CDC-RFA-DP19-1904.pdf

Centers for Disease Control

National Center for Chronic Disease Prevention and Health Promotion

Technical Assistance to Increase Tobacco Cessation

CDC-RFA-DP19-1904

Application Due Date: 05/13/2019

Technical Assistance to Increase Tobacco Cessation

CDC-RFA-DP19-1904

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Assistance Listings (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-DP19-1904. 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:

Technical Assistance to Increase Tobacco Cessation 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)).

New -Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP19-1904

E. Assistance Listings (CFDA) Number:

93.348 F. Dates:

1. Due Date for Letter of Intent (LOI): 04/11/2019

2. Due Date for Applications: 05/13/2019, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

A LOI is requested, but not required.

3. Date for Informational Conference Call:

April 25th at 1:00 pm EST Conference line (855) 644-0229 English (United States) Conference ID: 9227827

G. Executive Summary:

1. Summary Paragraph:

The Centers for Disease Control and Prevention's Office on Smoking and Health (OSH) is the lead federal entity for comprehensive tobacco prevention and control. OSH seeks applicants to provide technical assistance to state tobacco control programs and national partners to help translate the science of tobacco cessation into public health action. The expected outcomes include increased knowledge and adoption of strategies that improve and sustain the capacity of health systems and quitlines to deliver cessation services and support cessation interventions.

Strategies and activities include:

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

Develop mechanisms to facilitate information sharing on best and promising practices, experiences, and lessons learned.

Document and disseminate best and promising practices, experiences, and lessons learned

Provide technical assistance to states on health systems change initiatives to integrate treatment of tobacco use and dependence into routine clinical care.

Provide technical assistance on evaluating health systems change initiatives.

Provide technical assistance to states on quitline operations, including identifying and disseminating best and promising practices for maximizing the reach and impact of quitlines and strategies for sustaining quitline services.

Provide technical assistance on evaluating the impact of strategies related to providing cessation services through health systems and quitlines (e.g., tobacco control and healthcare policies, CMS Medicaid rules and quitline match)

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 2

d. Total Period of Performance Funding: $2,250,000

e. Average One Year Award Amount: $225,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 09/30/2019

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview Tobacco use is the leading cause of preventable disease, disability, and death in the U.S., and smoking places a significant financial burden on society. Each year in the U.S., smoking-related illness costs more than $300 billion, including nearly $170 billion in direct medical costs and more than $156 billion in lost productivity. About 34 million U.S. adults are current cigarette smokers, and disparities in smoking persist, including among persons who are from certain racial and ethnic groups, have low socioeconomic status, live with behavioral health conditions, live with a disability or limitation, who are lesbian, gay, or bisexual persons, and who have no health insurance or are enrolled in Medicaid.

Encouraging and helping tobacco users to quit can reduce tobacco-related disease, death, and related health care costs. About 70 percent of adult cigarette smokers want to quit, and more than half of adult smokers try to quit each year. However, fewer than one-third of smokers use evidence-based treatments when trying to quit. These treatments, including individual, group, and telephone cessation counseling and seven Food and Drug Administration (FDA)-approved cessation medications, can substantially increase the odds that smokers will quit successfully.

Therefore, increasing access to and use of these treatments would increase quit rates among cigarette smokers.

This project aims to provide technical assistance to state tobacco control programs and national and state partners on evidence-based cessation interventions aimed at increasing the number of adult smokers who attempt to quit and who succeed in quitting. Recipients will provide support for the following cessation goals described in CDC's Best Practices for Comprehensive Tobacco Control Programs - 2014:

1) Implement health systems change initiatives that seek to integrate treatment of tobacco use and dependence into routine clinical care, including treatment for mental health and substance use disorders; and

2) Improve state quitlines' capacity, infrastructure, operations, and services to further enhance their effectiveness, efficiency, and impact, increase state quitlines' reach, especially among populations experiencing tobacco-related disparities, broaden the range of cessation services offered by state quitlines, and enhance quitline sustainability.

Health care providers play an important role in helping smokers quit. Proven clinical cessation approaches exist, including the 5 A's (Ask about tobacco use, Advise to quit, Assess willingness to make a quit attempt, Assist in quit attempt, Arrange follow-up) and a condensed approach that encourages providers to Ask, Advise, and Refer smokers to a cessation resource (such as a quitline) for more intensive assistance. Health system approaches can optimize work flows and leverage electronic health records to integrate these approaches into routine clinical care.

