Opportunity Information: Apply for HHS 2009 AOA CD 0919
Apply for HHS 2009 AOA CD 0919
- The Administration on Aging in the income security and social services sector is offering a public funding opportunity titled "The Community Living Program" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.048 Special Programs for the AgingTitle IVand Title IIDiscretionary Projects.
- This funding opportunity was created on Jun 4, 2009 and posted on Jun 4, 2009.
- Applicants must submit their applications by Aug 3, 2009. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $6,000,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $1,000,000.00 in funding.
- The number of recipients for this funding is limited to 16 candidate(s).
- Eligible applicants include: State governments.
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Opportunity Summary:
The Community Living Program is a federal cooperative agreement opportunity from the Administration on Aging (AoA) designed to help State Units on Aging (SUAs) strengthen their statewide and local aging network so older adults who are not eligible for Medicaid, but are at immediate risk of entering a nursing home and eventually spending down to Medicaid, can stay at home with the right supports. The core idea is diversion: identifying high-risk people early, quickly arranging practical home and community-based services (HCBS), and using flexible, consumer-directed approaches so individuals can choose and manage the mix of supports that best fits their situation as needs change. Projects are expected to rely primarily on existing federal and state program dollars to pay for ongoing services, using the grant mainly to build or improve the system that finds, enrolls, and serves this target group.
Funding is structured with clear boundaries and expectations. Although projects may use grant dollars for direct HCBS, they can spend no more than 20 percent of the total grant award on those service costs. The rest is intended for building operational capacity: setting up strong referral and prioritization processes, improving assessment and options counseling, developing care planning and rapid service authorization workflows, ensuring quality assurance and evaluation, and putting in place the infrastructure needed for consumer direction. A major operational requirement is the ability to monitor clients closely and follow up to confirm services are authorized and started quickly, needs are met, and services can be adjusted promptly when a client or caregiver situation changes. Grantees must also be able to track participants over time and document outcomes, especially whether the program successfully prevented or delayed long-term nursing home placement and Medicaid spend down.
States can propose projects in one or more Planning and Service Areas (PSAs). In states with multiple PSAs, AoA encourages SUAs to have Area Agencies on Aging (AAAs) lead local implementation (coordinating with the local Aging and Disability Resource Center, or ADRC-type entity, if the AAA is not already functioning as one). A key implementation milestone is that by the end of month 12 of the 24-month project period, at least one local project must be fully operational and delivering services to the targeted high-risk population. That local project must: (A) use an ADRC or ADRC-type program to identify eligible individuals (not Medicaid-eligible but at imminent risk), (B) have formal protocols and tools that multiple partners can use to refer and prioritize clients, authorize services quickly, and follow up consistently (partners can include AAAs, ADRCs, hospitals, nursing homes, Centers for Independent Living, the Veterans Health Administration, and other providers), and (C) be able to provide Financial Management Services (FMS) to support consumer-directed services, including paying for goods and services and handling payroll, reporting, and related administrative functions.
The announcement defines several essential components. An ADRC (or ADRC-type program) must be able to identify people who truly are on the cusp of nursing home placement and spend down, assess needs, provide options counseling, help develop care plans, and connect clients to services. It must also offer streamlined access to publicly supported long-term services and supports, and it needs to be integrated in some way with the state Medicaid long-term care eligibility process so that people found ineligible for Medicaid but still at high risk can be routed into this diversion effort. “Aging services provider organizations†are those serving older adults with at least partial Older Americans Act funding (including eligible Title VI tribal organizations). “Financial Management Services†are the fiscal accountability and worker/payment safeguards that make self-direction workable, such as payroll processing, tax withholding and filings, vendor payments, and worker’s compensation insurance policy management, all done in compliance with applicable rules and on time. The program also emphasizes “models to deliver flexible services,†meaning authorization and delivery approaches that are not tied to a single provider and can be customized, and “consumer-directed models,†which give participants real control over what services they receive and how they are delivered.
In terms of what the grant can pay for, allowable uses include limited direct services (again, capped at 20 percent) such as personal care, homemaker/chore assistance, transportation, meal preparation and home-delivered meals, home modifications, respite, assistive devices, and other goods or services that help someone remain safely at home or reduce strain on family caregivers. Grant funds can also support ADRC operations tied to the Community Living Program, including better targeting criteria and screening tools to focus on those at imminent risk, plus case management or support brokerage to help participants plan and manage consumer-directed budgets, hire and supervise workers, and navigate self-direction responsibilities. Funds may be used to develop or contract for FMS capacity, provide training and technical assistance (including coordination with AoA’s Community Living Program Technical Assistance Center), design evaluation and quality assurance systems, and cover certain costs associated with implementing Veteran Directed Home and Community Based Services (VDHCBS), such as bridging service costs while reimbursement is pending from a VA Medical Center. Project administration is also allowable, with the caveat that it should not fund staff who have no direct role in the project.
