CDC-RFA-OT16-1601PPHF17.pdf

Centers for Disease Control

Office for State, Tribal, Local and Territorial Support

PPHF 2017: Strengthening the Public Health System in the U.S.-Affiliated Pacific Islands -

Financed in part by 2017 Prevention and Public Health Funds

CDC-RFA-OT16-1601PPHF17

Application Due Date: 06/23/2016

PPHF 2017: Strengthening the Public Health System in the U.S.-Affiliated Pacific Islands -

Financed in part by 2017 Prevention and Public Health Funds

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Catalog of Federal Domestic Assistance (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Application and Submission Information E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

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-OT16-1601PPHF17. 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) / Agency for Toxic Substances and Disease Registry (ATSDR)

B. Notice of Funding Opportunity (NOFO) Title:

PPHF 2017: Strengthening the Public Health System in the U.S.-Affiliated Pacific Islands - Financed in part by 2017 Prevention and Public Health Funds

C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf.

D. Agency Notice of Funding Opportunity Number:

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

93.861 Additional CFDA Number: 93.874 F. Dates:

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

2. Due Date for Applications: 06/23/2016, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

February 25, 2016 G. Executive Summary:

1. Summary Paragraph:

This amendment reflects a title modification and language related to activities that are financed in part by 2017 Prevention and Public Health Funds (PPHF). Guidance is also included on reporting requirements for semi-annual performance reports, see section on Reporting under Award Administration Information. This amendment is for informational purposes only. CDC announces the availability of funds for a regional, nonprofit organization to strengthen the quality, performance and sustainability of the U.S.-Affiliated Pacific Islands?

governmental and nongovernmental components of the public health system by providing capacity-building assistance. The FOA funds activities that increase capacity for public health leadership, workforce segments, public health systems, and other public health system https://www.grants.gov https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf 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 components. Over the five year project period the applicant is expected to increase capacity in at least three of the six areas: USAPI leadership knowledge and skills; organizational infrastructures and processes; workforce competencies and performance; development and implementation of public health laws and policies; dissemination of evidence-based practices;

and establishment of monitoring and surveillance systems. The goal is to optimize the quality and performance of public health systems, the public health workforce, public health data and information systems, public health practice and services, public health partnerships, and public health resources.

a. Eligible Applicants: Single

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 1

d. Total Project Period Funding: $50,000,000

e. Average One Year Award Amount: $10,000,000

f. Total Project Period Length: 5

g. Estimated Award Date: 07/01/2016

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The U.S.-Affiliated Pacific Islands (USAPI) consist of three U.S. Flag Territories of American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands, along with three Freely Associated States: the Republic of the Marshall Islands, Republic of Palau, and Federated States of Micronesia. The USAPI are populated by more than 500,000 people, its jurisdictions span millions of square miles of ocean and cross five Pacific Time zones.

The USAPI face a high incidence of communicable diseases along with the increasing prevalence of non-communicable diseases (NCDs), ranking among the world?s highest prevalence of obesity and other related NCDs. The USAPI are also burdened by environmental disasters in far excess of the United States. Their health systems are hindered from effectively addressing the growing burden of non-communicable and infectious diseases, high infant mortality, and health threats resulting from climate change.

Public health challenges in this region are exacerbated by widely dispersed populations, limited resources, and fragmented health systems (see Preventing Chronic Disease, 2014, 11, 130344)., A former District Health Officer for the Federated States of Micronesia noted their many challenges include lack of fully trained health workers, unreliable systems (i.e., power grids, government finances, transportation infrastructure), and the organizational complexity and interdependency of these systems account for poor public health delivery (International Journal for Quality in Health Care, 2010, 22[1]). A recent comprehensive assessment of the status of non-communicable diseases across 10 Pacific Island nations demonstrated significant strains on public health systems to deliver services, effect policies, and implement programs (see the Hawaii J Med Public Health, 2013, 72(5;1). Some of the top priorities from the assessment included develop and implement national health plans with viable resources and technical assistance; create national data systems/registries and provision of data training for personnel;

improved collaboration with community partners to provide prevention services in communities;

implement strategies that minimize fragmentation of healthcare and ensure continuity of care; and provide continuing education courses for public health professionals such as physicians, nurses and other health professionals.

