cdc-rfa-ck15-1503 amendment ii.pdf

Centers for Disease Control and Prevention

National Center for Emerging and Zoonotic Infectious Diseases

Establishment of Centers of Excellence in Refugee Health

CDC-RFA-CK15-1503

Application Due Date: 06/11/2015

AMENDMENT II

Q AND A FROM INFORMATIONAL CALL HELD ON MAY 1, 2015

Q AND A START ON PAGE: 31 thru 34 of the FOA

AMENDMENT I

The date for the second informational call is May 1, 2015 at 2:00 - 3:00 p.m. Eastern. The call in number is 1-877-489-9253, passcode 43915780. Page 3; Page 13;

The other change is the application due date. It is now 6/11/2015. Page 1;

Establishment of Centers of Excellence in Refugee Health

CDC-RFA-CK15-1503

TABLE OF CONTENTS

Part I. Overview Information

Federal Agency NameA.

Funding Opportunity TitleB.

Announcement TypeC.

Agency Funding Opportunity NumberD.

Catalog of Federal Domestic Assistance (CFDA) NumberE.

Dates F.

Executive Summary G.

Part II. Full Text

Funding Opportunity Description A.

Award Information B.

Eligibility Information C.

Required Registrations D.

Review and Selection Process E.

Award Administration Information F.

Agency Contacts G.

Other Information H.

Glossary I.

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-CK15-1503. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

Establishment of Centers of Excellence in Refugee Health C. Announcement Type: New - Type 1 This announcement is only for non-research domestic activities supported by CDC. If research is proposed, the application will not be considered Research for this purpose is defined at http://www.cdc. gov/od/ science / integrity/ docs/cdc- policy- distinguishing- public- health- research- nonresearch. pdf.

D. Agency Funding Opportunity Number:

CDC-RFA-CK15-1503

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

93.283 F. Dates:

1. Due Date for Letter of Intent (LOI): 05/02/2015

2. Due Date for Applications: 06/11/2015, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: 05/01/2015 The date for the second informational call is May 1, 2015 at 2:00 - 3:00 p.m. Eastern. The call in number is 1-877-489-9253, passcode 43915780.

The date of the informational call will be April 13, 2015 at 3:00 - 4:00 p.m. Eastern. The call in number is 1-866-760-5505, passcode 7415279.

G. Executive Summary:

1. Summary Paragraph:

CDC's Division of Global Migration and Quarantine (DGMQ) is focused on improving the health among immigrants and refugees through public health partnerships, science, and response. DGMQ is looking for new approaches to reach out to these populations to study and improve healthcare needs of refugee and immigrant populations. This funding opportunity will help create Centers of Excellence in refugee and/or immigrant health. The centers will focus on one or more areas including the development of multi-state/regional surveillance networks and long-term follow up of immigrants and refugees after they arrive in the United States; clinical and public health guideline development and maintenance; refugee orientation and health education activities; portable electronic health record strategies for this population; and clinical consultation services for overseas panel physicians managing complex medical conditions in U.S.-bound refugees. These centers will provide expertise in these diverse program areas and build upon existing infrastructure and collaborate with partners focusing on these vulnerable populations.

a. Eligible Applicants: Open Competition

b. FOA Type: Cooperative Agreement

c. Approximate Number of Awards: 0 http://foa.grantsolutions.gov/announcementmodule/www.grants.gov http://foa.grantsolutions.gov/announcementmodule/www.grants.gov http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.grants.gov

The expected number of awards is 3-5.

d. Total Project Period Funding: $25,000,000

e. Average One Year Award Amount: $0 The approximate average award will range from $500,000 to $1,500,000.

