CDC.RFA.OT18.1801.pdf

Centers for Disease Control

Office for State, Tribal, Local and Territorial Support

Strengthening the Nation's Public Health System Through a National Voluntary Accreditation

Program

CDC-RFA-OT18-1801

Application Due Date: 04/23/2018

Strengthening the Nation's Public Health System Through a National Voluntary Accreditation

Program

CDC-RFA-OT18-1801

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Catalog of Federal Domestic Assistance (CFDA) Number F. Dates G. Executive Summary

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

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-OT18-1801. 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) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Strengthening the Nation's Public Health System Through a National Voluntary Accreditation Program 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-OT18-1801

E. Catalog of Federal Domestic Assistance (CFDA) Number:

93.097 F. Dates:

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

2. Due Date for Applications: 04/23/2018, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

Not applicable.

G. Executive Summary:

1. Summary Paragraph:

The Centers for Disease Control and Prevention (CDC) announces the availability of funds to support a national accreditation program through CDC-RFA-OT18-1801, Strengthening the Nation’s Public Health System Through a National Voluntary Accreditation Program for State, Tribal, Local, and Territorial Health Departments. This five-year project, with approximately $900,000 available for each 12-month budget period, seeks to support the operations and continuous improvement of a national accreditation program for state, tribal, local, and territorial public health departments. Through this project, CDC will support the single recipient to 1) promote, communicate, and provide education regarding accreditation to diverse and relevant audiences; 2) evolve, improve, or develop new products, services, and tools to ensure a relevant, current, and smoothly functioning program; 3) strengthen strategic partnerships to 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.grants.gov support and advance accreditation; and 4) strengthen the evidence base for accreditation and the use of accreditation to advance public health practice. Short-term and intermediate outcomes/outputs of this project will include an increase in the number of public health departments using quality improvement and meeting national standards as evidenced by accreditation status. Ultimately, this can result in stronger public health agencies and improved community health outcomes.

a. Eligible Applicants: Single

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 1

d. Total Period of Performance Funding: $6,000,000

e. Average One Year Award Amount: $900,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 06/01/2018

h. Cost Sharing and / or Matching Requirements: N Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview National standards and accreditation programs have played important roles in ensuring accountability and advancing improvement for other community services and organizations, such as schools, daycare centers, hospitals, and police departments. Until recently, there had not been a national accreditation program or standards for public health departments.

This project supports the operations and continuous improvement of a national accreditation program for state, tribal, local, and territorial public health departments. The short-term and intermediate outcomes of this project include an increased number of state, tribal, local, and territorial public health departments meeting national consensus standards and achieving accreditation status, increased use of quality improvement, and increased accountability. Long-term outcomes include stronger public health agencies, improved community health and reduced health disparities, increased recognition of the role and value of public health, and new evidence of the relationship between accreditation, performance, and health outcomes.

Support for the national accreditation program is critical at this stage of its existence and is vital for determining the opportunities for improvement and impact of the national accreditation activities. This project will build on work conducted through previous cooperative agreements (OT13-1301 and HM08-805) through which necessary elements of the accreditation program— such as nationally established standards and measures, an assessment process, information technology, and staffing— were put into place. The Public Health Accreditation Board (PHAB), which was established in 2007, is widely recognized as the national accrediting body for state, tribal, local, and territorial health departments.

PHAB launched the nation’s first national accreditation program for public health departments in 2011. As of December 2017, nearly 70% of the US population is served by a nationally accredited health department. Accredited health departments include 31 state health departments (SHDs), 1 tribe, 179 independently accredited local health departments (LHDs), and 1 system of 67 county LHDs. The large majority of states (39) are either accredited or have formally applied to PHAB. The first accredited sites are already preparing for reaccreditation through PHAB.

More than 90% of accredited sites surveyed agreed or strongly agreed that accreditation stimulated performance improvement, created greater accountability, and improved management processes.

