thus, we recommend that when subcontracting,
the grantee should retain sufficient funding to adequately fulfill its
administrative and oversight responsibilities. In addition, it is
important for a state to maintain sufficient internal staff capacity to
learn from the pilot implementation stages and plan for broader systems
application.

**Q. When will states that are awarded an ADDGS cooperative agreement
begin receiving funds?**

All funds under the ADDGS program will be awarded on or before September
30, 2007. Shortly after the grant is awarded, grantees may begin drawing
down funds through the Payment Management System.

**A. Is an in-kind match allowable as part of the match required under
this funding opportunity?**

Yes. As described in the program announcement, "non-federal non-cash" or
"in-kind" contributions are allowable as part of an applicants match.
Note that the match can be provided by any of the partners in this
project including the state, and AAA, an Alzheimer's Chapter, a local
services provider, a foundation, or any other partner in this project.

**Q. Can these grant funds be used for services to persons under the age
of 60?**

A. Yes. There are no age restrictions in the ADDGS program.

### 

### Application

**Q. Are potential applicants required to submit a Letter of Intent to
apply?**

A. No. Submitting a letter of intent is not required.

**Q. Who will review the grant applications?**

Q. Applications that pass the initial application screening (see section
III.3 in the Program Announcement) will be reviewed by an independent
panel consisting of at least three individuals. These review panelists
will be experts in their field drawn from academic institutions,
non-profit organizations, state and local government, and Federal
agencies. People with disabilities and/or conditions requiring long term
support, and/or caregivers will be included in the review panels.