AMENDMENT CDC-RFA-OT21-2101.docx

Centers for Disease Control and Prevention

Office for State, Tribal, Local and Territorial Support

Strengthening the Public Health Systems and Services in US-Affiliated Pacific Islands

CDC-RFA-OT21-2101

05/24/2021

Table of Contents

Part I. Overview This section provides the necessary information for potential applicants to evaluate their eligibility and interest in applying for a published Notice of Funding Opportunity (NOFO). ASTDR must customize language to ASTDR where appropriate.

Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA-OT21-2101. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Include either Centers for Disease Control and Prevention (CDC) or Agency for Toxic Substances and Disease Registry (ATSDR).

Centers for Disease Control and Prevention (CDC) B. Notice of Funding Opportunity (NOFO) Title:

Insert the title. The title can be either the program title in the Assistance Listings at SAM.gov or the name of the particular initiative as determined by the CDC program. The title must be succinct; programs should keep in mind that the title is how the program will be commonly referenced.

Strengthening the Public Health Systems and Services in US-Affiliated Pacific Islands Comment by KATHERINE FRANCHOT: Please remove added text, “new non-research NOFO.” You are not required to add text in addition to the boilerplate language in this section.

C. Announcement Type: New - Type 1:

Insert the announcement type. Use corresponding Template for “New-Type 1”. A continuation or supplemental award is not a new NOFO.

Research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf. Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

The Notice of Funding Opportunity must be requested early in the NOFO development process from the appropriate CIO office (e.g., Extramural Office, Associate Director for Science, or Management Official) or the Office of Grants Services (OGS) Systems Support at ogstims@cdc.gov. OGS Systems Support will provide the number via email within 3 days. Always check with your CIO for specific procedures to obtain your number.

The request must include the NOFO title, the CIO name, the fiscal year of funding, and the anticipated number of awards. It also must indicate that the request applies only to a non-research NOFO.

CDC-RFA-OT21-2101

E. Assistance Listings Number:

SAM.gov Insert the valid Assistance Listings number and program title.

The Assistance Listings is a government-wide compendium of Federal programs, projects, services, and activities that provides assistance or benefits to the American public. Each program is assigned a unique number that follows the program throughout the assistance lifecycle enabling data and funding transparency. The complete Assistance Listings number is a five digit number, where the first two digits represent the Funding Agency and the second three digits represent the program.

To obtain an Assistance Listings see: SAM.gov and the SAM.gov Knowledge Base. For further guidance, contact the CIO’s Extramural Office or the CDC Office of General Counsel (OGC). New programs or initiatives that do not have an existing Assistance Listings must request one at "SAM.gov." Program Assistance Listings points of contact must update their information during the HHS annual data call.

93.874 F. Dates:

1. Due Date for Letter of Intent (LOI): Comment by SUDEVI GHOSH: Suggest stating clearly if required or recommended. Reads as recommended, but would be good to be clear. If required, OGC reminds program that the implementation of this requirement must be consistent. Comment by Megan Harbour: Moved to "Not applicable" as PPEO's suggestion Comment by KATHERINE FRANCHOT: Hi Devi and Megan, our apologies if our previous comment was unclear. Since this is a single source NOFO and you will only receive one application, we recommend not requesting a letter of intent. Comment by KATHERINE FRANCHOT: Please clarify if a letter of intent is requested. If so, please remove, “LOI is not required.” If you are not requesting a letter of intent, please remove, “Recommend but not required” and “LOI is not required.” Since this is a single source NOFO and LOIs are typically requested to estimate the number of applications that will be submitted, you may wish to note N/A. Comment by Megan Harbour: The purpose of an LOI is to allow CDC program staff to estimate the number of and plan for the review of submitted applications. Devi Hawkins-Prather CDC, Center for State, Tribal, Local, and Territorial Support (CSTLTS) Email address: duh4@cdc.gov The LOI date will generate once the Synopsis is published if Days or a Date are entered.

The following text is required – see additional information in [brackets] that may be inserted by CDC programs:

If LOI is not requested or required, insert the following: LOI is not requested or required as part of the application for this NOFO.

If LOI is required, insert information below. [Descriptive title of proposed project:

· Name, address, telephone number, and email address of the Principal Investigator or Project Director, or both

· Name, address, telephone number, and e-mail address of the primary contact for writing and submitting this application

· Number and title of this NOFO

· Other: [Insert any other requirements] LOIs may be sent via email, U.S. express mail or delivery service to:

Grants Management Officer (GMO) or Grants Management Specialist (GMS) point of contact – [NOFO number] Department of Health and Human Services CDC Office of Financial Resources Office of Grants Services 2920 Brandywine Rd, MS E-14 Atlanta, GA 30341 [Insert email address] [insert email address] If LOI is not requested, do not enter the following information.

