CDC-RFA-DP21-2110.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH

PROMOTION

Community Health Workers for COVID Response and Resilient Communities (CCR)-

Evaluation and Technical Assistance (ETA); CCR-ETA

CDC-RFA-DP21-2110

05/24/2021

Table of Contents 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 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- DP21-2110. 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:

Community Health Workers for COVID Response and Resilient Communities (CCR)- Evaluation and Technical Assistance (ETA); CCR-ETA C. Announcement Type: New - Type 1:

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52- 2.pdf. Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr- 46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP21-2110

E. Assistance Listings Number:

93.495 F. Dates:

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

Not Applicable

2. Due Date for Applications:

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.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

05/24/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

Date: April 5, 2021

Time: 2:30 pm - 4:00 pm U.S. Eastern Standard Time

Conference Number: 1-888-989-9773

Conference I.D.: 2568038#

Join via Computer: https://adobeconnect.cdc.gov/rvu1et3m3oy1/

F. Executive Summary:

Summary Paragraph The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 allocated funds to the Centers for Disease Control and Prevention (CDC) for states, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes. CDC announces the availability of funds to achieve the goal of the CARES Act in protecting the American people from the public health impacts of COVID-19. This four-year opportunity provides funds to conduct a national evaluation of the Community Health Workers for COVID Response and Resilient Communities (CCR) program, DP21-2109 and provide training and technical assistance (TA) to CCR recipients. This program has two components: 1) conduct a national evaluation of the CCR and 2) deliver training and TA to CCR recipients. Applicants may only apply for 1 component.

Component 1 (C1): National evaluation of CCR Component 2 (C2): Training/TA for CCR recipients

a. Eligible Applicants:

Open Competition

b. NOFO Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards Component 1: approximately 3 awards Component 2: approximately 2 awards

d. Total Period of Performance Funding:

$ 32,000,000

e. Average One Year Award Amount:

$ 1,500,000 https://www.grants.gov/ tel:1-888-989-9773 https://adobeconnect.cdc.gov/rvu1et3m3oy1/

Over four years, CDC will award approximately $9 million each year for three years and approximately $5 million each year for one year with the average award varying. These awards will range from approximately $1.5 million - $3 million depending on the size and scope of activity. The range of funds is broad to accommodate a varied number of organizations based on capacity and a range of catchment areas whose resource needs will vary. Average budget period award amounts for each component are:

Component 1 (C1): National evaluation of CCR: $2 million Component 2 (C2): Training/TA for CCR recipients: $1.5 million

f. Total Period of Performance Length:

g. Estimated Award Date:

August 01, 2021

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The novel Coronavirus Disease 2019 (COVID-19) has impacted communities nationwide, including states, localities, and territorial jurisdictions. Such public health crises exacerbate existing health disparities and inequities in the social determinants of health (SDOH), conditions in which people are born, live, learn, work, play, worship, and age. Black/African Americans, Hispanics/Latinos, and American Indian/Alaska Native populations have higher rates of unemployment; are more likely to work in essential, low-income positions that do not allow telework; live in communities with higher rates of environmental hazards; and do not have health insurance or paid sick leave through employers. Racial and ethnic minorities, economically disadvantaged persons, justice-involved, people experiencing homelessness, and people who use drugs and/or have certain underlying medical conditions are also at risk. These factors increase risk of exposure to COVID-19, while limiting ability to stay home or access care. Racial and ethnic minority groups experience higher incidence of some chronic diseases shown to increase severe illness from COVID-19. Distrust of medical and governmental entities and longstanding disparities in vaccine coverage may impact achievement of high COVID-19 vaccination rates.

Investments are needed to decrease disparities among these populations. Initiatives promoting health equity in policies and reducing inequities should be pursued and evaluated for effective and targeted systems’ changes across relevant sectors. Overwhelming evidence demonstrates that health is highly influenced by SDOHs (e.g., intergenerational wealth, quality education, stable employment opportunities). Through partnerships around community health assessment and planning efforts, federal, state, local, tribal, and territorial governments have invested in long-range policy and environmental change plans to improve SDOH in communities with the poorest health outcomes. Community Health Workers (CHWs) are well-positioned to reach communities, especially those disproportionately impacted by COVID-19. CHW interventions can improve uptake and access to health care services, improve communication between community members and health providers, reduce the need for emergency and specialty services, and improve adherence to health recommendations. While CHW administered interventions have a demonstrated impact, barriers to increased intervention implementation exist (e.g., insufficient numbers of trained individuals; lack of funding/reimbursement; poor integration of CHWs in care teams, the health care delivery system, or community organizations addressing SDOH; and limited communication technology).

