MP-CPI-20-001 State Partnership Initiative 2.0 REVISED.pdf

DEPARTMENT OF

HEALTH AND HUMAN SERVICES

OFFICE OF THE

ASSISTANT SECRETARY FOR HEALTH

Office of Minority Health

Funding Opportunity: State/Tribal/Territorial Partnership Initiative to

Document and Sustain Disparity-Reducing Interventions

Opportunity Number: MP-CPI-20-001

Application Due Date:

Wednesday August 26, 2020 6:00 PM Eastern

OVERVIEW

FEDERAL AGENCY NAME

Office of the Assistant Secretary for Health and the Office of Minority Health

FUNDING OPPORTUNITY TITLE

State/Tribal/Territorial Partnership Initiative to Document and Sustain Disparity-Reducing

Interventions

ACTION

Notice

ANNOUNCEMENT TYPE

Initial Competitive Grant

FUNDING OPPORTUNITY NUMBER

MP-CPI-20-001

CFDA NUMBER AND PROGRAM:

93.137 Community Program to Improve Minority Health

DATES

Application Deadline: Wednesday, August 26, 2020 by 6:00 PM Eastern

Technical Assistance: Webinar July 28, 2020 at 4:00 PM Eastern

EXECUTIVE SUMMARY

The Office of Minority Health (OMH) announces the availability of funds for Fiscal Year

(FY) 2020 grant awards under the authority of Section 1707 of the Public Health Service Act

(42 U.S.C. § 300u-6).

This notice solicits applications for projects to demonstrate if modifications to existing evidence-informed interventions for selected health issues will significantly improve health outcomes for racial and ethnic minority and disadvantaged populations.

Racial and ethnic minority and disadvantaged populations often experience persistent health disparities and worse health outcomes.1 OMH intends projects funded under this initiative to help build the capacity of state, tribal, and territorial governmental health agencies to achieve two main goals: (1) test modifications to existing public health programs or practices (interventions) to assess if the modified interventions are successful in significantly improving health outcomes for selected health issues; and (2) develop effective plan(s) to sustain successful interventions after the award period. Projects are expected to address two health issues, one from each of the following two lists: (1) HIV, maternal mortality and morbidity, physical activity, or substance use disorder; and (2) nutrition, sickle cell disease and trait, diabetes, Alzheimer’s, lupus, or cancer prevention (i.e., addressing risk factor(s) specifically for stomach, liver, or cervical cancer). Interventions proposed for modification can be those currently or recently (e.g., within the past two years) implemented by the applicant. OMH anticipates the availability of approximately $6,500,000 for this funding opportunity to support approximately 21 to 26 eligible applications with awards ranging from

$250,000 to $300,000 per year for up to two years. For recipients that demonstrate statistically significant improvement in health outcomes, develop a sustainability plan and begin implementing the sustainability plan in the first quarter of year two, OMH will consider a limited non-competitive continuation for a third year of funding to continue the implementation of the project’s sustainability plan.

OMH expects projects to involve a collaborative partnership. According to the National

Academies of Sciences, Engineering, and Medicine report, Communities in Action: Pathways to Health Equity, “effective partnerships are essential for community-based solutions for advancing health equity by making it a shared vision and value, increasing the community's capacity to shape outcomes, and fostering multi-sector collaboration.”2 OMH encourages applicants to include partnership with minority-serving institutions (MSIs), in particular medical schools at Hispanic-Serving Institutions (HSIs) and medical schools at Historically

Black Colleges and Universities (HBCUs), to support workforce diversity and encourage a focus on racial and ethnic health disparities. If the applicant is a not a state, tribal, or territorial governmental health agency or entity (e.g., a department of health or public health office, office of minority health/health equity or an organization with a similar function, or a state health agency), OMH expects the applicant to secure a formal partnership with a state, tribal, or territorial governmental health agency or entity. See Section E, Eligibility Information, for the organizations that are eligible to apply for this grant. HHS/OASH encourages applicants to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this funding announcement to ensure that applications comply with all requirements and instructions.

FUNDING OPPORTUNITY DETAILS

A. DATES

1. Application Deadline

Your application is due Wednesday August 26, 2020 by 6 p.m. Eastern Time. To receive consideration, you must submit your application electronically via Grants.gov no later than this due date and time. If you do not submit your application by the specified deadline, we will return it to you unread. You must submit electronically via Grants.gov unless you obtain a written exemption from this requirement 2 business days in advance of the deadline from the Director, HHS/Office of the Assistant Secretary for Health (OASH) Grants and Acquisitions Management

(GAM) Division. To obtain an exemption, you must request one via email from the

HHS/OASH/GAM, and provide details as to why you are technologically unable to submit electronically through Grants.gov. Your request should be submitted at least 4 business days prior to the application deadline to ensure your request can be considered prior to 2 business days in advance of the deadline. If you request an exemption, include the following in your e-mail request:

the HHS/OASH announcement number; your organization's DUNS number; your organization’s name, address and telephone number; the name and telephone number of your Authorizing

