CDC-RFA-DP20-2003.pdf

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

The National Healthy Brain Initiative

CDC-RFA-DP20-2003

Application Due Date: 01/08/2020

The National Healthy Brain Initiative

CDC-RFA-DP20-2003

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. Required Registrations 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 "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA- DP20-2003. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

The National Healthy Brain Initiative 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-DP20-2003

E. Assistance Listings (CFDA) Number:

93.334 F. Dates:

1. Due Date for Letter of Intent (LOI): 11/12/2019 Is a LOI: Recommended but not Required

2. Due Date for Applications: 01/08/2020, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: 10/29/2019 A 60-minute informational call will be held on October 29, 2019 at 1pm EST. Phone: 1-888- 455-9650, Passcode: 3425266. Following the call, Q&As will be posted at www.cdc.gov/aging /funding/hbi/index.html

In addition, an email address has been established to receive and respond to NOFO questions:

HBI_NOFO@cdc.gov

G. Executive Summary:

1. Summary Paragraph:

This NOFO is being competed to fund (Component A) an organization with national scope and reach within states to assist in the implementation and evaluation of the Healthy Brain Initiative's (HBI) State and Local Public Health Partnerships to Address Dementia, The 2018- 2023 Road Map, the 3rd in a series, and its companion, The Road Map for Indian Country.

Planned activities include creating informational resources and materials for the public, engaging state and local partners to adopt Road Map action items, developing training materials 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 https://wwwdev.cdc.gov/aging/funding/hbi/index.html https://wwwdev.cdc.gov/aging/funding/hbi/index.html https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf https://www.cdc.gov/aging/healthybrain/pdf/HBI-Road-Map-for-Indian-Country-508.pdf for current and future professionals about Alzheimer's disease and related dementias (ADRD), and disseminating effective messages related to brain health. Furthermore, it is expected that the Component A organization will develop the 4th State and Local Public Health Road Map plus several focused road maps in areas such as Indian Country, language-specific, etc., to be determined with input from CDC. In addition, CDC will fund (Component B) one or more organizations that support populations with a high burden of ADRD to develop products to communicate relevant messages to these populations and assist in the implementation of the Component A activities. NOFO activities are expected to promote brain health, address cognitive impairment including ADRD, and support the needs of caregivers (unpaid persons providing care or assistance to someone with ADRD). NOFO applicants may only apply for Component A or Component B.

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 6 Component A: One award Component B: Up to five awards

d. Total Period of Performance Funding: $12,500,000

e. Average One Year Award Amount: $2,500,000 Component A: $1,500,000 (one award) Component B: $200,000 (up to five awards)

f. Number of Years of Award: 5

g. Estimated Award Date: 08/03/2020

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview Alzheimer's disease and related dementias (ADRD) are a collection of fatal, progressive diseases that result in the incapacitation of the person with the disease, necessitating assistance in activities of daily living and ultimately around-the-clock care. Currently, an estimated 5.6 million Americans over age 65 have been diagnosed with ADRD; that is expected to rise to 8.4 million by 2030 [1]. In addition, the burden of ADRD is expected to disproportionately affect certain groups. For example, African Americans, American Indian/Alaska Natives, Hispanics, and persons with intellectual or developmental disabilities are more likely to have ADRD than non-Hispanic whites, and women are more likely to develop ADRD than men [1,2]. Outcomes of this NOFO will improve the quality of life and decrease disparities for those with ADRD and raise awareness of cognitive impairment as a public health issue.

The purpose of this NOFO is to identify one Component A organization to collaborate in the implementation, dissemination, and evaluation of the Healthy Brain Initiative's State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map and The Road Map for Indian Country and the development of the next in the series of Road Maps.

Additionally, this organization should develop and disseminate other evidence-based products that support Road Map actions and evolve with advances in the field of cognitive impairment.

These activities will help promote brain health, address cognitive impairment including ADRD, and support the needs of caregivers (unpaid persons providing care or assistance to someone with ADRD).

Furthermore, the purpose of this NOFO is to identify Component B organizations to develop products that will effectively communicate relevant messages within those populations with a high burden of ADRD. This includes integrating brain health messages about the importance of managing chronic conditions and maintaining heart health to reduce risk for later cognitive impairment [3-5].

This NOFO builds upon past work outlined in CDC NOFOs DP10-1003 and DP15-1505.

