Foa_Content_of_CDC-RFA-CE21-2103 (5).pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL

Comprehensive Addiction and Recovery Act (CARA) Local Drug Crises Grants

CDC-RFA-CE21-2103

04/01/2021

Table of Contents A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Application and Submission Information

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Comprehensive Addiction and Recovery Act (CARA) Local Drug Crises Grants C. Announcement Type: New - Type 1:

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52- 2.pdf. Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr- 46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-CE21-2103

E. Assistance Listings (CFDA) Number:

93.799 F. Dates:

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

02/01/2021

2. Due Date for Applications:

04/01/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov/

All applicants applying to the FY 2021 CARA NOFO are encouraged to attend the CARA Applicant Workshop Training, which will take place on Friday, February 5 at 11:00 AM EST. Details on how to register and access the training are posted on the following website: https://tvworldwide.com/events/ondcp/2021/CARA/. The training will be recorded and posted in mid-February. A link to the workshop training video can be found at https://tvworldwide.com/events/ondcp/2021/CARA/.

G. Executive Summary:

1. Summary Paragraph The Comprehensive Addiction and Recovery Act (CARA) Local Drug Crises Grants program was created by the Comprehensive Addiction and Recovery Act (P.L. 114-198). The Executive Office of the President, Office of National Drug Control Policy (ONDCP), and the Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Drug Free Communities (DFC) Branch are accepting applications for Fiscal Year (FY) 2021 Comprehensive Addiction and Recovery Act Community-based Coalition Enhancement Grants to Address Local Drug Crises Grants (CARA Local Drug Crises Grants). The purpose of this program is to prevent opioid, methamphetamine, and/or prescription drug use/misuse among youth ages 12-18 in communities throughout the United States.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

G (Grant)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$ 15,000,000

e. Average One Year Award Amount:

$ 50,000

f. Total Period of Performance Length:

g. Estimated Award Date:

July 01, 2021

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The ongoing drug overdose crisis and the changing nature of drugs that contribute to overdoses in the U.S. highlight the urgency and importance of preventing illicit and prescription drug use and misuse among youth. While there were slight declines in overdose deaths from 2017 to 2018, provisional data from 2019 show an increase in overdose deaths since 2018, and that x-apple-data-detectors://15 x-apple-data-detectors://15 https://tvworldwide.com/events/ondcp/2021/CARA/ https://tvworldwide.com/events/ondcp/2021/CARA/ https://www.congress.gov/bill/114th-congress/senate-bill/524/text synthetic opioid (e.g.., illicitly manufactured fentanyl), often combined with other substances such as cocaine and methamphetamines, are contributing to a substantial proportion of overdose deaths.

Addressing the root causes of youth substance use and misuse is critical. These can include adverse childhood experiences (ACES), lack of parental involvement and positive parental attitudes towards substance use behavior, family rejection of sexual orientation or gender identity, lack of involvement or achievement in school, and anxiety, depression, and other mental health challenges. In addition, the environment in which people live, learn, work, and play can affect many different aspects of life, including economic stability, educational opportunities, and health care access and quality, and can contribute to health inequities. These conditions are also important to consider in the prevention of substance use among youth. For example, the lack of school-based interventions, the availability and accessibility of substances, and community norms favorable to the use of substances can contribute to increased youth substance use.

Studies have shown that prescription opioid misuse among youth is strongly linked with developing an opioid use disorder, injection drug use, use of methamphetamines, and experiencing a drug overdose. Research has also shown that misuse of prescription opioids is associated with other risk behaviors, such as suicidal ideation, youth violence, and risky sexual behaviors. The increase of overdose deaths involving opioids and stimulants as well as the risks associated with youth initiation of these substances underline the need for enhanced efforts to prevent illicit and prescription opioid use/misuse among youth.

These factors put youth populations at risk. The Youth Risk Behavior Survey data from 2009 to 2019 shows that both Black and Hispanic youth populations are significantly more likely to use methamphetamines, and youth who identify their sexual orientation as LGBT are significantly more likely to engage in methamphetamine and prescription opioid use. Overall higher rates of opioid-related deaths and opioid prescriptions have been recorded in rural areas than in urban areas.

The complex and changing nature of substance use and misuse among youth highlights the need for a comprehensive approach to inform substance use and misuse prevention and response efforts. This includes interventions that target the individual, family, and community level and focuses on youth that are at the greatest risk. This funding opportunity will focus on preventing and reducing local opioid, methamphetamine, and/or prescription drug use/misuse among youth ages 12-18 in communities throughout the United States.

b. Statutory Authorities The statutory authority for this program is Section 103 of the Comprehensive Addiction and Recovery Act. It limits eligibility to domestic public and private nonprofit entities that are current or former Drug-Free Communities (DFC) Support Program recipients.

c. Healthy People 2030 This NOFO supports the Healthy People 2030 topic areas of injury, violence prevention, and substance use.

d. Other National Public Health Priorities and Strategies This NOFO supports the following public health priorities and strategies:

https://health.gov/healthypeople/objectives-and-data/browse-objectives/injury-prevention https://health.gov/healthypeople/objectives-and-data/browse-objectives/violence-prevention https://health.gov/healthypeople/objectives-and-data/browse-objectives/drug-and-alcohol-use

HHS Five-Point Opioid Strategy (https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html)

The National Prevention Council’s National Prevention Strategy – America’s Plan for Better Health (Tobacco-Free Living) (http://www.ldh.la.gov/assets/docs/GovCouncil/MinHealth/NationalPreventionStrategyJu ne2011.pdf)

e. Relevant Work This funding opportunity builds upon past Drugs Free Communities (DFC) and Comprehensive Addiction and Recovery Act (CARA) programs focused on substance use prevention:

Community-Based Coalition Enhancements Grants to Address Local Drug Crises (SP- 18-001)

Drug-Free Communities (DFC) Support Program-Competing Continuation (CDC-RFA-

CE20-2002)

Drug-Free Communities (DFC) Support Program- New (CDC-RFA-CE20-2003)

2. CDC Project Description

a. Approach Bold indicates period of performance outcome.

