cdc-rfa-gh15-1607.pdf

Centers for Disease Control and Prevention

Center for Global Health

Strengthening a Regional Public Health Surveillance, Capacity and Laboratory Network for Central America with the Secretaria General del Sistema de la Integracion Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamerica (COMISCA)

CDC-RFA-GH15-1607

Application Due Date: 04/20/2015

Signature Date

Strengthening a Regional Public Health Surveillance, Capacity and Laboratory Network for Central America with the Secretaria General del Sistema de la Integracion Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamerica (COMISCA)

CDC-RFA-GH15-1607

TABLE OF CONTENTS

Overview Information

Federal Agency NameA.

Funding Opportunity TitleB.

Announcement TypeC.

Agency Funding Opportunity NumberD.

Catalog of Federal Domestic Assistance (CFDA) NumberE.

Dates

Letter of Intent Deadline1.

Application Deadline2.

Informational Conference Call for Potential Applicants3.

F.

Executive Summary

Summary Paragraph1.

G.

I.

Full Text

Funding Opportunity Description

Background 1.

CDC Project Description 2.

A.

Award Information

Funding Instrument Type 1.

Funding Activity Category 2.

Fiscal Year 3.

Approximate Total Fiscal Year Funding 4.

Approximate Project Period Funding 5.

Total Project Period Length 6.

Expected Number of Awards 7.

Approximate Average Award 8.

Award Ceiling 9.

Award Floor 10.

Estimated Award Date 11.

Budget Period Length 12.

Funds Tracking 13.

Direct Assistance 14.

Indirect Costs 15.

B.

Eligibility Information

Eligible Applicants 1.

Additional Information on Eligibility 2.

Justification for Less than Maximum Competition 3.

Other 4.

Cost Sharing or Matching 5.

Maintenance of Effort 6.

C.

II.

Maintenance of Effort 6.

Application and Submission Information

Required Registrations 1.

Request Application Package 2.

Application Package 3.

Submission Dates & Times 4.

CDC Assurances and Certifications 5.

Content and Form of Application Submission 6.

Letter of Intent 7.

Table of Contents 8.

Project Abstract Summary 9.

Project Narrative 10.

Work Plan 11.

Budget Narrative 12.

Tobacco and Nutrition Policies 13.

Intergovernmental Review of Federal Programs 14.

Funding Restrictions 15.

Other Submission Requirements 16.

D.

Application Review Information

Review and Selection Process 1.

Anticipated Announcement and Award Dates 2.

E.

Award Administration Information

Award Notices 1.

Administrative and National Policy Requirements 2.

Reporting 3.

Federal Funding Accountability and Transparency Act of 2006

4.

F.

Agency Contacts G.

Other Information H.

Glossary I.

Part I. Overview Information A. Federal Agency Name:

B. Funding Opportunity Title:

Strengthening a Regional Public Health Surveillance, Capacity and Laboratory Network for Central America with the Secretaria General del Sistema de la Integracion Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamerica (COMISCA) C. Announcement Type:

D. Agency Funding Opportunity Number:

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

F. Dates:

N/A 04/20/2015 N/A

1. Summary Paragraph:

This project will:

1. Enhance and strengthen ongoing regional cooperation related to the creation of a shared surveillance information platform.

2. Contribute to efficiencies the small Central American countries are seeking to improve laboratory capacity by creating networks of reference laboratories.

3. Develop and implement regional guidelines for biosafety, as well as other guidelines that are appropriately developed regionally. It will strengthen the network of epidemiologists and regional epidemiological training.

4. Strengthen regional communication and the capacity of the countries of the region to respond in a coordinated manner to epidemiological and public health threats.

This program addresses the issues of Health Communication; Immunization and Infectious Diseases; Public Health Infrastructure;

Respiratory Diseases; and Sexually Transmitted Diseases, and is in alignment with HHS/CDC performance goal(s) to protect Americans from infectious diseases by providing global health promotion, health protection and health diplomacy.