CHWs can improve access to COVID-19 related services (e.g., testing, contact tracing, health education, immunization services) and management of other underlying medical conditions that increase the risk of severe COVID-19 illness and adverse outcomes. CDC is funding a new initiative, Community Health Workers for COVID Response and Resilient Communities (CCR), DP21-2109. Through this initiative, CDC will provide training and technical assistance (TA) to CCR recipients to increase community resiliency and respond to COVID-19 in the hardest hit communities.

The purpose of this NOFO, DP21-2110, is to support evaluation, training, and TA to strengthen capacity of CCR recipients and their partners to address disparities in access to COVID-19 related services. This NOFO has two components: Component 1 (C1), conduct a national evaluation of the CCR, and Component 2 (C2), deliver training and TA to CCR recipients. Applicants may only apply for 1 component.

b. Statutory Authorities This program is authorized under the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), Public Law 116-136 and under the Public Health Service Act 42 U.S.C. 301(a).

c. Healthy People 2030 This funding opportunity focuses on COVID-19 response and community resilience addressing Healthy People 2030 goals including emergency preparedness: https://health.gov/healthypeople/objectives-and-data/browse-objectives/emergency-preparedness and vaccination: https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccnation.

For further information, please see https://health.gov/healthypeople/objectives-and-data/browse-objectives.

d. Other National Public Health Priorities and Strategies The COVID-19 pandemic requires a coordinated public health response; recipients should consider the following in their proposed work:

Topics (e.g. social determinants of health) related to health conditions associated with increased risk of COVID-19 illness and poorer outcomes.

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Centers for Disease Control and Prevention (2020). Community Preventive Services Task Force. The Community Guide. Retrieved from The Guide to Community Preventive Services (The Community Guide).

https://health.gov/healthypeople/objectives-and-data/browse-objectives/emergency-preparedness https://health.gov/healthypeople/objectives-and-data/browse-objectives/emergency-preparedness https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccnation https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccnation https://health.gov/healthypeople/objectives-and-data/browse-objectives https://health.gov/healthypeople/objectives-and-data/browse-objectives https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html https://www.thecommunityguide.org/ https://www.thecommunityguide.org/

Health Resources and Services Administration (2020). Coronavirus-Related Supplemental Funding Allowable Uses Technical Assistance Resource.

https://bphc.hrsa.gov/emergency-response/coronavirus-info/supplemental-funding-uses

e. Relevant Work This NOFO will leverage previous work funded by the CDC with various public and private partners to implement and evaluate the effectiveness of different approaches for building the public health infrastructure to respond to COVID-19.

Centers for Disease Control and Prevention (2020). Public Health Crisis Response NOFO. https://www.cdc.gov/cpr/readiness/funding-covid.htm

Centers for Disease Control and Prevention (2020). CDC COVID-19 Funding for Tribes.

https://www.cdc.gov/tribal/cooperative-agreements/covid- 19.html?deliveryName=USCDC_289-DM25904Centers for Disease Control and Prevention (2020). COVID-19 Financial Resources. Retrieved from Financial Resources |

CDC.

2. CDC Project Description

a. Approach Bold indicates period of performance outcome.

Proposed Outcomes

Proposed High Level Strategies

Short Term Outcomes:

Year 1

Intermediate Outcomes:

Year 2

Long Term:>Year 3

Conduct a national evaluation of CCR (DP-21-2109) to monitor implementation, inform program improvement and assess overall program reach/outcomes.

Increased collection of high-quality monitoring and evaluation data for CCR

COVID-19

public health response efforts among priority populations.

Increased use and dissemination of data to inform improvement of COVID-19 public health response efforts among priority populations within communities.

Provide training and technical assistance

Increased capacity of

Increased reach of

Decreased impact of COVID-19 on those at highest risk (priority populations) and settings.

Increased community resilience to respond to COVID-19 and future public health emergencies.

IMPACT

Decreased health disparities https://bphc.hrsa.gov/emergency-response/coronavirus-info/supplemental-funding-uses https://www.cdc.gov/cpr/readiness/funding-covid.htm https://www.cdc.gov/tribal/cooperative-agreements/covid-19.html?deliveryName=USCDC_289-DM25904 https://www.cdc.gov/tribal/cooperative-agreements/covid-19.html?deliveryName=USCDC_289-DM25904 https://www.cdc.gov/coronavirus/2019-ncov/php/open-america/financial-resources.html https://www.cdc.gov/coronavirus/2019-ncov/php/open-america/financial-resources.html nationally to CCR recipients to ensure relevant knowledge and skills to support the COVID-19 public health response to manage outbreaks and community spread.

