Rickettsial Zoonoses Branch (RZB)

Notice of Funding Opportunity

Application due Thursday, July 9, 2026

Increasing awareness and knowledge of Alpha-gal Syndrome in the United States Opportunity number: CK-26-0193

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Agency priorities 10

Program description 13

Step 2: Get Ready to Apply 31

Get registered 32

Find the application package 33

Help applying 33

Step 3: Build Your Application 34

Application checklist 35

Application contents and format 37

Step 4: Understand Review, Selection, and Award 46

Application review 47

Award notices 49

Step 5: Submit Your Application 50

Submission requirements and deadlines 51

Step 6: Learn What Happens After Award 53

Post-award requirements and administration 54

Contacts and Support 58

Before you begin 3

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up to date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on Thursday, July 9, 2026.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Agency priorities 10

Program description 13

Basic information Centers for Disease Control and Prevention (CDC)

Division of Vector-Borne Diseases (DVBD)

Rickettsial Zoonoses Branch (RZB)

Improving awareness and knowledge of alpha-gal syndrome (AGS) in the United States.

Havequestions?

Go to Contacts and Support.

Key facts

Opportunity name:

Increasing awareness and knowledge of Alpha-gal Syndrome in the United States

Opportunity number:

CK26-0193

Assistance listing:

93.084

NOFO version: Original

Key dates

Application submission deadline:

Thursday, July 9, 2026

Optional letter of intent deadline:

June 7, 2026

Expected award date:

August 31, 2026

Expected start date:

September 30, 2026

See Submit Your Application for other time frames that may apply to this NOFO.

Summary This NOFO’s aim is to improve awareness and knowledge of alpha-gal syndrome (AGS) in the United States. AGS is an emerging condition and is not nationally notifiable. This will happen through:

• The creation of a professional network of AGS researchers and public health professionals.

• Improved surveillance.

• Improved communications materials.

This NOFO seeks to improve:

• AGS surveillance.

• Patient care.

• Awareness and understanding.

The NOFO’s three main strategies are to:

• Share: Disseminate the latest knowledge about AGS among stakeholders to improve patient care for AGS and the public health response.

◦ This includes public health agencies, academic researchers, and advocacy groups.

• Track: Conduct active or enhanced surveillance for AGS.

◦ This strategy could involve patient populations or geographic locations with limited access to specialized healthcare provider care.

• Educate: Create AGS communications targeted at the general public, AGS patients, and/or people at higher risk for tick encounters (outdoor enthusiasts, dog owners, etc.).

Step 1: Review the Opportunity 5

◦ Communications targeted at healthcare providers, healthcare provider educational resources, and training would also fall under this strategy.

Funding details Funding type: Cooperative agreement

Expected awards: 1-5

Period of performance: Five years in 12-month budget periods.

Expected total program funding over the performance period: $25,000,000 (up to 5 recipients at a maximum of $1,000,000 per year x 5 years)

Minimum and maximum award amounts over the period of performance:

$25,000-1,000,000

Expected funding per applicant per 12-month budget period:

$25,000-1,000,000

The number of awards is subject to available funds and program priorities.

Funding strategy This NOFO intends to fund recipients that are uniquely suited to make substantial contributions to the progress of the strategies and outcomes in the logic model.

Uniquely suited means having the necessary:

• Technical expertise.

• Infrastructure.

• Partnerships.

• Management capabilities.

You should focus your application on the strategies you are best suited to implement.

Funding cycles and levels The activities presented in this NOFO are intended to be funded on an annual basis.

Year one and future years’ funding levels are dependent on funding availability.

Step 1: Review the Opportunity 6

For planning purposes (including submitted budgets), you should estimate an average annual funding level for each award of $400,000 per year. Funding levels are subject to change and are dependent on the availability of funds.

Approved but unfunded (ABU) The funding strategy is also designed to collect proposals from approved applicants and designate them as “approved but unfunded” (ABU). Funding in some years may result in more recipients funded and depend on the CDC identifying a public health need to address AGS or other vector-borne disease needs or threats.

Depending on the nature of the need, specific applicants and specific components of their applications may be selected for funding. These funding decisions will consider various relevant factors, such as:

• Geographic location of the emergency.

• Expectations of spread.

• Applicant’s capabilities.

• National priorities.

Recipients will be provided with an opportunity to develop a customized project plan that builds off their initial project plan, once needs are identified.

Recipients may be funded out of rank order, depending on:

• The proposed activities.

• Response to CDC priorities outlined in this NOFO.

• Regional area covered.

CDC may fund all or some of the proposed strategies.

Step 1: Review the Opportunity 7

Eligibility Eligible applicants Only these types of organizations may apply.