Previous awards helped establish the public health framework to address ADRD through the previous Road Maps (2007-2023) by identifying appropriate action items for public health professionals and capitalizing on surveillance data relevant to state and local health agencies.

Previous awards have also helped identify gaps in effective messaging for specific populations disproportionately affected by ADRD.

References:

1. Alzheimer's Association. 2019 Alzheimer's disease facts and figures. Alzheimers Dement. 2019;15(3);321?387.

2. Matthews KA, Xu W, Gaglioti AH, et al. Racial and ethnic estimates of Alzheimer's disease and related dementias in the United States (2015-2060) in adults aged ?65 years.

Alzheimers Dement. 2019;15(1):17-24. doi: 10.1016/j.jalz.2018.06.3063.

3. The SPRINT MIND Investigators for the SPRINT Research Group. Effect of intensive vs standard blood pressure control on probable dementia: A randomized clinical trial.

JAMA. 2019;321(6):553-561. doi: 10.1001/jama.2018.21442

4. Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement 2015;11:718-26. doi: 10.1016/j.jalz.2015.05.016.

5. Institute of Medicine. Cognitive aging: progress in understanding and opportunities for action. Washington, DC: The National Academies Press; 2015.

https://www.nap.edu/catalog/21693/cognitive-aging-progress-in-understanding-and-opportunities-for-action

b. Statutory Authorities 301(a) Public Health Service (PHS) Act, 42 U.S.C. 241(a).

c. Healthy People 2030 Dementias, including Alzheimer's (DIA) Topic Area Objectives:

DIA-1: Increase the proportion of adults aged 65 years and older with diagnosed Alzheimer's https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf disease and other dementias, or their caregiver, who are aware of the diagnosis DIA-2: Reduce the proportion of preventable hospitalizations in adults aged 65 years and older with diagnosed Alzheimer's disease and other dementias DIA-3: (NEW - to be released at the start of 2020 for HP2030) Increase the proportion of adults aged 45 years and older with Subjective Cognitive Decline (SCD) who have discussed their confusion or memory loss with a health care professional Older Adult (OA) Topic Area Objectives:

OA-1, OA-5, OA-6, and OA-9.

d. Other National Public Health Priorities and Strategies National Alzheimer's Project Act (Public Law 111-375); BOLD Infrastructure for Alzheimer's Act (Public Law No. 115-406).

e. Relevant Work This NOFO builds upon past work outlined in CDC NOFOs DP10-1003 and DP15-1505, which included promotion of the Behavioral Risk Factor Surveillance System (BRFSS) Cognitive Decline and Caregiver modules for inclusion on states' BRFSS, development of HBI Road Maps for years 2007-2023, and dementia curricula for public health students. Additionally, the CDC's Alzheimer's Disease and Healthy Aging Program supported related projects through the CDC Prevention Research Center Special Interest Project, RFA-DP-14-011 (Healthy Brain Research Network), in 2014 and OT18-1802 Strengthening Public Health Systems and Services through National Partnerships, in 2018 and 2019.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

The National Healthy Brain Initiative logic model was developed to outline the activities and expected outcomes of this effort. This logic model depicts the strategies/activities, short-term/intermediate outcomes, and long-term outcomes in order to illustrate how this NOFO strives to achieve its overarching goals.

Applicant Type Strategies and Activities Short-term and Intermediate Outcomes

Long-Term Outcomes

Component A Organization

Assist with the adoption and revision of the BRFSS cognitive decline and caregiver modules Support implementation and conduct evaluation of Road Map for Indian Country and 3rd State and Local Public Health

Increase/maintain number of states adopting BRFSS cognitive decline and caregiver modules Increase number of Road Map actions implemented by states

Increase use of Annual Wellness Visits by older adults* Increase proportion of adults who talk to their health care provider about changes in their

Road Map Develop and disseminate 4th State and Local Public Health Road Map and expand the Road Map series Develop training materials for current and future professionals about ADRD and caregiving Implement related communications and other activities Assist with Healthy People objective analysis related to cognitive impairment, including

ADRD

and tribes

Increase number of health care and public health professionals and students with knowledge and skills about ADRD and caregiving as public health issues memory* Increase proportion of older adults with diagnosed ADRD, or their caregiver, who are aware of the diagnosis* Improve quality of life and care management for those with cognitive impairment or

ADRD*

Component B Organization(s)