CCR

recipients to support, train, and deploy CHWs for

COVID-19

public health response efforts among priority populations.

CHW-

influenced

COVID-19

mitigation efforts among priority populations within their communities.

Increased health equity

i. Purpose The purpose of this NOFO, DP21-2110, is to support evaluation, training, and technical assistance (TA) to strengthen the capacity of CCR recipients and their programmatic partners to address disparities in access to COVID-19 related services. There are two components to this initiative: Component 1 focuses on conducting a national evaluation of DP21-2109; Component 2 focuses on providing training and TA to CCR recipients.

ii. Outcomes Applicants are expected to focus on those outcomes that align with two high-level strategy categories that align with the two DP21-2110 Components, conducting a national evaluation of DP21-2109 (Component 1) and providing training and TA to DP21-2109 recipients (Component 2).

COMPONENT 1: NATIONAL EVALUATION OF DP21-2109

Short-term outcomes:

Increased collection of high-quality monitoring and evaluation data for CCR (DP21- 2109)

Intermediate outcomes:

Increased use and dissemination of data to inform improvement of COVID-19 public health response efforts among priority populations within communities.

COMPONENT 2: TRAINING AND TECHNICAL ASSISTANCE TO DP21-2109

RECIPIENTS

Short-term outcomes:

Increased capacity of CCR recipients to support, train, and deploy CHWs for COVID-19 public health response efforts among priority populations within their communities.

Intermediate outcomes:

Increased reach of CHW-influenced COVID-19 mitigation efforts among priority populations within their communities.

COMPONENTS 1 and 2: Long-term outcomes:

Decreased impact of COVID-19 on those at highest risk (priority populations) and settings.

Increased community resilience to respond to COVID-19 and future public health emergencies.

iii. Strategies and Activities Component 1. Conduct a national evaluation of DP21-2109 (CCR) to monitor implementation, inform program improvement, and assess overall reach and outcomes.

Applicants for Component 1 must describe how they will conduct all 5 strategies and related activities listed below.

1. Collaborate with other CCR-ETA Component 1 recipients.

a. Collaborate with other Component 1 recipients to plan and conduct the national evaluation of DP21-2109 (CCR). A recipient of Component 1 who is also a DP21-2109 CCR recipient should not collect data from their own program for the national evaluation.

b. Collaborate with Component 2 recipients to coordinate efforts in working and collaborating with CCR recipients.

2. Plan and conduct a national evaluation of CCR

a. Develop a national evaluation plan of DP21-2109 CCR Component A (Capacity Building) and Component B (Implementation Ready) to assess changes in 1) skills/capacity/roles of CHWs to provide services and support for COVID-19 public health response efforts among priority populations within communities, 2) workforce of CHWs delivering services to manage the spread of COVID-19, 3) referrals to community resources and clinical services among populations prioritized for CCR services, 4) program reach of CHW-influenced mitigation efforts among priority populations within communities, 5) integration of Community Health Workers into organizations and care teams to support the public health response to COVID-19 among priority populations within communities (e.g. community-clinical linkages), 6) referral to and provision of community resources to those at highest risk for poor health outcomes among priority populations within communities, and 7) key COVID-19 outcomes among priority populations (e.g., measures of immunization coverage, contact tracing, COVID-19 testing) among priority populations. The evaluation plan should have a detailed program logic model based on the model presented in DP21-2109, process and outcome evaluation questions, a description of the evaluation methods, specific process and outcome measures to be assessed, primary and secondary data sources to be used, data collection tools to be used, the approach to analysis, and data dissemination plans.

b. Develop a detailed evaluation protocol including data collection instruments and related data dictionaries. Outcomes that can be consistently measured among all CCR recipients in order to assess overall reach and aggregate performance for the overall CCR program as well as for individual CCR recipients should be identified. Additional outcomes that are common among programs, but not necessarily universal, also may be identified for inclusion if they help demonstrate the impact of the program.

c. Collaborate with CDC to define common measures for the national evaluation.

d. Collect data from CCR Component A and Component B recipients using standardized reporting methods or data collection system to ensure common data elements are collected and can be aggregated for the national evaluation. Collect secondary data as needed from existing reporting systems (e.g., CDC COVID Data Tracker that includes county-level data; census data) to measure COVID-19 outcomes at a level consistent with CCR recipient catchment areas for CHW interventions.

e. Develop and deliver training for CCR recipients to support their participation in the national evaluation, including for data collection and reporting. Provide ongoing training and technical assistance to support recipients in timely data reporting, including data for performance measure reporting and other primary data collected for the national evaluation.

f. Provide TA to CCR recipients to support their own, recipient-led evaluations. This should include, but not be limited to, review and feedback of each recipient’s individual evaluation plan. A system for delivering evaluation-focused TA should be established and recipients should track all TA that is provided.

g. Analyze and synthesize evaluation data to enable CCR recipient-specific and national-level reporting of evaluation results and related recommendations.