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Independent school districts.

• Public and state-controlled institutions of higher education.

• Native American tribal governments (federally recognized).

• Public housing authorities and Indian housing authorities.

• Native American tribal organizations, other than federally recognized tribal governments.

• Nonprofits having a 501(c)(3) status, other than institutions of higher education.

• Nonprofits without 501(c)(3) status, other than institutions of higher education.

• Private institutions of higher education.

• For-profit organizations other than small businesses.

• Faith-based organizations.

• Small businesses.

• Bona fide agents applying on behalf of state, territorial, local, and tribal government organizations.

Bona fide agents must submit documentation that demonstrates their arrangement with the eligible applicant. See attachments.

Responsiveness criteria We will review your application to make sure it meets these requirements.

These are the basic requirements you must meet to move forward in the competition. We won’t consider an application that:

• Is from an organization that doesn’t meet all eligibility criteria. See requirements in eligibility.

Step 1: Review the Opportunity 8

• Is submitted after the deadline.

• Proposes research activities. See the definition of research.

See the application checklists to understand which elements of your application are part of the responsiveness criteria.

Application limits You must follow these limits on the number of applications your organization can submit.

Under this NOFO, you may submit only one application under your organization’s UEI.

Cost sharing and matching funds This program has no cost-sharing requirement, meaning you do not need to contribute to the costs of this project.

If you choose to include cost-sharing funds, we won’t consider it during review. If you receive an award, we will include your voluntary commitment in the award, and you must report on the funds.

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 9 https://www.cdc.gov/grants/additional-requirements/ar-31.html

Agency priorities Required alignment with CDC priorities The recipient of this award must implement any funds awarded under this NOFO to effectuate program goals or agency priorities in accordance with the Centers for Disease Control and Prevention (CDC) Priorities when authorized (for a full description of the CDC Priorities, please follow the provided hyperlink).

Funded activities must:

• Align with CDC’s core priorities by demonstrating a commitment to gold-standard science, transparency, and evidence-based practices.

• Support CDC’s mission to protect Americans from infectious and chronic diseases, strengthen public health systems, and advance innovation in health data and infrastructure.

• Contribute to rapid, science-driven responses to health threats, promote global health leadership, and adhere to principles of integrity, accountability, and compliance with applicable laws and federal priorities.

Consistent with CDC’s values, in carrying out any project funded under this NOFO, the recipient must adhere to the following principles where consistent with the authority and scope of the award and its activities:

• A commitment to gold-standard science and ensuring trust, transparency, and credibility: To build trust and improve CDC’s ability to lead during health crises, CDC will increase transparency, be more accountable, and follow strict, gold-standard scientific practices that are open, unbiased, and based on clear evidence.

• A commitment to global leadership: With staff in 63 countries and supporting 20 more, CDC’s Global Health Center:

◦ Works to prevent disease and advance emergency response.

◦ Detect health threats early, sends response teams, trains health workers, and provides personal protective equipment, vaccines, and medicines.

◦ Test disease samples from around the world to prepare for flu and other serious outbreaks.

◦ Has strengthened systems to better protect people at home and abroad after the COVID-19 outbreak.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.cdc.gov/about/cdc/index.html

• A commitment to ensuring rapid, evidence-based responses to crises:

During public health emergencies, ensuring rapid, science-driven responses is critical to minimizing harm, maintaining public trust, and restoring stability. To meet this goal, CDC must continue to strengthen its emergency response systems by:

◦ Streamlining internal processes.

◦ Improving risk communication strategies.

◦ Ensuring that laboratory capacity is fully equipped and tested—capable of rapidly developing and deploying scalable diagnostics during crises.

◦ Embedding structures for real-time learning, independent after-action reviews, and the application of lessons learned will ensure that each crisis response is smarter, faster, and more effective than the last.

• A commitment to vaccine safety and efficacy research: CDC will apply “gold-standard” science to all of its vaccine safety and effectiveness research. It will make vaccine data, research methods, and related datasets publicly available through simple data use agreements to improve transparency, accountability, and trust.

• A commitment to advancing our understanding of the causes of autism spectrum disorder (ASD), neurodevelopmental disorders (NDDs), and chronic disease: CDC conducts research and works with partners to better understand the causes of autism spectrum disorder, neurodevelopmental disorders, and chronic diseases. It will use new and existing data to study the rise in these conditions, including the increase in autism diagnoses from 1 in 150 to nearly 1 in 31 over the past 25 years.

• A commitment to modernizing public health infrastructure and enhancing our approach to health data: CDC will modernize public health infrastructure to create a faster, more efficient health system that can detect and respond to outbreaks in real time. This effort includes:

◦ Replacing data silos with integrated systems.

