cdc-rfa-ip15-1505pphf15 final 10 19 15.rtf

Amendments I made 10.19.15 to the following Sections: SUMMARY - CFDA

Application Content, pages 1: FOA Number: CDC-RFA-IP-15-1505PPHF15

Revised the Information for CFDA #’s 93.733 and 93.268: The title of the Funding Opportunity Announcement should read as:

Immunization - Utilization of Immunization Information Systems (IIS) for Assessment, Feedback, Incentives, and eXchange (AFIX) Assessments - financed in part by 2015 Prevention and Public Health Funds

NO APPLICATIONS WILL BE SOLICITED UNDER THIS AMENDED FUNDING ANNOUNCEMENT

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Centers for Disease Control and Prevention

National Center for Immunization and Respiratory Diseases

PPHF 2015 - Immunization - Utilization of Immunization Information Systems (IIS) for Assessment, Feedback, Incentives, and eXchange (AFIX) Assessments - financed Solely by 2015 Prevention and Public Health Funds

CDC-RFA-IP15-1505PPHF15

Application Due Date: 08/18/2015 PPHF 2015 - Immunization - Utilization of Immunization Information Systems (IIS) for Assessment, Feedback, Incentives, and eXchange (AFIX) Assessments - financed Solely by 2015 Prevention and Public Health Funds

CDC-RFA-IP15-1505PPHF15 TABLE OF CONTENTS

Part I. Overview Information

Announcement Type

Dates

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-IP15-1505PPHF15. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

Federal Agency Name:

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

PPHF 2015 - Immunization - Utilization of Immunization Information Systems (IIS) for Assessment, Feedback, Incentives, and eXchange (AFIX) Assessments - financed Solely by 2015 Prevention and Public Health Funds 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/ scien ce/ integrity/ docs/cdc- policy- distinguishing- public- health- research- nonresearch. pdf.

Agency Funding Opportunity Number:

CDC-RFA-IP15-1505PPHF15

Catalog of Federal Domestic Assistance (CFDA) Number:

93.733 Additional CFDA Number: 93.268 Dates:

Summary Paragraph:

The purpose of this FOA is to assist current, eligible immunization awardees by transitioning the Assessment, Feedback, Incentives, and eXchange (AFIX) assessment functionality to Immunization Information Systems (IIS) to serve as a single reference source to ensure consistent reporting of provider-level coverage assessment results across jurisdictions.

Eligible Applicants:

FOA Type:

Approximate Number of Awards:

Cooperative Agreement 25

d. Total Project Period Funding:

$10,000,000

e. Average One Year Award Amount:

$125,000

f. Number of Years of Award:

Estimated Award Date:

Cost Sharing and / or Matching Requirements:

08/31/2015 N Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this FOA exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text

A. Funding Opportunity Description file_2.wmf

Background

Overview The Assessment, Feedback, Incentives and eXchange (AFIX) Program, officially launched in 1995, is a continuous quality improvement process informed by research and used by immunization programs to improve immunization rates and practices at the provider level. There is strong evidence that assessment and feedback, along with other elements such as incentives and exchange, are effective in increasing vaccination rates. In 2008, the Task Force on Community Preventive Services updated its original 1999 literature review on the topic and reaffirmed its earlier recommendation of using assessment and feedback “based on strong evidence of its effectiveness across a range of settings and populations.” In addition, the task force recommends assessment and feedback for their effectiveness in improving immunization rates in adults and children when used alone or with additional components (such as incentives). This same review is cited in CDC’s Advisory Committee on Immunization Practices (ACIP) 2011 General Recommendations in its endorsement of assessment and feedback.

The purpose of AFIX is to assist and support health care personnel by identifying low immunization rates, opportunities for improving immunization delivery practices, and ensuring that providers are:

Ready to try new immunization service strategies Capable of sustaining these new behaviors.

Immunization Information Systems, also known as immunization registries, are confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area. IIS have served as a resource for consolidated patient immunization records since the 1990s. IIS represent one of the most established and successful models of healthcare data sharing and exchange in the U.S. IIS collectively contain tens of millions of patient and vaccination records. These systems have evolved over the years into sophisticated data management systems with tools and processes to support the entire immunization workflow for vaccination providers, state/local immunization program staff, and other immunization stakeholders. In many jurisdictions, mandatory reporting laws have been passed requiring immunization providers to report all vaccinations administered to the IIS.

In 2013, the CDC announced that support for the software program developed and supported by CDC, Comprehensive Clinic Assessment Software Application (CoCASA), to perform provider level AFIX assessments will be discontinued, and program awardees are encouraged to leverage their IIS to support this key program activity in lieu of CoCASA. Due to advanced IIS feature functionality and the volume of available patient and vaccination data, IIS are best positioned to assume the role of provider coverage assessment activities when CoCASA is retired. With standardized guidance in the operational use of the IIS and defined technical requirements, IIS will be able to generate the required AFIX reports in a manner that maximizes information available to vaccination providers, immunization programs, annd CDC to increase vaccination coverage at the provider-level.