Through this project, CDC will support the recipient to 1) promote, communicate, and provide education regarding accreditation to diverse and relevant audiences; 2) evolve, improve, and/or develop new products, services, and tools to ensure a relevant, current, and smoothly functioning program, as well as respond to needs from the field; 3) strengthen strategic partnerships to support and advance accreditation; and 4) strengthen the evidence base for accreditation and the use of accreditation to advance public health practice.

b. Statutory Authorities The statutory authority for this NOFO is Section 317(k)(2) of the Public Health Service Act, [42 U.S.C. section 241(a) and 247 b(k)(2), as amended].

c. Healthy People 2020 Healthy People 2020 (HP2020) provides national objectives (http://www.healthypeople.gov) to improve the health of all Americans. National accreditation is the focus and data source for HP Public Health Infrastructure (https://www.healthypeople.gov/2020/topics-objectives/topic/publi c-health-infrastructure) objective, “Increase the proportion of Tribal, state, and local health agencies that are accredited,” and adds momentum toward objectives in core competencies, performance assessment , health improvement plans, and quality improvement. PHAB standards cite HP2020 as an important document for state/community health assessments and health improvement plans.

d. Other National Public Health Priorities and Strategies The national accreditation program aligns with and supports numerous national public health priorities and strategies, including

1) The National Quality Framework

2) The National Prevention Strategy (https://www.surgeongeneral.gov/priorities/prevention/strat egy/index.html)

3) Numerous recent Institute of Medicine reports (http://nationalacademies.org/hmd/Reports http://www.healthypeople.gov/ https://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure https://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure http://nationalacademies.org/hmd/Reports.aspx?filters=inmeta:activity=Public%20Health%20Strategies%20to%20Improve%20Health http://nationalacademies.org/hmd/Reports.aspx?filters=inmeta:activity=Public%20Health%20Strategies%20to%20Improve%20Health http://nationalacademies.org/hmd/Reports.aspx?filters=inmeta:activity=Public%20Health%20Strategies%20to%20Improve%20Health

.aspx?filters=inmeta:activity=Public Health Strategies to Improve Health)

4) The National Health Security Preparedness Index (see m87 at http://nhspi.org/indicator/cpe-community-planning-engagement-coordination/)

e. Relevant Work This funding opportunity builds upon the work completed previously under

CDC-RFA-OT13-1301, which ends in FY18

CDC-RFA-HM08-805

Through each of these funding opportunities, the national accreditation program has continued to evolve, from the initial work in developing and testing the program, to launching and initial implementation, to current efforts around reaccreditation, while also expanding and continuously improving accreditation efforts.

For additional information about the above mentioned cooperative agreements, please visit www.grants.gov and search the archived opportunities.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-OT18-1801 Logic Model: Strengthening the Nation’s Public Health System Through a National Voluntary Accreditation Program for State, Tribal, Local, and Territorial Health Departments

Bold indicates period of performance outcome

Strategies and Activities Short-Term Outcomes Intermediate Outcomes

Long-Term Outcomes

Promote, communicate, and educate about accreditation to diverse and relevant audiences -Develop, implement, support broad communications -Develop educational materials and tools -Communicate about accreditation in national

Public health professionals well-prepared to play their role in the accreditation process (accreditation coordinators, health officials, site visitors)

Increased accountability and transparency around public health department services

Increased adoption

Stronger public health agencies

Improved community health and/or reduced health disparities http://nationalacademies.org/hmd/Reports.aspx?filters=inmeta:activity=Public%20Health%20Strategies%20to%20Improve%20Health http://nhspi.org/indicator/cpe-community-planning-engagement-coordination/ http://nhspi.org/indicator/cpe-community-planning-engagement-coordination/ discussions -Provide training to different audiences serving roles in the accreditation process

Evolve, improve, and/or develop new products, services, and tools to ensure a relevant, current, and smoothly functioning accreditation program that is responsive to needs from the field -Monitor changes and refinements needed -Explore issues that might drive needed changes -Develop new standards or new elements of accreditation -Implement accreditation program changes

Strengthen strategic partnerships to support and advance accreditation -Sustain partnerships with key stakeholder organizations -Develop/strengthen partnerships with categorical

National consensus standards for public health departments (that are kept updated, relevant, etc.)