◦ Using advanced technology.

◦ Strengthening partnerships with states to ensure shared responsibility and strong local health data systems.

◦ Emphasizing collaboration across federal and state partners, resilient and adaptable systems, and accountability for funded programs to ensure they align with these priorities and federal requirements.

Step 1: Review the Opportunity 11

• Conflicts of interest: CDC will not support funding programs with conflicts of interest and ensure its work is based on transparent, unbiased science.

• Immigration: CDC funds will not be used to support or encourage illegal immigration, consistent with federal law.

• Protecting life and the family: CDC funds will not be used to support elective abortions, consistent with the Hyde Amendment, and will promote maternal health, the dignity of life, and strong families.

• Ending disorder on America’s streets: CDC will prioritize evidence-based programs that reduce homelessness, drug use, and public disorder. It will support comprehensive services for people with serious mental illness and substance use disorder. CDC will not support housing first strategies, harm-reduction or safe consumption sites, or related activities. To the extent allowable by federal law, CDC intends to give priority to grantees in States and municipalities that have laws and policies that support and enforce CDC’s priorities.

• Gender ideology and protecting children [PDF]: CDC will not fund medical interventions for minors seeking gender transition and will define sex based on biological criteria.

• DEI: CDC will not support DEI initiatives based on group identity and focus on merit-based, evidence-driven approaches to improve health outcomes.

• Parental rights: CDC will support policies that protect parental authority, promote transparency, and give parents greater control over their children’s education.

The recipient must demonstrate ongoing compliance with the full description and listing of CDC values and priorities, in all programs that are authorized to advance them, through program design, implementation, reporting, and evaluation.

Failure to meaningfully align funded activities with the applicable requirements may result in corrective action, additional reporting requirements, or other enforcement actions consistent with federal grant regulations found at 2 CFR Part 200 and the terms and conditions of this award. The full CDC Priorities Statement can be found here: Centers for Disease Control and Prevention (CDC) Priorities.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 12 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background Alpha-gal syndrome (AGS) is a serious, potentially life-threatening tick-borne disease defined as an emerging allergy to mammalian meat and its byproducts. As many as 450,000 Americans are estimated to have been affected by AGS in the United States (U.S.) since 2010.

The national burden of disease is largely unknown since AGS is not nationally notifiable and surveillance data are limited. There is currently minimal active surveillance to understand risk factors for exposure and the development of the disease.

Gaps in awareness Healthcare providers also aren’t generally aware of the disease. In a 2022 survey, healthcare provider knowledge of AGS was reportedly low, with 42% of U.S. healthcare providers unaware of the disease.

Access to care issue Because a diagnosis of AGS often requires repeated visits to a healthcare provider as well as an allergist or other specialists, access to care is a major issue affecting AGS patients.

• AGS patients have been reported as more likely to be non-Hispanic white, have a higher income, and have higher levels of educational attainment than a local control population.

• A recent CDC study found that while time to diagnosis of AGS had shortened in recent years, patients with higher educational attainment (graduate degrees vs high school diplomas) still received an AGS diagnosis multiple years sooner.

• The NOFO could fund targeted active and enhanced surveillance activities.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 13 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831189

Facilitating collaboration and disseminating information The formation of a professional network for AGS researchers and public health professionals will improve outcomes related to AGS. Meetings of the professional network will facilitate collaboration and improvements in AGS understanding, research, surveillance, and practice.

• The NOFO could support the formation of a professional network for AGS researchers and public health professionals.

• It could also fund the development of educational materials and trainings.

These combined efforts will move AGS research and practice forward and minimize health burden among patients.

Related work Rickettsial Zoonoses Branch publications on alpha-gal syndrome:

• Health Care Provider Knowledge Regarding Alpha-gal Syndrome — United States, March–May 2022 | MMWR (cdc.gov)

• Geographic Distribution of Suspected Alpha-gal Syndrome Cases — United States, January 2017–December 2022 | MMWR (cdc.gov)

• Tick bite as a risk factor for alpha-gal–specific immunoglobulin E antibodies and development of alpha-gal syndrome - ScienceDirect

• Intrinsic risk factors for alpha-gal syndrome in a case-control study, 2019 to 2020 - ScienceDirect

• Time From Onset to Diagnosis of Alpha-Gal Syndrome - JAMA Network

Additional helpful related research:

• Diagnosis & management of alpha-gal syndrome: lessons from 2,500 patients - PubMed (nih.gov)

• Diagnosis of Life-Threatening Alpha-Gal Food Allergy Appears to Be Patient Driven - PubMed (nih.gov)

