Program Instructions

AoA-PI-97-03

TO: STATE AGENCIES ON AGING ADMINISTERING PROGRAMS FOR THE PROTECTION OF ELDER 

RIGHTS UNDER TITLE VII OF THE OLDER AMERICANS ACT OF 1965, AS AMENDED

SUBJECT: Cooperative Agreements with State Agencies on Aging to Support Outreach and Education, 

Training, Technical Assistance, and Capacity Building to Prevent and Combat Health Care Fraud, 

Waste, and Abuse

LEGAL AND RELATED

REFERENCES: Older Americans Act, as Amended (Public Law 102-375); Health Insurance Portability 

and Accountability Act (Public Law 104-191)

This program instruction advises you of the intent of the Administration on Aging (AoA) to invite state 

agencies on aging to act on behalf of the aging network in their states and join the Department of 

Health and Human Services (DHHS) and the AoA in a national effort, now underway, to prevent and 

combat health care fraud, waste, and abuse. Each state agency on aging may apply for funding of up 

to $150,000 (up to $50,000 in each year of a three-year project period) in support of training, 

outreach, technical assistance, and capacity building activities. Guidelines for preparing and submitting 

the cooperative agreement application, for funding by the AoA, are enclosed.

On August 21, 1996, President Clinton signed into law legislation coauthored by Senators Kennedy 

and Kassebaum, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Public Law 

104-191). The legislation, among other purposes, guarantees the portability of health insurance, 

allows workers to maintain insurance coverage if they lose or leave their jobs, establishes a pilot 

program for medical savings accounts, increases the deductibility of health insurance for the selfemployed, and provides tax breaks to increase the use of long-term care insurance.

Of particular interest, the legislation also includes various health care fraud and abuse-related 

provisions. One anticipated result of the HIPAA will be to expand Operation Restore Trust (ORT) 

nationwide, by providing a stable source of funds, and creating a Health Care Fraud and Abuse Control 

Program to combat health care fraud and abuse in Medicare, Medicaid and other health care 

programs. The Program is being jointly coordinated by the Secretary of the DHHS and the Attorney 

General. It has a fiscal year (FY) 1997 funding of $104 million, to be drawn from the Medicare Trust 

Fund, for (1) coordinating federal, state and local law enforcement programs to control fraud and 

abuse with respect to health care plans; (2) conducting investigations, audits, evaluations and 

inspections relating to the delivery of and payment for health care; (3) facilitating enforcement of civil, 

criminal and administrative statutes applicable to health care fraud and abuse; (4) providing industry 

guidance relating to fraudulent health care practices; and (5) establishing a national data bank to 

receive and report final adverse actions against health care providers. 
The Program is authorized for seven years through FY 2003. In the DHHS implementation of the 

Program, the AoA has a collaborative role to play with both the Office of Inspector General (OIG) and 

the Health Care Financing Administration (HCFA). Beginning in FY 1997, with an allocation of $1.1 

million, and continuing during the course of the Program, the AoA, acting in concert with OIG and 

HCFA, will focus its activities on strengthening the roles played by older persons, their families and 

caregivers, and the aging network in combatting health care fraud and abuse. Specifically, the AoA will 

concentrate on two overall tasks, as successfully tested during the ORT demonstration in California, 

Florida, Illinois, New York and Texas. These are: (1) training and assisting both paid and volunteer 

long-term care ombudsmen, benefits counseling personnel, case managers and other direct service 

staff, in effectively recognizing actual and potential practices and patterns of fraud and abuse, and to 

advise and assist older persons and their families, as appropriate; and (2) to engage in outreach and 

education activities to educate and empower older persons, their families, and the communities to 

recognize fraudulent and abusive situations, and to prevent or minimize victimization by such 

behavior.

Our intent is to work in partnership with state agencies on aging, state long-term care ombudsmen, 

and others in the aging network, in mounting an aging network campaign against health care fraud 

and abuse. Sufficient funds are available in FY 1997 to begin project activities in roughly one-third of 

the states. Our goal, subject to funds availability, is that a comparable number of states would be 

provided start-up funding in FY 1998, with the third aggregate of states initiating their projects early 

in FY 1999. The goal is to have our joint effort well underway, across the nation, by January 1, 2000.