Public health agencies seeking accreditation or reaccreditation

Accredited public health agencies

Contributions to the evidence base around public health practice of evidence-based practices

Increased use of quality improvement

Improved management practices

Increased internal and external collaboration

New knowledge of public health practice

Increased recognition of the role and value of public health

Evidence of the relationship between accreditation, performance, and health outcomes programs -Develop/strengthen partnerships with traditional and non-traditional partners -Develop/strengthen partnerships with other accrediting bodies

Strengthen the evidence base for accreditation and the use of accreditation to advance public health practice -Conduct evaluation activities -Support a data infrastructure -Monitor/analyze data from accredited sites -Explore the impact of accreditation

i. Purpose The purpose of this project is to support the operations and continuous improvement of a national accreditation program for state, tribal, local, and territorial health departments. The goal of the national accreditation program is to “improve and protect the health of the public by advancing quality and performance” of health departments. The national accreditation program was launched in September 2011.

ii. Outcomes Support for this program will lead to a smoothly functioning accreditation program, with professionals who are trained and well-prepared to play their role in the accreditation program and national consensus standards that are updated and kept relevant. Other short-term outcomes will include an increased number of accredited and reaccredited public health agencies and new contributions to the evidence base around public health practice. As a result, intermediate outcomes will include increased accountability and transparency around public health department services, increased adoption of evidence-based practices, increased use of quality improvement, improved management practices, increased collaboration, and new knowledge of public health practice. Ultimately, these outcomes ideally contribute to stronger public health agencies, improved community health and reduced health disparities, increased recognition of public health, and new evidence for the relationship between accreditation, performance, and health outcomes.

iii. Strategies and Activities The applicant must propose activities to address each of the strategies listed. However, the activities listed below are not exhaustive and should be augmented, as needed.

1. Promote, communicate, and provide education regarding the accreditation program to diverse and relevant audiences. Activities may include but are not limited to o Develop, implement, and/or continually support broad communications regarding the value and impact of accreditation to public health practitioners, other stakeholders and the general public o Develop and disseminate educational materials, training curricula, and assessment tools to assist health departments that are participating in the accreditation process o Strategically and proactively communicate about accreditation and public health practice to public health practitioners, national organizations, and in national-level discussions o Provide training for specific groups of public health professionals who play key roles in the accreditation process, such as health officials, accreditation coordinators, PHAB site visitors who serve as peer reviewers, and technical assistance providers

2. Evolve, improve, and/or develop new products, services, and tools to ensure a relevant, current, and smoothly functioning program, as well as respond to new needs from the field. (All elements of the current program can be found at www.phaboard.org.)

Activities will include but are not limited to o Continually monitor changes and refinements needed through ongoing field-driven input o Explore issues that might drive needed changes or updates to the accreditation standards and measures, tools, information systems, and processes by conducting targeted activities (e.g., calls for input, topic-specific meetings, expert panels) o Develop and support new standards or new elements of the accreditation program, as needed, such as requirements and processes for reaccreditation or programmatic accreditation modules, including accreditation for Vital Records and Health Statistics o Implement and communicate changes incorporated into the accreditation program http://www.phaboard.org/

3. Strengthen strategic partnerships to support or advance accreditation. Activities will include but are not limited to o Sustain partnerships with key stakeholder organizations that are critical to the success of the national accreditation program, including but not limited to the organizations that represent the constituencies being accredited o Develop and/or strengthen partnerships with organizations and sectors that represent programmatic or categorical interests within public health to explore and illustrate the connection between accreditation and all elements of public health practice o Develop and/or strengthen partnerships with traditional and non-traditional partners, such as healthcare providers, academia, or sectors that affect the social determinants of health (education, housing, finance)Develop and/or strengthen relationships with other accrediting bodies to clarify the distinction between accreditation programs, identify collaborations, and create new learning opportunities

