# OMB Approval No. 0985-0018

> Expiration 05/31/2010

# 

# 

# Alzheimer's Disease Demonstration

# Grants to States (ADDGS) Program

# 

# 

# *Evidence-Based Intervention Grants* 

# *to Better Serve People with* 

# *Alzheimer's Disease and Related Disorders* 

# 

# 

# Program Announcement and Grant Application Instructions

# 

# U.S. Administration on Aging

**2008**

**Department of Health and Human Services (HHS)**

**Administration on Aging (AoA)**

**AoA Center for Policy and Management**

######## Funding Opportunity Title: Alzheimer's Disease Demonstration Grants to States (ADDGS) Program: Evidence-Based Intervention Grants to Better Serve People with Alzheimer's Disease and Related Disorders (ADRD). 

########  

**Announcement Type: Initial**

**Funding Opportunity Number:** HHS-2008-AoA-AE-0812

**Catalog of Federal Domestic Assistance (CFDA) Number: 93.051**

**Key Dates:** The deadline date for submission of applications is
August 11, 2008

The deadline date for submission of a letter of intent is July 25, 2008.
An open information teleconference for applicants of this solicitation
will be held July 16^th^, 2008 from 2:30 - 4:00 P.M. EDT. The Toll-free
teleconference number will be 800-857-2613, pass code: 2043392.

**Overview*:***

This Program Announcement provides an opportunity for states to
demonstrate how existing evidence-based service interventions that help
people with ADRD to remain in the community can be translated into
effective programs that administered [at the community
level]{.underline} through the Aging Services Network and its partner
organizations.

Applications will be accepted from all agencies of State Government,
which includes but is not limited to State Units on Aging (SUAs).

The Administration on Aging (AoA) plans to award approximately 8 to 10
cooperative agreements under this Announcement, with an average award of
approximately \$800,000 to cover a three year project period.

# 

# AoA is simultaneously issuing two (2) ADDGS Program Announcements that provide states with an opportunity to secure FY2008 grant funds to improve the delivery of services and supports to people with dementia:

# Evidence-Based Intervention Grants to Better Serve People with Alzheimer's Disease and Related Disorders (ADRD): HHS-2008-AE-0812. 

# Innovative Grant Projects to Better Serve People with Alzheimer's Disease and Related Disorders: HHS-2008-AoA-AI-0813.

# 

# States can apply for grants under either one or under both of these ADDGS Announcements. 

I.  **FUNDING OPPORTUNITY DESCRIPTION**

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1.  **Statutory Authority**

The statutory authority for grant awards for the Alzheimer's Disease
Demonstration Grants to States program is contained in Sec. 398 of the
Public Health Service Act (P.L. 78-410; 42 U.S.C. 280c-3). It was
amended by the Home Health Care and Alzheimer's Disease Amendments of
1990 (PL 101-557) and by the Health Professions Education Partnerships
Act of 1998 (PL 105-392). Full legislation for the ADDGS program is
available online at:
<http://www.access.gpo.gov/uscode/title42/chapter6a_subchapterii_partk_subpartii_.html>.

The Statute has specific requirements that help to shape the use of
ADDGS funds:

-   The statute governing the ADDGS program requires that grantees
    provide a 25% match (cash or in-kind) during the first year, 35%
    during the second year, and 45% during the third and subsequent
    years of the grant period. Waivers to these match requirements are
    not allowed.

-   The statute governing the ADDGS program states, "the State agrees to
    expend not less than 50 percent of the grant for the provision of
    \[direct\] services" to persons with Alzheimer's disease or related
    dementias and their families.

-   Those services which are listed as "direct services" in the
    program's statute are: "...home health care, personal care,
    \[adult\] day care, companion services, short-term care in health
    facilities, and other respite care to individuals with Alzheimer's
    disease or related disorders that are living in single family homes
    or congregate settings." For this program announcement, respite is
    defined as an interval of rest or relief [OR]{.underline} the result
    of a direct dementia-specific service or support intervention that
    generates rest or relief for the caregiver and/or care recipient.
    For example, if people with dementia and/or their family caregivers
    receive counseling or training through an intervention, the
    intervention will be considered to have generated respite for the
    participants. This may be considered part of the direct service
    requirement. Additionally, states are not allowed to make payments
    with grant funds under this Announcement for any items or services
    to the extent that payment has been made, or can reasonably be
    expect to be made, with respect to such item or service under any
    State compensation program, under an insurance policy, or under any
    State or Federal health benefits program, such as Medicare and
    Medcaid, or an entity that provides health services on a prepaid
    basis.

-   The statue governing the ADDGS program also states, "... the State
    agrees that not more than 10 percent of the grant will be expended
    for administrative expenses with respect to the grant."

-   There are no age restrictions on who may be served through the ADDGS
    Program. Any person with Alzheimer's disease or a related dementia
    or their caregiver, regardless of age, is eligible for ADDGS
    services.

-   In the ADDGS statute, there is a particular focus on providing
    access to services to individuals, "who are members of racial or
    ethnic minority groups, who have limited proficiency in speaking the
    English language, or who live in rural areas."

2.  **Background**

There is no cure for Alzheimer's disease or the related forms of
dementia, however, there are effective strategies to help maintain
cognitive function, reduce behavioral symptoms, prevent acute care
crises and excess disability, and delay functional decline as well as
nursing home placement. Alzheimer's disease or related dementias exist
on a continuum that begins before diagnosis and continues through
cognitive and functional decline, to eventual total disability and
death. Effective interventions begin at the earliest stages of the
disease, although most community-based programs are focused on the
middle stages when families are already in crisis. ADRD are chronic
conditions that typically exist in combination with other chronic
diseases.

At least 10 million baby boomers will develop Alzheimer's disease in
their remaining lifetimes -- twice as many people as the number
estimated to have the disease today.[^1] An additional 4 million baby
boomers will develop a related dementia.[^2] Although ADRD is not a
normal part of aging, one in 10 persons over 65 and nearly half of those
over 85 may have Alzheimer's disease or a related dementia. A small
percentage of people in their 30s and 40s also develop the disease.
Although ADRD eventually results in death, the disease can progress for
years. A person with ADRD lives an average of 5 years, but can live as
many as 20 years or more from the onset of symptoms.[^3]

Congress created the Alzheimer's Disease Demonstration Grants to States
(ADDGS) program in 1991to encourage states to develop models of
assistance for persons with Alzheimer's disease, and to encourage close
coordination and incorporation of those services into the broader home
and community-based care system, Congress transferred the administration
of the program to AoA in 1998, in an effort to ensure coordination with
other programs for older Americans. To date, the ADDGS program has
proven successful in targeting service and system development to
traditionally underserved populations, including ethnic minorities,
low-income, and rural families coping with Alzheimer's disease.

3.  **Description of Funding Opportunity**

The goal of this Evidence-Based Intervention Grants Program is to
demonstrate how existing evidence-based service interventions that help
people with ADRD to remain in the community can be translated into
effective programs administered at the community level through the Aging
Services Network and partner organizations. 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.

Under this Announcement, AoA plans to fund approximately 8 to 10 new
cooperative agreements nationwide through an open competition. The
cooperative agreements will be funded at an average federal share of
approximately \$800,000 per award for a 3-year period. Because the
nature and scope of the projects will vary widely from application to
application, it is anticipated that the size of each award will also
vary.

With this Announcement, AoA continues to move the ADDGS program towards
an evidence-based approach to ADRD services. Consistent with AoA's
emphasis on the use of "the best available science" in designing and
implementing community-based programs, it is AoA's expectation that
applicants will review and use available scientific research on
interventions that were designed to help people with ADRD to remain
living in their own homes and communities in the formulation of their
project proposals.

Applicants are expected to translate research interventions with
fidelity to the major program design elements that were included in the
original study or a related subsequent Randomized Controlled Trial
(RCT). A proposal to implement an intervention that has removed a core
element(s) of a published randomized control trial cannot be considered
evidence-based. As appropriate, the proposal should contain a document
from the "owners" of the original studies with permission to use any
copyright protected documents or manuals related to the intervention.

For purposes of this grant program, 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. Sources of evidence include HHS sponsored research funded by
the National Institutes of Health (including National Institute on
Aging), the Centers for Disease Control and Prevention (CDC), Agency for
Health Care Research and Quality (AHRQ), the Centers for Medicaid and
Medicare Services (CMS) and the Substance Abuse Mental Health Services
Administration (SAMHSA). Studies performed by universities or other
research organizations are also acceptable.

AoA is aware of a number of evidence-based interventions to help address
the needs of people with ADRD. These interventions are listed below and
are appropriate for states to propose as evidence-based interventions
for the purposes of this program announcement. AoA expects that each
applicant propose to implement only ONE intervention under this
Announcement. Proposing to implement additional interventions will not
earn a higher reviewer score. We have grouped the evidence-based
interventions of which we are aware into three categories:

-   Early-Stage Dementia Interventions

-   Interventions for Persons with Dementia

-   Interventions for Family Caregivers of People with ADRD

You can see more detail on interventions that you may consider using for
this grant in a bibliography that is included in Attachment F.

Other program interventions not listed in Attachment F that are designed
specifically to help people with ADRD remain living in their own homes
or communities can be proposed. If you propose to translate
evidence-based interventions other than those listed in Attachment F,
please include a copy of the journal article(s) that detail the original
study and outcomes with your application. Additionally, if you choose an
intervention which is not listed in attachment F, it must be categorized
into one of the three intervention categories listed above and be
consistent with AoA's definition of an evidence-based intervention.

The lists below contain the interventions in the three categories that
are known to AoA that fit the definition of evidence-based
interventions.

### Early-Stage Dementia Interventions

-   Brief Occupational Therapy Intervention (Dooley and Hinojosa)

-   Cleveland Alzheimer's Managed Care Demonstration (Bass, Clark,
    Looman, McCarthy and Eckert)

-   Project CARE (Gonyea, O'Connor, and Boyle)

### Interventions for Persons with Dementia

-   Nighttime Insomnia Treatment and Education for Alzheimer's Disease
    (NITE-AD) (McCurry, Giffons, Logsdon, Vitiello, and Teri)

-   Reducing Disability in Alzheimer's Disease (Teri and Logsdon)

### Interventions for Family Caregivers of people with ADRD

-   Coping with Caregiving (Gallagher-Thompson)

-   Home Environmental Skill-Building Program (Gitlin)

-   New York University Caregiver Intervention (Mittelman)

-   Nine-Week Cognitive-Behavioral Intervention to Reduce Anxiety in
    Caregivers of People with Dementia (Akkerman)

-   Progressively Lowered Stress Threshold (PLST) Model (Buckwalter)

-   Psycho-educative Group Intervention Program for Caregivers of People
    with Dementia (Hébert)

-   REACH II (Stahl, Burgio, Gallagher-Thompson, Koepke, and Schulz)

-   Savvy Caregiver (Hepburn)

-   STAR-Caregiver (Teri and Logsdon)

**Focus on the translation of research into practice:** Through these
cooperative agreements, AoA will demonstrate how existing research can
be translated into practical programs that can be delivered at a
reasonable cost at the community level through the Aging Services
Network, including and in particular its aging services provider
organizations. Research studies on direct services that are designed to
help people with ADRD remain in the community often demonstrate positive
effects on program participants. However, this research is often
conducted in relatively defined sets of circumstances and for limited
numbers of participants. Applicants for these cooperative agreements
must propose to demonstrate how **existing** evidence-based direct
services research can be effectively provided through Aging Services
Network programs (i.e., If the intervention worked in a research or
health care setting(s), can it work at the community level and at what
cost?) Applicants must explicitly describe the "translation" that they
will attempt to demonstrate and their plans to ensure fidelity. A
rigorous evaluation must indicate whether or not the results from the
initial research are maintained in this demonstration in the Aging
Services Network setting.

**Conceptual Framework:** For this grant opportunity, projects must be
developed, implemented, and evaluated based on the RE-AIM framework,
which has been developed with the support of the Centers for Disease
Control and Prevention. RE-AIM is a systematic way for researchers,
practitioners, and policy makers to design and evaluate health behavior
interventions that can be used to estimate the potential impact of
interventions on public health. The goal of RE-AIM is to focus attention
and critical thinking on essential program elements that can improve the
sustainable adoption and implementation of effective evidence-based
programs and policies. The RE-AIM components are: Reach, Efficacy or
Effectiveness, Adoption, Implementation, and Maintenance. More
information can be found at [www.re-aim.org](http://www.re-aim.org/).
View a full copy of *Assuring Healthy Caregivers, A Public Health
Approach to Translating Research into Practice: The RE-AIM Framework*,
published by Centers for Disease Control and Prevention (CDC) and
others, at <http://www.cdc.gov/aging/caregiving/index.htm>. Online
training modules for evidence-based health promotion using the RE-AIM
framework are available at:
<http://www.healthyagingprograms.org/content.asp?sectionid=135>

**Partnerships:** States must involve key community organizations as
full partners in the design, implementation, and evaluation of their
proposed projects. The following types of organizations are required,
but others could be added:

-   One or more [aging services community provider organizations, which
    are]{.underline} currently operating a program that serves older
    adults and is funded (at least in part) through the Older Americans
    Act, to provide direct services and supports to help people with
    ADRD under this Grant Announcement. A Native American Tribal
    Organization funded under Title VI of the Older Americans Act can be
    included as an aging services provider under this grant
    announcement.

-   An [AAA]{.underline} to help ensure that the program is linked to
    appropriate collateral services and participants in the Aging
    Services Network including other public and private community
    partners and to help promote the adoption and expansion of
    successful programs in the community. If the applicant is a Single
    Planning and Service Area state, the applicant must address in its
    narrative how the role of the State applicant will substitute for
    the AAA role.

-   [A local]{.underline} Alzheimer's Association Chapter or similar
    type organization.

