The file's text, extracted by GovTribe without its formatting.
Instructions
| Instructions to Complete "National Initiative to Address COVID-19 Public Health Disparities among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities" Work Plan | | | | | | | | | | |
| This workbook contains macros. Please enable the macros by clicking on "Enable Content" to ensure the workbook functions properly. | | | | | | | | | | |
| Overall Instructions | | | | | | | | | | |
| This file consists of seven worksheets (i.e., tabs across the bottom) you will use to complete your workplan: an instructions tab, cover sheet tab and strategy tabs. Each possible strategy from the NOFO has its own worksheet. | | | | | | | | | | |
| Worksheet Instructions | | | | | | | | | | |
| Cover sheet: Enter applicant name and the date this file is submitted. | | | | | | | | | | |
| Worksheets Numbered 1-5: Complete the sections for strategies you propose implementing with the grant funds. If you are not proposing to implement a particular strategy, you can leave that worksheet blank. Strategies and activities should be based on local needs and priorities. See below for instructions on what to enter for each section. | | | | | | | | | | |
| Strategy Description | Corresponding strategy description from NOFO (provided for you) | | | | | | | | | |
| NOFO Outcome(s) Addressed | Select which outcome(s) this strategy will work to achieve (Select all that apply) | | | | | | | | | |
| Other Outcomes | Enter other outcomes that the strategy addresses if not captured in the NOFO outcomes (optional) | | | | | | | | | |
| Data Source(s) Used to Identify Population(s) of Focus | Describe how you identified your populations of focus for this strategy - e.g., surveillance systems or other data sources, health assessments | | | | | | | | | |
| Estimated Amount of Funding Allocated to Strategy | | | | | | | | | | |
| (% of Total Funding and Dollar Amount) | Enter the percentage of total funding and dollar amount allocated to implement this strategy | | | Estimated Amount of Strategy Funding Allocated for Rural Activities (% and $ Amount) (if applicable) | | Enter the percentage and dollar amount of strategy funding allocated to activities that focus on rural communities (if applicable) | | | | | |
| Technical Assistance Needs | Indicate if there is an anticipated need for technical assistance to conduct one or more activities under this strategy. (Select one - Yes or No) | | | If Yes, please describe: | | Describe any anticipated technical assistance needs that would assist in the implementation of activities under this strategy (if applicable). | | | | |
| In order to achieve the outcome(s) proposed above, you will implement one or more activities. Include each activity in the worksheet tables with the following information. Add additional activity tables as needed. | | | | | | | | | | |
| Activity 1 Title | Enter a brief title for the activity | | | | | | | | | |
| Activity Focus | Select the focus area(s) for your proposed activity from the dropdown list provided (Select all that apply) | | | | | | | | | |
| Other Activity Focus (if applicable) | Enter other focus area for the activity if not captured in the provided drop down | | | | | | | | | |
| Racial and Ethnic Population(s) of Focus | Select the specific racial and ethnic populations who you will be serving with this activity (if applicable) (Select all that apply) | | | Describe the Racial and Ethnic Population(s) (if applicable) | | For the specific racial and ethnic population(s) selected, provide a detailed description of the population, including any racial and ethnic subpopulations. | | | | |
| Other Population(s) of Focus | Select other populations of focus who you will be serving with this activity (if applicable) (Select all that apply) | | | Describe the Rural Population Served (if applicable) | | If you selected "People living in rural areas" as a population of focus, provide a detailed description of the rural population served by the activity. If relevant, we encourage you to include data as context for how the activity supports the population. | | | | |
| Other Population (if applicable) | Enter any additional population(s) of focus for the activity if not captured in the provided drop down | | | | | | | | | |
| Estimated Reach of Population(s) of Focus | Enter the estimated number of people who will be reached. If you selected more than one population type, please provide the reach by each population (e.g., Asian: 100,000, Rural 25,000). | | | | | | | | | |
| Geographic Area | Select where this activity will be implemented (Select one) | | | | | | | | | |
| Setting | Select the type of setting in which the activity will take place (Select one) | | | | | | | | | |
| Other Setting (if applicable) | Enter other setting for the activity if not captured in the provided drop down | | | | | | | | | |
| Activity Description | | | Contributing Partners | Partner Type | Other Partner Type (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date |
| Describe the activity you will implement in support of the strategy. Please include a description of the problem the activity will address (e.g., structural barriers), what you will do to address the problem (e.g., policy change), and the process for implementing the activity. Also include key milestones to be achieved during the project period. | | | | | | | | | | |
| | | Name the contributing partner in support of this activity, if any | Select type of contributing partner (Select one) | Enter other partner type for the activity if not captured in the provided drop down | Name key contracts or consultants in support of this activity (if any) along with estimated dollar amount for each | | Indicate deliverables/ outputs expected from this activity | Indicate the anticipated activity start date | Indicate the anticipated activity end date | |
&1#&"Calibri"&10&K000000Restricted Use/Any User (No encryption)
Cover Sheet
| National Initiative to Address COVID-19 Public Health Disparities among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities |
| CDC-RFA-OT21-2103 Work Plan Template |
Recipient Name:
Submission Date:
&1#&"Calibri"&10&K000000Restricted Use/Any User (No encryption)
(Strat 1)Resources and Services
| Strategy Description | 1. Expand existing and/or develop new mitigation and prevention resources and services to reduce COVID-19 related disparities among populations at higher risk and that are underserved. |
| NOFO Outcome(s) Addressed | |
(Select all that apply)
| Other Outcome(s) (as identified by applicant) | | |
| Data Source(s) Used to Identify Population(s) of Focus | | |
| Estimated Amount of Funding Allocated to Strategy | | |