Official; the Grants.gov Tracking Number (for example, GRANT####) assigned to your submission; and a copy of the "Rejected with Errors" notification from Grants.gov. Send the request with supporting documentation to OASH_Grants@hhs.gov. Note: failure to have an active

System for Account Management (SAM) registration prior to the application due date will not be grounds for receiving an exemption to the electronic submission requirement. As a result of the public health emergency for COVID-19, the requirement for an active SAM registration at the mailto:ogm.oash@hhs.gov time of application submission has been relaxed (see Section F.4). However, if you do not have a

DUNS number at this time, you should contact the Grants.gov to establish a temporary DUNS number. Your application will not be accepted through Grants.gov without this number. Failure to follow Grants.gov instructions to ensure software compatibility will not be grounds for receiving an exemption to the electronic submission requirement.

The HHS/OASH/GAM will only accept applications via alternate methods (hardcopy paper via U.S. mail or other provider or PDF via email) from applicants obtaining prior written approval. If you receive an exemption, you must still submit your application by the deadline.

Only applications submitted through the Grants.gov portal or alternate format (hardcopy paper via

U.S. mail or other service or PDF via email) with an approved written exemption will be accepted.

See Section F.8 (“Other Submission Requirements”) for information on application submission mechanisms.

Executive Order 12372 comment due date: The State Single Point of Contact (SPOC) has

60 days from the application due date to submit any comments. For more information on the SPOC see section F.6 Intergovernmental Review.

To ensure adequate time to submit your application successfully, HHS/OASH recommends that you register as early as possible in Grants.gov since the registration process can take up to one month. You must register an authorizing official for your organization. HHS/OASH does not determine your organization’s authorizing official; your organization makes that designation. For information on registering for Grants.gov, refer to http://www.grants.gov or contact the Grants.gov

Contact Center 24 hours a day, 7 days a week (excluding Federal holidays) at 1-800-518-4726 or support@grants.gov.

http://www.grants.gov/ mailto:support@grants.gov

Your organization is strongly encouraged to register multiple authorized organization representatives in Grants.gov to ensure someone is available to submit your application.

2. Technical Assistance

A technical assistance webinar to answer questions for potential applicants will be held on

Tuesday, July 28, 2020. Please check the Office of Minority Health website, www.minorityhealth.hhs.gov, for more detailed information.

We recommend you review the entire announcement promptly so you can have any questions answered well in advance of the application due date. We also recommend you subscribe to this announcement in Grants.gov so you receive any amendments, question and answer documents, or other updates.

B. PROGRAM DESCRIPTION:

The Office of Minority Health (OMH) announces the availability of funds for Fiscal Year

(FY) 2020 grant awards under the authority of Section 1707 of the Public Health Service Act (42

U.S.C. § 300u-6). OMH is dedicated to improving the health of racial and ethnic minority and disadvantaged populations through the development of health policies and programs that will help eliminate health disparities. Through its demonstration grants, OMH supports the identification of effective approaches for improving health outcomes with the ultimate goal of promoting sustainability and dissemination of these approaches. This particular grant aligns with the Assistant

Secretary for Health’s priorities on physical activity, sickle cell disease, HIV and substance use;

the HHS Physical Activity Guidelines for Americans; the HHS National Youth Sports Strategy;

the HHS Ending the HIV Epidemic Initiative; the HHS 5-Point Strategy to Combat the Opioid

Crisis; and HHS Strategic Goal 2: Protect the Health of Americans Where They Live, Learn, Work and Play.3,4,5,6,7

The State/Tribal/Territorial Partnership Initiative is designed to demonstrate if modifications to existing evidence-informed interventions for selected health issues will significantly improve health outcomes for racial and ethnic minority and disadvantaged populations experiencing health disparities. This award is intended to help build the capacity of state, tribal, territorial, and/or local governmental health agencies to achieve two main goals: (1) test modifications to existing public health programs or practices (interventions) to assess if the modified intervention is successful in significantly improving health outcomes for selected health issues; and (2) develop and begin to implement effective plans that will sustain successful interventions after the award period.

1. Background

This demonstration project intends to address some of the health topics that are priorities for the U.S. Department of Health and Human Services for which health disparities are experienced by racial/ethnic minority and disadvantaged populations. For example:

a. Physical Activity

Lack of physical activity can contribute to disease risk and increased health care costs. 8,9

Only 19.1% of Asian, 23.9% of Native Hawaiian or Other Pacific Islander (NHOPI), 24.5% of

Black, 25.8% of Hispanic or Latino, 27.1% of non-Hispanic White, and 28.9% of American Indian and Alaska Native (AI/AN) adolescents (grades 9-12) met the current Federal physical activity guidelines.9 In addition, racial/ethnic minority adults were less likely than non-Hispanic White adults to engage in light or moderate physical activity.10

b. Substance Use Disorder11

AI/AN persons (10.1%) were most likely among all racial/ethnic groups to report having a substance use disorder in the past year, followed by NHOPIs (9.3%). AI/ANs (29.3%), NHOPIs

(21.2%) and Blacks/African Americans (20.8%) were more likely than non-Hispanic Whites

(20.2%) to report past-year illicit drug use.

c. HIV12

Blacks/African Americans and Hispanics/Latinos are disproportionately affected by HIV.

