cdc-rfa-eh15-1507 amend 1.pdf

Centers for Disease Control and Prevention

National Center for Environmental Health

Environmental Health Services Support for Public Health Drinking Water Programs to Reduce Drinking

Water Exposures

CDC-RFA-EH15-1507

Application Due Date: 06/22/2015

Environmental Health Services Support for Public Health Drinking Water Programs to Reduce Drinking Water Exposures

CDC-RFA-EH15-1507

TABLE OF CONTENTS

Part I. Overview Information

Federal Agency NameA.

Funding Opportunity TitleB.

Announcement TypeC.

Agency Funding Opportunity NumberD.

Catalog of Federal Domestic Assistance (CFDA) NumberE.

Dates F.

Executive Summary G.

Part II. Full Text

Funding Opportunity Description A.

Award Information B.

Eligibility Information C.

Required Registrations D.

Review and Selection Process E.

Award Administration Information F.

Agency Contacts G.

Other Information H.

Glossary I.

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-EH15-1507. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

Environmental Health Services Support for Public Health Drinking Water Programs to Reduce Drinking Water Exposures C. Announcement Type: New - Type 1 This announcement is only for non-research domestic activities supported by CDC. If research is proposed, the application will not be considered Research for this purpose is defined at http://www.cdc. gov/od/ science / integrity/ docs/cdc- policy- distinguishing- public- health- research- nonresearch. pdf.

N/A

D. Agency Funding Opportunity Number:

CDC-RFA-EH15-1507

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

93.070 F. Dates:

1. Due Date for Letter of Intent (LOI): 05/21/2015

2. Due Date for Applications: 06/22/2015, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: N/A Due date for letter of intent changed from 6/17/2015 to thirty days before award closes 05/21/2015.

G. Executive Summary:

1. Summary Paragraph:

This FOA seeks applications from state and local health departments and U.S. Territories and Native American tribal public health agencies. Funding these initiatives will improve the recipients’ ability to identify and address drinking water (DW) program performance gaps, improve efficiency and effectiveness of DW programs, and to identify and reduce exposures associated with drinking water contamination. The intended audiences of this FOA are communities and populations using small drinking-water systems (e.g., private wells, springs, cisterns, tankered water) that are not covered under the Federal Safe Drinking Water Act (SDWA). For example, approximately 13% of U.S. households, or about 43 million people, use private wells in the United States. CDC will fund as many as 20 awards to support DW programs to reduce exposure to waterborne contaminants that affect public health.

The purpose of this Amendment 1 is to provide clarification on the FOA submission of letter of intent LOI due date, and funding. The changes are on page 1 and 2 in the overview and eligibility section of the FOA.

a. Eligible Applicants: Limited

b. FOA Type: Cooperative Agreement

c. Approximate Number of Awards: 20 https://foa.grantsolutions.gov/announcementmodule/www.grants.gov https://foa.grantsolutions.gov/announcementmodule/www.grants.gov http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.grants.gov

CDC anticipates funding 15-20 awards, the number of awards funded will be at the discretion of the government and based on the availability of funds.

Spelling correction for word discretion

d. Total Project Period Funding: $10,000,000

e. Average One Year Award Amount: $100,000 CDC anticipates an award range from 100,000 to 133,333 with an average award of 130,000.

f. Number of Years of Award: 5

g. Estimated Award Date: 09/30/2015

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

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview

Drinking water programs across the United States demonstrate considerable variation in capacity, partnerships, policy environment, programmatic focus, efficiency, and effectiveness. This programmatic variability is influenced by the type of water resources, the size of the community being served, and the many point and non-point sources of pollution affecting the resource. A particular area of concern for many water programs are the numerous private wells and other small drinking-water systems that are not regulated under the Federal Environmental Protection Agency’s (EPA) Safe Drinking Water Act (SDWA). State, tribal, local, and territorial (STLT) public health departments are usually the only agencies working to protect the health and well-being of community household members that rely on these systems. State laws and regulations for private wells vary widely and tend to focus only on licensing the entities that construct wells and the construction of those wells. More than half of states in the U.S. do not require testing of private wells after they are constructed. Where state testing requirements do exist, the testing is usually infrequent (e.g., wells must be tested as part of a real estate transaction). Most DW programs offering services (e.g., water testing from wells and other unregulated drinking water sources) are voluntary and require strong outreach by the STLT health departments to assure the delivery of services.

b. Statutory Authorities

This program is authorized under Section 317(k)(2) of the Public Health Service Act [42 U.S.C. Section 247b(k)(2)], as amended.