If LOI is requested but optional, insert the following information: The purpose of an LOI is to allow CDC program staff to estimate the number of and plan for the review of submitted applications.

[LOI must be sent via U.S. express mail, delivery service, fax, or email to:

[Project Officer’s name]

CDC, [CIO]

Address: [address] Telephone number: [telephone number] Fax: [fax number] Email address: [email address]]

Not Applicable N/A

2. Due Date for Applications:

Insert the date the application is due at www.grants.gov. The minimum period is 60 days from the NOFO publication date, unless a waiver is approved.

05/24/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call: Comment by KATHERINE FRANCHOT: If planning to host an informational conference call, prior to publication, please provide call details (time, time zone, telephone number, passcode, and web link, as applicable). Comment by Megan Harbour: Added "Email USAPIPartnerCoAg@cdc.gov for conference call information."

Insert the date, time, and phone number for the informational conference call. If not applicable put N/A.

April 22, 2021 Comment by Megan Harbour: Working with communication - website/landing page Comment by Megan Harbour: Emailing "USAPIPartnerCoAg@cdc.gov" for info Email USAPIPartnerCoAg@cdc.gov for conference call information.

Develop the executive summary after the NOFO is written. It must not contain concepts and terminology not included in the body of the NOFO. As the NOFO is revised, remember to update the Executive Summary.

F. Executive Summary:

Summary Paragraph Comment by SUDEVI GHOSH: Given it is an SSJ, consider simply naming the entity here. As an aside, OGC notes that if this is the entity from the 16-1601 award, given the large amount of funding and HHS policy re: full and open competition, CDC should consider making these opportunities available to other orgs. There may be a sense of preference or endorsement if CDC continues to fund only one org in these efforts. Comment by Megan Harbour: Added "As a single source opportunity, the eligibility is limited to the Pacific Island Health Officers Association (PIHOA)." Comment by Megan Harbour: In previous guidance, we were advised to only name PIHOA in the following locations in the NOFO: "2. Additional Information on Eligibility" & "3. Justification for Less than Maximum Competition." Therefore the attached SSJ provides the review and approval for the limited eligibility. Comment by KATHERINE FRANCHOT: Please change ‘project period’ to ‘period of performance’.

A one paragraph summary (maximum 1500 characters) of the purpose, strategies, activities, and expected period of performance outcomes. This will be displayed on grants.gov.

Insert narrative under the following headers:

Amendment: The intent of this amendment is to implement the following revisions: Update the Period of Performance and Component estimated ceilings amount. Update Component B with 2 additional COVID-19 Project Plans.

CDC announces the availability of funds for a regional, nonprofit organization to strengthen the quality, performance, and sustainability of the US-Affiliated Pacific Islands’ (USAPI) governmental and nongovernmental components of the public health system and services through the provision of capacity-building assistance. As a single source opportunity, the eligibility is limited to the Pacific Island Health Officers Association (PIHOA).This NOFO funds activities that increase the capacity for public health leadership, workforce segments, public health departments, and other components of the public health system to improve the lives and wellbeing of people living in the region. Over the five year period of performance, the recipient is expected to increase capacity in the seven strategies: 1) public health workforce; 2) public health systems and infrastructures; 3) public health laws and policies; 4) Translation and implementation of evidence-based public health practices and services for USAPI population; 5) public health monitoring and surveillance systems, 6) communications, and 7) partnership. This five-year cooperative agreement is the second iteration based on the OT16-1601 Cooperative Agreement.

a. Eligible Applicants:

[Insert single, limited, or open competition] Single

b. NOFO Type:

Include mechanism, either grant or cooperative agreement, through which this NOFO will administer financial assistance. Click "Edit" to change the mechanism.

If the mechanism is a cooperative agreement, the following sentence will appear: “CDC’s substantial involvement in this program appears in the CDC Program Support to Recipients Section.

CA (Cooperative Agreement)

c. Approximate Number of Awards Comment by KATHERINE FRANCHOT: Please remove added text, “single source.” This information is covered in the Eligible Applicants section and will be covered in later sections of the NOFO.

