**OMB Approval No. 0985-0018**

**Model Approaches to**

**Statewide Legal Assistance Systems**

**Program Announcement and Grant Application Instructions**

**U.S. Administration on Aging**

**2007**

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

**Administration on Aging (AoA)**

**AoA Center:** Center for Wellness and Community-Based Services

**Funding Opportunity Title:** Model Approaches to Statewide Legal
Assistance Systems

**Announcement Type:** Initial

**Funding Opportunity Number:** HHS-2007-AoA-SL-0709

**Catalog of Federal Domestic Assistance (CFDA) Number:** 93.048

**Key Dates:** The deadline date for receipt of applications is July 13,
2007.

######## Executive Summary: 

With this grant opportunity, AoA maintains support for state leadership
efforts to develop integrated, coordinated state legal services delivery
systems that incorporate low-cost delivery mechanisms with Title III-B
legal services and other available legal resources in order to provide
maximum benefit and minimum overlap or duplication of effort from the
combined legal resources for elders in the state. Through this program
announcement, AoA plans to award seven (7) cooperative agreements to
support eligible states (see below) in developing approaches that will
maximize the use of federal, state, and other funds by incorporating the
utilization of low-cost legal services mechanisms into the state legal
services planning and development process. The awards will be
cooperative agreements because AoA will be substantially involved in the
development and execution of the activities of the projects.

Each cooperative agreement will be funded at a federal share of
approximately \$100,000 per year for a project period of three years,
contingent upon the availability of federal funds.

The intent of this announcement is to expand the Model Approaches to
Statewide Legal Assistance Systems program beyond the initial six states
of Alabama, Idaho, Iowa, Maryland, North Dakota, and Virginia. Awards
will be made to the entity within each eligible state that currently
houses (or proposes to house) the Legal Services Developer. Eligible
applicants include domestic public or private and non-profit entities
including state, local and Indian tribal governments, faith-based
organizations, community-based organizations, hospitals, and
institutions of higher education.

[]{.mark}

If the Legal Services Developer is not housed within the state unit on
aging, the applicant must provide a letter of commitment from the state
unit that clearly delineates the state unit's support of the application
and the role and responsibility of the state unit in support of this
effort. In addition, successful grantees must collaborate with an entity
experienced in providing legal services to older persons within that
state through a low-cost service delivery mechanism, such as the senior
legal helpline model, funded by AoA under the Title IV Legal Assistance
Grants Program. The purpose of this collaboration is to promote greater
involvement of expertise in various components of a comprehensive legal
services delivery system, and applications must detail how this
collaboration will be structured and accomplished.

**I. FUNDING OPPORTUNITY DESCRIPTION**

###### Background

The Older Americans Act (OAA) is one of the top funding sources for
senior legal assistance for those in social and economic need. Title
III-B funding provides support to approximately 1,000 legal services
providers nationwide who work to ensure that older Americans in greatest
need of help receive legal assistance, advice, and representation. These
providers help to address critical threats to independence (such as loss
of one\'s home through predatory lending and consumer scams), and
protect and enhance essential benefits such as food stamps, supplemental
security income and other public benefits that promote safety, health,
and independence. Under Title IV of the OAA, the Administration on Aging
(AoA) has provided grants in a number of states to support low-cost
legal service delivery mechanisms such as the senior legal helpline
model. These low-cost models were shown to be valuable and effective in
providing older Americans and their caregivers with important
information in areas such as consumer protection, public benefits, and
health and financial advance planning. In addition, Title IV funding
supports five (5) national legal resource centers that work to improve
the quality and accessibility of the legal assistance provided to older
people across the United States. The grantees provide state and area
agencies, elder law attorneys and aging services providers with
training, fact sheets, and other written materials, case consultations,
and help with service delivery issues.

In an effort to prevent duplication of effort and enhance protections
for seniors, many legal providers coordinate their activities with other
members of the aging network. For example, legal providers offer
training to case managers on how seniors can avoid being victimized by
predatory lenders, and area agencies on aging (AAAs) arrange
transportation to legal programs for elder abuse victims who need to
file restraining orders. Legal providers also provide training to aging
network staff and seniors on elder law topics such as guardianship,
Medicare, and reverse mortgages.

To promote and enhance this type of coordination, the OAA requires each
state to appoint a state Legal Services Developer. Similar to a state
long-term care ombudsman, this person enhances and coordinates the
state's legal services and elder rights programs. Specific duties can
include:

-   Providing technical assistance and training to local legal
    assistance programs and aging services providers;

-   Developing statewide reporting and outcome measurement systems to
    enhance results-oriented accountability;

-   Coordinating the activities of legal programs with AAAs and other
    elder rights programs such as ombudsmen, legal hotlines, Adult
    Protective Services (APS), and public guardians; and

-   Developing statewide standards that define what a quality legal
    assistance system is for the state and that help ensure that legal
    services are targeted to minorities, non-English speakers, rural
    seniors and other underserved groups.

AoA\'s overall goal for legal services under both Titles III and IV of
the OAA is to protect the rights and financial security of older
persons, and enhance their choice and independence. Although technology
has improved the quality and quantity of elder rights information and
services for many, there remains a great need to enhance seniors' access
to legal services, particularly for the underserved and most vulnerable
older adults. It is for this reason that AoA has supported efforts to
provide states with a cost-effective way to increase the number of
seniors who receive low-cost legal assistance, particularly through the
statewide senior legal helpline model.

