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Recovery Act Communities Putting Prevention to Work: Chronic Disease Self-Management Program (CDSMP)

 

A. TECHNICAL ASSISTANCE RESOURCES

1. Who are the AoA staff members who manage the CDSMP grant program?
2. Who are the NCOA staff members providing technical assistance for the CDSMP grant program?
3. When I need technical assistance, who do I contact? 
4. What’s the difference between my assigned AoA Program Officer and my assigned AoA Grants Management Specialist?
5. Who is the AoA Grants Management Specialist for the CDSMP grant program? 
6. Can I request a site visit? 
7. Will AoA or NCOA conduct site visits?
8. Will I participate in regularly scheduled technical assistance conference calls with AoA and NCOA staff? 
9. Where can I learn about NCOA’s resources? 

 B. PROGRAM ISSUES

1. Where can I access more information about CDSMPs and how to implement them in my state? 
2. How can I determine the capacity of my State’s CDSMP workforce? 
3. Who do I contact for licensing issues? 
4. Will there be a national brand name for CDSMP? 
5. Can CDSMP Leaders, Master Trainers and T-Trainers trained to administer the CDSMP classroom version also serve as facilitators of the online version of CDSMP?
6. Are A Matter of Balance; Program to Encourage Active, Rewarding Lives for Seniors (PEARLS); and Identifying Depression, Empowering Activities for Seniors (Healthy Ideas) considered Chronic Disease Self-Management Programs?

C. PERFORMANCE MONITORING AND REPORTING

1. How does the program announcement define “older adults”?
2. What is the definition of program completers? 
3. Can participants in workshops that are funded by CDC or other non-Recovery Act funding be counted towards the state’s target number of course completers it must reach under the Recovery Act CDSMP grant program? 
4. Can caregivers and other CDSMP participants under 60 be counted towards the completer goals? 
5. Can participants that complete the on-line CDSMP be included in the state’s number of completers?  
6. Are the state targets for completers for one year or two years?
7. Will workshops that end after March 30, 2012 count towards my completer requirement? 
8. Does the term “vulnerable populations” include residents of rural areas?
9. Are correctional facility populations an appropriate target group for the Recovery Act CDSMP grant program? 
10. What are the reporting requirements for this grant? 
11. Page 6 of the program announcement lists outcomes for participants who complete a CDSMP. Are all states required to track and report on these outcomes? 
12. What are the State and local obligations related to the national studies of CDSMP?

 D. CDSMP ONLINE REPORTING SYSTEM

1. Why does the Participant Information Survey and Workshop Information Cover Sheet not ask what county the participant lives in or what county the workshop was held in? 
2. Participant Information Survey asks “Have you taken a CDSMP workshop before?” Why is the question asked? It’s not clear to participants how to answer it/ participants don’t know if they’ve taken “CDSMP” before because we use different program names. 
3. I have information regarding the total number of participants who enrolled in a CDSMP workshop, but not the specific sessions that were attended by each participant. Should I still enter this information into the online reporting system?
4. Are pre-/post-surveys not required for the Recovery Act CDSMP project? What if we would like to do them to capture data we can use on the state level? May we do that using our own database, as long as we enter the required information in the online CDSMP Reporting System database?
5. What is the definition of a Host Organization or Implementation Site? 
6. There are staff on my State’s team that have not been trained on how to use the online CDSMP Reporting System. How can they get trained? 
7. There are staff on my State’s team that have viewed the archived CDSMP Reporting System training webinar (or viewed it live on June 22 or 23, 2010). They haven’t received their log-in information yet. How can they get this? 
8. If a participant leaves a question blank, can I leave that question blank in the online system?
9. When entering participant demographic data, there is no option for selecting “none” as a response to Chronic Conditions. How to we enter this in the online system? 
10. We had some people younger than age 60 in a workshop. When I entered their birthdates, I got a warning that says "the birth year you entered is outside the expected range (1901-1950). Please confirm that this is the correct birth year." Why does this happen? 
11. How do I delete a record that I entered accidentally?