c. Healthy People 2020

This FOA supports four of the basic themes of the Environmental Health Topic Area: Surface and Ground Water Quality, Toxic Substances and Hazardous Wastes, Homes and Communities, and Infrastructure and Surveillance. Please refer to: http://www.healthypeople.gov/2020/default.aspx

d. Other National Public Health Priorities and Strategies http://www.healthypeople.gov/2020/default.aspx

This program will be aligned with CDC’s Vision, Mission, and Core Values, which are located on the CDC Web site at: http://www.cdc.gov/about/organization/mission.htm , This program also draws from the important public health framework described as the 10 Essential Public Health Services, http://www.cdc.gov /nphpsp/essentialservices.html that describe the important services activities that are defined by the core functions of public health.

e. Relevant Work

In 2010, CDC-NCEH initiated the Private Well Initiative (PWI), which launched the PWI National Workgroup with more than 120 participants, and the Funding Opportunity Announcement (FOA EH11-1108, Enhancing Capacity for Environmental and Public Health Surveillance for Unregulated Drinking Water, issued in September 2011). EH11-1108 funded seven states to begin accessing and assessing existing water quality data from multiple jurisdictions and entities across their states. In addition, the Environmental Health Specialist Network (EHS-Net) Water program has supported state and local activities through EH10-001, Revitalizing Core Environmental Health Programs through the Environmental Health Specialists Network (EHS-Net); and EH10-1001, Revitalizing Core Environmental Health Programs through the Environmental Health Specialists Network (EHS-Net): Delivering Environmental Health Services. EH10-001 and EH10-1001 have collected data and implemented evidence-based interventions that identifed environmental factors that cause foodborne and waterborne illnesses and thus, prevented outbreaks of these illnesses. In 2013, CDC-NCEH launched the Funding Opportunity Announcement FOA EH13-1301: Improving state and local capacity to assess and manage risks associated with private wells and other small drinking water systems by using the Environmental Health Specialist Network [EHS-Net].

EH13-1301 funded 11 state and local health departments to 1. Create a sustainable system to analyze unregulated drinking water system data; 2. Describe exposures to contaminants and their associated health risks; and 3. Implement interventions to address identified hazards and exposures.

For more information, see: http://www.cdc.gov/nceh/ehs/EHSNet/index.htm or http://www.cdc.gov/nceh/hsb /cwh/pwi.htm or http://www.cdc.gov/nceh/ehs/News/Features/2014/private-wells.html

2. CDC Project Description

a. Approach

CDC-RFA-EH15-1507 Logic Model: Environmental Health Services Support for Public Health Drinking Water Programs to Reduce Drinking Water Exposures*

Strategy/Activities Short-term

Outcomes

Medium-term

Outcomes

Long-term

Outcomes

Identify and align project implementation activities with performance improvement areas based on program gaps* Implement performance improvement activities Reassess

a) Increase in community stakeholder awareness of DW problems, hazards, exposures, illness, and performance gaps

b) Increase in awareness and knowledge about the policies/regulations

e) Increase in DW programs and practices that have improved efficiency (time, effort, and cost)

f) Increase in the jurisdictions with enforecement of feasibile policies

i) Decreased drinking water hazards

j) Reduced exposure to waterborne contaminants

k) Decreased number of people in the U.S. drinking contaminated http://www.cdc.gov/about/organization/mission.htm http://www.cdc.gov/nphpsp/essentialservices.html http://www.cdc.gov/nphpsp/essentialservices.html http://www.cdc.gov/nceh/ehs/EHSNet/index.htm http://www.cdc.gov/nceh/hsb/cwh/pwi.htm http://www.cdc.gov/nceh/hsb/cwh/pwi.htm http://www.cdc.gov/nceh/ehs/News/Features/2014/private-wells.html

Reassess performance improvement activities as needed Conduct process and outcome evaluations policies/regulations that affect DW

c) Increase in the willingness of partner organizations to collaborate in evidence-based activities to reduce exposure to DW contaminants

d) Increase in customer satisfaction with DW services feasibile policies and regulations based on evidence and need

g) Increase in the reach of DW programs

h) Increase in DW programs that have established a continual process to routinely close performance gaps to improve DW services water

l) Improved health of Americans through better access to safe water

Bold indicates a project period outcome

*(Note: A complete programmatic logic model that displays the 10 performance improvement areas (i.e., the performance improvement areas that align with the 10 essential environmental public health services) is available at: http://www.cdc.gov/nceh/ehs/envphps/dw-logic -model.htm)

i. Purpose

EHSB’s mission is to strengthen the role of local, state, tribal, and national environmental public health programs and professionals to better anticipate, identify, and respond to adverse environmental exposures and their consequences for human health. This FOA will facilitate EHSB’s mission by improving the capacity of state and local health departments, U.S. Territories and Native American Tribal health agencies to identify, address, and close drinking water program performance gaps using performance improvement activities that align with the 10 Essential Environmental Public Health Services; improve efficiency and effectiveness of DW programs; and, to identify and reduce exposures from waterborne contaminants.