4. Strengthen the evidence base for accreditation and the use of accreditation to advance public health practice. Activities to support and enhance the accreditation program will include but are not limited to o Conduct evaluation activities to better understand process and outcomes of the accreditation program o Support a data infrastructure that provides information about accredited agencies and can contribute to understanding and exploration of the current state of health department performance o Monitor and analyze data from accredited and applicant agencies to increase understanding of health department practice o Explore the relationship between accreditation, public health agency performance, and health outcomes to better understand impact

1. Collaborations

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

The applicant must collaborate with OSTLTS, CDC programs, and other CDC centers, institutes, and offices to improve program activities. Collaboration with CDC/OSTLTS and CDC’s National Center for Health Statistics is expected for work related to the support of accreditation for Vital Records and Health Statistics Programs. Collaboration with other CDC programs will occur as appropriate (i.e., CSELS for surveillance related work or OPHPR for emergency preparedness related efforts.) Participation in stakeholder meetings and the provision of expert consultation to CDC/OSTLTS and other CDC programs (as requested) are additional activities required of the applicant. OSTLTS’s Division of Public Health Performance Improvement, which leads CDC’s support of national accreditation of health departments, will help identify and coordinate needs and opportunities for collaboration within CDC.

The applicant should build and/or continue strategic partnerships and collaborations with CDC-funded organizations that have a role in achieving the NOFO outcomes and proposed activities.

This includes partnerships with CDC-funded national organizations that are involved in supporting national accreditation.

b. With organizations not funded by CDC:

The applicant should build and/or continue strategic partnerships and collaborations with organizations that can advance progress toward the NOFO outcomes and proposed activities.

This includes state, tribal, local, and territorial public health agencies, and other funding organizations. The recipient should seek to establish and strengthen partnerships with organizations and sectors that represent programmatic or categorical interests within public health. The recipient should also explore building partnerships with traditional and non-traditional partners, such as healthcare providers, academia, or sectors that affect the social determinants of health (education, housing, finance).

2. Target Populations The primary target populations for the accreditation program supported through this funding opportunity are state, tribal, local, and territorial health departments. The populations that will benefit are people served by state, tribal, local and territorial (STLT) health departments.

a. Health Disparities A long-term outcome of this NOFO is to strengthen the role that accreditation can play in reducing health disparities and improving social determinants of health. The applicant/award recipient is encouraged to incorporate efforts to reduce health disparities and address social determinants of health in the execution of cooperative agreement activities, when appropriate.

The national accreditation program has great potential for addressing health disparities in communities, reaching persons with disabilities, and more effectively serving populations that experience language or cultural barriers. The accreditation program is intended to strengthen health departments serving different settings, such as rural areas, tribal jurisdictions, territories, and freely associated states. Further, the national accreditation standards advance attention to health equity by establishing expectations for health department activities in health equity, strengthening attention to the determinants of health, and advancing activities and engagement with different populations throughout the community served.

iv. Funding Strategy

NA

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation and performance measurement will demonstrate achievement of the work plan outcomes and show effective implementation of the strategies over the entire five-year period of performance. Evaluation findings can be used by the recipient and CDC to ensure continuous program and system improvement, help create an evidence base for accreditation, and assess which program strategies are most effective.

Within six months post-award, CDC and the recipient will collaboratively finalize process and outcome measures to ensure they are concrete and achievable. As part of the application, the applicant should define measures that will be used to

Track implementation of recipient strategies and activities (process evaluation) Determine progress on achieving the period of performance outcomes (outcome evaluation)