Include the estimated number of awards.

d. Total Period of Performance Funding:

$ 0

e. Average One Year Award Amount:

Enter the average funding amount you anticipate awarding to each recipient in the first year of the period of performance.

$ 14,000,000 Subject to the availability of funds.

f. Total Period of Performance Length:

Include the total number of years for which federal support has been approved (period of performance), which will be shown in the Notice of Award. Note that this does not constitute a commitment by the Federal Government to fund the entire period. The total period of performance comprises the initial competitive segment, any subsequent competitive segments resulting from a competing continuation award(s), and any no-cost or low-cost extension(s).

g. Estimated Award Date:

August 01, 2021

h. Cost Sharing and / or Matching Requirements:

Indicate if cost sharing or matching is required.

No Part II. Full Text This section is the CDC Description of the Project and must thoroughly describe the project including specific requirements for applicants. It includes the following eight sections:

A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Application and Submission Information E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

A. Funding Opportunity Description (Maximum 1,000 words for entire Background section, including subsections a-e, single- spaced, Calibri 12 point, 1-inch margins):

1. Background

a. Overview Comment by KATHERINE FRANCHOT: Please include a brief description of the Categories and Components here. Something like: “This NOFO will fund specific projects (called “components”) which may be funded at different times. Some components are likely to be funded for multiple years (Category A components) while others are single year projects (Category B components).” You could refer the applicant to either the strategies and activities section for more information or to the funding strategy section, depending on where you explain further. Comment by Megan Harbour: "Using component funding, this NOFO will facilitate collaborations on CBA efforts throughout the USAPI. The components (specific projects) maybe funded at different times throughout the period of performance. Some components are expected to be funded throughout the life cycle of the award (Category A) while other components may not be funded throughout the life cycle of the award (Category B). For more on components and the categories refer to the funding strategy section."

This section provides background information about the larger public health problem this NOFO will contribute to addressing and frames the NOFO approach. In this section, include the following:

· 1-2 sentences: overview of the larger problem (e.g., HIV infection rates in the U.S.).

· 1-2 sentences: specific outcome(s) this NOFO is trying to address (e.g., decrease HIV infection rates in particular sub-populations). 1-2 sentences: the approach being used in this NOFO and the rationale for that approach, including advancing health equity.

· Include evidence to support the approach (e.g., studies have shown that XX is an effective method to decrease infection rates among XX population). If no supporting evidence exists, describe the rationale for the proposed approach and the plans for evaluating the efforts.

· If a prior NOFO is informing efforts of this NOFO, describe findings and lessons learned from that NOFO.

The US-Affiliated Pacific Islands (USAPI) consist of the US flag territories of American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands, and the following freely associated states: Republic of the Marshall Islands, Republic of Palau, and Federated States of Micronesia. Collectively, their population is estimated to be a little more than 500,000 people, and its jurisdictions span millions of square miles of ocean and five Pacific Time zones.

The USAPI has a high burden of non-communicable diseases (NCDs) and infectious diseases, as well as health threats resulting from climate change (including environmental disasters). This includes high impact of outbreaks throughout the region, including influenza-like illness, dengue, measles.1 In addition, the region ranks among the world’s highest prevalence for some NCDs (e.g., cervical cancer, obesity, high blood pressure, and respiratory disease2,3). The World Health Organization identified the need to support USAPI health systems in coping with this double burden of increasing NCDs and infectious diseases.4

The public health challenges in the region are exacerbated by widely dispersed populations, limited resources, and fragmented health systems. The Journal of Public Health Practice cites a “perfect storm” of social, economic, environmental, political, and health complexities that pose challenges to improving health for all in the USAPI.5 Suggested solutions include strengthening public health systems, provision of support from US government agencies, and collaborations between organizations to build resiliency.

This NOFO is focused on supporting USAPI public health systems through capacity-building assistance (CBA). CBA is defined as activities that build, strengthen, and maintain the infrastructure and resources necessary to sustain or improve system, organizational, community or individual processes and competencies. CBA is delivered through technical assistance, training, information sharing, technology transfer, materials development, or funding that enable organizations to serve customers better and operate in a comprehensive, responsive, and effective manner.

Lessons learned from previous NOFOs showed that a coordinated and regional approach adds great value, helps optimize resources, and can increase impact. Capacity-building strategies can include workforce development to enhance knowledge, skills, competencies, and create resources; organizational development to enhance management structures, processes, and procedures within and between organizations and different sectors; and partnership development to build relationships to effectively address community needs, manage resources, and communicate with the public. Using component funding, this NOFO will facilitate collaborations on CBA efforts throughout the USAPI. The components (specific projects) maybe funded at different times throughout the period of performance. Some components are expected to be funded throughout the life cycle of the award (Category A) while other components may not be funded throughout the life cycle of the award (Category B). For more on components and the categories refer to the funding strategy section.

