ELC_NOFO_CK24-0002-published14Feb2024_v3.pdf

Centers for Disease Control and Prevention

National Center for Emerging and Zoonotic Infectious Diseases

Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC)

CDC-RFA-CK-24-0002

Application Due Date: April 30, 2024, no later than 11:59pm ET.

2/15/2024: Updated to correct formatting. See pages 150-166.

2/23/2024: Updated (1) Page 24, Evaluation Plan for 2024 sub-bullets; (2) Program J: VPD & Respiratory Diseases, Strategy/Activity numbering; and (3) Project M: Mycotics, Estimated

Total Availability of Funds.

Table of Contents NOFO Introduction A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Required Registrations

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

NOFO Guidance Section I: Cross-cutting Emerging Infectious Disease Capacity, Systems, and Leadership .50 Program A: Cross-cutting Epidemiology and Laboratory Capacity

Project B: ELC Leadership, Management, and Administration

Project C: Health Information System (HIS) Capacity Project D: Advanced Molecular Detection (AMD)

Project E: National Wastewater Surveillance System

Project F: Emerging Issues Section II: Emerging Infectious Disease Programs Program G: Enteric, Foodborne, Waterborne, and Zoonotic Diseases: Surveillance, Detection, Response, Reporting, and Prevention

Program H: Healthcare-associated Infections, Antimicrobial Resistance, and Antibiotic Stewardship Program I: Antimicrobial Resistance Laboratory Network (AR Lab Network) Program J: Enhanced Surveillance for Vaccine-Preventable Disease (VPD) and Respiratory Diseases

Program K: Vector-borne Diseases and Tick-Associated Conditions Section III: Disease-Specific Projects Project L: Prion Surveillance Project M: Mycotics: Detecting and Preventing Fungal Infections

Project N: Binational Border Infectious Disease Surveillance (BIDS)

Project O: Global Migration, Border Interventions, and Migrant Health

Project P: Parasitic Diseases Surveillance

Project Q: Combating Antimicrobial Resistant Gonorrhea and Other STIs (CARGOS)

Project R: Rabies Surveillance and Laboratory Capacity Project S: Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-

NET)

Project T: Human Papillomavirus Surveillance Among Men

Project U: HIV Centers for Cluster and Outbreak Response Enhancement (HIV C-CORE)

ELC Logic Model…………………………………………………………………………..….301

Part I. Overview Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA- CK-24-0002. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) B. Notice of Funding Opportunity (NOFO) Title:

Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) 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 purposes of this NOFO, research is defined as set forth in 45 CFR 75.2 and, for further clarity, as set forth in 42 CFR 52.2 (see eCFR :: 45 CFR 75.2 -- Definitions and https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR- 2007-title42-vol1-sec52-2.pdf. In addition, for purposes of research involving human subjects and available exceptions for public health activities, please see 45 CFR 46.102(l) (https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section- 46.102#p-46.102(l)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-CK-24-0002

E. Assistance Listings Number:

93.323 F. Dates:

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

The LOI date will generate once the Synopsis is published if Days or a Date are entered.

Not Applicable Not applicable 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.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l)

2. Due Date for Applications:

April 30, 2024, no later than 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call ELC will hold an information webinar.

Date: February 20, 2024 Time: 3:00 PM Eastern Time (US and Canada) Topic: Informational Webinar for ELC Cooperative Agreement (CK24-0002)

Register in advance for this webinar:

https://cdc.zoomgov.com/webinar/register/WN_dzVsHPEJRBqOqZ7HxuttPA

Or an H.323/SIP room system: H.323: 161.199.138.10 (US West) or 161.199.136.10 (US East) Meeting ID: 160 865 3428 Passcode: 74827076 SIP: 1608653428@sip.zoomgov.com Passcode:

74827076

After registering, you will receive a confirmation email containing information about joining the webinar.