African Americans accounted for only 13% of the population, but 43% of HIV diagnoses in 2017.

Hispanics/Latinos accounted for only 18% of the population, but 26% of HIV diagnoses in 2017.

Further, in the South the impact of HIV is greater than in any other region. Over half (52%) of the

38,739 new HIV diagnoses in 2017 were in Southern states, which account for just 38% of the

U.S. population. Data shows that 51% of annual HIV infections, 46% of persons with HIV, and

51% of undiagnosed HIV infections were found in the South.

d. Maternal Mortality13

Black/African American and AI/AN women are two to three times more likely to die from pregnancy-related causes than non-Hispanic White women. Non-Hispanic Black and non-

Hispanic AI/AN women experienced higher pregnancy-related mortality ratio (PRMRs) (40.8 and

29.7, respectively) than all other racial/ethnic populations (non-Hispanic White PRMR was 12.7, Asian/Pacific Islander PRMR was 13.5 and Hispanic PRMR was 11.5). This was 3.2 and 2.3 times higher than the PRMR for non-Hispanic White women – and the gap widened among older age groups.

2. Expectations

OMH expects the recipient to address the following:

a. Organizational capacity and use of collaborative approach

OMH expects the recipient to demonstrate a collaborative approach to complete grant activities successfully and support the sustainability of effective interventions. If the applicant is not a state, tribal, or territorial governmental health agency or entity, OMH expects that the applicant partnering with a state, tribal, or territorial governmental health agency or entity. Each recipient is responsible for project implementation, project management, and financial management. OMH encourages projects to demonstrate partnerships with minority-serving institutions (MSIs), in particular medical schools at Hispanic-serving institutions (HSIs) and medical schools at Historically Black Colleges and Universities (HBCUs), to support workforce diversity and encourage a focus on racial and ethnic health disparities.

b. Focus Areas

OMH expects recipient to select one topic from each of the two topic areas listed below for a total of two topics. OMH expects the recipient to produce health disparities profiles and to test a modified intervention(s) designed to improve health outcome for each of the selected topics. Select topics based on need as demonstrated by health disparities in area(s) with elevated burden of the disease impacting racial/ethnic minority and/or disadvantaged populations.

1) Topic Area 1: HIV, maternal mortality and morbidity, physical activity, substance use disorder

2) Topic Area 2: Nutrition, sickle cell disease and trait, diabetes, Alzheimer’s, lupus, cancer prevention (i.e., addressing risk factor(s) specifically for stomach, liver, or cervical cancer)

c. Health Disparities Profile

OMH expects the recipient to produce a health disparities profile for each selected topic which should include:

1) existing state, tribal, territorial, or local-level representative, population-based data on health disparities related to the selected health topics, disaggregated by race/ethnicity; and

2) geographic area(s) of elevated disease burden where the intervention will be targeted in the applicant’s service community, within two months following the award.

These two health disparities profiles could serve as the baseline data for the two selected topics.

d. Modification(s) to Existing Evidence-Informed Intervention(s)

OMH expects the recipient to implement and test modification(s) to an existing evidence-informed intervention(s) designed to improve health outcomes for the selected topics in the geographic area(s) of elevated disease burden identified in the health disparities profiles, within the project period. OMH expects recipients to initiate implementation of the modified intervention(s) shortly after awards are made.

OMH expects applicants to demonstrate readiness as evidenced by clearly stated rationale and description of the proposed modification(s) and a comprehensive and feasible plan for implementation. OMH expects applicants to clearly illustrate, through use of logic models, how the elements of the proposed intervention align across objectives, activities, outputs and outcomes.

Examples of modifications to evidence-informed approaches include adapting:

1) the existing CDC-defined Tier I evidence-based STD/HIV intervention, the

HORIZONS, to be gender and culturally congruent for African American girls;14

2) a nutrition and physical activity program from an urban area to be geographically congruent for a rural, low-income community;15 and

3) a diabetes management and care program developed for urban African

Americans to be culturally, linguistically, and geographically appropriate for implementation in American Samoa.16

e. Intervention and Impact Evaluation

1) OMH expects recipients to implement a rigorous program evaluation to assess impact of project activities.

2) OMH expects the applicants to identify appropriate indicators/measures for the selected health topics to document and monitor the impact of the intervention(s) on health outcomes.

3) OMH expects the recipient to demonstrate that evaluation of the impact of the intervention(s) will be able to detect a statistically significant difference, if present.