f. Number of Years of Award: 5

g. Estimated Award Date: 08/08/2015

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview

CDC's Division of Global Migration and Quarantine (DGMQ) is focused on improving the health among immigrants and refugees. Every year, approximately 70,000 refugees and 400,000 immigrants resettle to the U.S. from overseas. Refugees are particularly vulnerable populations, marginalized from public health surveillance, preventive treatment and health care in their home countries and countries of temporary asylum. They have complex health care issues, such as low baseline vaccination rates and high rates of infectious diseases, including tuberculosis, malaria, and intestinal parasites. Refugee populations resettled to the U.S. are dynamic and change over time. Identifying the specific health needs of the different populations in a timely manner is critical for developing and targeting appropriate health activities before and after arrival. Refugees and immigrants undergo a required medical examination overseas. The exam focuses on identifying specific "inadmissible" medical conditions that would exclude refugees from resettlement or require treatment before arrival in the U.S. However, this exam does not address many important preventable or treatable public health problems, including vaccine-preventable diseases, malaria, etc. One challenge to developing best practice health recommendations is that there is no standardized national surveillance system for the identification of acute illnesses in these newly arriving populations. Reporting of health conditions in refugees and immigrants identified post arrival is limited to the required reportable conditions as specified by state and federal requirements. However, the identification of these conditions as belonging to refugee or immigrants is not reported. Consequently, there is little data to evaluate the effectiveness and quality of the required overseas medical examination, the overseas presumptive treatment and other public health interventions or to guide the establishment of evidence-based guidelines for the post-arrival medical examination. Identifying and monitoring the specific health needs of refugees and immigrants is essential for educating health care providers in the U.S. about these conditions, particularly tropical diseases, with which they may be largely unfamiliar, and for providing assistance to state and local refugee health programs so that they can better prepare for the arrival of these populations.

b. Statutory Authorities

This program is authorized under the Public Health Service Act, Sections 301 and 317(k)(1)[42 U.S.C. 242I and 247b(k)(1)].

c. Healthy People 2020

This work contributes to the Healthy People 2020 focus areas of Access to Health Services, Global Health, and Health Communication and Health Information Technology to 1) detect and treat health conditions,

2) find a health care provider with whom the patient can communicate and trust, 3) prevent the international spread of disease, 4) protect the health of the U.S. population, 5) provide new opportunities to connect with culturally diverse and hard to reach populations, and 6) facilitate the meaningful use of health IT and exchange of health information among health care and public health professionals. The link to Healthy People 2020 topics and objectives is https://www.healthypeople.gov/2020/topicsobjectives2020/default.

d. Other National Public Health Priorities and Strategies n/a

e. Relevant Work

This FOA is in alignment with HHS/CDC/NCEZID's aims to prevent disease, disability, and death by a wide range of infectious diseases and HHS/CDC/NCEZID's tactics of providing leadership in public health, conducting exemplary science, strengthening preparedness efforts, establishing public health policy, sharing vital health information with the public, and building collaborations for the benefit of global health. This FOA builds upon the work currently underway towards building surveillance systems that gather information on refugee and immigrants newly arrived to the U.S. It will also expand upon already published refugee health guidelines ( www.cdc.gov/immigrantrefugeehealth/guidelines/refugee-guidelines.html ).

2. CDC Project Description

a. Approach

CDC-RFA-CK15-1503 Logic Model: Establishment of Centers of Excellence in Refugee Health

(Bold typeface indicates project period outcomes) Strategies and Activities Short Term/Intermediate

Outcomes Long Term Outcomes

Surveillance/Epidemiology

--Develop approaches to evaluate the effectiveness of implemented guidelines and public health programs

--Implement methods to evaluate guidelines based on data-driven approaches

--Expand surveillance systems for immigrant and/or refugee populations representative of the target population;

Capture data in a secure, electronic database format

--Multi-state/Regional networks developed or built upon existing systems

--Ensure network interoperability and standardization across systems

--Establish data standards for best practices

--Describe secondary migration patterns

--Creation of multi-state/regional surveillance networks

--Established long term follow up programs

--Ability to quantify incidence and prevalence of disease among immigrant and/or refugee populations

--Interventions to improve health outcomes based on data from long term follow up programs https://www.healthypeople.gov/2020/topicsobjectives2020/default http://www.cdc.gov/immigrantrefugeehealth/guidelines/refugee-guidelines.html

--Design long term follow up programs

--Implement long term follow up programs

Guideline Development

--Update and expand existing screening, treatment, clinical, and public health guidelines

--Develop population-specific guidelines (e.g. specific ethnic groups)

--Establish a system to continually update and maintain guidelines to meet best practices

--Updated and expanded published guidelines adopted by health care providers

--Creation of population specific guidelines

--Improved clinical outcomes

--Publication of a "Reverse" Yellow Book for care and treatment of incoming foreign-born populations

Refugee Orientation

--Develop orientation programs for refugees upon arrival to improve continuity of medical care