F. Executive Summary:

Summary Paragraph The Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Notice of Funding Opportunity (NOFO) builds upon the program that was initiated in 1995 as one of the key activities under CDC's plan to address emerging infectious disease threats. The purpose of this NOFO is to enhance the capacity of public health agencies to effectively detect, respond, prevent and control known and emerging (and re-emerging) infectious diseases. This is accomplished by providing financial and technical resources to (1) strengthen epidemiologic capacity; (2) enhance laboratory capacity; (3) improve information systems including public health informatics goals outlined in CDC's Data Modernization Initiative; and (4) enhance collaboration among epidemiology, laboratory, and information systems components of public health departments.

a. Eligible Applicants:

Open Competition

b. NOFO Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$1,150,000,000

e. Average One Year Award Amount:

$240,000,000 Figure is estimate only.

https://www.grants.gov/

This amount is subject to the availability of funds.

f. Total Period of Performance Length:

5 year(s)

g. Estimated Award Date:

August 01, 2024

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The goal of the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) program is to reduce illnesses, deaths, and related disparities caused by a wide range of infectious disease threats. The ELC Program provides annual funding, strategic direction and technical assistance to domestic jurisdictions for core capacities in epidemiology, laboratory, and health information technology activities. In addition to strengthening core infectious disease capacities nationwide, this cooperative agreement also supports a myriad of specific infectious disease programs.

b. Statutory Authorities Patient Protection and Affordable Care Act (PL 111-148) (42 USC 300hh-31).

c. Healthy People 2030 The ELC supports the following activities aligned with Healthy People 2030 Topics and Objectives: Food Safety, Health Communication and Health Information Technology, Healthcare Associated Infections, Immunization and Infectious Diseases, Public Health Infrastructure, and Respiratory Diseases.

d. Other National Public Health Priorities and Strategies Other national public health priorities and strategies are defined in individual program/project guidance.

e. Relevant Work This ELC Competing Continuation builds upon the program that was initiated in 1995 as one of the first key activities under CDC's plan to address emerging infectious disease threats. The program has grown to become one of CDC's nationwide cooperative agreements for supporting state and local infectious disease capacity for 1) cross-cutting epidemiology, laboratory and health information systems, and 2) specific infectious disease-area Programs and Projects. This also builds upon special one-time funding allocations (e.g., COVID-19) that helped to enhance epidemiology, laboratory, and health information systems to specific disease and health threats.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Abbreviated ELC Logic Model provided below. See Attachments for complete ELC Logic Model.

Strategies Short-Term Outcomes Intermediate Outcomes Long-Term

Outcomes

Enhance and sustain a highly skilled, diverse workforce

Assess public health workforce needs and build workforce capacity Conduct timely investigations

More effective and integrated public health workforce better prepared to respond to infectious disease threats

More timely, complete, and effective investigation efforts to:

• Respond to outbreaks

• Investigate outbreaks

• Implement control measures

Improve surveillance, reporting, investigation, preparedness, and response

Conduct surveillance and analyze, compile, and disseminate data

Improved understanding of the epidemiology and incidence of infectious diseases, including for people who are at increased risk

Improved use of data to:

• Inform public health response and control

• Develop and implement public health best practices and/or guidelines

• Inform program and policy development

Strengthen laboratory testing for surveillance, detection, preparedness, and response

Utilize modern laboratory techniques for surveillance, detection, and response

Improved surveillance resulting in:

•Improved completeness, accuracy, and representativeness of data •Increased use of data and distribution to public health partners, communities, and other types of partners

Reduced morbidity, mortality, and health disparities of infectious diseases

Enhance coordination and collaboration among laboratory network partners

Improve AMD capacity in state and local health departments

Expanded and improved PHL core and surge testing capacity

Sustain and enhance health information

Identify and assess gaps and inefficiencies

Improved efficiency of laboratory operations systems, electronic data exchange, and an enterprise infrastructure in line with data modernization efforts in public health lab (PHL) operations

Enhance coordination among epidemiology, laboratory, and health information systems

Improve coordination between PHLs and their partners

Improved operational efficiency between PHLs and their network partners

Support collection, use, and reporting of actionable data, including data to advance health equity

Increase interoperability and data exchange between public health and key partners

Progression toward development of enterprise infrastructure and shared services

Implement public health interventions and tools

Integrate surveillance information systems to meet public health needs

Inform policies using a health equity lens

Develop and implement strong public health interventions, tools, and policies using a health equity lens

Increased awareness of protective actions

Engage and sustain key partnerships

Engage and sustain multi-level and community partnerships

Disseminate relevant public health information

Ensure timely, accessible communications and outreach tailored for diverse populations

i. Purpose The purpose of this NOFO is to protect the public health and safety of the American people by enhancing the capacity of public health agencies to effectively detect, respond, prevent and control known and emerging (or re-emerging) infectious diseases. ELC is CDC's national funding strategy to support state, local, and territorial health departments to address infectious disease threats in the U.S.

