BOLD Public Health Programs Frequently Asked Questions

1. Question: How do I know if my organization should apply for Component 1 or Component 2?
   Answer: Potential applicants for this NOFO should carefully review the “Additional Information on Eligibility” section for both Component 1 and Component 2 in the NOFO, as well as the information in the “Review and Selection Process” section that describes how your applications will be reviewed.
2. Question: It is understood that an organization may apply for either Component 1 or Component 2. However, is there a limit to the number of submissions per Component (e.g., two Component A proposals from one organization)?
   Answer: An applicant may only submit one application for Component 1 or Component 2. Each applicant must include their Unique Entity Identifier (UEI) number. Only one application per UEI number will be accepted. Furthermore, applicants may only apply for Component 1 or 2, but not both.
3. Question: If we applied for the Component 2 and are not funded, would we automatically be considered for the Component 1 option?
   Answer: No. If you apply for a Component 2 award and are deemed ineligible or are not funded, your application will not be automatically considered for Component 1.
4. Question: Can my organization be the primary applicant on one application and a subcontract on other applications?
   Answer: Yes. An applicant can apply as primary recipient for only one award. An applicant may, however, be subcontracted on one or more other applications.
5. Question: Our state has a robust Elder Affairs Office as part of the state Health and Human Services that already manages ADRD issues. Rather than duplicate existing work/stop existing work to comply with grant requirements, can we at the state health department (also part of the state HHS) allocate the budget to that agency?
   Question: F/U to the superagency question: xx Department of Health and Human Services incorporates social determinants of health and health equity into all programs. Again, division of public health is not a stand-alone agency but part of DHHS, in which our state health director resides. We need to know if DHHS would qualify as eligible.
   Question: My state’s dementia and Alzheimer’s programs are not housed in public health but rather in aging & adult services. We are both part of a superagency, Department of Health & Human Services. Would DHHS qualify as a state health department?
   Answer: Please see the Overview (page 5), Eligibility (page 28) and Purpose (page 8) sections of the NOFO PDF. The purpose of this NOFO is to increase Public Health Departments capacity for ADRD. This includes using a public health approach to expand coordination of primary, secondary and tertiary prevention approaches across the jurisdiction. Recipients should be public health departments/departments of health and also overseeing the BOLD project.

6. Question: Are Urban Indian Organizations (UIOs) eligible applicants under the above referenced NOFO (BOLD Public Health Programs to Address Alzheimer’s Disease and Related Dementias)?
   Answer: “This NOFO is authorized by the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act; PL115-406 that amends the Public Health Service Act (Section 398A; 42 U.S.C. 280c-3-4.). This act authorizes funding for “health departments of states, political subdivisions of states, and Indian [American Indian/Alaska Native] tribes and tribal organizations” to develop a strong and uniform dementia infrastructure.” Please see page 28 of the NOFO PDF for additional information.
7. Question:  With regard to the eligibility in the FOA stating, “The applicant must be a state/local or tribal Public Health Department/Department of Health and must administer and oversee this cooperative agreement,” our Division of Public Health is not currently a BOLD recipient. Both our organization and sister Division of Aging and Adult Services are a part of the superagency. We need to know if the Division of Aging cannot apply. If they cannot, would our Department of Health and Human Services be considered eligible to apply?
   Answer: This NOFO provides funding for “health departments of states, political subdivisions of states, and Indian [American Indian/Alaska Native] tribes and tribal organizations” to develop a strong and uniform dementia infrastructure.” Please see the “Purpose” section on page 8 of the NOFO PDF, “Eligibility” section on page 28 of the NOFO PDF as well as the “Additional Information on Eligibility” section on page 29 of the NOFO for additional information.
8. Question: Is oral health a part of this NOFO? I am a geriatric dentist working with many elderly with Alzheimer’s and other forms of dementia. I wonder if oral health is eligible for this funding? 
   Answer: Please review the Background (Page 5), Eligibility (Page 28) and Strategies and Activities section (Page 9) of the NOFO to determine if you should apply for this funding.
9. Question: If a jurisdiction plan is almost complete and not published by the application submission deadline, because it still being revised and refined, do we need to submit it as a draft or must we submit it as a final document? If it’s submitted as a final plan, do we need to include a disclosure that some elements of the plan might change? 
   Answer: Please see the “Eligibility” section on page 28 as well as “Review and Selection Process” beginning on page 42 of the NOFO PDF for additional information on the criteria assigned to the ADRD Strategic plan in the Phase II review process.  CDC does not define “existing plan” or “published plan” within the NOFO.
10. Question: Can we get either slides documenting the “nonresponsive” amounts, or those amounts listed in the published FAQs?  
    Answer: Slides are not available. However, the nonresponsive criteria can be found under the “Eligibility” section on page 28 of the NOFO PDF.
11. Question: Can State Governments apply through a Bona fide agent?
    Question: We have a non-profit organization that has been the state designated Bona Fide Agent for our state. As such we hold many federal awards on the state’s behalf. We see local and territory bona fide agents are explicitly allowed in the guidance (p28). Are State governments also allowed to apply using a bona fide agent? 
    Answer: Yes, Bona fide agents are legal agreements between entities. You should determine if this arrangement exists before applying. If applying as a bona fide agent or fiscal intermediary of a state or local government, documentation must be submitted that establishes the validity of the agent.  Recipients should be public health departments/departments of health and also overseeing the BOLD project.

12. Question: If a county is in a state that has received Component 1 and developed a state plan, would the county be eligible to apply for Component 1, or would being in the state jurisdiction make a county ineligible?
    Answer: There is no eligibility restriction for counties within states that were previously funded under DP20-2004.   However, counties with states that have existing dementia strategic plans should work with the state coalition to ensure compatibility when creating their own county dementia strategic plans.
13. Question:  Our state has no county government. Each of the independent jurisdictions in our county are each responsible for all public health services including addressing dementia. There is no independent funding for regional collaborations. We rely exclusively on grants. Our population is only about 130,000.  I see that all the groups funded by previous BOLD grants are States, large cities or large counties.  Should we assume that an application from 24 small communities who have signed intermunicipal agreements to share grants would not be competitive or receive a waiver of the match?
    Answer: This NOFO provides funding for “health departments of states, political subdivisions of states, and Indian [American Indian/Alaska Native] tribes and tribal organizations” to develop a strong and uniform dementia infrastructure.” Please see the “Purpose” section on page 8 of the NOFO PDF, “Eligibility” section on page 28 of the NOFO PDF as well as the “Additional Information on Eligibility” section on page 29 of the NOFO for additional information. If applying, you must determine the eligibility category (page 28) within which you fall. Recipients should be public health departments/departments of health and oversee the BOLD project.
    Regarding services, in order to avoid duplication of effort, including the activities and mission of other federally funded programs, the funds awarded under this NOFO are not to be used to provide direct services, supports or health care, or training to individuals or duplicate any other federal funding opportunities.
14. Question:  Are territories and freely associated states eligible for this NOFO?
    Answer: Please see the “Eligibility” Section on page 28 of the NOFO PDF.  Eligible applicants include: “Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau”
15. Question: If we applied for this grant could we contract a program coordinator and probably an evaluator as well? The reason I ask that is because to our county doesn’t typically allow us to do federal grant grants that often. They are interested in this one, but they’re not interested in us growing the health department meaning me hiring people to take this grant on. But I do have a local organization that would be willing to do that, and we could sub award or contract. I was just calling to find out if that is possible.
    Answer: The recipient (the public health department) is expected to perform a substantive role in the project or program. Recipient must ensure that they are not acting as a conduit to another party (that may not be eligible to receive funding directly) and remains eligible for the award. The program director/coordinator must be either an employee of the health department or a contractor with direct supervision and reporting to the Principal Investigator. The public health department must have adequate staff to oversee the BOLD project and its activities. The purpose of this NOFO is to increase Public Health Departments capacity for ADRD.
16. Question: I am reaching out to clarify if our organization is eligible to apply for this funding announcement. Our state does not have traditional public health departments but instead consists of 13 regional public health networks through which state and federal funding from the DHHS flows to implement public health initiatives such as emergency preparedness, medical reserve corp, substance misuse prevention, and convening a public health council, etc. 
    Our 501(c)3 non-profit organization serves as one of the entities in charge of public health program delivery in our state. We also have a variety of statewide older adult programs that we would use to leverage this funding opportunity in conjunction with our partners at DHHS and local chapter of our Alzheimer’s Association. We have confirmation that our state government is not applying for this funding and is supportive of our application.
    Is our organization eligible to apply given the unique model of public health delivery described above?
    Answer: This NOFO provides funding for “health departments of states, political subdivisions of states, and Indian [American Indian/Alaska Native] tribes and tribal organizations” to develop a strong and uniform dementia infrastructure.” Please see the “Purpose” section on page 8 of the NOFO PDF, “Eligibility” section on page 28 of the NOFO PDF as well as the “Additional Information on Eligibility” section on page 29 of the NOFO for additional information. The purpose of this NOFO is to increase Public Health Departments capacity for ADRD. This includes using a public health approach to expand coordination of primary, secondary and tertiary prevention approaches across the jurisdiction.
    If applying, you must determine the eligibility category (page 28) within which you fall. Recipients should be public health departments/departments of health and oversee the BOLD project, including the recipient itself conducting the strategies and activities of the component being applied for. Please see “Approach” (page 7) and “Strategies and Activities” (page 9) sections for more information. If applying as a bona fide agent or fiscal intermediary of a state or local government, documentation must be submitted that establishes the validity of the agent.
17. Question:  We would like to apply for the BOLD grant (our DPH sits within a consolidated DHHS so all CDC grants are recognized as going to state Department of Health and Human Services and not DPH). Our DHHS would like to apply with the PI and funding sitting at our sister Division of Aging. I would like to confirm that this is acceptable eligibility before our staff in DPH and Aging teams work on the application. Can you please confirm that this would still be an acceptable application that would meet CDC’s eligibility criteria?
    Answer: CDC programs do not determine applicant eligibility – that authority rests with CDC’s Office of Grants Services (OGS). While CDC’s OGS cannot determine eligibility until an application is received, any applicant should meet the intention of the NOFO. The intent of this NOFO and the eligibility requirements were specified by Congress in the BOLD Infrastructure for Alzheimer’s Act (P.L. 115-406). According to the legislation, the funding is limited to Public Health Departments (or superagencies that have integrated their public health department into the larger organization) to build the infrastructure needed to address Alzheimer’s Disease and Related Dementias. That language can be found on page 29 of the NOFO under Additional Information on Eligibility which states, “the applicant must be a state/local or tribal Public Health Department/Department of Health and must administer and oversee this cooperative agreement.” Applicants should use a public health approach (as stated on page 5 of the NOFO) and should closely examine all review criteria (pages 43-46). While aging services departments are not the intended applicants, they do play an important role in this area, and, as stated on page 10, “letters of support are required from the organizations serving on the jurisdiction coalition for the application from the aging services and a national non-profit organization whose primary mission is Alzheimer’s disease (state or local chapter, as appropriate).”