I strongly encourage all state agencies on aging to apply for this funding.

INQUIRIES: Inquiries should be addressed to Regional Administrators on Aging, DHHS Regional 

Offices

William F. Benson

Acting Principal Deputy Assistant

Secretary for Aging

Administration on Aging (AoA)

Cooperative Agreement Awards to State Agencies on Aging for the Support of Training, Technical 

Assistance, Outreach, Education, and Capacity Building to Prevent and Combat Health Care Fraud, 

Waste, and Abuse

SUMMARY: These Guidelines have two parts. Part I describes the program priority, Preventing 

and Combatting Health Care Fraud, Waste, and Abuse, under which the AoA is inviting 

State Agencies on Aging to submit cooperative agreement award applications for funding. Part II

describes the procedures for preparing and submitting the application. 
All of the forms (Standard Form 424), Assurances, and Certifications necessary to complete the 

application are included following Part II. Project awards to be made under this program priority 

beyond fiscal year (FY) 1997 are subject to the availability of funds.

The deadline date for the submission of applications is 45 days after the issuance of the PROGRAM 

INSTRUCTION to which these guidelines pertain.

Application receipt point: U.S. Department of Health and Human Services, Administration on Aging, 

Office of Administration and Management, 330 Independence Avenue, S.W., Room 4643, Washington, 

DC 20201.

A background set of technical assistance and informational materials helpful in preparing the 

application is available by contacting, Department of Health and Human Services, Administration on 

Aging, Office of Governmental Affairs and Elder ights, 330 Independence Avenue, S.W., Washington, 

DC 20201, telephone: (202) 619-3951 or (202) 619-3106.

Part I. Background Information and Program Priority

A. Statutory Authority

The statutory authority for awards made under this program priority is contained in the Older 

Americans Act, (42 U.S.C. 3001 et seq.), as amended by the Older Americans Act Amendments of 

1992, Pub.L.102-375, September 30, 1992, and in the Health Insurance Portability and Accountability 

Act of 1997, Pub.L. 104-191.

B. Eligible Applicants

Eligibility is limited to State Agencies on Aging.

C. Level of Funding

State Agencies on Aging submitting acceptable applications shall each receive up to $50,000 for the 

first year, up to $50,000 for the second year, and up to $50,000 for the third year of a three year 

project cooperative agreement. It is expected that approximately one-third of the State Agencies on 

Aging will receive funding beginning in FY 1997. Subject to the availability of funds, another third will 

be funded to begin project activities in FY 1998 and the last complement of SUAs will begin operations 

in FY 1999. Funding available for the Virgin Islands, Guam, Palau, American Samoa, and the 

Commonwealth of the Northern Mariana Islands is limited to $10,000 per year.
D. Program Priority Description

Preventing and Combatting Health Care Fraud, Waste, and Abuse

1) Background

Based on estimates of the General Accounting Office, billions of Medicare dollars are lost every year to 

waste, fraud and abuse. These losses are due, to a considerable extent, to the many ways in which 

the funds are dispersed as well as to the sheer magnitude of health care expenditures. Both factors 

increase the probability of waste while opening wider the opportunities for fraud and abuse. Those 

operating unscrupulously in this arena, intent on obtaining vital health care dollars illegally, have done 

so based on the perception that the risks of detection have lessened over the years. There has been 

decline in the ability of governmental agencies to fight waste, fraud and abuse because of shifting 

priorities, decreased funding for program administration, the result of downsizing, etc.

In 1995, the AoA became a partner in a government-led effort to reverse that trend and to fight 

against health care waste, fraud and abuse through implementation of a two-year health care antifraud and abuse demonstration program called "Operation Restore Trust" (ORT). ORT, announced by 

the President at the 1995 White House Conference on Aging, was a federal-state partnership to 

combat fraud and abuse in the Medicare and Medicaid programs. It targeted provider fraud in nursing 

homes and home health care services, including hospice care, and in the durable medical equipment 

industry. The demonstration program centered on five states where close to forty percent of Medicare 

and Medicaid dollars are expended - New York, Florida, Texas, Illinois, and California.

