cdc-rfa-ip15-1504pphf15 uu.pdf

Centers for Disease Control and Prevention

National Center for Immunization and Respiratory Diseases

Improving Immunization Collaboration Among Pharmacists and Other Healthcare Providers - Financed

Solely by PPHF 2015 Prevention and Public Health Funds

CDC-RFA-IP15-1504PPHF15

Application Due Date: 07/27/2015

Improving Immunization Collaboration Among Pharmacists and Other Healthcare Providers - Financed Solely by PPHF 2015 Prevention and Public Health Funds

CDC-RFA-IP15-1504PPHF15

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-IP15-1504PPHF15. 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:

Improving Immunization Collaboration Among Pharmacists and Other Healthcare Providers - Financed Solely by PPHF 2015 Prevention and Public Health Funds 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.

D. Agency Funding Opportunity Number:

CDC-RFA-IP15-1504PPHF15

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

93.733 F. Dates:

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

2. Due Date for Applications: 07/27/2015, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: N/A

G. Executive Summary:

1. Summary Paragraph:

Progress on public health goals of immunization will depend on a higher standard of collaboration among pharmacists and other health care providers.

The purpose of this FOA is to demonstrate successful models of collaboration between pharmacists and other healthcare providers in a way that ensures up-to-date vaccination status of their shared patients.

Stalled progress in raising some categories of immunization rates could be overcome if pharmacists and other healthcare providers could achieve a higher level of "immunization collaboration."

Stronger immunization collaboration would be characterized by the following:

Primary care providers are efficiently informed of vaccination provided by pharmacists.

Both pharmacists and other healthcare providers use immunization information systems (IIS) for assessing vaccination status

Every vaccination is recorded in state-based immunization information systems.

Consumers have easier access to their immunization records.

Better systems are developed for managing, tracking and reporting adverse events.

Innovative effective approaches are developed that demonstrate stronger immunization collaboration among pharmacists and other healthcare providers.

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

Ongoing quality improvement efforts identify and address missed opportunities

Dissemination and outreach to a national audience of healthcare providers spark immunization collaboration in their communities.

Preparedness is ensured, in case of future disease outbreaks

This FOA seeks models that demonstrate successful approaches for ensuring patients are up-to-date on recommended immunizations. Applications should describe a technical package of activities in two phases.

The Demonstration Phase of the project focusses on the local level clinic setting. The Dissemination Phase has a national scope. Measures that demonstrate HPV vaccination series completion, better pandemic vaccine preparedness and increased adult vaccination rates are the desired long-term outcomes.

Project activities will likely be described in these categories, but other categories may be proposed:

Provider Education/Outreach1.

Changes in Patient Care Procedures2.

Quality Improvement Efforts3.

Pandemic Preparedness Activities4.

Improved Immunization Documentation and Data Sharing5.

a. Eligible Applicants: Open Competition

b. FOA Type: Cooperative Agreement

c. Approximate Number of Awards: 2

d. Total Project Period Funding: $1,600,000

e. Average One Year Award Amount: $800,000

f. Number of Years of Award: 2

g. Estimated Award Date: 09/01/2015

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview

Progress on public health goals of immunization will depend on a higher standard of collaboration between pharmacists and other health care providers.

The purpose of this FOA is to demonstrate successful models of collaboration between pharmacists and other healthcare providers in a way that ensures up-to-date vaccination status of their shared patients.

Stalled progress in raising some categories of immunization rates could be overcome if pharmacists and other healthcare providers could achieve a higher level of “immunization collaboration.” Better collaboration between pharmacists and other healthcare providers is needed because of the increasing interdependence of pharmacists and other clinicians. Pharmacists are providing a higher percentage of immunization than in previous years. With that comes the need to strengthen their collaboration with their patients’ other healthcare providers.

Pharmacists have an important role in the areas of adolescent, adult and pandemic immunization planning.

In adolescent immunization, the Presidents Cancer Panel identifies pharmacists as an important stakeholder for increasing vaccination rates against human papillomavirus. In adult immunization, better collaboration among the multiple providers of any single adult patient is needed. Adult patients access healthcare at numerous locations and with multiple healthcare providers. Assessing vaccination status and efficiently keeping all providers informed can be complex tasks. With regard to pandemic planning, the public’s health is served when pharmacists work with their local/state health departments to ensure formalized vaccine preparedness plans are put in place.