--Develop/deploy mobile device applications to communicate with refugees about health care issues

--Explore use of major ports of entry as anchor points for future relationships

--Evaluate the effectiveness of orientation programs

--Orientation programs for refugees upon arrival

--Improved continuity of medical care for refugees with complex medical issues

--Increased knowledge of the US health care system and health conditions among refugee populations leading to improved access to care

Health Education

--Identify gaps in health knowledge among those providing health care services to refugees

--Develop and deliver educational resources to improve health knowledge with the intent of improving identification of health care needs of arriving refugees

--Evaluate the effectiveness of education activities

--Educational materials developed

--Improved recognition of health care service needs of refugees

--Improved health outcomes of refugees

--Increased healthcare provider capacity and experience in treating refugee populations

Electronic Health Record Development

--Develop and establish portable electronic health records for immigrant and/or refugee populations

Secure, portable electronic health record system that can be used and viewed by providers in different institutions

Clinical Consultation --Develop a strategy and implement a medical consultation service for the International Organization for Migration (IOM) and overseas panel physicians for

Creation of a medical consultation service

Improved clinical outcomes of refugees with complex medical conditions the stabilization and management of refugees with complex medical conditions

--Design mechanism to improve communication and continuity of care between IOM and/or panel physicians with receiving agencies

i. Purpose

The purpose of this FOA is to create Centers of Excellence in immigrant and/or refugee health to 1) generate information from long term follow up programs to inform policy, 2) enhance guideline development to improve and standardize clinical care of immigrants and/or refugees, 3) orient refugees and provide tools to improve medical follow up compliance, 4) improve the health education of voluntary agencies (VOLAGs), health care providers, community agencies, and employers to better serve resettling refugees, 5) establish portable electronic medical records to improve continuity of care; 6) establish clinical consultation service to stabilize/manage refugees with complex medical conditions.

ii. Outcomes

Developed robust, multi-state/regional electronic surveillance networks for communicable and non-communicable diseases for immigrants and refugees Established long term follow up programs to identify and monitor health conditions of importance in specific populations to drive policy decisions Updated and expanded screening, treatment, clinical, and public health guidelines for immigrant and/or refugee populations to be used by health care providers in the US Developed systems to update and maintain guidelines Developed and implemented orientation programs for refugees to improve refugee communication with resettlement teams Developed educational materials for VOLAGs, health care providers, community agencies, and employers to improve healthcare service needs of refugees Established secure portable electronic health record system for immigrants and/or refugees that is accessible to health care providers in different institutions to improve continuity of care and health outcomes Development of a clinical consultation service for the IOM and panel physicians overseas to diagnose, stabilize, and manage complex medical conditions of refugees

iii. Strategies and Activities

Surveillance/Epidemiology

1) Expand surveillance systems for immigrant and/or refugee populations that are representative of the target population and capture data in a secure, electronic database format:

Develop systems/mechanisms to create multi-state and/or regional surveillance networks building on established systems Ensure surveillance networks communicate with established state-based systems and standardize data across systems Establish data standards for best practices in immigrant/refugee health surveillance

2) Design approaches to identify and monitor secondary migration patterns among immigrants and/or refugees

3) Design approaches for long term follow up of immigrants and/or refugees after they arrive in the U.S.

3) Design approaches for long term follow up of immigrants and/or refugees after they arrive in the U.S.

4) Implement long term follow up programs to study chronic non-infectious disease, mental health, maternal child health, infectious diseases, injuries, and/or occupational health issues

5) Assess the utility of existing data sources to identify and monitor health conditions among immigrants and/or refugees

Guideline Development

1) Expand and update screening, treatment, clinical, and public health guidelines for immigrant and/or refugee populations

2) Create populations-specific guidelines

3) Establish a system to continually update and maintain guidelines to meet best practices

4) Develop approach to evaluate the effectiveness of the guidelines

5) Evaluate effectiveness of guidelines and report the results

Refugee Orientation

1) Adopt program to orient refugees upon arrival

2) Develop and deploy mobile device applications to allow for better communication with refugees in need of health care services

3) Explore the use of major ports of entry (ie airports) as an anchor point for establishing relationships with refugees for future communication and public health interventions.