1. World Health Organization (WHO): Pacific Syndromic Surveillance System

2. Senkomago V, Royalty J, Miller JW, Buenconsejo-Lum LE, Benard VB, Saraiya M. Cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in four US-Affiliated Pacific Islands between 2007 and 2015. Cancer Epidemiol. 2017 Oct;50(Pt B):260-267. doi: 10.1016/j.canep.2017.04.011. PMID: 29120834; PMCID: PMC5739878.

3. CDC’s National Center for Chronic Disease Prevention and Health Promotion: How CDC Prevents Chronic Diseases and Promotes Health for US Territories and Affiliated Pacific Islands

4. World Health Organization (WHO): Division of Pacific Technical Support

5. Carlin, Margaret MPH; Mendoza-Walters, Alison MPH; Ensign, Karl MPP. Half an Ocean Away: Health in the US-Affiliated Pacific Islands, Journal of Public Health Management and Practice: September/October 2016 - Volume 22 - Issue 5 - p 492-495 doi: 10.1097/PHH.0000000000000467

b. Statutory Authorities Comment by SUDEVI GHOSH: Need end parent for P.L. 116-260. Comment by Megan Harbour: Worked with OGS to revised language on Statutory Authorities Comment by SUDEVI GHOSH: Since using COVID funds, the NOFO must include the standard COVID term and condition; OGS policy will have the latest version. Comment by Megan Harbour: Worked with OGS to revised language on Statutory Authorities Comment by SUDEVI GHOSH: Also, 317(k)(2) is 42 USC 247b(k)(2). Suggest adding section 1703 (42 USC 300u-2). Comment by SUDEVI GHOSH: Need 307 only if the activities include international work. Not clear here.

Identify the appropriate legal authority or authorities (e.g., from 42 U.S. Code) that specifically authorize(s) the NOFO.

An authorizing statute is a law that authorizes establishing a federal financial assistance program or award; all NOFOs must be authorized in statute. If direct assistance is available through this NOFO, programs must also include the appropriate statutory authority. Contact the relevant CIO policy office to determine authorities. If the policy office cannot provide authorities, contact the CIO's OGC, or CDC's OGC at 404-639-7200.

The program is authorized under sections 307 and 317(k)(2) of the Public Health Service Act (42 U.S.C. Sections 242(l) and 247b(k)(2), as amended). In addition, this program is authorized under section 4002 of the Patient Protection and Affordable Care Act, Public Law 111-148, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), 2020 (P.L. 116-136), the Paycheck Protection Program and Healthcare Enhancement Act, 2020 (P.L. 116-139), and the Consolidated Appropriations Act and the Coronavirus Response and Relief Supplement Appropriations Act, 2021 (P.L. 116-260).

c. Healthy People 2030 Comment by KATHERINE FRANCHOT: Please include a link to the Healthy People 2030 public health infrastructure topic area. In addition, since Healthy People 2030 objectives have been finalized, please remove the link to Proposed Objectives for HP2030. Comment by Megan Harbour: Updated with link to Healthy People 2030 and Infrastructure topic area.

Identify the Healthy People 2030 topic area(s) this NOFO supports and include internet links to the relevant topic area(s).

Healthy People 2030 (http://www.healthypeople.gov) contains national objectives to improve the health of all Americans by encouraging collaborations across sectors, guiding people toward making informed health decisions, and measuring the impact of prevention activities.

This NOFO addresses the Healthy People 2030 focus area of Public Health Infrastructure. The goal is to ensure that all levels of governmental public health have the necessary infrastructure to provide essential public health services effectively. Infrastructure is fundamental to planning, delivering, and evaluating public health. By addressing this focus area work can be done towards the 2030 overarching goal “Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.”

d. Other National Public Health Priorities and Strategies Identify which national strategies this NOFO supports and include internet links. Do not describe the national strategies.

Examples include National HIV/AIDS Strategy, National Health Security Strategy, National Stakeholder Strategy for Achieving Health Equity, National Quality Framework Aims and Priority Areas.

· Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health

· HHS Plan for Asian American, Native Hawaiian and Pacific Islander Health

· CDC’s Public Health Systems & Best Practices

· National Health Security Strategy and Implementation Plan

· HHS Strategic Plan

e. Relevant Work Identify which past or current CDC program activities this NOFO builds on and supports and include internet links.