ii. Outcomes As reflected in the ELC Logic Model, awardees are expected to show measurable progress, on an annual basis, made toward the outcomes for this five-year project period. Each of ELC's

Programs and Projects focuses on one or more of these outcomes; and are specified in the ‘Outcomes’ section of the respective guidance.

iii. Strategies and Activities Note that each Program/Project has a separate guidance (identified below) which details strategies, activities, and other key criteria. The preparation of your response to this NOFO, and subsequent implementation and monitoring/evaluation of funded activities must be coordinated via and ELC Governance Team.

The framework of the ELC Cooperative Agreement is organized into three major sections of content:

Section I: Cross-cutting Emerging Infectious Disease Capacity, Systems and Leadership

A. Cross-Cutting Epidemiology and Laboratory Capacity

B. ELC Leadership, Management and Administration

C. Health Information Systems Capacity

D. Advanced Molecular Detection (AMD)

E. National Wastewater Surveillance System

F. Emerging Issues

Section II: Emerging Infectious Disease Programs

G. Enteric, Foodborne, Waterborne, and Zoonotic Diseases: Surveillance, Detection, Response, Reporting, and Prevention

H. Healthcare-associated Infections (HAI) and Antimicrobial Resistance (AR)

I. Antimicrobial Resistance Laboratory Network (AR Lab Network)

J. Enhanced Surveillance of Vaccine Preventable Disease (VPD) and Respiratory Diseases

K. Vector-borne Diseases and Tick-Associated Conditions: Building Comprehensive Programs to Identify, Diagnose, Report, Prevent, and Respond

Section III: Disease-Specific Projects

L. Prion Surveillance

M. Mycotics: Detecting and Preventing Fungal Infections

N. Binational Border Infectious Disease Surveillance (BIDS) Program

O. Global Migration, Border Interventions and Migrant Health

P. Parasitic Diseases Surveillance

Q. Combating Antimicrobial Resistant Gonorrhea and Other STIs (CARGOS)

R. Rabies Surveillance and Laboratory Capacity

S. Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET)

T. Human Papillomavirus Surveillance Among Men

U. HIV Centers for Cluster and Outbreak Response Enhancement (HIV C-CORE)

As described above, ELC is a complex Cooperative Agreement with cross-cutting and large infectious disease programs, as well as a myriad of disease-specific projects. Within each program or project section, the activities will be grouped by key strategies that link back to the mid- and long-term outcomes (see below and Logic Model in Section 2.a). Programs and Projects will vary in the number of strategies applied, and specific activities associated with these strategies are described in the program and project attachments within this NOFO.

A. Surveillance, Detection and Response

1a: Enhance and sustain a highly skilled, diverse workforce

1b: Improve surveillance, reporting, investigation, preparedness, and response

1c: Strengthen laboratory testing for surveillance, detection, preparedness, and response

1d: Enhance coordination and collaboration among laboratory network partners

1e: Sustain and enhance health information systems, electronic data exchange, and an enterprise infrastructure in line with data modernization efforts

1f: Support collection, use, and reporting of actionable data, including data to advance health equity

B. Prevention and Intervention Strategies

2a: Implement public health interventions and tools

2b: Improve policies using a health equity lens

C. Coordination and Partnerships

3a: Engage and sustain key partnerships

3b: Disseminate relevant public health information

1. Collaborations Internal coordination for effective ELC portfolio management

Since 2012, all ELC recipients have been required to operate under a governance structure for the management and oversight of the portfolio of ELC activities in their jurisdiction. All ELC recipients are required to maintain an active ELC Governance Team comprised of a Project Director (PD) and representatives from epidemiology, laboratory, health information systems, and fiscal (the PD may serve as a representative for one of these areas). Representatives on the Governance Team should be positioned within the organization such that they may make strategic recommendations and decisions about the activities supported with ELC resources.

Members are expected to communicate with other staff regarding various aspects of ELC activities within the jurisdiction. Additionally, and for this new Project Period, there is an expectation that the Governance Team designate a member to work with the Senior Advisory Committee (described in next section).

The role of this Team is to work together to assure sufficient and appropriate oversight and integration of the ELC Cooperative Agreement planning and implementation.