1. Question: Is the annual funding for each component for direct cost or total cost?
   Answer: The estimated annual funding for each component is for the total cost (direct and indirect).
2. Question: What level of funding should I request?
   Answer: The anticipated estimated annual funding for year 1 for Component 1 is $250,000 and Component 2 is $450,000. Applications over $350,000 for Component 1 or $600,000 for Component 2 will be deemed non-responsive and will not be reviewed.
3. Question: Are there limitations on indirect costs in this funding application? Is there a cap rate on indirect costs?
   Answer: There is not a cap on the Indirect cost. The specific rate is dependent upon your organization and the final negotiated rate. If your organization has a negotiated rate agreement with a Federal Cognizant Agency, please use the rate that has been established.
4. Question: Can you clarify whether travel would be required yearly for two individuals to visit CDC or just at the onset (year one) of the grant
   Answer:  Annual travel for two individuals to CDC or to a CDC directed meeting is required by this NOFO.
5. Question: Can we include staffing in the budget proposal?
   Answer: You can include staffing in your budget.
6. Question: Do you prefer that we provide you with only a 12-month budget, or provide you with our three-year proposed budget?
   Answer:  A detailed budget is only required for budget period 1. An applicant will need to provide an estimated funding amount for years 2-5.  For guidance on completing a detailed budget, see Budget Preparation Guidelines at: https://www.cdc.gov/grants/applying/application-resources.html. This website also gives you other useful information for applying for a NOFO.
7. Question: Are we allowed to budget money for BRFSS for CDC caregiver or cognitive decline optional modules?
   Answer:  Yes, you can budget for BRFSS optional modules for caregiving and/or subjective cognitive decline.
8. Question: Can you clarify the exact dates for the five-year funding period of this NOFO?
   Answer:  The anticipated start date for the awards under this mechanism is September 30, 2023.  However, the actual award date may be earlier. Upon initiation, each budget year is 12 months long.  While the anticipated project period is 5 years, CDC will continue to award funding annually based on the availability of funds.
9. Question: Can funds be used to purchase promotional items?
   Answer:  Applicants should review the HHS Grants Policy Statement [PDF – 1.3MB]on the HHS website. It provides specific details on allowable costs on pages II-30 through II-43.
10. Question: How do you define a “Program Director” is that the PI or is that the Program Manager? I ask because if it is the Program Manager (me) I’d like to use my state dollars as a match for the 25% minimum time commitment required for the position.
    Answer: The Program Director is the hands-on person leading the day-to-day BOLD project. Please see the Cost Sharing/Matching Requirement on page 30 for details on what can be considered matching funds.
11. Question: If matching funds can only be found to match at 10% instead of 30%, should the waiver request letter ask for a reduction to 10%? 
    Answer: We encourage applicants to match as much as possible, however the waiver must be submitted if the match is under 30%.
12. Question: Match – is the amount of the match 30% of the PROJECT TOTAL. Thought I heard a $500k request would require a $150K match. This is different from my calculation. 
    Answer: Matching is based on the requested amount of federal funds. For example, if you were to request $450,000 for component 2, you will need to provide proof of matching funds in the amount of $135,000.
13. Question: Match Waiver – can we secure a Match waiver before submitting an application? Each application is a lot of work. We would like to know in advance if we would qualify for the waiver. 
    Answer: The match waiver is submitted as part of the application. No determinations prior to that are available.
14. Question: If we don’t have the match, how likely is the waiver? 
    Answer: We are unable to determine the approval of waivers at this time. If you are requesting a waiver, please submit that request with your application using the instructions on page 3 of the NOFO.
15. Question: I don’t see how to document the match in the CDC OFR budget prep guidance document.  Where should I find this? 
    Answer: Matching funds should be clearly delineated in the budget justification. CDC does not have direct guidance on format.
16. Question: Percent time – the NOFO states minimum of 25% for the coordinator and 15% for the evaluator. Since it would be impossible to hire people to assume these roles at these percentages. Assume that these roles can be assumed by current staff, i.e. not requiring a person whose only duties are funded through this coop agreement. 
    Answer: Correct. These staffing percentages are a minimum standard. Percent staff time may be more than this percentage, and staff may have other duties outside of the BOLD program.
17. Question: Are stipends for the coalition participants allowed to cover costs for their Travel and Time? 
    Answer: No, stipends are not allowed. Stipends are allowable for students and fellows only.  Please consult the HHS Grants Policy Statement [PDF – 1.3 MB] for further guidance.
18. Question: There is no award ceiling, but based on the NOFO: Can Component 2 applicants request up to $600,000 as long as there is a 30% match? 
    Answer: The approximate average award for Component 2 awards is $450,000. Requests over $600,000 will be deemed non-responsive and will not be reviewed. The 30% matching funds requirement is required.
19. Question: In the event that a match waiver is requested, would an applicant have an opportunity to try and find the match if the waiver was not approved? (Rather than not be funded). 
    Answer: Matching funds waiver decisions will be discussed at the time recipient is notified of their selection.
20. Question: Waiver criteria – Do you have a waiver evaluation criteria matrix already established to be shared? Similar to how the application would be scored. 
    Answer: The criteria to request a matching funds waiver is described on page 4 of the NOFO PDF. There is no other information available regarding CDC’s internal process for reviewing these waivers.
21. Question: Can unrecovered indirect costs be used to fulfill match requirement? 
    Answer: Unrecovered indirect cost means the difference between the amount charged to the Federal award and the amount which could have been charged to the Federal award under the non-Federal entity’s approved negotiated indirect cost rate. Unrecovered indirect costs, including indirect costs on cost sharing or matching may be included as part of cost sharing or matching only with prior approval of the HHS awarding agency.
22. Question:  If the grantee is partnering with other state agencies to implement certain programs, can we count a state employee’s time from another state agency as part of the indirect cost?
    Answer: Indirect costs may come from any non-federal source.  These costs must be directly used to fund program activities.
23. Question: Does the 450,000/per year budget limits include indirect costs? 
    Answer: Yes, the award amounts include indirect costs.
24. Question: If a state can make the match for several years but then finds it can’t in Y3 for example, can the state apply for a waiver at that point? 
    Answer: Yes, waivers will be considered each budget year. Please see “Cost Sharing and/or Matching Requirements” section on page 4 of the NOFO PDF for additional detail.
25. Question: F/U waiver criteria. Will you limit the number of waivers accepted. 
    Answer: Each hardship waiver is considered separately.
26. Question: What is the budget request limit, per year, and over the 5 years. 
    Answer: Please see page 27 of the NOFO PDF for the annual average award information for both components.
27. Question: Has the total funding for this 5-year grant been secured or is it still subject to congressional approval? 
    Answer: Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government.
28. Question: On page 38 of the CDC-23-0010 NOFO it states, “Applicant must budget funds sufficient for at least two people to attend one CDC meeting annually (for each budget year), in Atlanta, Georgia.” How many days is the annual meeting?  Is budgeting for travel and two nights in Atlanta, per person, sufficient?
    Answer: Applicants should budget for two people to attend one CDC directed meeting annually for approximately 3 days and 2 nights.
29. Question: In one of the Q&A’s there was a reference the HHS Grants Policy Statement. I skimmed through the document and couldn’t find the answer to the following question: Are we able to provide incentives, such as grocery store gift cards, with the BOLD funding (for those who participate in an activity plan identified in the implementation and evaluation plans)?
    Answer: Incentive payments to volunteers or patients participating in a grant-supported project or program are allowable. Incentive payments to individuals to motivate them to take advantage of grant-supported health care or other services are allowable if within the scope of an approved project. To find more information regarding allowable costs, please see the Grants Policy Statement (hhs.gov) [PDF – 1.3MB].
30. Question: We are planning to submit a Matching waiver request with our application.  Should our budget application reflect the amount of match we are requesting in the waiver request? If we are proposing a reduction to 10% match, do we reflect that 10% match in the budget application?  If we propose a complete waiver to zero match, do we reflect zero match in the budget application? Or does the budget need to reflect the original 30% and then the waiver may be granted after application review?
    Answer: If requesting a matching waiver request with your application, provide the level of match you are proposing in your waiver request and clearly reflect that itemized amount in your budget.  You will discuss any matching waiver approvals as well as any budget revisions necessary during your post-award budget negotiations.
31. Question: I am with the State Department of Health, but the department does not have a dedicated program addressing Alzheimer’s and related dementias.  The main groups working on these issues in the state are the State chapter of the Alzheimer’s Association and the University.  The grant is a collaboration between all 3 of these organizations.  The program coordinator will be “housed” in the Department of Health, but is it acceptable to have the .25 FTE Program Manager and Evaluator “housed” in the University?
    Answer: The recipient (the public health department) is expected to perform a substantive role in the project or program. Recipient must ensure that they are not acting as a conduit to another party that may not be eligible to receive funding directly. The program director/coordinator must be either an employee of the health department or a contractor with direct supervision and reporting to the Principal Investigator (at the Public Health Department). The public health department must have adequate staff to oversee the BOLD project and its activities. The purpose of this NOFO is to increase Public Health Department’s capacity for ADRD.
32. Question:  We have been notified by a partner (Alzheimer’s Association, State Chapter) that their association is stating that their staff time on our grant can be used toward our 30% match. In order for them to be part of the grant as a partner, they would be considered a contractor, and we did not think that a contractor could be included in the match. Can you clarify if some of staff time of a partner as a contract can be counted toward the match? If the partner can provide this match but not as a contract, how do we set this up in our organizational plan?
    Answer:  For all Federal awards, any shared costs or matching funds and all contributions, including cash and third-party in-kind contributions, must be accepted as part of the non-Federal entity’s cost sharing or matching when such contributions meet all of the following criteria:
    (1) Are verifiable from the non-Federal entity’s records;
    (2) Are not included as contributions for any other Federal award;
    (3) Are necessary and reasonable for accomplishment of project or program objectives;
    (4) Are allowable under subpart E of this part;
    (5) Are not paid by the Federal Government under another Federal award, except where the Federal statute authorizing a program specifically provides that Federal funds made available for such program can be applied to matching or cost sharing requirements of other Federal programs;
    (6) Are provided for in the approved budget when required by the HHS awarding agency; and
    (7) Conform to other provisions of this part, as applicable
    Therefore, if your organization ensures the match funds are not made up from another Federal Award, from any source, then the source and mechanism of those contributions is up to your organization.   Please see (45CFR 75-306(b)) for more information.