National public health priorities and strategies

• A National Public Health Framework for the Prevention and Control of

Vector-Borne Diseases in Humans

• National Public Health Strategy to Prevent and Control Vector-borne Diseases in People

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 14 https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a1.htm?s_cid=mm7230a1_w https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a1.htm?s_cid=mm7230a1_w https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm?s_cid=mm7230a2_w https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm?s_cid=mm7230a2_w https://www.sciencedirect.com/science/article/pii/S1081120622019639?dgcid=raven_sd_recommender_email https://www.sciencedirect.com/science/article/pii/S1081120622019639?dgcid=raven_sd_recommender_email https://www.sciencedirect.com/science/article/pii/S1081120624000747?ref=pdf_download&fr=RR-2&rr=8c9634295d00e283 https://www.sciencedirect.com/science/article/pii/S1081120624000747?ref=pdf_download&fr=RR-2&rr=8c9634295d00e283 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831189 https://pubmed.ncbi.nlm.nih.gov/32571129/ https://pubmed.ncbi.nlm.nih.gov/32571129/ https://pubmed.ncbi.nlm.nih.gov/28447914/ https://pubmed.ncbi.nlm.nih.gov/28447914/ https://www.cdc.gov/vector-borne-diseases/media/pdfs/Brochure_National_Framework_VBDs-P.pdf https://www.cdc.gov/vector-borne-diseases/media/pdfs/Brochure_National_Framework_VBDs-P.pdf https://www.cdc.gov/vector-borne-diseases/php/data-research/national-strategy/index.html https://www.cdc.gov/vector-borne-diseases/php/data-research/national-strategy/index.html

Purpose To support networks of professionals researching, diagnosing, treating, and preventing AGS.

This NOFO may support activities that promote and support networks of professionals, including AGS researchers and public health professionals who are researching, diagnosing, treating, and preventing AGS. Activities may include hosting a meeting of these professionals to facilitate networking, information sharing, and documentation of priorities among professionals working on AGS. This will foster partnerships that will increase our collective knowledge of AGS.

Improved surveillance The NOFO may fund active or enhanced AGS surveillance to improve patient outcomes.

• This surveillance could be conducted with patient populations experiencing higher burden of AGS.

• Improved surveillance will contribute to the body of AGS knowledge.

Communications materials The NOFO may also fund the creation of AGS communications targeted high-risk groups, AGS patients, and healthcare providers, along with the general public. The goal is to increase public awareness of AGS nationally. Examples of groups include:

• Outdoor enthusiasts.

• Hunters.

• Gardeners.

• Hikers.

• People working outdoors.

• Pet owners.

The communications materials will aim to increase healthcare provider awareness of AGS, as well as how to diagnose and manage the disease. Time to diagnosis can vary and has been previously reported to be upwards of 7 years. Delaying diagnosis can lead to negative outcomes, including life-threatening symptoms like anaphylaxis. This is in addition to the mental health impact of having repeated reactions and not knowing why or how to manage the disease.

Step 1: Review the Opportunity 15

Approach Overview The Alpha-Gal Syndrome Subcommittee Report to the Tick-Borne Disease Working Group* identified four priorities:

• Priority 1: Surveillance, Epidemiology, and the Role of Tick Bites in Alpha-gal Syndrome

• Priority 2: Diagnosis and Management of Alpha-gal Syndrome

• Priority 3: Education, Awareness, and Support from Patients’ Perspectives

• Priority 4: Tick Bite Prevention and Tick Control

This NOFO addresses these priority areas.

*(See TBDWG Reports | Health.gov)

Program logic model The following logic model includes the strategies and activities allowed under this NOFO.

The logic model also includes the program’s expected outcomes. Outcomes are the results that you intend to achieve. They usually show the intended direction of change, such as increase or decrease.

The asterisked ( * ) outcomes are those we expect you to achieve during the first-year period of performance. You are required to report on these outcomes.

Not all outcomes apply to all strategies. The table shows how they apply. You will use these outcomes as a guide for developing performance measures.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 16 https://health.gov/advisory-committees/tick-borne-disease-working-group/tbdwg-reports

Table: Strategies and outcomes

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1. Share

Disseminate latest knowledge of AGS among stakeholders

Convene AGS professionals by hosting a first-annual meeting and subsequent annual meetings.*

AGS professionals disseminate latest findings and build partnerships.

• Establishing a network of AGS professionals allows for stronger collaboration and furthers AGS research and practice.

• Ongoing annual meetings facilitate sharing of best practices among AGS professionals.