3. Use monitoring data for program improvement

a. Routinely assess data quality and identify areas for quality improvement in data quality.

b. Routinely review monitoring and evaluation data with CCR recipients to address data quality issues, monitor progress, and improve implementation of CCR strategies. Provide feedback to CCR recipients at least semi-annually. A quality improvement cycle should be applied in order to regularly provide feedback to CCR recipients for use in improving data quality and program implementation.

c. Use data dashboards or other data dissemination methods to support meaningful use of evaluation data for program improvement by CCR recipients.

4. Disseminate evaluation results

a. Disseminate evaluation results to all relevant stakeholders, including CCR recipients, CDC, national partners, and the public. Results should be summarized in various formats, including as manuscript(s) for publication.

5. Plan and conduct special studies with a subset of at least 5 CCR recipients to assess program effectiveness

a. Develop selection criteria and identify a subset of CCR recipients to participate in rigorous evaluations of CHW interventions to examine program effectiveness in achieving COVID-19 outcomes (e.g., increased immunization rates, effective contact tracing, increased testing), as well as cost-effectiveness. Cost-effectiveness studies should examine CHW reimbursement strategies.

b. Collaborate with each CCR recipient participating in a special study to design a unique evaluation study protocol appropriate for the intervention and context. Rigorous designs should be employed that allow for determination of intervention effectiveness.

c. In collaboration with the participating CCR recipient sites, conduct each study, including conducting data collection and analysis.

d. Disseminate evaluation results including through publishable manuscripts.

Component 2. Provide training and technical assistance (TA) to CCR recipients to ensure relevant knowledge and skills to support the COVID-19 public health response to manage outbreaks and community spread. Applicants for Component 2 must describe how they will conduct all 7 strategies and related activities below.

1. Conduct rapid assessment of CCR recipients to identify training/TA needs.

a. Develop and conduct a brief needs assessment that yields results to be used to inform training and TA needs of CCR recipients related to CCR recipient activities, including training, deploying and engaging CHWs to prevent and control COVID-19 infections and strengthening community resilience. Needs assessment should include assessing CCR recipients’ preferred modes of receiving training and TA on these topics.

b. In consultation with CDC, use needs assessment results to identify topics for training/TA.

2. Collaborate with other CCR-ETA recipients to develop a national CCR training/TA/peer learning plan for CCR recipients.

a. Collaborate with other Component 2 recipients in carrying out all Component 2 activities.

b. Collaborate with Component 1 recipients to ensure that relevant monitoring and evaluation data collected under Component 1 are used to inform training and TA provided by Component 2 recipients.

3. Develop a national CCR training/TA plan that includes peer learning.

a. In collaboration with other Component 2 recipients and using findings from Component 1 activities, develop a national training/TA plan, specifying training types, modes of delivery, training materials that exist or need to be developed, timeline for delivering training, and staff who will deliver training. Learning objectives for specific training should be included. The plan should also describe the frequency of peer learning meetings (i.e., Community of Practice) (at least quarterly, but may be more frequent), length of trainings, types of ongoing TA, and focus of peer learning. The Training and TA plan should be flexible to allow for changing needs of CCR recipients as their response to COVID-19 evolves. Trainings should be interactive to maximize participation and should use multiple methods to reinforce training and TA objectives.

b. Research and identify a platform for supporting Communities of Practice/Peer Learning that provides a structure for CCR recipients to learn from each other’s experiences.

4. Develop and/or identify training curricula and tools and instruments for evaluating delivery of training/TA/peer learning.

a. Identify existing COVID-19 CHW resources and websites that can be used for this effort.

b. Develop new COVID-19 CHW training curricula and tools where gaps exist, particularly as identified in the rapid needs assessment (Activity 1) and through ongoing monitoring of monitoring and evaluation data.

c. Develop new or modify existing surveys or other tools to evaluate training and TA delivered to CCR recipients that assesses participant satisfaction, acquisition of knowledge and skills, and how the training and TA relates to the implementation and intended outcomes of the CCR NOFO.