4) OMH expects the recipient to collect, analyze, and evaluate health outcome data to demonstrate the impact of the intervention within the project period.

5) OMH expects the recipient to document the intervention implementation process and ‘lessons learned’.

f. Project Sustainability

OMH expects the applicant to provide a description of efforts to sustain and support continued implementation of evidence-informed intervention(s) that have demonstrated effectiveness. OMH expects the recipient to develop a sustainability plan within one year following the award. OMH expects successful projects (i.e., projects demonstrating significant difference in key outcomes) to begin implementing the sustainability plan in the first quarter of year two.

C. AUTHORITY

Section 1707 of the Public Health Service Act (42 U.S.C. § 300u-6)

D. FEDERAL AWARD INFORMATION

The Office of Minority Health intends to make funds available for competing grants.

We will fund awards in annual increments (budget periods) and generally for a project period up to 2 years, although we may approve shorter project periods. For recipients that demonstrate statistically significant improvement in health outcomes, develop a sustainability plan and begin to implement a plan to sustain successful intervention(s) in the first quarter of year two, OMH will consider a limited non-competitive continuation for a third year of funding (budget period) to continue the implementation of the project’s sustainability plan. Budget periods may also vary from the estimate indicated below due to timing of award issuance or other administrative factors. Funding for all approved budget periods beyond the first is generally level with the initial award amount and is contingent upon the availability of funds, satisfactory progress of the project, adequate stewardship of Federal funds, and the best interests of the Government.

Award Information

Estimated Federal Funds Available: $6,500,000

Anticipated Number of Awards: 21 to 26

Award Ceiling (Federal Funds including indirect costs): $300,000 per budget period

Award Floor (Federal Funds including indirect costs): $250,000 per budget period

Anticipated Start Date: September 30, 2020

Estimated Period of Performance: Not to exceed 2 years. A limited non-competitive continuation among the award recipients demonstrating statistically significant improvement in health outcomes and beginning to implement a sustainability plan in year two will be considered for a third year of funding to continue the implementation of the project‘s sustainability plan.

Anticipated Initial Budget Period Length: 12 months

Type of Award: Grant

Type of Application Accepted: Electronic via Grants.gov ONLY unless an exemption is granted

E. ELIGIBILITY INFORMATION

1. Eligible Applicants.

• State Governments

• County Governments

• City or township governments

• Special district governments

• Independent school districts

• Public and State controlled institutions of higher education

• Native American tribal governments (Federally recognized)

• Public Housing authorities/Indian housing authorities

• Native American tribal organizations (other than federally recognized tribal governments)

• Nonprofits having 501(c)(3) status with the IRS, other than institutions of higher education

• Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education

• Private non-profit institutions of higher education

• U.S. Territories

2. Cost Sharing or Matching

You are not required to provide cost sharing or matching in your proposed budget.

3. Application Responsiveness Criteria

We will review your application to determine whether it meets the responsiveness criteria below. If your application does not meet the responsiveness criteria, we will disqualify it from the competition; we will not review it beyond the initial screening. The responsiveness criteria are as follows:

• The applicant has selected two topics, one from each of the two lists specified in Section B.2.b.

4. Application Disqualification Criteria

If you successfully submit an application, we will screen it to ensure it meets the requirements listed below. If we determine your application fails to meet the criteria described below, we will disqualify it, that is, we will not review it and will give it no further consideration.

(a) You must submit your application electronically via www.grants.gov

(unless an exemption was granted 2 business days prior to the deadline) by the date and time indicated in the DATES section (A.1) of this announcement.

(b) If you successfully submit multiple applications from the same organization for the same project, we will only review the last application received by the deadline.

(c) HHS/OASH/GAM deems your application eligible according to section

E.1 Eligible Applicants.

(d) You must complete the required forms in the application package: SF-424, SF-424A, SF-424B, SF-LLL, and Project Abstract Summary.

(e) Your Project Narrative section of the application must be double-spaced, on the equivalent of 8 ½ ” x 11” inch page size, with 1” margins on all sides (top, bottom, left and right) and font size not less than 12 points.

(f) Your Project Narrative must not exceed 60 pages. NOTE: The following items do not count toward the Project Narrative page limit: all required forms, including SF-424, SF-424A, SF-424B, SF-LLL, Project Abstract Summary, and

Budget Narrative (including budget tables).

(g) Your total application, including the Project Narrative plus Appendices, must not exceed 80 pages. NOTE: items listed in “(f)” immediately above do not count toward total page limit.

(h) Your Federal funds request including indirect costs must not exceed the maximum indicated in Award Ceiling.

(i) Your application must meet the Application Responsiveness Criteria outlined above.

F. APPLICATION AND SUBMISSION INFORMATION

1. Address to Request Application Package

You may obtain an application package electronically by accessing Grants.gov at http://www.grants.gov/. You can find it by searching on the CFDA number shown on page 2 of this funding opportunity announcement. If you have problems accessing the application or difficulty downloading, contact:

OASH Grants and Acquisitions Management

Phone: 240-453-8822

Email: OASH_Grants@hhs.gov

2. Content and Form of Application Submission

a. Application Format

Your application must be prepared using the forms and information provided in the online application package.