1. Question: Can state agencies applying for Component 2, collaborate with LPHAs pursuing Component 1? 
   Answer: Yes. Collaboration across the jurisdiction is encouraged. Please see the Collaboration section on page 17 of the NOFO PDF.
2. Question: If a county applies are they responsible for creating a coalition for the entire state? 
   Answer: No, the applicant must form a coalition and create an ADRD Strategic Plan for their own jurisdiction. However, collaboration and involvement with the state efforts is highly encouraged.
3. Question: Can you provide clarification on what you are looking for in a strategic plan? Specifically, if a state has an existing plan, will CDC need to review it? 
   Answer: Please refer to the “Strategies and Activities” section on page 9 and the “Review and Selection Process” section on page 42 of the NOFO PDF for more details.
4. Question: Is the implementation plan referred to in the logic model the same as the work plan to be included as part of the narrative? 
   Answer: The Strategic Plan and the Implementation Plan are separate from the cooperative agreement workplan. The workplan is specific to the recipients’ scope of work for the 9 strategies of the NOFO, while the Strategic Plan and Implementation plan are jurisdiction wide.
5. Question: Nine (9) strategies are listed in the RFA. Does the applicant need to address all 9 or can the applicant choose one of the 9? 
   Answer: Yes, all 9 are required.
6. Question: We understand the work plan is included in the 25-page limit and would like to know what is the best way to refer to a duplication of activities that may relate to two or more strategies?
   Answer:  If an activity may relate to two or more strategies, you may add a note to the activity that refers to it in another strategy.  For instance, describe the activity where it is first referenced, and use a (“see also”, or “also addresses Strategy x”).
7. Question: If applying for Component 2, do we need to acknowledge Strategy 3 in our work plan or other documentation or can we simply leave it off?
   Answer:  You do not need to refer to Strategy 3 in your Component 2 application.  See page 14 of the NOFO PDF “Strategies and Activities – Component 2”  for further information on the strategies required for Component 2.
8. Question: In your previous NOFO announcement, one of the strategies was to establish an advisory committee or a coalition.  We chose to have a Tribal Advisory Committee and not a coalition. In the Component 2 Implementation – Strategy 1, Maintain or expand an existing jurisdiction ADRD coalition. Does this also mean advisory committees? What are the expectations of maintaining or expanding existing committees?
   Answer: For the purposes of this program, a jurisdiction coalition is defined in the NOFO Glossary (page 64) as “a formal arrangement for cooperation and collaboration among a diverse cross-section of groups or sectors across the entire jurisdiction. Each group retains its identity and agrees to work together toward a common goal(s).” Your specific advisory group/coalition or other naming conventions for this group may be varied, however, what is important is the function of the group meets the expectations within the NOFO.
9. Question: In your previous NOFO announcement, there were specific actions that Tribal recipients needed to address from the RMIC.  I don’t see any actions specific to Tribal recipients or specifying the RM for Indian Country series.  It is my understanding as a Tribal organization we will continue to use the RMIC series.
   Answer: Tribes and Tribal Organizations should use the HBI Road Map for Indian Country (RMIC) for guiding work within this cooperative agreement.  “Recipients will use a public health approach to ADRD using CDC’s Healthy Brain Initiative State and Local Public Health Partnerships to Address Dementia: The 2023-2027 Road Map, the Road Map for Indian Country (RM Series), as well as future updates of both, as guides to expand and improve the response to ADRD in their jurisdictions.”
10. Question: The state I work in has a state plan to address Alzheimer’s disease and other dementias. In this plan there are a number of strategies, goals and recommendations. For this grant application strategy 4 asks applicants to develop an implementation plan. Is it safe to assume that the implementation plan is a separate document from the state plan, as the implementation plan for this grant will only include some of the strategies, goals and recommendations from the whole state plan?
    Answer: An Implementation Plan is a detailed description of the specific strategies, objectives, actions, and champions that are needed to implement the jurisdiction ADRD Strategic Plan goals. It is developed as an activity of the state/jurisdiction coalition and should be a comprehensive document addressing the implementation of the entire ADRD Strategic Plan.  This is a separate activity from your cooperative agreement workplan. Please see Component 2 “Strategy 4” on Page 16 and “Review and selection Process -Approach” on page 46 of the NOFO PDF for further information.
11. The NOFO talks about community-clinical linkages. Can you please define community-clinical linkages in the context of this NOFO?
    Answer: Community-clinical linkages (CCL) are connections between community and clinical sectors that aim to improve health within a community. Connections made between health care, public health, and community organizations to improve population health are called community-clinical linkages. These connections can reduce health disparities by bridging the gap between clinical care, community or self-care, and the public health infrastructure. CCL’s are explained further in Strategy 9 (Pages 13 and 17), in Evaluation Questions and Performance Measures (Page 21-22) and in the Glossary (Page 64).  As a Social Determinant of Health (SDOH), the link in the NOFO to the NCCDPHP SDOH page also provides further guidance. The specific page under this link that pertains to CCL is here.