Identify needs related to brain health and cognitive impairment among target population Develop and/or adapt existing information products to inform target population about important issues in brain health, cognitive impairment, and caregiving

Expand implementation of Road Map actions to target population Increase number of people reached by population-focused communications about brain health and cognitive impairment

Increase awareness of cognitive impairment and ADRD as public health issues within target population* Decrease disparities in health and quality of life related to cognitive impairment and ADRD among target populations*

*These outcomes are not expected to be achieved during the period of performance.

i. Purpose The overall purpose of this NOFO is to develop and implement public health strategies guided by the Healthy Brain Initiative (HBI) Road Map Series to promote brain health, address cognitive impairment, including ADRD, and support the needs of caregivers (unpaid persons providing care or assistance to someone with ADRD). The HBI Road Map Series advances brain health as an integral component of public health through an action agenda, outlining how public health agencies and their partners can prepare all communities to act quickly and strategically by stimulating changes in policies, systems, and environments.

ii. Outcomes For Component A applicants, as presented in the logic model, it is expected that progress towards the bolded short-term/intermediate outcomes will be achieved during the period of performance. These include:

Increased/maintained number of states adopting BRFSS Cognitive Decline and Caregiver modules

Increased number of Road Map actions implemented by states and tribes Increased number of health care professionals and students with knowledge and skills about ADRD and caregiving as public health issues

For Component B applicants, as presented in the logic model, it is expected that progress towards the bolded short-term/intermediate outcomes will be achieved during the period of performance. These include:

Expand implementation of Road Map actions to target population Increase number of people reached by population-focused communications about brain health and cognitive impairment

iii. Strategies and Activities Applicants may ONLY apply for Component A or Component B.

Component A Organization Component A organization should utilize the strategies outlined in the Logic Model within the "Strategies and Activities" column and restated below:

Assist with adoption and revision of the BRFSS cognitive decline and caregiver modules.

o Promote adoption and implementation of cognitive decline and caregiver modules among states and territories o Form panel of experts for revision of modules o Review, modify, delete and/or add module questions

Support implementation and conduct evaluation of the 3rd HBI Road Map for State and Local Partners and the Road Map for Indian Country.

Develop and disseminate the 4th State and Local Public Health Road Map, and additional Road Map products such as Indian Country or language-specific products.

Develop training materials for current and future professionals about ADRD and caregiving.

Implement related communications and other activities.

Assist with Healthy People objective analysis related to cognitive impairment, including

ADRD.

In addition to these strategies and activities, the Component A organization may use the action items from the HBI's State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map and/or The Road Map for Indian Country to guide period of performance activities. These actions are outlined at the end of this section.

Component B Organization(s) Component B organizations should utilize the strategies outlined in the Logic Model within the "Strategies and Activities" column and restated below:

Identify needs related to brain health among target population.

Develop and/or adapt existing information products to inform target population about important issues in brain health, cognitive impairment, and caregiving.

In addition to these strategies and activities, Component B organizations may use the action items from the Healthy Brain Initiative's State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map and/or The Road Map for Indian Country to guide period of performance activities. These actions are outlined at the end of this section.

Road Map Actions to Guide Work -- Component A and B Organizations In addition to the strategies and activities outlined in the logic model, the following Road Map actions under the four essential public health services outlined in the Healthy Brain Initiative's State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map and The Road Map for Indian Country support period of performance outcomes. These services listed in the Road Maps that may be used to guide the strategies for the activities and the actions during the period of performance can be found below.

Educate and Empower (E) Actions:

Educate the public about brain health and cognitive aging, changes that should be discussed with a health professional, and benefits of early detection and diagnosis (E-1).

Integrate the best available evidence about brain health and cognitive decline risk factors into existing health communications that promote health and chronic condition management for people across the life span (E-2).

Increase messaging that emphasizes both the important role of caregivers in supporting people with dementia and the importance of maintaining caregivers? health and wellbeing (E-3).

Promote prevention of abuse, neglect, and exploitation of people with dementia (E-4).

Provide information and tools to help people with dementia and caregivers anticipate, avert, and respond to challenges that typically arise during the course of dementia (E-5).

Strengthen knowledge about, and greater use of, care planning and related tools for people with all stages of dementia (E-6).

Improve access to and use of evidence-informed interventions, services, and supports for people with dementia and their caregivers to enhance their health, wellbeing, and independence (E-7).