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

Funding to support the ELC portfolio should complement and be closely coordinated with other CDC programs (e.g., Emerging Infections Program (EIP), Public Health Emergency Preparedness (PHEP), and Public Health Infrastructure Grant (PHIG), etc.) which also provide resources for improving surveillance, preparedness, and response to infectious diseases.

Furthermore, ELC recipients must coordinate with their Senior Advisory Committee, which is described in the Public Health Emergency Preparedness (PHEP) NOFO and where recipients are required to “describe plans for establishing and maintaining a jurisdictional Senior Advisory Committee or an equivalent entity.” This concept and requirement for collaboration is (or will

be) referenced in other CDC “Infrastructure” Cooperative Agreements such as the Public Health Infrastructure Grant (PHIG) and Preventive Health and Health Services Block Grant. The Senior Advisory Committee should be comprised of senior officials from governmental and non-government organizations. The committee’s purpose is to enhance the integration of disciplines involved in homeland security, health care, public health, behavioral health, environmental health, emergency management and emergency medical services, and to oversee resource coordination and alignment across federal resources. The advisory committee must include representatives who can facilitate collaboration on plans for key preparedness funding streams, including Public Health Emergency Preparedness (PHEP), Epidemiology and Laboratory Capacity (ELC), and Public Health Infrastructure Grant (PHIG). ELC is asking each recipients’ Governance Team to designate a member of the Governance Team, or staff outside the Governance Team with appropriate authority, to coordinate and collaborate with this Senior Advisory Committee.

Each Program or Project has its own description of required or suggested collaborations if applicable. This information may be found in each of the specific attachments.

b. With organizations not funded by CDC:

The financial assistance provided under the ELC Cooperative Agreement is finite and frequently is inadequate to cover the health department capacity needs in a given budget period. Even when resources are made available, the ELC is aware that there is not a standard approach that can be used to implement activities at the local level (including Local Health Department (LHD)). In providing local support, direct funding is one option; however, considerations of overall management need to be considered. Another approach to local support can be through direct assistance such as having State Health Department staff dedicated to provide outbreak support or assistance with community outreach or partnership building at the local level. Regardless of the type of support (fiscal, direct, combination), the goal is for ELC recipients to actively provide leadership, support and collaborate with the LHDs within their jurisdictions. ELC recipients should be able to report on how this support is being provided and demonstrate the benefit to the LHD and populations they serve.

Where appropriate, ELC recipients are encouraged to coordinate with tribal nations while acknowledging and respecting tribal sovereignty. ELC recipients should describe how they support tribes in areas such as testing, data sharing, and providing technical assistance with surveillance or outbreaks. Coordination and collaboration with tribal nations and the federal government should also aim to understand and address public health issues on tribal lands within the recipient geographic area.

Each program or project that appears in Part II of this NOFO has its own program guidance that provides collaboration (if applicable) information specific to that CDC program.

2. Population(s) of Focus Each program or project that appears in Part II of this NOFO has its own program guidance that provides a population of focus (if applicable) specific to that CDC program.

This NOFO, including funding and eligibility, is not limited based on, and does not discriminate on the basis of race, color, national origin, disability, age, sex (including gender identity, sexual orientation, and pregnancy) or other constitutionally protected statuses.

a. Health Disparities The goal of health equity is for everyone to have a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.

Broadly defined, social determinants of health are non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces (e.g., racism, climate) and systems include economic policies and systems, development agendas, social norms, social policies, and political systems. See content below and in other sections (e.g., Approach, Collaborations, Populations of Focus) for information on how this specific NOFO affects social determinants of health.

A health disparity is a preventable difference in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been socially, economically, geographically, and environmentally disadvantaged. Health disparities are inextricably linked to a complex blend of social determinants that influence which populations are most disproportionately affected by these diseases and conditions.

ELC strongly encourages recipients to prioritize understanding the drivers of health inequities in their jurisdictions, and recipients should use their funding to reduce inequities as they address existing and emerging infectious diseases within their respective jurisdictions. Recognizing there are many local strategies, activities, and approaches to advance health equity, ELC recipients have a unique role in advancing health equity within this body of work. ELC recipients are expected to coordinate and collaborate within and external to their agency to assess and understand health inequities and take action to reduce them.