Senior legal helplines and other low-cost mechanisms for delivery of
senior legal services have been tested and shown to produce increased
access to needed information and assistance for many seniors in an
efficient, cost-effective, streamlined, and measurable manner. A 1990's
evaluation showed that the initial group of senior legal helplines and
corresponding referral services resolved 81% of older consumers' legal
questions and 50% of their legal problems. Since between 50 and 75% of
calls to legal services entities seek an answer to a legal question,
rather than representation on a legal matter, the average percentage of
cases closed by the helpline component of a full-service program is
69%.[^1] In addition, the costs of reaching resolution for the cases
handled under these grants are extremely low. In 2005, the average cost
per call handled by senior legal helplines was \$42.23, and the average
cost per case was \$62.22.[^2] Furthermore, there has been an increase
in access to quality legal services for an increased number of seniors.
For example, in FY 2005, senior legal helplines funded by the AoA Legal
Assistance Grants Program:

-   Handled over 96,000 calls;

-   Closed nearly 65,000 cases with telephone advice or additional brief
    service; and

-   Reached more than 43,605 seniors through workshops and outreach
    events.[^3]

In addition to the demonstrated efficiency of low-cost legal mechanisms,
the types of services provided by Legal Assistance Grants are greatly
desired by seniors. In 2004, Utah conducted the first statewide survey
of senior legal needs. A majority of seniors (69%) cited a legal
helpline as the most desired service.[^4] Client satisfaction and
problem resolution rates also are very high. In the *2002 AARP
Foundation Senior Legal Hotline Outcome Survey*, it was reported that
87% of respondents rated the helpline advice as helpful or very helpful,
and that 84% of respondents would call the helpline again.

AoA views the low-cost legal delivery models as a critical component in
an overall legal delivery system designed to provide maximum benefit
from limited legal services resources. In FY 2003, AoA broadened its
Senior Legal Helplines Program (currently referred to as Legal
Assistance Grants) by encouraging states to build upon innovative
methods to reach previously underserved populations to augment the
services of the traditional statewide helpline model, such as self-help
offices, interactive websites, and collaborative efforts. In addition, a
focus on linkages with AoA's Eldercare Locator and the AoA-funded
National Legal Resource Centers facilitated streamlined access to senior
legal services and encouraged coordination and integration of legal
services delivery.

Despite the demonstrated efficiency and effectiveness of these programs,
however, they were not being consistently implemented across the
network. Many remained stand-alone programs, not fully coordinated with
full-service legal services programs, with the aging network, or with
other service networks within the state. Some states offered examples of
an effective, integrated approach to meeting the legal needs of their
senior population. Others had identified gaps in their service delivery
systems but were unable to address them due to limited resources or
other reasons. In many states there was not strong evidence of statewide
planning and coordination to make the best possible use of the combined
resources of the state Legal Services Developer, Title III-B legal
services, Title IV low-cost delivery models, and other resources that
are available in a state, such as the private bar and law school
clinics.

To address this deficiency, AoA released a program announcement in FY
2006 titled "Model Approaches to Statewide Legal Assistance Systems."
This was a departure from past announcements for grants to enhance
access to senior legal services. The FY 2006 grants represented an
attempt to modernize the approach to support activities for seniors in a
strategic manner that directly supports the mission of the OAA and that
conceptually and concretely incorporates legal services into the broader
group of OAA support services. As noted above, data demonstrated a
significant level of expertise and benefit in legal services provided
through low-cost mechanisms. Through the FY 2006 grants, AoA endeavored
to bring together within states the multiple components of a
comprehensive legal services delivery system and to share the models
developed, so that the broader network could benefit from the widespread
adoption of low-cost legal services delivery mechanisms and fully
integrated statewide legal assistance systems.

###### Project Objectives and Activities

The purpose of this grant announcement is to continue the efforts begun
in FY 2006, which utilize the leadership of the entity housing the State
Legal Services Developer, in partnership with an entity experienced in
low-cost delivery mechanisms, to develop models for coordinated
statewide delivery systems. Such coordinated models can insure maximum
impact from limited resources by (1) directing low-cost services such as
helplines to those elders who are capable of putting the advice and
information to use to protect their rights and independence; (2)
directing Title III-B resources to those who are the most needy, who
require special outreach, who need in-depth assistance/representation
and who have very limited capacity to advocate on their own behalf; and
(3) developing and promoting other resources such as pro-bono or
reduced-fee wills panels in ways that supplement and reduce demands on
the OAA resources.

With this grant opportunity, AoA maintains support for state leadership
efforts to develop integrated, coordinated state legal services delivery
systems that incorporate low-cost delivery mechanisms with Title III-B
legal services and other available legal resources in order to provide
maximum benefit and minimum overlap or duplication of effort from the
combined legal resources for elders in the state. Activities under these
cooperative agreements promote AoA's legal assistance program objectives
to:

-   Identify the components and levels of integration, funding,
    performance, and results that comprise the current legal services
    delivery system within the states;

-   Improve the overall efficiency of OAA legal services by increasing
    the utilization of low-cost legal services mechanisms;

-   Develop and demonstrate model legal services delivery systems that
    integrate Title III-B legal services, low-cost delivery mechanisms
    and other legal resources; and

-   Expand the adoption of model legal services delivery approaches by
    states.

Upon completion of the cooperative agreements, grantees will be able to
present cost-effective examples of integrated service systems that
increase overall access to services within their states by:

-   Developing new approaches to fully incorporate legal helplines and
    other low-cost mechanisms into the state's legal services system;

-   Demonstrating how to effectively use Title III-B funding to provide
    legal services to those in greatest social and economic need in a
    cost-effective and efficient manner that avoids overlap and
    duplication of effort with other low-cost services;

-   Improving statewide legal services program consistency,
    accountability, and overall program results; and

-   Increasing coordination with aging services delivery system.

Through this program announcement, AoA plans to award seven (7)
cooperative agreements to support states in developing approaches that
will maximize the use of federal, state, and other funds by
incorporating the utilization of low-cost legal services mechanisms into
the state legal services planning and development process. Each
cooperative agreement will be funded at a federal share of approximately
\$100,000 per year for a project period of three years.