Examples of relevant work include program priorities, goals, and ongoing or previous NOFOs.

This opportunity will support advancing the core capabilities of CDC’s Strategic Framework and Priorities. CDC collaborates with professional nonprofit, national organizations to coordinate national public health initiatives with a wide array of stakeholders. This NOFO builds on CDC’s current program, CDC-RFA-OT16-1601: Strengthening the Public Health Systems and Services in US-affiliated Pacific Islands and CDC-RFA-OT18-1802: Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health, by ensuring provision of capacity-building assistance to the USAPI to address public health challenges, such as fragile infrastructure, limited workforce, and insufficient information systems.

The maximum page length of the CDC Project Description for multi-component NOFOs is 30 pages. If you think you have a multi-component NOFO, contact PPEO and PGO before starting your NOFO to confirm that your understanding is correct and to discuss the approach for writing the NOFO.

A multi-component NOFO has different requirements based on the following:

· Funding Strategies: Different components/parts of the NOFO are funding through multiple funding streams. Programs need to identify what funding will be used for each component and what the requirements are for tracking each funding stream.

· Eligibility Requirements: Based on jurisdiction, region, disease burden, program capacity (e.g., basic v. enhanced), etc.

· Strategies and Activities: Strategies and activities are different for each component (e.g., ‘tiers’ of recipients based on capacity to do the work such as basic versus enhanced activities.

The Plain Writing Act of 2010 requires that federal agencies use clear communication that the public can understand and use. NOFOs must be written in clear, consistent language so that any reader can understand expectations and intended outcomes of the funded program. CDC programs should use NOFO plain writing tips when writing NOFOs.

CDC programs can use one of the following formatting options for complex NOFOs:

1) Provide a CDC Project Description for each component. For example,

· Component A – Problem, Purpose, Outcomes, etc.

· Component B – Problem, Purpose, Outcomes, etc.

2) Describe each component under every section in the CDC Project Description. For example,

· Problem – Component A, Component B, etc

· Purpose – Component A, Component B, etc.

· Outcomes – Component A, Component B, etc.

2. CDC Project Description

a. Approach Comment by SUDEVI GHOSH: Also, reminder that to the extent any of the activities lead to the development of tools, materials, etc., that are expected to be shared with CDC and/or the grantee, suggest stating that expressly. Same with any data that may be collected. Even if not expressly stated, grant regs allow CDC to obtain copies of materials produced and data collected. Comment by Megan Harbour: Added under Strategies and Activities Section "CDC anticipates activities funded under this NOFO will lead to the development of resources such as tools, data, materials, software, trainings, and webinars. Upon funding, recipients are expected to share these resources with CDC and will receive further guidance upon funding." Comment by KATHERINE FRANCHOT: Remove the text before and after the logic model. this section should include just the LM. Comment by Megan Harbour: Removed and moved to strategies and outcomes section. Comment by KATHERINE FRANCHOT: Please bold the outcomes you expect the recipient to achieve, track, and report to CDC. Comment by KATHERINE FRANCHOT: Please change ‘project period’ to ‘period of performance”.

The overall NOFO approach is depicted in a 1-page “high-level” logic model, which is elaborated in the sections that follow.

Logic models are visual depictions of the “if-then” relationship between a program’s activities and its intended outcomes. That is, “if” the activities are completed, “then” the outcomes are expected to be achieved. For the NOFO, the logic serves as a guide/roadmap for the following narrative sections:

· Purpose

· Strategies and Activities

· Outcomes

· Evaluation and Performance Measurement

· Scoring criteria in the Review and Selection Process section Logic models come in many shapes and formats, and programs have some flexibility in format. But the logic model must include, at minimum, the following 3 column headers:

· Strategies and Activities

· Short-term Outcomes

· Long-term Outcomes In addition, some programs may want to include an Intermediate Outcomes or Outputs column. A recommended logic model is presented below. Your NOFO logic model must bold the outcomes expected to be achieved during the project period.

Note: Formatting of logic models can be a challenge in GrantSolutions. Programs are encouraged to keep information brief in the logic model and add information in the narrative sections that follow, if needed.

Note: NOFOs that support surveillance and health informatics activities are required to include the following language: “This NOFO may fund health information systems infrastructure, including workforce and public health laboratories, to support the specific strategies, activities, and outcomes described in this NOFO." Any proposed health information system infrastructure activities should be reflected in the detailed budget submitted by grant applicants.