ii. Outcomes

Recipients of funds awarded through this Funding Opportunity Announcement (FOA) are expected to reach relevant outcomes as they relate to their implementation/intervention activities:

Short-Term:

a) Increase in community stakeholder awareness of DW problems, hazards, exposures, related illness, and performance gaps

b) Increase in awareness and knowledge about the policies/regulations that affect DW

c) Increase in the willingness of partner organizations to collaborate in evidence-based activities to reduce exposure to DW contaminants http://www.cdc.gov/nceh/ehs/envphps/dw-logic-model.htm http://www.cdc.gov/nceh/ehs/envphps/dw-logic-model.htm

Medium-term:

a) Increase in DW programs and practices that have improved efficiency (time, effort, and cost)

b) Increase in the reach of drinking water programs

c) Increase in DW programs that have established a continual process to routinely close performance gaps to improve DW services

Long-Term

a) Decreased drinking water hazards

b) Reduced exposure to waterborne contaminants

iii. Strategies and Activities

Specific strategies are:

1. Expect agencies intending to apply to the FOA to conduct a performance assessment of their drinking water program/activities using the 10 Essential Environmental Public Health Services to identify performance gaps, and develop quality improvement activities to close identified performance gaps.

More specifically, public health agencies that have previously conducted a performance assessment (http ://www.cdc.gov/nceh/ehs/envphps/ ) of their DW program/activities using the 10 Essential Environmental Public Health Services are encouraged to apply for this FOA. The previously conducted assessment should have identified DW program performance gaps and also prioritized potential quality improvement activities to help close the DW program gaps.

2. Develop and implement interventions that align with performance improvement areas and based on quality improvement plans and other relevant data and evidence to close programmatic gaps

Agencies that apply to this FOA will use information gathered during the performance assessment to develop implementation and intervention activities to close their identified gaps. In particular, agencies will develop and align implementation/intervention activities along performance improvement areas associated with the 10 Essential Environmental Public Health Services. It is not anticipated that agencies will address all performance improvement areas simultaneously, but that they propose an approach that will ensure their DW programs reach the stated outcomes by closing their programmatic gaps.

Examples of performance improvement areas, which align with the 10 Essential Environmental Public Health Services are as follows:

Performance Improvement Area 1 - Monitor environmental and health status to identify and solve community environmental public health problems

Organize DW quality, water system and health data in a format that aids clear communication and interpretation by the public and policy makers.

Collect and use DW hazard, exposure, and health outcome data from a range of sources involved in environmental and public health protection (e.g. epidemiology, disease registries, tracking partners, local and state departments of environmental quality).

Performance Improvement Area 2 - Diagnose and investigate environmental public health problems and health hazards in the community

Develop partnerships with epidemiologists, statisticians, laboratory professionals, toxicologists, hydrologists, and others needed to assist in analyzing DW program data (hazards, exposures, health outcomes).

Performance Improvement Area 3 - Inform, educate, and empower people about environmental public health issues http://www.cdc.gov/nceh/ehs/envphps/ http://www.cdc.gov/nceh/ehs/envphps/

Establish working environments/coalitions so that multiple partners (e.g., health department, planning and zoning, public works, building, environmental advocacy groups, and the media) have a forum to work together on DW education and promotion activities.

Performance Improvement Area 4 - Mobilize community partnerships and actions to identify and solve environmental health problems

Develop partnerships among government agencies and the private sector to enhance DW program effectiveness.

Performance Improvement Area 5 - Develop policies and plans that support individual and community environmental public health efforts

Promote prevention and protection policies for community members who bear a disproportionate burden of disease, or that are at greater risk of exposure to DW hazards.

Performance Improvement Area 6 - Enforce laws and regulations that protect environmental public health and ensure safety

Organize the updating and/or modification of existing or new rules, regulations, and ordinances designed to assure and improve DW protection programs and DW quality

Performance Improvement Area 7 - Link people to needed environmental public health services and assure the provision of environmental public health services when otherwise unavailable

Create and provide leadership for work groups of multiple agencies that have responsibility for assuring that DW program services delivery system is coordinated, timely and responsive to all community members.