The Project Narrative, and total application including appendices, must adhere to the page limit indicated in Application Disqualification Criteria listed in Section C. The page limit does not include the Budget Narrative (including budget tables), required forms, assurances, and mailto:ogm.oash@hhs.gov certifications as described in the Application Disqualification Criteria. Please do not number pages or include a table of contents. Our grants management system will generate page numbers once your application is complete. If your application exceeds the specified page limits for the Project

Narrative or Project Narrative plus Appendices when printed on 8.5” X 11” paper by

HHS/OASH/GAM, we will not review it. We recommend you print out your application before submitting electronically to ensure that it is within the page limits and is easy to read.

You must double-space the Project Narrative pages.

You should use an easily readable typeface, such as Times New Roman or Arial. You must use 12-point font. You may single-space tables or use alternate fonts but you must ensure the tables are easy to read.

b. Appendices Format

Your Appendices should include any specific documents outlined in Section D.2.iii., under the heading “Appendices” in the Application Content section of this funding opportunity announcement. Your documents should be easy to read. You should use the same formatting specified for the Project Narrative. However, documents such as résumés/CVs, organizational charts, tables, or letters of commitment may use formatting common to those documents, but the pages must be easy to read. All of your appendices must be uploaded as a single, consolidated file in the Attachments section of your Grants.gov application.

c. Project Abstract Summary Format

You must complete the Project Abstract Summary form provided in the application package. The abstract will be used to provide reviewers with an overview of the application and will form the basis for the application summary in grants management and program summary documents. If your project is funded, HHS may publish information from your form; therefore, do not include sensitive or proprietary information.

d. Budget Narrative Format

The Budget Narrative should use the formatting required of the Project Narrative for the explanatory text. Budget tables may be single-spaced but should be laid out in an easily-readable format and within the printable margins of the page.

3. Application Content

Your application must contain the following information:

a. Project Narrative Content

The Project Narrative is the most important part of the application, because it will be used as the primary basis to determine whether your project meets the minimum requirements for an award under this announcement. The Project Narrative should provide a clear and concise description of your project. HHS/OASH recommends that your project narrative include the following components: 1) Problem Statement; 2) Organizational Capability; 3) Goals, Objectives and

Outcomes; 4) Project Plan; 5) Evaluation Plan; and 6) Project Sustainability.

1) Problem Statement

Identify a topic from each of the two topic areas listed below for a total of two topics. After the award, these topics will be the focus of: (1) the development of detailed health disparities profiles; and (2) the implementation of modified intervention(s) to demonstrate the impact on health outcomes in the population(s) of focus.

Topic Area 1: HIV, maternal mortality and morbidity, physical activity, substance use disorder

Topic Area 2: Nutrition, sickle cell disease and trait, diabetes, Alzheimer’s, lupus, cancer prevention (i.e. addressing risk factor(s) specifically for stomach, liver, or cervical cancer)

For the selected topics, describe the need as demonstrated by health disparities within your service area in both quantitative and qualitative terms. Identify and describe the population(s) of need (e.g., race/ethnicity, demographics, socioeconomic status, and disadvantaged status).

Provide quantitative data to demonstrate the magnitude of the need, including the current health status, of the impacted population(s) for whom the proposed modified intervention(s) will be implemented. Identify and describe the geographic area(s) of elevated disease burden in which the proposed intervention(s) will be implemented.

2) Organizational Capability

Describe your organization’s capability to successfully implement the proposed project, including implementation readiness and ability to demonstrate impact on health outcomes within the project period. Provide evidence of your agency’s (or the particular division of a larger agency which will have responsibility for this project) ability to implement and evaluate community interventions effectively to address health disparities. You should include areas of expertise, key personnel, credentials of proposed staff, technical experience, unique capabilities, history of performing and implementing similar projects, why you are positioned to respond to the project requirements, and why you are best suited to implement and complete the project. Describe your and your partners’ connection to the community(ies) to be served. Describe the extent of your and any proposed partner’s knowledge of and experience with cultural competence and the National

Standards for Culturally and Linguistically Appropriate Services in Health and Health Care

(National CLAS Standards). (https://www.thinkculturalhealth.hhs.gov/Content/clas.asp) https://www.thinkculturalhealth.hhs.gov/Content/clas.asp

You should clearly delineate the roles and responsibilities of project staff, partners, and subrecipients, if any, and how they contribute to achieving the project’s objectives and outcomes.

You should clearly identify the individual who will serve as the Principal Investigator/Project

Director and that individual’s qualifications. HHS/OASH expects that, throughout the award period, the Principal Investigator/Project Director will have involvement in, and substantial knowledge about, all aspects of the project. You should clearly identify the individual who is responsible for evaluation activities and that individual’s qualifications.