This FOA defines capacity building as the development and strengthening of human and organizational resources and systems. It involves enhancing the ability to perform functions, solve problems, and achieve objectives at the individual, institutional and societal levels.

Capacity building strategies can include workforce development to enhance knowledge, skills, competencies, and create resources; organizational development to enhance management structures, processes and procedures within and between organizations and different sectors (public, private & community); and partnership development to build relationships to effectively address community needs, manage resources, and communicate with the public. Strategic investments in capacity building for the USAPI are expected to generate an increase in the quality, quantity, efficiency, effectiveness and prevention capacity of public health services and related outcomes, thus ultimately improving population health.

b. Statutory Authorities This program is authorized under Public Health Service Act, Section 317(k)(2) (42 USC 247b(k)(2), as amended, and Section 1703 (42 USC 300u-2).

c. Healthy People 2020 This FOA addresses the Healthy People 2020 focus area of Public Health Infrastructure. The goal is to ensure that all levels of governmental public health have the necessary infrastructure to effectively provide essential public health services. Infrastructure is fundamental to planning, delivering, and evaluating public health, (http://www.healthypeople.gov/2020/topics-objectives /topic/public-health-infrastructure).

d. Other National Public Health Priorities and Strategies The National Public Health Performance Standards Program: http://www.cdc.gov/nphpsp /index.html.

Institute of Medicine?s 2012 report, For the Public's Health: Investing in a Healthier Future:

http://www.iom.edu/Reports/2012/For-the-Publics-Health-Investing-in-a-Healthier-Future.

National Prevention Strategy, What Can State, Tribal, Local and Territorial Governments Do?:

http://www.surgeongeneral.gov/priorities/prevention/strategy/clinical-and-community-preventive -services.html.

The Public Health Preparedness Capabilities: National Standards for State and Local Planning: http://www.cdc.gov/phpr/capabilities/.

http://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure http://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure http://www.cdc.gov/nphpsp/index.html http://www.cdc.gov/nphpsp/index.html http://www.iom.edu/Reports/2012/For-the-Publics-Health-Investing-in-a-Healthier-Future http://www.surgeongeneral.gov/priorities/prevention/strategy/clinical-and-community-preventive-services.html http://www.surgeongeneral.gov/priorities/prevention/strategy/clinical-and-community-preventive-services.html http://www.cdc.gov/phpr/capabilities/

National Voluntary Accreditation for Public Health Departments: http://www.cdc.gov/stltp ublichealth/program/index.html.

HHS Plan for Asian American, Native Hawaiian and Pacific Islander Health (2013): http ://minorityhealth.hhs.gov/omh/content.aspx?ID=8806&lvl=3&lvlid=63).

e. Relevant Work A major CDC priority is to improve the health agency performance through provision of resources, staff, and technical support. CDC collaborates with professional nonprofit, national organizations to coordinate national public health initiatives with a wide array of stakeholders.

This FOA builds upon our current program, CDC-RFA-OT13-1302: Building Capacity of the Public Health System to Improve Population Health through National, Nonprofit Organizations-financed in part by 2013 Prevention and Public Health Funds, by ensuring capacity building to the USAPI to address public health challenges such as fragile infrastructure, limited workforce, and insufficient information systems.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

This FOA provides funding to deliver capacity building assistance to strengthen the USAPI public health system. The following logic model is a visual depiction of the program approach and reflects how the selected strategies will lead to achievement of short, intermediate and long term program outcomes. The grantee is expected to select three of the six CDC Office for State, Tribal, Local and Territorial Support program outcomes and will be responsible for demonstrating measureable progress for the short-term and intermiate outcomes over the five-year project period. The overall program outcomes include improvements in the quality and performance of 1) public health leadership, 2) public health systems and infrastructure, 3) public health workforce, 4) public health laws and policies, 5) public health practices and services, and

6) public health monitoring and surveillance systems.