ORT combined the efforts of three agencies within the U.S. Department of Health and Human Services 

- the Office of Inspector General (OIG), the Health Care Financing Administration (HCFA) and the AoA. 

Another Federal partner was the Department of Justice. A feature of ORT was also the partnership 

between Federal agencies and such state programs and agencies as long-term care ombudsmen, 

State Agencies onAging, Medicaid fraud control units, Attorney General offices, and Medicaid agencies 

and health departments. Teams of representatives from these programs in each target state worked 

to:

· increase public awareness of fraudulent practices;

· reduce and prevent the incidence of such practices;

· detect and punish wrong-doing; 

· identify policy weaknesses that encourage fraud and abuse; and

· encourage self-monitoring and reporting of fraud by provider companies.
Hundreds of millions of dollars in savings were achieved through court awards in fraud cases, 

decreased up-front billings for fraudulent and wasteful practices, and other savings and recoupments 

generated through the ORT initiative.

Aging network agencies, because of their daily contact with older persons, especially those with health 

problems, were vital members of the core federal-state interdisciplinary team for each of the five 

states. Those serving the elderly through programs under the Older Americans Act educated 

thousands of older persons and their families about how to recognize Medicare and Medicaid fraud and 

what to do when it is detected. In that way, aging network staff, volunteers and older people 

themselves became both effective agents and partners with program integrity and law enforcement 

personnel in reducing and preventing Medicare and Medicaid fraud and abuse.

ORT efforts focused on education and training to prepare state and local ombudsmen, health 

insurance counselors, the network of aging service agencies, older persons and their families, and 

others who work directly with older people to recognize individual instances and patterns of Medicare 

and Medicaid waste, fraud and abuse when they encounter it, followed by a clear understanding of 

how, and to whom, to refer cases for investigation. The five states held train-the-trainer sessions for 

local ombudsman coordinators, Medicare benefits counselors, and other key program staff, followed by 

local training events. HCFA, OIG, Medicare contractors and state Medicaid agencies and Attorney 

General (e.g., Medicaid Fraud Control Unit) staff served as trainers. Special resource materials were 

provided to each trainee. To date, over 4200 persons have been trained in 90 sessions within the five 

states, and thousands of older persons were reached through targeted outreach efforts initiated in 

New York city, central Florida, metropolitan Chicago and Los Angeles.

On February 11, 1997, the AoA announced the availability of funding for a secondanti-fraud and abuse 

initiative. This initiative, the Health Care Anti-Fraud, Waste, and Abuse Community Volunteers' 

Demonstration Projects, is intended both to respond to a congressional directive and to build on the 

ORT experience. The model activities to be funded by these projects seek to substantially increase the 

involvement of older persons and aging network agencies in support of the AoA's and HCFA's efforts 

under ORT to curb losses due to fraud and abuse. Based on congressional direction, $2 million in Fiscal 

Year 1997 was transferred through an intra-agency agreement from the HCFA to the AoA to facilitate 

a collaboration of aging network agencies (State and Area Agencies on Aging), health insurance 

counseling programs, senior centers, and other appropriate entities in carrying out this demonstration 

program of projects to combat health care waste, fraud, and abuse. Ten to twelve projects will be 

funded in early June 1997.

2) Building on ORT: The Program to Prevent and Combat Health Care Fraud, Waste and 

Abuse 

The recently-enacted Health Insurance Portability and Accountability Act (HIPAA) authorizes the 

continuation and expansion of anti-fraud, waste, and abuse activities, including those initiated under 

ORT. This measure provides funding for AoA to utilize its uniquely positioned network of communitybased agencies to play a principal role in demonstrating the effectiveness of education of aging 
network personnel, consumers and their families as a long term deterrence of health care fraud and 

abuse.

AoA's funded activities will build upon the successful efforts derived from collaborating with the OIG 

and the HCFA in planning and conducting fraud and abuse awareness activities with the State 

Agencies on Aging. These activities are (1) intensive training of long term care ombudsmen and 

ombudsman volunteers to identify health care providers and suppliers who render unnecessary 

services and excessive suppliers; (2) fraud and abuse awareness training for the staff of other aging 

network programs and services -- case management, information and assistance, senior centers, 

health insurance counseling and assistance, legal assistance, etc.; and (3) outreach and education 

efforts to provide fraud and abuse information to older persons, their families and caregivers that will 

help them on how to recognize instances and patterns of suspected fraud and abuse and on how to 

report the same.