You should describe how you plan to implement a collaborative approach to achieve project activities. Describe the specific roles, responsibilities, resources, and contributions of partner(s) to the project – including but not limited to: creating the health disparities profile, implementing the intervention(s), data collection and analysis, routine communication with the program lead, creating and/or implementing efforts to sustain successful evidence-informed intervention(s) , etc. – that will complement the lead organization’s capability and capacity to implement the intervention, improve health outcomes, and sustain the program. To the extent possible, the applicant should document the level of commitment of the partners as described below in the Appendices (Section F.3.d).

3) Goals, Objectives, and Outcomes

You should describe in this section your project’s proposed goal(s) and major objectives.

The objectives should be specific, measureable, achievable, realistic, and time-bound (SMART).

Unless your project involves multiple, complex interventions, we recommend you have only one overall goal for each selected topic, thus a minimum of two for this funding opportunity. You should clearly identify the indicators/measures for the selected topics to monitor and document progress toward health outcomes that will result from your project and explicitly state the expected magnitude of impact of your intervention on the outcomes. HHS/OASH will not fund any project that does not include measurable outcomes.

A “measurable outcome” is an observable end-result that describes how a particular intervention benefits program participants. It demonstrates the “impact” of the intervention. For example, it describes a change in participants’ financial, health, and/or functional status; mental well-being; knowledge; skill; attitude; awareness; or behavior. It can also describe a change in the degree to which participants exercise choice over the types of services they receive. Additional examples include: a change in the responsiveness or cost-effectiveness of a service delivery system; a new model of support or care that can be replicated; a measurable increase in community awareness; or a measurable increase in persons receiving services. A measurable outcome is not a measurable output, such as: the number of clients served; the number of training sessions held; or the number of service units provided. You should keep the focus of this section on describing what outcome(s) will be produced by the project.

4) Project Plan

Provide a detailed summary of activities to be undertaken and how they will assist in achieving the project goals and objectives. You should also describe the approach that will be used to monitor and track progress on the project’s tasks and objectives. Include a work plan describing how the project will be accomplished. Your work plan should reflect, and be consistent with, the

Project Narrative and Budget Narrative, and must cover all years of the project period. However, each year’s activities should be fully attainable in one budget year. You may propose multi-year activities, as well as activities that build upon each other, but each phase of the project must be discreet and attainable within a single budget year. Your work plan should include a statement of the project’s overall goal, anticipated outcome(s), key objectives, and the major tasks, action steps, or products that will be pursued or developed to achieve the goal and outcome(s). For each major task of each year, action step, or product, your work plan should identify the timeframes involved

(including start- and end-dates), and the lead person responsible for completing the task.

Describe the existing evidence-informed intervention(s) to be modified and tested, and provide rationale for the selection (including impact on health outcomes for the selected topics and evidence of effectiveness). Describe the proposed modification(s) to the evidence-informed intervention(s), and provide the rationale and the theoretical or empirical foundation for the modification(s). Describe how the proposed modified intervention(s) is expected to impact health outcomes for the selected health topics within the project period. The descriptions must align with the required logic models to be submitted with the application (see Appendices).

Provide an estimated number of individuals expected to participate in your proposed project and how this estimate has been determined. Describe your approach for reaching, engaging, and retaining the population(s) of focus in the proposed intervention(s) to support the feasibility of obtaining measurable outcomes within the project period. Describe how you will use the

National CLAS Standards to ensure the proposed project will be implemented in a culturally appropriate manner tailored to the population(s) of focus.

5) Evaluation Plan

Describe your evaluation design and how your evaluation design will clearly establish whether the modification(s) to evidence-informed intervention(s) result in statistically significant impact on key health outcomes to the two selected topics. Describe the technique you will use to establish/demonstrate statistical significance (e.g., power analysis, Baysian analysis, or other method). Describe how you will identify and document lessons learned in implementing this project. Describe your approach for collecting pre- and post-intervention data for both control and intervention groups. Describe how you will evaluate the quality of the implementation of the

National CLAS Standards through process and outcome measures. Describe the relationship between your evaluator and your organization and the degree of independence the evaluator will have.

6) Project Sustainability

Provide a description of your or your partner(s)’s experience and expertise in establishing or supporting the sustainability of a health-related project. Describe your strategies for identifying and securing financial, staff and supervisory, and material resources that are to sustain and support continued implementation of successful intervention(s) beyond the end of the project.

b. Budget Narrative Content

You must complete the required budget forms and submit a budget narrative with detailed justification as part of your application. You must enter the project budget on the Budget

Information Non-construction Programs standard form (SF 424A) according to the directions provided with this standard form. The budget narrative consists of a detailed line-item budget that includes calculations for all costs and activities by "object class categories" identified on the SF-

424A and justification of the costs. You must indicate the method you are selecting for your indirect cost rate. See Indirect Costs below for further information.