4) Evaluate the effectiveness of orientation programs and report findings

Health Education

1) Identify gaps in health knowledge among VOLAGs, health care providers, community agencies, and/or employers providing resettlement health care service to refugees

2) Develop and deliver educational resources to improve health knowledge with the intent of improving identification of health care needs of arriving refugees

3) Evaluate the effectiveness of education activities and report findings

Electronic Health Record Development

1) Develop and establish secure portable electronic health records for immigrant and/or refugee populations

2) Data stored in a secure database and easily extractable for analytical purposes

Clinical Consultation

1) Develop and implement a clinical consultation service for IOM and overseas panel physicians for refugee populations

2) Develop a strategy to provide clinical consultation services for the clinical management of refugees with complex medical conditions

3) Promote service to potential users

4) Evaluate the effectiveness of the service and document the results

1.Collaborations

a. With CDC-funded programs:

Collaboration with other CDC funded programs is required. If chosen, applicant should provide evidence of prior collaborations and should describe the collaborating CDC-funded programs in their jurisdiction or community, describe their role in achieving the FOA outcomes, and describe how the applicant will work with the program. Prior evidence may be provided as a MOU, MOA, or letters of support. Of most interest is the sharing of data from surveillance networks, cohort studies, and electronic health records to conduct collaborative studies.

b. With organizations external to CDC:

Collaborations with organizations external to the CDC is required. If chosen, applicant should provide evidence of prior collaborations and should describe the collaborating program in their jurisdiction or community, describe their role in achieving the FOA outcomes, and describe how the applicant will work with the program. Prior evidence may be provided as a MOU, MOA, or letters of support. Examples of potential collaborative partners include IOM, state and local health departments, academic institutions, non-governmental organizations, VOLAGs, health care providers, community agencies, and others.

2. Target Populations

Awardees are expected to focus on refugees arriving in the United States. Projects may include auxiliary focus on immigrant populations where appropriate. Applicants should clearly identify their focus in their proposed projects.

a. Inclusion n/a

iv. Funding Strategy (for multi-component FOAs only) n/a

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Awardee will report progress toward program outcomes on an annual basis. CDC will develop the specific performance measures that best meet the purpose and objective of this project as well as the timing of the performance measures. Some performance measures may be required in year 1 but not in succeeding years and others will be required in subsequent years only. The performance measures will be closely tied to the pertinent strategies, activities, and outcomes. There may be both qualitative and quantitative data collected for evaluation purposes. Overall, reports summarizing the progress and short-term outcomes of each project will be submitted, at a minimum, on an annual basis. Performance measures may include:

Number of jurisdictions included in a surveillance network Number of people and description of population included in a follow up program Number of guidelines expanded, updated, or developed Number of refugees enrolled in orientation program Compliance numbers for medical visits for refugees enrolled in orientation programs Number and description of educational products Number of trainings performed Number of patients included in a portable electronic health record system and number of visits per patient Number and outcomes of clinical consultations

ii. Applicant Evaluation and Performance Measurement Plan

Applicants are expected to have a project monitoring plan designed to demonstrate progress in project implementation (this should include timelines, schedule for conference calls, onsite meetings, submission of progress reports, etc.).

c. Organizational Capacity of Awardees to Execute the Approach

Below is the required organizational skill set the applicant would need to have to execute this FOA:

Program Management

Planning and execution Performance management and monitoring Communication management Partnership development Reporting Workforce management

Subject Matter Expertise (not all are required)

Clinical and public health expertise in refugee health Surveillance and informatics expertise Experience establishing longitudinal studies Health education/health promotion expertise Electronic health record (EHR) expertise

Financial Planning

Budget management and tracking Budget administration Financial reporting

d. Work Plan

A detailed work plan covering the first year of the project period and a high level plan for the subsequent years must be provided with each application. This work plan should include the expected outcomes, the program strategies, associated performance measures, milestones or target dates for activity completion, and identification of person(s) responsible for those activity completions.

Below is a sample work plan for illustrative purposes only:

Expected Outcome(s) for the Project Period: XXX

Program Strategy(ies); XXX Activity Performance Measures Person Responsible Target Date Activity Completion Date

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and awardees, site visits, and awardee 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 awardee progress in achieving the desired outcomes.

Ensuring the adequacy of awardee 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:

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

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

Working with awardees 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.

Other activities deemed necessary to monitor the award, if applicable.