Develop Policies and Mobilize Partnerships (P) Actions:

Promote the use of effective interventions and best practices to protect brain health, address cognitive impairment, and help meet the needs of caregivers for people with dementia (P-1).

Assure academic programs, professional associations, and accreditation and certification entities incorporate the best available science about brain health, cognitive impairment, and dementia caregiving into training for the current and future public health workforces (P-2).

Support better informed decisions by educating policymakers on the basics of brain health and impairment, the impact of dementia on caregivers and communities, and the role of public health in addressing this priority problem (P-3).

Improve inclusion of healthcare quality measures that address cognitive assessments, the delivery of care planning to people with diagnosed dementia, and improved outcomes (P-4).

Engage public and private partners in ongoing planning efforts to establish services and policies that promote supportive communities and workplaces for people with dementia and their caregivers (P-5).

Assure public health plans that guide emergency preparedness and emergency response address the special needs of people with dementia and their caregivers, support access to critical health information during crises, and prepare emergency professionals for situations involving people with dementia (P-6).

Assure a Competent Workforce (W) Actions:

Educate public health and healthcare professionals on sources of reliable information about brain health and ways to use the information to inform those they serve (W-1).

Ensure that health promotion and chronic disease interventions include messaging for healthcare providers that underscores the essential role of caregivers and the importance of maintaining their health and well-being (W-2).

Educate public health professionals about the best available evidence on dementia (including detection) and dementia caregiving, the role of public health, and sources of information, tools, and assistance to support public health action (W-3).

Foster continuing education to improve healthcare professionals' ability and willingness to support early diagnoses and disclosure of dementia, provide effective care planning at all stages of dementia, offer counseling and referral, and engage caregivers, as appropriate, in care management (W-4).

Strengthen the competencies of professionals who deliver healthcare and other care services to people with dementia through interprofessional training and other strategies (W-5).

Educate healthcare professionals about the importance of treating co-morbidities, addressing injury risks, and attending to behavioral health needs among people at all stages of dementia (W-6).

Educate healthcare professionals to be mindful of the health risks for caregivers, encourage caregivers' use of available information and tools, and make referrals to supportive programs and services (W-7).

Monitor and Evaluate (M) Actions:

Support the implementation of the Behavioral Risk Factor Surveillance System (BRFSS) optional module for Cognitive Decline and the BRFSS optional module for Caregiving (M-1).

Support national data collection on dementia and caregiving (M-2).

Use data gleaned through available surveillance strategies and other sources to inform the public health program and policy response to brain health, cognitive impairment, and caregiving (M-3).

Embed evaluation into training and caregiving support programs to determine program accessibility, effectiveness, and impact (M-4).

Estimate the gap between workforce capacity and anticipated demand for services to support people with dementia and their caregivers (M-5).

Indian Country Actions:

Work with community members to understand brain health, early warning signs of dementia, and benefits of early detection and diagnosis for persons with dementia and their caregivers (T-1).

Encourage community members to use effective interventions, best practices, and traditional wellness practices to protect brain health, address cognitive impairment, and support persons with dementia and their caregivers (T-2).

Provide information and tools to help older adults with dementia and their caregivers anticipate and respond to challenges that typically arise during the course of dementia (T-3).

Promote engagement among tribal leaders in dementia issues by offering information and education on the basics of brain health and cognitive impairment, the impact of dementia on caregivers and communities, and the role of public health approaches in addressing this priority problem (T-4).

Support collection and use of local data on dementia and caregiving in American Indians/Alaska Native communities to plan programs and approaches (T-5).

Promote the inclusion of healthcare quality measures that address both cognitive assessments and the delivery of care to American Indians/Alaska Natives with dementia (T-6).

Educate healthcare and aging services professionals in Indian Country about the signs and symptoms of dementia and about caregiving for persons with dementia (T-7).

Educate healthcare and aging services professionals on the best ways to support families and caregivers of older adults with dementia (T-8).