This FOA addresses the operational activities to prepare immunization programs to begin producing high quality, standardized AFIX assessments from their IIS for the purposes of provider feedback and for required reporting to CDC’s AFIX Online Tool.

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], as amended.

Healthy People 2020 Activities of the program will be in alignment with Healthy People 2020 goals for immunization and infectious diseases. These may include but are not limited to specific objectives:

IID-17: Increase the proportion of providers who have had vaccination coverage levels among children in their practice population measured within the past year.

IID-17.1 Target is 50% of public health providers IID-17.2 Target is 50% of private providers IID 18 Increase the percentage of children under age 6 years of age whose immunization records are in a fully operational, population-based immunization information system (IIS) IID 20 Increase the number of States, the District of Columbia, and other reporting areas that have 80 percent of adolescents with 2 or more age-appropriate immunizations recorded in an immunization information system (IIS) among adolescents aged 11 to 18 years For more information about Healthy People 2020 objectives, please visit the following website: http://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives

Other National Public Health Priorities and Strategies Measurable outcomes of the program will be in alignment with one (or more) of the following performance goal(s) for the National Center for Immunization and Respiratory Diseases.

Increase national public awareness and provider knowledge about vaccine-preventable diseases and immunization recommendations using an array of media and culturally-appropriate tools and resources to support informed decision-making about vaccination.

Improve methods to assess vaccination coverage levels across the lifespan in order to identify groups at risk of vaccine-preventable diseases, monitor racial and ethnic disparities in vaccine coverage, evaluate the effectiveness of programs designed to increase coverage levels, monitor uptake of new vaccines, assess differential impact of vaccine shortages, measure performance by various types of providers, and provide greater understanding of socio-demographic and attitudinal factors associated with vaccination.

For more information about NCIRD goals, please visit the following website: http://www.cdc.gov/ncird /index.html

Relevant Work NCIRD has worked closely with these immunization awardees for the last twenty years as part of our primary, ongoing immunization and VFC cooperative agreement (IP13-1301) and other related projects. Through the VFC cooperative agreement funds, awardees are tasked to implement AFIX quality improvement activities performed through site visits made to VFC-enrolled providers. The Centers for Disease Control and Prevention's AFIX (Assessment, Feedback, Incentives, and eXchange), is a research-supported continuous quality improvement process. AFIX works collaboratively with providers to increase and sustain high immunization coverage and incorporate evidence-based immunization practices at the immunization provider level.

CDC Project Description

Approach <<<<<<PLEASE SEE CORRECTLY FORMATTED LOGIC MODEL IN ADDENDUM. [REMOVE PRIOR TO POSTING]>>>>>>>

Strategies and Activities Short / Intermediate outcomes Long-term outcomes

Awardee works with IIS vendor (or IT staff if not using a vendor for IIS support) to monitor and complete system enhancements plan.

assessment report(s)

provider-level coverage assessment Increased ability to utilize IIS as the only source of immunization data for all

rates of children and adolescents Decreased morbidity and mortality caused by vaccine preventable diseases export file for the AFIX Online Tool.

3. Awardee works with vendor (or IT staff if not using a vendor for IIS support) to develop and implement requirements for report output structure.

AFIX assessments.

file_3.wmf

<<<<<<PLEASE SEE CORRECTLY FORMATTED LOGIC MODEL IN ADDENDUM. [REMOVE PRIOR TO POSTING]>>>>>>>

Purpose The purpose of this FOA is to assist current, eligible immunization awardees by transitioning the Assessment, Feedback, Incentives, and eXchange (AFIX) assessment functionality to Immunization Information Systems (IIS) to serve as a single reference source to ensure consistent reporting of coverage assessment results across jurisdictions.

Outcomes All project outcomes must be based on the technical and operational guidance provided in the AFIX-IIS Integration, Operational and Technical Guidance for Implementing IIS-Based Coverage Assessment - Phase I Guide' (Draft was shared with awardees via an All-Awardee Message on February 11, 2015).

Short/Intermediate Outcomes

Increased number of providers that are reporting their data to IIS

Increased ability to utilize IIS as the only source of immunization data for all AFIX assessments.

Long-term outcomes

Decreased morbidity and mortality caused by vaccine preventable diseases

Strategies and Activities For each strategy and related activities awardee shall use the ‘AFIX-IIS Integration, Operational and Technical Guidance for Implementing IIS-Based Coverage Assessment - Phase 1 Guide’ (Draft was shared with awardees via an All-Awardee Message on February 11, 2015).

outputs. Awardee works with the vendor (or IT staff if not using a vendor for IIS support) to develop and implement an IIS User Interface (UI) to produce AFIX Assessment Reports. The IIS AFIX UI query function should meet the needs of AFIX staff, IIS staff, and providers; each entity should have access to the IIS UI to generate required reports.