These activities may include 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 grantees.

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

AGREEMENTS)

CDC will be substantially involved with some of the activities of this FOA and will be a fully collaborating partner with certain activities. CDC will:

Technical Assistance

Collaborate with the awardee to establish priorities for the program through regular meetings and communication Collaborate with the awardee to establish goals, objectives, and effective and innovative strategies and methodologies for surveillance and long term follow up of target populations Provide consultation, guidance and technical assistance especially in areas of epidemiology of immigrant and/or refugee populations Provide analytic assistance for surveillance and long term follow up programs Assist in evaluating program operations and the overall effectiveness of the project activities through joint program review and analysis Review and approve the awardee's annual work plan, detailed budget, monitoring and evaluation plan Discuss on a quarterly basis with the awardee to assess quarterly technical and financial progress reports and modify plans as necessary

Information Sharing Between Awardees

Assist the awardee in reporting and disseminating results, recommendations, and relevant information Review and approve the process used by the awardee to select key personnel and/or post award subcontractors and/or sub awardees to be involved in the activities performed under this agreement Assist in communicating and sharing practices and lessons learned. Participate in meetings, webinar and work groups as appropriate Data collected on target populations by awardee will be shared with CDC

B. Award Information

1. Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the

CDC Program Support to Awardees Section.

2. Award Mechanism: U50

Health

3. Fiscal Year: 2015

Estimated Total Funding: $5,000,000

4. Approximate Total Fiscal Year Funding: $5,000,000

5. Approximate Project Period Funding: $25,000,000

6. Total Project Period Length: 5 year(s)

7. Expected Number of Awards: 0

The expected number of awards is 3-5.

8. Approximate Average Award: $0 Per Budget Period

The approximate average award will range from $500,000 to $1,500,000.

9. Award Ceiling: None

10. Award Floor: None

11. Estimated Award Date: 08/08/2015 Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the awardee (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 project period comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

12. Budget Period Length: 12 month(s)

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

C. Eligibility Information

1. Eligible Applicants Eligibility Category: State governments

County governments City or township governments Special district governments Independent school districts Public and State controlled institutions of higher education Native American tribal governments (Federally recognized) Public housing authorities/Indian housing authorities Native American tribal organizations (other than Federally recognized tribal governments) Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education Private institutions of higher education For profit organizations other than small businesses Small businesses Others (see text field entitled "Additional Information on Eligibility" for clarification) Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled "Additional Information on Eligibility"

Government Organizations:

State (includes the District of Columbia) Local governments or their bona fide agents Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

State controlled institutions of higher education American Indian or Alaska Native tribal governments (federally recognized or state-recognized)

Non-government Organizations:

American Indian or Alaska native tribally designated organizations

Other:

Private colleges and universities Community-based organizations Faith-based organizations

2. Additional Information on Eligibility There is no award ceiling for this FOA therefore all applications with a proposed award will be reviewed.

The award ceiling for this FOA is $0. CDC will consider any application requesting an award higher than this amount as non- responsive and it will receive no further review. If a pre-application is required, then specify here and include it in the special eligibility requirements section. (http:// www.hhs.gov/ asfr/ ogapa/ aboutog/ hhsgps107.pdf)

3. Justification for Less than Maximum Competition n/a

4. Cost Sharing or Matching Cost Sharing / Matching Requirement:

No

5. Maintenance of Effort

Maintenance of effort is not required for this program.

D. Required Registrations

Additional materials that may be helpful to applicants: http://www.cdc.gov/od/pgo/funding/docs/Financial ReferenceGuide.pdf.

1. Required Registrations http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf http://www.cdc.gov/od/pgo/funding/docs/FinancialReferenceGuide.pdf http://www.cdc.gov/od/pgo/funding/docs/FinancialReferenceGuide.pdf

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-awardees, those sub-awardees 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 an awardee. 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 usually requires not more than five business days, and registration must be renewed annually. Additional information about registration procedures may be found at www.SAM.gov.

c. Grants.gov: The first step in submitting an application online is registering your organization through www.grants.gov, the official HHS E-grant website. Registration information is located at the "Get Registered" option at www.grants.gov.

