AMENDMENT CDC-RFA-OT21-2101.pdf

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

A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Required Registrations

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview

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:

Centers for Disease Control and Prevention (CDC)

B. Notice of Funding Opportunity (NOFO) Title:

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

C. Announcement Type: New - Type 1:

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:

CDC-RFA-OT21-2101

E. Assistance Listings Number:

93.874

F. Dates:

1. Due Date for Letter of Intent (LOI):

The LOI date will generate once the Synopsis is published if Days or a Date are entered.

Not Applicable https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

N/A

2. Due Date for Applications:

05/24/2021

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

3. Due Date for Informational Conference Call:

April 22, 2021

Email USAPIPartnerCoAg@cdc.gov for conference call information.

F. Executive Summary:

Summary Paragraph

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:

Single

b. NOFO Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$ 0

e. Average One Year Award Amount:

$ 14,000,000

Subject to the availability of funds.

f. Total Period of Performance Length:

https://www.grants.gov/ mailto:USAPIPartnerCoAg@cdc.gov

g. Estimated Award Date:

August 01, 2021

h. Cost Sharing and / or Matching Requirements:

No

Part II. Full Text

A. Funding Opportunity Description

1. Background

a. Overview

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

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

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

• 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 https://www.who.int/westernpacific/emergencies/surveillance/pacific-islands-surveillance https://www.cdc.gov/chronicdisease/pdf/factsheets/island-health-H.pdf https://www.cdc.gov/chronicdisease/pdf/factsheets/island-health-H.pdf https://www.cdc.gov/chronicdisease/pdf/factsheets/island-health-H.pdf https://www.who.int/westernpacific/about/how-we-work/pacific-support https://health.gov/healthypeople https://health.gov/healthypeople/objectives-and-data/browse-objectives/public-health-infrastructure https://www.cdc.gov/cpr/readiness/capabilities.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcpr%2Fcapabilities%2Findex.html https://www.cdc.gov/cpr/readiness/capabilities.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcpr%2Fcapabilities%2Findex.html https://www.minorityhealth.hhs.gov/omh/content.aspx?lvl=3&lvlid=65&ID=8800 https://www.cdc.gov/publichealthgateway/bestpractices/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fpublichealthgateway%2Fprogram%2Findex.html https://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx https://www.hhs.gov/about/strategic-plan/index.html

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.

2. CDC Project Description

a. Approach

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

Strategies &

Activities

Short-Term

Outcomes

Intermediate

Outcomes

Long-Term

Outcomes

Public health workforce

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

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

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

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

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;

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

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

Improved operational efficiency and effectiveness https://www.cdc.gov/about/organization/strategic-framework/ https://www.cdc.gov/about/organization/strategic-framework/ https://www.cdc.gov/publichealthgateway/partnerships/pihoa.html https://www.cdc.gov/publichealthgateway/partnerships/pihoa.html https://www.cdc.gov/publichealthgateway/partnerships/capacity-building-assistance-OT18-1802.html https://www.cdc.gov/publichealthgateway/partnerships/capacity-building-assistance-OT18-1802.html https://www.cdc.gov/publichealthgateway/partnerships/capacity-building-assistance-OT18-1802.html 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

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

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

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

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

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

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

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

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

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

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

Communications

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

Improve communication capacity to inform the public effectively and efficiently

Strengthened capability to use communication to affect health decisions and actions

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

Partnerships

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

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

Strengthened capability to respond to public health priorities collaboratively and strategically

Improved capacity to address public health priorities through collaboration and

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

i. Purpose

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

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

iii. Strategies and Activities

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 (may include but are not limited to):

• Assess agency’s current internal and external partnerships

• Expand organization or program partnerships through community engagement and mobilization

• Perform network analysis to identify opportunities for collaboration

• Leverage partnerships to address specific public health issues or population health needs strategically

• Engage with the public health system and community in identifying and addressing health problems through collaborative processes

1. Collaborations

a. With other CDC programs and CDC-funded organizations:

The recipient is required to collaborate with CDC centers, institutes, and offices (CIOs) as appropriate to plan, implement, and execute CBA activities. The recipient is encouraged to participate in stakeholder meetings and provide expert consultation to CDC and other CDC-funded partners. This collaboration is expected to ensure activities and funding do not duplicate work but instead are coordinated with and complementary to efforts supported under other CDC programs. The recipient should collaborate with other CDC-funded public health partners and

CDC to identify and address emerging CBA needs.

b. With organizations not funded by CDC:

The recipient is encouraged to build and maintain strategic partnerships and leverage resources with regional, national, and international organizations. These partnerships are critical to building capacity of public health systems to maximize the impact and reduce duplication of capacity-building activities in the USAPI. It is highly recommended that the recipient collaborates with local organizations that have specialized public health-related capacity-building services and have experience working in the specific jurisdictions. It is highly recommended that the recipient collaborate with regional, national, and international organizations that have specialized public health-related capacity-building services to enhance the proposed capacity-building activities for the USAPI public health system.