Stronger “immunization collaboration”, (as applies to this FOA,) would be characterized by the following:

Primary care providers are efficiently informed of vaccination provided by pharmacists.

Both pharmacists and other healthcare providers use immunization information systems (IIS) for assessing vaccination status Every vaccination is recorded in state-based immunization information systems.

Consumers have easier access to their immunization records.

Better systems are developed for managing, tracking and reporting adverse events. Includes improved use of VAERS as the routine procedure in the case of adverse events.

Innovative effective approaches are developed that demonstrate stronger immunization collaboration between pharmacists and other healthcare providers.

Ongoing quality improvement efforts identify and address missed opportunities Successful models of immunization collaboration demonstrate how to identify missed opportunities and take actions to vaccinate.

Dissemination of best practices to a national audience of healthcare providers would spark immunization collaboration in their communities.

Preparedness is ensured, in case of future disease outbreaks

This FOA seeks models that demonstrate successful approaches for ensuring patients are up-to-date on recommended immunizations.

Applications should describe a technical package of activities designed to ensure up-to-date vaccination status among a group of patients shared by pharmacists and other healthcare providers.

The application should propose both a local-level plan and a national-level plan. In the first phase of the project (DEMONSTRATION Phase), efforts will focus on improving immunization rates among adolescents and adults in the clinic setting on a local or regional level. In the second phase of the project (DISSEMINATION PHASE), efforts will focus on implementing successful models of collaboration on a national level.

The technical package of activities should rely on evidence-based strategies, but may propose innovative approaches for selecting, combining or implementing strategies.

Project activities will likely be described in these categories, but other categories may be proposed:

Provider Education/Outreach Changes in Patient Care Procedures Quality Improvement Efforts Pandemic Preparedness Activities Improved Immunization Documentation and Data Sharing

The Funding Announcement Opportunity is seeking a two-year workplan that will demonstrate how better immunization collaboration with pharmacists can improve immunization rates, and then, will disseminate best practices and tools to make a national impact. To achieve this, the applicant organization must demonstrate a significant national-level membership of pharmacists, as outlined in the Organizational Capacity section of the FOA.

b. Statutory Authorities

This program is authorized under the Patient Protection and Affordable Care Act (PL 111-148), Title IV, Section 4002 (Prevention and Public Health Fund) and Section 317 of the Public Health Service Act [42 U.S.C. 247b(k)(1)].

For-profit entities are not eligible applicants under the Statutory Authority.

c. Healthy People 2020

Measurable outcomes of the program will be in alignment with Healthy People 2020 goals for immunization and infectious disease. HealthyPeople 2020 outlines adolescent, adult and pandemic vaccination goals. The relevant HPV goal is to increase the vaccination coverage level of 3 doses of human papillomavirus (HPV) vaccine for females and males by age 13 to 15 years. The relevant adult immunization goals are vaccine-specific goals for influenza, hepatitis b, pneumococcal, pertussis and zoster vaccine.

Source: http://www.healthypeople.gov/ http://www.healthypeople.gov/2020/topicsobjectives2020/objectives list.aspx?topicId=23

d. Other National Public Health Priorities and Strategies

This FOA aligns and supports other relevant national strategies:

GENERAL Advisory Committee on Immunization Practice The ACIP makes vaccine recommendations for the United States. These recommendations serve as a definition for what constitutes “up-date vaccination status.” Source: http://www.cdc.gov/vaccines/hcp/acip-recs/index.html http://www.cdc.gov/vaccines/sched ules/hcp/index.html Community Preventive Services Task Force This FOA direct applicants to propose evidence-based interventions, drawing on the Community Preventive Services Task Force findings and systematic reviews. Source: http://www.thecommunityguide.org/vaccines/vpd-jphpm-recs-IIS.pdf

HPV-FOCUS

President’s Cancer Panel Recommendations call for reducing missed opportunities to recommend and administer HPV vaccines. Other recommendations of this Panel include using electronic health records and immunization information systems as a tool for increasing rates, and for removing other barriers to access.