Measurable outcomes of the program will be in alignment with one (or more) of the following performance goal(s) the Center for Global Health’s priority areas identified in "Protecting the Nation’s Health in an Era of Globalization: CDC’s Global Strategy for Addressing Infectious Diseases". Priority areas for this cooperative agreement include: 1) implementation of proven disease prevention and control interventions, 2) application of proven public health tools, 3) identification of potential global initiatives for disease control and, 4) public health training and capacity building.

a. Eligible Applicants: Single Eligbility - COMISCA

b. FOA Type: Cooperative agreement

c. Approximate Number of Awards: 1

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

e. Average One Year Award Amount: $2,000,000

f. Number of Years of Award: 5

g. Approximate Date When Awards will be Announced: 08/01/2015

h. Cost Sharing and /or Matching Requirement: Cost sharing or matching is not required.

Part II. Full Text

Centers for Disease Control and Prevention

This announcement is only for non-research international 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.

CDC-RFA-GH15-1607

93.283

1. Due Date for Letter of Intent:

2. Due Date for Applications:

3. Date for Informational Conference Call:

G. Executive Summary:

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

A. Funding Opportunity Description

1. Background

The CDC Central American region commonly refers to the 8 countries (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Dominican Republic and Panama) in the southernmost part of the North American continent. These 8 countries are packed into a relatively small area totaling approximately 202,000 square miles but yet accounts for 7% of the world’s biodiversity.

The close geographic proximity of these countries makes movement across borders of people, animals and diseases a high probability; however regional capacity to detect and diagnose emerging infections is not only inadequate but also variable among different countries in Central America. The main public health problems facing the Central America region are an inability to quickly and efficiently review and analyze data and information; a lack of quality in the national reference laboratories; insufficient regulations and standardization of technical and biosafety procedures for quality control and quality assurance; and a lack of integration of epidemiological surveillance, laboratory and hospital systems.

COMISCA represents all of the Ministers of Health of Central America and is therefore best placed to address some of the public health issues identified above through a regional approach. In order to do that, COMISCA has identified through its Executive Secretariat the need for technical and financial support to address the existing public health problems at the regional level.

COMISCA is therefore the prime partner for CDC-CAR to assist in enhancing public health surveillance and laboratory networks and improved communication and information sharing in the region.

Alignment with Regional Priorities: Efforts supported through this FOA are aligned with national goals of Central American countries to advance country and regional ownership of activities through transition of program implementation from international partners to ministries of health and other appropriate local partners. Additionally, this FOA aligns with Central American Countries’ goals of creating a regional surveillance, laboratory and communications system.

a. Statutory Authorities

This program is authorized under:

(a) Public Health Service Act, Sections 301(a)[42 U.S.C. 241(a), 307[42 U.S.C. 242l]

b. Healthy People 2020

Healthy people 2020 provides national health objectives for improving the health of all persons by encouraging collaborations across sectors, guiding individual toward making informed health decisions, and measuring the impact of prevention activities. Additional information on Healthy People 2020 is available at htts://www.healthypeople.gov. This program addresses the Healthy People 2020 focus topic area of global health found at http://www.healthypeople.gov/2020/topics-objectives/topic/global-health .

c. Other National Public Health Priorities and Strategies

Key national priorities and strategies relevant to CDC’s mission in Central America are to (1) enhance existing integrated national public health networks (epidemiology, laboratory, clinical) under IHR and (2) develop international-caliber national public health surveillance and response systems that will be regional resources. Activities to support these two-overarching national priorities is predicated on assessment of capabilities, capacities, infrastructure, and training needs, with implementation through mentoring and technical assistance for the purpose of developing national guidelines and providing training in international standards.

Building on these two-overarching national priorities, activities that would address the following sub-priorities are of key interest:

a. Indicator-based surveillance includes an early warning function for the early detection of a public health event.

b. Event-based surveillance is established.

c. Infection prevention and control (IPC) is established at national and hospital levels.

d. Multi-hazard National Public Health Emergency Preparedness and Response Plan is developed.

e. Priority public health risks and resources are mapped.

f. Mechanisms for effective risk communication during a public health emergency are established.

g. Human resources are available to implement IHR core capacity requirements.

h. Laboratory services are available to test for priority health threats.

http://www.healthypeople.gov/2020/topics-objectives/topic/global-health 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

h. Laboratory services are available to test for priority health threats.

i. Laboratory biosafety and laboratory biosecurity (biorisk management) practices are in place.

j. Mechanisms for detecting and responding to zoonosis and potential zoonosis are established.

k. Mechanisms are established for detecting and responding to foodborne disease and food contamination.