Performance Improvement Area 8 - Assure a competent environmental public health workforce

Communicate workforce gaps and needs to appropriate stakeholders (governing bodies, advisory groups, academic institutions, and public and private agencies) that have the capabilities to effect change.

Performance Improvement Area 9 - Evaluate effectiveness, accessibility, and quality of personal and population-based environmental public health services

Develop an activity to assess and measure the satisfaction of stakeholders and residents with drinking water services programs that includes a process to provide increased quality of services.

Performance Improvement Area 10 - Essential Environmental Public Health Service 10: Find new insights and innovative solutions to environmental public health problems

Develop partnerships with colleges, universities and organizations needed to assure implementation of evidence-based practices to improve program performance.

Water programs addressing private wells and small drinking water systems not covered by the SDWA vary in capacity, size, funding, partners, priorities, and target population. Likewise, the performance improvement necessary to reach intended program outcomes such as a reduction in hazards and exposure to waterborne contaminants are going to vary by program. Aligning programmatic interventions and activities with performance improvement areas is intended to close programmatic gaps that prevent DW programs from reaching the prioritized outcomes.

It is expected that the agencies awarded funding will close DW program performance gaps. Agencies need to consider new and innovative ways to protect public health by changing and/or enhancing the way they practice environmental health as it relates to their drinking water program.

3. Reassess, realign, and develop new programmatic interventions and activities with new performance improvement areas as needed

During the course of this 5-year FOA, it is anticipated that applicants will need to periodically reassess their

During the course of this 5-year FOA, it is anticipated that applicants will need to periodically reassess their program gaps and work in new performance improvement areas as needed.

4. Conduct evaluations considering process and outcome questions to determine if there were improvements to efficiency and effectiveness of programs

Funded agencies will also monitor the performance of their activities and interventions and conduct process and outcome evaluations of their activities to determine if they have reached outcomes associated with improved efficiency and effectiveness; and if not, what may have prevented them from achieving those outcomes.

5. Disseminate findings with relevant partners and stakeholders

FOA activities will help NCEH/EEHS/EHSB to identify DW programmatic services areas that need strengthening. The activities of this FOA will also aid NCEH/EEHS/EHSB in their understanding of the environmental factors that contribute to the presence of hazards and exposures causing disease and illness related to private wells and other small drinking water systems not covered by the EPA’s SDWA.

1.Collaborations

Collaboration and partnership building is one of the essential environmental public health services.

Applicants should describe existing partnerships and collaborations in light of their capacity for continuing work related to their water program/activities. If applicants identify a performance improvement activity around partnerships, they should also describe the importance of the new partnership or collaboration and why they are fundamental for improving DW program/activity efficiency and effectiveness. Particularly important will be descriptions of partnerships and coalitions that will empower DW programs to address potential health disparities, underserved populations and environmental justice issues related to using unregulated drinking water systems.

a. With CDC-funded programs:

Applicants may describe ongoing activities with CDC funded programs (e.g., Environmental Health Specialists Network (EHS-NET) - http://www.cdc.gov/nceh/ehs/ehsnet/index.htm, and Environmental Public Health Tracking -http://www.cdc.gov/nceh/tracking/); however, these collaborations are optional and not not a requirement.

b. With organizations external to CDC:

Collaborate with organizations that can help achieve the FOA initiatives. Please provide Letters of Support as evidence of your collaboration with partners. Examples of these organizations may include:

business communities, nongovernment organizations, media organizations, environmental and social justice groups emergency management agencies nonprofit agencies, other federal, state, or local government agencies,and public health communities, and Tribes and/or tribal organizations.

2. Target Populations http://www.cdc.gov/nceh/ehs/ehsnet/index.htm http://www.cdc.gov/nceh/tracking/

This FOA will focus on households, individuals, and water systems not covered by the Safe Drinking Water Act (SDWA) and the programs that exist to serve them. Applicants should provide data and information that describe how segments of the target population may bear a disproportionate burden of health risk and how these segments of the target population may be described as a vulnerable population (i.e., a population at an increased risk for adverse health-related outcomes due to drinking water issues driven by racial, cultural, social, and economic conditions). Applicants should also consider how meaningful involvement of affected populations during performance improvement activities will be essential to addressing health and service inequities.

If possible applicants should describe barriers that have prevented reaching vulnerable populations and underserved communities and provide solutions for how these barriers can be overcome.

Another area of vulnerability cross-cutting all populations and leading to high risk are the influences of climatic changes. This includes the broad range of weather patterns affecting the hydrologic cycle, impact to watersheds, and impacts on the functional limits of existing water services infrastructure. Populations that have historically relied on stationarity of weather patterns to influence the design, management, and planning around water resource use, may be affected by changes in the volume, timing and quality of available water.