Process measures related to strategies/activities

Promote, communicate, and educate about accreditation o Number of participants completing PHAB trainings to support their health department’s role in applying for accreditation (accreditation coordinator, online orientation, reaccreditation training) o Number of participants completing PHAB trainings to support their role in delivering the accreditation program (i.e., site visitor trainings) o Number of conference sessions, webinars, and workshops conducted by PHAB o Number of news stories or social media mentions that are about PHAB-accredited sites or that mention PHAB Evolve, improve, and/or develop new products, services, and tools to ensure a relevant, current, and smoothly functioning program, as well as respond to new needs from the field o Updated products and tools to support the national accreditation program o Updated e-PHAB accreditation information system o Number of committee meetings, think tanks, expert panels convened o Percentage of site visitors who said they would serve again o Percentage of accredited sites that participate in the PHAB Accredited Site

Learning Community (a service available to accredited sites) Strengthen strategic partnerships to support and advance accreditation o Number of collaborations or meetings with key national accreditation partners (i.e., those serving the constituencies being accredited or providing technical assistance) o Number of organizations or national initiatives in which PHAB participates (as a proxy indication for illustrating recognition of the role PHAB is playing in the national public health system)

Strengthen the evidence base for accreditation and the use of accreditation to advance public health practice o Manuscripts developed and submitted for publication to peer reviewed journals by PHAB o Number of signed PHAB data use agreements in place, indicating provision of PHAB data for use in relevant research or other data exploration efforts o Data systems that are developed and/or improved so as to access, analyze, and report on information related to accredited health departments

Outcomes measures (tied to short-term, intermediate and long-term outcomes) Short-Term Outcomes:

Public health professionals well-prepared to play their role in the accreditation process (accreditation coordinators, health officials, site visitors) o Number of public health professionals trained by PHAB (accreditation coordinator training, site visitor training, online training) o Proportion of public health professionals trained who positively indicated they were well-prepare National consensus standards for public health departments (that are kept updated, relevant, etc.)

o Release of Version 2.0 of the PHAB Standards and Measures o Launch of new Vital Records and Health Statistics (VRHS) accreditation program module Public health agencies seeking accreditation or reaccreditation o Number of health departments applying for initial accreditation (state, tribal, local, territorial) o Proportion of accredited health departments applying for reaccreditation (state, tribal, local, territorial) o Number of health departments applying for VRHS accreditation Accredited public health agencies o Number and proportion of accredited public health agencies (state, tribal, local, territorial)—ties to HP2020 PHI-17 o Number of health departments applying for accreditation (state, tribal, local, territorial) o Population served by accredited health departments (total and by each type of health department) o Number of accredited VRHS programs Contributions to the evidence base around public health practice o Number of published manuscripts that address PHAB accreditation or include PHAB accreditation data (contributions to the evidence base)

Intermediate Outcomes:

Increased accountability and transparency around public health department services o Proportion of sites indicating that accreditation has improved accountability to stakeholders

Increased use of quality improvement o Percent of accredited sites that indicate accreditation has improved quality and performance Improved management practices o Percent of accredited sites that indicate accreditation has strengthened their management practices

Increased internal and external collaboration o Proportion of sites indicating that accreditation has increased collaboration (or integration) internally and externally

Long-Term Outcomes:

Stronger public health agencies o Proportion of sites indicating that accreditation has had a positive financial impact Evidence of the relationship between accreditation, performance, and health outcomes o Proportion of sites reporting positive changes in health indicators through the reaccreditation outcomes reporting process

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 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), if applicable, for accuracy throughout the lifecycle of the project. 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, they 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, within the first 6 months of award, as described in the Reporting Section of this NOFO.

Specifically, applicants for this NOFO must provide an evaluation and performance measurement plan that meets the requirements noted above and more specifically must describe how key program partners will participate in the all aspects of evaluation and performance measurement processes (not only the planning process).

Applicants must provide a statement of commitment to provide a Data Management Plan (DMP) post award, when specific data generation and collection activities are defined.

Recipients will describe how they intend to manage, preserve, and make accessible data https://www.cdc.gov/grants/additionalrequirements/ar-25.html generated or collected with CDC funds in a DMP. The funding program will define the details of how a DMP is to be provided (e.g., as a narrative, table format). DMPs will be submitted, evaluated, and approved before beginning data collection.

