Lifespan Respite Care Program: State Program Enhancement Grants - Reposting Opportunity to Apply

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Title
Lifespan Respite Care Program: State Program Enhancement Grants - Reposting Opportunity to Apply
Opportunity ID
334854
Center
AOA
Primary CFDA Number
93.072
Funding Opportunity Number
HHS-2021-ACL-AOA-LRLI-0115
Funding Instrument Type
Cooperative Agreement
Expected Number of Awards Synopsis
2
Length of Project Periods
60-month project period with five 12-month budget periods
Project Period Expected Duration in Months
60
Eligibility Category
State governments
Additional Information on Eligibility
By Statute, eligible applicants include State Units on Aging, State Medicaid Agencies, or another State agency designated by the governor to apply for funds. Eligible applicants must work in conjunction with the ADRC in the state and in concert with the statewide respite coalition or respite organization. This funding opportunity will be further limited to those states who have had at least one other Lifespan Respite Grant since program implementation began in 2009.
Foreign entities are not eligible to compete for, or receive, awards made under this announcement.
Estimated Award Date
Funding Opportunity Description

Purpose
The U.S. Administration for Community Living (ACL) is providing this new competitive funding announcement opportunity to assist eligible state agencies in further implementing requirements of the Lifespan Respite Care Act of 2006, as amended (The Act) – (P.L.109-442 and P.L. 116-324). The Act requires grantees to focus on expanding and enhancing respite care services to family caregivers across the lifespan; improving the statewide dissemination and coordination of respite care, and providing, supplementing, or improving access and quality of respite care services to family caregivers, thereby reducing family caregiver strain.

The Act defines respite care as, “…planned or emergency care provided to a child or adult with a special need in order to provide temporary relief to the family caregiver of that child or adult.” In The Act, Lifespan Respite Care is defined as “a coordinated system of accessible, community- based respite care services for family caregivers of children or adults with special needs.” Such a system brings together Federal, state and local resources and funding streams to help support, expand and streamline the delivery of planned and emergency respite services, while also providing for the recruitment and training of respite workers and caregiver training and empowerment.

Successful applicants will be required to enhance or expand state and local coordinated Lifespan Respite Care systems to serve family caregivers regardless of the age, disability or chronic condition of the care recipient. Grantees will also be required to develop and provide new and emergency respite services; train and recruit respite workers, including volunteers; and assist caregivers in gaining access to respite care services that meet the needs of both the caregiver and care recipient.

Eligible respite recipients include adult family members (including grandparents, of any age, and other relatives who are primary caretakers of children or adults with special needs), foster parents, or others providing care to children who require assistance beyond that required to meet the basic needs of the child and unpaid care to adults who require care to meet basic needs or prevent injury. Further, all programs must, from the outset, address the respite needs of all populations regardless of the age and/or disability/special needs of the care recipient population. No phase-in or preference for specific age groups or disability categories will be permitted.

State agencies eligible to receive funding under The Act must have the ability to work with State and community-based organizations; understand respite care and family caregiver issues across all age groups, disabilities, and chronic conditions; and have the capacity to ensure meaningful involvement of family members, family caregivers, and care recipients.

Background - The Lifespan Respite Care Act – Overview
The Act is intended to accomplish several objectives, as follows:

Respite is often in short supply or inaccessible to people of all ages and disabilities, the Act seeks to expand and enhance equitable respite services within each state;
Multiple respite programs are often funded through a variety of sources within each state. The Act is designed to improve coordination and dissemination of service delivery between the various programs, thereby minimizing duplicative programs and services;
Consumers often have trouble navigating the multiple respite programs that might exist in a state or community. A Lifespan Respite Program is intended to reduce the difficulties consumers experience with accessing and navigating respite programs and services; and
By expanding and enhancing respite services, and improving coordination and access, the Act is designed to improve the overall quality of the respite services currently available.

Rather than supplant, replace, or duplicate Federal, state, local and private respite care development and funding activities, the Act is intended to facilitate coordination between programs, reduce duplication of effort, and assist in the development of respite care infrastructure at the state and local levels. The implementation of the Act should improve the delivery and quality of respite services available to families across age and disability spectrums, by establishing coordinated lifespan respite systems.

A state lifespan respite care system brings together an array of public or private nonprofit statewide respite care coalitions or organizations, which includes aging and disability resource centers. With this in mind, grantees will be required to enhance existing lifespan respite care programs and partnerships by furthering their efforts to sustain a statewide systemic level of respite care.