Through such activities the long-term direction is to establish nations of Central America as role models and mentors to other nations and public health institutions in Latin America and the Caribbean.

d. Relevant Work

This FOA will build upon CDC’s prior collaboration with COMISCA. In 2015, COMISCA will complete their first five year cooperative agreement with CDC. During the period of 2010 to 2015 CDC and COMISCA worked together to strengthen emergency preparedness in Central America, develop Standard Operating Procedures (SOP) for a regional network of public health laboratories, facilitate the exchange of information especially related to best practices and lessons learned and strengthen regional surveillance for influenza. The next phase of the CDC COMISCA collaboration will build on these activities, as well as activities currently being implemented through the Universidad del Valle de Guatemala and the Pan- American Health Organization.

The activities requested in this FOA are also in alignment with HHS/CDC performance goal(s) to protect Americans from infectious diseases by providing global health promotion, health protection and health diplomacy. Measurable outcomes of the program will be in alignment with one (or more) of the performance goal(s) as identified in the Center for Global Health’s "Protecting the Nation’s Health in an Era of Globalization: CDC’s Global Strategy for Addressing Infectious Diseases". Priority areas for this cooperative agreement include:

1) implementation of proven disease prevention and control interventions,

2) application of proven public health tools,

3) identification of potential global initiatives for disease control and,

4) public health training and capacity building.

2. CDC Project Description

A.2.a. Approach

*Asterick denoted in the logic model below indicates outcomes to be achieved during the project period.

FOA CDC-PA-GH 15-1607 Logic Model:

"Strengthening a Regional Public Health Surveillance, Capacity and Laboratory Network for Central America with the Secretaría General del Sistema de la Integración Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamérica (COMISCA)."

Activities

Outcomes

(Intended effects or changes in the population/organization/system that will result from your FOA Activities - i.e. what will result from the awardee activities)

Outputs

Short-Term Outcomes

(2-3 years)

Intermediate Outcomes

(4 years)

Long-Term Outcomes

(5th year) 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

Provide technical assistance to national Ministries of Health to improve surveillance, and laboratory capacity for the detection, prevention and control of infectious diseases, particularly those of regional interest

Priority infectious diseases are identified by country and region and these diseases are part of routine national surveillance

Improved timeliness of detection and control of infectious disease outbreaks by countries in the COMISCA network *

Decreased regional transmission of outbreaks among COMISCA countries

Increased coordination and communication among COMISCA countries*

Improved regional Health Security*

Expand the regional epidemiological and surveillance information system platform initiated during the 2009 influenza pandemic to include data management for other priority diseases in the region

Regional epidemiological and surveillance information system platform is being used to track all priority diseases.

Increased early detection of outbreaks through the national platforms*

Develop regional epidemiological protocols and guidelines including data collection tools, standard core variables, and surveillance protocols in support of a regional epidemiological, surveillance network.

Fully implement standard data collection tools, standard core variables, and surveillance protocols for use in national surveillance within the

COMISCA

network

Increased uptake, adoption and utilization of epidemiological protocols and guidelines*

Develop a regional laboratory network to include implementation of SOPs for biosafety, biosecurity and sharing of laboratory results and establishment of accredited reference laboratories

Regional reference laboratories are identified and internationally accredited

Increased recognition of laboratories within Central America through international accreditation*

Increased collaboration among regional laboratories and increased use of regional reference laboratories for testing of unknown specimens and confirmation of laboratory results* 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

Convene quarterly conference calls and annual meetings among the COMISCA network to improve communication and data sharing within the network

Routine conference calls and meetings established during which time reports on activities, results and problems are shared

Increased data sharing, including best practices and lessons learned among countries in the COMISCA network*

Improved timeliness of information sharing, by countries in the COMISCA network, with regional partners pertaining to events of public health importance*

Provide technical assistance to countries in the region to implement the International Health Regulations

(IHR)

Countries in Central America are IHR compliant

Increased IHR compliance among COMISCA countries *

Improved performance of countries in the COMISCA network as IHR role models, thus providing technical assistance to other countries in the region who are not IHR compliant*

i. Problem Statement

The main public health problems facing the Central America region are an inability to quickly and efficiently review and analyze data and information; a lack of quality in the national reference laboratories; insufficient regulations and standardization of technical and biosafety procedures for quality control and quality assurance; and a lack of integration of epidemiological surveillance, laboratory and hospital systems. In this regional effort, COMISCA has identified through its Executive Secretariat the need for technical and financial support to solve the existing problems at the regional level in relation to: the lack of comprehensive approach to disease control, lack of coordination and networking, lack of compliance with International Health Regulations (IHR) and inadequate capacity to respond to emergencies and disease outbreaks.