Project budget calculations must include estimation methods, quantities, unit costs, and other similar quantitative detail sufficient to verify the calculations. If matching or cost sharing is required, you must include a detailed listing of any funding sources identified in box 18 of the SF-

424 (Application for Federal Assistance).

Please be sure to carefully review section F.7 Funding Restrictions for specific information regarding allowable, unallowable, and restricted costs.

You must provide an object class category budget using Section B, box 6 of the SF 424A for the first year of the proposed project. Provide a budget justification, which includes explanatory text and line-item detail, for the first year of the proposed project. The budget narrative should describe how the categorical costs are derived. Discuss the necessity, reasonableness, and allocation of the proposed costs.

For subsequent budget years, provide a summary narrative and line item budget. For categories or items that differ significantly from the first budget year, provide a detailed justification explaining these changes. Note, do not include costs beyond the first budget year in the object class budget in box 6 of the SF- 424A or box 18 of the SF-424; the amounts entered in these sections should only reflect the first budget year.

Your budget narrative should justify the overall cost of the project as well as the proposed cost per activity, service delivered, and/or product. For example, the budget narrative should define the amount of work you have planned and expect to perform, what it will cost, and an explanation of how the result is cost effective. For example, if you are proposing to provide services to clients, you should describe how many clients are you expecting to serve, the unit cost of serving each client, and how this is cost effective.

Use the following guidelines for preparing the detailed object class budget required by box

6 of the SF-424A. The object class budget organizes your proposed costs into a set of defined categories outlined below. Both federal and non-federal resources (when required) must be detailed and justified in the budget narrative. "Federal resources" refers only to the HHS/OASH funds for which you are applying. "Non-federal resources" are all other non-HHS/OASH federal and non-federal resources. We recommend you present budget amounts and computations in a columnar format: first column, object class categories; second column, federal funds requested;

third column, non-federal resources; and last column, total budget.

Sample Budget Table

Object Class Federal Funds Requested

Non-federal Resources

Total Budget

Personnel $100,000 $25,000 $125,000

Note, subrecipient/contract and consultant detailed costs should all be included in those specific line items, not in the overall project object class line items, i.e., subrecipient travel should be included in the Contractual line item not in Travel.

1) Object Class Descriptions and Required Justifications

(a) Personnel Description

Costs of staff salaries and wages, excluding benefits.

(b) Personnel Justification

Clearly identify the project director or principal investigator, if known at the time of application. Provide a separate table for personnel costs detailing for each proposed staff person:

the title; full name (if known at time of application), time commitment to the project as a percentage or full-time equivalent: annual salary and/or annual wage rate; federally funded award salary; non-federal award salary, if applicable; and total salary. No salary rate may exceed the statutory limitation in effect at the time you submit your application (see D.6 Funding Restrictions, Salary Rate Limitation for details). Do not include the costs of consultants, personnel costs of delegate agencies, or of specific project(s) and/or businesses to be financed by the applicant.

Contractors and consultants should not be placed under this category.

Sample Personnel Table

Position Title and Full Name

Percent Time Annual Salary Federally-funded Salary

Non-federal Salary

Total Project Salary

Project Director, John K. Doe

50% $100,000 $50,000 $0 $50,000

Data Assistant, Susan R. Smith

10% $30,000 $3,000 $3,000

(c) Fringe Benefits Description

Costs of employee fringe benefits unless treated as part of an approved indirect cost rate.

(d) Fringe Benefits Justification:

Provide a breakdown of the amounts and percentages that comprise fringe benefit costs such as health insurance, Federal Insurance Contributions Act (FICA) taxes, retirement insurance, and taxes.

(e) Travel Description

Costs of travel by staff of the applicant organization only.

(f) Travel Justification

For each trip proposed for applicant organization staff only, show the date of the proposed travel, total number of traveler(s); travel destination; duration of trip; per diem; mileage allowances, if privately owned vehicles will be used; and other transportation costs and subsistence allowances. Do not include travel costs for subrecipients or contractors.

(g) Equipment Description

Equipment means tangible personal property (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established by the non-Federal entity for financial statement purposes, or $5,000. (Note: Acquisition cost means the cost of the asset including the cost to ready the asset for its intended use. Acquisition cost for equipment, for example, means the net invoice price of the equipment, including the cost of any modifications, attachments, accessories, or auxiliary apparatus necessary to make it usable for the purpose for which it is acquired. Acquisition costs for software includes those development costs capitalized in accordance with generally accepted accounting principles (GAAP). Ancillary charges, such as taxes, duty, protective in transit insurance, freight, and installation may be included in or excluded from the acquisition cost in accordance with the non- Federal entity’s regular accounting practices.) See 45 C.F.R. § 75.2 for additional information.