 E. GRANT ADMINISTRATIVE / MANAGEMENT ISSUES

1. How many years is this cooperative agreement funded?  
2. Can a state that has an existing AoA evidence-based health prevention cooperative agreement continue to build infrastructure in communities it currently serves? 
3. Do we need to include a standardized acknowledgement anywhere that our CDSMP workshops are being supported by Recovery Act funding? 
4. Can an agency or organization other than an Area Agency on Aging or local Public Health Department serve as a “lead local agency”?
5. Can State lead agencies subcontract services to an external organization? 
6. How is the funding for this program distributed? 
7. What are some examples of types of jobs created under this Recovery Act initiative? 
8. What’s the difference between sub-recipients and vendors? 
9. What are the regulations for drawing down funds?
10. In extraordinary circumstances, can a state use a memorandum of understanding with a private, non-profit organization in place of a contract when that non-profit will be receiving Recovery Act funding and managing contracts with local lead organizations?
11. How much of my budget can I revise without seeking AoA approval? 
12. Can a grantee give fiscal or other types of incentives, such as small amounts of money or gifts to recruit CDSMP participants?  
13. Can a grantee use these Recovery Act funds to pay for transportation costs associated with getting participants to and from a CDSMP Program?
14. Can Recovery Act CDSMP grant funds be used to pay for meals during our Leader or Master Trainer trainings? Can we use our grant funds to support snacks for participants during workshops or during an event we are holding for our partners/ leaders?
15. My state is reimbursing partners on a per-completer basis. Can I use my Recovery Act CDSMP funds to pay for individuals who complete a workshop after March 30, 2012? 
16. When a state buys equipment to carry out a grant, what are the rules regarding who owns that equipment at the end of the grant period?
17. Can a grantee request a no-cost extension if it has not spent its entire Recovery Act funds by the closing date of the grant?
18. When does the Office of Grants Management want to receive no-cost extension requests? 
19. Can a grantee carry-over unspent Evidence-Based Disease and Disability grant funds into their Recovery Act funds? 
20. Can a grantee change the authorizing agency?
21. How can I change the Principal Investigator (PI) or the Authorized Organizational Representative (AOR) of my organization? 

A. TECHNICAL ASSISTANCE RESOURCES

 1. Who are the AoA staff members who manage the CDSMP grant program?

 2. Who are the NCOA staff members providing technical assistance for the CDSMP grant program?

 3. When I need technical assistance, who do I contact?

When you need technical assistance, you should email requests to your assigned NCOA Program Associate and also copy your assigned AoA Program Officer. Both of these individuals serve as the core team members for your technical assistance needs. Periodically, leadership staff and/or consultants may assist AoA and NCOA staff with meeting your technical assistance needs.

 4. What’s the difference between my assigned AoA Program Officer and my assigned AoA Grants Management Specialist? 

You should contact your assigned AoA Program Officer for any programmatic issues and contact your assigned AoA Grants Specialist for all budgetary and administrative issues regarding your grant. When contacting your assigned Grants Specialist, please cc your Program Officer on the email.

 5. Who is the AoA Grants Management Specialist for the CDSMP grant program?

Your assigned AoA Grants Specialist is Ms. Rebecca Mann. Please cc your Program Officer on all of your correspondences with the grants office.

 6. Can I request a site visit?

Yes. You can request a site visit for a variety of reasons: general technical assistance, support with partnership, kick-off or roll-out meetings, or specific troubleshooting and problem solving.

 7. Will AoA or NCOA conduct site visits?

AoA and NCOA will conduct site visits based on requests, grantee needs, and if funds are available. 

 8. Will I participate in regularly scheduled technical assistance conference calls with AoA and NCOA staff?

Yes. Conference calls are part of the Federal grant monitoring process. They allow the grantee to provide program updates and allow AoA and NCOA staff to provide technical assistance and help ensure success of the grantees in meeting their goals.

 9. Where can I learn about NCOA’s resources?

NCOA’s Center for Healthy Aging website has a wealth of tools and resources to assist aging services providers in implementing and disseminating evidence-based disease prevention/health promotion programs.  In addition, you can join our online community. This website allows for participants (you must register to be a participant) to post their own resources to the library as well as engage in discussions through a forum thread.  Once you have registered, you will be invited to join the “EBP Grantee” Group.  

B. PROGRAM ISSUES

 1. Where can I access more information about CDSMPs and how to implement them in my state?

There are two websites you should visit: 

  • The Stanford University Patient Education Center’s website provides detailed information about the English and Spanish versions of the Chronic Disease, Arthritis, and Diabetes Self-Management Programs; information about training and licensing; copies of the Implementation Guide and Fidelity Guide and Toolkit; and evaluation tools.
  • The National Council on Aging’s website provides information and links for CDSMPs and many tools that can help states plan, implement and sustain CDSMPs. Also see above for additional information about NCOA resources.

 2. How can I determine the capacity of my State’s CDSMP workforce?

Stanford University has developed a formula to determine how many Master Trainers and Lay Leaders you will need based on how many participants you’ve targeted for workshops. Access this formula on pages 7-8 of the Fidelity Manual.  In addition, NCOA has developed Cost and Training Calculators that allow you to plan your training needs more efficiently. The Calculators and accompanying Manual are posted in the NCOA online community, under the EBP Grantee Group Library.