1. Question: Can you recommend assessment or measurement tool(s) for any of the required performance measures?
   Answer: CDC does not have recommended tools for the purpose of this NOFO. Applicants are encouraged to seek out and use assessments and tools that are appropriate for their goals.
2. Question: For each of the required strategies and long-term outcomes, are there recommended/validated assessment or measurement tools for assessing baseline and improvements over time for each?
   Answer:  CDC does not have recommended tools for the purpose of this NOFO. Applicants are encouraged to seek out and use assessments and tools that are appropriate for their goals.
3. Question: If we contract out for our evaluation, are we still required to include an evaluator in the salary section?
   Question: I don’t see a requirement for an external evaluator. Is it required to have an official and/or external evaluator? Thank you.
   Answer:  Please refer to the Organizational Capacity section of the NOFO.  An evaluator must be designated at 15%. CDC does not have a preference for whether this position is contracted or salaried.

4. Question: Is a Data Management Plan required as part of the Evaluation and Performance Measurement plan submitted with the application? 
   Answer: No, a DMP is not required.
5. Question: Will the Paperwork Reduction Act of 1995 requirement be waived for this opportunity like it was in the previous one?
   Answer: Neither the previous BOLD Programs NOFO nor this NOFO (DP23-0010) have waived PRA. Please see “Applicant Evaluation and Performance Measurement Plan” section on page 36 of the NOFO PDF.
6. Question:  I have some questions about the evaluation portion of the BOLD NOFO that I’m hoping y’all can clarify for me. On page 36, it reads, “Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should be directed to…,” but I couldn’t find language around the number of evaluation questions (out of the 7) or evaluation studies that states are “expected to” pursue for this grant. Can you please provide some guidance for the number of evaluation studies we are expected to pursue and the number of evaluation questions we are expected to answer? 
   Answer: Applicants are not expected to take on any “specific evaluation studies” for this NOFO. The evaluation questions on page 20 of the NOFO outline CDC’s broad evaluation interests, and the required performance measures on pages 20-21 of the NOFO represent the minimum operationalization of these evaluation questions. Applicant evaluation plans should at a minimum demonstrate how they will report on the required performance measures. However, applicants are encouraged to propose additional evaluation activities that are both responsive to CDC’s evaluation questions and are tailored for applicant’s specific proposed activities.
   Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan within the first 6 months of award and CDC will work with recipients to ensure that plans meet CDC requirements.