(h) Equipment Justification

For each type of equipment requested you must provide a description of the equipment; the cost per unit; the number of units; the total cost; and a plan for use of the equipment in the project;

as well as a plan for the use, and/or disposal of, the equipment after the project ends. An applicant organization that uses its own definition for equipment should provide a copy of its policy, or section of its policy, that includes the equipment definition; include this with your Budget

Narrative file. Reference the policy in this justification and include the policy copy in your Budget

Narrative file (not your appendices).

(i) Supplies Description

Costs of all tangible personal property other than those included under the Equipment category. This includes office and other consumable supplies with a per-unit cost of less than

$5,000.

(j) Supplies Justification

Specify general categories of supplies and their costs. Show computations and provide other information that supports the amount requested.

(k) Contractual Description

Costs of all contracts or subawards for services and goods except for those that belong under other categories such as equipment, supplies, construction, etc. Include third-party evaluation contracts, if applicable, and contracts or subawards with subrecipient organizations

(with budget detail), including delegate agencies and specific project(s) and/or businesses to be financed by the applicant. This line item is not for individual consultants.

(l) Contractual Justification

Demonstrate that all procurement transactions will be conducted in a manner to provide, to the maximum extent practical, open, and free competition. Recipients and subrecipients are required to use 45 CFR § 75.329 procedures and must justify any anticipated procurement action that is expected to be awarded without competition and exceeds the simplified acquisition threshold fixed by 41 U.S.C. § 134 and currently set at $250,000. Recipients may be required to make pre-award review and procurement documents, such as requests for proposals or invitations for bids, independent cost estimates, etc., available to HHS/OASH.

Note: Whenever you intend to delegate part of the project to another agency, you must provide a detailed budget and budget narrative for each subrecipient/contractor, by agency title, along with the same supporting information referred to in these instructions. If you plan to select the subrecipients/contractors post-award and a detailed budget is not available at the time of application, you must provide information on the nature of the work to be delegated, the estimated costs, and the process for selecting the delegate agency.

(m) Other Description

Enter the total of all other costs. Such costs, where applicable and appropriate, may include but are not limited to: consultants; insurance; professional services (including audit charges); space and equipment rent; printing and publication; training, such as tuition and stipends; participant support costs including incentives, staff development costs; and any other costs not addressed elsewhere in the budget.

(n) Other Justification

Provide computations, a narrative description, and a justification for each cost under this category.

(o) Indirect Costs Description

Total amount of indirect costs. This category has one of two methods that you may select.

You may only select one.

• Your organization currently has an indirect cost rate approved by the

Department of Health and Human Services (HHS) or another cognizant federal agency. You should enclose a copy of the current approved rate agreement in your Budget Narrative file. If you request a rate that is less than allowed, your authorized representative must submit a signed acknowledgement that the organization is accepting a lower rate than allowed.

• Per 45 CFR § 75.414(f) Indirect (F&A) costs, “any non-Federal entity

[i.e., applicant] that has never received a negotiated indirect cost rate, … may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) which may be used indefinitely. As described in §

75.403, costs must be consistently charged as either indirect or direct costs, but may not be double charged or inconsistently charged as both.

If chosen, this methodology once elected must be used consistently for all Federal awards until such time as a non-Federal entity chooses to negotiate for a rate, which the non-Federal entity may apply to do at any time.”

This method only applies if you have never received an approved negotiated indirect cost rate from HHS or another cognizant federal agency. If you are waiting for approval of an indirect cost rate, you may request the 10% de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs to the award.

(p) Indirect Costs Justification

Provide the calculation for your indirect costs total, i.e., show each line item included in the base, the total of these lines, and the application of the indirect rate. If you have multiple approved rates, indicate which rate as described in your approved agreement is being applied and why that rate is being used. For example, if you have both on-campus and off-campus rates, identify which is being used and why.

(q) Program Income Description

Program income means gross income earned by your organization that is directly generated by this project if funded except as provided in 45 CFR § 75.307(f). Program income includes but is not limited to income from fees for services performed or the use or rental of real or personal property acquired under the award. Interest earned on advances of Federal funds is not program income. Except as otherwise provided in Federal statutes, regulations, or the terms and conditions of the Federal award, program income does not include rebates, credits, discounts, and interest earned on any of them. See also 45 CFR §§ 75.307, 75.407 and 35 U.S.C. §§ 200-212 (applies to inventions made under Federal awards).

(r) Program Income Justification

Describe and estimate the sources and amounts of program income that this project may generate if funded. Unless being used for cost sharing, if applicable, these funds should not be added to your budget. This amount should be reflected in box 7 of the SF-424A.

(s) Non-Federal Resources Description

Amounts of non-federal resources that will be used to support the project as identified in box 18 of the SF-424. 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 recipient’s cost sharing or matching when such contributions meet all of the criteria listed in 45

CFR § 75.306. For awards that require matching by statute, you will be held accountable for projected commitments of non-federal resources in your application budgets and budget justifications by budget period or by project period for fully-funded awards, even if the justification by budget period, or by project period for fully-funded awards, exceeds the amount required.