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-   A [research organization(s)]{.underline}, such as an institution of
    higher learning, to assist with the translation of the
    evidence-based service research, training, evaluation, cost
    assessment, and other technical aspects of the demonstration. It may
    be appropriate to partner with more than 1 research organization,
    such as the original researcher as well as a local university.

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-   Additionally, if the state agency submitting the proposal is not the
    [State Unit on Aging (SUA)]{.underline}, then the proposal must
    include the SUA as a substantive and active partner to the community
    project.

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-   **Direct Service Requirement:** Applicants must also include in
    their proposal their plan for meeting the requirement that 50% of
    federal funds must be used to offer one or more of the
    ADDGS-specific direct services, which include and [are]{.underline}
    limited to: personal care, \[adult\] day care, companion services,
    short-term care in health facilities, home health care and other
    respite care. The 50% direct service requirement cannot be
    negotiated. For this program announcement, respite is defined as an
    interval of rest or relief [OR]{.underline} the result of a direct
    dementia-specific service or support intervention that generates
    rest or relief for the caregiver and/or care recipient. For example,
    if people with dementia and/or their family caregivers receive
    counseling or training through an intervention, the intervention
    will be considered to have generated respite for the participants,
    and therefore, this intervention may be considered part of the
    direct service requirement. Additionally, states are not allowed to
    make payments with grant funds under this Announcement for any items
    or services to the extent that payment has been made, or can
    reasonably be expect to be made, with respect to such item or
    service under any State compensation program, under an insurance
    policy, or under any State or Federal health benefits program, such
    as Medicare and Medicaid, or an entity that provides health services
    on a prepaid basis.

**Design/Costs:** These demonstrations should aim to serve a substantial
number of persons with ADRD during the three-year period at a cost that
permits and encourages replication throughout the Aging Services
Network. In your proposal, you must estimated number of persons with
ADRD that will be served as well as the estimated cost per person with
ADRD. The demonstrations should provide enough service on a sustained
basis to make it possible to replicate the effects of the original
studies during the same time frames.

At least 50% of the federal funds under this program must be used in the
provision of direct services to the clients of the demonstrations. In
other words, not more than 50% of the total federal demonstration funds
can be used for outreach, community coalition/partnership building and
maintenance and project evaluation activities. No more than 10% of the
total project funds can be spent on administrative costs. This is
required by statute.

**Evaluation:** Project evaluation plans must be substantially detailed
in the application and include:

-   An evaluation design based on the RE-AIM framework. As noted above,
    the RE-AIM components are: Reach, Efficacy or Effectiveness,
    Adoption, Implementation, and Maintenance. In describing the
    proposed evaluation design, applicants must address each of these
    components separately and thoroughly. All applicants are expected to
    use tools and resources from the RE-AIM framework to enable
    documentation and reporting on program implementation fidelity and
    the effects of those changes for the participants.

-   A formative learning/continuous quality improvement process to help
    assure fidelity to the original study and to identify and correct
    implementation problems quickly. Consistent with the RE-AIM
    framework, fidelity monitoring and corrective action should be
    addressed as part of project management and local implementation,
    and as part of overall formative learning.

-   An evaluation of the effects (e.g., knowledge, behavior,
    self-reported health status, and satisfaction) of the intervention
    on the person with ADRD and/or their family caregiver that provides
    an indication that the original effect of the evidence-based
    research model has or has not been maintained. Selected outcome
    measures from the original research should be used in the project to
    validate the project outcomes. While some of the measures may be
    similar to those used in the original research, please keep in mind
    that the goal is not to replicate the original RCT, nor to embed an
    RCT into this project. Control groups are not needed for the
    required evaluation. This evaluation design should provide a
    foundation for publication of results in a peer-reviewed journal.

**Data Collection Requirement**: Grantees will need to collect data to
evaluate the core outcomes of the project and the RE-AIM objectives that
have been set. The ADDGS Resource Center will assist the funded projects
in refining data collection specifications and analytical strategies.

**Products:** At a minimum, there is a set of three required products.
Required products include:

1.  A report describing the key findings and "lessons learned" from the
    project.

2.  A "how-to" manual that will readily allow others to implement the
    demonstrated intervention program within their own state or
    community. For examples see:
    <http://www.healthyagingprograms.org/content.asp?sectionid=74&ElementID=418>
    and
    <http://www.healthyagingprograms.org/content.asp?sectionid=74&ElementID=561>

> The "how-to" manual should include materials (i.e., training tools,
> surveys, brochures, etc) that will allow others implementing the
> demonstrated service at the state or community level to easily modify
> and/or reproduce for the purpose of their own service delivery
> program;

3.  A cost analysis based on the sample format shown in Attachment G of
    this program announcement that will allow other state and local
    entities to estimate the cost of program start-up and operation and
    the costs of serving clients as the program matures. The ADDGS
    Resource Center will assist the funded projects in refining cost
    methodologies.

**Information Sharing:** Each project will work cooperatively with AoA,
and the ADDGS Resource Center, to share cross-site learning and
experience. Conference calls with projects will be convened to share
evaluation observations, experience, and suggestions. Where two or more
ADDGS grantees are implementing the same intervention, they are
encouraged to cooperatively coordinate the development of data
collection and evaluation strategies, program materials, as well as the
development of the how-to manual that are required for this grant. The
ADDGS Resource Center will ensure that existing ADDGS programs that are
already experienced in implementing evidence-based ADDGS interventions
are encouraged to participate in exchanges with new implementation
projects resulting from this grant announcement.

**Resources:** The list below identifies a few, but not all, of the
online resources available to assist you with planning and program
implementation:

-   AoA's Alzheimer's Resource Room (Programs that Work):
    <http://www.aoa.gov/alz/public/alzprof/ADDGS/programs.asp>

-   Centers for Disease Control (Healthy Aging; RE-AIM Monograph):
    <http://www.cdc.gov/Aging/caregiving/index.htm>

-   NCOA's National Resource Center on Evidence-Based Prevention:
    <http://www.healthyagingprograms.com/>.

-   NIA\'s Alzheimer\'s Disease Education and Referral Center:
    <http://www.nia.nih.gov/Alzheimers/>

-   RE-AIM: [www.re-aim.org](http://www.re-aim.org/)

-   Rosalyn Carter Institute for Caregiving (Evidence-Based Caregiver
    Intervention Resource Center): <http://www.rosalynncarter.org/grid/>

-   Assuring Healthy Caregivers, A Public Health Approach to Translating
    Research into Practice: The RE-AIM Framework:\
    [http://www.cdc.gov/aging/care
    iving/index.htm](http://www.cdc.gov/aging/care iving/index.htm).

-   Aging and Disability Resource Center -- Technical Assistance
    Exchange:
    <http://www.adrc-tae.org/tiki-index.php?page=PublicHomePage>

######## AWARD INFORMATION 

######## 

Under this Announcement, AoA plans to make approximately 8 to 10 new
cooperative agreements nationwide through an open competition funded at
an average federal share of approximately \$800,000 per award for a
3-year period. The anticipated start date for these projects is
September 30, 2008.

These three-year cooperative agreements are [available to all
States.]{.underline}

# As noted above, AoA is simultaneously issuing two (2) ADDGS Program Announcements that provide states with an opportunity to secure FY2008 grant funds to improve the delivery of services and supports to help people with dementia remain in the community:

# 

# Innovative Grant Projects to Better Serve People with Alzheimer's Disease and Related Disorders: HHS-2008-AoA-AI-0813.

# Evidence-Based Intervention Grants to Better Serve People with Alzheimer's Disease and Related Disorders (ADRD): HHS-2008-AoA-AE-0812. 

# 

# States can apply for grants under either one or under both of these ADDGS Announcements. 

# 

# Funding targets related to the estimated number of grants that AoA intends to fund and estimated funding levels for each announcement are provided below. However, depending upon the number of fundable proposals under either ADDGS Announcement, AoA may shift resources to a proposal(s) under the other ADDGS Announcement, if there are fundable proposals that would not otherwise be funded or would otherwise receive a smaller grant award. 

Awards under this Announcement will be in the form of cooperative
agreements since AoA will have substantial involvement with the
recipient during performance of funded activities.

The terms and conditions for this cooperative agreement are as follows:

AoA's involvement will consist of:

-   Collaboration, participation, or intervention in the funded
    activities;

-   Assisting the project leadership in understanding the strategic
    goals and objectives, policy perspectives, and priorities of AoA by
    sharing such information on an ongoing basis via e-mail, telephone
    calls, briefings, and other consultations;

-   Providing information on new research and its implications for
    programs operating in states.

-   Providing on-site technical assistance, training, and oversight
    throughout the project period.

-   Ensuring that the grantee is informed and aware of major AoA
    priorities and initiatives that impact or enhance the goals of the
    project.

-   Developing and moderating panels and seminars at national or
    regional conferences that will provide opportunities for grantees to
    share progress, issues, and findings related to the program.

-   Assuring that site visits and TA are supportive and responsive to
    the individual needs of each grantee.

-   Providing opportunities for collaboration, participation, and if
    necessary, constructive intervention to resolve issues that impede
    the progress of the grant.

-   Working with other Federal partner agencies to create new program
    related opportunities for state projects and local projects.

-   Reviewing and concurring in changes in project leadership.

-   Providing the grantee with linkages to AoA Resource Centers, in
    addition to the resource center for the ADDGS program.

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.

To facilitate appropriate involvement, during the period of this
cooperative agreement, AoA, the ADDGS Resource Center, and the grantee
will be in contact monthly and more frequently when appropriate.

The terms and conditions of the cooperative agreement under this
Announcement are in addition to, not in lieu of, 45 CFR Part 74 or 92.

Requests to modify or amend the cooperative agreement or the work plan
may be made by AoA or the grantee at any time. Modifications and/or
amendments to the Cooperative Agreement or work plan shall be effective
upon the mutual agreement of both parties, except where AoA is
authorized under the Terms and Conditions of award, 45 CFR Part 74 or
92, or other applicable regulation or statute to make unilateral
amendments.

**III. ELIGIBILITY INFORMATION**

**1. Eligible Applicants**

By statute, awards will be made only to agencies of State Governments.
If the applicant is not a State Unit on Aging, the applicant agency must
have the support and active involvement of the State Unit on Aging.

**2. Cost Sharing or Matching**

Section 398 of the Public Health Service Act (42 U.S.C. 398 et seq.), as
amended, requires that grantees provide a 25% match of total costs
during the first year of an ADDGS project, 35% during the second year,
and 45% during the third and subsequent years of the grant period. Match
can be made cash or in-kind. Match does not need to come from the state
grantee; it can be contributed by any non-federal sources and it can
come from multiple partners. Waivers to these match requirements are not
allowed.

Under this program, AoA will fund no more than 75 % of the project's
total cost in the first grant year, which means the applicant must cover
at least 25% of the project's total cost with non-federal resources. In
other words, for every three (3) dollars received in federal funding,
the applicant must contribute at least one (1) dollar in non-federal
resources toward the project's total cost (i.e., the amount on line
15g.). This "three-to-one" ratio is reflected in the above formula which
you can use to calculate your minimum required match: A common error
applicants make is to match 25% of the federal share, rather than 25% of
the project's total cost.

The formula for calculating the required first year match is:

> [Federal Funds requested (i.e.\$300,000) x Match Rate
> (i.e.25%)]{.underline} = Project
>
> Federal Match Rate (i.e.75%) Match

For this grant opportunity, **three (3) individual annual (12 month)
budgets must be submitted** to AoA for each project: 1) Year One
12-month budget with 25% match, 2) Year Two12-month budget with 35%
match, and 3) Year Three 12-month budget with 45% match. Each budget
must have a corresponding budget justification. Attachment B contains a
template Budget Justification. Please note that there are headers on the
budget justification template where you should note the budget interval
and match requirement for that interval on each page.

**3. Other**

Applicants must involve community-based organizations in the planning
and implementation of their project.

TRAVEL: The application must include funds for the project leadership to
participate in one 3-day annual national meeting each year over the
three year project period to be held in Washington, D.C.. Three (3)
persons, one of whom must be the State Project Director and one of whom
must be a research partner, from each project must attend the annual
meeting using grant funds.

**4. 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]{.underline}** be reviewed and will

receive **[no]{.underline}** further consideration.

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

1.  Applications must be submitted electronically via
    [www.grants.gov](http://www.grants.gov/) by 11:59PM August 11, 2008.

2.  The Project Narrative section of the Application must be
    **[double-spaced]{.underline}**, on 8 ½" x 11" plain white paper
    with **[1" margins]{.underline}** on both sides, and a **[font size
    of not less than 11]{.underline}**.

3.  **[The Project Narrative must not exceed 20 pages]{.underline}**.
    NOTE: The Project Work Plan, Letters of Commitment, and Vitae of Key
    Project Personnel **[are not counted]{.underline}** as part of the
    Project Narrative for purposes of the 20-page limit.

**5. Responsiveness Criteria**

Proposals will be reviewed to assure that they meet the following
responsiveness criteria. Proposals that do not meet the responsiveness
criteria will not be given further consideration for funding:

-   The proposed service intervention must be based on evidence-based
    research where the direct service intervention is specifically
    designed to help people with dementia remain living in the
    community.

-   If the application is from a state agency other than the State Unit
    on Aging (SUA), the SUA must be a substantive and active partner,
    demonstrated by a [letter]{.underline} from the SUA detailing their
    willingness and the extent of their participation in the proposed
    grant.

IV. **APPLICATION AND SUBMISSION INFORMATION**

## 1. Address to Request Application Package 

Application materials can be obtained from
[http://www.grants.gov](http://www.grants.gov/) or
<http://www.aoa.gov/doingbus/fundopp/fundopp.asp>.