The Evolving Respite Environment
Lifespan Respite Programs have been in existence in states since the 1990’s. Several state lifespan respite care programs came into existence through state legislation while others relied on the commitments and activities of a dedicated group of volunteers to implement a program without authorizing legislation. The early efforts by states helped to create community-based networks of local partnerships, including family caregivers, providers, state and federally funded programs, area agencies on aging, non-profit organizations, health services, local businesses and faith-based organizations all working to ensure capacity of available respite and related services. These programs were the precursors to the Federal program created in 2006 with the passage of the Lifespan Respite Care Act.

Since the passage of the 2006 Act, states have made considerable progress towards building sustainable programs capable of meeting the respite care needs of families and family caregivers across the lifespan. As evidenced by the coronavirus pandemic, respite programs must continue to evolve to changing needs and circumstances of caregivers and care recipients. The impact of the COVID-19 virus on all communities, across all age groups, affected every state’s delivery of respite services. Due to the pandemic, states coalitions had to look to other forms, or means, of service delivery, such as allowing the reimbursement of family or friends for respite services or the provision of virtual support groups, outreach, and even, respite care.

With the passage of the “Recognize, Assist, Include, Support, and Engage Family Caregivers Act of 2017 (RAISE Family Caregivers Act) and the formation of the Family Caregiving Advisory Council, which first convened in August 2019, focus on respite has grown. Based on the work of the Family Caregiving Advisory Council (FCAC) to date, there is an emerging opportunity for states to re-think their respite systems. The FCAC will develop a National Family Caregiving Strategy that will, among other things, focus on respite. It is anticipated that the National Strategy will afford states and communities ample opportunities to re-envision their respite programs and services.

Finally, over time, more has been learned about providing services that meet the cultural needs of caregivers and care recipients. Applicants should discuss how they will promote equity through service access and provision of culturally competent services.

Applicants to this funding opportunity are encouraged to read the text of the Lifespan Respite Care Act of 2006 and the Lifespan Respite Reauthorization Act of 2020 in its entirety, including the committee report accompanying the legislation. Full text of the 2006 Act may be found at: https://www.congress.gov/109/plaws/publ442/PLAW-109publ442.pdf. Full text of the Lifespan Respite Reauthorization Act of 2020, which was signed into law on January 5, 2021, may be found at https://www.congress.gov/116/bills/hr8906/BILLS-116hr8906enr.pdf.

Applicants should be aware that this is a highly competitive funding opportunity. Only those applications deemed to show the greatest likelihood of building upon previous advancements made toward sustainable lifespan respite care programs that focus on a sustained systemic approach will be selected for funding.
Program Priority Areas
The overarching goal of this funding opportunity is to enhance state systems and capacities to deliver respite care and related services to family caregivers of adults or children with disabilities. With this in mind, applicants should describe their current capacity and outline a strategy for building or strengthening the systemic infrastructure necessary to address gaps in, and assure consistent provision of, respite care services statewide. Applicants are also encouraged to discuss any objectives related to the development or strengthening of a policy framework aimed at furthering the long-term continuation and support of statewide respite care service provision. Applicants will also be expected to propose consumer, programmatic and systems level outcomes and describe how these outcomes will be measured and tracked for the people they will serve.

To be competitive, applicants should fully describe their proposed approaches for advancing their State Lifespan Respite Systems, with particular attention to the following Program Priority Areas:

Direct service provision, incorporating the lessons learned from the COVID-19 pandemic where appropriate;
Continued systems development;
Strengthened collaborations and partnerships ;
Paid and volunteer respite provider training;
Identification and reduction of gaps in current services; and
Targeting underserved populations, across the lifespan, with particular emphasis on addressing those most impacted by COVID-19.

1. Direct service provision, incorporating the lessons learned from the COVID-19 pandemic where appropriate
The Lifespan Respite Care Act stipulates the provision of five required and three optional services. Application narratives should clearly and completely describe the State agency’s plan for further developing and delivering each of the required and, where appropriate, optional services in a way that considers the available evidence, emerging strategies, and promising practices in the field of respite to expand capacities and deliver direct services. For more information on emerging, model, or promising practices in the field of respite and family caregiver support, applicants should review information available on the ARCH National Respite Network and Resource Center website at https://archrespite.org/ta-center-for-respite/

Based on the knowledge and understanding of the state's current respite environment, applicants are required to provide detailed plans for how respite services funded under this opportunity will be delivered over the entire length of the project. Proposals must provide sufficient detail so as to describe how funds will be allocated across all eligible population groups; how funds will flow to service recipients; the service delivery model and/or payment mechanism(s) that will be used; and how the investment in respite services will inform policy development and strategies to increase access to respite services beyond the life of the grant.

States should determine the proportion of their requested funds that will be used for developing a Lifespan Respite System and the proportion of requested funds that will be used for direct service provision over the entire 5-year project period. Applicants should propose to both further develop their Lifespan Respite Care System and fill gaps in respite service provision.