 3. Who do I contact for licensing issues?

Stanford offers the following types of licenses for their self-management programs and your point of contact regarding questions will vary depending upon the type. The following information is accurate as of July 2010 but is subject to change. For the most recent information, go to http://patienteducation.stanford.edu/licensing/

  • Single-Program License – for organizations that only offer only one Stanford Program in one language:
    o Cost is $500.00 for offering 10 or fewer workshops a year or $1000 for offering 30 or fewer workshop a year
    o For a copy of the contract, go to: http://patienteducation.stanford.edu/licensing/license_app_single.pdf
    o If offering more than 30 workshops, or for other questions, contact: self-manage-licensing@stanford.edu
  • Multiple-Program License Fees – for organizations that plan on offering more than one Stanford Self-Management Program (for example, CDSMP and Tomando, or CDSMP and Diabetes, etc.:
    o $1000.00 for offering up to 25 total (all programs combined) workshops and 2 Leader trainings a year
    o $1500.00 for offering up to 40 total (all programs combined) workshops and 4 Leader trainings a year
    o For a copy of the contract, go to: http://patienteducation.stanford.edu/licensing/license_app_multi.pdf 
    o For questions, contact: self-manage-licensing@stanford.edu
  • Multi-Site License
    o This license allows states to offer 200 courses a year for three years; mix and match multiple programs; include as many organizations as desired for a base cost of $8000.
    o To add additional courses, the cost is $400 for each additional 10 courses ($40 per course)
    o For additional information and questions, contact heather.carrico@stanford.edu and imelda.oropeza@stanford.edu at Stanford’s Office of Technology Learning.
  • To see a list of existing licensed agencies, go to: http://patienteducation.stanford.edu/organ/.
  • To modify, add or delete agencies during the term of your agreement, send a notification to self-manage-licensing@stanford.edu and reference your agreement.  

4. Will there be a national brand name for CDSMP?

  • The program name recognized by the Administration on Aging, in current legislation, and by the research and health care community is the Chronic Disease Self-Management Program (CDSMP).
  • AoA recognizes that many states have already developed awareness of their own program brand names.
  • To date, there is inadequate research about how different program names affect program participation or which names are most effective with potential participants, particularly those who are limited income, minority or other underserved populations.
  • Therefore at this time AoA is not endorsing any specific brand name besides CDSMP.
  • States who are requesting guidance about branding or marketing may contact NCOA about the customizable marketing materials they’ve developed and regarding research conducted by NCOA about possible names and by the CDC Arthritis Program about appropriate message points to include in promotional materials.

 5. Can CDSMP Leaders, Master Trainers and T-Trainers trained to administer the CDSMP classroom version also serve as facilitators of the online version of CDSMP?

Yes, provided that any additional specialized training required for CDSMP Leaders, Master Trainers and T-Trainers to serve as facilitators of the online version of CDSMP is paid with funds that are not administered by AoA including the Recovery Act funds.

 6. Are A Matter of Balance; Program to Encourage Active, Rewarding Lives for Seniors (PEARLS); and Identifying Depression, Empowering Activities for Seniors (Healthy Ideas) considered Chronic Disease Self-Management Programs?

No. These are evidence-based programs that promote healthy behaviors related to falls and depression but have not been categorized as “chronic disease self-management programs.”


C. PERFORMANCE MONITORING AND REPORTING

 1. How does the program announcement define “older adults”?

The term older adult is defined as individuals aged 60 and older. The applicant can propose to serve individuals under 60; however a state’s Recovery Act CDSMP must focus primarily on serving individuals over 60.

 2. What is the definition of program completers?

Stanford University defines a CDSMP completer as a participant who has completed at least four out of six sessions. This is the definition of completer that AoA has adopted.

 3. Can participants in workshops that are funded by CDC or other non-Recovery Act funding be counted towards the state’s target number of course completers it must reach under the Recovery Act CDSMP grant program?

All individuals who attend four out of six class sessions may be counted regardless of how the CDSMP was funded, as long as the CDSMP workshop is offered through a state’s evidence-based prevention program distribution and delivery system. This method of counting is being allowed since one of the goals of the Recovery Act CDSMP grant program is to leverage all the CDSMP programs being delivered in the state, regardless of their funding source, and to create a single statewide CDSMP delivery system.