The OAA requires the State Legal Services Developer to act as the lead
person to develop and coordinate legal services for the elderly for each
state. Under this grant program, it is expected that the State Legal
Services Developer will have a central role in developing a
state-appropriate approach for ensuring the integration of various legal
services delivery systems---including low-cost mechanisms---into an
overall state legal services system plan. Therefore, awards will be made
to the entity within each state that currently houses, or proposes to
house, the State Legal Services Developer. If the Legal Services
Developer is not housed within the state unit on aging, the applicant
must provide a letter of commitment from the state unit that clearly
delineates the state unit's support of the application and the role and
responsibility of the state unit in support of this effort.

Grants will be awarded to states who best demonstrate their readiness to
more fully incorporate and coordinate the low-cost mechanisms with the
Title III-B services into a comprehensive legal services delivery
system. Applicants preparing proposals under this program announcement
must submit a statewide plan for legal services program integration,
incorporating low-cost legal assistance mechanisms into the statewide
legal services development and delivery program, with the ultimate goal
of providing a comprehensive and cost-effective means of enhancing
access to senior legal services, particularly to those targeted under
the OAA, and making the most efficient use of the various legal resource
to provide superior case outcomes for seniors. Applications are expected
to fully describe the nature of the activities to be undertaken to
develop a coordinated, integrated service delivery system and to address
system gaps and identified issues, the reasons specific activities were
included in the proposal, and how those activities will assist in
achieving overall project goals and objectives for all funding years of
the grant.

In addition, applications will be reviewed and scored based on how well
they address the following requirements:

[A. PLANNING AND IMPLEMENTATION FRAMEWORK: YEARS 1 - 3]{.underline}

Proposals must include a timeline chart or its equivalent listing
project activities in chronological order and showing the target dates
for the projected accomplishments. In addition, proposed projects and
activities are expected to be cost-effective and programmatically
efficient, maximizing federal, state, and local resources. Although AoA
anticipates that each of the proposals is to be unique and to vary
according to the needs and special circumstances of each state, all
projects should describe their activities within the general timeframe
below for each of the grant years.

*Year 1: Planning*. During the Year 1 Planning phase, proposals should
include a discussion of what planning activities will be undertaken, who
will be involved, and the issues to be decided. If a planning period
requiring less than one year is anticipated, the proposal should reflect
an intent to move immediately towards the implementation phase once
planning is completed.

*Year 2: Implementation*. During the Year 2 Implementation phase,
applicants should be implementing their program(s) and preparing the
mechanisms to track progress towards outcomes.

*Year 3: Operation and Data Collection*. During the Year 3 Operation and
Data Collection phase, all programs should be operational and collecting
outcome data. All programs should have at least 12 months of data by the
end of Year 3.

[B. INVOLVEMENT OF STAKEHOLDERS]{.underline}

No effort will be successful without the involvement and support of
stakeholders: "individuals or organizations which stand to gain or lose
from the success or failure of a system."[^5] Stakeholders are all those
who are impacted by, or have an impact on, the project, and their
perspectives must be considered for a project to be successful. AoA
recognizes that in order to foster comprehensive and integrated legal
services delivery systems, a necessary component of successful projects
will include the involvement of the stakeholders within the state,
whether they are Older Americans Act program providers, private
attorneys, Legal Services Corporation providers, or seniors.

Incorporating the utilization of low-cost legal services mechanisms into
the state legal services systems is a primary objective of this grant
program, and therefore providers of legal services through such
mechanisms have been identified by AoA as a priority stakeholder. For
this reason, applicants are required to collaborate with an entity
experienced in providing legal services to older persons within that
state through a low-cost service delivery mechanism, such as the senior
legal helpline model, funded by AoA under the Legal Assistance Grants
Program, other statewide legal hotlines, or similar programs. This
collaboration will promote greater involvement of those with expertise
in various components of a comprehensive legal services delivery system,
and applications must detail how this collaboration will be structured
and accomplished. Applications must describe the nature of the
collaboration with each entity and include letters that further detail
the commitment.

Moreover, applications must discuss outreach strategies that include
close coordination with the broader aging services delivery system,
promote awareness and understanding of the types and levels of services
available from the various components of the state\'s legal services
system, and foster linkages with services providers and professionals in
the broader community-based aging and elder rights networks, including
AAAs, Aging and Disability Resource Centers, state long-term care
ombudsmen, and Adult Protective Services. Applications should address
how pro bono attorneys, the private bar, and law schools, among others,
will be involved in the coordinated service delivery system.
Applications are expected to involve disadvantaged populations,
including limited-English speaking populations, as stakeholders in
planning efforts to serve these target populations with the proposed
legal delivery system.

[C. ASSESSMENT OF NEEDS AND SYSTEM CAPACITY]{.underline}

The population of people 65 and over will increase from 35 million in
2000 to 40 million in 2010 (a 15% increase) and then to 55 million in
2020 (a 36% increase for that decade).

As the aging population grows, it can be expected that the number of
seniors needing legal services will also grow. However, many states do
not have a clear picture of what comprises the specific legal needs of
the seniors in their state. Moreover, many states are not clear about
the capacity of their current legal services delivery systems to meet
those needs. To make the best use of resources, it is essential to have
the best information about what seniors need, what the current legal
services delivery system is able to provide in response to those needs,
and areas where the system should be improved.

Because of the importance of understanding needs before specific
planning and targeting can occur, each grantee will be required to
conduct a needs assessment of seniors and an assessment of the capacity
and gaps of the current legal services delivery system. To the extent
possible, applicants must provide a discussion of the state's current
legal services delivery system (Title III-B programs, low-cost programs
and other resources). The description should include a discussion of
services provided; methods used for outreach to and targeting of the
hard-to-reach; program costs; demographics of program coverage
throughout the state; system capacity and gaps; client needs; and
proposed approaches for addressing identified system and service
weaknesses. Applications should then describe the methodology and
appropriateness of the needs assessment and system analysis they propose
to undertake during the grant. Descriptions of the assessment/analysis
should be feasible and reasonable in terms of time, costs, and resources
in relation to this grant.[^6] If the applicant can demonstrate that a
needs assessment and system analysis has been done of sufficient
representativeness and comprehensiveness within the last three years,
this requirement may be waived.