Because of the ongoing and anticipated impacts of the COVID-19 pandemic, applicants should view this as an opportunity to modify and further adapt their respite programs to be responsive to, or test new means of, providing services in multiple environments, based on lessons learned from the COVID-19 pandemic. As such, applicants are encouraged, but not required, to consider other forms, or means, of service delivery, such as allowing the reimbursement of family or friends for respite services or the provision of virtual support groups, outreach, and even, respite care to meet current needs as well as prepare for the ongoing provision of respite services in case of future emergencies or disaster situations. Applicants are encouraged to review and consider the recommendations in the resource developed by ACL’s Lifespan Respite Technical
Assistance and Resource Center titled, “Providing and Receiving Respite Care Safely During the
COVID-19 Pandemic: Voluntary National Guidelines for Respite Care Agencies, Providers, Family Caregivers, and Respite Care Recipients

2. Continued systems development
Applicants should describe in detail their objectives for systemically advancing existing lifespan respite care services statewide, with a focus on the following areas:

Capacity building of respite care providers (both paid and unpaid);
Leveraging of resources across various funding streams and partners to sustain and expand available respite care services;
Implementation of key administrative functions (including logistical, information technology, communications, operational, and service coordination activities); and
Ongoing monitoring and quality assurance of respite care service provision.

Through this funding announcement, ACL expects to realize tangible, measurable and sustainable advancements in state capacities to provide respite and related services to family caregivers across the age and disability spectrum. Applications will be evaluated, in part, on the extent to which a plan for the project’s sustainability beyond the period of Federal funding is articulated and appears feasible. Applicants are encouraged to consider and propose a range of potential approaches for ensuring sustainability of project efforts once Federal funding has ended. Tools and resources for the sustainability of Lifespan Respite Programs are available on
the ARCH National Respite Network and Resource Centers’ web site, https://lifespanrespite.wildapricot.org/Sustainability_Tools.

Applicants are strongly encouraged to consider including any objectives related to policy development that would support or sustain the continuation of lifespan respite care services beyond the project period. Furthermore, applicants should be mindful of the emerging opportunity to re-think their respite systems, based on the work of the Family Caregiving Advisory Council (FCAC) to date. Once the FCAC develops the National Family Caregiving Strategy that will, among other things, focus on respite, grantees will be afforded opportunities to re-envision their respite programs and services.

3. Strengthened collaborations and partnerships
Among those states eligible to apply for funding, there exists a great deal of variability with respect to stakeholder capacities, engagement, and active collaboration. Partnership, collaboration and stakeholder involvement are critical underpinnings of a successful statewide Lifespan Respite Care Program. Whether these partnerships are facilitated by the state agency, the statewide respite coalition/organization, the state aging and disability resource center or through collaborative efforts of multiple stakeholders, having the broadest possible array of stakeholders involved is essential for ensuring the needs of family caregivers.

Applicants funded under this funding opportunity must propose approaches for expanding collaboration and partnerships with relevant stakeholders to ensure the program reaches the broadest population of eligible services recipients possible. Potential stakeholders include:

Entities of state and local government that administer and deliver human services programs designed to meet the respite care needs of family caregivers;
State and local chapters of organizations and entities representing individuals with special needs from across the disease and disability spectrum and for whom respite is an essential component of their ongoing support in a community setting;
Any other public, private, or not-for-profit entities that are providing respite care services or other supports to caregivers focused on special or targeted populations that may not be otherwise captured in or involved with the state’s existing respite care coalition; and
Any additional federally funded, local, or state program that may provide supports or resources that can be leveraged to further support the expansion of lifespan respite care services.

Applications will be scored, in part, on the extent to which the proposed use of funds will advance the State’s capacity to leverage public and private partnerships to deliver and increase access to respite services and achieve desired outcomes. This may also include investing in the training and ongoing development of both new and existing respite care professionals (paid and unpaid).

IMPORTANT! A Memorandum of Agreement (MoA) regarding the joint responsibility for the development of the state’s lifespan respite program between the eligible State agency and the public or private nonprofit statewide respite coalition or organization must be in place at the time of application and submitted with the application. Applicants are encouraged to embed flexibility within the MOA so that all parties to the Agreement can modify scope, tasks or partnerships as the need arises. A copy of such memorandum must be included as part of ALL application packages.

4. Paid and volunteer respite provider training
Applicants should describe the extent to which their proposed projects will work to expand or strengthen the respite care workforce, whether paid or volunteer, including recruitment, training, and oversight with particular emphasis on cultural competence and quality in service delivery. In this regard, applicants should describe how the quality and safety of any respite care services provided will be monitored, including methods to ensure that respite care workers and volunteers are appropriately screened and possess the necessary skills to care for the needs of the care recipient in the absence of the family caregiver.