Quitlines that offer free counseling services provided by trained coaches have been shown to be effective in helping smokers quit, both generally and among subpopulations. Quitlines are widely accessible, convenient to use, and confidential. Publicly funded state quitlines operate in every state, the District of Columbia, Guam, and Puerto Rico. In addition, emerging technologies (including web, text messaging, chat, and apps) have the potential to expand the reach and use of cessation services, especially among young adults who may be accustomed to using these technologies and may prefer receiving cessation assistance through these modalities.

b. Statutory Authorities Section 301(a) of the PHS Act, 42 U.S.C. Section 241(a).

c. Healthy People 2020 This funding supports progress towards achieving the following Healthy People 2020 objectives:

TU-1 Reduce tobacco use by adults TU-4 Increase smoking cessation attempts by adult smokers TU-5 Increase recent smoking cessation success by adult smokers

TU-6 Increase smoking cessation during pregnancy TU-8 Increase comprehensive Medicaid insurance coverage of evidence-based treatment for nicotine dependency in States and the District of Columbia TU-9 Increase tobacco screening in health care settings TU-10 Increase tobacco cessation counseling in health care settings https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use/objectives

d. Other National Public Health Priorities and Strategies

The Government Performance Results Modernization Act Long-term Obj. 4.6: Reduce Death and Disability Due to Tobacco and 4.6.3: Reduce the proportion of adults who are current cigarette smokers.

Department of Health & Human Services Strategic Plan (Obj. 2.1: Empower people to make informed choices for healthier living) https://www.hhs.gov/about/strategic-plan /overview/index.html#strategic-plan

Ending the Tobacco Epidemic: A Tobacco Control Strategic Action Plan for the Department of Health and Human Services: http://www.hhs.gov/ash/initiatives/tobacco

e. Relevant Work This project aligns with two of the goals for state tobacco control programs' cessation activities described in CDC's Best Practices for Comprehensive Tobacco Control Programs - 2014: 1) Promoting health systems change to integrate evidence-based tobacco dependence treatment into routine clinical care; and 2) Supporting state quitline capacity. Additionally, this funding opportunity will build on the successes of the 2013 funding opportunity, DP 13-1316 Consortium for Tobacco Use Cessation Technical Assistance https://www.grants.gov/web/grants/search-grant s.html

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

ACTIVITIES

SHORT-TERM

OUTCOMES

INTERMEDIATE

OUTCOMES

LONG-TERM

OUTCOMES

Both Components:

Develop mechanisms to facilitate information

Component 1:

Provide technical assistance to state tobacco control

Increased knowledge /understanding of strategies to improve health systems' identification of

Increased adoption of health systems change strategies to promote and support cessation

Increased delivery of cessation treatment by health care providers and practices

Increased utilization of evidence-based cessation services https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use/objectives https://www.hhs.gov/about/strategic-plan/overview/index.html#strategic-plan https://www.hhs.gov/about/strategic-plan/overview/index.html#strategic-plan http://www.hhs.gov/ash/initiatives/tobacco%20 https://www.grants.gov/web/grants/search-grants.html https://www.grants.gov/web/grants/search-grants.html programs on health systems change initiatives to integrate treatment of tobacco use and dependence into routine clinical care.

Provide technical assistance on evaluating health systems change initiatives and the impact of policies that relate to the provision of cessation services through health systems tobacco users, delivery of cessation services, and support of cessation interventions sharing on best and promising practices, experiences, and lessons learned.

Document and disseminate best and promising practices, experiences, and lessons learned.

Assess knowledge, skills, and abilities of technical assistance recipients

Use assessment to plan, develop, and deliver appropriate training

Develop and implement project evaluation and performance plan.

Component 2:

technical assistance to state tobacco control programs on state quitline operations, including identifying

Increased knowledge/ understanding of strategies to increase state quitlines' capacity, reach, impact, and sustainability.

Increased adoption of strategies to improve and sustain quitline services

Increased capacity, reach, utilization, impact, and sustainability of state quitlines.