Proposed activities should be supported by identified needs and be
required to close identified gaps in service. Successful applicants will
have identified a need which they have not as yet been able to meet, or
current activities upon which they wish to improve.

[D. STATEWIDE COVERAGE]{.underline}

Applications must present a plan for providing statewide coverage of
legal services for the elderly. Proposals must present strategies for
reaching low-income, rural, non-English speaking or other important
target groups in the state facing ethnic or cultural barriers to access
of legal services. Applicants should demonstrate how the proposal
contributes to the overall integration and coordination of the delivery
of senior legal services. Proposed activities should ensure a
consistency, uniformity, and quality of the various levels and types of
services provided statewide. Applications should provide an outreach
plan detailing the use of promotional and informational materials and
technology to advertise legal programs and services for seniors
statewide, including strategies for targeting isolated, rural,
limited-English speaking, and other hard-to-reach populations. An
outreach plan which contains a strong interface with existing state
aging services outreach efforts should be included. Strategies should be
detailed for targeting the needy and hard-to-reach populations within
the state, and those currently underserved.

[E. OUTCOMES]{.underline}

Applicants must provide details about the goals, implementation
strategies, and achievable, measurable outcomes of their proposal.
Applications should include plans to develop and track measurable
outcomes to determine the impact of these activities on the
effectiveness and efficiency of the statewide legal delivery system, as
well as on the health, security, independence, and well-being of
vulnerable older adults. At a minimum, applications must demonstrate how
the proposal expands and improves *access* to legal services for older
Americans, particularly for the identified targeted groups. Over the
three year project period, grantees are expected to begin work toward
the development of (1) quality and (2) accountability standards to
ensure:

-   High quality, accessible, and targeted legal services;

-   A range of types and levels of service from self-help materials and
    information to in-depth one-on-one case assistance, and coordination
    of services so overall resources are used most efficiently;

-   Tangible measures of system performance and improvement, including:

    -   outcome measures, particularly the impact of legal services on
        the health, security, independence, and well-being of older
        persons; and

    -   program efficiency measures, including program costs relative to
        clients served; and

-   A statewide system to collect data and report performance results.

[F. CAPACITY AND PROGRAM SUPPORT]{.underline}

Project success and sustainability beyond the grant period are dependent
on adequate program development support and leadership. Therefore, AoA
expects that throughout the grant period, the Project Director and the
State Unit on Aging will have involvement in and substantial knowledge
about all aspects of the project. Applications should describe how this
will be achieved.

The project director and supporting entities must demonstrate their
capacity for carrying out activities and projects related to this grant
announcement. Applicants should demonstrate familiarity with previously
established models of access and delivery, such as the statewide legal
helplines, and the AoA-funded Technical Assistance Project for Statewide
Legal Hotlines. Applications should reflect the knowledge of various
legal services delivery models implemented in states.[^7] Furthermore,
applications must demonstrate knowledge of the history and policy
considerations surrounding access to and delivery of legal services to
older Americans, particularly target populations.

###### Statutory Authority 

The statutory authority for grants under this program announcement is
contained in Title IV of the Older Americans Act (OAA) (42U.S.C. 3032),
as amended by the Older Americans Act Amendments of 2006, P.L. 109-365
(Catalog of Federal Domestic Assistance 93.048, Title IV Discretionary
Projects).

## II. AWARD INFORMATION 

Award Type: Cooperative agreement

Estimated Federal Funds Available: \$745,500 per year

Estimated Number of Awards: Seven (7)

Project Start Date: September 30, 2007

Estimated Length of Project: Three (3) years

AoA plans to fund seven (7) cooperative agreements through this
competition. Each project will be funded at a federal share of
approximately \$100,000 per year for a project period of up to three
years, contingent upon the availability of federal funds.

The award is a cooperative agreement because AoA will be substantially
involved in the development and execution of the activities of the
projects. The grantees and AoA will work cooperatively to determine the
priority activities to be completed by the project and to modify and
execute the project work plans for each year of the project period.

**For this cooperative agreement, the grantee's involvement will
include:**

-   Identifying the components and levels of integration, funding,
    performance, and results that comprise the current legal services
    delivery system within the states;

-   Developing and demonstrating model legal services delivery systems
    that integrate Title III-B legal services, low-cost delivery
    mechanisms and other legal resources;

-   Providing a detailed plan for working toward the above objectives
    that includes: an assessment of the current legal needs of seniors
    within their state; an evaluation of their present legal services
    planning and management structures at the state and local area
    levels; and the development of a plan that effectively and
    efficiently incorporates the use of low-cost mechanisms to address
    identified needs;

-   Seeking technical assistance and support in developing and carrying
    out project work plans; and

-   Presenting cost-effective examples of integrated service systems
    that increase overall access to services within their state and that
    encourage the adoption of model legal services delivery approaches
    by states.

**For this cooperative agreement, AoA's involvement will include:**

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

-   Providing technical assistance and support on grant management and
    implementation issues, including execution of the cooperative
    agreement;

-   Providing technical advice and consultation relative to the 2006 AoA
    Legal Assistance Program goal and objectives;

-   Reviewing and commenting upon all materials, reports, documents,
    etc. produced by the project with funds provided through this award;

-   Defining project performance criteria and expectations;

-   Monitoring, evaluating and supporting the projects' efforts in
    achieving performance goals; and

-   Reviewing the project's performance in deciding upon future funding.