1. Collaborations

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

Applicants are expected to identify and leverage opportunities to enhance the applicant's work with other federally funded programs and networks where there are common interests and objectives related to brain health, cognitive impairment, and caregiving. Successful applicants awarded Component A or Component B of this funding opportunity will be required to collaborate with each other throughout the five year award period. This may include, but is not limited to, joint planning and leadership activities, joint funding of complementary activities based on program recipient activities, coalition alliances and joint health education and communication activities, data acquisition, analysis, presentations, publications, communication, and combined development and implementation of environmental, policy, systems, or community interventions, and other cost sharing activities that relate to recipient program activities.

b. With organizations not funded by CDC:

Applicants are strongly encouraged but not required to identify and leverage opportunities that will enhance the recipient's work with organizations external to CDC. Applicants are strongly encouraged but not required to collaborate with the following examples of groups and individuals:

Subject matter experts with expertise in brain health and cognitive impairment, including Alzheimer's disease, and caregiving.

Subject matter experts with expertise in public health tools, strategies and resources, including advanced knowledge of the public health system at the national, state, and local levels.

Persons with cognitive impairment.

Caregivers for persons with cognitive impairment.

Persons or groups representing people with cognitive impairment and/or their caregivers.

Representatives from the Aging Services Network.

State administrators managing applicable programs (e.g., Medicaid, senior public health officials, public health chronic disease directors).

Stakeholder groups (coalitions, strategic partnerships, other non-profit organizations) that have a common mission or interests.

Persons or groups representing target population(s) of this NOFO.

If applicants are collaborating with external organizations, applicants must provide letters of support and name the file "Letters of Support" and upload as PDF files on www.grants.gov.

Letters of support should clearly describe the partnership with the applicant and how the organization will support the applicant's activities under this NOFO.

2. Target Populations Component A: The target population(s) is expected to include state and local public health agencies and their national, state, and local partners described in the Collaborations section of this NOFO. Applicants are required to describe the target population or populations within this group that has been identified to achieve the greatest health impact (e.g., state health officials, state chronic disease directors, non-profit organizations, healthcare provider member organizations, etc.).

Component B: The target populations are expected to include those with an identified high burden of ADRD. Examples include but are not limited to: Hispanics, African-Americans, American Indians/Alaska Natives, women, and persons with intellectual or developmental disabilities.

a. Health Disparities Component B organizations funded under this NOFO will be selected, in part, based upon their ability to develop and/or adapt and disseminate products for groups at greatest risk for cognitive impairment including ADRD. These groups include but are not limited to: Hispanics, African- Americans, American Indians/Alaska Natives, women, and persons with intellectual or developmental disabilities.

iv. Funding Strategy (for multi-component NOFOs only) N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy For the strategies described in the logic model and the strategies and activities section, the following measures are expected for Component A applicants:

Component A Tier 1 Measures

1. Increase/maintain the number of states adopting the Behavioral Risk Factor Surveillance System (BRFSS) Cognitive Decline and Caregiver Modules. The data from these modules are critical for use by states and other jurisdictions to develop state plans, increase awareness about the needs of these populations, and guide elder justice and emergency preparedness efforts for older adults. These data also help states identify any existing or emerging disparities across racial and socioeconomic lines. This helps states tailor their efforts so they are most effective.

2. Increase the number of Road Map actions implemented by states and tribes to achieve improvement in health and quality of life outcomes for persons experiencing cognitive impairment or ADRD and their caregivers.

3. Increase the number of health care and public health professionals and students with knowledge and skills about ADRD and caregiving as public health issues. This will broaden the dementia-capable workforce and lead to improvements in quality of care for those with ADRD. Less than half of those with dementia are aware of their diagnosis.

Educating health professionals is a critical component towards ensuring that those with ADRD are adequately diagnosed and referred to services, preventing costly hospitalizations.

For the strategies described in the logic model and the strategies and activities section, the following measures are expected for Component B applicants:

Component B Tier 1 Measures

1. Expand the implementation of Road Map actions to the recipient's target population to achieve improvements in health and quality of life outcomes for persons experiencing cognitive impairment or ADRD and their caregivers.

2. Increase the number of people reached by population-focused communications about brain health and cognitive impairment within the recipient?s target population. This includes integrating brain health messages about the importance of managing chronic conditions and maintaining heart health.

For both Component A and Component B applicants, this NOFO does not involve the generation or collection of public health data. Therefore, a Data Management Plan is not required.

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).

https://www.cdc.gov/grants/additionalrequirements/ar-25.html

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.

In addition, at a minimum, the plan must:

Describe other information (e.g., performance measures to be developed by the applicant), as determined by the CDC program, that must be included.