1. Question: Regarding the Letter of Intent: if submitting a Letter of Intent, do you have to do the required registration first?
   Answer: No, the registrations are not required prior to submitting a Letter of Intent. Required registrations must be completed prior to submission of the application.
2. Question: If we’re working with other organizations, and we are the lead, is there one lead applicant (not the other organizations that may be applying with you?) Are you allowed to have more than one primary recipient?
   Answer: No, there may only be one primary applicant for an application. The primary applicant will submit the application.
3. Question: Can we use funds from this NOFO for research activities?
   Answer: No, this NOFO is only for non-research activities. If research is proposed, the application will not be considered. Please refer to Announcement Type on page 1 of the NOFO.
4. Question: Is there a preferred template for the Resumes/CVs (e.g., NIH Biosketch template)?
   Answer: There is no preferred template for resumes or CVs.
5. Question: Is there a limit on the number of Co-PIs allowed?
   Answer: There is no limit to the number of Co-PIs allowed.
6. Question: Is there an opportunity for those submitting a grant application to have a preview conducted by the CDC? By preview I mean review of our DRAFT application and provide feedback and/or suggestions. If this is an option when would the preview DRAFT application need to be submitted by?
   Answer: CDC will not review a draft of an application prior to official submission.
7. Question: I am having technical problems registering and inputting information into Grants.gov. Can you help?
   Answer: For assistance with technical difficulties with the Grants.gov system, please contact:
   GRANTS.GOV Applicant Support
   1-800-518-4726
   support@grants.gov
8. Question: Is there a preferred template for the Report on Programmatic, Budgetary, and Commitment Overlap?
   Answer: No, there is no preferred template. However, please see CDC Budget Preparation Guidelines for additional information https://www.cdc.gov/grants/documents/Budget-Preparation-Guidance.pdf [PDF – 415KB]
9. Question: In addition to the PD/PI(s), does the Report on Programmatic, Budgetary, and Commitment Overlap include information on current awards and pending applications submitted to another funding source in the same fiscal year by other senior/key personnel, such as Co-Investigators and Consortium PIs?
   Answer: This is applicable to the current awards and should not exceed 100 percent on all federal funding as the percentage of effort for all key personnel, such as Co Investigators and Consortium PI’s.
10. Question: Do the formatting requirements of single-spacing, 12-point font, and 1-inch margins, and page numbering apply to the combined Letters of Support attachment?
    Answer: There is no requirement in the NOFO for spacing, font, margins, or page numbers for the Letters of Support.
11. Question: Is the evaluation and performance measurement plan (EPMP) to be included within the 25-page limit?
    Answer: The Evaluation and Performance Measurement Plan is not included in the 25-page limit. This page limit is for the Project Narrative (including the work plan).
12. Question: Are charts or maps showing the target population allowed within the 25-page limit?
    Answer: Charts or maps are allowed within the 25-page limit.
13. Question: Do you have a template for the “staffing plan”?
    Answer: There is no template for the staffing plan.
14. Question: In our application we are going to list an agency that we plan to contract with if we are granted these award funds.  I have read through the grant application a number of times and read through the Budget Preparation Guidelines Office of Financial Resources.  I am wondering if CDC, for the purpose of this grant application, would consider the community-based organization (CBO) we are going to contract with a Consultant? I know there is an area on the Budget Preparation Guidelines that outlines the Consultant Costs.  If you don’t consider the CBO a consultant, how would you like us to represent them in our budgets?
    Answer: A Contract is defined as a written agreement between a recipient and a third party to acquire commercial goods or services.  A Consultant is defined as an individual who provides professional advice or services for a fee, but normally not as an employee of the engaging party. The term “consultant” also includes a firm that provides paid professional advice or services.  Your organization needs to determine which category this falls under within the organization’s approved structure.
15. Question: How do we complete Form SF–LLL if we are a nonprofit and don’t engage a lobbyist nor will a lobbyist be associated with the grant?
    Answer: By signing the application, you are validating that the grantee will not be using any funds for lobbying activities. The SF-LLL form only needs to be completed if you are going to engage in lobbying.
16. Question: Regarding formatting requirements, is there a preferred font type (e.g., Times New Roman)? Also, can page numbers appear in the 1-inch margin?
    Answer: Please refer to the “Other Information”. Text should be single spaced, 12-point font, 1-inch margins, and number all pages. Page numbers can be in the margin.
17. Question: Should the attachments: Resume/CV, Letters of Support, CDC Assurances and Certifications, and Risk Assessment Questionnaire, be uploaded via the “Other Attachments Form?” If not, how should they be uploaded?
    Answer: Please refer to the “Other Information” for more information on attachments applicants can upload as PDF files as part of their application at www.grants.gov.
18. Question: Do you allow those applying for this funding to schedule a phone call to get clarification on questions?
    Answer: All questions must be submitted through the NOFO email. If you have additional questions after receiving a response, please submit a follow-up email for clarification. All questions and answers are posted on the cdc.gov/aging FAQ page.
19. Question: Is there a preferred style for citations/references, and are footnotes allowable?  If footnotes are not allowable, does the reference list count toward the 25-page narrative page limit?
    Answer: There is no preferred style for citations/references but if you are using references, please use a consistent standard style throughout (e.g., AMA, APA, etc.). Footnotes may be used. The reference list will not count toward the 25-page limit for the project narrative.
20. Question: Is there a page limit for Budget Narrative document?
    Answer: No
21. Question: The NOFO mentioned, “CDC programs may require more frequent reporting of performance measures than annually in the APR. If this is the case, CDC programs must specify reporting frequency, data fields, and format for recipients at the beginning of the award period.” Can you tell me if there will be more frequent reports required — such as quarterly or semi-annual progress reports? That would help us better gauge the administrative management burden would we need to anticipate and plan for
    Answer: At this time, CDC has not determined further reporting requirements other than what is listed in the NOFO.
22. Question: We have a question about the ADRD Strategic Plan upload that is required under Component 2. We are a 2020-2023 BOLD grantee currently developing our ADRD state plan (it won’t be final until September 2023). We see that we won’t be able to apply for just Phase II of Component 1 and, therefore, are considering applying for Component 2. 
    As part of our Component 2 application, what does CDC advise BOLD grantees in our cohort upload in March 2023?
    Answer: Applicants previously funded under CDC-RFA-DP20-2004 are ineligible for all Component 1 awards. Please see the “Eligibility” section on page 28 as well as “Review and Selection Process” beginning on page 42 of the NOFO PDF for additional information on the criteria assigned to the ADRD Strategic plan in the Phase II review process. CDC does not define “existing plan” within the NOFO.
23. Question: Is it expected that our logic model use the same format as the logic model provided in the NOFO? 
    Answer: Applicant Logic Models are not required for this NOFO. We do not provide you a format for a logic model in the NOFO. If you submit a logic model for your application, it should clearly reflect how your strategies and activities will lead to short, intermediate, and long-term outcomes.
24. Question: For component II – Should dementia strategic plans be attached to the application packet? 
    Answer: Yes. Please see the “Review and Selection Process” section on page 42 and the “Other Information” section on page 57 of the NOFO PDF.
25. Question: Must we have a letter of support from all three Centers of Excellence and all recipients of the National Healthy Brain Initiative grant? 
    Answer: Letters of Support from collaborating partners and coalition members are not required but encouraged. However, letters of support are required from the aging services department and a national non-profit Alzheimer’s organization (state or local chapter as appropriate) and must include a specific description of their unique role in support of the proposed work. Tribal organizations/tribes should include members from their equivalent organizations.
26. Question: Will there be a corresponding NOFO for centers of excellence like there was in 2020? 
    Answer: The current NOFO for the Public Health Centers of Excellence is a five-year award and runs through 2025.
27. Question: How are reporting requirements met? Does the CDC require reports submitted through their own portal? Will you provide training in grant solutions?
    Answer: Reporting requirements will be discussed with recipients after their award. Currently, one of the systems used by CDC for grant reporting is GrantSolutions (GS). CDC does not provide training on GrantSolutions. Please contact GrantSolutions for training and technical assistance on using their platform.
28. Question: Could the state office of elder affairs serve as an bona fide agent applying on behalf of the state health department? 
    Answer: Bona fide agents are legal agreements between entities. You should determine if this arrangement exists before applying. If applying as a bona fide agent or fiscal intermediary of a state or local government, documentation must be submitted that establishes the validity of the agent.  Recipients should be public health departments/departments of health and also overseeing the BOLD project.
29. Question: May we submit the staffing plan as an attachment? Do you have a staffing plan template? 
    Answer: There is no staffing plan template. Please refer to “Other Information” on page 56 of the BOLD NOFO PDF for the list of acceptable attachments.
30. Question: Is the approval/granting of requested award amount based upon the breadth of the application, or is there a formula based upon jurisdiction population and other parameters? 
    Answer: Please refer to Review and Selection Process (pages 42 through 47) of the BOLD NOFO PDF. Each application is reviewed on its own merit according to the review criteria listed for the component for which the jurisdiction is applying.
31. Question: Page 23 of the NOFO under c. Organizational Capacity of Recipients to Implement the Approach, one of the attachments requires, “Position Descriptions.”  I want to be thorough in providing all the required positions descriptions.  Is it adequate to provide positions descriptions for the Director, Program Coordinator and Evaluator?  Or do you want other positions descriptions included as well?
    Answer: Position descriptions should be included for key staff and others which clearly defines staff roles and reporting structure. Key personnel for this program must include program director (minimum of 25%), program coordinator (minimum of 100%), and evaluator (minimum of 15%).  Other position descriptions are encouraged if these staff are key to accomplishing the goals of the proposed project.
32. Question:  Can the staffing plan be included as an attachment, or must this be included in the Organizational Capacity section? 
    Answer: Please refer to the “Other Information” on page 57 of the NOFO PDF for more information on attachments applicants can upload as PDF files as part of their application at www.grants.gov.  The staffing plan should be included in the narrative.
33. Question: What letters of support are we required to upload with our application?
    Answer: Letters of Support: Letters of support are required from the organizations from the aging services and a national non-profit Alzheimer’s organization (state or local chapter as appropriate) and must include a specific description of their unique role in support of the proposed work. Tribal organizations/tribes should include members from their equivalent organizations. Applicants are encouraged to also provide letters of support for other coalition members, if applicable. Letters of support should clearly describe the partnership with the applicant and how the organization will support the program. Applicants should name this file “XX Letters of Support”
34. Question: Do we submit our applications through www.grants.gov or through www.grantsolutions.gov?
    Answer: All applications must be submitted through www.grants.gov. Please see page 31 of the NOFO PDF for “Required Registrations” and submission requirements.  Also see page 41 of the NOFO PDF “Other Submission Requirements”. If technical difficulties are encountered at www.grants.gov , applicants should contact Customer Service at www.grants.gov . The www.grants.gov  Contact Center is available 24 hours a day, 7 days a week, except federal holidays. The Contact Center is available by phone at 1-800-518-4726 or by e-mail at support@grants.gov .
35. Question:  The NOFO calls for a “strategic plan” however, we are developing a “state plan”. Can we consider this to be the same?
    Answer:  The NOFO requires Component 1 applicants to create jurisdiction ADRD Strategic Plan with the elements provided in the Strategies and Activities Section (starting on page 9 of the NOFO PDF) of this NOFO. Component 2 applicants are required to upload a current jurisdiction ADRD Strategic Plan with the elements provided in the Strategies and Activities Section of this NOFO. Jurisdiction is defined in the glossary (page 65 of the NOFO PDF) as the entire political/geographical boundary of the state, political subdivision of a state, or Indian [American Indian/Alaska Native] tribes and tribal organization for which the applicant represents.
36. Question:  I understand that the evaluation and performance measurement plan is not part of the 25-page limit for the project narrative. Does this mean that we can include the evaluation and performance measurement plan as a separate attachment?
    Answer:  The Evaluation and Performance Measurement Plan is not included in the 25-page limit. This page limit is for the Project Narrative (including the work plan). You may upload the Evaluation and Performance Measurement Plan document as a PDF attachment and name it “XX Evaluation and Performance Measurement Plan”, where “XX” signifies your organization (state/local/tribal organization).
37. Question: We recently received a request from our State Health Department Alzheimer’s Program Coordinator asking us for a Letter of Support regarding the BOLD cooperative agreement.
    We (County) will also be applying for the same grant, but for a different component. I wanted to ask your opinion regarding this request due to the grant stating “duplication of efforts and programmatic overlap occurs when the same project is proposed in more than one application or is submitted to two or more funding sources for review and funding consideration or a specific objective and the project design for accomplishing the objective are the same or closely related in two or more applications or awards, regardless of the funding source.” We wish to confirm that it would be okay to do so.
    Answer:  There is nothing that prohibits an application from both the State and local health departments as separate applicants.  Applications are reviewed separately and must stand on their own merits.  The decision as to whether or not to write a letter of support for another applicant is a decision your organization should make, and will not alter the eligibility of your program. Recipients of awards under this cooperative agreement are encouraged to collaborate with other organizations within their jurisdictions (see page 17 “Collaborations”). Each individual applicant may only submit one application for Component 1 or Component 2. Each applicant must include their Unique Entity Identifier (UEI) number. Only one application per UEI number will be accepted. Please refer to the NOFO PDF, including section E:  “Review and Selection Process” for additional detail.
38. Question:  As part of this BOLD NOFO can we insert links into our application?
    For example, to the strategic plan for our states ADRD Coalition.
    Answer: Links to documents are acceptable however may not be reviewed.  Please see “Other Information” on page 57 of the NOFO PDF and “Review and Selection Process” on page 42 of the NOFO PDF for further information.