ii. Purpose

Through this FOA, CDC aims to assist COMISCA in improving regional capacity to detect and respond to disease outbreaks in a timely manner and improve coordination, collaboration and communication among Ministries of Health and other entities working to address public health issues in the region.

iii. Outcomes

Short Term- It is expected that these outcomes will be achieved in the first 2-3 years of the Cooperative Agreement due to the time needed to establish the systems required to achieve the outcomes:

· Improved timeliness of detection and control of infectious disease outbreaks by countries in the COMISCA network

· Increased early detection of outbreaks through the national surveillance platforms

· Increased uptake, adoption and utilization of epidemiological protocols and guidelines

· Increased recognition of laboratories within Central America through international accreditation

· Increased data sharing, including best practices and lessons learned among countries in the COMISCA network

· Increased IHR compliance among COMISCA countries

Intermediate Term- It is expected that these outcomes will be achieved in year 4 of the Cooperative Agreement. They will build on the outcomes and achievements in the first 3 years:

· Decreased regional transmission of outbreaks among COMISCA countries

· Increased collaboration among regional laboratories and increased use of regional reference laboratories for testing of unknown specimens and confirmation of laboratory results 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

· Improved timeliness of information sharing, by countries in the COMISCA network, with regional partners pertaining to events of public health importance

· Improved performance of countries in the COMISCA network as IHR role models, thus providing technical assistance to other countries in the region who are not IHR compliant

Long Term- Partners will be working towards these outcomes in year 5 and possibly beyond the end of the Cooperative Agreement:

Increased coordination and communication among COMISCA countries resulting in improved regional Health Security

iv. Funding Strategy

Not Applicable

v. Strategies and Activities

Through this FOA, COMISCA will:

· Provide technical assistance to national Ministries of Health to improve surveillance, and laboratory capacity for the detection, prevention and control of infectious diseases, particularly those of regional interest.

· Expand the regional epidemiological and surveillance information system platform initiated during the 2009 influenza pandemic to include data management for other priority diseases in the region.

· Develop regional epidemiological protocols and guidelines including data collection tools, standard core variables, and surveillance protocols in support of a regional epidemiological, surveillance network.

· Develop a regional laboratory network to include implementation of SOPs for sharing of laboratory results and establishment of reference laboratory capabilities.

· Convene quarterly conference calls and annual meetings among the COMISCA network to improve communication and data sharing within the network.

· Provide technical assistance to countries in the region to implement the International Health Regulations

1. Collaborations

With CDC-funded programs:

COMISCA may potentially collaborate with the Division of Global Health Protection’s Field Epidemiology Training Program (FETP) when FETP students are engaged in projects funded through "mini grants" to MOHs. COMISCA will also collaborate with other CDC-funded partners when engaging key stakeholders in strategy development. Such partners may include the Universidad del Valle de Guatemala (UVG), and the Pan-American Health Organization (PAHO).

With organizations external to CDC:

COMISCA represents the Central American Ministers of Health and carries out its authority to develop plans for regional public health networks. Given COMISCA’s charter, all of the MOHs are principal partners. As expected by the MOHs and as required by this FOA, COMISCA will routinely engage all key stakeholders in the region in strategy development. COMISCA is advised by UNAIDS, the Global Fund, PAHO, CDC and USAID. Close coordination with these stakeholders will minimize duplication of efforts.

2. Target Populations

Not applicable

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Evaluation Question

Performance Measure

Data Source

Collection Method

Frequency of Collection

Dissemination and Utilization 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

Activity 1: Provide technical assistance to national Ministries of Health to improve surveillance, and laboratory capacity for the detection, prevention and control of infectious diseases, particularly those of regional interest.

Have priority diseases been identified for purposes?

# of countries with a priority infectious disease list of purposes

MOH Staff

Staff Interviews

Document Review

Annually

Meet with key stakeholders to examine topics that still need to be improved, discuss barriers and best practices

Share with regional partners and compare common infectious diseases to determine regional approach to surveillance of those diseases.