Strategy 2. Educate

Create AGS communications materials targeted at the general public, AGS patients (or higher-risk groups), and/or healthcare providers

Increased availability of tailored resources about AGS.*

Improved AGS literacy in target populations (could be general public, healthcare providers, higher-risk groups).

Improved knowledge of AGS prevention and improved health outcomes for persons with AGS.

Strategy 3. Track

Conduct active or enhanced surveillance for AGS

Improved completeness, timeliness, and quality of AGS active or enhanced surveillance data.*

Increased ability to describe the geographic distribution, risk factors, and lifestyle influences related to

AGS.

Increased use of active or enhanced surveillance and epidemiological data to guide prevention and care efforts among specific at-risk groups and other focal populations.

*Indicates outcomes you are required to report on routinely.

Step 1: Review the Opportunity 17

Strategies and activities This section elaborates on the strategies and activities described in the logic model and provides details about how we expect you to implement your program.

Applicants may choose to apply for activities in Strategies 1, 2, and/or 3.

Strategy 1: Share Disseminate latest knowledge of AGS among stakeholders.

Activities may include:

• Forming and convening a network of AGS professionals. Professionals include:

◦ Epidemiologists.

◦ Public health officials.

◦ Allergists.

◦ Academic researchers.

◦ Entomologists.

◦ AGS healthcare providers.

• Hosting a meeting or conference for the network to collaborate and share AGS knowledge. Knowledge includes:

◦ Surveillance data.

◦ Newly published research.

Strategy 2: Educate Create AGS communications materials.

Activities may include:

• Developing public-facing communications materials focused on improving knowledge of AGS, including knowledge on:

◦ Causality (tick bite).

◦ Prevention.

◦ Symptoms.

◦ Sources of alpha-gal exposure.

• Conducting in-person healthcare provider training.

• Conducting healthcare provider training on public health reporting.

• Developing educational materials:

Step 1: Review the Opportunity 18

◦ For healthcare providers focused on identifying, diagnosing, and managing AGS.

◦ For healthcare providers focused on local risk of AGS.

◦ For the general public focused on local risk of AGS.

• Targeting AGS education at groups at higher risk for tick encounters (outdoor enthusiasts, dog owners, etc.).

• Adding alpha-gal syndrome to existing public-facing tick bite prevention education.

Strategy 3: Track Conduct active or enhanced public health surveillance for AGS.

Activities may include:

• Conducting active or enhanced public health surveillance in populations:

◦ In geographic locations with limited access to specialized provider healthcare.

◦ Areas at higher risk for tick encounters (outdoor enthusiasts, dog owners, etc.)

• Use active or enhanced surveillance to evaluate health impacts of AGS.

Step 1: Review the Opportunity 19

Outcomes This section includes information about the outcomes we expect you to report progress on and achieve within the performance period.

Not all outcomes may be relevant depending on to which Strategies applicants apply.

Outcomes for Strategy 1: Share

• Network of AGS professionals, including public health professionals and healthcare providers, is formed to foster collaboration.

• Host an annual meeting of the AGS professionals.

• AGS professionals disseminate latest findings to their professional network.

Outcomes for Strategy 2: Educate

• Increased availability of tailored resources about AGS.

• Improved knowledge of AGS prevention among the public.

• Improved healthcare provider literacy of AGS.

• Clinicians can identify, diagnose, and manage AGS using best practices.

• Clinicians understand the local distribution of AGS in their area.

Outcomes for Strategy 3: Track

• Improved completeness, timeliness, and quality of AGS data among specific at-risk groups and other focal populations.

• Increased ability to describe the geographic distribution, risk factors, and lifestyle influences related to AGS in specific populations.

Step 1: Review the Opportunity 20

Work plan You must provide a work plan for your project. The work plan connects your performance outcomes, strategies and activities, and measures. It provides more detail on how you will measure outcomes and processes.

Table: Sample format

Activities you will implement

Progress or process measures

From the data, monitoring, and evaluation section.

Relevant period of performance outcomes

From the outcomes section.

Responsible position or party

Completion date

Strategy 1:

1.

2.

3.

Strategy 2:

1.

2.

3.

Strategy 3:

1.

2.

3.

Step 1: Review the Opportunity 21

Data, monitoring, and evaluation CDC strategy CDC collects and reports on indicators to measure progress toward achieving the activities and outcomes. CDC will also use results for program planning, improvement, accountability, and reporting. CDC will share the results with key parties.

CDC will work with you throughout the life of an award to ensure that all activities and expected outcomes align with your strategies and goals, and those of the U.S. government.

You should dedicate some award funds to evaluate and monitor the performance of your project. You and CDC will agree on the final funding amount, but we expect that you will dedicate approximately 5 to 10% of your project’s funding to monitoring, reporting, and evaluation activities.