Increased quit attempts

Distal Outcomes Increased cessation of tobacco as early in life as possible Decreased tobacco use prevalence and consumption Decreased disparities in tobacco cessation and tobacco use

Bolded outcomes have associated and disseminating best practices for maximizing the reach and impact of state quitlines and strategies for sustaining quitline services over time.

technical assistance on evaluating the impact of quitline initiatives and policies that relate to the provision of cessation services through quitlines performance measures

i. Purpose CDC's Office on Smoking and Health seeks to continue to provide technical assistance and training to CDC, state tobacco control programs and national and state partners on: (1) promoting health systems change; and (2) supporting state quitline capacity. Developing, implementing, and sustaining effective population-based cessation strategies can lead to an increase in the number of adult smokers in the United States who try to quit and who succeed in quitting.

ii. Outcomes In the Notice of Funding Opportunity (NOFO), data sources for each outcome will be finalized and numerator/denominators will be clearly defined. Outcomes reported to Congress will include changes in the delivery of cessation services, cessation behaviors, cessation outcomes, and cigarette smoking prevalence. Recipients are expected to achieve all bolded outcomes indicated during the period of performance:

Short-term outcomes:

Component 1:

Increased knowledge/understanding of strategies to improve health systems' identification of tobacco users, delivery of cessation services, and support of cessation interventions.

Component 2:

Increased knowledge/understanding of strategies to increase state quitlines', capacity, reach, impact, and sustainability.

Intermediate outcomes:

Component 1:

Increased adoption of health systems change strategies to promote and support cessation.

Component 2:

Increased adoption of strategies to improve and sustain quitline services.

iii. Strategies and Activities Both components:

Develop mechanisms to facilitate information sharing on best and promising practices, experiences, and lessons learned.

Document and disseminate best and promising practices, experiences, and lessons learned.

Assess knowledge, skills and abilities of technical assistance recipients.

Use assessment to plan, develop,and deliver appropriate trainings.

Develop and implement project evaluation and performance plan.

Component 1. Promote health systems change

Provide technical assistance to states on health systems change initiatives to integrate tobacco dependence treatment into routine clinical care.

Provide technical assistance on evaluating health systems change initiatives and the impact of policies that relate to the provision of cessation services through health systems.

Specifically:

Provide technical assistance to states on how to work with health care delivery systems to integrate routine screening for tobacco use and treatment of tobacco use and dependence into the clinical workflow, including facilitating peer-to-peer learning.

Provide technical assistance to states on health systems changes, including how electronic health records can be used to enhance tobacco use screening and intervention in health care settings.

Provide technical assistance on evaluating the impact of health systems changes on cessation outcomes.

Develop health system and provider tools to maximize impact of electronic health records on providers' broader cessation interventions.

Develop case studies of successful health systems and provider experiences with implementing systems changes (including, but not limited to, workflow redesign, integration of robust cessation components into electronic health records, etc.).

Develop resources and tools to help states leverage data for surveillance/evaluation, including resources and tools related to the return on investment of health system cessation interventions.

Develop guidance documents, case studies, and tools to support health systems in establishing systems to refer patients to quitlines and other cessation treatment resources, including through the use of e-referrals.

Develop and/or disseminate resources evaluating the impact of policies that relate to the provision of cessation services through health systems (e.g., tobacco control and healthcare policies, CMS Medicaid rules).

Component 2. Enhance state quitline capacity and sustainability

Provide technical assistance to state tobacco control programs on quitline operations, including identifying and disseminating best practices for maximizing the reach and impact of state quitlines and strategies for sustaining quitline services over time.

Provide technical assistance on evaluating the impact of quitline initiatives and strategies that relate to the provision of cessation services through quitlines.

Specifically:

Provide technical assistance to states on quitline operations, including: identifying and disseminating best practices for maximizing the reach and impact of state quitlines and strategies to ensure sustainability of state quitlines (including public-private partnerships and the CMS Medicaid quitline match); program evaluation; and survey questionnaire development and implementation. Technical assistance should include planning for future developments in service delivery models including: various technology (web, text messaging, chat, apps, social media); stand-alone nicotine replacement therapy; and re-engaging past quitline callers in cessation activities by re-contacting them.

Establish mechanisms to facilitate information sharing on best practices, accomplishments, and lessons learned regarding quitline operations for state tobacco control programs and national and state partners by conducting conference calls, workgroup meetings, discussion groups, trainings, webinars, and other activities that facilitate peer-to-peer learning, and by developing web-based resources, guidance documents, case studies, scientific publications, tools, and other products that will enhance the reach, capacity, and impact of state quitlines.

Create and disseminate best practices, accomplishments, and lessons learned on state quitlines through publications in peer-reviewed journals and presentations at national and regional meetings and conferences.