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

Describe how evaluation and performance measurement will contribute to developing an evidence base for programs that employ strategies lacking a strong effectiveness evidence base.

Describe the frequency that evaluation and performance data are to be collected.

Describe how evaluation and performance measurement will yield findings to demonstrate the value of the NOFO (e.g., impact on improving public health outcomes, effectiveness of project, cost-effectiveness or cost benefit).

Describe dissemination channels and audiences (including public dissemination).

This more detailed evaluation and performance measurement plan should be developed by recipients with support from CDC as part of first year project activities. This more detailed evaluation plan will build on the elements stated in the initial plan. This plan should be no more than 35 pages.

A DMP is not required for this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach Organizational capacity ensures applicants demonstrate their ability to successfully execute the NOFO strategies and meet period of performance outcomes.

Component A applicants should have adequate infrastructure, including:

Previous experience and current ability to implement national public health initiatives for brain health and cognitive impairment, including ADRD, and caregiving -- in 25 or more states or U.S. territories -- to help ensure a comprehensive national scope.

Previous experience documenting the ability to establish and maintain strong working relationships with stakeholders, including subject matter experts in public health and brain health, cognitive impairment, and caregiving to inform programmatic and policy initiatives.

Ability to plan, implement, and monitor performance and evaluate programs.

Ability to improve population health by implementing strategies that develop or revise health-related policies or systems adopted by organizations or government entities.

Ability to manage people by overseeing and supporting optimal performance and growth of team members.

Previous experience and ability working with 10 or more BRFSS state coordinators on adopting cognitive decline and caregiver modules.

Previous experience and ability in training states and other partners on the use of BRFSS and other public health data and translating those data into public health action.

Ability to manage programs and resources ensuring the administrative, financial, and staff support necessary to sustain activities and to build opportunities, specifically ability of the organization to distribute funding in a timely manner, ability to hire or contract personnel with applicable skills needed to implement the program, and ability to write and award contracts in accordance with 45 CFR 75.

The ability to effectively gather, analyze, interpret, and use evidence-based or evidence-informed strategies where such information exists.

Ability to lead strategically through creation of a common agenda or strategic vision for national priority setting, serve as a catalyst for change, and demonstrate program accomplishments such as leveraging resources with respect to brain health, cognitive impairment, and caregiving, and other state and local health-related programs.

Applicants will be expected to describe their experience providing public health leadership in brain health and cognitive impairment, including ADRD. This includes the history of providing guidance and support; recent examples of the content and format of the guidance and support provided, and any outcomes or benefits that were demonstrated as a result. In addition, and if applicable, applicants will be expected to provide a description of their current federally-funded projects. Applicants will be allowed to implement NOFO requirements based on their own organizational design and approach, unless otherwise required by statute.

Component B applicants should have adequate infrastructure, including:

Previous experience and ability to integrate and disseminate public health messages nationally within target population.

Previous experience documenting the ability to establish and maintain strong working relationships with stakeholders, including subject matter experts in public health to inform programmatic and policy initiatives.

Ability to plan, implement, monitor performance, and evaluate programs.

Ability to improve population health by implementing strategies that inform the development or revision of health-related policies or systems adopted by organizations or government entities.

Ability to manage people by overseeing and supporting optimal performance and growth of team members.

Ability to manage programs and resources ensuring the administrative, financial, and staff support necessary to sustain activities and to build opportunities, specifically ability of the organization to distribute funding in a timely manner, ability to hire or contract personnel with applicable skills needed to implement the program, and ability to write and award contracts in accordance with 45 CFR 75.

The ability to effectively gather, analyze, interpret, and use evidence-based or evidence-informed strategies where such information exists.

Ability to lead strategically through creation of a common agenda or strategic vision, serve as a catalyst for change, and demonstrate program accomplishments such as leveraging resources.

Applicants will be expected to describe their experience providing public health leadership in serving or working with the recipient's target population. This includes the history of providing guidance and support, recent examples of the content and format of the guidance and support provided, and any outcomes or benefits that were demonstrated as a result. In addition, and if applicable, applicants will be expected to provide a description of their current federally-funded projects. Applicants will be allowed to implement NOFO requirements based on their own organizational design and approach, unless otherwise required by statute.