Strategies Short Term Outcomes Intermediate Outcomes Long Term Outcomes

1. Public Health Leadership Enhanced knowledge, skills and awareness of leaders to support current public health priorities

Increased capacity of leadership to execute strategic plans, policy formulation and program implementation

Improved multi-sectoral leadership action to strategically address population health needs

2. Public Health Systems and Infrastructure

Increased implementation of processes that build operational efficiency and effectiveness

Increased use of performance management systems to monitor and evaluate operational processes

Improved operational efficiency and effectiveness

3. Public Health Workforce Segments

Increased knowledge, skills, and competencies among public health workers

Strengthened workforce qualifications, performance and service delivery

Improved capacity to prepare for and respond to population health needs

4. Public Health Laws and Increased awareness of Increased practical, legal- and Increased implementation of http://www.cdc.gov/stltpublichealth/program/index.html http://www.cdc.gov/stltpublichealth/program/index.html http://minorityhealth.hhs.gov/omh/content.aspx?ID=8806&lvl=3&lvlid=63 http://minorityhealth.hhs.gov/omh/content.aspx?ID=8806&lvl=3&lvlid=63

Policies* how laws and policies impact the public's health policy-centered tools and resources for public health practitioners in health departments evidence-based public health laws and policies by public health practitioners in health departments

5. Evidence-based Public Health Practices and Services

Increased capacity to assess evidence-based public health practices and services for cultural relevance

Enhanced capacity to integrate and coordinate culturally relevant practices and services across multiple settings

Increased ability to translate and widely implement evidence-based practices and services across multiple settings

6. Public Health Monitoring and Surveillance Systems

Increased knowledge and capacity to develop national health data systems and registries

Improved collection, maintenance, interpretation and dissemination of population health data

Improved capacity to identify population health needs through data driven decision making

*For the purpose of this FOA, laws and policies are considered important tools for improving the health of the population. Policies and laws represent directives, regulations, or position statements that establish the authority of public health agencies and delineate their functions. They play an increasingly important role in addressing public health threats and emergencies such as food security, healthcare-associated infections, and EBOLA.

i. Purpose The purpose of this funding initiative is to provide capacity building assistance through a regional, nonprofit organization to strengthen the USAPI?s public health leadership, workforce, and public health systems and infrastructure. The overall goal is to optimize the quality and performance of public health business services, the public health workforce, public health data and information systems, public health practice and services, public health partnerships, laws and policies, and public health resources.

ii. Outcomes The applicant?s CBA program is expected to demonstrate measurable progress among governmental and/or nongovernmental components of the USAPI public health system towards three or more of the following outcomes, particularly those that address USAPI public health systems and infrastructure needs of highest priority. As various levels of CBA needs exist for the USAPI, the applicant is encouraged to select outcomes that are achievable by the end of the program period.

The awardee is expected to demonstrate progress toward the program?s outcomes. Short-term outcomes should be reached within 12-24 months of initiation of capacity building assistance projects and demonstrated progress for intermediate outcomes should occur by the end of the project period (60 months). Demonstration for some of the long-term outcomes may occur by the end of the project period or as a result of program efforts outside of the project period.

Strengthened leadership, governance and accountability:

Enhanced knowledge, skills and awareness of leaders to support current public health priorities.

Increased capacity of leadership to execute strategic plans, policy formulation and program implementation.

Improved multi-sectoral leadership action to strategically address population health needs.

Enhanced public health systems and infrastructure:

Increased implementation of processes that build operational efficiency and effectiveness.

Increased use of performance management systems to monitor and evaluate operational processes.

Improved operational efficiency and effectiveness.

Increased public health workforce capacity:

Increased knowledge, skills, and competencies among public health workers.

Strengthened workforce qualifications, performance and service delivery.

Improved capacity to prepare for and respond to population health needs.

Improved public health laws and policies:

Increased awareness of how laws and policies impact the public's health.

Increased practical, legal- and policy-centered tools and resources for public health practitioners in health departments.

Increased implementation of evidence-based public health laws and policies by public health practitioners in health departments.