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.

Evaluation questions could include the following:

• How can a newly formed network of diverse professionals advance and accelerate knowledge about AGS in a way that:

◦ Improves prevention?

◦ Improves patient care?

◦ Shortens time to diagnosis?

• How can targeted communication efforts reach and influence different populations?

• How can improved surveillance data increase our understanding of exposures and patient experiences of AGS?

Step 1: Review the Opportunity 22

Required performance measures This section describes the draft performance measures you will need to report on after award. We will likely refine the required measures for this program. If so, we will work with you and finalize them before we require you to submit any data.

• Updates on planning and implementing an annual AGS Professional Conference:

◦ Progress on draft and final agendas.

◦ Outreach plan to participants.

◦ Number of participants.

◦ Conference evaluation.

◦ Conference summary.

• Updates on establishing an AGS network:

◦ Number of members.

◦ Affiliations and expertise of members.

• Evidence of increased health communication messages to reach both the general population, populations experiencing higher burden of AGS, and healthcare providers:

◦ Number of public-facing communications materials focused on:

▪ Improving knowledge of AGS, including causality (tick bite).

▪ Prevention.

▪ Symptoms.

▪ Sources of alpha-gal exposure.

◦ Number of in-person healthcare provider trainings.

◦ Number of healthcare provider educational materials:

▪ Focused on identifying, diagnosing, and managing AGS.

▪ Focused on local risk of AGS.

◦ Number of public-facing educational materials focused on local risk of AGS.

◦ Number of educational outreach products targeted to groups at higher risk for tick encounters (outdoor enthusiasts, dog owners, etc.).

• Improved completeness and quality of AGS surveillance data through active or enhanced surveillance.

Step 1: Review the Opportunity 23

• Increased capacity to collect, analyze, and disseminate AGS data:

◦ Number and description of projects that increase ability to describe:

▪ The geographic distribution of AGS.

▪ The risk factors associated with AGS.

▪ Lifestyle influence associated with AGS.

▪ The health burden related to AGS in specific populations.

◦ Conduct active or enhanced public health surveillance:

▪ In populations or geographic locations with limited access to specialized provider healthcare.

▪ In populations at higher risk for tick encounters (outdoor enthusiasts, dog owners, etc.).

▪ Target active or enhanced surveillance to evaluate health burden impacts of AGS.

Reporting of performance measures may be required up to, but not to exceed, quarterly reporting.

Evaluation and performance measurement plan You must provide an evaluation and performance measurement plan. Use the measures required under the CDC strategy.

Include the following elements.

Methods Describe how you will:

• Collect the performance measures.

• Respond to the evaluation questions.

• Incorporate evaluation and performance measurement into planning, implementing, and reporting project activities.

• Use evaluation findings for continuous program quality improvement.

Additionally, explain:

• How key program partners will participate in the evaluation and performance measurement process.

• How feasible it will be to collect appropriate evaluation and performance data.

• How you will share evaluation findings with communities.

• Other relevant information, such as performance measures you propose.

Step 1: Review the Opportunity 24

Data management plan For all public health data you plan to collect, you must have a data management plan (DMP). For a definition of “public health data” and more information about CDC’s policy on the DMP, see Data Management and Access.

Submit your DMP with your application and include:

• The data you will collect or generate, and what its sources will be.

• Who can access data and how you will protect it.

• Data standards that explain what documentation the released data will have.

◦ That documentation should describe collection methods, what the data represent, and data limitations.

• Archival and long-term data preservation plans.

• Any reasons you cannot share data collected or generated under this award with CDC.

◦ These could include legal, regulatory, policy, or technical concerns.

• How you will update the DMP as new information becomes available over the life of the project.

◦ You will provide updates to the DMP in annual reports.

Evaluation activities You may choose to take on specific evaluation activities. Describe:

• The type of evaluations you will complete, such as process, outcome, or both.

• Key evaluation questions these evaluations will address.

• Measures and data sources.

• Any other relevant information.

Submit an initial draft of your evaluation and performance measurement plan, including the DMP, with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 25 https://www.cdc.gov/grants/additional-requirements/ar-25.html https://www.cdc.gov/grants/additional-requirements/ar-25.html

Paperwork Reduction Act Any activities involving information collection from 10 or more individuals or organizations may require the Paperwork Reduction Act (PRA) approval. The PRA requires review and approval of the information collection by the White House Office of Management and Budget. To determine if a proposed activity requires PRA approval, contact your program contact.

Collections include items like surveys and questionnaires. If you have collections requiring PRA approval, CDC is responsible for working with OMB to gain the approval.

For more information about CDC’s requirements under PRA see CDC Paperwork Reduction Act Compliance.