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

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 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 PGO staff at 770-488-2700 or e-mail PGO PGOTIM@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 FOA, it will not be processed. PGO 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 PGO.

a. Letter of Intent Deadline (must be emailed or postmarked by) Due Date for Letter of Intent: 05/02/2015

b. Application Deadline Due Date for Applications: 06/11/2015, 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov. If http://www.grants.gov http://fedgov.dnb.com/webform/displayHomePage.do https://www.SAM.gov http://www.Grants.gov http://www.grants.gov http://www.grants.gov http://www.grants.gov http://www.grants.gov http://www.grants.gov http://foa.grantsolutions.gov/announcementmodule/PGOTIM@cdc.gov%20

Due Date for Applications: 06/11/2015, 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 Informational Conference Call: 05/01/2015

The date for the second informational call is May 1, 2015 at 2:00 - 3:00 p.m. Eastern. The call in number is 1-877-489-9253, passcode 43915780.

The date of the informational call will be April 13, 2015 at 3:00 - 4:00 p.m. Eastern. The call in number is 1-866-760-5505, passcode 7415279.

5. CDC Assurances and Certifications All applicants are required to sign and submit “Assurances and Certifications” documents indicated at http://www.cdc.gov/grants/interestedinapplying/applicationprocess.html.

Complete the applicable assurances and certifications on an annual basis, name the file “Assurances and Certifications” and upload it as a PDF file 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.

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

If you choose to submit a letter of intent (LOI), it must be received via U.S. express mail, delivery service, fax, or email to:

Stephen Benoit

CDC/NCEZID/DGMQ

1600 Clifton Road NE, MS E-03

Atlanta, GA 30333

Telephone number: 404 639 5013

Fax number: 404 639 4441

Email address: bvy8@cdc.gov

8. Table of Contents (No page limit and not included in Project Narrative 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.

9. Project Abstract Summary http://www.grants.gov http://www.cdc.gov/grants/interestedinapplying/applicationprocess.html http://www.grants.gov/ http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://www.grants.gov mailto:bvy8@cdc.gov

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 (Maximum of 20 pages, single spaced, Calibri 12 point, 1-inch margins, number all pages. Content beyond 20 pages will not be considered. The 20 page limit includes the work plan. For a multi-component FOA, maximum page limit is 25.)

The Project Narrative must include all of the bolded headings shown in this section. The Project Narrative must be succinct, self-explanatory, and in the order outlined in this section. It must address outcomes and activities to be conducted over the entire project period as identified in the CDC Project Description section. Applicants must submit a Project Narrative with the application forms. Applicants must name this file “Project Narrative” and upload it at www.grants.gov.

a. Background Applicants must provide a description of relevant background information that includes the context of the problem (See CDC Background).

b. Approach

i. Purpose Applicants must describe in 2-3 sentences specifically how their application will address the problem as described in the CDC Background section.

ii. Outcomes Applicants must clearly identify the outcomes they expect to achieve by the end of the project period.

Outcomes are the results that the program intends to achieve. All outcomes must indicate the intended direction of change (e.g., increase, decrease, maintain). (See the logic model in the Approach section of the CDC Project Description.)

iii. Strategies and Activities Applicants must provide a clear and concise description of the strategies and activities they will use to achieve the project period outcomes. Applicants must select existing evidence-based strategies that meet their needs, or describe in the Applicant Evaluation and Performance Measurement Plan, how these strategies will be evaluated over the course of the project period. (See CDC Project Description: Strategies and Activities section.)

1. Collaborations Applicants must describe how they will collaborate with programs and organizations either internal or external to CDC.

Of most interest when collaborating with other CDC funded programs is the sharing of data from surveillance networks, follow up programs, and electronic health records to conduct collaborative evaluation projects. Examples of potential collaborative partners external to the CDC include the IOM, state and local health departments, academic institutions, non-governmental organizations, VOLAGs, healthcare providers, community agencies, and others.

http://www.grants.gov

2. Target Populations Applicants must describe the specific target population(s) in their jurisdiction and explain how such a target will achieve the goals of the award and/or alleviate health disparities. Refer back to the CDC Project Description section – Approach: Target Population.

Awardees are expected to focus on refugees arriving in the United States. Projects may include auxiliary focus on immigrant populations where appropriate. Applicants should clearly identify their focus in their proposed projects.

c. Applicant Evaluation and Performance Measurement Plan Applicants must provide an overall evaluation and performance measurement plan that is consistent with the CDC Evaluation and Performance Measurement Strategy section of the CDC Project Description of this FOA. Data collected must be used for ongoing monitoring of the award to evaluate its effectiveness, and for continuous program improvement.