Increased delivery of evidence-based public health practices and services:

Increased capacity to deliver the ten essential public health services.

Enhanced capacity to integrate and coordinate effective prevention strategies and actions across multiple settings to effectively address disease prevention and control.

Increased capacity to effectively partner with the health care sector and sectors to deliver public health services.

Enhanced monitoring and surveillance systems capacity:

Increased capacity to develop national health data systems and registries.

Improved collection, maintenance, interpretation and dissemination of population health data.

Improved capacity to identify population health needs through data driven decision making.

iii. Strategies and Activities The strategies and related activities described below stem from national recommendations for CBA and are based on the CDC Office for State, Tribal, Local and Territorial Support (OSTLTS) priorities, program experience, and evidence-based recommendations from the scientific literature and national reports published by federal councils and national public health organizations, such as the U.S. Department of Health and Human Services, Healthy People 2020, Institute of

Medicine, the National Prevention Strategy and the World Health Organization. These capacity building program strategies and related activities are designed to position components of the USAPI public health system to fulfill the mission of protecting and promoting population health.

The applicant may propose to address at least three or more of the five program strategies to carry out the following activities. To the extent that activities lead to the development of tools, materials, collected data, and other materials, awardees should anticipate sharing project products with CDC.

The activities listed below are not exhaustive and should be augmented on the basis of the priority needs of the target population(s).

1) Public Health Leadership ?Activities that build leadership knowledge, skills, and competencies to improve governance, decision making, and accountability:

Assess and identify skills sets, competencies, and needs of health officials and other health agency leaders.

Implement evidence-based strategies such as leadership institutes and workgroups.

Provide training to health officials and other health agency leaders regarding current

USAPI public health priorities and the official responsibilities of the health department and governing entity.

Acquaint leadership on operational definitions and statements of the public health sector roles, responsibilities, and authorities.

Strengthen existing leadership platform for effective leadership practice and multi-sector communication to address shared public health concerns.

2) Public Health System and Infrastructure - Activities that strengthen system and agency needs and determine steps to improve operational capacity may include but are not limited to:

Assess and identify strengths and weaknesses related to operational efficiency and effectiveness.

Examine capacity to deliver the core functions and essential public health services and the structures needs to carry out these functions.

Determine needs, develop processes, and establish standards to build performance management capacity.

Develop and implement a health department organizational strategic plan.

Facilitate mobilization of public and private sectors to enhance collaboration and partnerships.

Identify strategies to disseminate health information to targeted populations.

Provide technical assistance on developing effective financial management systems.

3) Public Health Workforce Segments - Activities that enable improvement of competencies and workforce attrition and retention, may include but are not limited to:

Recruit and hire qualified staff with public health backgrounds.

Assess workforce competencies.

Provide training and professional development.

Develop and sustain supportive work environments.

Create resources to facilitate achievement of public health workforce competencies.

Provide technical assistance to build and sustain workforce competencies.

Promote public health internships and fellowships to recruit and strengthen workforce.

4) Public Health Laws and Policies - Activities that strengthen responses to current challenges and the evolving physical, social and built environments that contribute new challenges, may include but are not limited to:

Review, study and disseminate information about existing laws and policies that may have application to public health.

Engage multiple sectors of society such as education, court systems, law enforcement, business, political leadership in identifying priorities and in developing and applying legal tools.

Create and/or engage public health councils of relevant government agencies.

Recruit legal counsel with public health expertise for public health agencies.

Develop practical, legal-centered tools for public health practitioners and policy makers.

Provide consultation and technical assistance to public health agencies.

Evaluate the health effects and costs of legislation, regulations, and policies that could have a meaningful impact on health.

5) Evidence-based Public Health Practices and Services - Activities that strengthen delivery essential public health services in a comprehensive manner, may include but are not limited to:

Provide technical assistance to deliver essential public health services.

Review of existing laws and policies to determine cultural, geographical and current relevance and provide revisions as needed.

Translate and disseminate evidence-based public health science.

Promote understanding and use of research results, evaluations, and evidence-based practices.

Facilitate the adoption of initiatives to develop, implement, and evaluate effective strategies that promote health and prevent disease and injury.

Create materials, manuals and toolkits that build knowledge, skills, and practices in public health policy.

6) Public Health Monitoring and Surveillance Systems - Activities that increase the capacity to support integration, maintenance, and interpretation of data and information systems across the public health system, may include but are not limited to:

Provide technical assistance on readiness for implementation, use and maintenance of information systems.

Create manuals and protocols to ensure best practices and standardization of data and information systems.

Establish data governance through the creation of policies and guiding principles to improve the collection, interpretation, and dissemination of population health data.

Foster health information systems buy-in and understanding of agency staff.

Provide staff training on data collection, analysis, interpretation, and reporting.

Increase information access, data use and sharing across public health agencies.

Integrate information systems and public access at the community level.

1. Collaborations

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

The applicant is required to collaborate with CDC to plan, implement and execute CBA programs. CDC will provide guidance for program planning, monitoring and evaluation activities.

It is highly recommended that the applicant will collaborate with regional, national and international organizations that have specialized public health-related capacity building services to enhance the proposed capacity building activities for the USAPI public health system.

Examples of such organizations include American Pacific Nursing Leaders Council, Pacific Basin Medical Association, Pacific Post-Secondary Education Council, Northern Pacific Environmental Health Association, University of Hawaii Schools of Public Health, University of Guam and Fiji National University (FNU), Local USAPI community colleges, and the Associaiton of State and Territorial Health Officers Association, Council of State and Territorial Epidemiologists, the Asian and Pacific Islander American Health Forum, the Public Health Instutite (California), and the World Health Organization,.

The applicant must describe how it will collaborate with programs and organizations that are internal and extenal to CDC to buidl capacity for the USAPI public health system.

b. With organizations not funded by CDC:

The applicant is encouraged to build strategic partnerships and leverage resources with regional, national and international organizations critical to building capacity of public health systems in effort to maximize impact and reduce duplication of capacity building activities in the USAPI. It is highly recommended that the applicant will collaborate with organizations that have specialized public health-related capacity building services and have experience working in the USAPI. Examples of organizations include American Pacific Nursing Leaders Council, Pacific Basin Medical Association, Pacific Post-Secondary Education Council, Northern Pacific Environmental Health Association, University of Hawaii Schools of Public Health, University of Guam and Fiji National University (FNU), Local USAPI community colleges, and the Associaiton of State and Territorial Health Officers Association, Council of State and Territorial Epidemiologists, the Asian and Pacific Islander American Health Forum, the Public Health Instutite (California), and the World Health Organization.

The applicant must describe how it will collaborate with programs and organizations that are external to CDC to strengthen its build capacity efforts for the USAPI public health system.

2. Target Populations Applicants should propose to address capacity building assistance needs on the basis of the most relevant evidence for the selected target population(s). The applicant must clearly describe the target population(s) and provide a rationale for selecting the target population(s) receiving CBA.

Potential target populations may include Pacific Island public health agency jurisdictions and their leadership, workforce segments across Pacific Island public health jurisdictions, monitoring and surveillance systems, and/or nongovernmental components of the public health system (e.g., pharmacists, transportation industry, law enforcement, tourism sector, etc.).

a. Inclusion This funding opportunity announcement is focused on strengthening the functional capacities of public health systems and infrastructure in the USAPI. The applicant is strongly encouraged to collaborate with partners that provide public health services to people with disabilities; non- English speaking populations; lesbian, gay, bisexual and transgender (LGBT) populations; people with limited health literacy; and/or USAPI populations with the greatest health disparities.

iv. Funding Strategy Not applicable.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy The CDC strategy for monitoring and evaluating the program will include several activities, spanning both process and outcome evaluation, and will be consistent with the approach presented earlier. As project activities will differ slightly year to year depending on target population needs and new and emerging issues, CDC will not develop a set of standardized performance measures with set targets. As part of the first-year project activities, the awardee is expected to develop a comprehensive evaluation and performance measurement plan with support from CDC. This will include a more detailed plan for the year one activities and identification of specific elements that will be evaluated over the length of the cooperative agreement. The more detailed evaluation plan will build on the initial proposed plan and will further define the information below if not previously indicated:

Describe the frequency that evaluation and performance data will be collected.

Describe how data will be reported.

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

Describe how evaluation and performance measurement will yield findings to demonstrate the value of the project.

CDC will use information collected from the awardee?s regular Progress Reports (frequency to be determined) and the Annual Performance Report to document project status and completion of program activities and outcomes. Monthly, or as needed, conference calls with the awardee will also take place and discussions will include awardee?s documentation of progress, needs for technical assistance, and challenges in meeting project objectives. In this section, they will develop project specific performance measures and add details of any additional evaluation to be completed. Applicant must:The questions below will serve as a guide track progress of the program. The findings from these evaluation efforts will be used to track progress toward program outcomes and ensure implementation of program activities using the best available scientific and practice based evidence.

Process Questions:

Has the grantee assessed the current capacity needs of the USAPI public health system, including leadership, workforce, policy and practice, and information systems?

Has the grantee described available data sources and feasibility of collecting appropriate evaluation and performance data?

What activities were conducted and products developed to achieve the program outcomes?

Has the relationship between the proposed activities, outputs, and outcomes been clearly demonstrated?

To what extent have the proposed objectives been achieved?

What partnerships were formed to achieve activity implementation?

What is the extent of partner involvement in implementing activities?

What are the key challenges and barriers that hinder progress toward achieving activities and outcomes?

What are the key factors that facilitate progress toward achieving activities and outcomes?

Do the CBA activities have cross-cutting benefits beyond a single entity?

Do the activities target specific UASPI challenges and opportunities?

Outcome Questions:

To what extent have the program activities and outputs contributed to the achievement of the expected outcomes?

Performance measures will be used to track the progress of strategy specific activities and their related outcomes. Process measures will ensure capacity building assistance activities are implemented accordingly and outcome measures will ensure capacity building achievement.

Example process measures include:

1. Public Health Leadership Ex: Trainings have been held to strengthen leadership abilities.

2. Public Health Systems and Infrastructure Ex: Needs assessments have been completed to improve operational efficiency and effectiveness.

3. Public Health Workforce Ex: Trainings have been provided to facilitate achievement of staff competencies.

4. Public Health Laws and Polices Ex: Current public health laws and policies have been reviewed to assess cultural, geographical, and current relevance

5. Evidence-based Public Health Practices and Services Ex: Evidence-based practices and services have been identified and implemented across multiple se.

6. Public Health Monitoring and Surveillance Systems Ex: Manuals have been developed to ensure best practices and standardization of data and information systems.

Example outcome measures include:

Short Term Outcomes Intermediate Outcomes Long Term Outcomes

1. Public Health Leadership

Enhanced knowledge, skills and awareness of leaders to support current public health priorities Ex: Leaders have gained knowledge, skills, and awareness

Increased capacity of leadership to execute strategic plans, policy formulation and program implementation Ex: Strategies have been identified and developed

Improved multi-sectoral leadership action to strategically address population health needs Ex: Strategies have been implemented through leadership actions

2. Public Health Systems and Infrastructure

Increased implementation of processes that build operational efficiency and effectiveness Ex: Operational processes have been implemented

Established performance management systems to monitor and evaluate operational processes Ex: Systems are used to monitor and evaluate operational processes

Improved operational efficiency and effectiveness Ex: Time and cost savings have been documented

3. Public Health Workforce

Increased knowledge, skills, and competencies among public health workers Ex: Staff have gained knowledge, skills and competencies

Strengthened workforce qualifications, performance and service delivery Ex: Newly acquired knowledge, skills and competencies have been applied

Improved capacity to prepare for and respond to population health needs Ex: Workforce development activities occur more frequently

4. Public Health Laws and Policies

Increased awareness of how health laws and policies impact the public's health Ex: Trainings/webinars on how existing laws and policies related to public health have been conducted with health departments

Increased practical, legal- and policy-centered tools and resources for public health practitioners in health departments Ex: Tools and other resources on public health-related laws and policies have been developed

Increased implementation of evidence-based public health laws and policies by public health practitioners in health departments Ex: Public health laws and policies have been established

5. Evidence-based Public Health Practices and Services

Increased capacity to assess evidence-based public health practices and services for cultural relevance Ex: Existing evidence-based practices and services have been assessed and revised, as needed, Enhanced capacity to integrate and coordinate culturally relevant practices and services across multiple settings Ex: Expanded amended practices and services have been implemented to meet cultural health priorities

Increased ability to translate and widely implement evidence-based practices and services across multiple settings Ex: Expanded amended practices and services have been established and implemented

6. Public Health Monitoring and Surveillance Systems

Increased capacity to develop national monitoring and surveillance data systems and registries

Improved collection, maintenance, interpretation and dissemination of population surveillance data

Improved capacity to identify population health needs through data driven decision making

Ex: Increased number of health departments that adopted new data systems and registries has increased

Ex: Increased the number of Health status reports that have been generated and disseminated across all USAPIs

Ex: Most of the USAPI health departments health ministers use data to drive public health decision making

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the awardee will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this FOA. At a minimum, the plan must describe:

How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

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

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant).

Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should be directed to:

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

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Awardees will be required to submit a more detailed Evaluation and Performance Measurement plan within the first 6 months of award, as described in the Reporting Section of this FOA.

c. Organizational Capacity of Awardees to Implement the Approach Organizational capacity ensures applicants demonstrate their ability to successfully execute the FOA strategies and meet project outcomes. Applicant should have adequate infrastructure (physical space and equipment), workforce capacity and competence, relevant skill sets, capable information and data systems, and accessible electronic information, and communication systems to implement the award. Applicant must provide evidence of adequate program management/staffing plans, performance measurement, evaluation, financial reporting, management of travel requirements, workforce development and training, and full capability to manage the required procurement efforts, including the ability to write and award subcontracts in accordance with 45 CFR 75, as applicable. Applicant will be expected to describe the nature of their relationship with the target population and history (including number of years) serving or working with the target population selected for this project. This includes the history of providing CBA, recent examples of the content and format of the CBA provided, and CBA outcomes or benefits that resulted. In addition, applicants will be expected to provide a description of their current CDC-funded capacity building projects. Flexibility will be allowed to enable applicants to implement FOA requirements based on their own organizational design and approach, unless otherwise required by statute.

d. Work Plan The applicant must provide a high-level CBA work plan consisting of a logic model and related narrative for the five-year program, with a detailed description of the first year of the award. The work plan should not exceed 20 pages. Applicant is strongly encouraged to use activities indicated under the ?Strategies and Activities? section, but is expected to augment those activities on the basis of the priority needs of the target population(s). The work plan should provide outcomes, program strategies, activities, and objectives for the priority subpopulation(s) that are proposed within the target population category. The work plan must, at a minimum, include:

1. Intended outcomes for the five year project period.

2. Program strategies to be used during the first year of the project period.

3. Expected outcomes for the first year of the project period.

4. Objectives for the first year of the project period.

Note: Objectives should be written in SMART (specific, measurable, achievable, realistic, and time-bound) format. Quantitative baselines should be provided for each objective that leads to an increase, decrease, or maintenance over time. Depending on the program strategy, CBA mechanisms, and the needs being addressed, each priority subpopulation might require a unique CBA work plan with goals, objectives, and activities, along with a unique budget and budget narrative.

1. Activities for the first year of the project period. (Note: Activities must align with the proposed objectives and the chosen strategies and must include activities the applicant selects as priority, based on the cited evidence, for the first year of the project).

2. Describe staff and administrative roles and functions to support implementation of the award.

3. Explain administration and assessment processes to ensure successful implementation and quality assurance.

4. Timeline for the first year of the project period

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

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)

In a cooperative agreement, CDC staff members are substantially involved in program activities, above and beyond routine grant monitoring. CDC activities for this program are as follows:

1. Collaborate to ensure coordination and implementation of strategies to provide capacity building assistance to governmental and nongovernmental components of the public health system.