2. Target Populations

The applicant should propose to address CBA needs based on the most relevant evidence for the selected target population(s). The applicant must clearly describe the target population(s) and provide a rationale for selecting the target population(s) receiving CBA for each component.

Potential target populations may include Pacific Island public health agency jurisdictions and their leaders, workforce segments across Pacific Island public health jurisdictions, monitoring and surveillance systems, and/or nongovernmental components of the public health system (e.g., pharmacists, transportation industry, law enforcement, tourism sector).

a. Health Disparities

This program is focused primarily on strengthening the public health infrastructure and services for the USAPI. The strategies and activities address public health needs and priorities to improve the public health system, which can include addressing and improving social determinants of health and decreasing health disparities. The recipient is expected to leverage its established relationships with CDC, current and new partners, and the Pacific Region to create relevant and lasting impact to populations at risk, such as people with high risk health behaviors, socioeconomic disparities, disabilities, non-English speaking populations, tribal populations, people who live in remote areas and other geographically underserved communities; and people with limited health literacy.

iv. Funding Strategy

This award is composed of multiple components and will be funded by component. A component is equivalent to a stand-alone project that requires an activity or activities and associated budget. Note the following key points:

• Each component must be a discrete activity(ies) with an associated budget.

• The recipient should not duplicate efforts across components.

• Once components are awarded, funds cannot be redirected between components.

The Component Funding is split into categories:

Category A: Base funding – These components will be considered throughout the life of this cooperative agreement as funds are available. Applicants will submit a work plan and budget narrative in response to CIO project plans and address strategies and outcomes outlined in the

CIO project plan. Refer to the CIO Project Plan attachment.

Category A

# Component Title Proposed Component

Funding

1 Regional Health Policy, Advocacy and Secretariat

Support Initiative

$ 800,000

2 Regional Human Resources for Health/Workforce

Development

$ 500,000

3 Regional Health Information and Public Health

Surveillance Initiative

$ 500,000

Category B: CIO Project Plans – Each component represents a CIO project plan. This is an opportunity for the recipient and CIO to collaborate on CBA activities. The applicant can apply for all components. The applicant should clearly indicate which component it is applying for.

The applicant will submit a work plan and budget narrative in response to CIO project plans and address strategies and outcomes outlined in the CIO project plans. As public health priorities emerge, CDC may add additional opportunities to complete CBA activates.

Category B

# Component Title Proposed

Component

Funding

4 Building capacity for COVID-19 and Disaster

Communications in Asia Pacific $TBD

5 Evaluating the expansion of cervical cancer screening coverage in USAPIs $1,800,000

6 Pacific Public Health Fellowship Program (PPHFP) $ 1,200,000

7 Lymphatic Filariasis Elimination and Prevention in American

Samoa Population $ 500,000

8 Health Systems Performance Improvement $ 500,000

9 Building and Enhancing NCD Surveillance and Data Use in the USAPI

$ 400,000

10 Strengthening HIV, STD, viral hepatitis and TB surveillance and prevention in the U.S. Affiliated Pacific Islands $ 100,000

11 Strengthening Operations and Grants Management in the

USAPI $ 300,000

12 Strengthened USAPI Vector-borne Disease Diagnostic, Surveillance and Vector Control Capacities $ 300,000

13 Building and Maintaining Pacific Community Influenza

Surveillance and Response Capacity $ 200,000

14 Improving vector-borne disease preparedness and strengthening public health through entomology networks $ 200,000

15 Tuberculosis (TB) Prevention and Control Laws $ 160,000

16 Strengthening USAPI Lab-Based Public Health Surveillance and Capacities $ 100,000

17 Pacific Islands Tuberculosis Nurses Network (PITBNN) $ 60,000

18 COVID-19 Surge Response and Preparedness in the USAPI $2,000,000

19 Strengthening Health Interventions in the Pacific (SHIP) Field

Epidemiology Training Program $4,200,000

20 TBD - Emerging Public Health Initiatives $ TBD

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

ii. Applicant Evaluation and Performance Measurement Plan

Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance

Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

• How the applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

• How key program partners will participate in the evaluation and performance measurement planning processes.

• Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

• Plans for updating the Data Management Plan (DMP) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to

DMP should be provided in annual progress reports. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data;

data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, the applicant should be directed to:

• Describe the type of evaluations (i.e., process, outcome, or both).

• Describe key evaluation questions to be addressed by these evaluations.

• Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, if applicable, within the first 6 months of award, as described in the

Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach

Organizational capacity ensures the demonstrates the applicants ability to successfully execute the NOFO strategies and meet outcomes. The applicant should have adequate infrastructure (e.g., physical space and equipment), workforce capacity and competence, relevant skill sets, capable information and data systems, accessible electronic information, and communication systems to implement the award. The applicant must provide evidence of adequate program management/staffing plans, performance measurement, evaluation, financial reporting, management of travel requirements, workforce development and training, and full capability to manage the required procurement efforts, including the ability to write and award subcontracts in accordance with 45 CFR 75, as applicable. The applicants must name supporting documents clearly. For example CVs/resumes files must be named "CVs&Resumes" as a PDF file and upload to www.grants.gov. Refer to H. Other Information section for a list of supporting documents.

Staffing and Partnerships: The applicant must demonstrate adequate capacity and expertise in personnel management and program staffing. Program staffing includes the ability to develop and maintain partnerships and recruit and hire for general staff expansion and specialized expertise. Documentation to illustrate adequate staffing plan and program management structure https://www.cdc.gov/grants/additionalrequirements/ar-25.html includes organizational charts, job descriptions, CVs/resumes, and staffing plans that clearly define staff roles and expertise as they relate to the activities and outcomes. Letters of support from other organizations should be used to demonstrate ability to build and maintain partnerships.

Collaboration: The applicant must describe how it will collaborate on each component with organizations that are internal and external to CDC to build capacity for the USAPI public health system (refer to Work Plan). The recipient will be strongly encouraged to collaborate with

USAPI partners in advancing capacity building for public health services to create relevant and lasting impact to at risk populations, such as: people with high-risk health behaviors, socioeconomic disparities, disabilities, non-English speaking populations, tribal populations, people who live in remote areas and other geographically underserved communities, and people with limited health literacy. Applicants must provide Letters of support from other organizations to demonstrate ability to build and maintain partnerships (refer above for file naming convention).

Procurement Activities: The applicant must demonstrate expertise in writing, negotiating, awarding, and executing contracts and consulting agreements as they relate to individual components funded under this program. The applicant must also demonstrate expertise in financial reporting, budget management and budget administration. The applicant must be fully capable of managing the required deliverables in accordance with 45 C.F.R. The applicant must submit a CV/resume for staff who will be involved in procurement activities and describe the organization’s capacity to execute contracts and consulting agreements.

Relationship with Target Population: The applicant must also describe the nature of its relationship with the target population and history (including number of years) of serving or working with the target population selected for this cooperative agreement. The history should include examples of previous efforts providing CBA, such as the content and format of the CBA provided, and the results of those CBA efforts. If the applicant submits letters of support from members of the target population and related stakeholders, the letters should outline the target population’s interest in the CBA services to be provided, the current relationship with the applicant, and previous examples of CBA received from the applicant.

Affiliate Organizations: If applicable, the applicant must provide a description of its affiliate organizations. Affiliates are subsidiary or subordinate organizations that are officially connected to the applicant organization. The description of affiliated organizations should include the name(s) and the affiliate’s public health-related area of expertise. The applicant must also submit evidence, such as bylaws, signed board resolution, or other documentation of guiding principles that recognize the affiliate organizations and their relationship with the applicant.

Current CDC CBA Funding: The applicant must provide a description of its current CDC-funded capacity-building projects, including the name of the funding mechanism (CDC-RFA number), target population, type of CBA provided and delivery method, and outcomes achieved.

As illustrated in the Review and Selection Process section of this NOFO, the Organizational

Capacity of Applicants to Implement the Approach will be weighed heavily during the Objective

Review process. Applicants are strongly encouraged to address all areas of capacity mentioned above.

d. Work Plan

The applicant must provide a component level CBA work plan, with a detailed description of the first year of the component. The applicant is strongly encouraged to use activities indicated under the “Strategies and Activities” section but is expected to augment those activities based on the priority needs of the target population(s). The work plan should provide outcomes, program strategies, activities, and objectives for the priority subpopulation(s) that are proposed within the target population category. The applicant will submit a work plan for each component the applicant is applying for.