The ELC-funded recipients, which are comprised of state, large local, and U.S. territory and affiliate health departments, serve as the foundation for our national public health infrastructure.

Incorporating health equity-centered language, principles, and practices into ELC work is a fundamental step toward further strengthening the infrastructure necessary to protect the health of the overall population, including those in areas where the social vulnerability is high (e.g., rural areas, geographic locations experiencing inequities due to climate change or overall infectious disease).

iv. Funding Strategy (amounts and awards are per year averages) Section I: Cross-cutting Emerging Infectious Disease Capacity, Systems and Leadership

A. Cross-Cutting Epidemiology and Laboratory Capacity; $24,000,000 ; 65 awards

B. ELC Leadership, Management and Administration; $5,800,000; 65 awards

C. Health Information Systems Capacity; $28,000,000; 65 awards

D. Advanced Molecular Detection (AMD); $4,000,000; 65 awards

E. National Wastewater Surveillance System; $6,000,000; 20 awards

F. Emerging Issues; $TBD; TBD awards

Section II: Emerging Infectious Disease Programs

G. Enteric, Foodborne, Waterborne, and Zoonotic Diseases: Surveillance, Detection, Response, Reporting, and Prevention; $33,000,000; 58 awards

H. Healthcare-associated Infections (HAI) and Antimicrobial Resistance (AR); $15,400,000; 65 awards

I. Antimicrobial Resistance Laboratory Network (AR Lab Network); $15,300,000; 65 awards

J. Enhanced Surveillance of Vaccine Preventable Disease (VPD) and Respiratory Diseases;

$16,700,000; 60 awards

K. Vector-borne Diseases and Tick-Associated Conditions: Building Comprehensive Programs to Identify, Diagnose, Report, Prevent, and Respond; $14,000,000; 60 awards

Section III: Disease-Specific Projects

L. Prion Surveillance; $500,000; 6 awards

M. Mycotics: Detecting and Preventing Fungal Infections; $1,000,000; 40 awards

N. Binational Border Infectious Disease Surveillance (BIDS) Program; $1,200,000; 4 awards

O. Global Migration, Border Interventions and Migrant Health; $150,000; 2 awards

P. Parasitic Diseases Surveillance; $404,000; 11 awards

Q. Combating Antimicrobial Resistant Gonorrhea and Other STIs (CARGOS); $13,000,000; 20 awards

R. Rabies Surveillance and Laboratory Capacity; $200,000; 20 awards

S. Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET);

$8,000,000; 26 awards

T. Human Papillomavirus Surveillance Among Men; $375,000; 3 awards

U. HIV Centers for Cluster and Outbreak Response Enhancement (HIV C-CORE); $6,900,000; 9 awards

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Strategy

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, including, as applicable to the award, how findings will contribute to reducing or eliminating health disparities and inequities.

• 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).

• How evaluation findings will be disseminated to communities and populations of interest in a manner that is suitable to their needs.

• Plans for updating the Data Management Plan (DMP) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual progress reports. 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/additional-requirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, the applicant 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, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

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.

https://www.cdc.gov/grants/additional-requirements/ar-25.html

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

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

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

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

• Describe key evaluation questions to be addressed by these evaluations.

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

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

If needed, ELC will work with recipients during the first six months of the project period to finalize an evaluation and performance measurement plan to monitor the progress of the activities implemented and outcomes achieved. Each ELC Program or Project attachment illustrates its specific requirements for the NOFO.

Performance measures included throughout this NOFO and guidance are representative and may not be final at the time of NOFO publication. Please see the CK24-0002 Performance Measure Guidance document for all final measures and descriptions.

d. Work Plan Each Program or Project for which the applicant is applying (see Part III) must include a Work Plan. Work Plans should be detailed and should focus on the first year of the project period with only a high level plan for subsequent years. Work Plans should demonstrate alignment among the outcomes, strategies, activities, timelines, and staffing/collaborations. Additional information on performance measures, data sources, and population of focus can also be included. (Note:

recipients will incorporate this Work Plan into their Approach for each ELC project they are applying for. See Program and Project Attachments).

c. Organizational Capacity of Recipients to Implement the Approach The successful ELC recipient must have a demonstrated core organizational capacity in order to effectively conduct the activities for which awards are made. This organizational capacity includes skill sets such as program planning and performance management, partnership development, evaluation, performance monitoring, financial reporting, budget management and administration, and personnel management (including developing staffing plans, developing and training workforce and developing a sustainability plan). Applicants also must be fully capable of managing the required procurement efforts, including the ability to write and award contracts in accordance with 45 or 74 C.F.R.