 4. Can caregivers and other CDSMP participants under 60 be counted towards the completer goals?

While grantees should target their programs primarily to older adults, all individuals who attend four out of six class sessions may be counted regardless of age as long as the CDSMP workshop is offered through a state’s evidence-based prevention program distribution and delivery system. 

 5. Can participants that complete the on-line CDSMP be included in the state’s number of completers?

The Recovery Act CDSMP funds can only be used to support the "classroom" versions of the CDSMP. However, if a state's overall CDSMP delivery system includes the classroom version and the online CDSMP, then the state can include the online CDSMP course completers as well as the classroom completers toward the total target number of CDSMP course completers it must serve under the Recovery Act Program.

 6. Are the state targets for completers for one year or two years?

The targets for the minimum number of program completers are for two years. 

 7. Will workshops that end after March 30, 2012 count towards my completer requirement?

As long as the workshop starts on or before March 30, 2012, those participants that complete the course may be counted toward your Recovery Act CDSMP grant completer requirement.

 8. Does the term “vulnerable populations” include residents of rural areas?

Yes.

 9. Are correctional facility populations an appropriate target group for the Recovery Act CDSMP grant program?

Yes. A few states have already successfully implemented CDSMP workshops within correctional facilities. This is a high-need population and according to data collected by one state, a significant percentage (45%) of the participants were older adults.

 10. What are the reporting requirements for this grant?

There are three levels of reporting: the grantee progress report, financial reporting, and Recovery Act reporting.

a) Grantee Quarterly Program Progress Report

The first reporting requirement is the standard Grantee Progress Report, which all grantees must complete on a quarterly basis. Grantee Progress Reports are to be submitted (1) to your assigned AoA Program Officer and copies also sent to (2) Rebecca Mann, the Grants Management Specialist, to (3) grants.office@aoa.hhs.gov, and (4) Binod Suwal at NCOA. A clear description and discussion of these reporting requirements begins on page 21 of the program announcement. 

The Grantee Progress Report includes both a quantitative and qualitative section and can be downloaded from the CDSMP Data Collection and Reporting System. After logging on to the reporting system, navigate to: My State Reports>Standard Export Reports. Under the heading Quarterly Program Progress Report, click on the appropriate quarter to create the reporting template which will appear on your screen as a word document. 

The first section of the quarterly progress report is a table that reports quantitative information such as the number of completers. The quantitative section of the report will be pre-populated by the data entered into the CDSMP Data Collection and Reporting System for the respective quarter. Instructions on how to complete the qualitative section of the report can be located on the Grantee Section of NCOA’s Center for Healthy Aging’s website (www.healthyagingprograms.org/content.asp?sectionid=133).

To facilitate the collection and reporting of the required quantitative participant data, standardized pen and pencil forms and a web-based data entry system are available through NCOA.  The forms and directions can be found at www.healthyagingprograms.org/content.asp?sectionid=133 and the web portal can be accessed at www.ncoa.org/cdsmpdata. Grantees must be trained and licensed to receive a user name and login information to access the system.

b) Financial Reporting

A Financial Status Report (SF-269) will be required as denoted in the Notice of Award. (Please Note: Grantees are also required to submit a quarterly Federal Cash Transaction Report – the SF-272 to the Payment Management System as identified in their award documents for the calendar quarters ending 3/31, 6/30, 9/30, and 12/31 through the life of their award.  HHS is transitioning to the combined Federal Financial Report (FFR) known as the SF-425, which will replace the Financial Status SF-269 and Federal Cash Transaction Report SF-272.  HHS/AOA will provide further guidance implementing the use of the new form at a later date.)

c) Recovery Act Reporting

Recipients of Federal awards from funds authorized under the Recovery Act (Public Law 111-5) must comply with all requirements specified in Division A, including the reporting requirements outlined in Section 1512. www.FederalReporting.gov  is the central government-wide data collection and review system for federal agencies and recipients of Recovery Act funding. Recipients will use www.FederalReporting.gov  in order to fulfill their reporting obligations.

Section 1512 of the Recovery Act requires reports on the use of Recovery Act funding by recipients no later than the 10th day after the end of each calendar quarter and for the federal agency providing those funds to make the reports publicly available no later than the 30th day after the end of that quarter. For the full list of the recipient reporting data elements, visit:
http://www.whitehouse.gov/omb/assets/memoranda_fy2009/m09-21-supp2.pdf.

Recipients of Recovery Act funding should report job data as prescribed in Section 5 of the Office of Management and Budget (OMB) Recovery Act guidance (M-09-21). The Recovery Act requires an estimate of the number of jobs created or retained. The estimate should be expressed as “full-time equivalents” (FTE). For guidance related to calculating jobs created or retained please visit: http://www.whitehouse.gov/omb/assets/memoranda_2010/m10-08.pdf.