To what extent do COMISCA countries have a functional National system in place?

% of countries with functional National systems

Surveillance System Data

Self- Report

Review of surveillance system data discuss barriers and best practices

Creation of annual surveillance reports discussing results and findings from surveillance platforms.

# of diseases under per country

Quarterly population under per country

Self- Report

Do the systems include all identified priority diseases?

# of countries whose surveillance platform includes all identified priority diseases

System

Review and comparison of documents related to identified priority diseases and discuss barriers and best practices

Have surveillance systems reduced the amount of time it takes to identify an outbreak?

# of days between patient zero presenting with symptoms and an outbreak being declared system

Surveillance system

Semi-annually

Data from the first two years of a functional surveillance system will serve as baseline data for future comparison

Meet with COMISCA countries to examine results and discuss barriers and best practices 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

Activity 2: Expand the regional epidemiological and surveillance information system platform initiated during the 2009 influenza pandemic to include data management for other priority diseases in the region.

Does information surveillance system platform priority diseases in addition to influenza?

# of priority diseases included in information surveillance platform

System Platform

Interviews platform discuss barriers and best practices

Creation of annual surveillance reports discussing results and findings from surveillance platforms.

# of

COMISCA

countries with expanded information surveillance platforms

Are more outbreaks being identified due to improved system?

outbreaks first identified through surveillance system versus other means such as local media reports

Media reports

Clinic and hospital records

Household surveys

Newspapers, radio reports, news broadcasts

Review of patient records

Interviews of a sample of constituents of affected areas annually functional surveillance system will serve as baseline data for future comparison

Meet with COMISCA countries to examine results and discuss barriers and best practices

Activity 3: Develop regional epidemiological protocols and guidelines including data collection tools, standard core variables, and surveillance protocols in support of a regional epidemiological, surveillance network

Have standard protocols and data collection tools been developed?

Standard Operating Procedures (SOP) in place

Approved SOPs and protocols

Document Review

Semi-annually discuss barriers and best practices

Disseminate standardized documents to all COMISCA countries and other international partners in the region involved in public health projects

#of standard surveillance protocols in place 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

Are COMISCA countries using the standardized SOPs, protocols and data collection methods?

countries using standardized data collection tools

Approved protocols and SOPs

MOH staff discuss barriers and best practices

Assess utilization of standardized documents and provides countries an opportunity to provide feedback on documents countries using standardized countries using standardized protocols

Have standardized data collection tools improved case reporting?

Compare number of cases reported using data collection tools versus other methods

Data Collection Tools

Review Data Reported on collection tools functional surveillance system will serve as baseline data for future comparison

Meet with COMISCA countries to examine results and discuss barriers and best practices

Activity 4: Develop a regional laboratory network to include implementation of SOPs for sharing of laboratory results and establishment of reference laboratory capabilities.

Have regional reference laboratories been identified?

# of regional reference laboratories identified

MOH staff

Laboratory Mission and

Semi-Annually discuss barriers and best practices

Share list of regional reference laboratories and their capabilities with COMISCA countries

# of pathogens for which a regional reference lab is identified 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

Are identified regional reference laboratories internationally accredited?

identified regional reference laboratories with an international accreditation

Documents

Accreditation Bodies

Accreditation Certificate discuss barriers and best practices

Share international accreditation documentation with COMISCA countries countries increasingly using the regional reference laboratories for testing of unknown pathogens or confirmation of test results?

# of samples received by regional reference laboratories compared to # of samples received in 12 months prior

Records

Staff review interviews as baseline data for future comparison

Meet with key stakeholders to examine topics that still need to be improved, discuss barriers and best practices

Creation of annual laboratory report discussing results and findings from testing run at reference laboratories.

Activity 5: Convene quarterly conference calls and annual meetings among the COMISCA network to improve communication and data sharing within the network.