Applicants should try to indicate areas within their target populations where water resource management and planning activities must adapt to the impacts of extreme weather events and how they should better accommodate the needs of the populations being served.

a. Inclusion

N/A

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

N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

The purpose of this project is to support public health program capacity to identify, address, and close programmatic performance gaps; and, improve the efficiency and effectiveness of DW programs. The project is designed to also meet the diverse needs of DW programs to strengthen the core functions of their programmatic efforts. Awardees will provide process and outcome evaluations to measure the success of their project’s initiatives. The process and outcome evaluations will enable awardees to: 1) identify and describe project strengths and weaknesses; 2) detect project areas that need improvement; and 3) determine whether project objectives and intended outcomes are being achieved and 4) identify barriers preventing the implementation of performance improvement efforts; and 5) identify new program gaps and initiate new interventions and activities aligned with the relevant performance improvement areas to close them. EHSB will aggregate data from awardees to determine overall program impact.

(1) Process Evaluation

Awardees will conduct process evaluations during each project year for the length of the award to determine specifically whether the project is being implemented as designed, is operating as intended, and is achieving expected outputs and moving towards outcomes. Process questions align with the strategies presented in the logic model and narrative. The process evaluation should answer the questions:

Strategy: Identify and align project implementation activities with performance improvement areas based on program gaps

1. Was a program gap analysis conducted?

2. Do the chosen program improvement areas align with the gaps?

3. Do the chosen project implementation activities align with the performance improvement areas?

Strategy: Implement performance improvement activities

1. Have all planned project activities been implemented?

Potential output measures depending on the selected performance improvement activity:

Surveillance system established Number of DW samples and inspections processed in a timely manner Number of assessments completed to relate DW water problems to environmental factors Number of datasets made publicly available Number of culturally appropriate community meetings implemented Number of targeted educational activities delivered Plan developed to create/revise feasible policies/regulations/recommendations Evidence-based intervention plan developed to identify and remove hazards Number of partnerships developed

Note: Outputs from applicant activities are expected to vary depending on the activities and interventions chosen and as they align with the selected performance improvement areas. However, particularly important for the approach are the following output measures:

Wells newly identified Wells newly tested Number of wells identifying hazards of concern Wells with hazards exceeding standards or health action limits, and Number of wells with hazards decreased and exposures prevented

2. Were project activities implemented on schedule?

% of work plan activities completed on schedule Number of performance improvement activities and interventions completed Number of project completion dates met

Strategy: Reassess performance improvement activities as needed

1. What problems were encountered with project implementation?

Qualitative description of the challenges encountered and the solutions to overcome challenges

2. What additional gaps were identified and what new implementation objectives were added as a result?

Number of new performance improvement activities undertaken in the project period Number of performance assessments conducted in project period

Strategy: Conduct process and outcome evaluations

1. Number of performance assessments conducted in project period

2. Number of outcome evaluations conducted in project period

(2) Outcome Evaluation

Awardees will continually monitor performance and understand progress towards outcomes annually; and, a full outcome evaluation will be conducted on all activities by the end of Year 5 to assess changes that occurred as a result of their project, and determine whether proposed outcomes have been achieved.

Outcome indicators measure the quantity and quality of the results achieved through implementing a project and its activities. To evaluate an outcome, awardees will have to compare baseline data with outcome data.

CDC is recommending the following outcomes and measures as examples and guidance for this project.

Short-Term Outcomes

Variability is expected with short-term outcomes since these will align with selected performance improvement areas. Some possible examples include:

Outcome: Increase in community stakeholder awareness of DW problems, hazards, exposures, illness, and performance gaps

Measure: Percent of the target audience aware of a prevention message at baseline and project or period end date Measure: Percent of target audience that test well water at baseline and project period end date Measure Number of households that have never tested their drinking water source that engage in testing based on new information Measure: Number of private well/small water system customers counseled about a specific exposure control behavior at baseline and/or project period end date

Outcome: Increase in awareness and knowledge about the policies/regulations that affect DW

Measure: comparison of the baseline values and end of project value of private well owners who comply with a new policy item or regulation.

Outcome: Increase in the willingness of partner organizations to collaborate in evidence-based activities to reduce exposure to DW contaminants

Measure: comparison of the baseline number and end of project number of partnerships/collaborative efforts to implement evidence-based activities/interventions to reduce exposure to waterborne contaminants.

Outcome: Increase in customer satisfaction with DW services

Measure: comparison of the percentage of customers that is positively satisfied with a DW service or package of services at project start and end.