CDC-RFA-[Insert NOFO Number Here] Logic Model: [Insert NOFOTitle Here] Bold indicates period of performance outcome

Strategy

- Activity

- Activity Strategy

- Activity

- Activity

- Activity

- Activity Strategy

- Activity

- Activity

- Outcome 1

- Outcome 2

- Outcome 3

- Outcome 4

- Outcome 5

- Outcome 1

- Outcome 2

- Outcome 3

- Outcome 1

- Outcome 2

The logic model guides the writing of the later NOFO sections as follows:

Outcomes Long-Term Outcomes

– Purpose

– Outcomes (sometimes)

For additional information on developing logic models:

http://www.cdc.gov/eval/resources/index.htm.

Bold indicates period of performance outcome.

CDC-RFA-OT21-2101

Logic Model: Strengthening the Public Health System in the US-Affiliated Pacific Islands Bold indicates period of performance outcome

Public health workforce Activities to enable improvement of competencies and resources to strengthen leadership and workforce

Public health system and infrastructure Activities to strengthen system and agency needs and determine steps to improve operational capacity

Sub-strategies: Accountability performance management, quality improvement; business process improvement; communications; financial management; information technology; other

Public health laws and policies Activities to improve the ability to interpret and inform laws, including statutes and regulations, and policies that affect health

Public health monitoring and surveillance systems Activities to increase the capacity to support collection, integration, maintenance, dissemination, and interpretation of data across the public health system

Communications Activities to improve the use of communications to affect health decisions and actions

Partnerships Activities to improve the establishment and maintenance of results-driven partnerships

Note the strategy “Public health system and infrastructure” contain sub-strategies to further categorize key activities.

i. Purpose In 100 words or less, specify the particular public health problem/issue this NOFO will contribute to solving and how this NOFO will specifically address the problem. This typically describes the overarching strategies (identified in the logic model) that will address the public health problem/issue identified in the Background Overview section. For example, this NOFO will implement XX, XX, and XX in order to reduce morbidity and mortality due to XX.

The purpose of this new funding initiative is to provide capacity-building assistance through a regional, nonprofit organization to strengthen the USAPI’s public health leadership, workforce, and public health systems and infrastructure. The recipient will optimize the quality and performance of the public health systems and services of the USAPI using the identified strategies in the logic model.

ii. Outcomes Comment by KATHERINE FRANCHOT: Please change ‘program period’ and ‘component period’ to ‘period of performance’. Comment by KATHERINE FRANCHOT: Related to above comments. Only include the bolded outcomes from the logic model.

Outcomes are intended effects (or changes in someone or something other than the recipient) resulting from the activities of the NOFO. Describe the outcomes recipients are expected to achieve by the end of the period of performance (i.e., the ones bolded in the logic model) and not all outcomes.

• Use the same language and same order as in the logic model, but feel free to add language to elaborate on the brief description from the logic model.

• Do not present the outcomes as performance measures (the actual indicators/measures that will be used to determine success). Those will go in the Evaluation and Performance Measurement section.

The recipient’s CBA overall award is expected to demonstrate measurable progress among governmental and/or nongovernmental components of the USAPI public health system through the 7 strategies and related outcomes, particularly those that address USAPI public health systems and infrastructure needs of highest priority. As various levels of CBA needs exist for the USAPI, the applicant is encouraged to select outcomes that are achievable by the end of the period of performance.

The recipient is expected to demonstrate progress toward the program’s outcomes (award-level). Short-term outcomes should be reached within 12–24 months of initiation of CBA activities and demonstrated progress for intermediate outcomes should occur by the end of the period of performance. Demonstration for some of the long-term outcomes may occur by the end of the period of performance as a result of program efforts outside of the budget periods.

CDC may require or allow the applicant to propose additional related component outcomes other than those identified in the NOFO.

