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The Aging Network
Program Instructions
AOA-PI-98-06
- September 30, 1998
AOA-PI-98-06 -
Grants to State Agencies on Aging for the Support of Information
and Referral for Medicare Beneficiaries:
Part II. Guidelines for Preparing and Submitting
the Application Attachment
See also: Part
I. Background Information and Program Priority [of this announcment],
and the second announcement: Grant
Awards to State Agencies on Aging for the Support of Model State
Projects to Develop Medicare Information and Referral Protocols
and Reports
The closing date for submission
of applications has been extended to: November 9, 1998.
Part II. Guidelines for Preparing
and Submitting the Application
Part II contains guidelines for State Agencies on
Aging in preparing and submitting applications for Information
and Referral for Medicare Beneficiaries Projects. Application
forms also are provided along with instructions for preparing
the application package for submittal to the AoA.
A. General Information
1. Review Process and Considerations for Funding
a. Notification: All applicants will automatically
be notified of the receipt of their application and informed of
the identification number assigned to it.
b. Review and Decision-Making Process: Applicants
may be contacted by AoA staff to furnish additional information.
c. Timeframe: Awards will be made within
ten days of receipt of application.
2. Notification Under Executive Order 12372
This is not a covered program under Executive Order
12372.
B. Deadline for Submission of Applications
The closing date for submission of applications
is October 30, 1998.
C. Grantee Share of the Project Costs
State Agencies on Aging are not required to share
in the costs of these projects.
D. Application Screening Criteria
Applicants are expected to meet the following two
screening criteria:
1. Applications must be either postmarked by midnight,
October 30, 1998, or hand-delivered by 5:00 p.m., Eastern Time,
on October 30, 1998 to:
Department of Health and Human Services
Administration on Aging
Office of Administration and Management
330 Independence Avenue, S.W., Room 4643
Washington, D.C. 20201
2. An application must be relevant and responsive
to this program announcement for Information and Referral
for Medicare Beneficiaries Projects..
In addition, the applicant is asked to adhere to
the following guidelines in preparing the application:
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The
body of the application should not exceed ten
(10) pages, double-spaced. A suggested arrangement of
the substantive portions of the application follows:
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Summary description (suggested length: one
page);
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Narrative (suggested length: six pages);
and
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Letters of commitment from collaborating
organizations (suggested length: three pages).
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The
following forms/documents are excluded from the 10 page limitation:
(1) Standard Form (SF) 424, SF 424A (including a short budget
justification) and SF 424B; (2) the certification forms regarding
lobbying; debarment, suspension, and other responsibility
matters; and drug-free workplace requirements.
E. Indirect Costs
As a state government agency, the SUA may include
indirect charges (costs) in its budget as determined in accordance
with HHS requirements.
F. The Components of an Application
To expedite the processing of applications, we request
that you arrange the components of your application, the original
and two copies, in the following order:
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SF 424, Application for Federal Assistance;
SF 424A, Budget, accompanied by your budget justification;
SF 424B (Assurances); and the certification forms regarding
lobbying; debarment, suspension, and other responsibility
matters; and drug-free workplace requirements. Note:
The original copy of the application must have an original
signature in item 18d on the SF 424;
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Project summary description;
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Program narrative; and
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Letters of commitment from collaborating organizations
as appropriate.
G. Communications with AoA
All applicants will be notified (using the information
provided by the SF 424, item 5) of the receipt of their application
and informed of the identification number assigned to it.
H. Completing the Application
In completing the application, please recognize
that the set of standardized forms is prescribed by the Office
of Management and Budget and is not perfectly adaptable to the
particulars of this program. If you need technical help in completing
the forms, please call Al Duncker at (202) 619-1269. Please prepare
your application consistent with the following guidance:
1. SF 424, Cover Page: Complete only the
items specified in the following instructions:
Item 1. Preprinted on the form.
Item 2. Fill in the date you submitted the
application. Leave the applicant identifier box blank.
Item 3. Not applicable.
Item 4. Leave blank.
Item 5. Provide the legal name of the applicant;
the name of the primary organizational unit which will undertake
the assistance activity; the applicant address; and the name and
telephone number of the person to contact on matters related to
this application.