Mid-term Outcomes:

Outcome: Increase in DW program and practices that have improved efficiency:

[Example: time]: Reduce the amount of time to complete a DW program process or activity

Measure: comparison of a baseline value of the time recorded for a specific process/service to the actual value after implementation of a performance improvement activity

[Example: Cost of service]: Reduce the cost of DW program service

Measure: comparison of a baseline value of the cost for a specific service to the actual value after implementation of a performance improvement activity

[Example: Cost of implementation]: Reduce the cost of DW program process implementation

Measure: comparison of a baseline value of the cost for DW program process implementation to the actual value after implementation of a performance improvement activity

[Example: Effort]: Reduce the number of steps required to complete a DW process or service

Measure: comparison of a baseline value of the steps needed for DW program process implementation to the actual value after implementation of a performance improvement activity

Outcome: Increase the reach of the DW program [i.e., percentage of a target population that has been offered/received/engaged in programmatic service area]

Measure: Size of intervention population(s) being offered/receiving/engaging in a programmatic service at project start and end.

Long-term Outcomes:

Outcome: Reduce hazards that threaten UDWS

Measure: Degree of contamination of local concern in drinking water comparison before and after implementation/intervention activities

Outcome: Eliminate exposure to waterborne contaminants

Measure: number or percentage of households engaging in a personal protection activity/preventative behavior to control exposure

The awardee must report progress attained from their performance measures in their bi-annual reports.

ii. Applicant Evaluation and Performance Measurement Plan

Applicants must provide an agency logic model, and evaluation and performance measurement plan that is consistent with the CDC strategies and represents the nuances of their approach. It is expected that the agency logic model will use similar or adapted medium- and long-term outcomes measures that might slightly vary in specificity based on contaminant(s) of concern. Variability is expected related to project inputs, strategies/activities, outputs and short-term outcomes. The variability of applicant’s logic model and evaluation and performance measurement plans will reflect the results of their performance assessment and the alignment of project interventions and activities with applicable performance improvement areas.

At a minimum, the plan must:

Describe how current key program partners and future partners will support the execution of activities to achieve outcomes of the applicant’s project.

Describe key evaluation questions to be answered.

Describe process/performance and outcome measures to be used by the applicant as they mirror the suggested measures described by CDC/EHSB (see section i. CDC Evaluation & Performance Measurement Strategy). If there is specific information needed to describe “success” of the measure, it should be provided.

Describe a data collection plan that specifies data sources and feasibility of collecting the appropriate data needed for the process/performance and outcome evaluation. The data use/collection plan should align evaluation questions with their corresponding indicators, data collection method, data source, frequency of data collection, and describe the responsible parties that will assure the data collection activity is implemented.

Describe how process/performance and outcome findings will be used to assess program progress for closing performance gaps and identifying new interventions and activities that align with performance improvement areas to continuously improve program quality.

c. Organizational Capacity of Awardees to Execute the Approach

Applicants must be able to describe their capacity to execute the CDC program strategy and to conduct programmatic efforts and activities that align with their selected performance improvement areas.

Additionally, this will require knowledge of the Environmental Public Health Performance Standards for completing a performance assessment and identifying performance improvement areas (http://www.cdc.gov /nceh/ehs/envphps/docs/envphpsv2.pdf); or, require knowledge of and capacity to use a similar process for identifying programmatic gaps and developing quality improvement activities. Additionally, the applicants have to demonstrate the ability to meet the project period outcomes as outlined in the FOA approach.

The applicant should also describe their organizational capacity and relevant experience to execute the award in each of the following areas: 1) Program planning; 2) Program evaluation; 3) Performance monitoring; 4) Financial reporting; 5) Budget management and administration, and 6)Personnel management. In the applicant description of each preceding area, emphasis should be placed on relevant experience and capacity that will ensure that prioritized outcomes will be addressed.

In specific regards to personnel management and staffing, applicants should include a clear description of the roles and responsibilities of project staff. Applicants should also clearly indicate the staff persons that have day-to-day responsibilities for key tasks as mentioned above (i.e., program planning, program evaluation, performance monitoring, financial reporting, and budget management and administration) and additionally describe communication responsibilities with CDC and other partners.

Applicants may consider describing their current status in applying for public health department accreditation or their evidence of accreditation. Information on accreditation is available at: http://www .phaboard.org.

d. Work Plan

All applicants are expected to accomplish the following types of activities:

Propose projects, evidence-based interventions, and/or activities that align with their identified performance improvement areas that are prioritized for closing programmatic gaps and for empowering programs to address and reach their stated outcomes as identified in their program logic model. The projects, evidence-based interventions and/or activities should be described in terms of the expected duration to implement for a period of up to five years. Applicants may also describe a process in their work plan whereby they indicate the need for subsequent performance assessments and how the results of these assessments would be incorporated into ongoing activities and implemented, and the duration of these new activities.