For more information on OMB Recovery Act reporting links and AoA Recovery Act reporting tools and resources, access this link on to the AoA webpage:
http://www.aoa.gov/AoAroot/PRESS_Room/News/2009/03_18_09.aspx.

 11. Page 6 of the program announcement lists outcomes for participants who complete a CDSMP.  Are all states required to track and report on these outcomes?

No. These outcomes apply to the national program and will be tracked and measured through nationally administered studies. A subset of states will be selected for participation in these projects after they receive the Recovery Act CDSMP grant. States will assist with identifying individuals to participate in the projects. States and their associated local agencies that accepted the Recovery Act awards and funding have agreed to cooperate with this study if selected. The specific study methods have not yet been determined. Federal funds will be used for the projects.

 12. What are the State and local obligations related to the national studies of CDSMP?

All State grantees and their local lead agencies must agree to cooperate with two nationally funded studies. One is a nationally administered survey of program completers at “baseline,” 6-months, and 12 months after finishing the program to assess the impact of CDSMP on completers’ health behaviors, health status and self-reported health care utilization. The second project is an AoA-CMS collaboration to develop and pilot test a quality assurance process that will track Medicare claims data of CDSMP participants and compare their health care utilization and costs to a comparable group of Medicare beneficiaries not participating in CDSMP. This will occur in one state. We do not know which states will be selected at this point for these studies, nor do we know what state and local cooperation will entail. However, the federal government will fund these studies; they are not a state responsibility.


D. CDSMP ONLINE REPORTING SYSTEM

 1. Why does the Participant Information Survey and Workshop Information Cover Sheet not ask what county the participant lives in or what county the workshop was held in?

The zip code is collected for both participants and workshops. The online CDSMP Reporting System automatically derives county from the zip code entered for the workshop implementation site. County is displayed, reported, and included in data export files and reports.

 2. Participant Information Survey asks “Have you taken a CDSMP workshop before?” Why is the question asked? It’s not clear to participants how to answer it/ participants don’t know if they’ve taken “CDSMP” before because we use different program names.

This question is intended to identify people who have specifically completed a Stanford University self-management program in the past (attended at least four of six sessions). AoA is interested in determining the number of unduplicated self-management program completers; therefore, those who have already completed a Stanford University self-management program will not count towards your state’s overall number of completers.

It might be helpful to provide group leaders with a list of the names of the self-management programs offered in their regions, so that leaders can clarify the question as they are administering the Survey. For example, they could say to participants, “The final question asks if you have taken a workshop like this one before. You may have taken it under the names ‘Living Well [My State]’ or ‘[My State] Take Control of Diabetes’. Answer ‘no’ if you have not completed one of these specific workshops, even if you have taken other health education workshops. Also, States may edit the Survey form itself, replacing the “CDSMP” reference in that question with your local program names.

 3. I have information regarding the total number of participants who enrolled in a CDSMP workshop, but not the specific sessions that were attended by each participant. Should I still enter this information into the online reporting system?

Because the Recovery Act grant requires grantees to reach a certain number of CDSMP completers (those participants who attend at least four sessions), it is important to have comprehensive attendance information entered into the system to track this outcome. Therefore, you should only enter workshop data that includes attendance information for each participant.

 4. Are pre-/post-surveys not required for the Recovery Act CDSMP project? What if we would like to do them to capture data we can use on the state level? May we do that using our own database, as long as we enter the required information in the online CDSMP Reporting System database? 

There is no pre-/ post-survey requirement for the Recovery Act project. If you would like to capture pre-/ post- survey data within your state, that is fine, and many states do. You can add those pre-/ post-survey forms to the “standard” form packet that captures the required Recovery Act data (workshop data, participant demographics and attendance), and enter the data for the pre-/ post-surveys into your own data management system.

 5. What is the definition of a Host Organization or Implementation Site?

The definition of a “Host Organization”:

The organization or agency that sponsors CDSMPs offered in your state under the AoA Recovery Act grant is the Host Organization. The Host Organization is often responsible for training CDSMP Master Trainers and Group Leaders, and for planning and monitoring the implementation of workshops. Often (but not always) the Host Organization holds the license to train and offer CDSMP. We recognize that sometimes a Host Organization may also serve as an Implementation Site.

The definition of an “Implementation Site”:

The physical location where CDSMP workshops are offered in the community is the Implementation Site. An Implementation Site may be identical to the Host Organization, or it may be a location (such as a community center, health care facility, church, etc.) that the Host Organization arranges to use.

