ARRA Communities Putting Prevention to Work: Chronic Disease Self-Management Program

The American Recovery and Reinvestment Act of 2009 (Recovery Act), signed into law February 17, 2009, is designed to stimulate economic recovery in various ways: to preserve and create jobs; to promote economic recovery; to assist those most impacted by the recession, to stabilize state, territorial
and local government budgets to minimize and avoid reductions in essential services and counterproductive state, territorial, and local tax increases; to strengthen the Nation s healthcare infrastructure; and to reduce healthcare costs through prevention activities.

The Recovery Act includes $650 million for evidence-based clinical and community-based prevention and wellness strategies that deliver specific, measurable health outcomes.

The legislation provides an important opportunity for communities, States, territories, cities, rural areas, and tribes to advance public health across the lifespan and to eliminate health disparities.

Of the $650 million appropriated for this initiative (Communities Putting Prevention to Work), $32.5 million will support States and territories in promoting wellness by deploying evidence-based chronic disease self-management programs targeted at older adults with chronic conditions.

AoA, in collaboration with CDC, is providing Recovery Act funding under this announcement to support state efforts to deploy evidence-based chronic disease self-management (CDSMP) programs that empower older people with chronic diseases to maintain and improve their health status.

The community-based collaborative networks setup through these efforts will provide the foundation for an infrastructure and statewide distribution system that States can use for delivering CDSMP and other evidence-based prevention programs to older adults.

These statewide distribution systems will include a quality assurance component to ensure the evidence-based prevention programs are being delivered with fidelity and achieving results comparable to those produced in the original research.

The ultimate goal is to have States and communities embed these structures into their statewide systems that provide community-based services and supports to older adults to help them maintain their health and independence in the community.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - See Regional Agency Offices.

See Regional Agency Offices.

Regional Administrator, Administration on Aging, Department of Health and Human Services, located at all HHS Federal Regional Offices.

(See Appendix IV of the Catalog for addresses.).
Website Address

http://www.aoa.gov



Program Accomplishments

Fiscal Year 2009: No funding was available in 2009. Fiscal Year 2010: This is a new program for FY 2010 therefore there are no program accomplishments to date. The agency anticipates up to 56 awards to states and territories. The key objectives of this 2-year funding opportunity are to: (a) Deliver CDSMP to 50,000 individuals; (b) Document the impact of CDSMP on participant behavior and health status; (c) Develop and test an approach for using Medicare claims data to track the impact of CDSMP on participant health care utilization; and (d) Strengthen the capacity of States and communities to systematically deploy CDSMP and other evidence-based prevention programs that benefit older adults. Fiscal Year 2011: No Current Data Available

Uses and Use Restrictions

In general, the use of these funds is to support state efforts to deploy evidence-based chronic disease self-management (CDSMP) programs that empower older people with chronic diseases to maintain and improve their health status.

These funds are not to be used for "free standing" CDSMP programs that are not part of a state s larger systems development effort to delivery community-based evidence-based prevention programs to older adults.

In using funds for this award for infrastructure investment, recipients shall give preference to activities that can be started and completed expeditiously, including a goal of using at least 50 percent of the funds for activities that can be initiated not later than 120 days after the date of the enactment of Recovery Act.

Recipients shall also use grant funds in a manner that maximizes job creation and economic benefit (Recovery Act Sec.

1602).

The following activities are not fundable: construction and/or major rehabilitation of buildings; basic research (e.g.

scientific or medical experiments); and, continuation of existing projects without expansion.

Furthermore, none of the funds appropriated or otherwise made available in the Recovery Act may be used by any State or local government, or any private entity, for any casino or other gambling establishment, aquarium, zoo, golf course, or swimming pool.

(Recovery Act Sec.

1604).

These funds are not to be used for "free standing" CDSMP programs that are not part of a state s larger systems development effort to delivery community-based evidence-based prevention programs to older adults.

The following activities are not fundable: construction and/or major rehabilitation of buildings; basic research (e.g.

scientific or medical experiments); and, continuation of existing projects without expansion.

Furthermore, none of the funds appropriated or otherwise made available in the Recovery Act may be used by any State or local government, or any private entity, for any casino or other gambling establishment, aquarium, zoo, golf course, or swimming pool.

Eligibility Requirements

Applicant Eligibility

Eligible applicants include all 56 States and territories as follows: in the 24 States with existing AoA Evidence-Based Disease Prevention cooperative agreements, eligibility is limited to the recipient State agency of those existing cooperative agreements; in the 32 States and territories that do not have existing AoA Evidence-Based Disease Prevention cooperative agreements, only State units on aging and State health departments are eligible to apply.

Regardless of which agency applies, both the State unit on aging and State health department must be full partners in the development and implementation of the proposed program.

The State Medicaid Agency must also be involved in the development and implementation of the program.

Only one application will be permitted for each State or territory.

Beneficiary Eligibility

In general, older adults with chronic diseases. Within this population grantees will be asked to define how they will specifically target low-income, minority, and limited English speaking older adults with chronic diseases.

Credentials/Documentation

The application must include a letter of support from the state s Governor in support of the appointed lead agency (i.e. the State unit on aging or the State health department). OMB Circular No. A-87 applies to this program.