Organizational capacity Describe how you will address the requirements in the organizational capacity section of the program description.

You must provide attachments that support this section, including:

• Resumes and job descriptions.

• Organizational chart.

Collaborations

• You must describe how you will collaborate with programs and organizations, either internal or external to CDC.

• You must address the Collaboration requirements as described in the CDC Project Description.

• Collaborations could include:

◦ Other CDC-funded institutions (e.g., the Centers of Excellence for Vector-Borne Diseases or the Training and Evaluations Centers).

◦ State and local public health agencies.

◦ Community-based organizations serving the population of focus.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 26 https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm

Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS will adopt 2 CFR 200, with some exceptions included in 2 CFR 300. These regulations replace those in 45 CFR 75. You can find details in HHS Summary of Regulatory Changes, which is posted in the Grants.gov Related Documents tab for this opportunity.

General guidance All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate; racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration;

or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

• You may use funds only for reasonable program purposes consistent with the award, its terms and conditions, and federal laws and regulations that apply to the award. If you have questions about these purposes, ask the grants management specialist.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting your project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If needed, and where consistent with the scope of the NOFO.

◦ You may use funds to meet national standards or seek health department accreditation or reaccreditation through the Public Health Accreditation Board (PHAB).

▪ This allowability applies only to state, tribal, local, and territorial government agencies within the U.S. and its territories.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 27 https://www.ecfr.gov/current/title-2/part-200 https://phaboard.org/ https://phaboard.org/

▪ Include the proposed activities and describe the connection to national standards or accreditation achievement in the budget narrative.

◦ You may use funds to support your jurisdiction’s vital records office (VRO) to do any of the following:

▪ Build its capacity through partnerships.

▪ Provide technical or financial assistance to improve vital records timeliness, quality, or access.

▪ Support vital records improvement efforts.

◦ You may use funds to make sure that state, tribal, local, and territorial employees funded by CDC grant or cooperative agreement awards are adequately trained and prepared to effectively participate in jurisdictional emergency response activities.

• If we receive more funding for this program, we will consider options such as:

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

See also program-specific limitations.

Unallowable costs You may not use funds for:

• Research.

• Clinical care, except as allowed by law.

• Pre-award costs, unless we give you prior written approval.

• Other than for normal and recognized executive-legislative relationships:

◦ Publicity or propaganda purposes, including preparing, distributing, or using any material designed to support or defeat the enactment of legislation before any legislative body.

◦ The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before any legislative body.

◦ See Anti-Lobbying Restrictions for CDC Grantees.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 28 https://www.cdc.gov/grants/documents/Anti-Lobbying-Restrictions.pdf

• For guidance on some types of costs that we restrict or do not allow, see 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

Indirect costs Indirect costs are those shared across multiple projects and not easily separated. Learn more at CDC Budget Preparation Guidelines.

To charge indirect costs you can select one of two methods:

Method 1 — Approved rate. If you currently have an indirect cost rate approved by your cognizant federal agency, you may use that rate.

Enclose a copy of the current approved rate agreement in your attachments.

Method 2 — De minimis rate. If you do not have a current negotiated indirect cost rate, you may elect to charge a de minimis rate (see 2 CFR 200.414(f)). This rate is 15% of modified total direct costs (MTDC). See the definition of MTDC (2 CFR 200.1). You can use this rate indefinitely.

Other indirect cost policies As described in 2 CFR 200.403(d), you must consistently charge items as either indirect or direct costs and may not double charge.

Indirect costs may include the cost of collecting, managing, sharing, and preserving data.

Salary rate limitation The salary rate limitation in the current appropriations act applies to this program. As of January 2026, the salary rate limitation is $228,000. We update this limitation when it changes.

Program income If you earn any money from your award-supported project activities (known as program income), you must use it for the purposes and under the conditions of the award. Find more about program income at 2 CFR 200.307.

Program-specific limitations Not applicable.

Expanded authority For more information on expanded authority and pre-award costs, see the HHS Grants Policy Statement and speak to the grants management contact.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 29 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-2/part-200#p-200.403(d) https://www.ecfr.gov/current/title-2/section-200.307 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html

Pre-award costs may be allowable as an expanded authority, but only if we authorize the costs.

Statutory authority This program is authorized under Public Health Service Act section 301(a) [42 U.S.C. section 241(a)] and Public Health Service Act section 317(k)(2) [42 U.S.C.

section 247b(k)(2)]. Additional authority may also stem from an applicable emergency supplemental appropriation; such appropriation and any requirements and/or limitation associated with that emergency supplemental will be added to the notice of award.