Recipients will be required to submit a more detailed Evaluation and Performance Management plan including a DMP, within the first 6 months of award as described in the Reporting Section of this NOFO.

The applicant evaluation and performance measurement plan must provide a detailed description for year one evaluation activities and specific elements to be evaluated over the five-year period of performance. Applicants are expected to develop performance measures specific to the strategies, activities, and outcomes outlined in the proposed work plan. The evaluation and performance measurement plan must meet the minimum requirements, as stated above.

c. Organizational Capacity of Recipients to Implement the Approach The successful applicant for this sole source NOFO will be recognized as the accrediting body for state, tribal, local, and territorial public health departments. Additionally, the successful applicant organization will have the capacity and demonstrate its ability to successfully execute CDC program goals and strategies and meet period of performance outcomes. The recipient should have adequate infrastructure (physical space and equipment), workforce capacity and competence, relevant skill sets, and information and data systems to implement the award.

Required infrastructure, workforce capacity, and information systems to implement the award may include, but is not limited to, program management, performance measurement, evaluation, financial reporting, management of travel requirements, development of staffing plans, 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.

Flexibility will be provided to enable applicants to implement NOFO requirements based on their own organizational design and approach, unless otherwise required by statute. See the “Application and Submission Information” section for more information.

d. Work Plan No specific work plan format is required, as long as it is clear how the components in the work plan crosswalk to the strategies and activities, outcomes, and evaluation and performance measures presented in the logic model and the narrative sections of the NOFO.

A sample work plan format is presented below to show how a traditional work plan aligns with the logic model and narrative.

In this format, the table would be completed for each period of performance outcome. If a particular activity leads to multiple outcomes, it should be described under each outcome measure.

Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities

Process Measure [from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

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.

f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO

COOPERATIVE AGREEMENTS)

In a cooperative agreement, CDC staff are substantially involved in the program activities, above and beyond routine grant monitoring. CDC will

1. Collaborate to ensure coordination and implementation of strategies to support the accreditation program

2. Identify and implement appropriates activities that CDC can undertake to uniquely support and advance the national accreditation program (e.g., establishing incentives, providing technical expertise)

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

4. Participate in key meetings and workgroups convened by the applicant and in support of NOFO program strategies and accreditation program objectives

5. Support ongoing opportunities to foster networking, communication, coordination, and collaboration and serve as a conduit for information exchange, including fostering collaboration with other areas of CDC and other CDC-funded organizations

6. Collaborate to compile and publish accomplishments, successful strategies, lessons learned, and impacts during the period of performance

7. Collaborate, as appropriate, in assessing progress toward meeting strategic and operational goals and objectives and in establishing measurement and accountability systems for documenting outcomes, such as increased performance improvements and best or promising practices

B. Award Information

1. Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism: U90 Cooperative Agreement

3. Fiscal Year: 2018

4. Approximate Total Fiscal Year Funding: $900,000

5. Approximate Period of Performance Funding: $6,000,000

This amount is subject to the availability of funds.

Estimated Total Funding: $6,000,000

6. Approximate Period of Performance Length: 5 year(s)

7. Expected Number of Awards: 1

8. Approximate Average Award: $900,000 Per Budget Period

9. Award Ceiling: $0 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor: $900,000 Per Budget Period

11. Estimated Award Date: 06/01/2018

12. Budget Period Length: 12 month(s)

Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is not available through this FOA.

C. Eligibility Information

1. Eligible Applicants Eligibility Category: Others (see text field entitled "Additional

Information on Eligibility" for clarification)

Additional Eligibility Category:

2. Additional Information on Eligibility The only eligible applicant for this award is the Public Health Accreditation Board, a 501(c)3 independent accrediting body that administers the national voluntary accreditation program for health departments.

3. Justification for Less than Maximum Competition The anticipated recipient, PHAB, is the only organization with demonstrated capacity to implement and ensure the continuity of activities outline in this NOFO. PHAB’s efforts will focus on the development guidelines and measures related to the accreditation of public health departments.