Application materials are also available by writing to:

U.S. Department of Health and Human Services

Administration on Aging

Donald Grantt

Office for Planning and Policy Development

Washington, D.C. 20201

Or by calling: 202-357-0149

Or e-mailing: <Donald.Grantt@aoa.hhs.gov>

It is AoA's policy that all applications be submitted electronically
through [www.grants.gov](http://www.grants.gov/). The Grants.gov
registration process can take several days. If your organization is not
currently registered with [www.grants.gov](http://www.grants.gov/),
please begin this process immediately. **For assistance with
[www.grants.gov](http://www.grants.gov/), please contact them at**
[support@grants.gov](mailto:support@grants.gov?subject=Support) **or
1-800-518-4726 between 7 a.m. and 9 p.m. Eastern Time.** At
[www.grants.gov](http://www.grants.gov/), you will be able to download a
copy of the application packet, complete it off-line, and then upload
and submit the application via the Grants.gov website.

Applications submitted via [www.grants.gov](http://www.grants.gov/):

-   You may access the electronic application for this program on
    [www.Grants.gov](http://www.Grants.gov/). You must search the
    downloadable application page by the Funding Opportunity Number
    (HHS-2008-AoA-AE-0812) or CFDA number (93.051).

-   At the www.grants.gov website, you will find information about
    submitting an application electronically through the site, including
    the hours of operation. AoA strongly recommends that you do not wait
    until the application due date to begin the application process
    through [www.grants.gov](http://www.grants.gov/) because of the time
    delay.

-   All applicants must have a Dun and Bradstreet (D&B) Data Universal
    Numbering System (DUNS) number and register in the Central
    Contractor Registry (CCR). You should allow a minimum of **five
    days** to complete the CCR registration.

-   You must submit all documents electronically, including all
    information included on the SF424 and all necessary assurances and
    certifications.

-   Prior to application submission, Microsoft Vista and Office 2007
    users should review the Grants.gov compatibility information and
    submission instructions provided at
    [www.grants.gov](http://www.grants.gov/) (click on "[Vista and
    Microsoft Office 2007 Compatibility Information]{.underline}").

-   **Your application must comply with any page limitation requirements
    described in this program announcement.**

-   After you electronically submit your application, you will receive
    an automatic acknowledgement from www.grants.gov that contains a
    Grants.gov tracking number. The Administration on Aging will
    retrieve your application form from Grants.gov.

-   Each year organizations registered to apply for federal grants
    through [www.grants.gov](http://www.grants.gov/) will need to renew
    their registration with the Central Contractor Registry (CCR). You
    can register with the CCR online and it will take about 30 minutes
    ([http://www.ccr.gov](http://www.ccr.gov/)).

###### 2. Content and Form of Application Submission 

**a. Letter of Intent**

Applicants are requested, but not required, to submit a letter of intent
to apply for this funding opportunity to assist AoA in planning for the
application independent review process. The deadline for submission of
the letter of intent is July 25, 2008.

**b. DUNS Number**

The Office of Management and Budget requires applicants to provide a Dun
and Bradstreet (D&B) Data Universal Numbering System (DUNS) number when
applying for Federal grants or cooperative agreements on or after
October 1, 2003. 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 1-866-705-5711 or by
using this link to access a guide:
<https://www.whitehouse.gov/omb/grants/duns_num_guide.pdf> **.**

**c. Project Narrative**

##  

[The Project Narrative must be double-spaced, on 8 ½" x 11" paper with
1" margins on both sides, and a font size of not less than
11]{.underline}. You can use smaller font sizes to fill in the Standard
Forms and Sample Formats. The suggested length for the Project Narrative
is ten to twenty pages; twenty pages is the maximum length allowed. [AoA
will not accept applications with a Project Narrative that exceeds 20
pages.]{.underline} The Project Work Plan, Letters of Commitment, and
Vitae of Key Personnel are not counted as part of the Project Narrative
for purposes of the 20-page limit, but all of the other sections noted
below are included in the limit.

The components of the Project Narrative counted as part of the 20 page
limit include:

-   Summary/Abstract

-   Problem Statement

-   Goal(s) and Objective(s)

-   Proposed Intervention Program

-   Special Target Populations and Organizations

-   Outcomes

-   Project Management

-   Evaluation

-   Data Collection

-   Product Dissemination

-   Organizational Capability

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 Sec. 398 of
the Public Health Service Act (42 U.S.C. 398 et seq.), as amended by
Public Law 101-157 and by 105-379, the Health Professions Education
Partnerships Act of 1998. The Project Narrative should provide a **clear
and concise** description of your project, which include the following
components:

**Summary/Abstract.** This section should include a brief - no more than
265 words maximum - description of the proposed project, including: the
goal, the list of objectives and the products to be developed. Detailed
instructions for completing the summary/abstract are included in
Attachment E of this document.

**Problem Statement.** This section should describe, in both
quantitative and qualitative terms, the nature and scope of the
particular problem, issue, or need the proposed intervention is designed
to address. This section should include epidemiological and other data
on the target populations *and* assessments of challenges faced by
current services and posed by the community and policy environments.

**Goals and Objectives.** This section should consist of a description
of the project's goal(s) and major objectives. Unless the project
involves multiple, complex interventions, we recommend you have only one
overall goal. The project's goals and objectives must support the
implementation and replication of community-level projects using
evidence-based interventions that have proven effective in helping
people with ADRD to remain living in the community. 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.

**Proposed Intervention Program.** As appropriate, applicants should use
the RE-AIM framework to describe their proposed approach. Applicants
must provide a clear and concise description of the rationale for the
community-level intervention selected, and demonstrate in their
application a thorough understanding of the extant research literature
that provides the specific evidence base for the efficacy of their
proposed intervention. This should include information on factors that
are related to the success or failure of similar interventions at the
community level, when such information is available, including relevant
literature citations. The applicant should also describe how the
community-level intervention addresses risk factors specific to the
target population and include a description of how the program will
service low-income and minority groups. Also note any major barriers you
anticipate encountering, and how your project will be able to overcome
those barriers. Be sure to describe the role and makeup of any strategic
partnerships you plan to involve in implementing the intervention,
including other organizations, funders, and/or consumer groups.

Applicants should describe in detail the selected evidence-based
intervention and associated activities, such as:

-   Outreach and engagement of target population for service;

-   Screening, assessment, and referral;

-   Procedures to ensure participant confidentiality (including
    Institutional Review Board approval, if required);

-   Service-related interventions to be implemented;

-   Integration/linkage with partner agencies; and

-   Training and ongoing technical assistance by topic experts.

    Applicants should clearly explain how the project will meet the 50%
    direct service requirement. Include information on: the dollar
    amount that will be used to meet the ADDGS-specific direct service
    requirement; how many people with ADRD are expected to be served;
    and, what populations (e.g., specific ethnic groups, rural, young
    onset, early stage, persons with developmental disabilities) will be
    targeted.

**Project Reach.** The proposed project should aim to serve a
substantial number of people with ADRD during the three-year period at a
cost that permits and encourages replication throughout the Aging
Services Network. The applicant must include an estimate of the number
of persons with ADRD that will be served. The demonstrations should
provide enough service on a sustained basis to make it possible to
replicate the effects of the original studies during the same time
frames.

**Project Evaluation:** Applicants are required to use RE-AIM
([www.re-aim.org](http://www.re-aim.org/)) to plan and evaluate their
program's development and effectiveness. In conjunction with RE-AIM,
this section should describe the methods, techniques, and tools that
will be used.

Project evaluation plans must describe in substantial detail in the
application and include:

-   An evaluation design based on the RE-AIM framework. As noted above,
    the RE-AIM components are: Reach, Efficacy or Effectiveness,
    Adoption, Implementation, and Maintenance. In describing the
    proposed evaluation design, applicants must address each of these
    components separately and thoroughly. All applicants are expected to
    use tools and resources from the RE-AIM framework to enable
    documentation and reporting on program implementation fidelity and
    the effects of those changes for the participants.

-   A formative learning/continuous quality improvement process to: 1.)
    to assure that fidelity to the selected evidence-based intervention
    is being maintained and to address ongoing implementation problems
    or concerns as they arise; 2) determine whether or not the proposed
    intervention achieved its anticipated outcome(s); and, 3) document
    the "lessons learned" -- both positive and negative - from the
    project that will be useful to people interested in replicating the
    program, if it proves successful. Consistent with the RE-AIM
    framework, fidelity monitoring and corrective action should be
    addressed as part of project management and local implementation.

-   An evaluation of the effects (e.g., knowledge, behavior,
    self-reported health status, and satisfaction) of the intervention
    on the person with ADRD and/or their family caregiver that provides
    an indication that the original effect of the evidence-based
    research model has or has not been maintained. Selected outcome
    measures from the original research should be used in the project to
    validate the project outcomes. While some of the measures may be
    similar to those used in the original research, please keep in mind
    that the goal is not to replicate the original RCT, nor to embed an
    RCT into this project. Control groups are not needed for the
    required evaluation. This evaluation design should provide a
    foundation for publication of results in a peer-reviewed journal.

Applicants must specify the type of data they plan to collect to
evaluate the core outcomes of the project and the RE-AIM objectives that
have been set. The ADDGS Resource Center will assist the funded projects
in refining data collection specifications and analytical strategies.

**Anticipated Outcomes**. This section of the project narrative must
clearly identify the measurable outcome(s) that will result from the
project. [Selected outcome measures from the original research should be
used in the project to validate the project outcomes.]{.underline} List
measurable outcomes in the attached work plan grid (Attachment D) 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. 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, and which types of organizations, throughout
the nation to address the same or similar problems.)

A "measurable outcome" is an observable end-result that describes how a
particular intervention benefits consumers. It measures change in
functional status, mental well-being, knowledge, skill, attitude,
awareness or behavior.) It can also describe a change in the degree to
which consumers exercise choice over the types of services they receive,
or whether they are satisfied with the way a service is delivered.
Additional examples include: a change in the responsiveness or
cost-effectiveness of a service delivery system; a new model of support
or care that can be replicated in the aging network; or new knowledge
that can contribute to the field of aging. A measurable outcome is not a
measurable "output", such as: the number of clients served; the number
of training sessions held; or the number of service units provided. Your
application will be scored in part on the clarity and nature of your
proposed outcomes, not on the number of outcomes cited. You should keep
the focus of this section on describing [what]{.underline} measurable
outcome(s) will be produced by the project. You should use the
Evaluation section noted below to describe [how]{.underline} the
outcome(s) will be measured and reported.

**Project Management**. This section should include a clear delineation
of the roles and responsibilities of project staff, consultants and
partner organizations, and how they will contribute to achieving the
project's objectives and outcomes. It should specify who would have
day-to-day responsibility for key tasks such as: leadership of project;
monitoring the project's on-going progress; integrating this project
into agency operations; preparation of reports; communications with
other partners and AoA. It should also describe the approach that will
be used to monitor and track progress on the project's tasks and
objectives. All project staff must disclose any work they are doing on
projects funded by other grants; this information can be contained in
the descriptions of staff capabilities and/or staff resumes.

**Product Dissemination.** Applicants should provide confirmation that
the project will comply with the required products. This section should
also describe the method that will be used to disseminate the required
products in a timely manner and in easily understandable formats, to
parties who might be interested in using the results of the project to
inform practice, service delivery, program development, and/or
policy-making, including and especially those parties who would be
interested in replicating the project.

## Organizational Capability Statement. Each application should include an organizational capability statement and vitae for key project personnel. The organizational capability statement should describe how the applicant agency (or the particular division of a larger agency which will have responsibility for this project) is organized, the nature and scope of its work and/or the capabilities it possesses. This description should cover capabilities of the applicant agency not included in the program narrative, such as any current or previous relevant experience and/or the record of the project team in preparing cogent and useful reports, publications, and other products. If appropriate, include an organization chart showing the relationship of the project to the current organization. Please attach short vitae for key project staff only. Neither vitae nor an organizational chart will count towards the narrative page limit. Also include information about any contractual organization(s) that will have a significant role(s) in implementing project and achieving project goals. 

**d. Work Plan**.

The Project Work Plan should reflect and be consistent with the Project
Narrative and Budget and should cover the entire 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 Sample Work Plan format included in
the Attachments. 

**e. Letters of Commitment from Key Participating Organizations and
Agencies.**

Include confirmation of the commitments to the project (should it be
funded) made by [key]{.underline} collaborating organizations and
agencies in this part of the application. Any organization that is
specifically named to have a significant role in carrying out the
project should be considered an essential collaborator. For applications
submitted electronically via Grants.gov, signed letters of commitment
should be scanned and included as attachments. Applicants unable to scan
the signed letters of commitment may fax them to the AoA Office of
Grants Management at 202-357-3466 by the application submission
deadline.

**f. Project Budget Narrative**

A detailed budget for each of the three years of the grant is required.
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. The Budget Narrative should be provided
using the format included as Attachment C of this Program Announcement.
Applicants are encouraged to pay particular attention to Attachment B,
which provides an example of the level of detail sought Please note that
all subcontracts must be identified, and when more than 33% of project's
budget falls under contractual, detailed budget narratives must be
provided for each sub-contractor or sub-grant.  

**3. Submission Dates and Times**

The deadline for the submission of applications under this program
announcement is August 11, 2008. Applications must be submitted
electronically by 11:59PM Eastern Time, August 11, 2008.

Applications that fail to meet the application due date will
**[not]{.underline}** be reviewed and will receive **[no]{.underline}**
further consideration.

Grants.gov will automatically send applicants a tracking number and date
of receipt verification electronically once the application has been
successfully received and validated in Grants.gov.

**Potential applicants are encouraged to submit a letter of intent to
apply for a grant no later than July 25, 2008. Letters of intent should
be no more than one page and include information on the program to be
implemented and the state agency that will be submitting the
application.** Letters of Intent should be submitted by facsimile or
e-mail to the ADDGS Project Officer, Donald Grantt, (202) 357-3447, Fax
(202) 357-3469, and
[Donald.Grantt@aoa.hhs.gov](mailto:Meredith.Eisenhart@aoa.hhs.gov) .