The Panel also recommends promoting HPV vaccination in venues outside the medical home. Source: http ://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/index.htm#sthash.j0M1EEMZ.dpbs

ADULT-FOCUS

Standards for Adult Immunization Practice: This FOA aims to develop models of Standards Implementation and demonstrate the practicalities of improved immunization assessment, service delivery, documentation and referral. Source: http://www.cdc.gov/vaccines/hcp/patient-ed/adults/for-practice/standards/index.html

PANDEMIC Focus

Focus on Pandemic Preparedness is outlined here: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6306a1 .htm?s_cid=rr6306a1_e http://www.astho.org/Infectious-Disease/Pandemic-Influenza/Public-Health-and -Pharmacy-Collaboration-in-an-Influenza-Pandemic/

e. Relevant Work http://www.healthypeople.gov/ http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=23 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=23 http://www.cdc.gov/vaccines/hcp/acip-recs/index.html http://www.cdc.gov/vaccines/schedules/hcp/index.html http://www.cdc.gov/vaccines/schedules/hcp/index.html http://www.thecommunityguide.org/vaccines/vpd-jphpm-recs-IIS.pdf http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/index.htm#sthash.j0M1EEMZ.dpbs http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/index.htm#sthash.j0M1EEMZ.dpbs http://www.cdc.gov/vaccines/hcp/patient-ed/adults/for-practice/standards/index.html http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6306a1.htm?s_cid=rr6306a1_e http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6306a1.htm?s_cid=rr6306a1_e http://www.astho.org/Infectious-Disease/Pandemic-Influenza/Public-Health-and-Pharmacy-Collaboration-in-an-Influenza-Pandemic/ http://www.astho.org/Infectious-Disease/Pandemic-Influenza/Public-Health-and-Pharmacy-Collaboration-in-an-Influenza-Pandemic/

CDC’s National Center for Immunization and Respiratory Diseases is focused on reducing death and disability from vaccine-preventable diseases. (ACIP). NCIRD works on a number of fronts to increase immunization rates and reduce immunization disparities. Some of the key mechanisms are surveillance of vaccine-preventable diseases, the Vaccines for Children program, communications messaging and materials, support of state-based immunization programs, training, etc.

2. CDC Project Description

a. Approach

Activities of Grantee Organization Representing Pharmacists

Short term Outcomes

Among

TARGET GROUP OF

PHARMACISTS

And OTHER HEALTHCARE

PROVIDERS

with a shared pool of patients

Intermediate Outcomes

AMONG

NATIONAL LEVEL

AUDIENCE

Long-term Outcomes

The grantee will:

In PHASE ONE:

Local-Level Demonstration Projects: Review, select, and implement a technical package of activities designed to ensure up-to-date vaccination status among a group of patients shared by pharmacists and other healthcare providers.

Project activities will likely be described in these categories, but other categories may be proposed: • Provider Education/Outreach • Changes in Patient Care Procedures • Quality Improvement Efforts • Pandemic Preparedness Activities • Improved Immunization

The grantee is expected to achieve all these short-term outcomes, highlighted in red below.

A target group of pharmacists demonstrate evidence that:

• Every vaccination is recorded in state-based immunization information systems (IIS).

• Primary care providers are efficiently informed of vaccination provided by pharmacists.

• Consumers have easier access to immunization records, through hardcopy or IIS

• Immunization information

Among NATIONAL

LEVEL AUDIENCE

OF HEALTHCARE

PROVIDERS

•Every vaccination is recorded in state-based immunization information systems.

•Primary care providers are efficiently informed of vaccination provided by pharmacists.

•Consumers have easier access to immunization records •Better use of IIS, E.H.R technologies and/or patient reporting..

•Successful models of immunization

Immunization collaboration among pharmacists and other providers results in high quality immunization services for patients.

Patients are up-to-date on their recommended vaccinations.

Immunizations are documented in immunization

Documentation and Data Sharing

In PHASE TWO:

National-Audience Dissemination:

Disseminate and promote best practices/ successes nationally to

NATIONAL

AUDIENCE OF

HEALTHCARE

PROVIDERS, to include both pharmacists and other healthcare providers.

systems are used to forecast or screen prospectively.

• Changes in patient care procedures make the vaccination assessment more routine

• Strong clinical protocols are in place to ensure management and reporting of adverse events.

The target group of pharmacists collaborates with other healthcare providers to improve immunization collaboration as characterized by:

• Measurable evidence of better data exchange between pharmacists and other healthcare providers regarding the vaccination status of their shared

• Pharmacy groups and public health have formalized vaccine preparedness plans which leverage strengths of public health and pharmacy distribution and vaccine management systems

The grantee implements a national level effort directed at a national audience of healthcare providers, inclusive of pharmacists. Outcomes are:

• Tools, materials or other collaboration between pharmacists and other healthcare providers •Increased number of formalized preparedness agreements .

information systems.