Applications are scored with a strong preference for proposals that show they can (1) clearly identify the funding sources they will use to pay for HCBS beyond the limited grant-funded portion, especially by month 12 and through the full 24 months, (2) accurately and efficiently identify the right high-risk individuals, (3) deliver services quickly once someone is identified, (4) offer a broad menu of service options including meaningful consumer-directed/self-directed choices, (5) serve significant numbers of people in one or more geographic areas during the grant period, and (6) implement system changes that differ from the status quo and are likely to be sustained after the grant ends. Applicants must estimate how many people they expect to divert from nursing home placement and Medicaid spend down during the 24-month period, using state-specific risk estimates provided in the announcement as a reference point.
The opportunity also allows states to include diversion strategies that transition non-Medicaid-eligible individuals out of hospitals, nursing homes, or other facilities when they might otherwise remain in or be discharged to a nursing facility for a long stay and eventual spend down. Applicants are expected to coordinate with other funding streams and clearly explain how activities will complement rather than duplicate existing efforts (for example, other ADRC grants, hospital discharge planning initiatives, or prior Community Living Program awards). There is also an optional VDHCBS component tied to the Veterans Health Administration: states interested in that option submit additional materials describing how VDHCBS will be implemented alongside the Community Living Program, including the amount of funding needed for start-up. States where VHA has already committed VDHCBS funding do not need to reapply for that option.
Program logistics from the source notice include: Funding Opportunity Number HHS-2009-AOA-CD-0919; instrument type is a Cooperative Agreement; expected awards were 16; total estimated funding was $6,000,000; award sizes ranged from $600,000 to $1,000,000; the project period is 24 months; eligible applicants are state governments (through SUAs); and cost sharing or matching is required. The opportunity was posted June 4, 2009, with an original closing date of August 3, 2009, and it is now archived.
Community Living Program (AoA) - FAQs
What is the Community Living Program?
The Community Living Program is a federal cooperative agreement opportunity from the Administration on Aging (AoA). It is designed to help State Units on Aging (SUAs) strengthen the statewide and local aging network so certain high-risk older adults can remain at home with appropriate home and community-based services (HCBS).
What problem is this program trying to solve?
The program focuses on diversion: finding older adults early who are not eligible for Medicaid but are at immediate risk of entering a nursing home and eventually spending down to Medicaid, then quickly arranging practical supports so they can safely stay at home.
Who is the target population?
The target group is older adults who are not Medicaid-eligible, but are at imminent risk of nursing home placement and eventual Medicaid spend down. The program emphasizes accurate targeting to identify people truly on the cusp of nursing home placement.
Who can apply for this grant opportunity?
Eligible applicants are state governments, applying through State Units on Aging (SUAs).
What is the Funding Opportunity Number (FON)?
The Funding Opportunity Number is HHS-2009-AOA-CD-0919.
What type of funding instrument is used?
This opportunity uses a Cooperative Agreement instrument type.
How long is the project period?
The project period is 24 months.
How much funding was available and what were typical award sizes?
Total estimated funding was $6,000,000. Expected awards were 16. Award sizes ranged from $600,000 to $1,000,000.
Is cost sharing or matching required?
Yes. Cost sharing or matching is required.
Is this opportunity still open?
No. The opportunity was posted June 4, 2009, had an original closing date of August 3, 2009, and it is now archived.
Can states implement the project statewide or only in certain areas?
States can propose projects in one or more Planning and Service Areas (PSAs).
What role do Area Agencies on Aging (AAAs) play?
In states with multiple PSAs, AoA encourages SUAs to have AAAs lead local implementation, coordinating with the local Aging and Disability Resource Center (ADRC) or ADRC-type entity if the AAA is not already functioning as one.
What is the required implementation milestone by month 12?
By the end of month 12 of the 24-month project period, at least one local project must be fully operational and delivering services to the targeted high-risk population.
What must the fully operational local project include by month 12?
By month 12, at least one local project must: (A) use an ADRC or ADRC-type program to identify eligible individuals (not Medicaid-eligible but at imminent risk), (B) have formal protocols and tools multiple partners can use to refer and prioritize clients, authorize services quickly, and follow up consistently, and (C) be able to provide Financial Management Services (FMS) to support consumer-directed services.
What partners can be involved in referrals and coordination?
The announcement notes that partners can include AAAs, ADRCs, hospitals, nursing homes, Centers for Independent Living, the Veterans Health Administration, and other providers.
What is an ADRC (or ADRC-type program) expected to do in this program?
An ADRC (or ADRC-type program) must be able to identify individuals at imminent risk, assess needs, provide options counseling, help develop care plans, and connect clients to services. It must also provide streamlined access to publicly supported long-term services and supports.
How does the program connect to Medicaid eligibility processes?