**4. Intergovernmental Review**

This funding opportunity announcement is not subject to the requirements
of Executive Order 12372, "Intergovernmental Review of Federal Programs"

**5. Funding Restrictions**

The following activities are not fundable:

-   Construction and/or major rehabilitation of buildings

-   Basic research (e.g. scientific or medical experiments)

-   Continuation of existing projects without expansion or new and
    innovative approaches

**6. Other Submission Requirements**

Electronic submissions must be sent to: http://www.grants.gov.

Applicants submitting their application through
[www.grants.gov](http://www.grants.gov/) must register in the Central
Contractor Registry (CCR) database in order to be able to submit the
application. One element of the CCR is the DUNS number (see section
IV.2), which must be obtained separately from CCR registration.
Information about CCR is available at
[http://www.ccr.gov](http://www.ccr.gov/). You must also register with
the grants.gov credential service provider to receive a username and
password to securely submit your grant application. Information is
available at <http://apply07.grants.gov/apply/OrcRegister>.

V.  **APPLICATION REVIEW INFORMATION**

**1. Criteria**

### Applications are scored by assigning a maximum of 100 points across four criteria:

### Purpose and Need for Assistance - (10 points); 

### Approach/Method -- Work Plan and Activities - (50 points);

### Outcomes/Evaluation/Dissemination - (30 points); and 

### Level of Effort - (10 points).

> A. [Purpose and Need for Assistance]{.underline} [Weight: 10
> points]{.underline}

i.  Does the proposed project clearly and adequately respond to the
    priority areas of this Program Announcement? Does this section
    clearly describe the need for developing the chosen evidence-based
    direct service intervention for people with Alzheimer's disease and
    related dementias in their state? (5 points)

ii. Does the applicant provide appropriate quantitative information as
    it applies to the State and to specific sub-State geographic areas
    where the program will be implemented? Is the project justified in
    terms of the most recent, relevant, and available information and
    knowledge? (5 points)

> B. [Approach, Work Plan and Activities]{.underline} [Weight: 50
> points]{.underline}

i.  Was an evidence-based intervention selected that is consistent with
    the three intervention categories in the Program Announcement? If an
    intervention was selected that was not on the list of AoA-known
    interventions, are supporting materials, including a journal
    article(s) included? (10 points)

ii. Has the applicant stated clear and realistic goals and objectives
    for the proposed program? Are they consistent with the priority
    areas of this program announcement? Did the applicant address how
    they will attempt to "translate" the evidence-based intervention and
    address program fidelity? Is the grantee proposing a project that
    will be implemented at the community level? (10 points)

iii. Has the applicant addressed which component of their program will
     meet the 50% of federal funds be used for direct services
     requirement? Does the proposal take into account barriers and
     opportunities that exist in the larger environment that may impact
     on the project's success? Has the applicant described a coherent,
     realistic approach to addressing the problems described? (10
     points)

iv. Is the project's planning and implementation guided RE-AIM? Has the
    direct service program been identified and realistic implementation
    plans provided? Do implementation plans permit ongoing assessment of
    fidelity and clear accountability for such assessment and for
    corrective action? (10 points)

v.  Does the proposal include the required partners, including aging
    services provider organizations to delivery direct services and
    supports under the grant? Do the partners each have active,
    substantial roles in the project? Does the application describe how
    the partners will be involved in a meaningful way in the planning
    and implementation of the project? Are there partner(s) involved who
    have expertise in research? (10 points)

    C. [Project Outcomes, Evaluation and Dissemination]{.underline}
    [Weight: 30 points]{.underline}

```{=html}
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i.  Are the expected project benefits/results clear, realistic, and
    consistent with the objectives and purpose of the project? Does the
    evaluation plan include selected outcome measures from the original
    research? Does the application include a plan for formative
    learning/continuous quality improvement? (10 points)

ii. Does the project evaluation, using RE-AIM, reflect a thoughtful and
    well-designed approach that will be able to successfully measure
    whether or not the project has achieved its proposed outcome(s).
    Will the evaluation system permit a process evaluation? Will the
    evaluation permit a determination of whether objectives have been
    achieved? (15 points)

iii. Has the applicant addressed and agreed to the required products? Is
     there a plan to submit findings to an academic/research journal?
     Has the grantee agreed to collect data for ADDGS? Will the
     dissemination plan get relevant and easy to use information in a
     timely manner to relevant parties, particularly those who may want
     to replicate the project? Does the applicant indicate which types
     of organizations/ parties would be most likely to want
     dissemination information and what types of information and tools
     would be most useful for that audience? (5 points)

     D. [Level of Effort]{.underline}: [Weight: 10 points]{.underline}