All healthcare providers use immunization information systems prospectively, e. g.

to forecast or screen for vaccinations.

Pharmacists and other healthcare providers exchange information on vaccination status of their shared

Increased vaccination uptake and coverage rates methodologies that have been demonstrated to improve immunization collaboration among pharmacists and other healthcare providers

• Verification that the products/models/tools will contribute to improved immunization rates

• Dissemination and promotion of best practices/successes to

NATIONAL AUDIENCE

OF HEALTHCARE

PROVIDERS with measures that demonstrate use by a national audience of providers

i. Purpose

The purpose of this FOA is to demonstrate successful models of collaboration between pharmacists and other healthcare providers in a way that ensures up-to-date vaccination status of their shared patients.

ii. Outcomes

The logic model describes the relationship between the program’s activities and its intended outcomes.

Grantees will be held accountable for showing progress of all the short-term outcomes listed on the logic model. They may propose plans to achieve intermediate outcomes.

These short-term outcomes for the two-year project period are:

A target group of pharmacists demonstrate improvements in their immunization services for a defined group of adolescent and adult patient so as to provide evidence that: • Every vaccination is recorded in state-based immunization information systems (IIS). • Primary care providers are efficiently informed of vaccination provided by pharmacists. • Consumers have easier access to immunization records, through hardcopy or IIS

• Immunization information systems are used to forecast or screen prospectively. • Changes in patient care procedures make the vaccination assessment more routine • Strong clinical protocols are in place to ensure management and reporting of adverse events.

The target group of pharmacists collaborate with other healthcare providers to ensure up-to-date vaccination status among their shared patients. This improved immunization collaboration is characterized by:

• Measurable evidence of better data exchange between pharmacists and other healthcare providers regarding the vaccination status of their shared patients. • Pharmacy groups and public health have formalized vaccine preparedness plans which leverage strengths of public health and pharmacy distribution and vaccine management systems

The grantee implements a national level effort directed at a national audience of healthcare providers, inclusive of pharmacists. Outcomes are: • Tools, materials or other methodologies that have been demonstrated to improve immunization collaboration among pharmacists and other healthcare providers

• Verification that the products/models/tools will contribute to improved immunization rates • Dissemination and promotion of best practices/successes to NATIONAL AUDIENCE OF HEALTHCARE PROVIDERS with measures that demonstrate use by a national audience of providers

iii. Strategies and Activities

The applicant will propose a combination of activities, hereafter referred to as the technical package. This technical package of activities should be designed to specifically and efficiently to achieve project period outcomes. Whenever possible, applicants should use evidence-based strategies as identified by the Community Guide. Applicants may propose strategies to achieve project outcomes that are not described in the Community Guide, but they must then describe the rationale for developing and evaluating new strategies or practice-based interventions.

The technical package should propose the most cost-efficient, impact-driven set of activities for two phases of the project.

PHASE ONE: Local-Level Demonstration Projects: Review, select, and implement a technical package of activities designed to ensure up-to-date vaccination status among a group of patients shared by pharmacists and other healthcare providers.

Project activities will likely be described in these categories, but other categories may be proposed:

• Provider Education/Outreach • Changes in Patient Care Procedures • Quality Improvement Efforts

• Pandemic Preparedness Activities • Improved Immunization Documentation and Data Sharing

Note: Applicants are not required to stratify activities into these five distinct activity categories, since they can sometimes overlap. Applicants should ensure these elements are covered in the technical package they propose and that they can demonstrate that their “selected group of related interventions that, together, will likely achieve and sustain substantial and synergistic improvements.” Applicants may propose different categories of activities, if relevant and with rationale.

Phase TWO: National-Audience Dissemination Disseminate and promote best practices/ successes nationally to NATIONAL AUDIENCE OF HEALTHCARE PROVIDERS, to include both pharmacists and other healthcare providers.

Source: Community Guide: http://www.thecommunityguide.org/index.html

1.Collaborations

a. With CDC-funded programs:

http://www.thecommunityguide.org/index.html

Applicants must describe intentions to collaborate with CDC to improve technical and program guidance and evaluation. Their application should demonstrate an expert understanding of the national landscape and current progress towards these three immunization goals: 1. Series completion of the HPV vaccination series. 2. Up-to-date immunization status of adult patients and 3. Pandemic preparedness. They are not required to collaborate directly with CDC-funded projects, but must demonstrate their proposed activities will complement, rather than duplicate, already-existing efforts.

b. With organizations external to CDC:

Applicants are required to collaborate with external partners that have a role in achieving the FOA outcomes and proposed activities. Applicants must demonstrate a capacity to make impact on BOTH a local level in a clinical setting AND on a national level, so must explain their collaborations with organizations that make this possible. Concrete collaborative relationships must be put in place between pharmacist and the other healthcare providers with whom they share patients. Other healthcare providers could be primary care physicians, specialist physicians, nurses, physician assistants or even teams of healthcare providers. Written Memoranda of Understanding or Letters of Intent must be included.