On March 25, 1997, President Clinton announced plans to send Congress new legislation to fight fraud 

and abuse in health. He proposed enactment of the "Medicare-Medicaid Anti-Waste, Fraud and Abuse 

Act of 1997." The legislation would establish tough new requirements for individuals and companies 

that wish to participate in the programs, provide new sanctions against providers who commit fraud 

and close loopholes that lead to fraud and abuse. This follows four years of focused efforts that has 

helped save more than $20 billion in health care claims through policy changes, penalties, recoveries, 

claims denials, and settlements.

3) Project Objectives and Activities

The Program to Prevent and Combat Health Care Fraud, Waste and Abuse Program is designed to 

strengthen the capability of State Agencies on Aging and other aging network agencies to plan and 

carry out a program of provider and consumer education regarding enforcement efforts against fraud 

and abuse in federal and private health care programs. Applications are sought to recast existing ORT 

train-the-trainers' models and test new models for 1) training and assisting both paid and volunteer 

long term care ombudsmen, benefits counseling personnel, case managers and other direct service 

staff, especially those associated with the OAA programs and services, in effectively recognizing actual 

and potential practices and patterns of fraud and abuse and to advise and assist older persons and 

their families, as appropriate; and 2) engaging in outreach and education activities to educate and 

empower older persons, their families, and their communities to recognize fraudulent and abusive 

situations and to prevent or minimize victimization by such behavior. One result of such training, 

education and outreach activities will be referrals to the OIG and other investigative and enforcement 

agencies, which, in turn, will lead to various sanctions, recoupments, prosecutions and convictions.

In every case, the State Agency on Aging should propose activities which will effectively employ the 

unique talents of its ready-made network to empower those being served to have a greater 

understanding and expertise necessary to assess their health care bills and report suspected instances 

of waste, fraud and abuse. Examples of practices deserving their careful scrutiny include protecting 

Medicare cards, billing for services not rendered, overcharging for services performed, waiving patient 
coinsurance, accepting or paying kickbacks for patient referrals, and providing inappropriate or 

unnecessary services.

State Agencies on Aging have considerable flexibility in pursuing various methods of establishing 

projects to prevent and combat health care fraud, waste and abuse. However, the application should 

encompass each of the following components:

· state/local planning and coordination committees among participating agencies of the state's aging 

network, including ombudsman programs, area agencies on aging, health insurance counseling and 

assistance programs, and senior advocacy groups (e.g. AARP); 

· collaborative outreach and education efforts and linkages to improve public awareness and outreach 

services;

· statewide or regional fraud and abuse train-the-trainers' training to cover such topics as (a) an 

overview of the Medicare and Medicaid programs, (b) federal waste, fraud and abuse provisions, (c) 

an overview of the state's health careprograms, (d) issues that affect provision of health care services, 

(e) documentation necessary for making referrals of possible waste, fraud and abuse investigations, 

and (f) an overview of the state's system for investigating waste, fraud and abuse; 

· statewide, regional or local fraud and abuse training for aging network staff; 

· the collection, assessment, and reporting of information regarding key indicators of program 

effectiveness; such information would focus on the older consumers reached by the state program, 

their demographic characteristics, and their efforts at recognizing and reporting instances of suspected 

waste, fraud and abuse; and

· system(s) to track waste, fraud and abuse referrals to appropriate federal and state investigative 

agencies; and

· plan(s) for measuring the degree to which objectives have been accomplished.

Approximately one-third of the State Agencies on Aging will be funded to begin operations in FY 1997. 

It is expected those states will be selected from among the five (5) ORT demonstration states (CA, FL, 

IL, NY and TX), the several states where the OIG-Office of Investigations will open new field offices in 

FY 1997 (including CT, IA, OH, OK, SC, and TN), and those states where the HCFA plans to form new 

fraud and abuse coordinating committees (AZ, CO, GA, LA, MA, MO, NJ, PA, VA, and WA). It is the 

intention of the AoA, provided sufficient funding is made available, to make project awards to a 

second set of states in FY 1998, and to the last aggregate of states in FY 1999, which would complete 

the expansion process nationally. 