Within 45 days of the award and 45 days of each continuation award, the
grantee will agree upon and adhere to a work plan that details
expectations for major activities, products, and reports during the
current budget period. The work plan will include a timetable for
project and activity implementation, staff assignments, and other areas
that require AoA consultation, review, and/or prior approval. Either the
Administration on Aging or the project director can propose a revision
of the final work plan at any time.

Funding beyond the initial budget period will be determined on a
non-competitive basis. Continuation funding, as outlined in the terms
and conditions of Notice of Award, for all the grantees will be subject
to:

-   Assessment of the Year 1 progress report and determination that
    satisfactory progress was achieved;

-   Review and approval of other documents necessary for continuation;

-   Availability of funds;

-   Execution of the original line-item budget; and

-   Determination that the project is in the best interest of the
    government.

## III. ELIGIBILITY INFORMATION

######## 1. Eligible Applicants 

The intent of this announcement is to expand the Model Approaches to
Statewide Legal Assistance Systems program beyond the initial six states
of Alabama, Idaho, Iowa, Maryland, North Dakota, and Virginia. Awards
will be made to the entity within each eligible state that currently
houses (or proposes to house) the Legal Services Developer. Eligible
applicants include domestic public or private and non-profit entities
including state, local and Indian tribal governments, faith-based
organizations, community-based organizations, hospitals, and
institutions of higher education.

If the Legal Services Developer is not housed within the state unit on
aging, the applicant must provide a letter of commitment from the state
unit that clearly delineates the state unit's support of the application
and the role and responsibility of the state unit in support of this
effort. In addition, successful grantees must collaborate with an entity
experienced in providing legal services to older persons within that
state through a low-cost service delivery mechanism, such as the senior
legal helpline model, funded by AoA under the Title IV Legal Assistance
Grants Program. The purpose of this collaboration is to promote greater
involvement of expertise in various components of a comprehensive legal
services delivery system, and applications must detail how this
collaboration will be structured and accomplished.

######## 2. Cost Sharing or Matching

Under this Older Americans Act program, AoA will fund no more than 75%
of the project's total cost, 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 18g
of the SF 424). This "three-to-one" ratio is reflected in the formula
included under Item 18 in Attachment A. You can use this formula 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.

######## 3. Application Screening Criteria

All applications will be screened to assure a level playing field for
all applicants. Applications that fail to meet the 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 midnight July 13, 2007.

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

3.  The Project Narrative must [not]{.underline} exceed 20 pages. 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.

4.  Responsiveness Criteria: Applications will go through an initial
    screening to verify that the eligibility criteria outlined above in
    Section III(1) is satisfied, and that the applicant:

    a.  Is the entity in the state which houses (or proposes to house)
        the Legal Services Developer; and

    b.  Includes letters of support from (i) an entity experienced in
        providing legal services in the state through low-cost delivery
        mechanisms and (ii) from the state unit on aging if the Legal
        Services Developer is not housed in the state unit.

## IV. APPLICATION AND SUBMISSION INFORMATION

All applicants are required to submit electronically through
[http://www.grants.gov](http://www.grants.gov/) by midnight July 13,
2007.

######## 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
>
> Valerie Soroka
>
> Center for Wellness and Community Based Services
>
> Washington, D.C. 20201
>
> Or by calling: 202-357-3531
>
> Or e-mailing: valerie.soroka@aoa.hhs.gov

Please note: AoA is requiring applications for this announcement to 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 CFDA number (93.048).

-   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 number and register in the Central Contractor
    Registry (CCR). You should allow a minimum of **five days** to
    complete the CCR registration.

-   You may submit all documents electronically, including all
    information included on the SF 424 and all necessary assurances and
    certifications.

-   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.

-   We may request that you provide original signatures on forms at a
    later date.

-   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
    ([www.grants.gov/CCRRegister](http://www.grants.gov/CCRRegister)).
    You should receive your CCR registration within 7 -- 10 business
    days.  

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

######## a. 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:
<https://www.whitehouse.gov/omb/grants/duns_num_guide.pdf>.

######## b. 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. 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. The Project
Work Plan, Letters of Cooperation, 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 counted as part of the 20 page limit include:

-   Summary/Abstract

-   Problem Statement

-   Goal(s) and Objective(s)

-   Proposed Intervention

-   Special Target Populations and Organizations

-   Outcomes

-   Project Management

-   Evaluation

-   Dissemination

-   Organizational Capability

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 Title IV of
the Older Americans Act. The Project Narrative should provide a **clear
and concise** description of your project. AoA recommends that your
project narrative include the following components:

**Summary/Abstract.** This section should include a one page - 300 words
maximum - description of the proposed project, including: the goal,
priority area(s), target population, activities, products and measurable
outcomes. 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 or issue the proposed intervention is designed to
address, including how the project will potentially affect the targeted
elderly population and/or their caregivers (including specific subgroups
within those populations), and possibly the health care and social
services systems (e.g., the use of health care and/or nursing home
services.)

**Goals and Objectives.** This section should consist of a description
of the project's goal(s) and major objectives in terms of the priority
area(s). Unless the project involves multiple, complex interventions, we
recommend you have only one overall goal.

**Proposed Intervention.** This section should provide a clear and
concise description of the intervention you are proposing to use to
address the problem described in the "Problem Statement". You should
also describe the rationale for using the particular intervention,
including factors such as: "lessons learned" for similar projects
previously tested in your community, or in other areas of the country;
factors in the larger environment that have created the "right
conditions" for the intervention (e.g., existing social, economic or
political factors that you'll be able to take advantage of, etc.). 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 strategic partnerships you plan to involve in
implementing the intervention, including other organizations, funders,
and/or consumer groups.

**Special Target Populations and Organizations.** This section should
describe how you plan to systematically involve community-based
organizations experienced with the target population in the planning and
implementation of the proposed statewide project. Specifically, your
application should discuss proposed strategies for targeting minority
and hard-to-reach populations, including low-income, rural, isolated,
and limited English-speaking individuals. (Suggested length: one to two
pages.)