Collaboration with the applicant’s state or regional associations, affiliates or chapters may be appropriate to implement the Demonstration Phase of the project.

Evidence of planned collaboration should demonstrate ground-breaking approaches that can be replicated and will be well-received among a national audience of pharmacists.

2. Target Populations

The aim is to demonstrate evidence of better multi-provider immunization collaboration resulting in higher rates of up-to-date immunization status of patients. Project activities will target pharmacists and other healthcare providers to take actions, with the eventual benefit occurring in their patients, as measured by the patient’s vaccination status.

There are four distinct target groups in this project:

For the DEMONSTRATION Phase, the applicant should identify and define these three target groups: 1.

Target Group of Pharmacists 2. Target Group of Other Healthcare Providers 3. Shared Pool of Adult and Adolescent Patients

For the DISSEMINATION Phase, applicant should identify and define the fourth target group of the project: A national-level audience of pharmacists and other immunizing healthcare providers. The target groups of the project will be defined by the applicant, given the parameters outlined below. The applicant should draw on its unique resources, capacity and experience as it considers and plans for its target groups.

These are the general parameters:

TARGET GROUP OF PHARMACISTS: This is the group of pharmacists who will carry out the local-level demonstration activities in their clinical practice setting. Applies to Demonstration Phase One only.

TARGET GROUP OF OTHER HEATLHCARE PROVIDERS This is the group of any other healthcare providers who could or should be collaborating with TARGET GROUP of PHARMACISTS to improve up-to-date vaccination status of a SHARED POOL of PATIENTS. Applies to Demonstration Phase One only. These are the clinicians who are licensed to immunize, and who have a stake in developing new working relationships with pharmacists in their community. They could be primary or specialty physicians, nurses, health departments or possibly practice teams.

SHARED POOL OF PATIENTS: This is the group of patients or potential patients that are shared by both the TARGET GROUP of PHARMACISTS and the TARGET GROUP OF OTHER HEALTHC ARE PROVIDERS. The applicant should demonstrate ability to track immunization rates of the SHARED POOL OF PATIENTS who must include both adolescents and adults.

NATIONAL-LEVEL AUDIENCE OF HEALTHCARE PROVIDERS For the Dissemination Phase Two, the applicant should propose a plan for making national level impact to increase the collaboration of pharmacists and other healthcare providers. The applicant should consider how to best disseminate and promote best practices/ successes nationally in order to achieve long-term goal of ensuring patients are up-to-date on their recommended vaccinations. The National-Level Audience of Healthcare Providers could be defined as just pharmacists or some combination of pharmacists and other category of healthcare providers. The applicant should draw on its unique resources, capacity and experience to explain how they will make an impact on their defined National-Level Audience, and why it is a significant group of healthcare providers.

Applicants should carefully consider how to define these target groups and include descriptions on how they will establish baseline and post-intervention measures. They should also explain how they will allocate budgeted funds to reach each of the respective target groups and estimate a per-capita cost and benefit for their four applicant-defined target groups.

The applicant’s definitions should reflect a consideration of these planning questions: How will they demonstrate evidence of successful immunization collaboration among the target groups they define? How can they make immunization collaboration work in a way that ensures up-to-date vaccination status of their adolescent and adult patients?

In the applicant’s definitions of the four target groups, they should explain how they will allocate budgeted funds to reach each of their target groups and estimate a per-capita cost and benefit associated with targeted patients and providers.

a. Inclusion

Low immunization rates are characterized by disparities associated with race, ethnicity, income, insurance coverage and other factors. Improved office-based practices that standardize and routinize immunizations could significantly impact Healthy People 2020 goals by increasing vaccine uptake among all groups. The applicant should provide data to document any relevant disparate immunization rates and identify the most promising intervention at hand for reducing such disparities.