The plan must:

Affirm the ability to collect the performance measures and respond to the evaluation questions specified in the CDC strategy. (For guidance regarding the Paperwork Reduction Act, please visit http://www.hhs.gov/ocio/policy/collection/infocollectfaq.html) Describe how key program partners will participate in the evaluation and performance measurement planning processes.

Describe how evaluation findings will be used for continuous program quality improvement.

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

Describe the type of evaluation(s) (i.e., process, outcome, or both) to be conducted.

Describe key evaluation questions to be addressed by these evaluations.

Describe other information relevant to the evaluation (e.g., measures, data sources)

Awardees will be required to submit a more detailed evaluation and performance measurement plan within the first 6 months of the project, as outlined in the reporting section of the FOA.

d. Organizational Capacity of Applicants to Implement the Approach Applicant must address the organizational capacity requirements as described in the CDC Project Description.

11. Work Plan (Included in the Project Narrative’s 20 page limit)

Applicants must prepare a work plan consistent with the CDC Project Description Work Plan section. The work plan integrates and delineates more specifically how the awardee plans to carry out achieving the project period outcomes, strategies and activities, evaluation and performance measurement.

Applicants must name this file "Work Plan" and upload it as a PDF file at www.grants.gov.

Applicant must address the organizational capacity requirements as described in the CDC Project Description.

12. Budget Narrative Applicants must submit an itemized budget narrative, which may be scored as part of the Organizational Capacity of Awardees to Execute the Approach. When developing the budget narrative, applicants must consider whether the proposed budget is reasonable and consistent with the purpose, outcomes, and program strategy outlined in the project narrative. The budget must include:

Salaries and wages http://www.hhs.gov/ocio/policy/collection/infocollectfaq.html

Fringe benefits Consultant costs Equipment Supplies Travel Other categories Contractual costs Total Direct costs Total Indirect costs

Indirect costs will not be reimbursed under grants to foreign organizations, international organizations, and foreign components of grants to domestic organizations (does not affect indirect cost reimbursement to the domestic entity for domestic activities). The CDC will not reimburse indirect costs unless the recipient has an indirect cost rate covering the applicable activities and period.

For guidance on completing a detailed budget, see Budget Preparation Guidelines at:http://www.cdc.gov/grants/interestedinapplying/applicationresources.html .

If applicable and consistent with the cited statutory authority for this announcement, applicant entities may use funds for activities as they relate to the intent of this FOA to meet national standards or seek health department accreditation through the Public Health Accreditation Board (see: http://www.phaboard.org).

Applicant entities to whom this provision applies include state, local, territorial governments (including the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau), or their bona fide agents, political subdivisions of states (in consultation with states), federally recognized or state-recognized American Indian or Alaska Native tribal governments, and American Indian or Alaska Native tribally designated organizations. Activities include those that enable a public health organization to deliver public health services such as activities that ensure a capable and qualified workforce, up-to-date information systems, and the capability to assess and respond to public health needs. Use of these funds must focus on achieving a minimum of one national standard that supports the intent of the FOA. Proposed activities must be included in the budget narrative and must indicate which standards will be addressed.

Applicants must name this file “Budget Narrative” and upload it as a PDF file at www.grants.gov. If requesting indirect costs in the budget, a copy of the indirect cost-rate agreement is required. If the indirect costs are requested, include a copy of the current negotiated federal indirect cost rate agreement or a cost allocation plan approval letter for those Grantees under such a plan. Applicants must name this file “Indirect Cost Rate” and upload it at www.grants.gov.

13. Tobacco and Nutrition Policies Awardees are encouraged to implement tobacco and nutrition policies.

Unless otherwise explicitly permitted under the terms of a specific CDC award, no funds associated with this FOA may be used to implement the optional policies, and no applicants will be evaluated or scored on whether they choose to implement these optional policies.