 6. There are staff on my State’s team that have not been trained on how to use the online CDSMP Reporting System. How can they get trained?

The archived CDSMP Reporting System training webinar can be viewed at:
http://www.healthyagingprograms.org/content.asp?sectionid=164&ElementID=911.  

Once they have viewed the training webinar, they should so certify by emailing CDSMPdata@ncoa.org.

 7. There are staff on my State’s team that have viewed the archived CDSMP Reporting System training webinar (or viewed it live on June 22 or 23, 2010). They haven’t received their log-in information yet. How can they get this?

Once State staff have viewed the training webinar, email the following details to CDSMPdata@ncoa.org:

  • Name
  • Email address
  • Whether they will be Data Entry Users or State Admin Users

Note: typically there are between one and five Data Entry Users and one or two State Admin Users per State. (The State Admin User’s account can also perform data entry functions, in addition to viewing reports and entering State quarterly targets and Master Trainer/Group Leader counts.)

 8. If a participant leaves a question blank, can I leave that question blank in the online system?

Yes.

 9. When entering participant demographic data, there is no option for selecting “none” as a response to Chronic Conditions. How to we enter this in the online system?

If someone marks “none” for chronic conditions, you will leave the chronic conditions item blank on the online data entry screen. Such responses will be counted as persons reporting no chronic conditions.

 10. We had some people younger than age 60 in a workshop. When I entered their birthdates, I got a warning that says "the birth year you entered is outside the expected range (1901-1950). Please confirm that this is the correct birth year." Why does this happen?

The date of birth field is set to show a warning for birth-year that is not between 1901 and 1950, in order to alert people when they’re entering an unexpected date. However, the system still allows you to enter dates outside of that range (just click Okay on the warning message, and continue entering data). In this way, the system requires a double-check on unusual dates, in order to help screen out typos.

 11. How do I delete a record that I entered accidentally?

Email CDSMPdata@ncoa.org with information about the record you need to delete.

 

E. GRANT ADMINISTRATIVE / MANAGEMENT ISSUES

 1. How many years is this cooperative agreement funded?

The funding for this opportunity is for two years, from March 31, 2010 and an end date of March 30, 2012. States have two years from the date their award started (3/31/10) to complete their work.

 2. Can a state that has an existing AoA evidence-based health prevention cooperative agreement continue to build infrastructure in communities it currently serves?

Yes. AoA encourages states to build upon their existing CDSMP programmatic infrastructure. Therefore, an applicant can serve existing and/or new CDSMP communities. In communities with existing CDSMPs, the grantee must demonstrate that it will in some way significantly expand the program with these funds.

 3. Do we need to include a standardized acknowledgement anywhere that our CDSMP workshops are being supported by Recovery Act funding?

There is not any standard language, but it is recommended that grantees note the Recovery Act funding on any materials using a statement such as, “Funding for this workshop (these materials etc.) was provided by the American Recovery and Reinvestment Act.” If materials refer readers to a web site for more information, it is also recommended that you include a reference to hhs.gov/recovery. For more information about the Recovery Act, please see: www.hhs.gov/recovery and www.recovery.gov.

 4. Can an agency or organization other than an Area Agency on Aging or local Public Health Department serve as a “lead local agency”?

No, except in states where the State Health Department or State Unit on Aging also serve as the local health department or area agency on aging (e.g., in states with single “Planning and Serve Areas”). Those agencies can simultaneously serve as the “lead state agency” and the “lead local agency” as described in the Funding Opportunity Announcement.

 5. Can State lead agencies subcontract services to an external organization?

Yes, certain services can be contracted out at the state level. Examples of such services are training of lay leaders, and quality assurance functions. However, the State lead agency has programmatic and fiduciary responsibility for the grant, including meeting program milestones, goals, guidelines and all reporting requirements. States must distribute funding for delivering CDSMP to local lead agencies, which may subcontract services, including program delivery.

 6. How is the funding for this program distributed?

Funding will flow from the Administration on Aging through cooperative agreements to the lead State agency. The lead State agency then dispenses the funds to the local lead agencies. Local lead agencies can channel funds to community-based agencies and organizations, such as aging services provider organizations and health care entities. States may propose other approaches to managing the flow of funds to support local CDSMP programs, but they must maintain the roles and identities of the “Lead State Agency” and the “Lead Local Agency” as prescribed in the Funding Opportunity Announcement.

 7. What are some examples of types of jobs created under this Recovery Act initiative?

Examples are T-Trainers, Master Trainers, and Lay Leaders and staff who support the administration of the CDSMP. Under Recovery Act reporting requirements, grantees must submit information from their vendors who create jobs.