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

N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

The CDC Strategy for monitoring and evaluating program and awardee performance will include several activities, spanning both process and outcome evaluation and will be consistent with the logic model and approach presented earlier. CDC will monitor process and outcome measures of progress throughout the course of the project. Evaluation of the project should align with the project’s short-term outcomes. At the start of the project, CDC and the awardee will review the project work plan and evaluation strategy, ensuring process and outcome measures are concrete and achievable, and represent the best use of funding. The focus is on the EIGHT outcomes in the Demonstration Phase and THREE outcomes in the Dissemination Phase.

Project modifications may occur, if merited.

Awardees will submit further details or revisions to their Awardee Evaluation and Performance Management Plan six months following the award date. The logic model describes the relationship between the program’s activities and its intended outcomes. Grantees will be held accountable for showing progress of all the short-term outcomes listed on the logic model. They may propose plans to achieve intermediate outcomes.

CDC’s evaluation and performance measurement strategy will be to ensure the applicants’ proposed outcome and process measures are consistent with the purpose of the funding announcement opportunity. Applicants are directed to propose outcome and process measures that will demonstrate achievement relevant to these evaluation questions:

DEMONSTRATION PHASE OUTCOMES

• Demonstration Phase Outcome #1: Every vaccination is recorded in state-based immunization information systems (IIS). Was every vaccination recorded in state-based IIS? Were measurable improvements or efficiencies demonstrated in the way pharmacists record vaccinations in IIS? Did increased number of providers use IIS? Was there an increase in the number of adolescent and adult patients with vaccinations documented in IIS?

• Demonstration Phase Outcome #2: Primary care providers are efficiently informed of vaccination provided by pharmacists. Did the pharmacists improve procedures for keeping primary care providers efficiently informed of the vaccinations given to their patients? Did primary care providers work with pharmacists to improve the exchange of vaccination information? Is there evidence of improved efficiencies or better provider satisfaction? Were there other achievements that signaled efficient immunization communication between pharmacists and other healthcare providers?

• Demonstration Phase Outcome #3: Consumers have easier access to immunization records, through hardcopy or IIS. Did patients have greater access to their personal immunization record? Did an increased number or proportion of patients have access to an electronic immunization records? Did patients report greater satisfaction/knowledge regarding their individualized vaccination status?

• Demonstration Phase Outcome #4: Immunization information systems are used to forecast or screen prospectively. Were state-based IIS used prospectively to check on patients’ immunization status? Did increased numbers of pharmacists and other healthcare providers using IISU to forecast or screen prospectively? Did IIS assist pharmacists to better determine appropriate intervals between each of the three doses of HPV vaccination? Were IIS used to ensure non-duplication of vaccination?

• Demonstration Phase Outcome #5: Changes in patient care procedures make the vaccination assessment more routine. Was there an increase in the routine vaccination assessment, as measured through documentation in patient records? Were new technologies or procedures utilized to streamline the vaccine assessment? Did the pharmacists improve procedures for making immunization recommendations? Were the immunization recommendations made in a stronger way or in a more routine way? Did multiple categories of providers communicate to determine vaccination status, appropriate intervals or medical conditions that impact vaccination decision-making? (* E.g. Pharmacists and primary care providers ). Did changes in patient care procedures result in higher rates of HPV series completion? Did changes in patient care procedures result in higher rates of immunization among adults? Did changes occur in the clinic set-up or patient flow procedures that resulted in better immunization services? Did referral procedures improve? If relevant, were disparities in immunization rates detectable? Could disparities be monitored and/or addressed through changes in patient care procedures?

• Demonstration Phase Outcome #6: Strong clinical protocols are in place to ensure management and reporting of adverse events. Did the pharmacists improve procedures for managing adverse events following vaccination? Did pharmacists improve their knowledge and use of the Vaccine Adverse Events Reporting System (VAERS)? Were there improvements in the knowledge and/or use of VAERS by other healthcare providers? As a result of training, was there an improvement in knowledge and use of VAERS by all healthcare providers on a large systems/community level?

• Demonstration Phase Outcome #7: Measurable evidence of better data exchange between pharmacists and other healthcare providers regarding the vaccination status of their shared patients. Were there improvements in how immunizations are documented in immunization information systems (IIS) or in electronic health records? Did pharmacists and other healthcare providers develop better ways to exchange immunization information about their shared pool of patients? Did pharmacists and other healthcare providers develop better ways to use Electronic Health Records or IIS as a tool to improve immunization services? Were there increases in the numbers of pharmacists and other healthcare providers who exchange immunization information about their patients? Were there improvements to the information technology systems used by both pharmacists and other healthcare providers? Did immunization data exchange occur more smoothly or efficiently? Did multiple categories of healthcare provider work together to streamline immunization assessment, documentation, and/or recommendation of immunization? Were there other achievements in the immunization collaboration between pharmacists and other healthcare providers?