CDC supports implementing evidence-based programs and policies to reduce tobacco use and secondhand smoke exposure, and to promote healthy nutrition. CDC encourages all awardees to implement the following optional recommended evidence-based tobacco and nutrition policies within their own organizations. The tobacco policies build upon the current federal commitment to reduce exposure to secondhand smoke, http://www.cdc.gov/grants/interestedinapplying/applicationresources.html http://www.phaboard.org specifically The Pro-Children Act, 20 U.S.C. 7181-7184, that prohibits smoking in certain facilities that receive federal funds in which education, library, day care, health care,or early childhood development services are provided to children.

Tobacco Policies:

Tobacco-free indoors: Use of any tobacco products (including smokeless tobacco) or electronic cigarettes is not allowed in any indoor facilities under the control of the awardee.

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Tobacco-free indoors and in adjacent outdoor areas: Use of any tobacco products or electronic cigarettes is not allowed in any indoor facilities, within 50 feet of doorways and air intake ducts, and in courtyards under the control of the awardee.

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Tobacco-free campus: Use of any tobacco products or electronic cigarettes is not allowed in any indoor facilities or anywhere on grounds or in outdoor space under the control of the awardee.

3.

Nutrition Policies:

Healthy food-service guidelines must, at a minimum, align with HHS and General Services Administration Health and Sustainability Guidelines for Federal Concessions and Vending Operations.

These guidelines apply to cafeterias, snack bars, and vending machines in any facility under the control of the awardee and in accordance with contractual obligations for these services (see: http://www.gsa.gov/ graphics/pbs/Guidelines_for_ Federal_ Concessions_and_Vending _ Operations.pdf).

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Resources that provide guidance for healthy eating and tobacco-free workplaces are:2.

http://www.cdc.gov/ nccdphp/dnpao/hwi/ toolkits/ tobacco/index.htm http://www. thecommunityguide.org/ tobacco/index.html http:// www.cdc.gov /obesity /strategies /food-serv-guide.html

14. Health Insurance Marketplaces A healthier country is one in which Americans are able to access the care they need to prevent the onset of disease and manage disease when it is present. The Affordable Care Act, the health care law of 2010, creates new Health Insurance Marketplaces, also known as Exchanges, to offer millions of Americans affordable health insurance coverage. In addition, the law helps make prevention affordable and accessible for Americans by requiring health plans to cover certain recommended preventive services without cost sharing.

Outreach efforts will help families and communities understand these new options and provide eligible individuals the assistance they need to secure and retain coverage as smoothly as possible. For more information on the Marketplaces and the health care law, visit: www.HealthCare.gov.

15. Intergovernmental Review

The application is subject to Intergovernmental Review of Federal Programs, as governed by Executive Order 12372, which established a system for state and local intergovernmental review of proposed federal assistance applications. Applicants should inform their state single point of contact (SPOC) as early as possible that they are applying prospectively for federal assistance and request instructions on the state's process. The current SPOC list is available at: http://www.whitehouse.gov/omb/grants_spoc/.

16. Pilot Program for Enhancement of Employee Whistleblower Protections Pilot Program for Enhancement of Employee Whistleblower Protections: All applicants will be subject to a term and condition that applies the terms of 48 CFR section 3.908 to the award and requires that grantees inform their employees in writing (in the predominant native language of the workforce) of employee whistleblower rights and protections under 41 U.S.C. 4712.

17. Funding Restrictions http://www.gsa.gov/graphics/pbs/Guidelines_for_Federal_Concessions_and_Vending_Operations.pdf http://www.gsa.gov/graphics/pbs/Guidelines_for_Federal_Concessions_and_Vending_Operations.pdf http://www.cdc.gov/nccdphp/dnpao/hwi/toolkits/tobacco/index.htm http://www.thecommunityguide.org/tobacco/index.html http://www.cdc.gov/obesity/strategies/food-serv-guide.html http://www.HealthCare.gov http://www.whitehouse.gov/omb/grants_spoc/

17. Funding Restrictions Restrictions that must be considered while planning the programs and writing the budget are:

Awardees may not use funds for research.

Awardees may not use funds for clinical care.

Awardees may use funds only for reasonable program purposes, including personnel, travel, supplies, and services.

Generally, awardees may not use funds to purchase furniture or equipment. Any such proposed spending must be clearly identified in the budget.

Reimbursement of pre-award costs is not allowed.

Other than for normal and recognized executive-legislative relationships, no funds may be used for:

publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before any legislative body

See http:// www.cdc.gov /grants…