Included activities may be:

Performance Improvement Area 1 - Monitor environmental and health status to identify and solve community environmental public health problems

Organize DW quality, water system and health data in a format that aids clear communication and interpretation by the public and policy makers (e.g., Use an existing dataset to identify geographical areas targeted for interventions).

Collect and use DW hazard, exposure, and health outcome data from a range of sources involved in environmental and public health protection (e.g. epidemiology, disease registries, tracking partners, local and state departments of environmental quality).

Additional activities under performance improvement area 1 could include:

Conduct a community environmental health assessment to identify drinking water issues.

http://www.cdc.gov/nceh/ehs/envphps/docs/envphpsv2.pdf http://www.cdc.gov/nceh/ehs/envphps/docs/envphpsv2.pdf http://www.phaboard.org/ http://www.phaboard.org/

Determine drinking water quality trends by comparing analysis results to relevant benchmarks and historical data.

Develop a drinking water profile for a geographical location/jurisdiction.

Make drinking water quality data, health information and water system information easily available to individuals, community groups, and other organizations in a printed and web-based version.

Identify appropriate tools, such as GIS, and other technology needed to support the monitoring of drinking water associated hazards, exposures and health outcomes (e.g., Develop a model to predict or assess the presence or movement of groundwater contaminants that may affect private wells or other

UDWS).

Identify drinking water system information and data gaps.

Identify drinking water hazard, exposure and health outcome information and data gaps.

Performance Improvement Area 2 - Diagnose and investigate environmental public health problems and health hazards in the community

Develop partnerships with epidemiologists, statisticians, laboratory professionals, toxicologists, hydrologists, and others needed to assist in analyzing DW program data (hazards, exposures, health outcomes).

Additional activities under performance improvement area 2 could include:

Create a drinking water surveillance system that uses timely information from a variety of sources (e.g., Digitize data currently held in another, less accessible format).

Develop protocols to investigate patterns and/or outbreaks of water-related illness, disease, hazards, and exposures.

Enhance environmental health staff ability to apply epidemiologic and statistical methods.

Roles and responsibilities of environmental health staff related to drinking water integrated into the all hazards emergency response plan.

Develop protocols to guide investigation of and response to drinking water threats and emergencies.

Develop a roster of personnel with technical expertise to respond to potential natural disasters, biological, chemical or radiological drinking water emergencies.

Establish agreements and/or procurement processes to access (24 hours-per-day/7 days-per-week) approved laboratories capable of supporting investigations of drinking water problems, hazards and emergencies.

Develop guidelines for the collection and handling of laboratory samples and reporting of results.

Performance Improvement Area 3 - Inform, educate, and empower people about environmental public health issues

Establish working environments/coalitions so that multiple partners (e.g., health department, planning and zoning, public works, building, environmental advocacy groups, and the media) have a forum to work together on DW education and promotion activities.

Additional activities under performance improvement area 3 could include:

Develop an environmental health communications plan that regularly provides the community (general public, policy makers, and public and private stakeholders) with EH information on drinking water to enable effective individual, community and policy action.

Work with the community to identify health education needs and implement a plan for reaching different segments of the community.

Develop appropriate drinking water messaging for vulnerable, sensitive, or disproportionately impacted segments of the community. Assure that existing drinking water communication plans provide guidance on creating messages and materials appropriate for different communication channels (e.g. Internet, print, radio, and television, social media).

Develop emergency communication plan(s) to share information among key responders and the public in the event of potentially serious environmental health threats, disease outbreaks and other emergencies around drinking water.

Performance Improvement Area 4 - Mobilize community partnerships and actions to identify and solve environmental health problems

Develop partnerships among government agencies and the private sector to enhance DW program effectiveness.

Additional activities under performance improvement area 4 could include:

Develop a directory of key constituents and stakeholders interested in drinking water protection.

Implement a process that involves constituents in key decisions and development of drinking water policy.

Performance Improvement Area 5 - Develop policies and plans that support individual and community environmental public health efforts

Promote prevention and protection policies for community members who bear a disproportionate burden of disease, or that are at greater risk of exposure to DW hazards.

Additional activities under performance improvement area 5 could include:

Establish a community environmental health improvement process for the drinking water program to identify policy needs.

Establish a process to review existing policies every two years for feasibility and effectiveness.