Additional information pertaining to eligibility:

To maximize the impact of funding anticipated to be available, the ELC program is leveraging the legislative authorities associated with this funding to prioritize recipients to those meeting the population thresholds described below. Working with recipients of sizeable populations allows

ELC to take advantage of economies of scale in implementing programs and reducing the marginal cost of additional resources added per population served. This strategy allows ELC to reach the greatest number of people within the allotted budget while also balancing the need for direct support to some of the United States’ largest cities and counties.

The health department or agency must:

A. have sufficient and timely access to public health data for the for which they have public health authority.

B. have independent authority to promote and protect health within their jurisdiction.

C. have the requisite legal, financial, and technical capabilities to receive and administer

Federal funds.

D. be registered in the System for Award Management (SAM) database and maintain an active SAM registration with current information when it has an active federal award or an application.

E. must have functional infectious disease detection, prevention, and control programs, and already existing public health outbreak response infrastructure and capacity.

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 post-award monitoring for grants and cooperative agreements:

• Tracking recipient progress in achieving the desired outcomes.

• Ensuring the adequacy of recipient systems that underlie and generate data reports.

• Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

• Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

• Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

• Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

• Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including Work Plans, progress, program performance, and financial reporting). Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for cooperative agreements:

• Tracking recipient progress in achieving the desired outcomes.

• Ensuring the adequacy of recipient systems that underlie and generate data reports.

• Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

• Ensuring that Work Plans are feasible based on the budget and consistent with the intent of the award.

• Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

• Working with recipients on adjusting the Work Plan based on achievement of outcomes, evaluation results and changing resources.

• Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

ELC CAMP or other systems may be utilized for the programmatic documentation of performance.

B. Award Information

1. Funding Instrument Type:

CA (Cooperative Agreement) CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism:

U51

3. Fiscal Year:

Estimated Total Funding:

$240,000,000

4. Approximate Total Fiscal Year Funding:

$240,000,000 This amount is subject to the availability of funds.

5. Approximate Period of Performance Funding:

$1,150,000,000

6. Total Period of Performance Length:

5 year(s)

7. Expected Number of Awards:

8. Approximate Average Award:

$3,538,462

Per Budget Period

Figure is estimate only.

This amount is subject to the availability of funds.

9. Award Ceiling:

$0 Per Budget Period

None.

10. Award Floor:

$0 Per Budget Period

None.

11. Estimated Award Date:

August 01, 2024

12. Budget Period Length:

12 month(s)

Throughout the period of performance, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government.

The total number of years for which federal support has been approved (period of performance) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

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

If you are successful and receive a Notice of Award, in accepting the award, you agree that the award and any activities thereunder are subject to all provisions of 45 CFR Part 75, currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.

C. Eligibility Information

1. Eligible Applicants Eligibility Category:

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

2. Additional Information on Eligibility To maximize the impact of available funding, the ELC program has chosen to leverage the legislative authorities associated with this funding to limit recipients to those meeting the population thresholds described below. Working with recipients of sizeable populations allows ELC to take advantage of economy of scale in implementing programs and reducing the marginal cost of additional resources added per population served. This strategy allows ELC to reach the greatest number of people for its budget while also balancing the need for direct support to some of the United States’ largest cities and counties.

Pursuant to 42 USC 300hh-31, eligible applicants include:

• The 51 State health departments or their bona fide agents, including the District of Columbia.

• Local health agencies or their bona fide agents, if they serve a city population of 1.5M or more (i.e., Chicago, Houston, New York City, Philadelphia). If the city does not have a public health department, then the county covering the jurisdiction may apply (i.e., Los Angeles, CA covered by Los Angeles County and Phoenix, AZ covered by Maricopa County).

• All U.S. territories and affiliates in the Caribbean and Pacific (American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Puerto Rico, Republic of Palau, Republic of the Marshall Islands, and U.S. Virgin Islands).

*Population for county and city jurisdictions. Source: U.S. Census Bureau, Population Division - Annual Estimates of the Resident Population for Counties in the United States: April 1, 2020, to July 1, 2021 - Release Date: March 2022.