 8. What’s the difference between sub-recipients and vendors?

Sub-recipients are defined in the OMB Recovery Act guidance as those entities that receive funding from the prime recipient to support the performance of any portion of the substantive project or program for which the prime recipient received Recovery Act funding. The terms and conditions of the federal award are carried forward to the sub-recipient. Vendors are defined as entities that operate in a competitive environment and provide similar goods and services to many different purchasers, and these goods and services are ancillary to the operation of the federal program.

 9. What are the regulations for drawing down funds?

A grantee may draw down funds on an as needed basis from the Payment Management System (PMS) generally for expenses that are going to be incurred three days in advance. For example, if payroll is due on a Monday, recipients can draw down funds from PMS on the proceeding Thursday to meet that expense. If cash remains on hand for longer than three days, an explanation would be required on the federal cash transactions report at the end of the reporting cycle.

 10. In extraordinary circumstances, can a state use a memorandum of understanding with a private, non-profit organization in place of a contract when that non-profit will be receiving Recovery Act funding and managing contracts with local lead organizations?

We cannot advise on this situation. The prime recipient must follow their established procurement policies and procedures which must be compliant with the basic Federal requirements established in the applicable code of Federal regulations associated with their award terms and conditions. If one deviates from the normal procurement process, then the relationship could be questioned in an audit review.

 11. How much of my budget can I revise without seeking AoA approval?

You may revise 25% or less of your budget without seeking AoA approval.

 12. Can a grantee give fiscal or other types of incentives, such as small amounts of money or gifts to recruit CDSMP participants?

This is not recommended, but in limited circumstances to meet programmatic goals, a State may do it.  Remember these are tax payer dollars and issuing cash or gift cards may not be received favorably by the general public. If a grantee offers such incentives, it must present a compelling reason and evidence as to why it is necessary to do so along with detailed accounting of the incentives for audit purposes. An applicant needs to weigh its programmatic resources and fiscal costs against its ability to meet or exceed the minimum number of program completers it must produce. In other words, is the expenditure for an incentive going to help the grantee meet its target or will it actually limit its ability to support a core activity key to the grant’s success? From a fiduciary perspective, every cost in the grant must meet the Federal Cost Principle guidelines. Each cost must be reasonable, allowable and allocable. Additionally, from a programmatic perspective, grant expenditures should be developed within the context of sustainability.

 13. Can a grantee use these Recovery Act funds to pay for transportation costs associated with getting participants to and from a CDSMP Program?

This is not recommended, but in limited circumstances to meet programmatic goals, a State may propose to do so. A better approach would be for a state to demonstrate how it is going to leverage existing transportation resources from various public and private sources to provide for any needed transportation. A grantee needs to weigh its programmatic resources and fiscal costs against its ability to meet or exceed its minimum number of program completers. In other words, is the expenditure for a transportation going to help the grantee meet its target or will it actually limit its ability to support a core activity key to the grant’s success? From a fiduciary perspective, every cost in the grant must meet the Federal Cost Principle guidelines. Each cost must be reasonable, allowable and allocable. Additionally, from a programmatic perspective, grant expenditures should be developed within the context of sustainability.

 14. Can Recovery Act CDSMP grant funds be used to pay for meals during our Leader or Master Trainer trainings? Can we use our grant funds to support snacks for participants during workshops or during an event we are holding for our partners/ leaders?

Grant funds may not be used for meals. The cost of providing snacks during CDSMP workshops or partner/ leader events is an allowable expense. However, grantees are encouraged to find partners and implementation sites or other funding sources to provide refreshments or support these expenses. They should also determine if this expense will help or hinder their ability to achieve their target number of program completers and other grant goals. From a fiduciary perspective, every cost in the grant must meet the Federal Cost Principle guidelines. Each cost must be reasonable, allowable, and allocable. Additionally, from a programmatic perspective, grant expenditures should be developed within the context of sustainability.

 15. My state is reimbursing partners on a per-completer basis. Can I use my Recovery Act CDSMP funds to pay for individuals who complete a workshop after March 30, 2012?

As long as (1) the funds are obligated on or prior to March 30, 2012 and (2) the workshop begins on or prior to March 30, 2012, grant funds may be used to pay for individuals who complete a workshop after the grant period has ended.

 16. When a state buys equipment to carry out a grant, what are the rules regarding who owns that equipment at the end of the grant period? 

HHS regulations provide guidance on equipment purchased under a grant. These rules can be found at 45 CFR Part 92.32. The general rule is that States can use, manage, and dispose of equipment acquired under a grant in accordance with State laws and procedures. For grantees other than state agencies, the regulations provide guidance and should be reviewed by the grantee to ensure compliance.