**Outcomes**. This section of the project narrative must clearly
identify the [measurable]{.underline} outcome(s) that will result from
the project. (NOTE: AoA will not fund any project that does not include
measurable outcomes). This section should also describe how the
project's findings might benefit the field at large, (e.g., how the
findings could help other organizations throughout the nation to address
the same or similar problems). List measurable outcomes in the 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. (Suggested Length: one to
two pages.)

A "measurable outcome" is an observable end-result that describes how a
particular intervention benefits consumers. It can describe a change in
the degree of customer satisfaction; a change in the responsiveness or
cost-effectiveness of a service delivery system; an increase in access
to service for previously underserved target groups; a measurable
increase in awareness, skills, and behaviors that result in protection
of the financial security and consumer rights of elders; a measurable
improvement in seniors' financial, emotional, physical, and mental
well-being; or an increase in the number of cases closed with a
favorable result for the client.

A measurable outcome is not a measurable "output" such as: the number of
clients served; the number of training sessions held; the number of
informational materials disseminated, or the number of service units
provided.

You should keep the focus of this section on describing
[what]{.underline} 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. This
includes a description of the proposed data collection system and its
ability to collect the information necessary to measure outcomes. Your
application will be scored on the clarity and nature of your proposed
outcomes, not on the number of outcomes cited.

**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, 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. (Suggested Length: one to two pages.)

**Evaluation**. This section should describe the method(s), techniques
and tools that will be used to: 1) measure the success of the proposed
intervention, products and practices in achieving anticipated outcomes;
and 2) document project "lessons learned" (both positive and negative)
that will be useful to other Legal Assistance grantees, as well as other
senior legal services and elder rights professionals interested in
replicating the intervention. (Suggested Length: one to two pages.)

**Dissemination.** This section should describe the method that will be
used to disseminate the project's successful products and practices in a
timely manner and in easily understandable formats, to legal services
professionals who might be interested in using these as models to
improve practice, service delivery, program and partnership development.
(Suggested Length: one to two pages.)

**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 entity (or the particular division of a larger
organization) 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
entity 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 vitas 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.

######## Attachments

**Work Plan**. The Project Work Plan should reflect, and be consistent
with, the Project Narrative and Line-Item Budget. For each major task
and action step, the work plan should identify the timeframes to achieve
the proposed objectives and the lead person responsible for completing
the task. It is recommended that the Work Plan include the following
information as outlined in Attachment D: Work Plan Template. There are
no page limits for completing a Work Plan:

-   Overall goal;

-   Measurable outcome(s);

-   Key objectives;

-   Major tasks and action steps;

-   Lead person; and

-   Timeframe with start and end dates.

**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. The signed
letters of collaboration must specify the commitment, role, and
resources/activities that will be provided in support of the applicant.
Strategies to reach targeted populations must be documented with letters
of commitment that detail the specific role/function in support of the
project's effort that will be played by the collaborating organization.
The organization's expertise, experience, and access to the targeted
population(s) should also be described in the letter of commitment.

Of special note: If the Legal Services Developer is not housed within
the state unit on aging, the application [must]{.underline} include a
letter of commitment from the state unit that clearly delineates the
state unit's support of the application and the role and responsibility
of the state unit in support of this effort. In addition, because
successful grantees must collaborate with an entity experienced in
providing legal services to older persons within that state through a
low-cost service delivery mechanism, applications also must include
letters of commitment from parties identified as collaborators in the
application detailing how this collaboration will be structured and
accomplished.

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
Grants Management Office at 202-357-3466 by the application submission
deadline. The Program Announcement number should appear at the top of
each page faxed.

######## 3. Submission Dates and Times 

The deadline for the submission of applications under this program
announcement is July 13, 2007. Applications must be submitted
electronically by midnight Eastern time, July 13, 2007.

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.

######## 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](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.grants.gov/CCRRegister>. You must also register with a
Credential Provider to receive a username and password to securely
submit your grant application. Information is available at
<http://www.grants.gov/CredentialProvider> .

######## V. APPLICATION REVIEW INFORMATION 

######## 1. Criteria 

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

-   Purpose and Need for Assistance - (15 points);

-   Approach/Method -- Workplan and Activities - (30 points);

-   Outcomes/Evaluation/Dissemination - (25 points); and

-   Level of Effort - (30 points).

  ------------------------------------------------------ ---------------------
  a\. [Purpose and Need for Assistance]{.underline}      [Weight: 15
                                                         points]{.underline}

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

i.  [Purpose and Need]{.underline}: Does the project proposal clearly
    identify and adequately respond to the priority area, and is it
    consistent with the AoA program purpose, as described in the Program
    Announcement? Does the project proposal identify the components and
    levels of integration, funding, performance, and results that
    comprise the [current]{.underline} legal services delivery system
    within the state? Does the applicant demonstrate a familiarity with
    the history, current status, and policy considerations bearing on
    the development of comprehensive and integrated legal services for
    the elderly delivery systems and the roles of national, state, and
    local agencies? (10 points)

ii. [Targeting]{.underline}: Does the project proposal identify and
    prioritize target populations within its state region and
    substantiate their need for increased access to senior legal
    service? Is the problem identified for target populations by the
    applicant consistent with the AoA program's purpose and objectives?
    Does the project proposal include a discussion of effective methods
    used for outreach to and targeting of hard-to-reach populations?
    Does the project proposal clearly describe how an integrated service
    delivery system will enhance access for target populations? (5
    points)

  ------------------------------------------------------ ---------------------
  b\. [Approach, Work Plan, and Activities]{.underline}  [Weight: 30
                                                         points]{.underline}