Item 6. Enter the employer identification
number (EIN) of the applicant organization as assigned by the
Internal Revenue Service. Please include the suffix to the EIN,
if known.
Item 7. Preprinted on the form.
Item 8. Preprinted on form.
Item 9. Preprinted on form.
Item 10. Leave blank.
Item 11. The title should describe concisely
the nature of the project.
Item 12. Preprinted on form.
Item 13. Enter the desired start day, no
later that October 30, 1998 and the end date for the project,
October 29, 1999.
Item 14. List the applicant's Congressional
District and the District(s), if any, directly affected by the
proposed project.
Item 15. All budget information entered
under item #15 should cover the 12 months of the project.
The applicant should show the federal support requested first
under sub-item 15a and then again under 15g.
Item 16. Preprinted on form.
Item 17. This question applies to the applicant
organization, not the person who signs as the authorized representative.
Categories of debt include delinquent audit disallowances, loans
and taxes.
Item 18. To be signed by an authorized representative
of the State Agency on Aging.
2. SF 424A - Budget Information
This form (SF424A) is designed to apply for funding
under more than one grant program; thus, for purposes of this
AoA program, most of the budget item columns/blocks are superfluous
and should be regarded as not applicable. The applicant should
consider and respond to only the budget items for which guidance
is provided below.
Section A - Budget Summary and Section B - Budget
Categories should include both federal and (if applicable) non-federal
funding for the proposed project covering the 12 month project
period.
Section A - Budget Summary
On line 5, enter total Federal Costs in column (e)
and again in column (g). The amount shown on line 5, column (g)
should be identical to that entered in Item 15 (g) Total on the
SF 424 face sheet.
Section B - Budget Categories
Use only the last column under Section B, namely
the column headed Total (5), to enter the total requirements for
federal funds by object class category. Show the totals in row
6-k, column 5.
A separate budget justification sheet(s)
should be included which shows the breakdown of budget cost items.
This separate budget presentation should fully explain the major
budget items: personnel, travel, other, etc., as outlined below.
The full budget justification should be included in the application
immediately follow the SF 424 budget forms.
Line 6a - Personnel: Enter total costs of
salaries and wages of applicant/grantee staff. Do not include
the costs of consultants, which should be included under 6h -
Other.
Justification: Identify the project director,
if known. Specify the key staff, their titles, and time commitments
in the budget justification.
Line 6b - Fringe Benefits: Enter the total
costs of fringe benefits unless treated as part of an approved
indirect cost rate.
Justification: Provide a break-down of amounts
and percentages that comprise fringe benefit costs, such as health
insurance, FICA, retirement insurance, etc.
Line 6c - Travel: Enter total costs of out-of-town
travel (travel requiring per diem) for staff of the project.
Justification: Include the total number
of trips, destinations, length of stay, transportation costs and
subsistence allowances.
Line 6d - Equipment: Enter the total costs
of all equipment to be acquired by the project. Equipment is defined
as non-expendable tangible personal property having a useful life
of more than two years and an acquisition cost of $5,000 or more
per unit. If the item does not meet the $5,000 threshold, include
it in your budget as part of supplies.
Justification: Equipment to be purchased
with federal funds must be justified as necessary for the conduct
of the project. The equipment, or a reasonable facsimile, must
not be otherwise available to the applicant or its sub-grantees.
The justification also must contain plans for the use or disposal
of the equipment after the project ends.
Line 6e - Supplies: Enter the total costs
of all tangible expendable personal property (supplies) other
than those included on line 6d.
Line 6f - Contractual: Enter the total costs
of all contracts, including (1) procurement contracts (except
those which belong on other lines such as equipment, supplies,
etc.) and, (2) contracts with secondary recipient organizations
including delegate agencies. Also include any contracts with organizations
for the provision of technical assistance. Do not include payments
to individuals on this line.
Justification: Attach a list of contractors
indicating the name of the organization, the purpose of the contract,
and the estimated dollar amount. If the name of the contractor,
scope of work, and estimated costs are not available or have not
been negotiated, indicate when this information will be available.