5. Identification and reduction of gaps in current services
Applicants are expected to demonstrate knowledge in their current system of respite services and provide details that inform how the current system of respite services forms the foundation for their statewide systems of lifespan respite care services, including how such services are targeted and delivered. Based on the applicant’s description of the current statewide respite care system, applicants should then identify and explain known gaps in the provision of respite services and propose how those gaps in respite services will be addressed should the applicant receive federal funding as a result of their application to this funding announcement.

6. Targeting underserved populations, across the lifespan, with particular emphasis on addressing those most impacted by COVID-19
Applicants should continue to address equity among populations across the lifespan, particularly given what we know about the disproportionate impact the coronavirus had on many traditionally underserved populations. Underserved populations is defined as those in greatest economic and social need, who are further isolated from services and supports by their race, ethnicity, cultural background, sexual orientation/gender identity, geographic location, and/or limited English speaking proficiency. Applicants are expected to explain current efforts, and results, under their current lifespan respite system of care to serve underserved populations across the lifespan. Based on this description, applicants should then explain how they propose to target and increase services to traditionally underserved populations that have been identified in their state and local communities.

Additional Application Elements
In addition to the priority areas described above, as well as the required narrative elements described in “Section IV. Project Narrative” section of this funding announcement, applicants should clearly demonstrate/address the following in their applications:

Programmatic Performance and Outcomes Measurement
Performance is an important component of a fully functioning Lifespan Respite Care System. This includes programmatic performance outcomes (including associated cost/benefits) with particular attention to consumer level information regarding service delivery and impact on consumers. Applicant goals should identify relevant consumer-based, programmatic and systems-level outcomes the state would like to measure and proposed approaches.

Awardees under this funding opportunity will work with ACL to implement the data collection and reporting requirements, under Section 2904 of the Lifespan Respite Reauthorization Act of 2020. As such, grantees under this program should expect reporting requirements to change over the course of the project and will be expected to comply with those changes when they are implemented.

Applicants should describe how they plan to count and record the experiences of the people being served with these funds as well as the impact of a statewide lifespan respite care system on consumers, their families, and employers. Successful applicants will describe how such data would be collected and presented and do so in concert with current efforts across existing respite programs/funding streams. Applicants may identify a consumer level outcome measure (or measures) of their choosing or draw upon the "Measuring Systems Change and Consumer Outcomes: Recommendations for Developing Performance Metrics for State Lifespan Respite Programs" document to assist in the conceptualization, development and implementation of useful performance metrics. This resource can be accessed at https://archrespite.org/images/docs/2014_Guidebooks/PerformanceMeasurme…. Applicants are encouraged to review the document and consider this information when designing their application for this announcement.

Products
Grantees will be doing much to advance Lifespan Respite Care Programs at the state and local level. As such, grantees’ experiences during the course of the project will be looked at with interest by other states seeking guidance and direction as they embark on the development of similar programs into the foreseeable future. To more easily facilitate replication of programs and approaches by other states and to eliminate the need to “reinvent the wheel,” grantees will be asked to submit to ACL and the ACL Lifespan Respite Technical Assistance Center, key products that can serve as resource guides for future Lifespan Respite Care Program development, enhancement, and expansion.

Participation in Technical Assistance Efforts
Grantees will be expected to participate in technical assistance activities as they pertain to Lifespan Respite Care Program and System development, management, and integration. This includes, but is not limited to, participation in regularly scheduled conference calls, web casts and one-on-one Technical opportunities initiated by the ACL Project Officer, the Lifespan Respite Program Technical Assistance Resource Center, or as requested by the grantee and stakeholder themselves.

Additionally, grantees are strongly encouraged to budget resources for travel to and participation in the National Respite Conference, convened annually by ARCH. This conference provides participants with the opportunity to learn about the latest trends in respite program development and the opportunity to network and share best practices associated with Lifespan Respite Care Program implementation and Lifespan Respite Care System development.

Grants/Subcontracts
Grantees may carry out the required activities described above directly or by sub-grant to, or contract with, public or private entities. Due to the nature of this program, the State Project Director must maintain an active role in the management of this project. Applicants who propose conduit or pass-through funding for another agency to lead the project will not be considered for funding.

Applicants under this funding announcement should clearly describe, if necessary, their processes for sub-granting or sub-contracting specific activities under this funding announcement. Additionally, applicants should clearly describe the role of the project director along with the stakeholder group that will guide the design and implementation of the statewide lifespan respite care system.

Award Ceiling
275000
Award Floor
100000
Due Date for Applications

Last modified on 07/26/2021


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