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

i.  [Approach]{.underline}: Is the intervention clearly defined? Are the
    activities described in the application consistent with AoA
    priorities, as described in Section I? Does the intervention reflect
    a coherent and feasible approach for successfully addressing the
    identified problem and achieving the identified outcome(s)? Does the
    project proposal set forth strategies for enhancement of the
    state\'s overall legal services system and for accountability
    through the development or implementation of statewide legal service
    delivery standards? Are the method, level, and scope of systems
    integration clearly described? Does the proposal take into account
    barriers and opportunities that may impact the project's success?
    Does the approach identify appropriate aging network, federal,
    state, and community-based organizations for collaboration and
    specify the roles of these partner organizations in implementing the
    project? (15 points)

ii. [Work Plan]{.underline}: Is the project work plan clear and
    comprehensive? Does the project proposal set forth a comprehensive
    plan for an integrated, coordinated, state legal services delivery
    system that incorporates low-cost delivery mechanisms with Title
    III-B legal services and other available legal resources? Does it
    include sensible and feasible timeframes for the accomplishment of
    tasks presented? Does the work plan include specific objectives and
    tasks that are linked to measurable outcomes? Does the proposal
    include a clear and coherent management plan? Are the roles and
    responsibilities of project staff, consultants, and partners clearly
    defined in the work plan and linked to specific objectives and
    tasks? (10 points)

iii. [Outreach]{.underline}: Has the applicant identified well-defined
     outreach and service delivery strategies for reaching the
     identified target populations, such as isolated, disadvantaged, and
     limited-English speaking seniors? Does the project proposal
     describe an outreach plan which coordinates with existing aging
     services delivery system outreach programs and initiatives? Are the
     proposed outreach strategies cost-effective and appropriate to the
     areas and clients served? (5 points)

  ------------------------------------------------------ ---------------------
  c\. [Project Outcomes, Evaluation, and                 [Weight: 25
  Dissemination]{.underline}                             points]{.underline}

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

i.  [Outcomes]{.underline}: Are the benefits and results clear,
    realistic, and consistent with the purpose of the project? Are the
    proposed outcomes quantifiable and measurable, consistent with the
    definition of a project outcome contained in Section IV.2.b. of the
    Program Announcement? Are the expected project outcomes directly
    linked to the AoA program objectives? Does the proposal clearly
    describe the anticipated efficiencies and outcomes, in addition to
    the outcome "increased access" set forth in Section I of the program
    announcement? (10 points)

ii. [Evaluation]{.underline}: Does the project evaluation 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)? Does the project proposal include a description
    of the current and/or anticipated data collection system and its
    ability to collect the information necessary to measure outcomes?
    Does the plan include the qualitative and/or quantitative methods
    necessary to reliably measure outcomes? Is the evaluation also
    designed to capture "lessons learned" from the overall effort that
    might be of use to others in the field of senior legal services
    delivery, especially those who might be interested in replicating
    the project? (10 points)

iii. [Dissemination]{.underline}: Does the proposal detail a plan for
     sharing its findings with all appropriate audiences, through such
     methods as conferences, reports, via the national legal resource
     centers, etc.? Will the dissemination plan get relevant and easy to
     use information in a timely manner to parties that might be
     interested in making use of its findings, particularly to those who
     might want to replicate the project? (5 points)

  ------------------------------------------------------ ---------------------
  d\. [Level of Effort]{.underline}                      [Weight: 30
                                                         points]{.underline}

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

i.  [Capacity]{.underline}: Do the proposed project director(s), key
    staff, and consultants have the background, experience, and other
    qualifications required to carry out their designated roles and the
    project? Has the applicant demonstrated capacity and experience in
    using quantitative and/or qualitative performance outcome
    information to support their activity and management decisions? (5
    points)

ii. [Collaborations]{.underline}: Are letters included from stakeholders
    and organizations identified as collaborators, as appropriate, and
    do they express clear commitment and areas of responsibility of
    those organizations, consistent with the work plan description of
    their intended roles and contributions? Does the project proposal
    describe anticipated collaboration with an entity experienced in
    providing legal services to older persons within that state through
    a low-cost service delivery mechanism? If the Legal Services
    Developer is not housed within the state unit on aging, is there a
    letter of commitment from the state unit that clearly delineates the
    state unit's support of the application and the role and
    responsibility of the state unit in support of this effort? (10
    points)

iii. [Level of Effort]{.underline}: Is the level of effort of the
     project staff, consultants, and/or partners appropriate and
     adequate to carry out the project? 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? Does the project proposal assign the state Legal Services
     Developer a central role in developing a state-appropriate approach
     for ensuring the integration of various legal services delivery
     systems---including low-cost mechanisms---into an overall state
     legal services system plan? (10 points)

iv. [Budget]{.underline}: Is the project cost-effective and
    programmatically efficient, maximizing Federal and all other
    resources? Is the budget justified with respect to the adequacy and
    reasonableness of resources requested? 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. These reviewers are experts in
their field, and are drawn from academic institutions, non-profit
organizations, state and local government, and federal government
agencies other than AoA. Based on the specific programmatic
considerations as outlined under section I, Funding Opportunity
Description, the reviewers will comment on and score the applications,
focusing their comments and scoring decisions on the criteria identified
above.

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;
and the likelihood that the proposed project will result in the benefits
expected.

Applicants have the option of omitting from the application copies (not
the original) specific salary rates or amounts for individuals specified
in the application budget and Social Security Numbers. The copies may
include summary salary information.

## VI. AWARD ADMINISTRATION INFORMATION

######## 1. Award Notices 

Successful applicants will receive an Approval Letter, and a Notice of
Award. The Notice of Award is the authorizing document, and will be
signed by the AoA grants management officer, the AoA authorizing
official, and the AoA budget office. Unsuccessful applicants are
notified within 30 days of the final funding decision and will receive a
disapproval letter via 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, October 1, 2006
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. The final
performance report will replace the final semi-annual report. However,
the final performance report should include a discussion of the
activities, progress, and achievements from the last 6 months of the
project along with a summary of the overall project.