| (% of Total Funding and Dollar Amount) | | Amount of Strategy Funding Allocated for Rural Activities (% and $ Amount) (if applicable) | |
| Technical Assistance Needs | | If Yes, please describe: |
| Activity 1 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 2 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 3 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 4 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 5 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 6 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 7 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 8 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 9 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 10 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 11 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 12 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 13 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 14 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 15 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 16 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 17 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 18 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 19 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 20 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
&1#&"Calibri"&10&K000000Restricted Use/Any User (No encryption)
(Strat 2)Data and Reporting
| Strategy Description | 2. Increase/improve data collection and reporting for populations experiencing a disproportionate burden of COVID-19 infection, severe illness, and death to guide the response to the COVID-19 pandemic |
| NOFO Outcome(s) Addressed | |
(Select all that apply)
| Other Outcome(s) (as identified by applicant) | | |
| Data Source(s) Used to Identify Population(s) of Focus | | |
| Estimated Amount of Funding Allocated to Strategy | | |
| (% of Total Funding and Dollar Amount) | | Amount of Strategy Funding Allocated for Rural Activities (% and $ Amount) (if applicable) | |
| Technical Assistance Needs | | If Yes, please describe: |
| Activity 1 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 2 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 3 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 4 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 5 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 6 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 7 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 8 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 9 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 10 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 11 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 12 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 13 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 14 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 15 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 16 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 17 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 18 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 19 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 20 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
&1#&"Calibri"&10&K000000Restricted Use/Any User (No encryption)
(Strat 3)Infrastructure Support
| Strategy Description | 3. Build, leverage, and expand infrastructure support for COVID-19 prevention and control among populations that are at higher risk and underserved |
| NOFO Outcome(s) Addressed | |
(Select all that apply)
| Other Outcome(s) (as identified by applicant) | | |
| Data Source(s) Used to Identify Population(s) of Focus | | |
| Estimated Amount of Funding Allocated to Strategy | | |
| (% of Total Funding and Dollar Amount) | | Amount of Strategy Funding Allocated for Rural Activities (% and $ Amount) (if applicable) | |
| Technical Assistance Needs | | If Yes, please describe: |
| Activity 1 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 2 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 3 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 4 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 5 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 6 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 7 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 8 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 9 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 10 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 11 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 12 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 13 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 14 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 15 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 16 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 17 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 18 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 19 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 20 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
&1#&"Calibri"&10&K000000Restricted Use/Any User (No encryption)
(Strat 4)Partner Mobilization
| Strategy Description | 4. Mobilize partners and collaborators to advance health equity and address social determinants of health as they relate to COVID-19 health disparities among populations at higher risk and that are underserved |
| NOFO Outcome(s) Addressed | |
(Select all that apply)
| Other Outcome(s) (as identified by applicant) | | |
| Data Source(s) Used to Identify Population(s) of Focus | | |
| Estimated Amount of Funding Allocated to Strategy | | |
| (% of Total Funding and Dollar Amount) | | Amount of Strategy Funding Allocated for Rural Activities (% and $ Amount) (if applicable) | |
| Technical Assistance Needs | | If Yes, please describe: |
| Activity 1 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
| Estimated Reach of Population(s) of Focus | |
| Geographic Area | |
(Select one) Setting (Select one)
| | Other Setting (if applicable) | | | | |
| | Activity Description | | | Contributing Partners | Partner Type |
| (Select one) | Other Partner Type | | | | | |
| (if applicable) | Key Contracts & Consultants | | Key Deliverables/ Outputs | Start Date | End Date | |
| Activity 2 Title |
| Activity Focus |
(Select all that apply)
| Other Activity Focus (if applicable) | |
| Racial and Ethnic Population(s) of Focus | |
| (Select all that apply) | | Describe the Racial and Ethnic Population(s) (if applicable) |
| Other Population(s) of Focus | |
| (Select all that apply) | | Describe the Rural Community Served (if applicable) |
| Other Population (if applicable) | |
This is the start of the file's text. The full file is on GovTribe.