Are routine conference calls and meetings among COMISCA network being held?

conference calls held

Quarterly discuss barriers and best practices

Conference Call and Meeting Minutes distributed to COMISCA countries and other regional partners

# of

COMISCA

countries regularly participating in the conference calls

Conference Call Minutes

Minute meetings held countries regularly participating in the meetings

Meeting Minutes

Minute review 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

Has routine meetings and calls resulted in improved data sharing and coordination among COMISCA countries?

coordination events (emails or phone calls) held outside of routine calls representatives

Interview country Reps to COMISCA

Review of relevant emails, briefings, notices, etc as baseline data for future comparison

Meet with COMISCA countries to examine results and discuss barriers and best practices

# of data sets, reports or press releases shared within the network

Activity 6: Provide technical assistance to countries in the region to implement the International Health Regulations (IHR) countries IHR compliant?

countries reporting

IHR

compliance

WHO IHR

reports discuss barriers and best practices

Dissemination of IHR reports including on which elements countries are compliant and on which they are requesting additional assistance to become compliant

ii. Applicant Evaluation and Performance Measurement Plan

Applicants must provide an overall jurisdiction- or community-specific evaluation and performance measurement plan that is consistent with the CDC strategy. At a minimum, the plan must:

Describe how key program partners will participate in the evaluation and performance measurement planning processes.

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

Describe key evaluation questions.

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

Describe potentially available data sources and feasibility of collecting appropriate evaluation and performance data.

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

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

c. Organizational Capacity of Awardees to Execute the Approach

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

d. Work Plan 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

Applicants should provide a high-level work plan that covers the duration of the project, with more detail for the first year of the project period. The work plan should cross walk to the strategies and activities, outcomes, and performance measures presented in the logic model and narrative sections of the FOA. The table below should be completed for each project period outcome identified in the logic model. If a particular activity leads to multiple outcomes, it should be described under each outcome measure.

Project Period Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies/Activities Process Measure

[from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

3.

4.

5.

6.

7.

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). HHS grants policy specifies the following HHS expectations for post-award monitoring for grants and cooperative agreements:

Tracking awardee progress in achieving the desired outcomes.

Insuring 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 objectives within stated timeframes.

Working with awardees on adjusting the work plan based on achievement of objectives 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 may include monitoring and reporting activities as outlined in HHS grants policy that assists grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk grantees.

No additional monitoring and accountabiltiy approach provided other than what has already been stated.

f. CDC Program Support to Awardees

CDC Activities with Substantial Involvement

Additional CDC Activities

1. Organize an orientation meeting with the grantee for a briefing on applicable U.S. Government and HHS/CDC, expectations, regulations and key management requirements, as well as report formats and contents.

2. Meet with the awardee(s) on at least a quarterly basis to review expenditures, and technical progress and revise work plan or spend plan as necessary.

3. Collaborate with the grantee on designing and implementing the activities listed above, including, but not limited to: the provision of technical assistance to develop program activities, data management and analysis, quality assurance, the presentation and possibly publication of program results and findings, and the management and tracking of finances.

4. Provide technical oversight for all activities under this award.

5. Monitor and evaluate scientific and operational accomplishments of this project through frequent consultation, review of technical 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

5. Monitor and evaluate scientific and operational accomplishments of this project through frequent consultation, review of technical reports, and interim data analyses.

6. Provide in-country administrative support to help awardee meet U.S. Government financial and reporting requirements approved by the Office of Management and Budget (OMB) under 0920-0428 (Public Health Service Form 5161).

7. Advise and assist in the provision of special reagents, equipment or other materials as needed.

8. Meet on an annual basis with the grantee to review annual progress report for each US Government fiscal year and to review annual work plans and budgets for subsequent years.

9. Review and approve abstracts, manuscripts and presentations related to activities funded through this FOA.

10. Assist the awardee with target setting for each activity.

11. Provide technical assistance or advice on any data collections on 10 or more people that are planned or conducted by the awardee. All such data collections-- where CDC staff will be or are approving, directing, conducting, managing, or owning data--must undergo OMB project determinations by CDC and may require OMB PRA clearance prior to the start of the project.

B. Award Information

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

Support to Awardees Section.

2. Funding Activity Category: HL

3. Fiscal Year: 2015 Estimated Total Funding: $10,000,000

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

5. Approximate Project Period Funding: $10,000,000

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

7. Expected Number of Awards: 1

8. Approximate Average Award: $2,000,000 Per Budget Period

9. Award Ceiling: $2,000,000 Per Budget Period

10. Award Floor: $0 Per Budget Period

11. Estimated Award Date: 08/01/2015

12. Budget Period Length: 12 month(s) Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the awardee (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period.