1. Question: Should the year 1 work plan be in table format with all the elements of the one-year plan? Should the year 1 work plan have specific SMART objectives? Can you elaborate on what is intended in the year 1 workplan?
   Answer: A sample work plan is included in the Work Plan section of the NOFO. As a part of your NOFO application, you may choose to use the sample work plan for the required year 1 work plan. CDC will provide feedback and technical assistance to recipients to finalize the work plan post-award.
2. Question: Should the high-level work plan for subsequent years be in table format with all the elements of the one-year plan or a more general narrative? Should the high-level work plan also have specific SMART objectives? Can you elaborate on what is intended in the high-level workplan?
   Answer: The high-level work plan for subsequent years should provide enough detail to allow your proposed approach for the 5-year project period to be adequately evaluated.
3. Question: Is there any criteria available for the Annual Objectives and Milestones of the work plan? Should Annual Objectives be broad, or specific such as SMARTIE goals? Are Milestones similar to process measures we had for the last NOFO?
   Answer:  Please see “Work Plan” section on pages 24 and 25 of the NOFO PDF for further guidance on the work plan.  Also, see “Evaluation and Performance Measurement” section on page 21 of the NOFO PDF.
4. Question: Can we use an 11-point font for Tables and Workplan? Can we submit the workplan as an attachment?  
   Answer:  There is no requirement in the NOFO for spacing, font, or margins for the Tables and Workplan. However, these elements should be clearly and easily read by the reviewers. The page limit for the Project Narrative is 25 pages. This includes the work plan. Content beyond the specified page number will not be reviewed.  Please refer to  “Project Narrative” on page 35 and “Other Information” on page 56 of the BOLD NOFO PDF for the list of acceptable attachments.
5. Question: For the purposes of this NOFO, please define “milestone.” The work plan instructions require entry of a milestone in the description of each action. The glossary does not define the term.  Is the milestone a salient point, process measure in the development of the action?
   Answer: A milestone is a project accomplishment that represents meaningful progress toward completion of a workplan activity. Milestones function as series of checkpoints used to measure progress toward the completion of workplan activities.
6. Question:  In the workplan table, it states that annual objectives should be described, however we historically have described objectives as part of the Strategies and Activities of the narrative. Do we need to describe the objectives and activities in the workplan template and the narrative section?
   Answer:  A brief statement of the annual objectives must be included in the work plan. Please provide additional details for these activities in the Project Narrative section of your application, where indicated.
7. Question:  For the workplan example on Page 24, can we list a Road Map Action in our Annual Objective description to link our work for that strategy to the Road Map? For example, for Strategy 6: Educate providers and other professionals, we list W-1 Educate public health and healthcare professionals on sources of reliable information about brain health and ways to use the information to inform those they serve.
   Answer: In creating your work plans, you may create your own annual objective and link it back to the specific Road Map action.  You may also decide to use a Road Map action verbatim from the Road Map however this is not required.  You may also refer your own annual objective back to the Road Map by indicating its designated number (e.g., W-1, P-1, M-3).
8. Question: If activities we outline in our Year One Workplan cannot be accomplished in a single year what do you suggest we do about entering an end date in the workplan table outlined in the NOFO?  Is it permissible to have an end date at another point later in the 5-year period of the cooperative agreement – or, should we enter an end date of 9/30/2024 and indicate in the high level workplan for Years 2- 5 that the activity will continue?
   Answer:  Please list an end date of 9/29/2024 and indicate in the high level workplan for years 2-5 that the activity will continue.
9. Question:  I have a question about the Work Plan. I have referred to the sample on page 24 of the NOFO.  From all of the written and visual instructions, it is not clear to me what information should be included in each area. Can you please provide additional instruction?
   Answer:  The content of your workplan for each strategy should flow logically from Top (Annual Objective) to bottom (Activities).  A brief statement of the annual objectives must be included in the work plan template.  A milestone is a project accomplishment that represents meaningful progress toward completion of a workplan activity. Milestones function as series of checkpoints used to measure progress toward the completion of workplan activities. Please provide additional details for these activities in the Project Narrative section of your application, where indicated. CDC will provide feedback and technical assistance to recipients to finalize the work plan post-award.

Activities: The actual events or actions that take place as a part of the program.

Administrative and National Policy Requirements, Additional Requirements (ARs): Administrative requirements found in 45 CFR Part 75 and other requirements mandated bystatute or CDC policy. All ARs are listed in the Template for CDC programs. CDC programs must indicate which ARs are relevant to the NOFO; recipients must comply with the ARs listed in the NOFO.

To view brief descriptions of relevant provisions, see https://www.cdc.gov/grants/additional-requirements/index.html. Note that 2 CFR 200 supersedes the administrative requirements (A-110 & A-102), cost principles (A-21, A-87 & A-122) and audit requirements (A-50, A-89 & A-133).

Approved but Unfunded: Approved but unfunded refers to applications recommended for approval during the objective review process; however, they were not recommended for funding by the program office and/or the grants management office.

Assistance Listings: A government-wide compendium published by the General Services Administration (available on-line in searchable format as well as in printable format as a .pdf file) that describes domestic assistance programs administered by the Federal Government.

Assistance Listings Number: A unique number assigned to each program and NOFO throughout its lifecycle that enables data and funding tracking and transparency

Award: Financial assistance that provides support or stimulation to accomplish a public purpose. Awards include grants and other agreements (e.g., cooperative agreements) in the form of money, or property in lieu of money, by the federal government to an eligible applicant.

Budget Period or Budget Year: The duration of each individual funding period within the project period. Traditionally, budget periods are 12 months or 1 year.

Carryover: Unobligated federal funds remaining at the end of any budget period that, with the approval of the GMO or under an automatic authority, may be carried over to another budget period to cover allowable costs of that budget period either as an offset or additional authorization. Obligated but liquidated funds are not considered carryover.

Competing Continuation Award: A financial assistance mechanism that adds funds to a grant and adds one or more budget periods to the previously established period of performance (i.e., extends the “life” of the award).

Continuous Quality Improvement: A system that seeks to improve the provision of services with an emphasis on future results.

Contracts: An award instrument used to acquire (by purchase, lease, or barter) property or services for the direct benefit or use of the Federal Government.

Cooperative Agreement: A financial assistance award with the same kind of interagency relationship as a grant except that it provides for substantial involvement by the federal agency funding the award. Substantial involvement means that the recipient can expect federal programmatic collaboration or participation in carrying out the effort under the award.

Cost Sharing or Matching: Refers to program costs not borne by the Federal Government but by the recipients. It may include the value of allowable third-party, in-kind contributions, as well as expenditures by the recipient.

Direct Assistance: A financial assistance mechanism, which must be specifically authorized by statute, whereby goods or services are provided to recipients in lieu of cash. DA generally involves the assignment of federal personnel or the provision of equipment or supplies, such as vaccines. DA is primarily used to support payroll and travel expenses of CDC employees assigned to state, tribal, local, and territorial (STLT) health agencies that are recipients of grants and cooperative agreements. Most legislative authorities that provide financial assistance to STLT health agencies allow for the use of DA. https://www.cdc.gov/grants/additional-requirements/index.html.

Evaluation (program evaluation): The systematic collection of information about the activities, characteristics, and outcomes of programs (which may include interventions, policies, and specific projects) to make judgments about that program, improve program effectiveness, and/or inform decisions about future program development.

Evaluation Plan: A written document describing the overall approach that will be used to guide an evaluation, including why the evaluation is being conducted, how the findings will likely be used, and the design and data collection sources and methods. The plan specifies what will be done, how it will be done, who will do it, and when it will be done. The NOFO evaluation plan is used to describe how the recipient and/or CDC will determine whether activities are implemented appropriately and outcomes are achieved.