Develop guidance documents, case studies, and tools to support state quitlines in developing technical capacity to receive e-referrals and to transmit follow-up reports to health care providers on patients' use of quitline services and progress in quitting.

Develop and/or disseminate resources evaluating the impact of policies that relate to the provision of cessation services through quitlines (e.g., tobacco control and healthcare policies, CMS Medicaid rules and Medicaid quitline match).

For background information, see: https://www.cdc.gov/tobacco/quit_smoking/cessation/index .htm

1. Collaborations

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

Recipients will be required to collaborate, as appropriate, with CDC programs outside of OSH that are implementing health system change and quitline strategies related to tobacco, as well as other national organizations that are providing technical assistance to states and national partners.

MOUs or MOAs are not required.

b. With organizations not funded by CDC:

Recipients will be required to collaborate with organizations that have a role in conducting the proposed activities and achieving the NOFO outcomes. In particular, recipients will be required to work closely with certain national tobacco control organizations, including nongovernmental organizations as well as governmental agencies, in order to coordinate with these organizations in providing joint technical assistance to states and national partners on cessation topics. MOUs or MOAs are not required.

2. Target Populations

NA

a. Health Disparities Although significant declines in cigarette smoking have occurred among adults overall over the past several decades, disparities in tobacco use persist among certain groups, including certain racial and ethnic groups, persons with low socioeconomic status, persons living with behavioral health conditions, persons with a disability or limitation, lesbian, gay, and bisexual persons, and persons without health insurance or with Medicaid coverage. Technical assistance should address strategies for increasing such populations' access to and use of proven cessation treatments and services through health systems and state quitlines.

https://www.cdc.gov/tobacco/quit_smoking/cessation/index.htm https://www.cdc.gov/tobacco/quit_smoking/cessation/index.htm

iv. Funding Strategy This announcement will fund two distinct entities. Applicants may apply for either Component 1 or Component 2, but may not apply for both.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Over the course of this cooperative agreement, CDC will use performance measures to assess recipients' progress in contributing to the implementation of proven health systems change strategies to integrate tobacco dependence treatment into routine clinical care (component 1), as well as to increase the capacity, reach, impact, and sustainability of state quitline services (component 2).

Performance measures associated with this cooperative agreement will measure the extent to which the recipients achieve the following:

Associated Activities or Outcomes Performance Measures Component 1 (Activities)

Provide technical assistance to state tobacco control programs on health systems change initiatives to integrate treatment of tobacco use and dependence into routine clinical care.

Provide technical assistance on evaluating health systems change initiatives and the impact of policies that relate to the provision of cessation services through health systems

Increase in the number of innovative products related to health care delivery systems a) developed and/or b) delivered to technical assistance recipients.

Component 1 (Short-term Outcome)

Increased knowledge of strategies to improve health systems' identification of tobacco users, delivery of cessation services, and support of cessation interventions.

Increase in change documented by before and after knowledge checks among nationally representative recipients receiving technical assistance and training.

Component 1 (Intermediate Outcome)

Increased adoption of health care

Examples of recipients of technical assistance and training modifying their practices related to cessation interventions and health care delivery systems to adopt proven strategies and to take systems change strategies to promote and support cessation.

advantage of emerging opportunities (policies, regulations, quality measures, technology, etc.)

after receiving technical assistance and training.

Component 2 (Activities)

Provide technical assistance to state tobacco control programs on state quitline operations, including identifying and disseminating best practices for maximizing reach and impact of state quitlines and strategies for sustaining quitline services over time.

Provide technical assistance on evaluating the impact of quitline initiatives and policies that related to the provision of cessation services through quitlines.

Increase the number of innovative products related to quitlines a) developed and/or b) delivered to technical assistance recipients.

Component 2 (Short-term Outcome)

Increased knowledge of strategies to improve and sustain quitline services.

Increase in change documented by before and after knowledge checks among nationally representative recipients receiving technical assistance and training.

Component 2 (Intermediate-Outcome)

Increased adoption of strategies to improve and sustain quitline services.

Examples of recipients of technical assistance and training modifying their practices related to quitlines to adopt proven strategies and to leverage emerging opportunities (policies, regulations, quality measures, technology, etc.)

after receiving technical assistance and training.

Evaluation Evaluation should identify baseline metrics and measures that will be used to assess the extent to which the provision of technical assistance and training to states and national partners enhanced and facilitated:

1. Understanding and implementation of evidence-based cessation interventions related to health systems and quitlines.

2. Understanding of cessation as a key component of a comprehensive state tobacco control program and how related strategies fit within the program's broader framework.