Part II. Guidelines for Preparing and Submitting the 

Application
Part II contains guidelines for State Agencies on Aging in preparing and submitting applications for 

projects to support training, technical assistance, and capacity building aimed at preventing and 

combatting health care fraud, waste, and abuse. Application forms are also provided along with 

instructions for preparing the application package for submittal to the AoA. 

1. Review Process and Considerations for Funding

a. Notification: All applicants will automatically be notified of the receipt of their application and 

informed of the identification number assigned to it.

b. Review and Decision-Making Process: State Agencies on Aging are expected to indicate in their 

application their preferred start-up year for the three-year funding period (i.e., FY 1997, expected 

start date: August 1, 1997; FY 1998, expected start date: March 1, 1998; FY 1999, expected start 

date: January 1, 1999). Acceptable project applications will be approved for start-up funding, 

wherever possible, in accordance with the expressed preference. Applicants may be contacted by AoA 

staff to furnish additional information. 

c. Timeframe: The State Agencies on Aging approved for funding beginning in FY 1997 will be notified 

30-40 days after the deadline for submitting their application. State Agencies on Aging scheduled to 

begin project activities in FY 1998 or FY 1999 will be notified no later than two months before the 

anticipated start date.

2. Notification Under Executive Order 12372

This is not a covered program under Executive Order 12372.

The closing date for submission of applications is 45 days after the issuance of the PROGRAM 

INSTRUCTION to which these guidelines pertain.

State Agencies on Aging are not required to share in the costs of these projects.

Applications can be either sent or hand-delivered to the address specified below. Hand-delivered 

applications are accepted during the hours of 9:00 a.m. to 5:30 p.m., Monday through Friday. 

Department of Health and Human Services

Administration on Aging

Office of Administration and Management

330 Independence Avenue, S.W., Room 4643

Washington, D.C. 20201
As a state government agency, the SUA may include indirect charges (costs) in its budget as 

determined in accordance with HHS requirements.

To expedite the processing of applications, we request that you arrange the components of your 

application, the original and two copies, in the following order:

o SF 424, Application for Federal Assistance; SF 424A, Budget, accompanied by your budget 

justification; SF 424B (Assurances); and the certification forms regarding lobbying; debarment, 

suspension, and other responsibility matters; and drug-free workplace requirements. Note: The 

original copy of the application must have an original signature in item 18d on the SF 424.

o Project summary description;

o Program narrative;

o Letters of commitment from participating organizations and agencies;

G. Communications with AoA

All applicants will be notified (using the information provided by the SF 424, item 5) of the receipt of 

their application and informed of the identification number assigned to it. This number should be 

referred to in all subsequent communication with AoA concerning the application. If acknowledgment 

is not received within four weeks after the deadline date, please notify the Office of Governmental 

Affairs and Elder Rights by telephone at (202) 619-3106.

H. Completing the Application

In completing the application, please recognize that the set of standardized forms is prescribed by the 

Office of Management and Budget and is not perfectly adaptable to the particulars of this program. If 

you need technical help in completing the forms, please call Al Duncker at (202) 619-1269. Please 

prepare your application consistent with the following guidance:

1. SF 424, Cover Page: Complete only the items specified in the following instructions:

Item 1. Preprinted on the form.

Item 2. Fill in the date you submitted the application. Leave the applicant identifier box blank.

Item 3. Not applicable.

Item 4. Leave blank.
Item 5. Provide the legal name of the applicant; the name of the primary organizational unit which will 

undertake the assistance activity; the applicant address; and the name and telephone number of the 

person to contact on matters related to this application.

Item 6. Enter the employer identification number (EIN) of the applicant organization as assigned by 

the Internal Revenue Service. Please include the suffix to the EIN, if known.

Item 7. Preprinted on the form.

Item 8. Preprinted on form.

Item 9. Preprinted on form.

Item 10. Leave blank.

Item 11. The title should describe concisely the nature of the project. Avoid repeating the title of the 

priority area or the name of the applicant. Try not to exceed 10 to 12 words and 120 characters 

including spaces and punctuation.

Item 12. Preprinted on form.