```{=html}
<!-- -->
```
i.  Does the proposal include a clear and coherent management plan? Do
    the proposed project director(s), key staff and consultants have
    qualifications required to carry out their designated roles? Are the
    roles and responsibilities of project staff, consultants and
    partners clearly defined and linked to specific objectives and
    tasks? Are letters from participating organizations included, as
    appropriate, and do they express the clear commitment and areas of
    responsibility of those organizations, consistent with the work plan
    description of their intended roles and contributions? (5 points)

ii. Is the budget justified with respect to the adequacy and
    reasonableness of resources requested? Is the time commitment of the
    proposed director and other key project personnel sufficient to
    assure proper direction, management and timely completion of the
    project? Are budget line items clearly delineated and consistent
    with work plan objectives? (5 points)

**2. Review and Selection Process**

An independent review panel of at least three individuals will evaluate
applications that pass the screening and meet the responsiveness
criteria, if applicable. These reviewers are experts in their field, and
are drawn from academic institutions, non-profit organizations, state
and local government, and federal government agencies. Based on the
Application Review Criteria as outlined under section V.1, the reviewers
will comment on and score the applications, focusing their comments and
scoring decisions on the identified criteria.

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.

## Applicants have the option of omitting from the application specific salary rates for individuals specified in the application budget. 

## VI. AWARD ADMINISTRATION INFORMATION 

###### 1. Award Notices

Successful applicants will receive an electronic Notice of Award. The
Notice of Award is the authorizing document from the Administration on
Aging authorizing official, Grants Management Office, and the AoA budget
office. Unsuccessful applicants are notified within 30 days of the final
funding decision and will receive a disapproval letter via e-mail or
U.S. mail.

###### 2. Administrative and National Policy Requirements 

The award is subject to DHHS Administrative Requirements, which can be
found in 45CFR Part 74 and 92 and the Standard Terms and Conditions
implemented through the HHS Grants Policy Statement located at
http://www.hhs.gov/grantsnet/adminis/gpd/index.htm.

###### 3. Reporting 

The SF-269 (Financial Status Report) is due annually and the AoA program
progress report is due semi-annually. Final performance and SF-269
reports are due 90 days after the end of the project period.

## VII. AGENCY CONTACTS 

> [Project Officer:]{.underline}
>
> U.S. Department of Health and Human Services
>
> Administration on Aging
>
> Washington, DC 20201
>
> Attn: [Donald Grantt]{.underline}
>
> Telephone: (202) 357-3447, e-mail: <Donald.Grantt@aoa.hhs.gov> .
>
> [Grants Management Officer:]{.underline}
>
> U.S. Department of Health and Human Services
>
> Administration on Aging
>
> Washington, DC 20201
>
> Attn: Alexis Lynady
>
> Telephone: (202) 357-3465, e-mail: <Alexis.Lynady@aoa.hhs.gov>

## VIII. OTHER INFORMATION 

###### A. Application Elements

> 1\. SF 424 -- Application for Federal Assistance.

2.  SF 424A -- Budget Information.

3.  Separate Budget Narrative/Justification (See Attachments for Sample
    Format).

4.  SF 424B -- Assurances. Note: Be sure to complete this form according
    to instructions and have it signed and dated by the authorized
    representative (see item 18d on the SF 424).

> 5\. Certifications. These are required of the applicant organization
> regarding lobbying, debarment, suspension, and other responsibility
> matters; and drug free workplace requirements.
>
> 6\. Proof of non-profit status
>
> 7\. Copy of the applicant\'s most recent indirect cost agreement, if
> requesting indirect costs.
>
> 8\. Project Narrative with Work Plan (See Attachment for Sample Work
> Plan Format).
>
> 9\. Organizational Capability Statement and Vitae for Key Project
> Personnel.
>
> 10\. Letters of Commitment from Key Partners.
>
> 11\. "Survey on Ensuring Equal Opportunity for Applicants" (Optional
> non-profit applicants)
>
> **B. The Paperwork Reduction Act of 1995 (P.L. 104-13)**
>
> An agency may not conduct or sponsor, and a person is not required to
> respond to, a collection of information unless it displays a currently
> valid OMB control number.
>
> The project description and budget justification is approved under OMB
> control number 0985-0018 which expires on 5/31/10.
>
> Public reporting burden for this collection of information is
> estimated to average 10 hours per response, including the time for
> reviewing instructions, gathering and maintaining the data needed and
> reviewing the collection information.

**ATTACHMENTS**

**Attachment A:**

**Instructions for completing the SF 424, Budget (SF 424A), Budget
Narrative and Other Required Forms**

**Attachment B:**

**Budget Justification Format -- Sample Format with Examples**

**Attachment C:**

**Budget Justification -- Sample Format**

**Attachment D:**

**Project Work Plan - Sample Format**

**Attachment E:**

**Instructions for Completing the Summary/Abstract**

**Attachment F:**

# Annotated Bibliography: Evidence-Based Interventions That May Be Proposed for the 2008 ADDGS Grant Announcement

**Attachment G:**

**Cost Analysis -- Sample Format**

**Attachment H:**

**"Survey on Ensuring Equal Opportunity for Applicants"**

# Attachment A

# Instructions for completing the SF 424, Budget (SF 424A), Budget Narrative, and Other Required Forms

This section provides step-by-step instructions for completing the four
(4) standard federal forms required as part of your grant application,
including special instructions for completing Standard Budget Forms 424
and 424A. Standard Forms 424 and 424A are used for a wide variety of
federal grant programs, and federal agencies have the discretion to
require some or all of the information on these forms. AoA does not
require all the information on these Standard Forms. Accordingly, please
use the instructions below in lieu of the standard instructions attached
to SF 424 and 424A to complete these forms.

###### 

######   {#section-16 .unnumbered}

###### a. Standard Form 424

1\. **Type of Submission:** (Required): Select one type of submission in
accordance with agency instructions.

• Preapplication • Application • Changed/Corrected Application -- If AoA
requests, check if this submission is to change or correct a previously
submitted application.

2\. **Type of Application**: (Required) Select one type of application
in accordance with agency instructions.

• New. • Continuation • Revision

3\. **Date Received:** Leave this field blank.

4\. **Applicant Identifier**: Leave this field blank

5a **Federal Entity Identifier**: Leave this field blank

5b. **Federal Award Identifier**: For new applications leave blank. For
a continuation or revision to an existing award, enter the previously
assigned Federal award (grant) number.

6\. **Date Received by State:** Leave this field blank.

7\. **State Application Identifier:** Leave this field blank.

8\. **Applicant Information**: Enter the following in accordance with
agency instructions:

**a. Legal Name**: (Required): Enter the name that the organization has
registered with the Central Contractor Registry. Information on
registering with CCR may be obtained by visiting the Grants.gov website.

**b. Employer/Taxpayer Number (EIN/TIN):** (Required): Enter the
Employer or Taxpayer Identification Number (EIN or TIN) as assigned by
the Internal Revenue Service.

**c. Organizational DUNS**: (Required) Enter the organization's DUNS or
DUNS+4 number received from Dun and Bradstreet. Information on obtaining
a DUNS number may be obtained by visiting the Grants.gov website.

**d. Address**: (Required) Enter the complete address including the
county.

**e. Organizational Unit:** Enter the name of the primary organizational
unit (and department or division, if applicable**)** that will undertake
the project.

**f. Name and contact information of person to be contacted on matters
involving this application**: Enter the name (First and last name
required), organizational affiliation (if affiliated with an
organization other than the applicant organization), telephone number
(Required), fax number, and email address (Required) of the person to
contact on

matters related to this application.

9\. **Type of Applicant:** (Required) Select the applicant organization
"type" from the following drop down list.

A. State Government B. County Government C. City or Township Government
D. Special District Government E. Regional Organization F. U.S.
Territory or Possession G. Independent School District H. Public/State
Controlled Institution of Higher Education I. Indian/Native American
Tribal Government (Federally Recognized) J. Indian/Native American
Tribal Government (Other than Federally Recognized) K. Indian/Native
American Tribally Designated Organization L. Public/Indian Housing
Authority M. Nonprofit with 501C3 IRS Status (Other than Institution of
Higher Education) N. Nonprofit without 501C3 IRS Status (Other than
Institution of Higher Education) O. Private Institution of Higher
Education P. Individual Q. For-Profit Organization (Other than Small
Business) R. Small Business S. Hispanic-serving Institution T.
Historically Black Colleges and Universities (HBCUs) U. Tribally
Controlled Colleges and Universities (TCCUs) V. Alaska Native and Native
Hawaiian Serving Institutions W. Non-domestic (non-US) Entity X. Other
(specify)

10\. **Name Of Federal Agency**: (Required) Enter U.S. Administration on
Aging

11\. **Catalog Of Federal Domestic Assistance Number/Title:** The CFDA
number can be found on page one of the Program Announcement.

12\. **Funding Opportunity Number/Title:** (Required) The Funding
Opportunity Number and title of the opportunity can be found on page one
of the program announcement.

13\. **Competition Identification Number/Title:** Leave this field
blank.

14\. **Areas Affected By Project:** List the largest political entity
affected (cities, counties, state etc).

15\. **Descriptive Title of Applicant's Project:** (Required) Enter a
brief descriptive title of the project.

16\. **Congressional Districts Of**: (Required) 16a. Enter the
applicant's Congressional District, and 16b. Enter all district(s)
affected by the program or project. Enter in the format: 2 characters
State Abbreviation -- 3 characters District Number, e.g., CA-005 for
California 5th district, CA-012 for California 12^th^ district, NC-103
for North Carolina's 103rd district. • If all congressional districts in
a state are affected, enter "all" for the district number, e.g., MD-all
for all congressional districts in Maryland. • If nationwide, i.e. all
districts within all states are affected, enter US-all.

17\. **Proposed Project Start and End Dates**: (Required) Enter the
proposed start date and end date of the project.

18\. **Estimated Funding:** (Required) Enter the amount requested or to
be contributed during the first funding/budget period by each
contributor. Value of in-kind contributions should be included on
appropriate lines, as applicable. If the action will result in a dollar
change to an existing award, indicate only the amount of the change. For
decreases, enclose the amounts in parentheses.

**NOTE:** Applicants should review cost sharing or matching principles
contained in Subpart C of 45 CFR Part 74 or 45 CFR Part 92 before
completing Item 18 and the Budget Information Sections A, B and C noted
below.

All budget information entered under item 18 should cover the upcoming
budget period. For sub-item 18a, enter the federal funds being
requested. Sub-items 18b-18e is considered matching funds. The dollar
amounts entered in sub-items 18b-18f must total at least 1/3^rd^ of the
amount of federal funds being requested (the amount in 18a). For a full
explanation of AoA's match requirements, see the information in the box
below. For sub-item 18f, enter only the amount, if any, that is going to
be used as part of the required match.

There are two types of match: 1.) non-federal cash and 2.) non-federal
non-cash (i.e., in-kind). In general, costs borne by the applicant and
cash contributions of any and all third parties involved in the project,
including sub-grantees, contractors and consultants, are considered
[cash matching funds]{.underline}. Generally, most contributions from
third parties will be non-cash (i.e., in-kind) matching funds. Examples
of [non-cash (in-kind) match]{.underline} include: volunteered time and
use of facilities to hold meetings or conduct project activities.

NOTE: **Indirect charges** may only be requested if: (1) the applicant
has a current indirect cost rate agreement approved by the Department of
Health and Human Services or another federal agency; or (2) the
applicant is a state or local government agency. State governments
should enter the amount of indirect costs determined in accordance with
DHHS requirements. **If indirect costs are to be included in the
application, a copy of the approved indirect cost agreement must be
included with the application.**

19\. **Is Application Subject to Review by State Under Executive Order
12372 Process?** Check c. Program is not covered by E.O. 12372

20\. **Is the Applicant Delinquent on any Federal Debt?** (Required)
This question applies to the applicant organization, not the person who
signs as the authorized representative. If yes, include an explanation
on the continuation sheet.

21\. **Authorized Representative**: (Required) To be signed and dated by
the authorized representative of the applicant organization. Enter the
name (First and last name required) title (Required), telephone number
(Required), fax number, and email address (Required) of the person
authorized to sign for the applicant. A copy of the governing body's
authorization for you to sign this application as the official
representative must be on file in the applicant's office. (Certain
Federal agencies may require that this authorization be submitted as
part of the application.)

**b. Standard Form 424A**

+-----------------------------------------------------------------------+
| > NOTE: Standard Form 424A is designed to accommodate applications    |
| > for multiple grant programs; thus, for purposes of this AoA         |
| > program, many of the budget item columns and rows are not           |
| > applicable. You should only consider and respond to the budget      |
| > items for which guidance is provided below. Unless otherwise        |
| > indicated, the SF 424A should reflect a one year budget.            |
+-----------------------------------------------------------------------+

##### Section A ‑ Budget Summary

> [Line 5]{.underline}: Leave columns (c) and (d) blank. Enter TOTAL
> federal costs in column (e) and total non‑federal costs (including
> third party in‑kind contributions and any program income to be used as
> part of the grantee match) in column (f). Enter the sum of columns (e)
> and (f) in column (g).

##### Section B ‑ Budget Categories

> Column 3: Enter the breakdown of how you plan to use the federal funds
> being
>
> requested by object class category (see instructions for each object
> class category below).
>
> Column 4: Enter the breakdown of how you plan to use the non-federal
> share by object class category.
>
> Column 5: Enter the total funds required for the project (the sum of
> Columns 3 and 4) by object class category.

+-----------------------------------------------------------------------+
| ###### Separate Budget Narrative/Justification Requirement            |
|                                                                       |
| > You must submit a separate budget narrative as part of your         |
| > application. **A blank sample format (and one with examples) has    |
| > been included in the attachments for your use in developing and     |
| > presenting your Budget Narrative.** In your budget justification,   |
| > you should include a breakdown of the budget which shows the costs  |
| > for all of the object class categories noted in Section B, across   |
| > three columns: federal; non-federal cash; and non-federal in-kind.  |
| > The justification should fully explain and justify the costs in     |
| > each of the major budget items for each of the object class         |
| > categories, as described below. Third party in-kind contributions   |
| > designated as non-federal match contributions should be clearly     |
| > identified and justified separately from the justification for the  |
| > budget line items. The full budget justification should be included |
| > in the application immediately following the SF 424 forms. **The    |
| > budget justification should provide a detailed breakdown of large   |
| > dollar values. A separate budget justification must be completed    |
| > for each year of support requested.**                               |
+-----------------------------------------------------------------------+

> [Line 6a]{.underline}: [Personnel]{.underline}: Enter total costs of
> salaries and wages of applicant/grantee staff. Do not include the
> costs of consultants; consultant costs should be included under 6h ‑
> Other. [In the Justification]{.underline}: Identify the project
> director, if known. Specify the key staff, their titles, brief summary
> of project related duties, and the percent of their time commitments
> to the project in the budget justification.
>
> [Line 6b]{.underline}: [Fringe Benefits]{.underline}: Enter the total
> costs of fringe benefits unless treated as part of an approved
> indirect cost rate. [In the Justification]{.underline}: Provide a
> break‑down of amounts and percentages that comprise fringe benefit
> costs, such as health insurance, FICA, retirement insurance, etc.
>
> [Line 6c]{.underline}: [Travel]{.underline}: Enter total costs of
> [out‑of‑town travel]{.underline} (travel requiring per diem) for staff
> of the project. Do not enter costs for consultant\'s travel - this
> should be included in line 6h. [In the Justification]{.underline}:
> Include the total number of trips, destinations, purpose, length of
> stay, subsistence allowances and transportation costs (including
> mileage rates).
>
> [Line 6d]{.underline}: [Equipment]{.underline}: Enter the total costs
> of all equipment to be acquired by the project. For all grantees,
> \"equipment\" is non‑expendable tangible personal property having a
> useful life of more than one year and an acquisition cost of \$5,000
> or more per unit. If the item does not meet the \$5,000 threshold,
> include it in your budget under Supplies, line 6e. [In the
> Justification]{.underline}: Equipment to be purchased with federal
> funds must be justified as necessary for the conduct of the project.
> The equipment must be used for project-related functions; the
> equipment, or a reasonable facsimile, must not be otherwise available
> to the applicant or its sub‑grantees. The justification also must
> contain plans for the use or disposal of the equipment after the
> project ends.
>
> [Line 6e]{.underline}: [Supplies:]{.underline} Enter the total costs
> of all tangible expendable personal property
>
> (supplies) other than those included on line 6d. [In the
> Justification:]{.underline} Provide general description of types of
> items included.
>
> [Line 6f]{.underline}: [Contractual]{.underline}: Enter the total
> costs of all contracts, including (1) procurement
>
> contracts (except those, which belong on other lines such as
> equipment, supplies, etc.). Also include any contracts with
> organizations for the provision of technical assistance. Do not
> include payments to individuals on this line. [In the
> Justification]{.underline}: Attach a list of contractors indicating
> the name of the organization, the purpose of the contract, and the
> estimated dollar amount. If the name of the contractor, scope of work,
> and estimated costs are not available or have not been negotiated,