Aplication and Award Process

Preapplication Coordination

Only one application will be accepted from each State or territory, and a letter of support from the Governor must be included with the State s application.

States are expected to coordinate with tribal entities in their jurisdiction, and give special attention to serving low-income, minority and limited English speaking seniors.

States are encouraged to link with other community-based efforts with special attention to leveraging other public and private sector resources, including federally funded (including Recovery Act, Older Americans Act, Public Health Services Act, Medicare, and Medicaid funded) activities, State revenue programs, and private philanthropy.

This funding opportunity is an opportunity for State units on aging and State health departments to collaborate on the development of distribution and delivery systems for CDSMP and eventually other evidence-based prevention programs that have the potential to improve the quality of life for millions of seniors and reduce health care costs.

A State government s State unit on aging or health department will be the lead agency for this cooperative agreement.

Regardless of which agency is the lead, the entire grant application, including the work plan, should reflect substantial mutual effort, cooperation, and substantive contributions by both agencies throughout the grant period as well as a significant role for the State Medicaid agency.

Environmental impact information is not required for this program.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Application Procedures

OMB Circular No. A-102 applies to this program. This program is excluded from coverage under OMB Circular No. A-110. Grant applications for federal assistance (Nonconstruction Programs) are in accordance with program announcements developed by the Administration on Aging (AoA) and will be simultaneously published on Grants.gov (www.grants.gov) and on the AoA web site at http://www.aoa.gov/AoARoot/Grants/index.aspx when funding is available. As specified in the program announcement, application forms and instructions may be obtained by writing to the U.S. Department of Health and Human Services, Administration on Aging, Grants Management Office, Washington, D.C., 20201

Award Procedures

Notification of Award will be issued to the grantee.

Deadlines

Contact the headquarters or regional office, as appropriate, for application deadlines.

Authorization

The statutory authority for cooperative agreements under this program announcement is contained in Division A, Title VIII of the American Recovery and Reinvestment Act (Recovery Act) of 2009 (Public Law 111.5). , Title VIII, Public Law 111-5.

Range of Approval/Disapproval Time

From 60 to 90 days.

Appeals

Not Applicable.

Renewals

Not Applicable.

Assistance Considerations

Formula and Matching Requirements

Statutory formulas are not applicable to this program.
This program has no matching requirements. This program has no statutory formula or matching requirement.
MOE requirements are not applicable to this program.

Length and Time Phasing of Assistance

Cooperative Agreements will be made for a 2 year period. Grant extensions are available and may be requested from the grantee"s Program Officer. Method of awarding/releasing assistance: by letter of credit.

Post Assistance Requirements

Reports

Semi-annual program progress reports are required through the life of the award.

Financial Reports are required on a quarterly basis through the life of the award.

Final program progress reports and financial reports are due 90 days after the end of the project period.

Semi-annual program progress reports are required through the life of the award.

Financial Reports are required on a quarterly basis through the life of the award.

Final program progress reports and financial reports are due 90 days after the end of the project period.

All grantees must also comply with all requirements specified in Division A of the Recovery Act, including the reporting requirements outlined in Section 1512.

Section 1512 of the Recovery Act requires reports on the use of Recovery Act funding by grantees 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.

A full list of the recipient reporting data elements is available at: http://www.whitehouse.gov/omb/assets/memoranda_fy2009/m09-21-supp2.pdf and the HHS ARRA award terms and conditions are available at: http://www.hhs.gov/recovery/grantscontracts/recoverytermsconditions.html.

Audits

In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records

Records must be maintained for 3 years after submission of the final financial report.

Financial Information

Account Identification

75-0142-0-1-506.

Obigations

(Formula Grants) FY 09 $0; FY 10 est $27,500,000; FY 11 est $0 - ARRA funding. No future funding anticipated.

Range and Average of Financial Assistance

$50,000 to $2,000,000.

Regulations, Guidelines, and Literature

All grantees must also comply with all requirements specified in Division A of the Recovery Act, including the reporting requirements outlined in Section 1512. Section 1512 of the Recovery Act requires reports on the use of Recovery Act funding by grantees 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. A full list of the recipient reporting data elements is available at: http://www.whitehouse.gov/omb/assets/memoranda_fy2009/m09-21-supp2.pdf and the HHS ARRA award terms and conditions are available at: http://www.hhs.gov/recovery/grantscontracts/recoverytermsconditions.html

Information Contacts

Regional or Local Office

See Regional Agency Offices. See Regional Agency Offices. Regional Administrator, Administration on Aging, Department of Health and Human Services, located at all HHS Federal Regional Offices. (See Appendix IV of the Catalog for addresses.).

Headquarters Office

Jane Tilly, Administration on Aging, One Massachusetts Ave., Washington, District of Columbia 20001 Email: Jane.Tilly@aoa.hhs.gov Phone: (202) 357-3438 Fax: (202) 357-3469.

Criteria for Selecting Proposals

Cooperative agreements will be awarded on a competitive basis. Specific details for evaluating applications are published as part of the program announcement. Major emphases are: (1) documented need; (2) expected outcomes and benefits; (3) innovative approach; (4) level of effort; (5) coordination and partnerships; and (6) projects that benefit disadvantaged groups, including low-income, minority and limited English speaking populations.



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