Short-term outcomes

· Increased knowledge, skills, resource, support, and structure to enhance competencies among public health leadership and workforce

· Increased implementation of processes and services that build operational efficiency and effectiveness

· Increased awareness of how laws and policies affect the public’s health among public health practitioners, government and non-governmental agencies, and political leaders

· Increased capacity to assess evidence-based public health practices and services for cultural relevance

· Increased knowledge and capacity to develop national health data systems and registries

· Improve communication capacity to inform the public effectively and efficiently

· Improved capacity to establish and maintain partnerships within and across sectors to create a shared public health vision Intermediate outcomes

· Strengthened workforce qualifications, performance, service delivery, and increase leadership capacity around policy formulation and program implementation

· Increased use of performance management systems to monitor and evaluate operational processes

· Increased practical, legal-and policy-centered tools and resources for public health practitioners, government and non-governmental agencies, and political leaders

· Enhanced capacity to integrate and coordinate culturally relevant practices and services across multiple settings

· Improved collection, maintenance, interpretation, and dissemination of population health data

· Strengthened capability to use communication to affect health decisions and actions

· Strengthened capability to respond to public health priorities collaboratively and strategically Long-term outcome

· Improved multi-sectoral leadership action to strategically address population health needs and build workforce capacity and retention

· Improved operational efficiency and effectiveness

· Increased implementation of evidence-based public health laws and policies by public health practitioners, government and non-governmental agencies, and political leaders

· Increased ability to translate and widely implement evidence-based practices and services across multiple settings

· Improved capacity to identify population health needs through data driven decision-making

· Increased communication capacity through public health practitioners, government and non-governmental agencies, and political leaders

· Improved capacity to address public health priorities through collaboration and partnerships

iii. Strategies and Activities Comment by KATHERINE FRANCHOT: Recommend moving reference to OMB to the CDC Support to Program Recipients section. Comment by Megan Harbour: Removed "Any activities involving information collection (e.g., surveys, questionnaires) from 10 or more non-federal individuals/entities are subject to OMB/PRA requirements and may require CDC to coordinate with the recipient on an OMB Information Collection Clearance." The CDC substantial Involvement section covers this aspect. Comment by Megan Harbour: Moved language from Logic Model section to this section. Comment by KATHERINE FRANCHOT: Recommend describing how these strategies and activities are related to the project components. For example, are these a broader description of work that is to be done in the specific components that are identified later? Is there a way to embed the components into the appropriate strategy and activity to help the applicant connect the dots? Comment by Megan Harbour: "For each component, the applicants are required to address the program strategies to carry out its proposed activities. The selected strategies for each component will be indicated in the corresponding work plans (refer to work plan section). The activities listed below are not exhaustive and should be tailored based on the priority needs of the target population(s)."

Describe what recipients will be expected to do. Only include strategies and activities the recipient is expected to implement during the period of performance.

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

• Present strategies and activities using the same language and in the same order as in the logic model. But feel free to add language to elaborate on the brief description from the logic model.

• If your logic model included an “outputs column,” provide narrative on those as well.

• In selecting strategies, emphasize:

o strategies with the potential for sustainability beyond the project period.

o strategies and activities with strong evidence of effectiveness. If your strategies are not evidence-based, be sure to indicate in your Evaluation and Performance Measurement section how these strategies will be evaluated over the course of the project period.

• strategies with the potential to advance health equity.

What should not go in this section:

• Background information on the program, importance of the strategies, or the reason for the NOFO—these go earlier in the purpose section.

• Outcomes expected from the activities—these have already been presented.

• Activities that will be conducted by someone other than the recipient (e.g., CDC)

Note that the CDC program may allow the applicants to propose additional strategies and activities (beyond what is included in the logic model) to achieve the outcomes.

This NOFO provides funding to deliver capacity-building assistance to strengthen the USAPI public health system. The logic model is a visual depiction of the program approach and reflects how the selected strategies will lead to achievement of short-, intermediate- and long-term program outcomes. Long-term outcomes may be achieved over the five-year period of performance. Overall program outcomes should be achieved through the 7 strategies: 1) public health workforce, 2) public health systems and infrastructure, 3) public health laws and policies, 4) Translation and implementation of evidence-based public health practices and services for USAPI population , 5) public health monitoring and surveillance systems, 6) communication, and 7) partnerships . The recipient is not required to work on all strategies at once, but it is expected to achieve measurable progress in all seven strategies and related outcomes by the end of the period of performance through multiple components.

For each component, the applicants are required to address the program strategies to carry out its proposed activities. The selected strategies for each component will be indicated in the corresponding work plans (refer to work plan section). The activities listed below are not exhaustive and should be tailored based on the priority needs of the target population(s).

CDC anticipates activities funded under this NOFO will lead to the development of resources such as tools, materials, data, software, trainings, and webinars. Upon funding, recipients are expected to share these resources with CDC and will receive further guidance upon funding.

Note the applicant must ensure compliance with Administrative Requirement-12 (Anti-Lobbying) when engaging in all activities, especially those related to laws, policies, data management and regulations.