> indicate when this information will be available. Whenever the
> applicant/grantee intends to delegate a substantial part (one-third,
> or more) of the project work to another agency, the applicant/grantee
> must provide a completed copy of Section B, SF 424A Budget Categories
> for each contractor, and separate budget justifications for each year
> of support requested.
>
> [Line 6g]{.underline}: [Construction]{.underline}: Leave blank since
> construction is not an allowable cost under this AoA program.
>
> [Line 6h]{.underline}: [Other]{.underline}: Enter the total of all
> other costs. Such costs, where applicable, may
>
> include, but are not limited to: insurance, medical and dental costs
> (i.e. for project volunteers this is different from personnel fringe
> benefits); non-contractual fees and travel paid directly to
> *individual* consultants; [local]{.underline} transportation (all
> travel which does not require per diem is considered local travel);
> postage; space and equipment rentals/lease; printing and publication;
> computer use; training and staff development costs (i.e. registration
> fees). If a cost does not clearly fit under another category, and it
> qualifies as an allowable cost, then rest assured this is where it
> belongs. [In the Justification:]{.underline} Provide a reasonable
> explanation for items in this category. For individual consultants,
> explain the nature of services provided and the relation to activities
> in the work plan. Describe the types of activities for staff
> development costs.
>
> [Line 6i]{.underline}: [Total Direct Charges]{.underline}: Show the
> totals of Lines 6a through 6h.
>
> [Line 6j]{.underline}: [Indirect Charges]{.underline}: Enter the total
> amount of indirect charges (costs), if any. If no indirect costs are
> requested, enter \"none.\" Indirect charges may be requested if: (1)
> the applicant has a current indirect cost rate agreement approved by
> the Department of Health and Human Services or another federal agency;
> or (2) the applicant is a state or local government agency. Indirect
> costs are administrative costs. If the negotiated state indirect cost
> rate exceeds the 10% administrative ceiling for this grant (as
> established by statute) then no more that 10% indirect cost may be
> taken from the federal funds for this grant.
>
> Justification: [State governments should enter the amount of indirect
> costs determined in accordance with DHHS requirements]{.underline}. An
> applicant that will charge indirect costs to the grant must enclose a
> copy of the current rate agreement. If the applicant organization is
> in the process of initially developing or renegotiating a rate, it
> should immediately upon notification that an award will be made,
> develop a tentative indirect cost rate proposal based on its most
> recently completed fiscal year in accordance with the principles set
> forth in the cognizant agency\'s guidelines for establishing indirect
> cost rates, and submit it to the cognizant agency. Applicants awaiting
> approval of their indirect cost proposals may also request indirect
> costs. It should be noted that when an indirect cost rate is
> requested, those costs included in the indirect cost pool should not
> also be charged as direct costs to the grant. Also, if the applicant
> is requesting a rate which is less than what is allowed under the
> program, the authorized representative of the applicant organization
> must submit a signed acknowledgement that the applicant is accepting a
> lower rate than allowed.
>
> [Line 6k]{.underline}: [Total]{.underline}: Enter the total amounts of
> Lines 6i and 6j.
>
> [Line 7]{.underline}: [Program Income]{.underline}: As appropriate,
> include the estimated amount of income, if any, you expect to be
> generated from this project. Program Income must be used as additional
> costs.

##### Section C ‑ Non‑Federal Resources

> [Line 12]{.underline}: Enter the amounts of non‑Federal resources that
> will be used in carrying out the proposed project, by source
> (Applicant; State; Other) and enter the total amount in Column (e).
> Keep in mind that if the match requirement is not met, federal dollars
> may be reduced.
>
> ***Section D ‑ Forecasted Cash Needs*** - Not applicable.
>
> ***Section E ‑ Budget Estimate of Federal Funds Needed for Balance of
> the Project***
>
> [Line 20]{.underline}: Section E is relevant for multi-year grant
> applications, where the project period is 24 months or longer. This
> section does not apply to grant awards where the project period is
> less than 17 months.

###### Section F ‑ Other Budget Information

> [Line 22]{.underline}: [Indirect Charges]{.underline}: Enter the type
> of indirect rate (provisional, predetermined, final or fixed) to be in
> effect during the funding period, the base to which the rate is
> applied, and the total indirect costs. Include a copy of your current
> Indirect Cost Rate Agreement.
>
> [Line 23]{.underline}: [Remarks]{.underline}: Provide any other
> comments deemed necessary.

###### c. Standard Form 424B - Assurances

> This form contains assurances required of applicants under the
> discretionary funds programs administered by the Administration on
> Aging. Please note that a duly authorized representative of the
> applicant organization must certify that the organization is in
> compliance with these assurances.

###### d. Certification Regarding Lobbying

> This form contains certifications that are required of the applicant
> organization regarding lobbying. Please note that a duly authorized
> representative of the applicant organization must attest to the
> applicant's compliance with these certifications.

###### e. Other Application Components

**Survey on Ensuring Equal Opportunity for Applicants**

> The Office of Management and Budget (OMB) has approved an HHS form to
> collect information on the number of faith-based groups applying for a
> HHS grant. Non-profit organizations, excluding private universities,
> are asked to include a completed survey with their grant application
> packet. Attached you will find the OMB approved HHS "Survey on
> Ensuring Equal Opportunity for Applicants" form (Attachment G). Your
> help in this data collection process is greatly appreciated.

**Proof of Non-Profit Status**

> Non-profit applicants must submit proof of non-profit status. Any of
> the following constitutes acceptable proof of such status:
>
> A copy of a currently valid IRS tax exemption certificate.
>
> A statement from a State taxing body, State attorney general, or other
> appropriate State official certifying that the applicant organization
> has a non-profit status and that none of the net earnings accrue to
> any private shareholders or individuals.
>
> A certified copy of the organization's certificate of incorporation or
> similar document that clearly establishes non-profit status.

## Indirect Cost Agreement

> Applicants that have included indirect costs in their budgets must
> include a copy of the current indirect cost rate agreement approved by
> the Department of Health and Human Services or another federal agency.
> This is optional for applicants that have not included indirect costs
> in their budgets.

**Attachment B: Budget Narrative, Page 1 -- Sample Format with
EXAMPLES**

**Budget Interval: *[(e.g. 9/30/2008- 9/30/2009) ]{.mark}***

**Match Requirement: [(*e.g. 25%, 35%, or 45%)*]{.mark}**

+----------+-------+------+------+------+-----------------------------+
| >        | **Fe  | **N  | **N  | # T  | ### Justification           |
| **Object | deral | on-F | on-F | OTAL |                             |
| > Class  | Fu    | eder | eder |      |                             |
| > Ca     | nds** | al** | al** |      |                             |
| tegory** |       |      |      |      |                             |
|          |       | **Ca | **I  |      |                             |
|          |       | sh** | n-Ki |      |                             |
|          |       |      | nd** |      |                             |
+----------+-------+------+------+------+-----------------------------+
| **Per    | \$4   |      | \$5  | \$45 | Project Supervisor (name) = |
| sonnel** | 0,000 |      | ,000 | ,000 | .3FTE @ \$50,000/yr =       |
|          |       |      |      |      | \$15,000                    |
|          |       |      |      |      |                             |
|          |       |      |      |      | Project Director (name) =   |
|          |       |      |      |      | 1FTE @ \$30,000 = \$30,000  |
+----------+-------+------+------+------+-----------------------------+
| **Fringe | \$1   | 0    | 0    | \$12 | Fringes on Supervisor and   |
| Be       | 2,600 |      |      | ,600 | Director @ 28% of salary.   |
| nefits** |       |      |      |      |                             |
|          |       |      |      |      | FICA (7.65%) = \$3,442      |
|          |       |      |      |      |                             |
|          |       |      |      |      | Health (12%) = \$5,400      |
|          |       |      |      |      |                             |
|          |       |      |      |      | Dental (5%) = \$2,250       |
|          |       |      |      |      |                             |
|          |       |      |      |      | Life (2%) = \$ 900          |
|          |       |      |      |      |                             |
|          |       |      |      |      | Workers Comp Insurance      |
|          |       |      |      |      | (.75%) = \$ 338             |
|          |       |      |      |      |                             |
|          |       |      |      |      | Unemployment Insurance      |
|          |       |      |      |      | (.6%) = \$ 270              |
+----------+-------+------+------+------+-----------------------------+
| **       | \$    | 0    | \$   | \$3  | Travel to Annual Grantee    |
| Travel** | 3,000 |      | 967  | ,967 | Meeting:                    |
|          |       |      |      |      |                             |
|          |       |      |      |      | Airfare: 1 RT x 2 people x  |
|          |       |      |      |      | \$750/RT = \$1,500          |
|          |       |      |      |      |                             |
|          |       |      |      |      | Lodging: 3 nights x 2       |
|          |       |      |      |      | people x \$100/night = \$   |
|          |       |      |      |      | 600                         |
|          |       |      |      |      |                             |
|          |       |      |      |      | Per Diem: 4 days x 2 people |
|          |       |      |      |      | x \$40/day = \$ 320         |
|          |       |      |      |      |                             |
|          |       |      |      |      | Out-of-Town Project Site    |
|          |       |      |      |      | Visits                      |
|          |       |      |      |      |                             |
|          |       |      |      |      | Car mileage: 3 trips x 2    |
|          |       |      |      |      | people x 350 miles/trip     |
|          |       |      |      |      |                             |
|          |       |      |      |      | x \$ .365/mile = \$ 767     |
|          |       |      |      |      |                             |
|          |       |      |      |      | Lodging: 3 trips x 2 people |
|          |       |      |      |      | x 1 night/ trip             |
|          |       |      |      |      |                             |
|          |       |      |      |      | x \$50/night = \$300        |
|          |       |      |      |      |                             |
|          |       |      |      |      | Per Diem: 3 trips x 2       |
|          |       |      |      |      | people x 2days/trip         |
|          |       |      |      |      |                             |
|          |       |      |      |      | x \$40/day = \$480          |
+----------+-------+------+------+------+-----------------------------+

Attachment B: Budget Narrative, Page 2 - Sample Format with EXAMPLES

**Budget Interval: *[(e.g. 9/30/2008- 9/30/2009) ]{.mark}***

**Match Requirement: [(*e.g. 25%, 35%, or 45%)*]{.mark}**

+-----+-----+------+------+------+-----------------------------------+
| **  | **  | #    | *    | ##   | ### Justification                 |
| Obj | Fed | #### | *Non | ## * |                                   |
| ect | era |  Non | -Fed | [TOT |                                   |
| C   | l** | -Fed | eral | AL]{ |                                   |
| las |     | eral | I    | .und |                                   |
| s** | #   |      | n-Ki | erli |                                   |
|     |  Fu | ##   | nd** | ne}* |                                   |
| **C | nds | ###  |      |      |                                   |
| ate |     | Cash |      |      |                                   |
| gor |     |      |      |      |                                   |
| y** |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+
| *   | 0   | 0    | 0    | 0    | No equipment requested            |
| *Eq |     |      |      |      |                                   |
| uip |     |      |      |      |                                   |
| men |     |      |      |      |                                   |
| t** |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+
| **S | \   |      | \$2  | \$3  | Laptop computer for use in client |
| upp | $1, |      | ,000 | ,500 | intakes = \$1,340                 |
| lie | 500 |      |      |      |                                   |
| s** |     |      |      |      | Consumable supplies (paper, pens, |
|     |     |      |      |      | etc.)                             |
|     |     |      |      |      |                                   |
|     |     |      |      |      | \$100/mo x 12 months = \$1,200    |
|     |     |      |      |      |                                   |
|     |     |      |      |      | Copying \$80/mo x 12 months = \$  |
|     |     |      |      |      | 960                               |
+-----+-----+------+------+------+-----------------------------------+
| **C | \$2 | \$50 | 0    | \    | Contracts to A,B,C direct service |
| ont | 00, | ,000 |      | $250 | providers (name providers)        |
| rac | 000 |      |      | ,000 |                                   |
| tua |     |      |      |      | adult day care contractor =       |
| l** |     |      |      |      | \$75,000                          |
|     |     |      |      |      |                                   |
|     |     |      |      |      | respite care contractor in home=  |
|     |     |      |      |      | \$75,000                          |
|     |     |      |      |      |                                   |
|     |     |      |      |      | respite care contractor-NF =      |
|     |     |      |      |      | \$50,000                          |
|     |     |      |      |      |                                   |
|     |     |      |      |      | personal care/companion provider  |
|     |     |      |      |      | = \$50,000                        |
|     |     |      |      |      |                                   |
|     |     |      |      |      | See detailed budget justification |
|     |     |      |      |      | for each provider (and then       |
|     |     |      |      |      | provide it!)                      |
+-----+-----+------+------+------+-----------------------------------+

+-----+-----+------+------+------+-----------------------------------+
| A   |     |      |      |      |                                   |
| tta |     |      |      |      |                                   |
| chm |     |      |      |      |                                   |
| ent |     |      |      |      |                                   |
| B:  |     |      |      |      |                                   |
| Bud |     |      |      |      |                                   |
| get |     |      |      |      |                                   |
| N   |     |      |      |      |                                   |
| arr |     |      |      |      |                                   |
| ati |     |      |      |      |                                   |
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| Re  |     |      |      |      |                                   |
| qui |     |      |      |      |                                   |
| rem |     |      |      |      |                                   |
| ent |     |      |      |      |                                   |
| :** |     |      |      |      |                                   |
| [(* |     |      |      |      |                                   |
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| .g. |     |      |      |      |                                   |
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| 3   |     |      |      |      |                                   |
| 5%, |     |      |      |      |                                   |
| or  |     |      |      |      |                                   |
| 45% |     |      |      |      |                                   |
| )** |     |      |      |      |                                   |
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| .ma |     |      |      |      |                                   |
| rk} |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+
| **O | \$  | \$8  | \$19 | \$37 | Local conference registration fee |
| the | 10, | ,000 | ,800 | ,800 | (name conference) = \$ 200        |
| r** | 000 |      |      |      |                                   |
|     |     |      |      |      | Printing brochures (50,000 @ \$   |
|     |     |      |      |      | .05 ea) = \$ 2,500                |
|     |     |      |      |      |                                   |
|     |     |      |      |      | Video production = \$19,800       |
|     |     |      |      |      |                                   |
|     |     |      |      |      | Video Reproduction = \$ 3,500     |
|     |     |      |      |      |                                   |
|     |     |      |      |      | NF Respite Training Manual        |
|     |     |      |      |      | reproduction                      |
|     |     |      |      |      |                                   |
|     |     |      |      |      | \$3/manual x \$2000 manuals = \$  |
|     |     |      |      |      | 6,000                             |
|     |     |      |      |      |                                   |
|     |     |      |      |      | Postage \$150/mo x 12 months = \$ |
|     |     |      |      |      | 1,800                             |
|     |     |      |      |      |                                   |
|     |     |      |      |      | Caregiver Forum meeting room      |
|     |     |      |      |      | rentals                           |
|     |     |      |      |      |                                   |
|     |     |      |      |      | \$200/day x 12 forums = \$ 2,400  |
|     |     |      |      |      |                                   |
|     |     |      |      |      | Respite Training Scholarships =   |
|     |     |      |      |      | \$1,600                           |
+-----+-----+------+------+------+-----------------------------------+
| *   | 0   | 0    | 0    | 0    | None                              |
| *In |     |      |      |      |                                   |
| dir |     |      |      |      |                                   |
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| rge |     |      |      |      |                                   |
| s** |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+
| ##  | \$2 | \$58 | \$27 | \    |                                   |
| ### | 67, | ,000 | ,767 | $352 |                                   |
|  TO | 100 |      |      | ,267 |                                   |
| TAL |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+

Attachment C: Budget Narrative -- Page 1 -- Sample Format