5. Establish communities of practice to facilitate information sharing and peer learning across CCR recipients.

a. Implement peer learning/Community of Practice for CCR recipients in order to provide a platform for CCR recipients to learn from one another’s experiences.

b. Facilitate Community of Practice/Peer Learning sessions at least quarterly that include both a brief didactic component and an opportunity for peer-to-peer learning but allows for more frequency should the CCR recipients prefer this method of TA provision over others.

6. Promote and deliver/facilitate training, TA, and peer learning to CCR recipients.

a. Promote training/on-going TA/peer learning for CCR recipients.

b. Deliver training/on-going TA to CCR recipients.

c. Facilitate peer learning meetings (Communities of Practice) among CCR recipients.

7. Evaluate training and TA delivered and Peer Learning/Community of Practice activities.

a. Evaluate all training delivered to assess whether learning objectives were met.

b. Use training/TA evaluation results to inform and refine future training, TA and peer learning/Community of Practice activities to ensure continuous quality improvement.

c. Track individual TA provided so that the number, type, and extent of TA can be assessed.

d. Evaluate effectiveness of peer learning/Community of Practice activities.

e. Evaluate CCR recipients’ satisfaction with TA and Community of Practice/Peer

Learning activities.

1. Collaborations

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

Required Collaborations:

Recipients are required to collaborate with one another, CCR recipients, and other CDC funded programs. Strategies and activities will be planned and conducted collaboratively by recipients of the cooperative agreement to ensure a comprehensive approach to technical assistance and evaluation. Collaboration with CCR recipients is essential to achieve the goals and outcomes of this cooperative agreement. Recipients are also encouraged to collaborate and coordinate with other CDC funded programs operating in the same area and avoid duplications of efforts. State-and/or local-level CDC funded programs to advance efforts to mitigate the spread of COVID-19 infection include:

CDC-RFA-DP21-2109: Community Health Workers for COVID Response and Resilient Communities (CCR) NOFO

Epidemiology and Laboratory Capacity Program:

https://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html

State (and jurisdictional) Immunization Program: https://www.cdc.gov/vaccines/imz-managers/awardee-imz-websites.html

Supporting Tribal Public Health Capacity in Coronavirus Preparedness and Response Program: https://www.cdc.gov/tribal/documents/cooperative-agreements/COVID-19- Funding-for-Tribes-Grant-Recipients-OT20-2004-508.pdf

Tribal Public Health Capacity Building and Quality Improvement Program:

https://www.cdc.gov/tribal/cooperative-agreements/tribal-capacity-building-OT18- 1803.html

Cooperative Agreement for Emergency Response: Public Health Crisis Response and COVID-19 Crisis Response Cooperative Agreement Components A and B Supplemental Funding Program: https://www.cdc.gov/cpr/readiness/funding-covid.htm

Racial and Ethnic Approaches to Community Health (REACH) Flu Vaccine Supplement.

DP18-1813. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/current_programs/index.html.

Encouraged Collaborations:

Recipients are also highly encouraged to collaborate with other CDC-funded programs that focus on population health approaches to reduce health disparities and address the social determinants of health that contribute to them such as injury prevention, mental health promotion, sexually transmitted disease and chronic disease prevention. These collaborations are especially essential for implementing the strengthening community resilience strategies of this NOFO. This will ensure proposed activities are complementary with other CDC- funded programs operating in the same area and avoid duplications of efforts.

b. With organizations not funded by CDC:

Required Collaborations:

Recipients are required to collaborate with organizations that have expertise to enhance efforts to complete the required activities for each component. To demonstrate organizational capacity to establish partnerships, applicants must provide a signed Letter of Support from at least one organization. The letter of support should describe the unique expertise of the organization and how they will support the recipient to carry out the required activities and achieve the goals and outcomes of the NOFO. The letter of support should be dated within 45 days of the application due date. These letters must state the role of organizations and specify how they will help the applicant achieve the goals and outcomes of the NOFO. Applicants must file the letter of support, as appropriate, name the file “CHW-ETA_LOS_Applicant Name”, and upload it as a PDF file at www.grants.gov.