The nature of the activities under this award are best employed by focusing on the entity to which this cooperative agreement is limited, per memorandum for approval for single-eligibility competition, which was approved and dated June 7, 2017.

PHAB was found to be uniquely qualified, as it is the organization that has been established as the national accrediting body for state, tribal, local, and territorial health departments. PHAB was determined to have the experience and program infrastructure, which includes field-driven and tested standards, measures, and accreditation assessment process. PHAB is also widely accepted as the national accrediting body for state, tribal, local, and territorial health departments by the constituency organizations for these agencies and as evidenced by the visible mention of PHAB within national policy documents (e.g., Institute of Medicine reports, Healthy People 2020).

4. Cost Sharing or Matching Cost Sharing / Matching Requirement: No Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged

5. Maintenance of Effort Maintenance of effort is not required for this program.

D. Application and Submission Information

1. Required Registrations An organization must be registered at the three following locations before it can submit an application for funding at www.grants.gov.

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number.

A DUNS number is a unique nine-digit identification number provided by Dun & Bradstreet (D&B). It will be used as the Universal Identifier when applying for federal awards or cooperative agreements.

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll free) or internet at http:// fedgov.dnb. com/ webform/ displayHomePage.do. The DUNS number will be provided at no charge.

If funds are awarded to an applicant organization that includes sub-recipients, those sub-recipients must provide their DUNS numbers before accepting any funds.

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as a recipient. All applicant organizations must register with SAM, and will be assigned a SAM number. All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC. If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at www.SAM.gov.

https://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/portal/public/SAM/

c. Grants.gov:

The first step in submitting an application online is registering your organization at www.grants.gov, the official HHS E-grant Web site. Registration information is located at the “Get Registered” option at www.grants.gov.

All applicant organizations must register at www.grants.gov. The one-time registration process usually takes not more than five days to complete. Applicants should start the registration process as early as possible.

Step System Requirements Duration Follow Up 1 Data

Universal Number System

(DUNS)

1. Click on http:// fedgov.dnb.com/ webform

2. Select Begin DUNS search/request process

3. Select your country or territory and follow the instructions to obtain your DUNS 9-digit #

4. Request appropriate staff member(s) to obtain DUNS number, verify & update information under DUNS number

1-2 Business Days

To confirm that you have been issued a new DUNS number check online at (http:// fedgov.dnb.com/ webform) or call 1-866-705-5711

2 System for Award Management

(SAM)

formerly Central Contractor Registration

(CCR)

1. Retrieve organizations DUNS number

2. Go to www.sam.gov and designate an E-Biz POC (note CCR username will not work in SAM and you will need to have an active SAM account before you can register on grants.gov)

3-5 Business Days but up to 2 weeks and must be renewed once a year

For SAM Customer Service Contact https://fsd.gov/ fsd-gov/ home.do Calls:

866-606-8220

3 Grants.gov 1. Set up an individual account in Grants.gov using organization new DUNS number to become an authorized organization representative (AOR)

2. Once the account is set up the E-BIZ POC will be notified via email

3. Log into grants.gov using the password the E- BIZ POC received and

Same day but can take 8 weeks to be fully registered and approved in the system (note, applicants

MUST

obtain a

DUNS

Register early!

Log into grants.gov and check AOR status until it shows you have been approved https://grants.gov/ https://www.grants.gov/ https://www.grants.gov/ https://www.grants.gov/ http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://www.sam.gov https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do create new password

4. This authorizes the AOR to submit applications on behalf of the organization number and

SAM

account before applying on grants.gov)

2. Request Application Package Applicants may access the application package at www.grants.gov.

3. Application Package Applicants must download the SF-424, Application for Federal Assistance, package associated with this notice of funding opportunity at www.grants.gov. If Internet access is not available, or if the online forms cannot be accessed, applicants may call the CDC OGS staff at 770-488- 2700 or e-mail OGS ogstims@cdc.gov for assistance. Persons with hearing loss may access CDC telecommunications at TTY 1-888-232-6348.