3. Justification for Less than Maximum Competition

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

No

5. Maintenance of Effort D. Required Registrations

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

PLEASE NOTE: Effective April 4, 2022, applicants must have a Unique Entity Identifier (UEI) at the time of application submission (SF-424, field 8c). The UEI is generated as part of SAM.gov registration. Current SAM.gov registrants have already been assigned their UEI and can view it in SAM.gov and Grants.gov. Additional information is available on the GSA website, SAM.gov, and Grants.gov- Finding the UEI.

https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-systems-information-kit/unique-entity-identifier-update https://sam.gov/content/home https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/ https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/

a. Unique Entity Identifier (UEI):

All applicant organizations must obtain a Unique Entity Identifier (UEI) number by registering in SAM.gov prior to submitting an application. A UEI number is a unique twelve-digit identification number assigned to the registering organization.

If funds are awarded to an applicant organization that includes sub-recipients, those sub-recipients must provide their UEI numbers before accepting any funds.

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as a recipient. All applicant organizations must register with SAM, and will be assigned a SAM number and a Unique Entity Identifier (UEI). All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC.

If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at SAM.gov and the SAM.gov Knowledge Base.

c. Grants.gov: The first step in submitting an application online is registering your organization atwww.grants.gov, the official HHS E-grant Web site. Registration information is located at the "Applicant Registration" option atwww.grants.gov.

All applicant organizations must register at www.grants.gov. The one-time registration process usually takes not more than five days to complete. Applicants should start the registration process as early as possible.

Step

System Requirements Duration Follow Up

System for Award Management

(SAM)

1. Go to SAM.gov and create an Electronic Business Point of Contact (EBiz POC) (You will need to have an active SAM account before you can register on grants.gov). The UEI is generated as part of your registration.

7-10 Business Days but may take longer and must be renewed once a year

For SAM Customer Service Contact https://fsd.gov/ fsd-gov/ home.do Calls:

866-606-8220

2 Grants.gov

1. Set up an account in Grants.gov, then add a profile by adding the organization's new UEI number.

2. The EBiz POC can designate user roles, Allow at least one business day (after you enter the EBiz POC name and EBiz POC email in SAM) to receive a UEI (SAM)

Register early!

Applicants can register within minutes.

https://sam.gov/content/home https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.fsd.gov%2Fgsafsd_sp%3Fid%3Dgsa_kb_view2%26kb_id%3Df66d8e6cdb76d4100d73f81d0f9619c6&data=04%7C01%7Ccshifflett%40dminc.com%7C8eee7a2adab549a3b3c008d925e9a364%7Cdb7ac9ef779d46e59bca00509580ad6b%7C0%7C0%7C637582507851821018%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=UrR%2B%2FM2wWF2fZG05Z8O6JS2C3FXXSl%2F7B3%2FB45XHRrg%3D&reserved=0 https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.fsd.gov%2Fgsafsd_sp%3Fid%3Dgsa_kb_view2%26kb_id%3Df66d8e6cdb76d4100d73f81d0f9619c6&data=04%7C01%7Ccshifflett%40dminc.com%7C8eee7a2adab549a3b3c008d925e9a364%7Cdb7ac9ef779d46e59bca00509580ad6b%7C0%7C0%7C637582507851821018%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=UrR%2B%2FM2wWF2fZG05Z8O6JS2C3FXXSl%2F7B3%2FB45XHRrg%3D&reserved=0 https://grants.gov/ https://www.grants.gov/ http://www.grants.gov/ https://www.grants.gov/ https://sam.gov/content/home https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do including Authorized Organization Representative

(AOR).

3. AOR is authorized to submit applications on behalf of the organization in their workspace.

which will allow you to register with Grants.gov and apply for federal funding.

2. Request Application Package Applicants may access the application package at www.grants.gov. Additional information about applying for CDC grants and cooperative agreements can be found here:

https://www.cdc.gov/grants/applying/pre-award.html

3. Application Package Applicants must download the SF-424, Application for Federal Assistance, package associated with this funding opportunity at www.grants.gov.

4. Submission Dates and Times If the application is not submitted by the deadline published in the NOFO, it will not be processed. Office of Grants Services (OGS) personnel will notify the applicant that their application did not meet the deadline. The applicant must receive pre-approval to submit a paper application (see Other Submission Requirements section for additional details). If the applicant is authorized to submit a paper application, it must be received by the deadline provided by OGS.

a. Letter of Intent Deadline (must be emailed)

The LOI date will generate once the Synopsis is published if Days or a Date are entered.