2. Target Populations The target population for this NOFO is CCR recipients. Component 1 and 2 recipients must collaborate with the DP21-2109, CCR recipients to conduct the program activities detailed above for the respective components.

a. Health Disparities CDC recognizes that social and economic opportunities, health behavior, and the physical environment in which people live greatly impact health outcomes. Health disparities represent https://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html https://www.cdc.gov/vaccines/imz-managers/awardee-imz-websites.html https://www.cdc.gov/vaccines/imz-managers/awardee-imz-websites.html https://www.cdc.gov/tribal/documents/cooperative-agreements/COVID-19-Funding-for-Tribes-Grant-Recipients-OT20-2004-508.pdf https://www.cdc.gov/tribal/documents/cooperative-agreements/COVID-19-Funding-for-Tribes-Grant-Recipients-OT20-2004-508.pdf https://www.cdc.gov/tribal/cooperative-agreements/tribal-capacity-building-OT18-1803.html https://www.cdc.gov/tribal/cooperative-agreements/tribal-capacity-building-OT18-1803.html https://www.cdc.gov/cpr/readiness/funding-covid.htm https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/current_programs/index.html https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/current_programs/index.html preventable differences in the burden of disease, disability, injury or violence, or in opportunities to achieve optimal health. This announcement provides the opportunity to conduct a national evaluation of the CCR and deliver training/TA to CCR recipients in order to strengthen their efforts to address health-related social needs (i.e. housing instability and poor quality, food insecurity, insufficient utility resources, interpersonal violence, insufficient transportation, and inadequate educational resources) for the priority populations described in DP21-2109. The CCR is an opportunity to demonstrate how increased awareness of available community services, navigation assistance to access services, and partner alignment to ensure that available services support community needs can positively impact health in these communities.

iv. Funding Strategy Applicants may apply for Component 1 only or Component 2 only, but not both.

Component 1 focuses on conducting a national evaluation of DP21-2109/CCR, including assessment of standardized data and measures across all recipients, and a subset of special studies. We expect to fund approximately 3 recipients for Component 1 for approximately $2 million each for four years.

Component 2 focuses on delivering training and TA to recipients of DP21-2109/CCR. We expect to fund approximately 2 recipients for Component 2 for approximately $1.5 million each year for three years.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation and performance measurement help demonstrate achievement of project outcomes;

build a stronger evidence base for specific interventions; clarify applicability of the evidence base to different populations, settings, and contexts; and, drive continuous improvement.

Evaluation and performance measurement can also determine if the intended populations are reached and program impact is achieved. CDC’s evaluation strategy is grounded in the CDC Evaluation Framework for Public Health, MMWR, September 18, 1999, Vol. 48 / No. RR-11.

CDC requires ongoing evaluation and performance measurement under this NOFO. CDC expects recipients to maintain sufficient staffing and analytic capacity to meet these requirements.

With support from CDC, recipients will be required to submit a more detailed Evaluation and Performance Measurement Plan, including a Data Management Plan (DMP), within the first 6 months of receiving the award, as described in the Reporting Section of this NOFO. CDC will review and approve the recipient’s monitoring and evaluation plan to ensure that it is appropriate for the activities to be undertaken as part of the agreement and for compliance with the monitoring and evaluation guidance established by CDC or other guidance otherwise applicable to this cooperative agreement. The evaluation plan should include a program logic model specific to the recipient's program, and specify process and outcome evaluation questions, methods, analysis, and how results will be used and disseminated.

CDC will work individually and collectively with DP21-2110 CCR-ETA recipients to track the implementation of recipient strategies and activities and assess progress in achieving NOFO outcomes within the four-year period of performance. Recipients are required to report data to CDC on a regular basis so that CDC can monitor progress. For Component 1 recipients, evaluation data reported to CDC will include results of the national evaluation of the CCR grant, including CCR recipient performance measure data; individual recipient evaluation plans, progress and results; and recipient performance measure data as described in this NOFO. Component 2 recipients will report evaluations and assessments of technical assistance/training/peer support activities and performance measure data as described in this

NOFO.

The data CDC collects for performance measurement and evaluation are directly related to the implementation of the strategies and/or the desired outcome indicated in the logic model.

Performance measures related to Component 1 and 2 may be proposed by recipients based on activities conducted and finalized in collaboration with CDC and recipients of DP21-2109. All performance measure data will be reported to CDC via a secure system. Recipients will report their performance measure data annually via the data system and will have access to their data only. Over the 4-year performance period, data will be secured with limited access to authorized CDC program and evaluation staff.

Short-term measures and intermediate term measures reported by recipients are described in the table below. Recipients will be required to report only on measures that align with the component they are working on (Component 1 or 2):

short-term outcomes measures for each required strategy intermediate outcomes measures

The tables below align with the logic model and show the alignment among the overarching high-level approach for each component, along with the specific strategies, outcomes and performance measures for Components 1 and 2.

CCR-Evaluation, Training, and TA:

Component 1 Strategies, Outcomes, and Performance Measures

Strategies Short-term

Outcomes and Measures

Intermediate

Long-Term Outcomes

Conduct a national evaluation of CCR efforts to monitor implementation, inform program improvement, Increased collection of high-quality monitoring and evaluation data for

CCR COVID-19

public health response efforts

Increased use and dissemination of data to inform improvement of COVID-19 public health response efforts among priority populations.