4. Submission Dates and Times If the application is not submitted by the deadline published in the NOFO, it will not be processed. Office of Grants Services (OGS) personnel will notify the applicant that their application did not meet the deadline. The applicant must receive pre-approval to submit a paper application (see Other Submission Requirements section for additional details). If the applicant is authorized to submit a paper application, it must be received by the deadline provided by

OGS.

a. Letter of Intent Deadline (must be emailed or postmarked by) Due Date for Letter of Intent: N/A

b. Application Deadline Due Date for Applications: 04/23/2018 , 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov. If Grants.gov is inoperable and cannot receive applications, and circumstances preclude advance notification of an extension, then applications must be submitted by the first business day on which grants.gov operations resume.

Date for Information Conference Call Not applicable.

5. CDC Assurances and Certifications All applicants are required to sign and submit “Assurances and Certifications” documents indicated at http://wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa)) /Homepage.aspx.

Applicants may follow either of the following processes:

Complete the applicable assurances and certifications with each application submission, https://www.grants.gov https://www.grants.gov mailto:ogstims@cdc.gov https://www.grants.gov http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx name the file “Assurances and Certifications” and upload it as a PDF file with at www.grants.gov

Complete the applicable assurances and certifications and submit them directly to CDC on an annual basis at http://wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa))/ Homepage.aspx

Assurances and certifications submitted directly to CDC will be kept on file for one year and will apply to all applications submitted to CDC by the applicant within one year of the submission date.

Duplication of Efforts Applicants are responsible for reporting if this application will result in programmatic, budgetary, or commitment overlap with another application or award (i.e. grant, cooperative agreement, or contract) submitted to another funding source in the same fiscal year.

Programmatic overlap occurs when (1) substantially the same project is proposed in more than one application or is submitted to two or more funding sources for review and funding consideration or (2) a specific objective and the project design for accomplishing the objective are the same or closely related in two or more applications or awards, regardless of the funding source. Budgetary overlap occurs when duplicate or equivalent budgetary items (e.g., equipment, salaries) are requested in an application but already are provided by another source.

Commitment overlap occurs when an individual’s time commitment exceeds 100 percent, whether or not salary support is requested in the application. Overlap, whether programmatic, budgetary, or commitment of an individual’s effort greater than 100 percent, is not permitted.

Any overlap will be resolved by the CDC with the applicant and the PD/PI prior to award.

Report Submission: The applicant must upload the report in Grants.gov under “Other Attachment Forms.” The document should be labeled: "Report on Programmatic, Budgetary, and Commitment Overlap.”

6. Content and Form of Application Submission Applicants are required to include all of the following documents with their application package at www.grants.gov.

7. Letter of Intent A letter of intent is not requested or required as part of the application for this NOFO.

8. Table of Contents (There is no page limit. The table of contents is not included in the project narrative page limit.): The applicant must provide, as a separate attachment, the “Table of Contents” for the entire submission package.

Provide a detailed table of contents for the entire submission package that includes all of the documents in the application and headings in the "Project Narrative" section. Name the file "Table of Contents" and upload it as a PDF file under "Other Attachment Forms" at www.grants.gov.

https://www.grants.gov http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx

9. Project Abstract Summary (Maximum 1 page) A project abstract is included on the mandatory documents list and must be submitted at www.grants.gov. The project abstract must be a self-contained, brief summary of the proposed project including the purpose and outcomes. This summary must not include any proprietary or confidential information. Applicants must enter the summary in the "Project Abstract Summary" text box at www.grants.gov.

10. Project Narrative (Unless specified in the "H. Other Information" section, maximum of 20 pages, single spaced, 12 point font, 1-inch margins, number all pages. This includes the work plan. Content beyond the specified page number will not be reviewed.)

Applicants must submit a Project Narrative with the application forms.