Step 1: Review the Opportunity 30

Step 2:

Get Ready to Apply

In this step

Get registered 32

Find the application package 33

Help applying 33

Need help? See Contacts and Support.

Get registered SAM.gov You must have an active account with SAM.gov to apply. SAM.gov registration can take several weeks. Begin that process today.

To register:

• Go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist for the information you will need to register.

• You must agree to the financial assistance general certifications and representations specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier

(UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 32 https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants

Find the application package You can find it online. Go to Grants Search at Grants.gov and search for opportunity number CK-26-0193. After opening the opportunity, select the “package” tab to see the forms.

We recommend that you select the Subscribe button from the View Grant Opportunity page for this NOFO to get updates.

If you can’t use Grants.gov to download application materials or have other technical difficulties, including issues with application submission, contact Grants.gov for assistance.

Help applying For help related to the application process and tips for preparing your application, see How to Apply on our website. For other questions, see Contacts and Support.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 33 https://grants.gov/search-grants https://www.grants.gov/support https://www.grants.gov/support https://www.cdc.gov/grants/applying/index.html

Step 3:

Build Your Application

In this step

Application checklist 35

Application contents and format 37

Application checklist This checklist includes every component you will need to submit a complete application:

Narratives

Item Grants.gov form Page limit Responsiveness factor?

Project summary Project Abstract Summary form

1 page No

Project narrative Project Narrative Attachment form

20 pages Yes

Budget narrative Budget Narrative Attachment form

None Yes

Attachments Put all of your attachments into a single Other Attachments form.

Attachments Page limit Responsiveness factor?

1. Table of contents None No

2. Indirect cost agreement None No

3. Resumes and job descriptions None No

4. Organizational chart None Yes

5. Letters of support None No

6. Report on overlap None No

Step 3: Build Your Application 35

Other required forms

Other forms Grants.gov form

Responsiveness factor?

Application for Federal Assistance (SF-424) Form

SF-424

No

Budget Information for Non-Construction Programs (SF-424A) Form

SF-424A

No

Disclosure of Lobbying Activities (SF-LLL) (if applicable) Form SF-

LLL

No

See submission requirements and deadlines to see if there are other requirements beyond the application itself.

See responsiveness criteria to understand how they affect your application.

Step 3: Build Your Application 36

Application contents and format Applications include narratives, attachments, and other required forms. This section includes guidance on each.

Required format

Required format for project summary, project narrative, and budget narrative.

Font: Aptos or Times New Roman

File format: PDF

Size: 12-point font Footnotes and text in graphics may be 10-point.

Ink color: Black

Spacing: Single-spaced

Margins: 1-inch

Include page numbers.

Step 3: Build Your Application 37

Project summary (0 points) Page limit: 1

File name: Project summary

Provide a self-contained summary of your proposed project, including the purpose and outcomes. Do not include any proprietary or confidential information. We use this information when we receive public information requests about funded projects.

Project narrative (100 points) Page limit: 20

File name: Project narrative

Your project narrative must use the exact headings, subheadings, and order as follows.

Evaluation criterion Scoring

Background and approach 60 point section total

Background 5 points

Strategies and activities 20 points

Outcomes 10 points

Work plan 25 points

Evaluation and performance measurement plan 20 points section total

Organizational capacity 20 points section total

Step 3: Build Your Application 38

Background (5 points) Describe the problem you plan to address. Be specific about your population and geographic area.

See the background section of the program description.

Table: Scoring criteria

Reviewers will evaluate the extent to which the applicant provides: Point value

A background that supports a clear understanding of AGS. 5 points

Strategies and activities (20 points) Describe how you will implement the proposed strategies and activities to achieve performance outcomes. Explain whether the strategies are:

• Existing evidence-based strategies.

• Other strategies. Note where in your evaluation and performance measurement plan you describe how you will evaluate them.

See the strategies and activities section of the program description.

Table: Merit review criteria

Reviewers will evaluate the extent to which the applicant provides: Point value

Approach to the Share component, including strategies and activities consistent with establishing a network of professionals working on AGS. This includes hosting an annual meeting as well as the approach to the optional Educate and Track components if included.

20 points

Outcomes (10 points) Identify outcomes you expect to achieve or make progress on by the end of the performance period. Use the program logic model to identify your outcomes.

Table: Scoring criteria

Reviewers will evaluate the extent to which the applicant provides: Point value

Outcomes consistent with the outcomes in the program’s logic model. 10 points

Step 3: Build Your Application 39

Work plan (25 points) Include a work plan using the requirements in the work plan section of the program description.

Table: Scoring criteria

Reviewers will evaluate the extent to which the applicant provides: Point…