1.Collaborations

With CDC-funded programs:

It is expected that the awardee will collaborate extensively with NCIRD/ISD/IISSB and NCIRD/ISD/POB on all activities outline in the Project Description. Specific collaborative activities will include, but not be limited to:

Participate in annual face-to-face site visits to review progress to date, planned activities, and exchange of ideas for future activities.

Participate in regularly scheduled and/or ad hoc status conference calls with CDC.

With organizations external to CDC:

IIS vendors will be funded directly by CDC. As described in the Project Description, Awardees that use a vendor for IIS support will collaborate with the vendor on required activities but Awardees are not responsible for developing/executing a contract or task order with the vendor(s) that support their IIS or allocating budget for vendor tasks. A copy of the CDC Task Order to IIS vendors is included in Appendix 1.

Target Populations Immunization provider sites that participate in the Vaccines for Children Program.

Inclusion N/A

Funding Strategy (for multi-component FOAs only) N/A

Evaluation and Performance Measurement CDC Evaluation and Performance Measurement Strategy CDC will evaluate the progress of each awardee throughout the duration of the performance period. Awardees will be evaluated for the following:

Outcome Measures:

CDC will evaluate progress on these activities through aggregation of the quarterly data submitted by awardees. Awardees will be asked to report qualitative and quantitative data on a quarterly basis to monitor:

Process Measures

Strategy 1e: Plan for evaluating enhancements developed Strategy 1e: Plan for evaluating enhancements implemented

Strategy 2a: IIS User Interface (UI) requirements meets report generation needs of awardee AFIX staff Strategy 2a: IIS User Interface (UI) requirements meets report generation needs of awardee IIS staff Strategy 2a: IIS User Interface (UI) requirements meets report generation needs of provider staff

Financial information reported on award draw-down and expenditure will also be collected and reported. CDC technical monitors will conduct at least one site visit to each awardee to assess implementation progress, address barriers, and facilitate awardee understanding of project requirements and standards.

Applicant Evaluation and Performance Measurement Plan

Organizational Capacity of Awardees to Execute the Approach Applicant should provide a brief staffing plan describing the organization of project implementation staff, including where they will fit within applicant’s overall organization, and a brief (one-to-two paragraph) description of the qualifications/experience of each individual designated to manage or implement this project, or each position to be hired or contracted with project funds. In the event new staff are to be hired or contracted, this section should also contain assurances from applicant’s organization regarding their ability to hire or contract (as appropriate) within the time constraints of the project period.

Work Plan

Work plan shall describe each outcome to be addressed by this plan, using the S.M.A.R.T. rubric to ensure that objectives are Specific, Measurable, Attainable, Realistic, and Time-based. Strategies and activities contemplated for each objective should be clearly linked to an outcome, and should likewise meet SMART criteria. Where appropriate, the personnel or resources that will be responsible for implementing or executing each strategy and activity should be identified. Include any necessary explanatory language to make clear how each strategy, activity, or purchase links to a desired outcome.

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.

No other requirements from program.

CDC Program Support to Awardees (THIS SECTION APPLIES ONLY TO COOPERATIVE AGREEMENTS) CDC's Program Operations Branch (POB) and Immunization Information Systems Support Branch (IISSB) will provide technical and operational support to ensure award recipients make timely and successful progress towards meeting the goals and objectives of the FOA. These activities include the following:

Provide technical assistance and consultation to Awardees in the submission of quarterly reports. Guidance for the development and implementation of project evaluation plans to ensure that they are appropriately focused and feasible for the awardee.

Organize agenda content and facilitate conference calls and other meetings as identified.

B. Award Information file_4.wmf

Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the CDC Program Support to Awardees Section.

Award Mechanism: H23

Approximate Total Fiscal Year Funding: $10,000,000

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).

Budget Period Length: 24 month(s) Direct Assistance Direct Assistance (DA) is not available through this FOA.

C. Eligibility Information file_5.wmf

Eligible Applicants Eligibility Category: State governments City or township governments Special district governments

Government Organizations:

State (includes the District of Columbia) Local governments or their bona fide agents Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

Additional Information on Eligibility The award ceiling for this FOA is $450,000. 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)

Justification for Less than Maximum Competition Eligibility is limited to those awardees currently funded under CDC-RFA-IP13-1301 “Immunization and Vaccines for Children Program” and that receive Vaccines For Children (VFC) funding.

Cost Sharing or Matching Cost Sharing / Matching No Requirement:

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

Maintenance of Effort Maintenance of effort is not required for this program.

D. Required Registrations file_6.wmf

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

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

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 athttp:// 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.

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.

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 atwww.grants.gov.