Item 13. Enter the desired start date for the project, either August 1, 1997, orMarch 1, 1998, or 

January 1, 1999 and the end date for the project, three years later.

Item 14. List the applicant's Congressional District and the District(s), if any, directly affected by the 

proposed project.

Item 15. All budget information entered under item #15 should cover only the first 12 months of the 

project. The applicant should show the federal support requested under sub-item 15a. Sub-items 15b15e are considered cost-sharing or "matching funds". Cost sharing is at the discretion of the State 

Agency on Aging and any organizations collaborating with the SUA on this project.

Item 16. Preprinted on form.

Item 17. This question applies to the applicant organization, not the person who signs as the

authorized representative. Categories of debt include delinquent audit disallowances, loans and taxes.

Item 18. To be signed by an authorized representative of the State Agency on Aging.

2. SF 424A - Budget Information

This form (SF424A) is designed to apply for funding under more than one grant program; thus, for 

purposes of this AoA program, most of the budget item columns/blocks are superfluous and should be 
regarded as not applicable. The applicant should consider and respond to only the budget items for 

which guidance is provided below.

Section A - Budget Summary and Section B - Budget Categories should include both federal and (if 

applicable) non-federal funding for the proposed project covering the first 12 months of the 36 month 

project period.

Section A - Budget Summary

On line 5, enter total Federal Costs in column (e) and, if applicable, total non-Federal Costs (including, 

third party in-kind contributions and program income) in column (f). Enter the total of columns (e) 

and (f) in column (g).

Section B - Budget Categories

Use only the last column under Section B, namely the column headed Total (5), toenter the total 

requirements for funds (combining the federal share with, if applicable, costs borne by the applicant 

and cash contributions of any and all third parties involved in the project, including sub-grantees, 

contractors and consultants) by object class category. Show the totals in row 6-k, column 5.

If applicable, under row 7, Program Income/Third Party In-Kind, column 5, include any in-kind (third 

party) contributions and program income shown in Item 15 (d) (e) and (f) on the face sheet of the SF 

424.

A separate budget justification sheet(s) should be included which shows in three columns the 

breakdown of budget cost items by federal, non-federal (if applicable), and total funds. The rest of this 

separate budget presentation should fully explain the major budget items: personnel, travel, other, 

etc., as outlined below. The column for non-federal funds shown for any of the budget line items in the 

budget justification sheet reflects only cash match contributions (see instructions above for item 15 on 

the face sheet of the SF 424). Third party in-kind contributions and program income designated as 

non-federal match contributions should be identified and justified separately from the justification for 

the budget line items. The full budget justification should be included in the application immediately 

follow the SF 424 budget forms.

Line 6a - Personnel: Enter total costs of salaries and wages of applicant/grantee staff. Do not include 

the costs of consultants, which should be included under 6h - Other.

Justification: Identify the project director, if known. Specify the key staff, their titles, and time 

commitments in the budget justification.

Line 6b - Fringe Benefits: Enter the total costs of fringe benefits unless treated as part of an approved 

indirect cost rate.
Justification: Provide a break-down of amounts and percentages that comprise fringe benefit costs, 

such as health insurance, FICA, retirement insurance, etc.

Line 6c - Travel: Enter total costs of out-of-town travel (travel requiring per diem) for staff of the 

project. Please set aside travel funds for an annual meeting in Washington, D.C. of Project Directors 

(the date to be mutually agreed upon). Do not enter costs for consultant's travel or local 

transportation.

Justification: Include the total number of trips, destinations, length of stay, transportation costs and 

subsistence allowances.

Line 6d - Equipment: Enter the total costs of all equipment to be acquired by the project. Equipment is 

defined as non-expendable tangible personal property having a useful life of more than two years 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 as part of supplies. 

Justification: Equipment to be purchased with federal funds must be justified as necessary for the 

conduct of the project. 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 - Supplies: Enter the total costs of all tangible expendable personal property (supplies) other 

than those included on line 6d.

Line 6f - Contractual: Enter the total costs of all contracts, including (1) procurement contracts 

(except those which belong on other lines such as equipment, supplies, etc.) and, (2) contracts with 

secondary recipient organizations including delegate agencies. Also include any contracts with 

organizations for the provision of technical assistance. Do not include payments to individuals on this 

line.