The total project period comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Funds Tracking

Applicant is required to track funds by P-Accounts/Sub-Accounts for each project/cooperative agreement awarded.

14. Direct Assistance Direct assistance is not available through this FOA.

15. Indirect Costs Indirect Costs are not an allowable cost through this FOA.

C. Eligibility Information

1. Eligible Applicants Eligibility Category: Others (see text field entitled "Additional Information on Eligibility" for clarification)

2. Special Eligibility Requirements http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf

Assistance will be provided only to the Secretaría General del Sistema de la Integración Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamérica (COMISCA). No other applications are solicited.

Secretaría General del Sistema de la Integración Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamérica (COMISCA) Rolando Hernando ArquetaCCD/icddrb Blvd. Orden de Malta; Edificio Eben Ezer 4 Nivel Urb. Santa Elena, Antiquo Cuscatlan, El Salvador

3. Justification for Less than Maximum Competition

SG-SICA/COMISCA is the most appropriate and qualified agency to conduct the activities specified under this cooperative agreement because:

1. SG-SICA/COMISCA is the entity that represents all of the Ministers of Health of Central America. It is both a political and a technical entity. SG-SICA/COMISCA is uniquely positioned, in terms of legal authority and support from all Ministries of Health in Central America, to collaborate with CDC-Central America Region (CAR) to enhance sustainable public health surveillance and laboratory networks in the region.

2. As such, the SG-SICA/COMISCA can easily work with all of the Ministries of Health of the Central America region in a way that no other entity can. The Ministers of Health of eight countries have agreed to support the development of a shared information platform which will be managed by the SG-SICA/COMISCA. No other entity in the region has this capacity.

3. SG-SICA/COMISCA has experience executing a large public health project financed by the World Bank that was focused on training and laboratory strengthening.

4. As the entity that represents the Central American Ministers of Health from eight countries in the region SG-SICA/COMISCA is the only organization in the region that has the authority to develop plans for regional public health networks including surveillance and laboratory.

5. SG-SICA/COMISCA is the only entity that can pass funds to the Central American Ministries of Health and can contract personnel for the Ministries of Health in eight countries in the region.

6. SG-SICA/COMISCA has the political authority necessary to convene regional meetings, and since it has been doing this for years it also has the administrative capacity needed. SG-SICA/COMISCA is the only organization able to function in this capacity as they are actually mandated by eight national Ministries of Health to do so.

7. SG-SICA/COMISCA has a fiscal management system in place that is unique within the region in that their financial records (consisting of funds from all eight Ministries of Health from each of the eight countries) for all of their activities are audited by an independent third-party organization.

8. SG-SICA/COMISCA has demonstrated previous success both programmatically and establishing public health policy by brokering an agreement (the Integration Treaty for Central America) between all eight Central American countries to have a uniform list of 36 different medications that can be used to treat several fundamental health concerns within the region. No other entity in Central America has the capability to issue multi-lateral agreements of this nature that reflects an agreement between not only Ministers of Health, but also the Presidents of each of the countries in Central America; other public health entities are only able to provide recommendations for action.

9. SG-SICA/COMISCA has established, and coordinates, multiple subject matter expert groups (e.g., medical services, surveillance, epidemiology, laboratory, etc.) that are considered to be an authoritative voice by all eight countries in Central America.

10. SG-SICA/COMISCA has established a five year plan for public health in Central America that has been formulated and agreed upon by all eight Ministers of Health in the region; the activities in this plan directly coincide with CDC-CAR's public health initiatives.

11. Because of their unique position, both politically and programmatically, in the region, the US Secretary for Health has signed a Letter of Intent with the Ministers of Health of Central America.

SG-SICA/COMISCA has been a collaborative partner with CDC for a number of years, receiving its first direct funding from CDC in 2010. SG-SICA is currently funded through CDC Cooperative Agreement 1U19GH000064, "Developing a Regional Public Health Surveillance and Laboratory Network for Central America with the Secretaría General del Sistema de la Integración Centroamericana (SG-SICA) / Consejo de Ministros de Salud de Centroamérica (COMISCA)". The project period for this award is September 15, 2010 through September 14, 2015. Prior to the public release of this FOA in 2010, CDC-CAR submitted, and received approval for single eligibility justification for COMISCA.