Federal Funding Accountability and Transparency Act of 2006 (FFATA): Requires that information about federal awards, including awards, contracts, loans, and other assistance andpayments, be available to the public on a single website at www.USAspending.gov.

Fiscal Year: The year for which budget dollars are allocated annually. The federal fiscal year starts October 1 and ends September 30.

Grant: A legal instrument used by the federal government to transfer anything of value to a recipient for public support or stimulation authorized by statute. Financial assistance may be money or property. The definition does not include a federal procurement subject to the Federal Acquisition Regulation; technical assistance (which provides services instead of money); or assistance in the form of revenue sharing, loans, loan guarantees, interest subsidies, insurance, or direct payments of any kind to a person or persons. The main difference between a grant and a cooperative agreement is that in a grant there is no anticipated substantial programmatic involvement by the federal government under the award.

Grants.gov: A “storefront” web portal for electronic data collection (forms and reports) for federal grant-making agencies at www.grants.gov.

Grants Management Officer (GMO): The individual designated to serve as the HHS official responsible for the business management aspects of a particular grant(s) or cooperative agreement(s). The GMO serves as the counterpart to the business officer of the recipient organization. In this capacity, the GMO is responsible for all business management matters associated with the review, negotiation, award, and administration of grants and interprets grants administration policies and provisions. The GMO works closely with the program or project officer who is responsible for the scientific, technical, and programmatic aspects of the grant.

Grants Management Specialist (GMS): A federal staff member who oversees the business and other non-programmatic aspects of one or more grants and/or cooperative agreements. These activities include, but are not limited to, evaluating grant applications for administrative content and compliance with regulations and guidelines, negotiating grants, providing consultation and technical assistance to recipients, post-award administration and closing out grants.

Health Disparities: Differences in health outcomes and their determinants among segments of the population as defined by social, demographic, environmental, or geographic category.

Health Equity: Striving for the highest possible standard of health for all people and giving special attention to the needs of those at greatest risk of poor health, based on social conditions.

Health Inequities: Systematic, unfair, and avoidable differences in health outcomes and their determinants between segments of the population, such as by socioeconomic status (SES), demographics, or geography.

Healthy People 2030: National health objectives aimed at improving the health of all Americans by encouraging collaboration across sectors, guiding people toward making informed health decisions, and measuring the effects of prevention activities.

Inclusion: Both the meaningful involvement of a community’s members in all stages of the program process and the maximum involvement of the target population that the intervention will benefit. Inclusion ensures that the views, perspectives, and needs of affected communities, care providers, and key partners are considered.

Indirect Costs: Costs that are incurred for common or joint objectives and not readily and specifically identifiable with a particular sponsored project, program, or activity; nevertheless, these costs are necessary to the operations of the organization. For example, the costs of operating and maintaining facilities, depreciation, and administrative salaries generally are considered indirect costs.

Letter of Intent (LOI): A preliminary, non-binding indication of an organization’s intent to submit an application.

Lobbying: Direct lobbying includes any attempt to influence legislation, appropriations, regulations, administrative actions, executive orders (legislation or other orders), or other similar deliberations at any level of government through communication that directly expresses a view on proposed or pending legislation or other orders, and which is directed to staff members or other employees of a legislative body, government officials, or employees who participate in formulating legislation or other orders. Grass roots lobbying includes efforts directed at inducing or encouraging members of the public to contact their elected representatives at the federal, state, or local levels to urge support of, or opposition to, proposed or pending legislative proposals.

Logic Model: A visual representation showing the sequence of related events connecting the activities of a program with the programs’ desired outcomes and results.

Maintenance of Effort: A requirement contained in authorizing legislation, or applicable regulations that a recipient must agree to contribute and maintain a specified level of financial effort from its own resources or other non-government sources to be eligible to receive federal grant funds. This requirement is typically given in terms of meeting a previous base-year dollar amount.

Memorandum of Understanding (MOU) or Memorandum of Agreement (MOA): Document that describes a bilateral or multilateral agreement between parties expressing a convergence of will between the parties, indicating an intended common line of action. It is often used in cases where the parties either do not imply a legal commitment or cannot create a legally enforceable agreement.

Nonprofit Organization: Any corporation, trust, association, cooperative, or other organization that is operated primarily for scientific, educational, service, charitable, or similar purposes in the public interest; is not organized for profit; and uses net proceeds to maintain, improve, or expand the operations of the organization. Nonprofit organizations include institutions of higher educations, hospitals, and tribal organizations (that is, Indian entities other than federally recognized Indian tribal governments).

Notice of Award (NoA): The official document, signed (or the electronic equivalent of signature) by a Grants Management Officer that: (1) notifies the recipient of the award of a grant; (2) contains or references all the terms and conditions of the grant and Federal funding limits and obligations; and (3) provides the documentary basis for recording the obligation of Federal funds in the HHS accounting system.

Objective Review: A process that involves the thorough and consistent examination of applications based on an unbiased evaluation of scientific or technical merit or other relevant aspects of the proposal. The review is intended to provide advice to the persons responsible for making award decisions.

Outcome: The results of program operations or activities; the effects triggered by the program. For example, increased knowledge, changed attitudes or beliefs, reduced tobacco use, reduced morbidity and mortality.

Performance Measurement: The ongoing monitoring and reporting of program accomplishments, particularly progress toward pre-established goals, typically conducted by program or agency management. Performance measurement may address the type or level of program activities conducted (process), the direct products and services delivered by a program (outputs), or the results of those products and services (outcomes). A “program” may be any activity, project, function, or policy that has an identifiable purpose or set of objectives.

Period of Performance – formerly known as the project period: The time during which the recipient may incur obligations to carry out the work authorized under the Federal award. The start and end dates of the period of performance must be included in the Federal award.

Period of Performance Outcome: An outcome that will occur by the end of the period of performance.

Plain Writing Act of 2010: Plain Writing Act of 2010, Public Law 111-274 requires federal agencies to communicate with the public in plain language to make information more accessible and understandable by intended users, especially people with limited health literacy skills or limited English proficiency. The Plain Writing Act is available at www.plainlanguage.gov.

Program Strategies: Strategies are groupings of related activities, usually expressed as general headers (e.g., Partnerships, Assessment, Policy) or as brief statements (e.g., Form partnerships, Conduct assessments, Formulate policies).

Program Official: Person responsible for developing the NOFO; can be either a project officer, program manager, branch chief, division leader, policy official, center leader, or similar staff member.

Period of performance – formerly known as the project period: The time during which the recipient may incur obligations to carry out the work authorized under the Federal award. The start and end dates of the period of performance must be included in the Federal award.

Period of performance Outcome: An outcome that will occur by the end of the NOFO’s funding period.

Public Health Accreditation Board (PHAB): A nonprofit organization that works to promote and protect the health of the public by advancing the quality and performance of public health departments in the U.S. through national public health department accreditation http://www.phaboard.org.

Social Determinants of Health: Conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Statute: An act of the legislature; a particular law enacted and established by the will of the legislative department of government, expressed with the requisite formalities. In foreign or civil law any particular municipal law or usage, though resting for its authority on judicial decisions, or the practice of nations.

Statutory Authority: Authority provided by legal statute that establishes a federal financial assistance program or award.

System for Award Management (SAM): The primary vendor database for the U.S. federal government. SAM validates applicant information and electronically shares secure and encrypted data with federal agencies’ finance offices to facilitate paperless payments through Electronic Funds Transfer (EFT). SAM stores organizational information, allowing www.grants.gov to verify identity and pre-fill organizational information on grant applications.

Technical Assistance: Advice, assistance, or training pertaining to program development, implementation, maintenance, or evaluation that is provided by the funding agency.

Work Plan: The summary of period of performance outcomes, strategies and activities, personnel and/or partners who will complete the activities, and the timeline for completion. The work plan will outline the details of all necessary activities that will be supported through the approved budget.

ADRD Topics for this NOFO include and are not limited to brain health, cognitive aging, dementia risk reduction, early detection and diagnosis, linkages to treatment, care, and services, prevention and management of comorbidities leading to preventable hospitalizations and poor health outcomes, and caregiving for persons with dementia.