Justification: 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 should provide a completed copy of 

Section B, Budget Categories for each contractor, along with supporting information.

Line 6g - Construction: Leave blank since new construction is not allowable and federal funds are 

rarely used for either renovation or repair.

Line 6h - Other: Enter the total of all other costs. Such costs, where applicable, may include, but are 

not limited to: insurance, medical and dental costs; noncontractual fees and travel paid directly to 

individual consultants; local transportation (all travel which does not require per diem is considered 
local travel); space and equipment rentals; printing and publication; computer use; training and staff 

development costs.

Line 6i - Total Direct Charges: Show the totals of Lines 6a through 6h.

Line 6j - Indirect Charges: Enter the total amount of indirect charges (costs), if any. If no indirect 

costs are requested, enter "none." 

Line 6k - Total: Enter the total amounts of Lines 6i and 6j.

Line 7 - Program Income/Third Party In-Kind Contributions: Estimate the amount of income, if any, 

expected to be generated from this project which you wish to designate as match (equal to the 

amount shown in Item 15 (f) on SF 424) and combine that with third party in-kind contributions, if 

any.

Non-match anticipated program income should be described in the Level of Effort section of the 

Program Narrative.

Section C - Non-Federal Resources

Line 12 - Totals: If applicable, enter amounts of non-federal resources that will be used in carrying out 

the proposed project. Do not include program income unless it is used to meet match requirements.

Section D - Forecasted Cash Needs: Not applicable.

Section E - Budget Estimate of Federal Funds Needed for Balance of the Project

Complete this section since the total project period encompasses three funding periods.

Line 20 - Totals: Enter the estimated required federal funds for the period covering months 13 through 

24 under column "(b) First," [and for the period covering months 25 through 36 under column "(c) 

Second."]

Section F - Other Budget Information

Line 21 - Direct Charges: Not applicable

Line 22 - Indirect Charges: 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.

Line 23 - Remarks: Provide any other explanations or comments deemed necessary.
3. SF 424B - Assurances

SF 424B, Assurances--Non-Construction Programs, contains assurances required of applicants. Please 

note that a duly authorized representative of the applicant organization must certify that the applicant 

is in compliance with these assurances.

4. Certification Forms

Certifications are required of the applicant regarding (a) lobbying; (b) debarment, suspension, and 

other responsibility matters; and (3) 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.

5. Project Summary Description

The project summary description (page one) begins the substantive part of the application. It should 

be headed by two identifiers: (1) the name of the applicant organization as shown in SF 424, item 5 

and (2) the program priority, namely, Preventing and Combatting Health Care Fraud, Waste, 

and Abuse. Please limit the summary description to one page with a maximum of 1,200 characters, 

including words, spaces, and punctuation.

Be specific and succinct. Outline the objectives of the project, the approaches to be used and the 

outcomes expected. At the end of the summary, list major products that will result from the proposed 

project (such as manuals, data collection instruments, training packages, audio-visuals, software 

packages). The project summary description, together with the information on the SF 424, becomes 

the project "abstract" which is entered into AoA's computer data base. The project description 

provides the reviewer with an introduction to the substantive parts of the application. Therefore, care 

should be taken to produce a summary which accurately and concisely reflects the proposal.

6. Program Narrative

The Program Narrative is the critical part of the application. It should be clear, concise, and, of course, 

responsive to the program priority as described above under Part I, D, pp 2-6. The narrative should 

cover: (A) the project's purpose(s), relevance, significance, and responsiveness to the program 

priority; (B) the workplan/approach(es) the project will follow to achieve its purpose(s); (C) the 

anticipated outcomes/results/benefits of the project and how these will be disseminated and utilized, 

and; (D) the level of effort needed to carry out the project, in terms of the Project Director and other 

key staff, funding, and other resources.

Please have the narrative typed, double-spaced, on one side of 8 1/2" x 11" plain white paper with 1" 

margins on both sides. All pages of the narrative (including charts, tables, etc.) should be sequentially 

numbered, beginning with "Objectives and Need for Assistance" as page number two (2). At the close 
of the project narrative, please identify the author(s) of the proposal, their relationship with the 

applicant, and the role they will play, if any, should the project be funded.