Note: Use the SMART (specific, measurable, achievable, realistic, and time-bound) format.

Quantitative baselines should be provided that lead to an increase, decrease, or maintenance over time. Review the logic model provided in section “A.2.a. Approach”

The work plan must, at a minimum, include:

A Year 1 detailed work plan and budget narrative for each component the applicant is applying for: (Use the work plan template in related documents section on grants.gov)

1. Expected outcomes for the first year of the component

2. Program activities and strategies to be used during the first year of the period of performance (Select no more than 2 strategies per component)

3. Description of the process measures for the strategies and activities

4. Description of responsible position/party to support implementation of the component

5. Provision of completion date for each outcome measure

6. Estimated cost per strategy

CDC will provide feedback and technical assistance to the recipient to finalize the work plan post-award.

e. CDC Monitoring and Accountability Approach

Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

• Tracking recipient progress in achieving the desired outcomes.

• Ensuring the adequacy of recipient systems that underlie and generate data reports.

• Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

• Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

• Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

• Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

• Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

CSTLTS will collaborate with the recipient to determine if other activities are necessary to monitor the award.

f. CDC Program Support to Recipients

Substantial Involvement by CDC: In a cooperative agreement, CDC program staff are substantially involved in post-award program activities, above and beyond routine grant monitoring. Substantial involvement is in addition to all post-award monitoring, technical assistance, and performance reviews undertaken in the normal course of stewardship of federal funds.

CDC program staff will assist, coordinate, or participate in carrying out all efforts under the award, and recipients agree to the responsibilities therein, as detailed in the NOFO. CDC activities for this program are as follows:

• Collaborate to ensure coordination and implementation of strategies to provide capacity-building assistance (CBA) to governmental and nongovernmental components of the public health system.

• Provide guidance and appropriate clearances (policies and scientific) of products co-branded or co-authored by CDC.

• Provide guidance and coordination to funded organization to improve the quality and effectiveness of work plans, evaluation strategies, products and services, and collaborative activities with other organizations.

• Support ongoing opportunities to foster networking, communication, coordination, and collaboration, and serve as a conduit for information exchange, including fostering collaboration between funded organizations that would not normally interact or collaborate on public health efforts.

• Collaborate to compile and publish accomplishments, best practices, performance criteria, and lessons learned during the period of performance.

• Collaborate, as appropriate, to assess progress toward meeting strategic and operational goals and objectives and to establish measurement and accountability systems for documenting outcomes, such as increased performance improvements and best or promising practices.

CDC Substantial Involvement in Clearance of Products

In addition to requiring CDC clearance of products co-branded or co-authored by CDC, CDC staff will be given an opportunity to review and provide feedback on products developed with program funds, if at least one of the following is true:

• The content of the information product is determined to be potentially sensitive or controversial. The determination of sensitive or controversial content is made by CDC.

o Includes products that present new science or contradicts previous findings.

• The information product describes or includes content about programs or initiatives of

CDC or other federal agencies.

• The information product includes content about or directly relating to priorities or initiatives of the CDC Director, Department of Health and Human Services, the

Administration, or Congress.

• The information product describes or includes content related to federal policies, guidelines, or regulations.

• The information product discusses or includes information or statements about public health resources or funding (e.g., types, levels, distribution/allocation strategies) at any level of the public health system (federal, national, state, tribal, local, or territorial).

• The information product discusses or includes information or statements about policy and policy options. “Policy” is defined as “a law, regulation, procedure, administrative action, incentive or voluntary practice of governments and other institutions.”

• The information product discusses or includes statements related to or prescribing roles and responsibilities of governmental stakeholders at any level (e.g., federal, national, state, tribal, local, or territorial governments).

Review of such products is part of CDC’s substantial involvement to improve the quality and effectiveness of products and services. CDC and the recipient should reach consensus on the content of the product prior to publication or dissemination to audiences external to the CDC. It is the responsibility of the CIO Technical Monitor to ensure timely review is completed by the appropriate CDC entities, and consensus on the content is reached within 14 business days of receipt to minimize undue burden on the recipient.

B. Award Information

1. Funding Instrument Type:

CA (Cooperative Agreement)

CDC's substantial involvement in this program appears in the CDC Program Support to

Recipients Section.

2. Award Mechanism:

U38 - Uniform National Health Program Reporting System

3. Fiscal Year:

Estimated Total Funding:

$ 70,000,000

4. Approximate Total Fiscal Year Funding:

$ 14,000,000

This amount is subject to the availability of funds.

5. Approximate Period of…