Alzheimer’s Disease is an irreversible, progressive brain disorder and the most common cause of dementia. Early symptoms include difficulty with memory and thinking. As the disease progresses, symptoms include impaired communication and judgment, confusion, behavior changes, and challenges with basic bodily functions. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Alzheimer’s disease and related dementias (ADRD) include Alzheimer’s disease as well as frontotemporal degeneration (FTD), Lewy body dementia (LBD), vascular contributions to cognitive impairment and dementia (VCID), and mixed etiology dementias (MED).

Alzheimer’s disease and related dementias (ADRD) Jurisdiction Strategic Plans are created through a jurisdiction-wide, comprehensive and collaborative effort that includes a wide variety dementia stakeholders. An ADRD strategic plan helps to coordinate and support the work of private, non-profit, public entities, and other stakeholders throughout the jurisdiction. The ADRD strategic plan is intended to help the jurisdiction leverage limited resources and set priorities for action, with a focus on supportive, population based, policies, systems, and environments that will support widespread impact and address the needs identified by the jurisdiction effort. The recommendations and strategies of the plan are meant to be accomplished through the joint efforts of private organizations, non-profit entities, state, tribal and local government agencies, as well as interested stakeholders and individuals.

Balanced Approach is a principle applied to the ADRD Strategic Plan. It requires including goals and actions that address all 4 domains of the Road Map at least once as well as each of the prevention levels at least once.

Behavioral Risk Factor Surveillance System (BRFSS) is the nation’s premier system of health-related telephone surveys that collects state-level data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. BRFSS collects data in all 50 states as well as the District of Columbia and three U.S. territories. BRFSS completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world. The BRFSS includes two optional modules related to the activities in this NOFO- Cognitive Decline and Caregiving.

Brain Health is a concept that involves making the most of the brain’s capacity and helping to reduce some risks that occur with aging. Brain health refers to the ability to draw on the strengths of the brain to remember, learn, play, concentrate, and maintain a clear, active mind.

Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act (P.L. 115-406) is a law that creates an Alzheimer’s public health infrastructure across the country to implement effective Alzheimer’s interventions focused on public health issues such as increasing early detection and diagnosis, reducing risk, and preventing avoidable hospitalizations. The BOLD Infrastructure for Alzheimer’s Act will accomplish this by establishing Alzheimer’s and Related Dementias Public Health Centers of Excellence, providing funding to state, local, and tribal public health departments, and increasing data analysis and timely reporting.

Caregiving for persons with dementia is unpaid help provided by spouses, partners, adult children, other relatives, and friends to persons living with dementia. Caregivers for persons with dementia often assist with activities of daily living such as personal care, household management, medication and healthcare management, and coordination of financial matters.

Coalition For the purposes of this program, a jurisdiction coalition is defined as a formal arrangement for cooperation and collaboration among a diverse cross-section of groups or sectors across the entire jurisdiction. Each group retains its identity and agrees to work together toward a common goal(s).

Cognition is the mental function involved in attention, thinking, understanding, learning, remembering, solving problems, and making decisions. Cognition is a fundamental aspect of an individual’s ability to engage in activities, accomplish goals, and successfully negotiate the world. It can be viewed along a continuum—from optimal functioning to mild cognitive impairment to Alzheimer’s and severe dementia.

Cognitive Impairment is trouble remembering, learning new things, concentrating, or making decisions that affect everyday life.

Community-Clinical Linkages (CCL) are connections between community and clinical sectors that aim to improve health within a community. CCLs are an effective, evidence-based approach to preventing and managing chronic diseases such as ADRD.

Dementia is an umbrella term for a particular group of symptoms, including difficulties with memory, language, problem-solving, and other thinking skills that are severe enough to interfere with daily life. Alzheimer’s disease is the most common cause of dementia. Other causes include vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Often, dementia can be caused by multiple types and is referred to as mixed dementia.

Healthy Brain Initiative (HBI) envisions a nation in which public health embraces brain health and caregiving as vital components of health that are included in public health efforts. To advance public health activities in brain health, cognitive impairment, and caregiving, State and Local Public Health Partnerships to Address Dementia: The 2018—2023 Road Map [PDF – 19MB] was released in 2018 and the Road Map for Indian Country [PDF – 10MB] was released in 2019.

Implementation Plan a detailed description of the specific strategies, objectives, actions, and champions that are needed to implement the jurisdiction ADRD Strategic Plan goals.

Intellectual and Developmental Disabilities (IDD) are disorders that are usually present at birth and that negatively affect the trajectory of the individual’s physical, intellectual, and/or emotional development. Many of these conditions affect multiple body parts or systems. Intellectual disability starts any time before a child turns 18 and is characterized by problems with both: (1) Intellectual functioning or intelligence, which include the ability to learn, reason, problem solve, and other skills; and (2) Adaptive behavior, which includes everyday social and life skills. The term “developmental disabilities” is a broader category of often lifelong disability that can be intellectual, physical, or both.

Jurisdiction is the entire political/geographical boundary of the state, political subdivision of a state, or  Indian [American Indian/Alaska Native] tribes and tribal organization for which the applicant represents.

National Alzheimer’s Project Act (NAPA) creates an important opportunity to build upon and leverage Department of Health and Human Services (HHS) programs and other federal efforts to help change the trajectory of Alzheimer’s disease and related dementias (ADRD). The law calls for a National Plan for ADRD with input from a public-private Advisory Council on Alzheimer’s Research, Care and Services. The Advisory Council makes recommendations to HHS for priority actions to expand, coordinate, and condense programs in order to improve the health outcomes of people with ADRD and reduce the financial burden of these conditions on those with the diseases, their families, and society.

Prevention Levels are opportunities for public health intervention that include primary (e.g., dementia risk reduction), secondary (e.g., early detection and diagnosis; linkages to treatment, care, and services), and tertiary (e.g., prevention and management of comorbidities leading to preventable hospitalizations and poor health outcomes; caregiving for persons with dementia) prevention.

Primary Prevention is intervening before health effects or conditions occur. For the purpose of this NOFO, this means dementia risk reduction activities such as altering risky behaviors like poor eating habits or tobacco use or preventing and managing certain chronic conditions such as high blood pressure.

Provider includes any individual who promotes, protects, and improves the health of individuals and communities. This includes health care providers, first responders, paid caregivers, and others who provide care or services to people living with dementia and/or their caregivers.

Public Health Approach, for this NOFO, focuses on improving the health of entire populations across the lifespan, including dementia risk reduction, early detection and diagnosis, prevention and management of comorbidities leading to preventable hospitalizations, community-clinical linkages, referral to services, and caregiving for persons with dementia. It also includes building coordinated systems that bind together jurisdiction efforts for ADRD and caregiving for persons with dementia.

Risk Reduction (see Primary Prevention) is a comprehensive approach to your brain and cognitive wellness through healthy behaviors and preventing and managing certain chronic conditions that may elevate your risk for dementia.

Road Map Series (RM Series) refers to the Healthy Brain Initiative’s (HBI) series of Road Map documents and supporting materials. These can be found at www.cdc.gov/aging, and include the State and Local Public Health Partnerships to Address Dementia, The 2023-2027 Road Map [PDF – 20 MB] and the Road Map for Indian Country [PDF – 10MB] and all related supporting materials such as RM implementation and dissemination guides, topic specific Issue Maps, 1 pagers and supporting messaging. The Road Map Series prepares all communities to act quickly and strategically by stimulating changes in policies, systems, and environments and can be incorporated efficiently into existing public health initiatives.

RM domains refers to 4 of 10 essential services of public health used as a framework for the State and Local Public Health Partnerships to Address Dementia: The 2023-2027 Road Map, as well as future updates.  These domains include Educate and Empower (E), Develop Policies and Mobilize Partnerships (P), Assure a Competent Workforce (W), and Monitor and Evaluate (E)).

Secondary Prevention is detecting diseases in the earliest stages before the onset of more severe symptoms. For the purpose of this NOFO, this means early detection and diagnosis of cognitive impairment and ADRD and linkages to treatment, care, and services.

Strategic Plan is a jurisdiction level document that lays out a range of goals, objectives, and strategies, including new initiatives to address ADRD.

Subjective Cognitive Decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss in the past year. It is a form of cognitive impairment and is an early indicator of possible future Alzheimer’s disease and related dementias.

Sustainability is the capacity for program activities and resources to continue after the conclusion of the period of performance.

Tertiary Prevention includes managing disease post diagnosis to minimize negative health and quality of life effects. For the purpose of this NOFO, this means prevention and management of comorbidities leading to preventable hospitalizations and poor health outcomes, and caregiving for people with dementia.