**Budget Interval: *[(e.g. 9/30/2008- 9/30/2009) ]{.mark}***

**Match Requirement: [(*e.g. 25%, 35%, or 45%)*]{.mark}**

+-----+------+------+------+------+-----------------------------------+
| >   | *    | **N  | **N  | # T  | ### Justification                 |
|  ** | *Fed | on-F | on-F | OTAL |                                   |
| Obj | eral | eder | eder |      |                                   |
| ect | Fun  | al** | al** |      |                                   |
| >   | ds** |      |      |      |                                   |
|  Cl |      | **Ca | **I  |      |                                   |
| ass |      | sh** | n-Ki |      |                                   |
| > C |      |      | nd** |      |                                   |
| ate |      |      |      |      |                                   |
| gor |      |      |      |      |                                   |
| y** |      |      |      |      |                                   |
+-----+------+------+------+------+-----------------------------------+
| *   |      |      |      |      |                                   |
| *Pe |      |      |      |      |                                   |
| rso |      |      |      |      |                                   |
| nne |      |      |      |      |                                   |
| l** |      |      |      |      |                                   |
+-----+------+------+------+------+-----------------------------------+
| **  |      |      |      |      |                                   |
| Fri |      |      |      |      |                                   |
| nge |      |      |      |      |                                   |
| B   |      |      |      |      |                                   |
| ene |      |      |      |      |                                   |
| fit |      |      |      |      |                                   |
| s** |      |      |      |      |                                   |
+-----+------+------+------+------+-----------------------------------+
| *   |      |      |      |      |                                   |
| *Tr |      |      |      |      |                                   |
| ave |      |      |      |      |                                   |
| l** |      |      |      |      |                                   |
+-----+------+------+------+------+-----------------------------------+
| *   |      |      |      |      |                                   |
| *Eq |      |      |      |      |                                   |
| uip |      |      |      |      |                                   |
| men |      |      |      |      |                                   |
| t** |      |      |      |      |                                   |
+-----+------+------+------+------+-----------------------------------+

**Attachment C: Budget Narrative -- Page 2 -- Sample Format**

**Budget Interval: *[(e.g. 9/30/2008- 9/30/2009) ]{.mark}***

**Match Requirement: [(*e.g. 25%, 35%, or 45%)*]{.mark}**

+------+------+------+----+------+-----------------------------------+
| >    | *    | **N  | *  | # T  | ### Justification                 |
| **Ob | *Fed | on-F | *N | OTAL |                                   |
| ject | eral | eder | on |      |                                   |
| > C  | Fun  | al** | -F |      |                                   |
| lass | ds** |      | ed |      |                                   |
| > Ca |      | **Ca | er |      |                                   |
| tego |      | sh** | al |      |                                   |
| ry** |      |      | ** |      |                                   |
|      |      |      |    |      |                                   |
|      |      |      | *  |      |                                   |
|      |      |      | *I |      |                                   |
|      |      |      | n- |      |                                   |
|      |      |      | Ki |      |                                   |
|      |      |      | nd |      |                                   |
|      |      |      | ** |      |                                   |
+------+------+------+----+------+-----------------------------------+
| **Su |      |      |    |      |                                   |
| ppli |      |      |    |      |                                   |
| es** |      |      |    |      |                                   |
+------+------+------+----+------+-----------------------------------+
| **C  |      |      |    |      |                                   |
| ontr |      |      |    |      |                                   |
| actu |      |      |    |      |                                   |
| al** |      |      |    |      |                                   |
+------+------+------+----+------+-----------------------------------+
| *    |      |      |    |      |                                   |
| *Oth |      |      |    |      |                                   |
| er** |      |      |    |      |                                   |
+------+------+------+----+------+-----------------------------------+
| **   |      |      |    |      |                                   |
| Indi |      |      |    |      |                                   |
| rect |      |      |    |      |                                   |
| C    |      |      |    |      |                                   |
| harg |      |      |    |      |                                   |
| es** |      |      |    |      |                                   |
+------+------+------+----+------+-----------------------------------+
| ###  |      |      |    |      |                                   |
| ## T |      |      |    |      |                                   |
| OTAL |      |      |    |      |                                   |
+------+------+------+----+------+-----------------------------------+

Attachment D: Project Work Plan, Page 1 -- Sample Format

  --------------- ------------------------------- ---------- ------------- ------- ------- ------- ------- ------- ------- ------- ------- -------- -------- --------
  **Goal:**                                                                                                                                                  

  **Measurable                                                                                                                                               
  Outcome(s):**                                                                                                                                              

  **Major         **Key Tasks**                   **Lead     **Timeframe                                                                                     
  Objectives**                                    Person**   (Start and                                                                                      
                                                             End Date by                                                                                     
                                                             Month)**                                                                                        

                                                             **1**         **2**   **3**   **4**   **5**   **6**   **7**   **8**   **9**   **10**   **11**   **12**

  1\.                                                                                                                                                        

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             

  2\.                                                                                                                                                        

                                                                                                                                                             

                                                                                                                                                             

                                                                                                                                                             
  --------------- ------------------------------- ---------- ------------- ------- ------- ------- ------- ------- ------- ------- ------- -------- -------- --------

Attachment D: Project Work Plan, Page 2 -- Sample Format

  -------------- ------------------------------- ---------- ------------- ------- ------- ------- ------- ------- ------- ------- ------- -------- -------- --------
  **Major        **Key Tasks**                   **Lead     **Timeframe                                                                                     
  Objectives**                                   Person**   (Start and                                                                                      
                                                            End Date by                                                                                     
                                                            Month)**                                                                                        

                                                            **1**         **2**   **3**   **4**   **5**   **6**   **7**   **8**   **9**   **10**   **11**   **12**

  3\.                                                                                                                                                       

                                                                                                                                                            

                                                                                                                                                            

                                                                                                                                                            

  4\.                                                                                                                                                       

                                                                                                                                                            

                                                                                                                                                            

                                                                                                                                                            
  -------------- ------------------------------- ---------- ------------- ------- ------- ------- ------- ------- ------- ------- ------- -------- -------- --------

Attachment D: Project Work Plan, Page 3 -- Sample Format

  -------------- ------------------------------- ---------- ------------- ------- ------- ------- ------- ------- ------- ------- ------- -------- -------- --------
  **Major        **Key Tasks**                   **Lead     **Timeframe                                                                                     
  Objectives**                                   Person**   (Start and                                                                                      
                                                            End Date by                                                                                     
                                                            Month)**                                                                                        

                                                            **1**         **2**   **3**   **4**   **5**   **6**   **7**   **8**   **9**   **10**   **11**   **12**

  5\.                                                                                                                                                       

                                                                                                                                                            

                                                                                                                                                            

                                                                                                                                                            

  6\.                                                                                                                                                       

                                                                                                                                                            

                                                                                                                                                            

                                                                                                                                                            
  -------------- ------------------------------- ---------- ------------- ------- ------- ------- ------- ------- ------- ------- ------- -------- -------- --------

NOTE: Please do note infer from this sample format that your work plan
must have 6 major objectives. If you need more pages, simply repeat this
format on additional pages.

**Attachment E:**

Instructions for Completing the Project Summary/Abstract

-   All applications for grant funding must include a Summary/Abstract
    that concisely describes the proposed project. It should be written
    for the general public.

-   To ensure uniformity, please limit the length to no more than 265
    words on a single page with a font size of not less than 11,
    doubled-spaced.

-   The abstract must include the project's goal(s), objectives, overall
    approach (including target population and significant partnerships),
    anticipated outcomes, products, and duration. The following are very
    simple descriptions of these terms, and a sample Compendium
    abstract.

> **Goal(s)** -- broad, overall purpose, usually in a mission statement,
> i.e. what you want to do, where you want to be
>
> **Objective(s)** -- narrow, more specific, identifiable or measurable
> steps toward a goal. Part of the planning process or sequence (the
> "how"). Specific performances which will result in the attainment of a
> goal.
>
> **Outcomes -** measurable results of a project. Positive benefits or
> negative changes, or measurable characteristics that occur as a result
> of an organization's or program's activities. (outcomes are the
> end-point)

**Products --** materials, deliverables.

-   A model abstract/summary is provided below:

> The grantee, Okoboji University, supports this three year Dementia
> Disease demonstration (DD) project in collaboration with the local
> Alzheimer's Association and Related Dementias groups. The
> [goal]{.underline} of the project is to provide comprehensive,
> coordinated care to individuals with memory concerns and to their
> caregivers. The approach is to expand the services and to integrate
> the bio-psycho-social aspects of care. The [objectives]{.underline}
> are: 1) to provide dementia specific care, i.e., care management fully
> integrated into the services provided; 2) to train staff, students and
> volunteers; 3) to establish a system infrastructure to support
> services to individuals with early stage dementia and to their
> caregivers; 4) to develop linkages with community agencies; 5) to
> expand the assessment and intervention services; 6) to evaluate the
> impact of the added services; 7) to disseminate project information.
> The expected [outcomes]{.underline} of this DD project are: patients
> will maintain as high a level of mental function and physical
> functions (thru Yoga) as possible; caregivers will increase ability to
> cope with changes; and pre and post -- project patient evaluation will
> reflect positive results from expanded and integrated services. The
> [products]{.underline} from this project are: a final report,
> including evaluation results; a website; articles for publication;
> data on driver assessment and in-home cognitive retraining; abstracts
> for national conferences.

ATTACHMENT F:

# Annotated Bibliography:

**Evidence-Based Interventions That Target People with ADRD**

**or their Caregivers**

AoA is aware of a limited number of evidence-based program interventions
to help address the needs of people with Alzheimer's disease and related
dementias and their family caregivers. These program interventions are
listed below and are appropriate for states to propose as evidence-based
interventions for the purposes of an application under this program
announcement. AoA expects that each applicant propose to implement only
ONE intervention. Proposing to implement additional interventions will
not earn a higher reviewer score. We have grouped the evidence-based
interventions of which we are aware into three categories:

-   Early-Stage Dementia Interventions

-   Interventions for Persons with Dementia

-   Interventions for Caregivers

Other program interventions of which we are not adequately informed that
specifically target people with ADRD or their caregivers can be
proposed. If you propose to translate and evaluate evidence-based
research other than those listed below, please include a copy of the
journal article(s) that detail the original study and outcomes with your
application. Additionally, if you choose an intervention which is not
listed below, it must be categorized into one of the three intervention
categories listed above and be consistent with AoA's definition of an
evidence-based intervention.

This annotated bibliography contains interventions in the three
intervention categories that are known to AoA and that fit AoA's
definition of evidence-based interventions. We have included hyperlinks
to the abstracts for the evidence-based interventions. Few full-text
articles are available online at no cost. However, once you access the
websites, there is information on how to purchase the full-text
articles. If purchasing the full-text articles is not feasible, you
should consider working with a library to gain access to the journals.

## [Early-Stage Dementia Interventions]{.underline}

**Brief Occupational Therapy Intervention**

Dooley, N., and Hinojosa, J. (2004). Improving Quality of Life for
Persons With Alzheimer's Disease and Their Family Caregivers: Brief
Occupational Therapy Intervention. *American Journal of Occupational
Therapy*, 58(5), 561--569.

[http://www1.aota.org/ajot/abstract.asp?IVol=58&INum=5&ArtID=9&Date=September/October%202004](http://www1.aota.org/ajot/abstract.asp?IVol=58&INum=5&ArtID=9&Date=September/October 2004)

This study examined the extent to which adherence to occupational
therapy recommendations would increase the quality of life of persons
with Alzheimer's disease living in the community and decrease the burden
felt by family members caring for them. Caregiving strategies that were
recommended to participant pairs in the treatment group generally fell
into three categories: environmental modifications, caregiver
approaches, and community-based assistance. All participants received a
combination of all three types of recommendations. The population
targeted was people diagnosed with possible or probable Alzheimer's
disease in mild to moderate stages of impairment. Treatment had a
significant effect, in the expected direction, on caregiver burden, and
on positive affect, activity frequency, and self-care status for the
person with Alzheimer's disease.

**Cleveland Alzheimer's Managed Care Demonstration**

Bass, D.M., Clark, P.A., Looman, W.J., McCarthy, C.A., & Eckert, S.
(2003). The Cleveland Alzheimer's Managed Care Demonstration: Outcomes
after 12 months of implementation, *The Gerontologist*, 43(1), 73-85.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/43/1/73>

Clark PA, Bass DM, Looman WJ, McCarthy CA, & Eckert S. (2004). Outcomes
for patients with dementia from the Cleveland Alzheimer's Managed Care
Demonstration. *Aging & Mental Health, 8*(1), 40-51.

<http://www.ingentaconnect.com/content/routledg/camh/2004/00000008/00000001/art00006;jsessionid=e4nsbilpqphpt.alice?format=print>