Additionally, given COMISCA's authority to represent the Ministries of Health throughout Central America in enhancing sustainable public health networks, disapproval of this Single Eligibility Justification (SEJ) request could undercut CDC-CAR http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf sustainable public health networks, disapproval of this Single Eligibility Justification (SEJ) request could undercut CDC-CAR gains in and continuing efforts to establish regional coordination and credibility. Having to re-establish regional coordination and communication without COMISCA's partnership would be expensive and time consuming and would go against the expectations of the individual MOHs as well as the spirit of the Letter of Intent executed by the US Secretary of Health.

4. Other

Not Applicable

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

No

Cost sharing or matching funds are not required for this program. Although there is no statutory match requirement for this FOA, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

6. Maintenance of Effort

Maintenance of Effort is not required.

D. Application and Submission Information

1. Required Registrations An organization must be registered at the three following locations before it can submit an application for funding at www.grants.gov.

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number. A DUNS number is a unique nine-digit identification number provided by Dun & Bradstreet (D&B). It will be used as the Universal Identifier when applying for federal awards or cooperative agreements.

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll free) or internet at http:// fedgov.dnb. com/webform/ displayHomePage.do. The DUNS number will be provided at no charge.

If funds are awarded to an applicant organization that includes sub-awardees, those sub-awardees must provide their DUNS numbers before accepting any funds.

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as an awardee. All applicant organizations must register with SAM, and will be assigned a SAM number. All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC. If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at www.SAM.gov.

c. Grants.gov:

The first step in submitting an application online is registering your organization at www.grants.gov, the official HHS E-grant Web site. Registration information is located at the “Get Registered” option at www.grants.gov.

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

Step System Requirements Duration Follow Up

1 Data Universal Number System

(DUNS)

1. Click on http:// fedgov.dnb.com/webform

2. Select Begin DUNS search/request process

3. Select your country or territory and folllow the instructions to obtain your

DUNS

9-digit #

1-2 Business Days To confirm that you have been issued a new DUNS number check online at

(http:// fedgov.dnb.com/ webform) or call 1-866-705-5711 http://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/portal/public/SAM/ http://grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://www.grants.gov/ http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf

4. Request appropriate staff member(s) to obtain DUNS number, verify & update information under DUNS number

2 System for Award Management (SAM) formerly Central Contractor Registration (CRR)

1. Retrieve organizations DUNS number

2. Go to www.sam.gov and designate an E-Biz POC (note CCR username will not not work in SAM and you will need to have an active SAM account before you can register on grants.gov)

3-5 Business Days but up to 2 weeks and must be renewed once a year

For SAM Customer Service Contact www.fsd.gov/US Calls: 866-606-8220

3 Grants.gov 1. Set up an individual account in Grants.gov using organization new DUNS number to become an authorized organization representative (AOR)

2. Once the account is set up the E-BIZ

POC will be notified via email

3. Log into grants.gov using the password the E-BIZ POC received and create new password

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

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

SAM

account before applying on grants.gov)

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

2. Request Application Package Applicants may access the application package at www.grants.gov.

3. Application Package Applicants must download the SF-424 application package associated with this funding opportunity from www.grants.gov. If Internet access is not available, or if the online forms cannot be accessed, applicants may call the CDC PGO staff at 770-488-2700 or e-mail PGO PGOTIM@cdc.gov for assistance. Persons with hearing loss may access CDC telecommunications at TTY 1-888-232-6348.

4. Submission Dates and Times If the application is not submitted by the deadline published in the FOA, it will not be processed. PGO personnel will notify the applicant that their application did not meet the deadline. The applicant must receive pre-approval to submit a paper application (see Other Submission Requirements section for additional details). If the applicant is authorized to submit a paper application, it must be received by the deadline provided by PGO.

If Grants.gov cannot receive applications due to an emergency or other unanticipated event (and circumstances preclude advance notification of an extension), then applications must be submitted by the first business day on which government operations resume.

Due Date for Applications: 04/20/2015

Electronically submitted applications must be submitted no later than 11:59 p.m., ET, on the listed application due date.

5. CDC Assurances and Certifications All applicants are required to sign and submit CDC Assurances and Certifications documents that can be found on the CDC Web site: http:// www.cdc.gov/od/pgo/ funding/grants/foamain. shtm

Applicants may follow either…