3. Understanding of cessation opportunities created by federal initiatives (e.g., quality measures, the CDC Tips From Former Smokers® (Tips®) national tobacco education media campaign, behavioral health initiatives, Medicaid initiatives, CDC's 6|18 initiative), and increased state efforts to take advantage of these opportunities).

4. Approaches to sustaining health systems cessation strategies and state quitline efforts over time, including through fostering health system changes that permanently integrate treatment of tobacco use and dependence into routine clinical care, developing public-private partnerships with health insurers, health systems, and employers, putting in place quitline referral systems, and leveraging emerging technologies to deliver cessation services through alternative modalities.

5. Any additional evaluation questions identified by the recipient.

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, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

The recipient will be expected to develop and implement a comprehensive written evaluation plan that includes, but is not limited to, the performance measures as described above. For example, additional evaluations questions related to improving the quality, delivery, and reach of training and technical assistance may be considered. This recipient should consider utilizing CDC's Developing A Successful Evaluation Plan https://www.cdc.gov/grants/additionalrequirements/ar-25.html https://www.cdc.gov/tobacco/stateandcommunity/tobacco_control_programs/surveillance_ev aluation/evaluation_plan/pdfs/developing_eval_plan.pdf

Comprehensive evaluation plans should:

Identify key evaluation stakeholders and describe the stakeholder engagement strategy.

Describe evaluation stakeholders' potential role in evaluation planning and implementation.

Describe how evaluation stakeholders will utilize evaluation findings.

Include a logic model to illustrate program design.

Describe specific, measurable, and realistic short-term (one-year), intermediate, and long-term program objectives consistent with the purpose of this funding announcement for the accomplishment of program activities.

Address how the applicant intends to assess the extent to which program strategies and component activities are implemented appropriately, as well as the extent to which these activities yield the intended outcomes.

Describe indicators for process and outcome measures, and address data collection sources and methods.

Describe how findings will be disseminated to CDC, state tobacco control programs, partners, and other key stakeholders in order to support the use of evidence-based and practice-based strategies/interventions.

Describe how evaluation findings will be used to inform and improve project implementation efforts.

c. Organizational Capacity of Recipients to Implement the Approach Applicants must demonstrate organizational capacity that includes:

1. Adequate infrastructure and capacity to implement the project and achieve the project outcomes, including the ability to provide technical assistance on tobacco cessation issues to state tobacco control programs and national tobacco control organizations on a nationwide basis.

2. Existing relationships with state tobacco control programs and/or national tobacco control organizations.

3. Expertise as demonstrated by an established track record of providing technical assistance and trainings related to tobacco cessation and health systems (Component 1) and/or quitlines (Component 2) to CDC-funded programs.

Additionally, applicants must demonstrate the following related to project management/staffing plans:

1. Appropriate staff member experience.

2. Clearly defined roles for staff members.

3. Sufficient staff member capacity to accomplish program goals.

d. Work Plan Applicants should provide a detailed work plan for the first year of the project and a high-level work plan for subsequent years.

https://www.cdc.gov/tobacco/stateandcommunity/tobacco_control_programs/surveillance_evaluation/evaluation_plan/pdfs/developing_eval_plan.pdf https://www.cdc.gov/tobacco/stateandcommunity/tobacco_control_programs/surveillance_evaluation/evaluation_plan/pdfs/developing_eval_plan.pdf

The work plan must, at a minimum, include period of performance outcomes per those bolded in the logic model (based on component). Activities must be in alignment with the proposed outcomes and program strategies and must include those activities the applicant selects as priority, based on the cited evidence, for the first year of the project.

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

The following workplan table should 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 Objective:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities

Measure

Responsible Position / Party

Completion Date

1.

2.

3.

4.

5.

6.

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.

Recipients will collaborate with CDC in proactively identifying and addressing the needs of these partners, and in responding to their requests (within the limits of the funded program strategies and related activities). In particular, recipients will be required to work closely with state tobacco control programs in order to understand and effectively address their technical assistance needs.

CDC will use monthly calls and annual reporting on performance measures and evaluation data to track recipient progress toward adoption of strategies to increase adoption of health systems change strategies to promote and support cessation and to improve and sustain quitline services.