 17. Can a grantee request a no-cost extension if it has not spent its entire Recovery Act funds by the closing date of the grant? 

AoA will consider requests for no-cost extensions on a case by case basis. Requests should be submitted by March 1, 2012 and must provide sufficient justification for why the grantee was unable to complete their programmatic activities according to their work plan within the project period.  Requests for NCEs will not be approved if the primary purpose of the proposed extension is to permit the use of unexpended funds.   

Approval may be granted if any of the following applies:

  • Additional time beyond 3/30/12 is required to ensure adequate completion of program activities originally listed in the grantee’s original application and budget, or activities subsequently approved by the AoA Program Officer, particularly the following grantee responsibilities outlined in the program announcement:
    • Achievement of the targeted number of CDSMP participant completers 
    • Development of a sustainable distribution and delivery system that systematically delivers CDSMP and other evidence-based prevention programs for older adults, including the following key components:
      • Establishment of an ongoing leadership and project management structure that will continue directing program dissemination beyond 3/30/12
      • Strengthening the infrastructure and partnerships that will be necessary over the long-run to effectively embed CDSMP within the statewide health and long-term care systems, including an adequate workforce, host sites that have embedded the program into their ongoing delivery mechanism,  implementation  sites, and referral sources.
      • Development of a business/ sustainability plan
      • Development of a quality assurance program
  • An extension is necessary to permit an orderly phase-out of the program including completion of any approved post-workshop evaluation activities.

If you request and receive a no-cost extension, you may continue to expend funds and complete workshops and other programmatic activities until the adjusted project period end date.

 18. When does the Office of Grants Management want to receive no-cost extension requests?

Generally speaking, no-cost extension requests are to be submitted to the agency (AoA) 30 days prior to the expiration date of the project period.

Requests for no-cost extensions are prior approval requests and as such are governed by the DHHS policies for requesting prior approval:

  1. Prior-approval requests needs to be signed by the Principle Investigator/Project Director on official letterhead if coming in by hardcopy or sent by the PI if by e-mail. 
  2. All requests must include the name of the grant recipient organization; the name of the initiating PI/PD; the PI/PD’s telephone number, fax number, and e-mail address; and comparable identifying information for the authorized organization official.
  3. E-mail requests must be clearly identified as prior-approval requests (no cost extension) and must reflect the complete grant number in the subject line. Send to the following e-mail address: grants.office@aoa.hhs.gov and copy the Grants Management Specialist (GMS) indicated on the Notice of Award (Rebecca Mann: rebecca.mann@aoa.hhs.gov) and the relevant AoA Program Officer.
  4. State what program activities remain to be done and provide a reasonable justification to why a no cost extension is needed i.e.) reasons for delay, hiring problems, contract fell through, etc. Just having money left to spend does not warrant an extension.
  5. Provide an estimated budget of what funds will remain after the current grant end date and state how they will be used in your justification.
  6. The requesting extension date must be clearly stated. Provide an end date of a month, e.g. June 30, September 30, etc.

Before the grants office processes the NCE, they will make sure that the file is up to date on all progress reports and fiscal status reports (SF-425’s).  If any reports are missing, they will ask for them and will need to receive them before they process the NCE. 

AoA will review the request and the grants office will provide a response to the authorized organizational representative, with a copy to the PI/PD, indicating the final disposition of the request. Only responses provided by the grants office are to be considered valid. Recipients that proceed on the basis of actions by unauthorized officials do so at their own risk, and AoA/HHS is not bound by such responses.

 19. Can a grantee carry-over unspent Evidence-Based Disease and Disability grant funds into their Recovery Act funds?

No, funds cannot be commingled with another award. They must be tracked separately.

 20. Can a grantee change the authorizing agency?

Yes. A grantee can change the authorizing agency of the grant as long as it is a State Public Health or a State Unit on Aging entity. Changes in authorizing agency should be submitted to both your AoA Program and Grants Specialist. The Recovery Act Grants Specialist, Ms. Rebecca Mann will take the lead in processing this request. There will need to be a relinquishment letter along with an accounting of funds and activities from the initial agency and then an application from the agency taking over the grant related activities. The initial award was made to one entity and by changing entities we must execute a transfer in our database system based on the appropriate documentation.

 21. How can I change the Principal Investigator (PI) or the Authorized Organizational Representative (AOR) of my organization?

You’ll need to submit a Prior Approval Request asking for a Change In Key Personnel.  Please contact your AoA program officer to begin this process. 

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