• Demonstration Phase Outcome #8: Pharmacy groups and public health have formalized vaccine preparedness plans which leverage strengths of public health and pharmacy distribution and vaccine management systems Did pharmacists work with other healthcare providers to put in place formalized vaccine preparedness plans? Did the project make significant contributions to the readiness of pharmacists in case of vaccination-related emergencies? In a case where formalized vaccine preparedness plans was already in place, did the project bring significant progress to the community or state’s level of preparedness?

Dissemination Phase Outcomes

• Dissemination Phase Outcome #1: Tools, materials or other methodologies that have been demonstrated to improve immunization collaboration among pharmacists and other healthcare providers Did the project identify and develop useful national-level products to increase adult and HPV immunization rates? If the project is developing a model of change, is it clear what the model consists of, and why it will be used by pharmacists? Does the definition of the national-level products reflect an expert understanding of the current needs and gaps in the field immunization? Does the definition of the national-level products demonstrate expert knowledge of the state of the art and of the successes and failures to date in the field of immunization?

• Dissemination Phase Outcome #2: Verification that the products/models/tools will contribute to improved immunization rates Did the project evaluate the effectiveness or utility of their national-level products? Will healthcare providers perceive the national-level products as helpful to them? Did the project demonstrate that the national-level products will be used or have been used by a national-level audience of pharmacists?

Did the project demonstrate that use of the national-level products contribute to improved immunization rates?

• Dissemination Phase Outcome #3: Dissemination and promotion of best practices/successes to NATIONAL AUDIENCE OF HEALTHCARE PROVIDERS with measures that demonstrate use by a national audience of providers Did the project disseminate their national-level products to their national target audience? Did the project demonstrate use of the national-level products among their target audience? Did the project demonstrate changes in knowledge or behavior of their target audience? Did the project disseminate to and make an impact upon a significant audience?

ii. Applicant Evaluation and Performance Measurement Plan

Applicants must provide an initial evaluation and performance measurement plan to show how they will identify progress in implementing activities in their program strategies and achieving their selected outcomes. Applicants will have already described measurable results in the workplan referenced above. In this section, they will refine those into performance measures and add details of any additional evaluation to be completed. Applicants should also:

Describe how they target population will be engaged in the evaluation and performance measurement planning process;

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

Describe how evaluations findings will be used for continuous program/quality improvement; and

Describe how evaluation and performance measurement will contribute to the development of the evidence based for improving adult immunization rates.

c. Organizational Capacity of Awardees to Execute the Approach

Applicants must demonstrate capacity in all three of these categories: 1. An important national constituency of pharmacists, 2. Documentation of a proven track record in bringing about measurable changes in immunization or other relevant health indicators 3. Reach into both the local-level clinic setting as well as to a national audience of immunizing pharmacists.

Evidence of An Important National Constituency of Pharmacists:

Applicants should demonstrate a significant pharmacist membership on a national level. To demonstrate national-level capacity, they must demonstrate active membership of pharmacists in two-thirds of the states.

Active membership is typically characterized by dues paying status as well as other member actions. They should provide evidence of a substantial national role that their constituency/membership plays in immunization. They should explain how and why their constituency can make an impact on practice-level and national-level immunization rates. The applicant should include information about their working relationships with their own state chapters, associations or affiliate members.

Documentation of a Proven Track Record For Bringing About Measurable Improvements in Immunization or Other Relevant Health Indicators:

The applicant must provide documentation of a proven track record of outreach, education and implementation of behavior and systems change among pharmacists. The applicant should provide evidence of past achievement when they have mobilized their constituency/membership to bring about measurable improvements in immunization or other relevant health indicators. Significant past achievement with a measurable impact on a national audience of healthcare providers should be demonstrated for a minimum of five years. The applicant should explain how the cited significant past achievement is equivalent or nearly equivalent to the achievement planned for this project. The applicant should have a history of collaborating with multiple partners to accomplish similar health objectives; have expertise in assembling the resources needed to execute the particulars of the FOA; and have capability of disseminating, publicizing, and promoting the outputs and other work to relevant parties and partners.