Outcome:

Decreased impact of COVID-19 on and assess overall reach/outcomes.

among priority populations

C1.S1.

Collaborate with other CCR- ETA recipients

Measure: Successful , coordinated evaluation efforts across Component A recipients

C1.S2. Plan and conduct a national evaluation of

CCR

Measure: Successful completion of an evaluation protocol, data collection tools, dissemination plan, and related training for CCR recipients Measure: # and role of CCR recipients completin g training for data collection and reporting Measure: # of CCR recipients reporting high quality data according to timelines

C1.S3. Use monitoring data for program improvement

Measure: # and types of data monitoring reports or dashboards for CCR recipients Measure: # of CCR recipients participating in regular data review processes.

C1.S4.

Dissemination

Measure: Successful completion of annual

Measure: # and type of dissemination products with evaluation results that are disseminated.

Measure: # of published manuscripts based on national evaluation and special study results.

Measure: Improved rea ch of CCR recipients as measured by evaluation outcomes (e.g., improved ratios of individuals in a community with access to CHWs) those at highest risk (priority populations) and settings.

Outcome:

Increased community resilience to respond to COVID-19 and future public health emergencies

IMPACT

Decreased health disparities evaluation results evaluation report

C1.S5. Plan and conduct special studies with a subset of CCR recipients to assess program effectiveness

Measure: Successful completion of study protocols.

Measure: # CCR recipients participati ng in special studies.

CCR-Evaluation, Training, and TA:

Component 2 Strategies, Outcomes, and Performance Measures

Strategies Short-term

Intermediate

Long-Term Outcomes

Provide training and technical assistance (TA) nat ionally to CCR recipients to ensure relevant knowledge and skills to support the COVID-19 public health response to manage outbreaks and community spread.

Increased capacity of CCR recipients to support, train, and deploy CHWs for COVID-19 public health response efforts among priority populations within their communities.

Increased reach of CHW-influenced

COVID-19

mitigation efforts among priority populations within their communities.

C2.S1. Conduct rapid assessment of CCR recipients to identify training/TA needs

Measure: # of CCR recipients participating in rapid assessment Measure: Successful completion of report with assessment results

C2.S2. Collaborate with other CCR-

Measure: Successful completion

Measure:

Improved capacity among CCR recipients to deploy CHWs to assist with COVID-19 mitigation strategies

Measure:

Outcome:

Decreased impact of COVID-19 on those at highest risk (priority populations) and settings.

Outcome:

Increased community resilience to respond to COVID- 19 and future public health emergencies

ETA recipients to develop national CCR training/TA/pe er learning plan for CCR recipients of a comprehensive tr aining/TA plan, including methods for its evaluation

C2.S3. Develop a national CCR training/TA plan that includes peer learning

C2.S4.

Develop and/or iden tify training curricul a and tools and instruments for evaluating delivery of training/TA/peer learning

Measure: # and types of training curricula dev eloped and related resources Measure: # and types of existing training curricula identified Measure: # and types of tools for evaluating training/TA

C2.S5. Establish communities of practice to facilitate information sharing and peer learning across CCR recipients

Measure: # of CCR staff participating in communities of practice per recipient Measure: Participant s’ satisfaction in communities of practice

C2.S6. Promote and deliver / facilitate training, T A, and peer learning to CCR recipients

Measure: #, mode, and type of training sessions deliv ered to CCR recipients Measure: # of CCR staff participa ting in training per recipient Measure: Increased knowledge and skills of COVID-19 mitigation strategies for CHWs Measure: #, Improved reach of CCR recipients as measured by evaluation outcomes (e.g., improved ratios of individuals in a community with access to CHWs)

IMPACT

Decreased health disparities time, and topics of T A sessions delivered per CCR recipient

C2.S7. Evaluate training and TA delivered and peer learning/community of practice activities

Measure: Successful completion of annual evaluation reports

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 the 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) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual progress reports. 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, the applicant 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.

c. Organizational Capacity of Recipients to Implement the Approach Core Capacity for All Applicants Upon receipt of award all recipients must be able to implement this program in the state, locality, https://www.cdc.gov/grants/additionalrequirements/ar-25.html territory, or tribal area in which they operate and are located. To ensure that recipients are able to execute CDC program requirements and meet period of performance outcomes, applicants must:

describe relevant experience to implement the activities and achieve the project outcomes, describe experience and capacity to implement the evaluation plan, provide a staffing plan with clearly defined staff roles (including contractual staff if applicable) and resumes of key staff, and ensure a project management structure sufficient to achieve the project outcomes. This information must be described in the project narrative. Applicants must name the staffing plan file “Component [1 or 2] Staffing Plan” and upload to www.grants.gov. Applicants must name the resumes “Component [1 or 2] Resumes” and upload to www.grants.gov. Applicants must name the organizational chart file "Component [1 or 2] Organizational Chart" and upload to www.grants.gov. Key capacity requirements include:

Leadership and management to plan and supervise the project and improve outcomes.