CDC will use this information and national surveillance systems and the internal Management Information System to measure progress toward outcomes associated with this award, particularly long-term outcomes, and to provide feedback to recipients as available to determine the overall NOFO performance.

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

COOPERATIVE AGREEMENTS)

In this cooperative agreement, CDC staff will be substantially involved in program activities, above and beyond routine grant management.

To assist recipients in achieving the purpose of this NOFO, CDC will conduct the following activities:

Provide ongoing guidance, technical assistance, training, and support related to partnership development and project monitoring and evaluation.

Provide to recipients periodic updates regarding comprehensive tobacco control.

Develop and maintain partnerships with other Federal agencies, including collaboration with the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration (FDA), and the Substance Abuse and Mental Health Services Administration (SAMHSA), and provide recipients with information on relevant CMS, FDA, and SAMHSA regulations and initiatives.

Facilitate communication between recipients and other national partners, including other Federal agencies.

Provide expert resources to assist in the design, collection, analysis, and use of evaluation data to assess, inform, and improve this project as well as state and national cessation efforts.

Provide appropriate performance measures along with guidance on formats and timelines for submission of required information.

Serve as a convener and resource for continued expansion of the science base for tobacco cessation and effective cessation approaches.

Collaborate with recipients in the development of training and technical assistance efforts and resources.

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: U58

3. Fiscal Year: 2019

4. Approximate Total Fiscal Year Funding: $450,000

5. Approximate Period of Performance Funding: $2,250,000

This amount is subject to the availability of funds.

Estimated Total Funding: $2,250,000

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

7. Expected Number of Awards: 2

8. Approximate Average Award: $225,000 Per Budget Period

9. Award Ceiling: $225,000 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor: $225,000 Per Budget Period

11. Estimated Award Date: 09/30/2019

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 NOFO.

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"

Additional Eligibility Category:

2. Additional Information on Eligibility

NA

3. Justification for Less than Maximum Competition

4. Cost Sharing or Matching Cost Sharing / Matching Requirement: No

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.

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 "Applicant Registration" 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.

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

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 create new password

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

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

MUST

obtain a

DUNS

number and

SAM

account before applying on grants.gov)

Register early!

Log into grants.gov and check AOR status until it shows you have been approved

2. Request Application Package 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

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: 04/11/2019

b. Application Deadline Due Date for Applications: 05/13/2019 , 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.

A LOI is requested, but not required.

Date for Information Conference Call April 25th at 1:00 pm EST Conference line (855) 644-0229 English (United States) Conference ID: 9227827

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, 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/ 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 http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx

(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.

Risk Assessment Questionnaire Requirement CDC is required to conduct pre-award risk assessments to determine the risk an applicant poses to meeting federal programmatic and administrative requirements by taking into account issues such as financial instability, insufficient management systems, non-compliance with award conditions, the charging of unallowable costs, and inexperience. The risk assessment will include an evaluation of the applicant’s CDC Risk Questionnaire, located at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, as well as a review of the applicant’s history in all available systems; including OMB-designated repositories of government-wide eligibility and financial integrity systems (see 45 CFR 75.205(a)), and other sources of historical information. These systems include, but are not limited to: FAPIIS (https://www.fapiis.gov/), including past performance on federal contracts as per Duncan Hunter National Defense Authorization Act of 2009; Do Not Pay list; and System for Award Management (SAM) exclusions.

CDC requires all applicants to complete the Risk Questionnaire, OMB Control Number 0920- 1132 annually. This questionnaire, which is located at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, along with supporting documentation must be submitted with your application by the closing date of the Notice of Funding Opportunity Announcement. If your organization has completed CDC’s Risk Questionnaire within the past 12 months of the closing date of this NOFO, then you must submit a copy of that questionnaire, or submit a letter signed by the authorized organization representative to include the original submission date, organization’s EIN and DUNS.

When uploading supporting documentation for the Risk Questionnaire into this application package, clearly label the documents for easy identification of the type of documentation. For example, a copy of Procurement policy submitted in response to the questionnaire may be labeled using the following format: Risk Questionnaire Supporting Documents _ Procurement Policy.

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, http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf 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 The purpose of a LOI is to allow CDC program staff to estimate the number of and plan for the review of submitted applications. A LOI is requested, but not required.

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

Anna Schecter, MPH

CDC, NCCDPHP

Address: 4770 Buford Hwy, NE S107-7 Telephone number: 770-488-2499 Fax: 770-488-5848 Email address: zho7@cdc.gov

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…