The ADRC (or ADRC-type program) needs to be integrated in some way with the state Medicaid long-term care eligibility process so that people found ineligible for Medicaid but still at high risk can be routed into this diversion effort.
What are “aging services provider organizations†in this notice?
They are organizations serving older adults with at least partial Older Americans Act funding, including eligible Title VI tribal organizations.
What are Financial Management Services (FMS) and why are they required?
FMS are the fiscal accountability and worker/payment safeguards that make self-direction workable. Examples include payroll processing, tax withholding and filings, vendor payments, and worker’s compensation insurance policy management, completed on time and in compliance with applicable rules. The local project must be able to provide FMS to support consumer-directed services.
What does “consumer-directed†mean in this program?
Consumer-directed (or self-directed) models give participants real control over what services they receive and how those services are delivered, allowing people to choose and manage the mix of supports that best fits their situation as needs change.
What does the notice mean by “models to deliver flexible services�
It refers to authorization and delivery approaches that are not tied to a single provider and can be customized, supporting a broad menu of options and consumer-directed choices.
Can grant funds pay for direct home and community-based services (HCBS)?
Yes, but with a strict cap: no more than 20 percent of the total grant award may be spent on direct HCBS service costs.
Why is there a limit on using grant funds for direct services?
The program expects projects to rely primarily on existing federal and state program dollars to pay for ongoing services. The grant is mainly intended to build or improve the system that finds, enrolls, and serves the target group.
What types of direct services are listed as allowable (within the 20 percent cap)?
Allowable examples include personal care, homemaker/chore assistance, transportation, meal preparation and home-delivered meals, home modifications, respite, assistive devices, and other goods or services that help someone remain safely at home or reduce strain on family caregivers.
What non-service (system-building) activities can the grant support?
The grant is intended largely for operational capacity such as: strong referral and prioritization processes; improved assessment and options counseling; care planning and rapid service authorization workflows; quality assurance and evaluation; and infrastructure needed for consumer direction.
Can grant funds support ADRC operations?
Yes. Grant funds can support ADRC operations tied to the Community Living Program, including improved targeting criteria and screening tools, and case management or support brokerage to help participants plan and manage consumer-directed budgets and responsibilities.
Can grant funds be used to create or contract for Financial Management Services (FMS) capacity?
Yes. Funds may be used to develop or contract for FMS capacity.
Can grant funds pay for training and technical assistance?
Yes. Funds may be used to provide training and technical assistance, including coordination with AoA’s Community Living Program Technical Assistance Center.
Can grant funds be used for evaluation and quality assurance?
Yes. The notice allows funds to be used to design evaluation and quality assurance systems.
Is close monitoring and follow-up of clients required?
Yes. A major operational requirement is the ability to monitor clients closely and follow up to confirm services are authorized and started quickly, needs are met, and services are adjusted promptly when client or caregiver circumstances change.
What outcomes are grantees expected to track and document?
Grantees must be able to track participants over time and document outcomes, especially whether the program prevented or delayed long-term nursing home placement and Medicaid spend down.
How are applications scored or what does AoA prefer to see?
The notice indicates a strong preference for proposals that: clearly identify ongoing HCBS funding sources beyond the limited grant-funded portion (especially by month 12 and through the 24 months); accurately identify high-risk individuals; deliver services quickly; offer a broad menu with meaningful consumer-directed options; serve significant numbers of people; and implement system changes that differ from the status quo and are likely to be sustained after the grant ends.
Do applicants have to estimate how many people they will divert from nursing home placement and Medicaid spend down?
Yes. Applicants must estimate how many people they expect to divert during the 24-month period, using state-specific risk estimates provided in the announcement as a reference point.
Can the project include diversion strategies focused on transitions out of facilities?
Yes. The opportunity allows diversion strategies that transition non-Medicaid-eligible individuals out of hospitals, nursing homes, or other facilities when they might otherwise remain in or be discharged to a nursing facility for a long stay and eventual spend down.
Does the program require coordination with other initiatives or funding streams?
Yes. Applicants are expected to coordinate with other funding streams and explain how activities will complement rather than duplicate existing efforts (such as other ADRC grants, hospital discharge planning initiatives, or prior Community Living Program awards).
Is project administration an allowable cost?
Yes, project administration is allowable, with the caveat that it should not fund staff who have no direct role in the project.
What is the optional Veterans Directed Home and Community Based Services (VDHCBS) component?
There is an optional VDHCBS component tied to the Veterans Health Administration. States interested in this option submit additional materials describing how VDHCBS will be implemented alongside the Community Living Program, including the amount of funding needed for start-up.
Are there any special notes about VDHCBS funding commitments?
States where the Veterans Health Administration has already committed VDHCBS funding do not need to reapply for that option.
Can grant funds cover any VDHCBS-related costs?
Yes. The notice states funds can cover certain costs associated with implementing VDHCBS, such as bridging service costs while reimbursement is pending from a VA Medical Center.
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