Whenever the applicant/grantee intends to delegate a substantial
part (one-third, or more) of the project work to another agency,
the applicant/grantee should provide a completed copy of Section
B, Budget Categories for each contractor, along with supporting
information.
Line 6g - Construction: Leave blank since
new construction is not allowable and federal funds are rarely
used for either renovation or repair.
Line 6h - Other: Enter the total of all
other costs. Such costs, where applicable, may include, but are
not limited to: insurance, medical and dental costs; noncontractual
fees and travel paid directly to individual consultants; local
transportation (all travel which does not require per diem is
considered local travel); space and equipment rentals; printing
and publication; computer use; training and staff development
costs.
Line 6i - Total Direct Charges: Show the
totals of Lines 6a through 6h.
Line 6j - Indirect Charges: Enter the total
amount of indirect charges (costs), if any. If no indirect costs
are requested, enter "none."
Line 6k - Total: Enter the total amounts
of Lines 6i and 6j.
Line 7 - Program Income/Third Party In-Kind
Contributions: Leave blank.
Section C - Non-Federal Resources: Leave
blank.
Section D - Forecasted Cash Needs: Not applicable.
Section E - Budget Estimate of Federal Funds
Needed for Balance of the Project: Not applicable.
Section F - Other Budget Information
Line 21 - Direct Charges: Not applicable
Line 22 - Indirect Charges: Enter the type
of indirect rate (provisional, predetermined, final or fixed)
to be in effect during the funding period, the base to which the
rate is applied, and the total indirect costs.
Line 23 - Remarks: Provide any other explanations
or comments deemed necessary.
3. SF 424B - Assurances
SF 424B, Assurances--Non-Construction Programs,
contains assurances required of applicants. Please note that a
duly authorized representative of the applicant organization must
certify that the applicant is in compliance with these assurances.
4. Certification Forms
Certifications are required of the applicant regarding
(a) lobbying; (b) debarment, suspension, and other responsibility
matters; and (3) drug-free workplace requirements. Please note
that a duly authorized representative of the applicant organization
must attest to the applicant's compliance with these certifications.
5. Project Summary Description
The project summary description (page one) begins
the substantive part of the application. It should be headed by
two identifiers: (1) the name of the applicant organization as
shown in SF 424, item 5 and (2) the program priority, namely,
Information and Referral for Medicare Beneficiaries grants.
6. Program Narrative
The Program Narrative is the critical part of the
application. It should be clear, concise, and, of course, responsive
to the program priority as described above under Part I, Section
D, The narrative should cover: (A) the project's purpose(s), relevance,
significance, and responsiveness to the program priority; (B)
the workplan/ approach(es) the project will follow to achieve
its purpose(s); (C) the anticipated outcomes/results/benefits
of the project and how these will be disseminated and utilized,
and; (D) the level of effort needed to carry out the project,
in terms of the project director and other key staff, funding,
and other resources.
Please have the narrative typed, double-spaced,
on one side of 8 1/2" x 11" plain white paper with 1"
margins on both sides. All pages of the narrative (including charts,
tables, etc.) should be sequentially numbered, beginning with
"Objectives and Need for Assistance" as page number
two (2).
7. Letters of Commitment From Collaborating
Organizations and Agencies
Include confirmation of the commitments to the project
(should it be funded) made by collaborating agencies after the
narrative section of the application.
J. Points to Remember
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Please send an original and two copies of your
application.
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The summary description should accurately reflect
the nature and scope of the proposed project.
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Do not include testimonial letters which
endorse the project in general and perfunctory terms. In contrast,
letters which describe and verify tangible commitments to
the project, e.g., funds, staff, space, should be included.
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The application must be mailed by midnight,
or hand-delivered by 5:00 p.m., Eastern Time, on October 30,
1998, to:
Department of Health and Human Services
Administration on Aging
Office of Administration and Management
330 Independence Avenue, S.W., Room 4643
Washington, D.C. 20201
INQUIRIES: Inquiries should be addressed to Regional
Administrators on Aging, HHS regional offices.
| Last Modified: 12/1/2010 10:44:17 AM |
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