Reach Into Both Local-Level Clinical Setting and on the National Arena:.

The applicant should demonstrate their reach on both a clinical/local level, as well as on a national level.

“Reach” is defined as the ability to have an influence or impact on a group of pharmacists, other healthcare providers and/or the patients they serve. For purposes of the Demonstration Phase One of the project, the applicant should document how they can influence or impact immunization rates in a clinical setting on a local or regional level. Pharmacists must use state IIS in this project, so applicant should document this level of access for the geographic locations where they will work in the Demonstration Phase of the project. For purposes of the Dissemination Phase Two of the project, they must demonstrate their ability to disseminate findings and practical tools that will be utilized by a national-level of pharmacists. Through the description of the four applicant-defined target groups, the applicant can demonstrate its ability to reach into and make an impact on both the clinical practice level and on the national level.

d. Work Plan

Applicants must identify and address the activities under this FOA in no more than 15 pages. Specific details on how the proposed strategies will achieve the outcomes should be included. CDC will provide feedback and technical assistance to recipients to finalize the workplan post award. Workplans must include

a. For each selected activity, a descriptive plan, process and timeline with milestones/measures for efforts related to each short term outcome in the logic model, for the Year-One detailed work plan. A high-level work plan for Years Two through Four should address how progress will continue;

b. A description of the staff and administrative roles and functions to support the project work plan and the outcomes. Awardees should identify and assign staff, contractors, and/or consultants, sufficient in number and expertise, to carry out the activities of this FOA;

c. A description of administrative and assessment processes to ensure successful implementation, reporting and quality assurance;

d. A description of organizational capacity to successfully achieve the project outcomes, including demonstrated experience leading to collective action;

e. A description of capacity and plans to successfully implement sustainable practices that result in the improved immunization rates of the target population.

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.

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

AGREEMENTS)

CDC will 1) provide technical assistance in identifying major immunization issues, setting program priorities, and implementing and evaluating project activities. 2) Assist in the review of immunization messages and materials both for technical accuracy and for compliance with proven health education and communication strategies. 3) Facilitate the transfer of successful prevention interventions and program models to other areas through meetings of grantees, workshops, conferences, newsletters, and communications with project officers. 4) Monitor the recipient’s performance of program activities and progress toward program goals.

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. Award Mechanism: H23

3. Fiscal Year: 2015 Estimated Total Funding: $1,600,000

4. Approximate Total Fiscal Year Funding: $1,600,000

5. Approximate Project Period Funding: $1,600,000

6. Total Project Period Length: 2 year(s)

7. Expected Number of Awards: 2

8. Approximate Average Award: $800,000 Per Project Period

9. Award Ceiling: $800,000 Per Project Period

10. Award Floor: $500,000 Per Project Period

11. Estimated Award Date: 09/01/2015 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).

12. Budget Period Length: 24 month(s)

13. Direct Assistance Direct Assistance (DA) is not available through this FOA.

C. Eligibility Information

1. Eligible Applicants Eligibility Category: Unrestricted (i.e., open to any type of entity above), subject to any clarification in text field entitled "Additional Information on Eligibility"

2. Additional Information on Eligibility

There are no special eligibility requirements. Applicants should note, however, the section of the FOA related to “ Applicant’s Organizational Capacity.” Applicants must be able to demonstrate their capacity to make a national impact, through a significant membership of pharmacists on a national level and from a history of national-level achievement. Full details are outlined in the Applicant Organizational Capacity Section. Commercial entities cannot apply due to restrictions outlined in the Statutory Authority.

The award ceiling for this FOA is $800,000. CDC will consider any application requesting an award higher than this amount as non- responsive and it will receive no further review. If a pre-application is required, then specify here and include it in the special eligibility requirements section. (http:// www.hhs.gov/ asfr/ ogapa/ aboutog/ hhsgps107.pdf)

3. Justification for Less than Maximum Competition

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

No

5. Maintenance of Effort

Maintenance of effort is not required for this program.

D. Required Registrations

Additional materials that may be helpful to applicants: http://www.cdc.gov/od/pgo/funding/docs/Financial ReferenceGuide.pdf.

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

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

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll free) or Internet at http:// fedgov.dnb.com/webform/displayHomePage.do. The DUNS number will be provided at no charge.If funds are awarded to an applicant organization that includes sub-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 usually requires not more than five 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 through www.grants.gov, the official HHS E-grant website. Registration information is located at the "Get Registered" option at www.grants.gov.

http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf…