CDC-RFA-OT18-1802 Amend 1.pdf

Centers for Disease Control

Office for State, Tribal, Local and Territorial Support

PPHF 2018: Preventive Health and Health Services Block Grants - Strengthening Public Health Systems and Services through National Partnerships to Improve and Protect the Nation's Health

- financed in part by Prevention and Public Health Funds (PPHF)

CDC-RFA-OT18-1802

Application Due Date: 03/29/2018

PPHF 2018: Preventive Health and Health Services Block Grants - Strengthening Public Health

- financed in part by Prevention and Public Health Funds (PPHF)

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-OT18-1802. 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 2018: Preventive Health and Health Services Block Grants - Strengthening Public Health

- financed in part by Prevention and Public Health Funds (PPHF)

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 https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

New - Type 1 Amendment: The intent of this amendment is to implement the following revisions described herein and written in bold, red font throughout this NOFO: 1) to add state, local, and territorial governments or their bona fide agents to the eligibility list (Part II, Section C); 2) to revise the title to reflect the authority to use Patient Protection and Affordable Care Act (PPACA) (Part I, Section B); 3) to add the authority to use the PPACA (Part I, Section E; Part II, Section F.2); 4) to instruct applicants to develop work plans based on receipt of the established average award each year, which is supported under Funding Strategy 1 (Part II, Section A.2.d); and 5) to provide instructions for using the Project Title naming convention (Part II, Section A;

Part II, Section E). Please note the application deadline has not changed.

D. Agency Notice of Funding Opportunity Number:

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

93.421 Additional CFDA Number: 93.430 F. Dates:

1. Due Date for Letter of Intent (LOI): 02/27/2018

2. Due Date for Applications: 03/29/2018, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

The Informational Conference Calls will be held Tuesday, February 20, 2018, 10:00-11:30am https://www.grants.gov 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 https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov

ET and Thursday, February 22, 2018, 4:30-6:00pm ET. The dial-in information for the Informational Conference Calls will be posted to https://www.cdc.gov/stltpublichealth/partn erships/index.html no later than Friday, February 9, 2018.

To facilitate appropriate timely responses, CDC encourages proactive written inquiries concerning this announcement to be submitted prior to the Informational Conference Calls. Due to the volume and variety of questions anticipated during the Informational Conference Calls, applicants are encouraged to submit questions to OSTLTSPartnersNOFO@cdc.gov by Friday, February 16, 2018.

G. Executive Summary:

1. Summary Paragraph:

The purpose of this notice of funding opportunity (NOFO) is to announce a CBA program to strengthen the nation’s public health infrastructure, ensure a competent, current and connected public health system, and improve delivery of essential services through capacity-building assistance (CBA). CBA is defined as activities that strengthen and maintain the infrastructure and resources necessary to sustain or improve system, organizational, community, or individual processes and competencies. CBA is delivered through technical assistance, training, information sharing, technology transfer, materials development, or funding that enables organizations to operate in a comprehensive, responsive, and effective manner. The goal is to fund organizations that have the capability, expertise, resources, national reach, and history of providing capacity-building relevant to implementing this program’s key strategies and activities to achieve expected outcomes. The program strategies include strengthening the capacities and capabilities of public health systems infrastructure; leadership and workforce;

data and information systems; communication and information technology; partnerships; laws and policies; and programs and services. The capacity-building efforts of this program are expected to strengthen and optimize the public health system and services to improve and protect the nation’s health.

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 24 The expected number of awards will vary by target population category as outlined below.

Category A: 4 awards Category B: 10 awards Category C: 10 awards

d. Total Period of Performance Funding: $40,000,000 This amount represents approximate funding provided by the Office for State, Tribal, Local and Territorial Support (OSTLTS). Additional funding from other CDC centers, institute, and offices (CIOs) is anticipated.

e. Average One Year Award Amount: $500,000 The approximate average award will vary by target population category as outlined below.

Category A: $2,000,000 https://www.cdc.gov/stltpublichealth/partnerships/index.html

Category B: $1,000,000 Category C: $500,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 08/01/2018

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview The Institute of Medicine’s (IOM’s) landmark 1988 report, The Future of Public Health, recognized the daunting role of governmental public health in ensuring basic health and safety.

It stated that governmental public health agencies—representing the mainstay of the public health enterprise—were fragmented, underfunded, and lacked cross-cutting capabilities.

Recommendations included building key abilities; providing adequate funding for basic services and achieving national goals; and clarifying basic authorities and responsibilities entrusted to public health agencies, boards of health, and health officials.

Persistent challenges such as underfunding, fragmented programs, workforce declines, health disparities and inequities, and emerging health threats continue to strain public health’s capacity, resources, and impact. A 2012 IOM report, For the Public’s Health: Investing in a Healthier Future, recommended that investments be made in six foundational capacities and capabilities for public health departments: 1) information systems, surveillance, and epidemiology; 2) health planning; 3) partnership development and community mobilization; 4) policy development, analysis, and decision support; 5) communication; and 6) research, evaluation, and quality improvement. These investments were further defined by a national workgroup and then tied to national accreditation standards for public health departments (http ://phnci.org/fphs). Both have been cited as complementary and valuable frameworks for strengthening health departments and our nation's public health infrastructure. These needs have also been outlined in two key initiatives: Healthy People 2020 and Public Health 3.0: A Call to Action to Create a 21st Century Public Health Infrastructure.

The public health system represents a complex and broad range of agencies, organizations, and individuals in which each plays a significant role in affecting the health of the population. Engaging multiple entities facilitates coordination and collaboration to address public health needs in a systematic manner. Therefore, this CBA program is designed to fund organizations that represent both governmental and nongovernmental components of the public health system.

This program’s purposes are to strengthen the nation’s public health infrastructure, ensure a competent, current, and connected public health system, and improve delivery of essential public health services through capacity-building assistance (CBA). Applicants must address https://phnci.org/fphs https://phnci.org/fphs

CBA needs for one of three target population categories: A) Governmental Public Health Departments; B) Workforce Segments Across Governmental Public Health Departments; or C) Nongovernmental Public Health Components.

The goal is to fund organizations with demonstrated capability, expertise, resources, national reach, and track record to implement one or more of the CBA program strategies: 1) health systems infrastructure; 2) leadership and workforce; 3) data and information systems; 4) communication and information technology; 5) partnerships; 6) laws and policies; and 7) programs and services.

The CBA program has a two-part funding strategy—this NOFO details the first funding strategy. The second funding strategy is subject to the availability of appropriated funds and agency priorities, and will be made available only to organizations that are awarded funds under this NOFO. The second strategy will be detailed in a supplement to CDC-RFA-OT18-1802 and posted to www.grants.gov following selection and notification of organizations that will receive initial funding.

b. Statutory Authorities The program is authorized under sections 317(k)(2) and 307 of the Public Health Service Act (42 U.S.C. Sections 242(l) and 247b(k)), as amended. In addition, this program is authorized under section 4002 of the Patient Protection and Affordable Care Act, Public Law 111- 148.

c. Healthy People 2020 This program addresses the following Healthy People 2020 topic areas:

Public Health Infrastructure: https://www.healthypeople.gov/2020/topics-objectives /topic/public-health-infrastructure

Social Determinants of Health: https://www.healthypeople.gov/2020/topics-objectives /topic/social-determinants-of-health

Health Communication and Health Information Technology: https://www.healthypeople .gov/2020/topics-objectives/topic/health-communication-and-health-information-techn ology.

d. Other National Public Health Priorities and Strategies This program addresses the following national public health priorities and strategies:

National Public Health Performance Standards Program: https://www.cdc.gov/nphpsp/ National Voluntary Accreditation for Public Health Departments: https://www.cdc.gov

/stltpublichealth/accreditation/ and http://www.phaboard.org/ National Health Security Strategy and Implementation Plan: https://www.phe.gov/Prepa redness/planning/authority/nhss/Pages/default.aspx For the Public’s Health: Investing in a Healthier Future: http://www.nationalacademies

.org/hmd/Reports/2012/For-the-Publics-Health-Investing-in-a-Healthier-Future.aspx http://www.grants.gov/ https://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure https://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-health-information-technology https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-health-information-technology https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-health-information-technology https://www.cdc.gov/nphpsp/ https://www.cdc.gov/stltpublichealth/accreditation/ https://www.cdc.gov/stltpublichealth/accreditation/ http://www.phaboard.org/ https://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx https://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx http://www.nationalacademies.org/hmd/Reports/2012/For-the-Publics-Health-Investing-in-a-Healthier-Future.aspx http://www.nationalacademies.org/hmd/Reports/2012/For-the-Publics-Health-Investing-in-a-Healthier-Future.aspx

e. Relevant Work An important CDC priority is to support improved performance of health departments by providing resources, staff, and technical support. CDC’s Office for State, Tribal, Local and Territorial Support is committed to advancing the US public health agency and system performance, capacity, agility and resilience. CDC has previously collaborated with national, nonprofit organizations to coordinate wide-ranging public health initiatives and priorities, and to provide CBA to an array of public health stakeholders under CDC-RFA-HM08-805, CDC- RFA-OT13-1302, CDC-RFA-OT13-1301, and CDC-RFA-OT16-1601 cooperative agreements.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-OT18-1802 Logic Model: Strengthening Public Health Systems and Services through National Partnerships to Improve and Protect the Nation’s Health The following high-level logic model is a visual representation of the program approach and demonstrates how the strategies and outcomes are related. The short-term outcomes focus on building capacity of key components of the public health system. The intermediate outcomes are capabilities that are expected to strengthen as a result of built capacity. The long-term outcomes are strengthened capacities and capabilities that lead to an improved public health system.

i. Purpose This program’s purposes are to strengthen the nation’s public health infrastructure, ensure a competent, current and connected public health system, and improve delivery of essential public health services through CBA. Program strategies will address public health challenges, emerging trends, knowledge, and cross-cutting skillsets to build capacities and capabilities of the public health system. The program supports the recommended capacities and capabilities in Healthy People 2020 and key national reports.

ii. Outcomes During the period of performance, the successful applicant is expected to carry out the program capacity-building strategies and activities to achieve the program outcomes and to identify and document additional outcomes accomplished. The CBA efforts performed under this program should work toward the short-term and intermediate outcomes outlined in the logic model.

Applications that identify target populations under Category A or B must identify at least two outcomes. Applications that identify target populations under Category C must identify at least one outcome. The outcomes include Short-term

Improved operational capacity to evaluate, manage, and improve public health systems Improved leadership capacity to identify and prioritize public health needs Strengthened core and discipline-specific public health competencies among the workforce to improve job performance Improved capacity of data and information systems to conduct public health monitoring and surveillance Improved communication and information technology capacity to inform the public efficiently and effectively Improved capacity to establish and maintain partnerships within and across sectors to create a shared vision of health Increased capacity to evaluate laws and policies to improve health Improved capacity to identify, prioritize, and customize relevant programs and services to address public health needs

Intermediate

Increased capability of public health systems to achieve nationally established standards Increased leadership decision-making to address public health needs strategically and systematically Strengthened capability of the public health workforce to deliver essential public health services Increased capability to use data to inform decision-making and support evidence-based practices and policies Strengthened capability to use communication and information technology to affect health decisions and actions Strengthened capability to respond to public health priorities collaboratively and strategically Strengthened capability to systematically apply and use laws and policies to improve health Increased capability to implement evidence-based/informed public health programs, policies, and services to address public health needs

Long-term

Current, competent, and connected public health system

Improved delivery of essential public health services Improved health outcomes related to national objectives

In the long-term, the CBA provided will contribute to improvements in public health capacities and capabilities, such as leadership action and governance, delivery of essential public health services, information infrastructure and communication processes, use of research and evaluation findings, and policy assessment. Strengthening these capacities and capabilities will advance the US public health agency and system performance, capacity, agility, and resilience.

These efforts will improve and protect the nation’s health to create a safer and healthier nation.

iii. Strategies and Activities The program strategies and associated activities described below represent national recommendations related to critical public health capacities and capabilities outlined in Healthy People 2020, the National Public Health Performance Standards, various IOM reports, and Public Health 3.0. These cross-cutting strategies and activities are designed to position components of the public health system to strengthen infrastructure and improve delivery of essential services. The activities listed below are not exhaustive and should be augmented based on the target population’s priority needs.

Public Health Systems Infrastructure – Activities to improve operational capacity, such as polices and plans, administration and management, and quality improvement. CBA provided will strengthen the target population’s ability to

Assess and address gaps in organizational performance, using tools such as national accreditation standards

Assess and reduce agency fragmentation and duplication Develop and implement organizational strategic plans Formulate population health goals and strategies Ensure generation, analysis, and use of information about emerging health trends Ensure organizational structure aligns with health goals and strategies Establish performance management systems to monitor organizational objectives Establish and maintain effective financial management systems Build models that align public health with other sectors Ensure system transparency and accountability Identify, strengthen, and coordinate stakeholders' roles Develop and implement quality improvement processes for practices, processes, and interventions Develop and maintain operational infrastructure to support performance of public health functions Maintain current operational definitions and statements of organizational roles, responsibilities, and authorities

Leadership and Workforce – Activities to improve leadership and workforce competencies, recruitment, and retention. CBA provided will strengthen the target population’s ability to

Strengthen leadership engagement across public and private sectors

Determine leaders' engagement in specific public health priorities Establish feedback loops across systems for organizational planning Address existing and emerging public health priorities Address the social determinants of health and health disparities and inequities Perform network analysis to identify opportunities for collaboration Assess workforce training needs Establish and maintain workforce development plan Assess the workforce's scientific skills and subject matter expertise Develop workforce strategy for hiring and retaining employees Develop and implement strategies to sustain supportive work environments Establish relationships with organizations that promote the development of future public health workers Implement activities to scale-up delivery of public health training at lower costs Sustain the working relationship among public health and leaders across sectors

Data and Information Systems – Activities to improve the collection, management, interpretation, and dissemination of data to guide decision-making. CBA provided will strengthen the target population’s ability to

Assess health and health-related data sources Assess available information systems used across organizations Develop systems or processes for cross-integration and ease of use Improve system infrastructure for data storage, protection, and management Determine readiness for information system implementation, use, and maintenance Create manuals and protocols to ensure best practices and standardization of data and information systems Establish data governance by creating policies and guiding principles to improve the collection, interpretation, and meaningful use of data Increase information access, data use, and sharing across organizations Develop and implement protocols critical for integrating surveillance and monitoring systems Develop workforce training on managing data and information systems Link public health data, clinical care data, and other relevant data sources to improve surveillance Determine effective ways to use public health data, health care data, and other relevant data sources to monitor the health of populations

Communication and Information Technology – Activities to improve the use of communication and information technology to affect health decisions and actions. CBA provided will strengthen the target population’s ability to

Develop communication processes for effective cross-sector collaboration Develop communication procedures to provide information to the public Create communication campaigns that are relevant, culturally competent, and at a sufficient level of health literacy

Provide accessible, accurate, actionable, and current information that is culturally sensitive and linguistically appropriate

Develop communication systems to enable efficient and effective community-centered dialogue

Develop and disseminate educational materials, health communication and marketing activities, and program evaluation and assessment tools

Provide information about public health issues and functions to diverse audiences through multiple methods to inform public health decision making

Partnerships – Activities to improve the establishment and maintenance of results-driven partnerships. CBA provided will strengthen the target population’s ability to

Assess agency’s current internal and external partnerships Expand organization or program partnerships through community engagement and mobilization Perform network analysis to identify opportunities for collaboration Leverage partnerships to address specific public health issues or population health needs strategically Identify successful practices and develop new mechanisms to inform and mobilize the public and private sectors in collaborative efforts Engage with the public health system and community in identifying and addressing health problems through collaborative processes Engage various sectors in the adoption of Health in All Policies

Laws and Policies – Activities to improve the ability to interpret and inform laws, including statutes and regulations, and policies that affect health. CBA provided will strengthen the target population’s ability to

Conduct systematic surveillance of applicable laws and policies to public health aims and evaluate them

Engage multiple sectors to identify priorities for development of relevant laws and policies based on needs and data

Provide technical assistance and develop tools to support public health practitioners and policymakers in advancing evidence-based or evidence-informed law and policy

Engage multiple sectors in activities that contribute to providing evidence to inform laws and policies that affect public health

Inform governing entities, elected officials, and the public of potential public health effects from laws and policies

Educate individuals and organizations on purpose, benefit, and requirements of laws and policies that affect public health

Identify the common barriers and facilitators of legal and policy strategies that affect health

Programs and Services – Activities to improve the identification of best practices and implementation of evidence-based/informed programs and services. CBA provided will strengthen the target population’s ability to

Identify, prioritize, and fund programs that lower disease rates, prevent injuries, and improve health

Integrate prevention strategies and actions across multiple settings Adopt initiatives to develop, implement, and evaluate effective health promotion and disease prevention strategies Translate and disseminate evidence-based public health science to improve health and lower health care costs Identify effective mechanisms to ensure capable assessment and response to public health needs Develop indicators and measures to determine effectiveness in meeting public health needs Use evidence to implement programs and services that address emerging or real-time priority public health needs Develop and adopt evidence-based interventions that reduce high-burden diseases Assess access to health care services Identify and implement strategies to improve access to health care services

CDC anticipates activities funded under this NOFO will lead to the development of resources such as tools, materials, software, trainings, and webinars. Upon funding, recipients are expected to share these resources with CDC and will receive further guidance upon funding.

1. Collaborations

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

Upon funding, recipients will collaborate with other CDC centers, institutes, and offices (CIOs) to ensure that activities and funding do not duplicate work but instead are coordinated with and complementary to efforts supported under other CDC programs. Additionally, collaboration across the CDC CIOs is anticipated to improve program guidance, implementation, and evaluation. Successful applicants are expected to participate in stakeholder meetings and provide expert consultation to CDC/OSTLTS and other CDC CIOs (as requested). Successful applicants will also collaborate with other CDC-funded public health partners and CDC to identify and address emerging CBA needs.

b. With organizations not funded by CDC:

Recipients will be encouraged to build and sustain strategic partnerships and collaborations with organizations that have a role in implementing this program’s strategies and activities, and achieving the expected outcomes. Applicants are encouraged to submit letters of support to demonstrate collaborations with other organizations

2. Target Populations Successful applicants will receive funding to conduct projects that address the CBA needs of a selected target population. Applicants are expected to deliver CBA to their selected target population throughout the five-year period of performance. The NOFO provides funding to deliver CBA to one target population under one of these three categories:

Categories A and B address the CBA needs of target populations within governmental public health departments.

Category A: Governmental Public Health Departments – Meets the priority organizational-level CBA needs of one of the following health department types: state, tribal, local, or territorial. Organizational level includes, but is not limited to, business processes, system design, strategic planning, resource management, agency leadership, and governance.

Category B: Workforce Segments across Governmental Public Health Departments – Meets the priority CBA needs of one workforce segment across two or more health department types (state, tribal, local and territorial). Workforce segments can include, but are not limited to, epidemiologists, chronic disease specialists, public health lawyers, environmentalists, informaticians, and nutritionists.

Category C addresses the CBA needs of target populations outside of governmental public health departments. CBA activities conducted for this category must also leverage the organization’s expertise and networks to benefit a health department type (state, tribal, local or territorial) or workforce segment.

Category C: Nongovernmental Public Health Components – Meets the priority CBA needs of one type of nongovernmental component of the public health system.

Nongovernmental components represent, but are not limited to, community-based organizations, community health centers, primary care providers, governors, hospitals, economists, legislators, education organizations, social action organizations, and public safety agencies.

Organizations may submit up to two stand-alone applications. Each application must identify one target population. If two applications are submitted, each application must identify a distinct target population within a single category or across two different categories. For example, an organization could submit two applications for target populations within Category A to include one for state health departments and one for tribal health departments. Or, an applicant could submit two applications to include one from Category A for territorial health departments and one from Category C for community health centers.

When submitting your applications, you will need to identify a “Project Title” on line 15 of the SF-424. Your project title must represent the Target Population Category and the Target Population. Use the following naming convention for the Project Title and enter it on line 15 of the SF-424: “Target Population Category: Target Population.” For example: “Category A:

Tribal Health Departments.” If an applicant submits two applications for the same target population, the last submission will be reviewed and applications submitted earlier will be deemed non-responsive (considered duplicative and will not be reviewed).

a. Health Disparities This program is focused primarily on strengthening the public health system’s infrastructure and services. The program’s strategies and activities address public health needs and priorities to improve the capacities and capabilities that ensure a current, competent, and connected public health system. It is expected that an enhanced public health system will effectively address social determinants of health (SDOH) and health disparities. Generally, there are five key areas that determine health outcomes: 1) economic stability, 2) education, 3) social/community context, 4) health care, and 5) neighborhood/built environment. Disparities in health outcomes may be based on race, ethnicity, gender identity, sexual orientation, geography, socioeconomic status, disability status, primary language, health literacy, and other relevant dimensions.

Applicants are strongly encouraged to demonstrate how their CBA activities will improve the target population's ability to effectively address the SDOH and health disparities.

iv. Funding Strategy This funding opportunity will use a two-part strategy.

Funding Strategy 1: Initial Funding – Applicants are permitted to submit no more than two stand-alone applications. Responsive applications submitted under this funding opportunity will be reviewed objectively as described in the Review and Selection Process section of this NOFO.

Awards under Funding Strategy 1 will support building capacities and capabilities of the selected target population. The applications will be compiled and reviewed according to the target population category. Applicants selected for Funding Strategy 1 will become part of a group of organizations that are eligible for funding under Funding Strategy 2.

Funding Strategy 2: CIO Project Plans – The second funding strategy is subject to the availability of appropriated funds and agency priorities. To maximize CDC’s program priorities and U.S. health system needs, applicants funded under Funding Strategy 1 will be eligible to apply for additional funding under Funding Strategy 2. Under Funding Strategy 2, CDC will publish and compete CIO Project Plans according to target population categories. The plans will be published on http://www.grants.gov as a NOFO supplement to CDC-RFA-OT18-1802.

Organizations will submit “Work Plans in Response to CIO Project Plans” that are relevant to the target population category and target population for which they were awarded funding under Funding Strategy 1.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation and performance measurement will monitor the extent to which planned activities are completed successfully, show the effectiveness of CBA activities, and demonstrate achievement of program outcomes. The CDC uses evaluation findings to ensure continuous program quality improvement, create an evidence base for CBA strategies and activities, and inform decisions about future CBA efforts.

The CDC strategy for monitoring and evaluating recipient and program performance will be consistent with the logic model and approach presented earlier. The recipient is expected to track implementation of CBA strategies and activities and determine progress in achieving outcomes for the selected target population. CDC will use information collected from recipient progress reports (frequency to be determined) and annual performance reports to document project status and completion. As needed, conference calls with the recipient will include discussion of project updates, technical assistance needs, and challenges in completing http://www.grants.gov/ activities.

The program does not require uniform performance measures because the CBA strategies, activities, and outcomes will depend on target population needs and new and emerging public health issues. Instead, the NOFO proposes examples to demonstrate the types of measures that will show progress toward achieving program outcomes. Process measures are used to track the implementation of recipient strategies and activities. Outcome measures are used to determine progress in achieving the period of performance outcomes.

The “Examples of Process and Outcomes Measures” table below provides some examples of potential measures for the outcomes in the NOFO logic model. The applicant's proposed measures of effectiveness must be objective, quantitative, and measure the intended outcome of the program. The proposed measures must indicate meaningful change over time (e.g. increase, decrease, sustain, etc.) and clarify unit of measurement (e.g. number of, percentage of, proportion of, etc.).

CDC will provide guidance to develop performance measures that are specific to the recipient work plan and consistent with the program logic model. CDC and recipients will have six months post-award to discuss and finalize measures.

The evaluation questions assess CBA contributions that span across the logic model from strategies and activities to outcomes accomplished by the overall program. Each applicant’s evaluation and performance measurement strategy is unique and relevant evaluation questions will vary. Key evaluation questions to consider include Process Evaluation Questions:

Is the recipient able to successfully track implementation progress of strategies and activities?

How many agencies or individuals participated in CBA activities?

What products or deliverables were produced as a result of program activities?

What resources (e.g., funds, staffing, partnerships) were used for the planning, implementation, and evaluation of CBA provided?

What are the key challenges and barriers to implementing activities and achieving outcomes?

What are the key facilitators to successful implementation of activities and achievement of outcomes?

Are new activities identified that address specific target population challenges and opportunities?

Do the CBA activities have cross-cutting benefits beyond the target population?

Outcome Evaluation Questions:

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

How did tools and processes implemented strengthen public health system infrastructure?

What nationally established standards were achieved to improve operational capacity of the public health system?

How did leadership decision-making effect change of policies, programs, and services that affect public health?

How did leadership capacity improve to strategically and systematically address public health needs?

What core and discipline-specific public health competencies were strengthened to improve job performance?

What capabilities of the public health workforce increased?

What decisions were informed from improved collection, maintenance, and interpretation of data?

What decisions were informed from improved exchange of data across systems?

What actions were taken to inform the public in an efficient and effective manner?

What partnerships were established within and across sectors?

How did partnerships improve capacity to address public health needs and priorities?

What laws and policies were evaluated to affect health?

What programs and services were identified, prioritized, and customized to address public health needs?

Data sources to answer evaluation questions may include recipient applications and progress reports (e.g., work plans, annual performance reports), qualitative and quantitative process evaluation methods with recipients, and surveys of select target populations.

Applicants must provide a statement of commitment to provide a Data Management Plan (DMP) post award, when specific data generation and collection activities are defined.

Recipients will describe how they intend to manage, preserve, and make accessible data generated or collected with CDC funds in a DMP. The funding program will define the details of how the DMP is to be provided (e.g., as a narrative, table format). DMPs will be submitted, evaluated, and approved before beginning data collection.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. 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)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans.

For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

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).

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

The applicant evaluation and performance measurement plan must provide a description for year one evaluation activities and specific elements to be evaluated over the five-year period of performance. Applicants are expected to develop performance measures specific to the https://www.cdc.gov/grants/additionalrequirements/ar-25.html strategies, activities, and outcomes outlined in the proposed work plan. The evaluation and performance measurement plan must meet the minimum requirements, as stated above.

c. Organizational Capacity of Recipients to Implement the Approach Organizational capacity provides an opportunity for applicants to demonstrate their ability to execute this CBA program's strategies and activities and achieve its outcomes. As previously mentioned, this NOFO is designed to fund a group of organizations that have the knowledge, experience, expertise and national reach necessary to provide CBA services effectively and efficiently to governmental health departments and nongovernmental components of the public health system. Applicants should have adequate infrastructure (equipment and physical space), information and data systems, electronic information and communication systems, and workforce capacity and competence to execute the award.

Current and Recent Programs: Applicants must demonstrate adequate expertise in program planning, program implementation, performance monitoring, and program evaluation as they relate to the strategies and activities. Expertise in these areas should be demonstrated in descriptions of current or recent programs designed, implemented, and evaluated by the applicant. When describing current and recent programs, applicants must also demonstrate adequate capacity and experience necessary to develop and implement programs that have a national reach. For the purposes of this NOFO, national reach is the extent to which current and recent programs cover the 10 HHS regions. Descriptions of current and recent programs should include the program reach and mode of delivery.

Staffing and Partnerships: Applicants must demonstrate adequate capacity and expertise in personnel management and program staffing. Program staffing includes the ability to develop and maintain partnerships and recruit and hire for general staff expansion and specialized expertise. Documentation to illustrate adequate staffing plan and program management structure includes organizational charts, job descriptions, CVs/resumes, and staffing plans that clearly define staff roles and expertise as they relate to the activities and outcomes. Letters of support from other organizations should be used to demonstrate ability to build and maintain partnerships.

Procurement Activities: Applicants must demonstrate expertise in writing, negotiating, awarding and executing contracts and consulting agreements as they relate to individual projects funded under this program. Applicants must also demonstrate expertise in financial reporting, budget management and budget administration. Applicants must be fully capable of managing the required deliverables in accordance with 45 C.F.R. Applicants must submit a CV/resume for staff who will be involved in procurement activities and describe the organization’s capacity to execute contracts and consulting agreements.

Relationship with Target Population: Applicants must also describe the nature of their relationship with the target population and history (including number of years) of serving or working with the target population selected for this cooperative agreement. The history should also include examples of previous efforts providing CBA, such as the content and format of the CBA provided, and the results of those CBA efforts. If applicants submit letters of support from members of the target population and related stakeholders, the letters should outline the target population’s interest in the CBA services to be provided, the current relationship with the applicant, and previous examples of CBA received from the applicant.

https://www.hhs.gov/about/agencies/iea/regional-offices/

Relationship with Governmental Health Departments-Category C: Applicants who plan to address the CBA needs of a Category C target population must also leverage their capacity, reach, and experience to benefit a health department type (state, tribal, local, or territorial) or workforce segment. Category C applicants must demonstrate a relationship with the health department or workforce segment that will benefit from their CBA efforts. Letters of support from state, tribal, local, or territorial health departments should be included. The letters should speak to their current relationship with the applicant and include examples of previous CBA they have received from the applicant.

Affiliate Organizations: If applicable, applicants must provide a description of their affiliate organizations. Affiliates are subsidiary or subordinate organizations that are officially connected to the applicant organization. The description of affiliated organizations should include the name(s) and the affiliate’s public health-related area of expertise. Applicants must also submit evidence, such as bylaws, signed board resolution, or other documentation of guiding principles that recognize the affiliate organizations and their relationship with the applicant.

Current CDC CBA Funding: If applicable, applicants must provide a description of their current CDC-funded capacity building projects, including the name of the funding mechanism (CDC- RFA number), target population, type of CBA provided and delivery method, and outcomes achieved.

As illustrated in the Review and Selection Process section of this NOFO, the Organizational Capacity of Applicants to Implement the Approach will be weighed heavily during the Objective Review process. Applicants are strongly encouraged to address all areas of capacity mentioned above.

d. Work Plan Development of the work plan must be based on the established Average One Year Award Amount, which is supported under Funding Strategy I. The Average One Year Award Amount varies by the Target Population Categories A ($2 million), B ($1 million), and C ($500,000) to support capacity-building efforts as outlined in the program’s logic model.

Applications submitted above the Average One Year Award Amount for the selected Target Population Category will be considered non-responsive.

Applicants must develop a CBA work plan that provides a detailed plan for the first year of the period of performance and a high-level plan for the subsequent years. Applicants must clearly describe how the sections in their work plans crosswalk to the strategies, activities, outcomes, and evaluation and performance measures presented in the logic model and the narrative sections of the NOFO.

Applicants proposing to build capacity of a target population under Category C must also identify at least one strategy and related activity to build the capacity for one or more health department type (state, tribal, local, or territorial) or workforce segment. Applicants are encouraged to align work plans with activities indicated under the “Strategies and Activities” section, but are allowed to augment those activities based on the target population’s priority needs.

The applicant’s work plan must, at a minimum, include:

Five-Year Overview of the Project Work Plan

(Written in narrative format.)

Intended outcomes to be achieved by the end of the five-year period of performance Intended strategies, activities, and outputs to be achieved by the end of the five-year period of performance Administration and assessment processes to ensure successful implementation and quality assurance

Year 1 Detailed Work Plan (Use template below.)

Intended strategies and activities that correspond with the selected outcomes Description of the process measures for the strategies and activities Description of responsible position/party to support implementation of the project Provision of completion date for each outcome measure Estimated cost per strategy

The work plan format presented below shows how a traditional work plan aligns with the program’s logic model and approach as presented earlier. Applicants are required to use the table below for the first year activities. In this format, the table would be completed for the budget period outcomes that are selected by the applicant. Applications that identify target populations under Category A or B must identify at least two outcomes. Applications that identify target populations under Category C must identify at least one outcome. If a particular activity leads to multiple outcomes, it should be described under each outcome measure.

CDC will provide feedback and technical assistance to recipients to finalize the work plan to adjust for available funding and better address the various CBA priorities for the target population.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in…