2. Provide guidance and coordination to funded organizations to improve the quality and effectiveness of work plans, evaluation strategies, products and services, and collaborative activities with other organizations.

3. Support ongoing opportunities to foster networking, communication, coordination, and collaboration, and serve as a conduit for information exchange, including fostering collaboration between funded organizations that would not normally interact with each other or collaborate on public health efforts.

4. Collaborate to compile and publish accomplishments, best practices, performance criteria, and lessons learned during the project period.

5. Collaborate, as appropriate, in assessing progress toward meeting strategic and operational goals and objectives and in establishing measurement and accountability systems for documenting outcomes, such as increased performance improvements and best or promising practices.

6. Collaborate on strategies to ensure the provision of CBA to state, tribal, local and territorial (STLT) health departments on an as needed request basis.

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: U38 Uniform National Health Program Reporting System

3. Fiscal Year: 2017

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

5. Approximate Project Period Funding: $50,000,000

This amount is subject to the availability of funds.

Estimated Total Funding: $50,000,000

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

7. Expected Number of Awards: 1

8. Approximate Average Award: $10,000,000 Per Budget Period

9. Award Ceiling: $10,000,000 Per Budget Period

This amount is subject to the availability of funds.

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

11. Estimated Award Date: 07/01/2016

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 recipient (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 period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is available through this FOA.

Consistent with the cited authority for this funding opportunity announcement, direct assistance may be available in the form of equipment, supplies, materials and/or Federal personnel. Award recipients will be encouraged to use the Public Health Associates Program (PHAP) to meet staffing needs (http://www.cdc.gov/phap/).

http://www.cdc.gov/phap/

C. Eligibility Information

1. Eligible Applicants Eligibility Category: Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education

Additional Eligibility Category:

2. Additional Information on Eligibility Organization that meet ALL of the following criteria:

Nonprofit 501(c)(3) with IRS status (other than institutions of higher education) The applicant must provide evidence of federally assigned 501(c)(3) with IRS status designation by submitting a copy of the current, valid IRS determination letter.

Evidence can be submitted by uploading this documentation in Grants.gov under “Other Attachment Forms.” The document should be labeled “Proof of Nonprofit Status”

Eligibility is limited to the Pacific Island Health Officers Association due to its unique relationship with the collective interests of the Ministers, Secretaries, and Directors of Health of the US-Affiliated Pacific Islands (USAPI) and Freely Associated Territories.eled “Proof of Nonprofit Status”

3. Justification for Less than Maximum Competition The Pacific Island Health Officer Association (PIHOA) is the only membership and member-directed organization of its kind for improving the health and well-being of the citizens of the U.S. Affiliated Pacific Islands (USAPI), and therefore is unique in its knowledge, skills, and abilities to provide the services specified under this FOA.

There is no other organization that is designed to or that serves the USAPI population in the following ways:

PIHOA is a non-profit organization that is led by and represents the collective interests of the Ministers, Secretaries, and Directors of Health of the USAPI.

It is the only organization that represents the health officials of all of the six US-affiliated Pacific Islands, providing a regional voice for all.

The PIHOA Board of Directors consists of the Ministers, Secretaries and Directors of health for the six USAPI. Additional membership includes USAPI health deputies and senior subordinates, along with eight health professional associations for medicine, nursing, dentistry, behavioral health, primary care, cancer control, and education.

PIHOA members represent a USAPI population of more than 500,000 people who live on hundreds of islands and atolls spanning millions of square miles of ocean and crossing five Pacific Time zones.

PIHOA Affiliate Membership is reserved for Pacific-based and Pacific-governed health professional organizations that PIHOA recognizes as having a role in the establishment of health policy. These entities sometimes form "sub-committees" where regional work specific to workforce and health systems development can take place.

4. Cost Sharing or Matching Cost Sharing / Matching Requirement: No

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

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-recipients, those sub-recipients 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 a recipient. 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.