This intervention, delivered by a local Alzheimer's Association chapter,
provided care consultations to people with dementia and their families
who were members of a managed care organization. This telephone
intervention included a structured initial assessment, identifying
problems or challenges, and developing strategies for using personal,
family and community resources. The targeted populations was people with
a diagnosis of dementia or a symptom code indicating memory loss, aged
55 or over, residing outside of a nursing home. The intervention
resulted in significantly reduced caregiver depression and increased
caregiver satisfaction with services provided by the managed care
organization. For patients, the intervention resulted in significantly
decreased feelings of embarrassment and isolation related to their
memory problems and decreased self-reported difficulty in coping. For
patients whose memory problems worsened over the year of the study, the
intervention resulted in significantly less likelihood of an emergency
room visit or hospitalization, decreased depression, and increased
satisfaction with services provided by the managed care organization.

**Project CARE**

Gonyea, J., O'Connor, M., and Boyle, P. (2006). Project CARE: A
Randomized Controlled Trial of a Behavioral Intervention Group for
Alzheimer's Disease Caregivers. *The Gerontologist*, 46(6), 827--832.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/46/6/827>

This is a 5-week targeted, multi-component group intervention for
Alzheimer's caregivers aimed at reducing caregiver distress as well as
general caregiver burden, and decreasing neuropsychiatric symptoms among
the care recipients with dementia. The intervention utilizes three
primary behavioral components including behavioral management training,
pleasant events training, and relaxation training. Care recipients were
limited to those whose level of dementia severity falls in the mild to
moderate range. Compared with caregivers in the control group,
caregivers in the behavioral intervention group displayed significantly
greater reductions in caregiver distress related to neuropsychiatric
symptoms.

## [Interventions for Persons with Dementia]{.underline}

**Nighttime Insomnia Treatment and Education for Alzheimer's Disease
(NITE-AD)**

McCurry, S., Gibbons, L., Logsdon, R., Vitiello, M., and Teri, L.
(2005). Nighttime Insomnia Treatment and Education for Alzheimer's
Disease: A Randomized, Controlled Trial. *Journal of the American
Geriatric Society*, 53, 793--802.

<http://www.blackwell-synergy.com/doi/abs/10.1111/j.1532-5415.2005.53252.x>

NITE-AD is a 2-month intervention program on sleep in people with
dementia living at home with family caregivers. The intervention was
introduced in six sessions over 6 weeks. The targeted population was
people with dementia living at home with family caregivers. Patients
showed significantly posttest differences with control subjects,
including reductions in number of nighttime awakenings, total time awake
at night, depression, and an increase in mean weekly exercise days. A
treatment manual is available for both the active treatment and contact
control conditions described in the McCurry et al. 2005

**Reducing Disability in Alzheimer's Disease (RDAD)**

Teri, L., Logsdon, R.G., Uomoto, J., and McCurry, S.M. (1997).
Behavioral Treatment of Depression in Dementia Patients: A Controlled
Clinical Trial. *Journals of Gerontology: Psychological Sciences and
Social Sciences, 52B(4),* P159--P166.

<http://psychsoc.gerontologyjournals.org/cgi/content/abstract/52/4/P159>

Teri, L., Gibbons, L., McCurry, S., Logsdon, R., Buchner, D., Barlow,
W., Kukull, W., LaCroix, A., McCormick, W., and Larson, E. (2003).
Exercise Plus Behavioral Management in Patients with Alzheimer's
Disease: A Randomized Controlled Trial. *Journal of the American Medical
Association*, 290(15), 2015--2022.

<http://jama.ama-assn.org/cgi/content/abstract/290/15/2015>

RDAD provides a home-based program of exercise combined with caregiver
training in behavioral management techniques. The targeted population
was people with dementia who are community-dwelling, ambulatory, and
live with an actively involved spouse or other adult family caregiver.
At 3 months, people in the treatment group were exercising significantly
more often than people in the control and had significantly improved
physical functioning and mobility, reduced days of restricted activity,
and reduced depression. Compared with people in the control group,
people in the treatment group continued to have significantly improved
physical functioning and mobility and significantly reduced depression
after 2 years. The intervention treatment manual is available.

## [Interventions for Caregivers]{.underline}

**Coping with Caregiving**

Gallagher-Thompson, D., Coon, D., Solano, N., Ambler, C., Rabinowitz,
Y., and Thompson, L. (2003). Change in Indices of Distress Among Latino
and Anglo Female Caregivers of Elderly Relatives With Dementia:
Site-Specific Results From the REACH National Collaborative Study. *The
Gerontologist*, 43(4), 580--591.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/43/4/580>

Coping with Caregiving (CWC) is a psychoeducational group intervention
based on the work of Beck and Lewinsohn. CWC taught cognitive-behavioral
mood management skills. Participants in the Coping with Caregiving
intervention have reported a significant reduction in depressive
symptoms, increased use of adaptive coping strategies, and a trend
toward decreased use of negative coping strategies

**Home Environmental Skill Building (ESP)**

Gitlin, L., Winter, L., Corcoran, M., Dennis, M., Schinfeld, S., and
Hauck, W. (2003). Effects of the Home Environmental Skill-Building
Program on the Caregiver--Care Recipient Dyad: 6-Month Outcomes From the
Philadelphia REACH Initiative. *The Gerontologist*, 43(4), 532--546.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/43/4/532>

Gitlin, L., Hauck, W., Dennis, M., and Winter, L. (2005). Maintenance of
Effects of the Home Environmental Skill-Building Program for Family
Caregivers and Individuals with Alzheimer's disease and Related
Disorders. *Journal of Gerontology: Medical Sciences*, 60A(3), 368--374.

<http://biomed.gerontologyjournals.org/cgi/content/abstract/60/3/368?ck=nck>

The Environmental Skill-Building Program (ESP) study was a part of the
National Institutes of Health initiative, Resources for Enhancing
Alzheimer's Caregiver Health (REACH). ESP has four elements: (1)
education about dementia and the impact of the home environment on
troublesome behaviors and deficits in activities of daily living, (2)
instruction in problem solving and developing effective approaches to
manage caregiving concerns that involve manipulating the physical and
social environment, (3) implementation of environmental strategies
tailored to the caregiver's context, and (4) generalization of
strategies to emerging problems. Strategies may involve changing the
physical environment, simplifying interactions with the care recipient,
and enhancing the support of the caregiver's social network. After 6
months, treatment group caregivers reported a significant reduction in
the person's behavioral symptoms and a significant improvement in their
own affect and caregiving skills while control group caregivers reported
opposite trends.

**New York University Caregiver Intervention**

Mittelman, M., Ferris, S., Shulman, E., Steinberg, G., and Levin, B.
(1996). A Family Intervention to Delay Nursing Home Placement of
Patients with Alzheimer Disease - A Randomized Controlled Trial.
*Journal of the American Medical Association,* 276(21), 1725--1731.

<http://jama.ama-assn.org/cgi/content/abstract/276/21/1725>

Mittelman, M., Roth, D., Coon, D., and Haley, W. (2004). Sustained
Benefit of Supportive Intervention for Depressive Symptoms in Caregivers
of Patients With Alzheimer's Disease. *American Journal of Psychiatry,*
161, 850--856.

<http://ajp.psychiatryonline.org/cgi/content/abstract/161/5/850>

Mittelman, M., Haley, W., Clay, O., and Roth, D. (2006). Improving
Caregiver Well-Being Delays Nursing Home Placement of Patients with
Alzheimer Disease. *Neurology,* 67, 1592--1599.

<http://www.neurology.org/cgi/content/abstract/67/9/1592>

This is a multifaceted structured treatment program for
spouse-caregivers of persons with Alzheimer's disease. The goal of the
intervention was to enable spouse-caregivers to postpone or avoid
nursing home placement while minimizing the negative consequences to the
caregivers. Treatment included individual and group counseling, support
groups, and ad hoc counseling.

The intervention resulted in a significant reduction in caregiver
depression and caregiver negative reactions to the person's behavioral
symptoms. Time to nursing home placement was 1.5 years longer for people
in the treatment group than for people in the control group. An
intervention manual is available: *Counseling the Alzheimer's Caregiver:
A Resource for Health Care Professionals* (Chicago, IL: AMA Press,
2003).

**Nine-Week Cognitive-Behavioral Intervention to Reduce Anxiety in
Caregivers of People with Dementia**

Akkerman, R.L., and Ostwald, S.K. (2004). Reducing Anxiety in
Alzheimer's Disease Family Caregivers: The Effectiveness of Nine-Week
Cognitive-Behavioral Intervention. *American Journal of Alzheimer's
Disease and Other Dementias,* 19(2), 117--123.

<http://aja.sagepub.com/cgi/content/abstract/19/2/117>

This study evaluates the effective of a 9-week cognitive-behavioral
group therapy intervention for anxious community-dwelling family
caregivers of persons diagnosed with Alzheimer's disease. After the
active group received the intervention, anxiety levels for the active
group declined from a mean of 15.39 on the Beck Anxiety Inventory at
baseline to a mean of 7.72 at the 10-week post intervention and 6.92 at
the 16 week assessment.

**Progressively Lowered Stress Threshold (PLST) Model**

Garand, L., Buckwalter, K.C., Lubaroff, D.M. et al. (2002). A Pilot
Study of Immune and Mood Outcomes of a Community-Based Intervention for
Dementia Caregivers: The PLST Intervention. *Archives of Psychiatric
Nursing*, 16*,* 156--167.

<http://www.blackwell-synergy.com/doi/abs/10.1111/j.1532-5415.2004.52473.x?journalCode=jgs>

Buckwalter, K.C., Gerdner, L., Kohout, F., Hall, G.R., Kelly, A.,
Richards, B., et al. (1999). A Nursing Intervention to Decrease
Depression in Family Caregivers of Persons with Dementia. *Archives of
Psychiatric Nursing,* 13(2), 80-88.

<http://www.ncbi.nlm.nih.gov/pubmed/10222636>

The progressively lowered stress threshold (PLST) model developed
provides the foundation for a psychoeducation intervention to assist
formal and informal caregivers in understanding behaviors and planning
care for persons with dementia (PWD). To achieve this purpose the model
addresses three dimensions of dementia and the interaction of these
dimensions across the disease process. The three dimensions include: 1)
losses associated with cognitive decline and their accompanying symptom
clusters, 2) behavioral states, and 3) stage of the disease process. An
important assumption of the PLST model is that all behavior has meaning,
therefore, all stress-related behavior has an underlying cause. An
experimental 3-year study evaluated the effectiveness of a family
caregiver training program based on the PLST model. The intervention is
a community-based psycho-educational nursing intervention that teaches
family caregivers to manage behavioral problems of people with dementia
on caregiver affective responses, primarily depression. At 6 months the
experimental group caregivers were significantly less depressed on the
Profile of Moods States Depression-Dejection subscale than those of the
comparison group, but this difference became insignificant at 12 months.

**REACH II**

Belle, S., Burgio, L., Burns, R., Coon, D., Czaja, S.,
Gallagher-Thompson, D., Gitlin, L., Klinger, J., Koepke, K., Lee, C.,
Martindale-Adams, J., Nichols, L., Schulz, R., Stahl, S., Stevens, A.,
Winter, L., and Zhang, S. (2006). Enhancing the Quality of Life of
Dementia Caregivers from Different Ethnic or Racial Groups - A
Randomized, Controlled Trial. *Annals of Internal Medicine*, 145,
727--738.

<http://www.annals.org/cgi/content/abstract/145/10/727>

Nichols, L., Chang, C., Lummus, A., Burns, R., Martindale-Adams, J.,
Graney, M., Coon, D., and Czaja, S. (2007). The Cost-Effectiveness of a
Behavior Intervention with Caregivers of Patients with Alzheimer's
Disease. *Journal of the American Geriatric Society,* 56(3), 413--420.

<http://www.blackwell-synergy.com/doi/abs/10.1111/j.1532-5415.2007.01569.x>

REACH II combined the elements of the diverse interventions tested in
REACH I into a single multi-component psychosocial intervention.
Components of the intervention targeted five problem areas: caregiver
burden, emotional well-being, self-care and health behaviors, social
support, and care-recipient problem behaviors. An underlying assumption
was that the intervention would reduce the time spent in caregiving
activities by reducing the amount of caregiver stress and by improving
the caregiver's ability to manage behavior problems. Results showed
positive outcomes in social support, depression, and positive aspects of
caregiving. However, activities of daily living stress and behavioral
bother did not change for the better for caregivers.

**Savvy Caregiver**

Ostwald, S., Hepburn, K., Caron, W., Burns. T., and Mantell, R. (1999).
Reducing Caregiver Burden: A Randomized Psychoeducational Intervention
for Caregivers of Persons with Dementia. *The Gerontologist*, 39(3),
299--309.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/39/3/299>

Hepburn, K., Lewis, M., Sherman, C., and Tornatore, J. (2003). The Savvy
Caregiver Program: Developing and Testing a Transportable Dementia
Family Caregiver Training Program. *The Gerontologist*, 43(6), 908--915.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/43/6/908>

Scharf, L., Bell, P., and Smith, S. (2006). Number of Training Sessions
Does Not Change Program Effectiveness - Evaluation of Formats of One,
Two, or Three Sessions for the Alzheimer's Savvy Caregiver Training
Program. *Dementia,* 5(4), 559--569.

<http://dem.sagepub.com/cgi/content/refs/5/4/559>

Savvy Caregiver is an intervention designed to increase caregiver skills
and confidence, create reliable and accessible networks of support for
caregivers, and increase access to supportive services. The program
consists of approximately 12 hours of sessions that involve
accomplishing various objectives for the caregivers (e.g., acknowledging
the disease, developing emotional tolerance, taking control) in addition
to providing them with a caregiver manual and educational CD-ROM. The
intervention resulted in significantly reduced caregiver negative
reactions to the person's behavioral symptoms and caregiver burden while
the control caregivers had substantial increases in burden. Materials
for the intervention include a detailed trainer's manual and a
caregiver's manual and are available in English and Spanish.

**STAR-Caregiver**

Logsdon, R., McCurry, S., and Teri, L. (2005). Star Caregivers - A
Community-based Approach for Teaching Family Caregivers to Use
Behavioral Strategies to Reduce Affective Disturbances in Persons With
Dementia. *Alzheimer\'s Care Quarterly*, 6(2), 146--153.

<http://www.acqjournal.com/pt/re/acq/abstract.00130990-200504000-00008.htm;jsessionid=LvJDLjFT3X1v45RywnSTr7QYXXLQmhTQJ5pQmnq3qY9p16brNv09!-1787533625!181195629!8091!-1>

Teri, L., McCurry, S., Logsdon, R., and Gibbons, L. (2005). Training
Community Consultants to Help Family Members Improve Dementia Care: A
Randomized Controlled Trial. *The Gerontologist,* 45(6), 802--811.

<http://gerontologist.gerontologyjournals.org/cgi/content/abstract/45/6/802>

STAR-C is a behavioral intervention to decrease depression and anxiety
in individuals with Alzheimer's disease and their family caregivers. The
STAR-C program was able to teach caregivers new behavioral strategies
and to change their own behaviors. The caregivers were able to have a
positive impact on the behaviors of their care recipients.

ATTACHMENT G:

**Cost Analysis -- Sample Format**

> A cost analysis is one of the required products for these projects. A
> cost analysis provides an estimation of the cost of program start-up
> and operation and the costs of serving clients as the program matures.
> A sample cost analysis template is inserted below.

![](media/image1.wmf)

**Attachment H**

**Survey Instructions on Ensuring Equal Opportunity for Applicants**

**Applicant Organization's Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Applicant's DUNS Number:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Grant Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_CFDA
Number: \_\_\_\_\_\_\_\_\_\_\_**

1\. Does the applicant have 501(c)(3) status?

Yes No

2\. How many full-time equivalent employees does the applicant have?
*(Check only one box).*

> 3 or Fewer 15-50
>
> 4-5 51-100
>
> 6-14 over 100

3\. What is the size of the applicant's annual budget? *(Check only one
box.)*

Less Than \$150,000

\$150,000 - \$299,999

\$300,000 - \$499,999

\$500,000 - \$999,999

\$1,000,000 - \$4,999,999

\$5,000,000 or more

4\. Is the applicant a faith-based/religious\
organization?

Yes No

5\. Is the applicant a non-religious community-based organization?

Yes No

6\. Is the applicant an intermediary that will manage the grant on
behalf of other organizations?

> Yes No

7\. Has the applicant ever received a government grant or contract
(Federal, State, or local)?

Yes No

8\. Is the applicant a local affiliate of a national\
organization?

Yes No

**Attachment H, page 2**

**Provide the applicant's (organization) name and DUNS number and the
grant name and CFDA number.**

1\. 501(c)(3) status is a legal designation provided on application to
the Internal Revenue Service by eligible organizations. Some grant
programs may require nonprofit applicants to have 501(c)(3) status.
Other grant programs do not.

2\. For example, two part-time employees who each work half-time equal
one full-time equivalent employee. If the applicant is a local affiliate
of a national organization, the responses to survey questions 2 and 3
should reflect the staff and budget size of the local affiliate.

3\. Annual budget means the amount of money your organization spends
each year on all of its activities.

4\. Self-identify.

5\. An organization is considered a community-based organization if its
headquarters/service location shares the same zip code as the clients
you serve.

6\. An "intermediary" is an organization that enables a group of small
organizations to receive and manage government funds by administering
the grant on their behalf.

7.  Self-explanatory.

8.  Self-explanatory.

**Paperwork Burden Statement**

According to the Paperwork Reduction Act of 1995, no persons are
required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control
number for this information collection is 1890-0014. The time required
to complete this information collection is estimated to average five (5)
minutes per response, including the time to review instructions, search
existing data resources, gather the data needed, and complete and review
the information collection. **If you have any comments concerning the
accuracy of the time estimate(s) or suggestions for improving this form,
please write to:** U.S. Department of Education, Washington, D.C.
2202-4651.

**If you have comments or concerns regarding the status of your
individual submission of this form, write directly to:** Joyce I. Mays,
Application Control Center, U.S. Department of Education, 7^th^ and D
Streets, SW, ROB-3, Room 3671, Washington, D.C. 20202-4725

OMB No. 1890-0014 Exp. 1/31/2006

[^1]: Alzheimer's Association, 2008 Alzheimer's Disease Facts and
    Figures. *Alzheimer's and Dementia, 4(2).*

[^2]: Alzheimer's Association, 2008 Alzheimer's Disease Facts and
    Figures. *Alzheimer's and Dementia, 4(2).*

[^3]: Larson, EB; Shadlen, M; Wang, L; McCormick, WC; Bowen, JD, Teri,
    L; et al.  "Survival after initial diagnosis of Alzheimer disease."
    *Annals of Internal Medicine* 2004;140:501-509.