Budget management and administration capacity to establish financial procedures and track, monitor, and report expenditures.

Contract management to manage any procurement efforts, including the ability to write, award, and monitor contracts, if included.

Evaluation and performance monitoring to implement the recipient evaluation plan and maintain programmatic quality, consistency, and fidelity.

Description in the project narrative of awareness of CDC-funded programs or other federally funded programs, that support the ongoing COVID-19 response.

Description in the project narrative of experience convening and/or supporting a community coalition to achieve program goals.

Component 1: National evaluation of DP21-2109 (CCR). Applicants for Component 1 must have the following:

Readiness and ability to begin program activities within 1 month of award.

Approximately 5 years’ experience conducting large-scale evaluations of public health activities carried out by multiple entities (e.g., states, localities, tribal organizations).

Provide an organizational chart.

Expertise in program evaluation, including expertise in multiple evaluation methods (e.g., surveys, cost studies, qualitative case studies) and analysis methods (e.g., descriptive analysis, logical regression modeling).

Experience developing performance measures and collecting/analyzing performance measurement data.

Knowledge of CHW interventions to address public health problems.

Experience working with diverse populations.

Experience designing and conducting rigorous evaluation studies.

Experience in designing data collection instruments (e.g., surveys, case study interviews) and providing training/technical support to support data collection efforts Data management expertise to support development of data reporting systems and maintenance of high quality data.

Experience disseminating evaluation results, including writing publishable manuscripts and visually engaging briefing documents.

http://www.grants.gov/

Component 2: Training and technical assistance (TA) for CCR recipients

Readiness and ability to begin program activities within 1 month of award.

Experience collaborating with partners on public health efforts.

Approximately 5 years’ experience developing and delivering training and technical assistance to public health agencies.

Provide an organizational chart.

Expertise in developing culturally appropriate curricula and training materials and in designing and facilitating communities of practice.

Knowledge of CHW interventions to address public health problems.

Experience working with diverse populations.

Experience evaluating training/TA efforts.

d. Work Plan Applicants should provide a detailed work plan for the first year of the project and a high-level work plan for the subsequent year. Objectives should be written in SMART (specific, measurable, achievable, realistic, timely) format. The work plan should include evidence-based strategies and activities to achieve all outcomes listed in the logic model.

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

Applicants must name this file "Component ___[1 or 2] Work Plan" and upload to www.grants.gov.

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.

Collaboration with CDC is required to maintain alignment with the overall mission and to track progress and performance. The proposed work plans and performance measures will be reviewed by CDC and may need to be altered to better reflect program activities as outlined in the NOFO.

CDC will analyze programmatic and performance measure data to assess areas of improvement, identify technical assistance needs and report progress and outcomes.

CDC will review and approve the recipient’s monitoring and evaluation plan to ensure that it is appropriate for the activities to be undertaken as part of the agreement and for compliance with the monitoring and evaluation guidance established by CDC or other guidance otherwise applicable to this cooperative agreement. The evaluation plan should include a program logic model specific to the recipient's program, and specify process and outcome evaluation questions, methods, analysis, and how results will be used and disseminated.

f. CDC Program Support to Recipients

If funded, a cooperative agreement, as defined by the Federal Grant and Cooperative Agreement Act of 1977 (P.L. 95-224, 31 USC 6301 et seq.), will be used as the funding mechanism to award funds. CDC will have substantial programmatic involvement after the award is made. Substantial involvement is in addition to all post-award monitoring, technical assistance, and performance reviews undertaken in the normal course of stewardship of federal funds and is not intended to gain stricter controls. CDC will coordinate, facilitate, collaborate, and/or intervene to programmatically effectuate performance under the award. The substantial involvement responsibilities enumerated in this NOFO and any additional substantial involvement responsibilities will be used to benefit the program.

CDC will provide technical assistance to recipients through a variety of mechanisms including:

Support collaboration across recipients of each component;

Collaborate to determine the best means to collect program data from CCR recipients;

Provide technical…