SUPPORTING DOCUMENTS:

Component A Component A applicants must provide copies of organization bylaws and Memoranda of Understanding (MOU). See below guidance on uploading these documents:

1. A copy of the organization bylaws that demonstrates existing community or state-level affiliates in a minimum of 25 states or territories. Highlight the relevant section of the bylaws. Name this file "Bylaws" and upload it at www.grants.gov.

2. Component A applicants must provide copies of Memoranda of Understanding (MOU) from 10 or more state public health departments for inclusion of BRFSS cognitive decline or caregiver modules between 2014-2018. The documents should be included as a separate attachment containing the first page (title page) and the final page (signature page) for each MOU. Highlight each state name in the document. Name these files "[state name] BRFSS MOU", inserting the applicable state name in the file name, and upload them at www.grants.gov.

All Applicants (Component A and Component B) All applicants must provide Resumes/CVs and name this file "Resumes/CVs" or "Organizational Charts" and upload it at www.grants.gov.

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. Work plans help project officers monitor implementation of activities and progress on period of performance outcomes. No specific work plan format is required, as long as it is clear how the components in the work plan crosswalk to the strategies and activities, outcomes, and evaluation and performance measures presented in the logic model and the narrative sections of the NOFO. Objectives should be written in SMART (specific, measurable, achievable, realistic, timely) format. This work plan is expected to be augmented each year based on the required direction of the work, including identified needs of any target populations.

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

e. CDC Monitoring and Accountability Approach http://www.grants.gov http://www.grants.gov http://www.grants.gov

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.

No additional requirements.

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

COOPERATIVE AGREEMENTS)

The CDC program that oversees this NOFO will provide substantial involvement in addition to yearly site visits and regular performance and financial monitoring during the 5-year period of performance. The CDC program will work in partnership with recipients to ensure the success of the cooperative agreement by providing technical assistance to the recipient through the availability of subjective matter experts in brain health, cognitive impairment, caregiving, and with obtaining, analyzing, and interpreting data from BRFSS Cognitive Decline and Caregiver Modules. In addition, CDC anticipates partnering with the recipient(s) on the development of communication products including, but not limited to, social media offerings, webinars, conference programs, and professional presentations and publications co-branded by the recipient and CDC. Recipient budgets should include travel funds sufficient for two individuals to attend one recurring annual site visit to CDC. CDC will collaborate with the recipient(s) to develop work plans, evaluation tools, and other measures of program outcomes as necessary.

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 The National Healthy Brain Initiative

3. Fiscal Year: 2020 Estimated Total Funding: $12,500,000

4. Approximate Total Fiscal Year Funding: $2,500,000

This amount is subject to the availability of funds.

5. Approximate Period of Performance Funding: $12,500,000

6. Total Period of Performance Length: 5

7. Expected Number of Awards: 6 Component A: One award Component B: Up to five awards

8. Approximate Average Award: $2,500,000 Per Budget Period Component A: $1,500,000 (one award) Component B: $200,000 (up to five awards)

This amount is subject to the availability of funds.

9. Award Ceiling: $4,750,000 Per Budget Period Component A: $3,000,000 (one award) Component B: $350,000 (up to five awards)

CDC will not accept and review applications with budgets greater than the ceiling of the award range. Applications with budgets that exceed the ceiling of the award, which includes both direct and indirect costs, will be considered non-responsive, and will not be entered into the review process.

10. Award Floor: $950,000 Per Budget Period Component A: $800,000 (one award) Component B: $150,000 (up to five awards)

11. Estimated Award Date: 08/03/2020

Throughout the period of performance, 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

(period of performance) 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).

12. Budget Period Length: 12 month(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) 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:

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 Applicants may apply for only Component A or Component B.

For both Component A and Component B, CDC will not accept and review applications with budgets greater than the ceiling of the award range. Applications with budgets that exceed the ceiling of the award, which includes both direct and indirect costs, will be considered non-responsive, and will not be entered into the review process.

3. Justification for Less than Maximum Competition

4. Cost Sharing or Matching

Cost Sharing / Matching Requirement: No

5. Maintenance of Effort N/A

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 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 https://www.sam.gov/SAM/.

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

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

1-2 Business Days To confirm that you have been issues a new DUNS number check online at http://www.cdc.gov/od/pgo/funding/docs/FinancialReferenceGuide.pdf http://www.cdc.gov/od/pgo/funding/docs/FinancialReferenceGuide.pdf https://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/SAM/ https://grants.gov/…