Strategy 1: Public Health Workforce – Activities to enable improvement of competencies and resources to strengthen leadership and workforce (may include but are not limited to):

· Assess and identify skills sets, competencies, and needs of health officials and other health agency leaders

· Implement evidence-based strategies, such as leadership institutes and workgroups

· Provide training to health officials and other health agency leaders regarding current USAPI public health priorities and the official responsibilities of the health department and governing entity

· Inform leaders on operational definitions and statements of the public health sector roles, responsibilities, and authorities

· Strengthen existing leadership platform for effective leadership practice and multi-sector communication to address shared public health concerns

· Recruit and hire qualified staff with public health backgrounds

· Assess workforce competencies

· Provide technical assistance to deliver essential public health services

· Provide training and professional development

· Develop and sustain supportive work environments

· Create resources to facilitate achievement of public health workforce competencies

· Provide technical assistance to build and sustain workforce competencies

· Promote public health internships and fellowships to recruit and strengthen workforce Strategy 2: Public Health System and Infrastructure – Activities to strengthen system and agency needs and determine steps to improve operational capacity (may include but are not limited to):

· Provide technical assistance to deliver essential public health services

· Assess and identify strengths and weaknesses related to operational efficiency and effectiveness

· Examine capacity to deliver the core functions and essential public health services and the structures needed to carry out these functions

· Determine needs, develop processes, and establish standards to build performance management capacity

· Develop and implement a health department organizational strategic plan

· Facilitate mobilization of public and private sectors to enhance collaboration and partnerships

· Identify strategies to disseminate health information to targeted populations

· Provide technical assistance on developing effective financial management systems Strategy 3: Public Health Laws and Policies – Activities to improve the ability to interpret and inform laws, including statutes and regulations, and policies that affect health (may include but are not limited to):

· Review, study, and disseminate information on existing laws and policies that may apply to public health

· Engage multiple sectors, such as education, court systems, law enforcement, business, and political leaders in identifying priorities and in developing and applying legal tools

· Create and/or engage public health councils of relevant government agencies

· Recruit legal counsel with public health expertise for public health agencies

· Develop practical, legal-centered tools for public health practitioners and policy makers

· Provide consultation and technical assistance to public health agencies

· Evaluate the health effects and costs of legislation, regulations, and policies that could have a meaningful impact on legislation and governance

· Review and analysis of existing laws and policies to determine cultural, geographical, and current relevance and provide revisions as needed

· Develop materials, manuals, and toolkits that build knowledge, skills, and practices in public health policy Strategy 4: Translation and implementation of evidence-based public health practices and services for USAPI population – Activities to strengthen the delivery of essential public health services in a comprehensive manner (may include but are not limited to):

· Provide technical assistance to translate and disseminate evidence-based public health science

· Promote understanding and use of research results, evaluations, and evidence-based practices through inclusive public health research and services

· Promote and facilitate adoption of public health strategies, initiatives to develop, implement, and evaluate effective strategies that promote health

· Create materials, manuals, and toolkits that build knowledge, skills, and practices in evidence-based public health practices and services Strategy 5: Public Health Monitoring and Surveillance Systems – Activities to increase the capacity to support collection, integration, maintenance, dissemination, and interpretation of data across the public health system (may include but are not limited to):

· Provide technical assistance on readiness for implementation, use, and maintenance of information systems

· Create manuals and protocols to ensure best practices and standardization of data and information systems

· Establish data governance through the creation of policies and guiding principles to improve the collection, interpretation, and dissemination of population health data

· Foster health information systems buy-in and understanding of agency staff

· Train staff on data collection, analysis, interpretation, and reporting

· Increase information access, data use, and sharing across public health agencies

· Integrate information systems and public access at the community level Strategy 6: Communication – Activities to improve the use of communications to affect health decisions and actions (may include but are not limited to):

· Develop communication processes for effective cross-sector collaboration

· Develop communication procedures to provide information to the public

· Create communication campaigns that are relevant, culturally competent, and at a sufficient level of health literacy

· Provide accessible, accurate, actionable, and current information that is culturally sensitive and linguistically appropriate

· Develop communication systems to enable efficient and effective community-centered dialogue

· Develop and disseminate educational materials, health communication and marketing activities, and program evaluation and assessment tools

· Provide information about public health issues and functions to diverse audiences through multiple methods to inform public health decision making Strategy 7: Partnerships – Activities to improve the establishment and maintenance of results-driven partnerships…