Not applicable

b. Application Deadline

April 30, 2024, no later than 11:59 pm U.S. Eastern Time, at www.grants.gov. If Grants.gov is inoperable and cannot receive applications, and circumstances preclude advance notification of an extension, then applications must be submitted by the first business day on which Grants.gov operations resume.

Due Date for Informational Conference Call ELC will hold an information webinar.

Date: February 20, 2024 Time: 3:00 PM Eastern Time (US and Canada) Topic: Informational Webinar for ELC Cooperative Agreement (CK24-0002)

Register in advance for this webinar:

https://cdc.zoomgov.com/webinar/register/WN_dzVsHPEJRBqOqZ7HxuttPA

Or an H.323/SIP room system: H.323: 161.199.138.10 (US West) or 161.199.136.10 (US East) Meeting ID: 160 865 3428 Passcode: 74827076 SIP: 1608653428@sip.zoomgov.com Passcode:

74827076 http://www.grants.gov/ https://www.cdc.gov/grants/applying/pre-award.html

After registering, you will receive a confirmation email containing information about joining the webinar.

5. Pre-Award Assessments Risk Assessment Questionnaire Requirement

CDC is required to conduct pre-award risk assessments to determine the risk an applicant poses to meeting federal programmatic and administrative requirements by taking into account issues such as financial instability, insufficient management systems, non-compliance with award conditions, the charging of unallowable costs, and inexperience. The risk assessment will include an evaluation of the applicant’s CDC Risk Questionnaire, located at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, as well as a review of the applicant’s history in all available systems; including OMB-designated repositories of government-wide eligibility and financial integrity systems (see 45 CFR 75.205(a)), and other sources of historical information. These systems include, but are not limited to: FAPIIS (https://www.fapiis.gov/), including past performance on federal contracts as per Duncan Hunter National Defense Authorization Act of 2009; Do Not Pay list; and System for Award Management (SAM) exclusions.

CDC requires all applicants to complete the Risk Questionnaire, OMB Control Number 0920- 1132 annually. This questionnaire, which is located at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, along with supporting documentation must be submitted with your application by the closing date of the Notice of Funding Opportunity Announcement. If your organization has completed CDC’s Risk Questionnaire within the past 12 months of the closing date of this NOFO, then you must submit a copy of that questionnaire, or submit a letter signed by the authorized organization representative to include the original submission date, organization’s EIN and UEI.

When uploading supporting documentation for the Risk Questionnaire into this application package, clearly label the documents for easy identification of the type of documentation. For example, a copy of Procurement policy submitted in response to the questionnaire may be labeled using the following format: Risk Questionnaire Supporting Documents _ Procurement Policy.

Duplication of Efforts

Applicants are responsible for reporting if this application will result in programmatic, budgetary, or commitment overlap with another application or award (i.e. grant, cooperative agreement, or contract) submitted to another funding source in the same fiscal year.

Programmatic overlap occurs when (1) substantially the same project is proposed in more than one application or is submitted to two or more funding sources for review and funding consideration or (2) a specific objective and the project design for accomplishing the objective are the same or closely related in two or more applications or awards, regardless of the funding source. Budgetary overlap occurs when duplicate or equivalent budgetary items (e.g., equipment, salaries) are requested in an application but already are provided by another source.

Commitment overlap occurs when an individual’s time commitment exceeds 100 percent, whether or not salary support is requested in the application. Overlap, whether programmatic, https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf budgetary, or commitment of an individual’s effort greater than 100 percent, is not permitted.

Any overlap will be resolved by the CDC with the applicant and the PD/PI prior to award.

Report Submission: The applicant must upload the report in Grants.gov under “Other Attachment Forms.” The document should be labeled: "Report on Programmatic, Budgetary, and Commitment Overlap.”

6. Content and Form of Application Submission Applicants are required to include all of the following documents with their application package at www.grants.gov.

7. Letter of Intent Is a LOI:

Not Applicable

8. Table of Contents (There is no page limit. The table of contents is not included in the project narrative page limit.):

The applicant must provide, as a separate attachment, the “Table of…