## VII. AGENCY CONTACTS 

Project Officer:

U.S. Department of Health and Human Services

Administration on Aging

Washington, DC 20201

Attn: Valerie Soroka

Telephone: (202) 357-3531, e-mail: <valerie.soroka@aoa.hhs.gov>

Director, Office of Grants Management:

U.S. Department of Health and Human Services

Administration on Aging

Washington, DC 20201

Attn: Stephen Daniels

Telephone: (202) 357-3464, e-mail: <Stephen.Daniels@aoa.hhs.gov>

## VII. OTHER INFORMATION

###### A. Application Elements

To expedite the processing of applications, we request that you arrange
the components of your application in the following order:

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.  Certification

6.  Proof of non-profit status

7.  Copy of the applicant\'s most recent indirect cost agreement, as
    necessary.

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.

######## 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:**

**"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. Please note that
  in FY 2006, a new version of the SF 424 is being used for new grants.

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

###### 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 three types of match: 1.) non-federal cash; 2.) non-federal
non-cash (i.e., in-kind); and 3.) program income. 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. A third form of non-federal
match is projected [program income]{.underline} derived from activities
of the project such as participant fees and sale of publications. [Only
program income that is to be used as part of the required match should
be shown on Line 15.]{.underline}

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   |
| > and program income 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.**              |
+-----------------------------------------------------------------------+

> [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, Budget Categories for each
> contractor, along with supporting information and justifications.
>
> [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.
>
> 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 that you wish to designate as match (equal
> to the amount shown for Item 15(f) on Form 424). [Note]{.underline}:
> Any program income indicated at the bottom of Section B and for item
> 15(f) on the face sheet of Form 424 will be included as part of
> non-Federal match and will be subject to the rules for documenting
> completion of this pledge. If program income is expected, but is not
> needed to achieve matching funds, do not include that portion here or
> on Item 15(f) of the Form 424 face sheet. Any anticipated program
> income that will not be applied as grantee match should be described
> in the Level of Effort section of the Program Narrative.

##### 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). Do
> not include program income unless it is used to meet the match
> requirement. Keep in mind that if program income used to meet the
> match requirement and the projected level of program income is not
> met, thereby decreasing the level of match, the amount of federal
> funds available to the grantee may be reduced if the match falls below
> required levels.
>
> [Section D ‑ Forecasted Cash Needs]{.underline} - Not applicable.
>
> [Section E ‑ Budget Estimate of Federal Funds Needed for Balance of
> the Project]{.underline}
>
> [Line 20]{.underline}: NOTE: Leave this line blank. Section E is
> relevant only 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 (a) lobbying; (b) debarment, suspension, and
> other responsibility matters; and (c) drug-free workplace
> requirements. 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**

+----------+-------+------+------+------+-----------------------------+
| >        | **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

+-----+-----+------+------+------+-----------------------------------+
| **  | **  | #    | *    | ##   | ### 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 |     |      |      |      |                                   |
| ve, |     |      |      |      |                                   |
| P   |     |      |      |      |                                   |
| age |     |      |      |      |                                   |
| 3   |     |      |      |      |                                   |
| --  |     |      |      |      |                                   |
| Sam |     |      |      |      |                                   |
| ple |     |      |      |      |                                   |
| For |     |      |      |      |                                   |
| mat |     |      |      |      |                                   |
| w   |     |      |      |      |                                   |
| ith |     |      |      |      |                                   |
| EX  |     |      |      |      |                                   |
| AMP |     |      |      |      |                                   |
| LES |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+
| **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 |     |      |      |      |                                   |
| ect |     |      |      |      |                                   |
| Cha |     |      |      |      |                                   |
| rge |     |      |      |      |                                   |
| s** |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+
| ##  | \$2 | \$58 | \$27 | \    |                                   |
| ### | 67, | ,000 | ,767 | $352 |                                   |
|  TO | 100 |      |      | ,267 |                                   |
| TAL |     |      |      |      |                                   |
+-----+-----+------+------+------+-----------------------------------+

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

+-----+------+------+------+------+-----------------------------------+
| >   | *    | **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**

+------+------+------+----+------+-----------------------------------+
| >    | *    | **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.

```{=html}
<!-- -->
```
-   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.

**Applicant's (Organization) 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

# Survey Instructions on Ensuring Equal Opportunity for Applicants

**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. 1/31/20

[^1]: Legal Hotlines Self Evaluation Measures Report 2003
    ([www.legalhotlines.org](http://www.legalhotlines.org/)).

[^2]: Calls to helplines sometimes involve more than one problem, or
    case. Technical Support for Legal Hotlines Project Annual Report
    2005 ([www.legalhotlines.org](http://www.legalhotlines.org/)).

[^3]: Senior Legal Hotlines Annual Report 2005
    ([www.legalhotlines.org](http://www.legalhotlines.org/)).

[^4]: Planning for the Legal Needs of Utah's Seniors, 2004
    (<http://www.tcsg.org/finalreport1018_04.pdf>).

[^5]: Nuseibeh and Easterbrook. 2000. Requirements Engineering: A
    Roadmap. ICSE--Future of SE Track.
    (<http://www.doc.ic.ac.uk/~ban/pubs/sotar.re.pdf>).

[^6]: Examples of two statewide senior legal needs assessments can be
    viewed at: [www.tcsg.org](http://www.tcsg.org/). Choose the "Law &
    Aging" tab at the bottom right of the page, then select the "State
    Legal Services Development \-- Including Daily Legal & Elder Rights
    News Reports" link. Once there, scroll the page to find *Elderly
    Legal Assistance Program: Report on the Legal Needs of Seniors in
    Georgia* and *Legal Needs Assessment of Utah\'s Seniors*.

[^7]: The Borchard Center on Law & Aging's State Legal Assistance
    Development Program Study (2003) provides one source of such
    information.