Integrate community environmental health assessment findings and stakeholder input into a community drinking water improvement plans focusing on environmental health priorities, policies and resources.

Develop a community all-hazards emergency preparedness and response plan for drinking water.

Performance Improvement Area 6 - Enforce laws and regulations that protect environmental public health and ensure safety

Organize the updating and/or modification of existing, or new rules, regulations, and ordinances designed to assure and improve DW protection programs and DW quality

Additional activities under performance improvement area 6 could include:

Conduct a revision of state and local laws, regulations, and ordinances periodically (at least once every five years) to assess their impact on the health of the community and determine whether they need updating.

Identify and develop plans for closing gaps in public health and environmental laws, regulations, or ordinances related to drinking water.

Develop a process to assure the drinking water program provides timely, consistent and equitable enforcement of environmental health protection laws, regulations, ordinances, and policies within all segments of the jurisdiction.

Educate community members (e.g., individuals and businesses) that have to comply with environmental health laws, regulations and ordinances related to drinking water by providing information about their meaning and purpose.

Assess the ability of community members to comply and be responsive with drinking water regulations.

Performance Improvement Area 7 - Link people to needed environmental public health services and assure the provision of environmental public health services when otherwise unavailable the provision of environmental public health services when otherwise unavailable

Create and provide leadership for work groups of multiple agencies that have responsibility for assuring that DW program services delivery system is coordinated, timely and responsive to all community members.

Additional activities under performance improvement area 7 could include:

Enhance the drinking water services being offered and received by target populations with a focus on those communities and members that have limited access or barriers to environmental public health services.

Design an active outreach and referral mechanism to link community members to drinking water and public health and protection services.

Build and define activities for drinking water coalitions by developing written agreements (memorandums of understanding) with stakeholders that have responsibility for protecting the environment and drinking water quality.

Performance Improvement Area 8 - Assure a competent environmental public health workforce

Communicate workforce gaps and needs to appropriate stakeholders (governing bodies, advisory groups, academic institutions, and public and private agencies) that have the capabilities to effect change.

Additional activities under performance improvement area 8 could include:

Develop a plan to identify and close workforce gaps to assure the timely delivery of drinking water services to the community members that receive them.

Establish a program/process to assure that the environmental health workforce has the proper licensure, registration and certification for environmental public health drinking water services.

Develop clear and targeted workforce plan that describes the positions, capacities, performance, and evaluation of performance required to run an efficient and effective drinking water program.

Establish a process/plan to enhance competencies and leadership abilities of the environmental public health workforce to anticipate, address and solve drinking water program problems that includes incentives (improvements in pay, tuition reimbursement, time-off from work).

Performance Improvement Area 9 - Evaluate effectiveness, accessibility, and quality of personal and population-based environmental public health service

Develop an activity to assess and measure the satisfaction of stakeholders and residents with drinking water services program that includes a process to provide increased quality of services.

Additional activities under performance improvement area 9 could include:

Develop a process or series of action plans to establish an ongoing process to assess drinking water program performance and quality improvement.

Promote the evaluation of how multiple agencies with responsibility in drinking water protection work together to coordinate and provide timely responses to all constituents.

Evaluate an existing intervention designed to promote the safety of water from Unregulated Drinking Water System.

Performance Improvement Area 10 - Essential Environmental Public Health Service 10: Find new insights and innovative solutions to environmental public health problems

Develop partnerships with colleges, universities and organizations needed to assure the implementation of evidence-based practice to improve program performance.

Additional activities under performance improvement area 10 could include:

Work with partners to prioritize evidence base needed to improve drinking water services and conditions.

Disseminate drinking water program best practices and innovations, and apply these practices to existing program.

Additional work plan activities should address the following:

Where possible, applicants that are aware of their state Performance Improvement Managers should work with them to develop quality improvement activities using available quality improvement tools for solving efficiency and effectiveness priorities as they align with their prioritized performance improvement areas.

Applicants should include in their work plans a description of their availability for participating in Grantee discussions, Private Well Community of Practice Webinars, and collaborating with other private well and small drinking water system practice-based workgroups of importance to identify and address emerging UDWS-related priorities and focus areas.

How they share datasets or develop relevant indicators and measures for state Environmental Public Health Tracking (EPHT) portal (http://www.cdc.gov/nceh/tracking/) if applicable.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and awardees, site visits, and awardee reporting (including work plans, performance, and financial reporting). Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking awardee progress in achieving the desired outcomes.

Ensuring the adequacy of awardee systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities:

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

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

Working with awardees on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

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

These activities may include monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk grantees.