The approach is described below within the CARA Framework and the Outcomes and Strategies and Activities sections. The Framework of the CARA Program (Table 1) outlines the recommended strategies and activities based on the Seven Strategies for Community-Level Change (refer to the CDC Project Description: Strategies and Activities section for additional information) and identifies the intended short-term, immediate, and long-term outcomes for this

NOFO.

Table 1. CARA Framework Goal: Prevent local youth opioid, methamphetamine, and/or prescription drug use/misuse among youth aged 12-18 in communities by engaging with a diverse range of sectors in the community.

Strategies and Activities Short-Term Outcomes

Intermediate Outcomes

Long-Term Outcomes

Provide information to raise awareness of opioid, methamphetamine, and/or prescription drug use among youth.

Enhance skills to promote community education and patient safety.

Provide support to increase involvement in drug-free/healthy

Identify patterns of youth opioid, methamphetamine, and/or prescription drug use.

Increase community and provider awareness of youth opioid, methamphetamine, Address factors in the community that increase the risk of youth opioid, methamphetamine, and/or prescription drug use.

Increase the promotion of factors that minimize the risk

Reduce and prevent the use of opioids, methamphetamine, and/or prescription drugs among youth.

Change the culture and context regarding the https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html http://www.ldh.la.gov/assets/docs/GovCouncil/MinHealth/NationalPreventionStrategyJune2011.pdf http://www.ldh.la.gov/assets/docs/GovCouncil/MinHealth/NationalPreventionStrategyJune2011.pdf alternative activities.

Enhance access/reduce barriers for systems and services that help prevent youth opioid, methamphetamine, and/or prescription drug use.

Change consequences to incentivize positive practices and disincentive negative practices.

Change physical design of the community protection against youth opioid, methamphetamine, and/or prescription drug use.

Educate and inform about modifying/changing policies that reduce access and availability to substances among youth.

Identify community conditions that contribute to youth opioid, methamphetamine, and/or prescription drug use.

Increase the capacity of local agencies and/or organizations to address youth opioid, methamphetamine, and/or prescription drug use.

Increase intergovernmental cooperation, coordination, and collaboration on issues to prevent youth opioid, methamphetamine, of opioid, methamphetamine, and/or prescription drug use.

Increase the ease, ability, and opportunity for youth to access settings, such as programs emphasizing self-efficacy and learning skills that prevent opioid, methamphetamine, and/or prescription drug use.

Decrease the ease, ability, and opportunity for youth to access opioid, methamphetamine, drugs.

acceptability of opioid, methamphetamine,

i. Purpose The purpose of this program is to enhance the efforts of current or former Drug-Free Communities (DFC) recipients to prevent opioid, methamphetamine, and/or prescription drug use among youth ages 12-18 in communities throughout the United States. This program also seeks to change the culture and context regarding the acceptability of youth use and misuse of these substances.

ii. Outcomes A series of short-term and intermediate outcomes are expected to be achieved as a result of recipient efforts (shown in Table 1 CARA Framework). The short-term and intermediate outcomes should be tailored to the Work Plan (i.e., the 12-Month Action Plan) of strategies selected.

iii. Strategies and Activities

Recipients are expected to work with leaders in their communities across sectors to identify and address local youth substance use problems and create sustainable community-level change through the implementation of evidence-based and practice-based strategies. Such strategies seek to: (1) limit access to substances; (2) change the culture and context within which decisions about substance use are made; and/or (3) shift the consequences associated with youth substance use. Recipients are expected to propose strategies and activities that are comprehensive and that can be implemented during the period of performance (over the 5-year period). Recipients are expected to use the Seven Strategies for Community-Level Change, described below and outlined in the CARA Framework (Table 1) and the Strategic Prevention Framework to inform their approach. Please see Appendix B: Resources on Evidence-Based and Practice-Based Strategies and Activities for more information.

Seven Strategies for Community-Level Change The Seven Strategies for Community-Level Change include efforts that affect individuals as well as an entire community.

1. Provide information to raise awareness of opioid, methamphetamine, and/or prescription drug use among youth: Educational presentations, workshops or seminars, and data or media presentations (e.g., Public Service Announcements (PSAs), brochures, town halls, forums, web communication, including social media).

2. Enhance skills to promote community education and patient safety: Workshops, seminars, or activities designed to increase the skills of participants, members, and staff (e.g., training and technical assistance, parenting classes, strategic planning retreats, model programs in schools).

3. Provide support to increase involvement in drug-free/healthy alternative activities:

Creating opportunities for participation in activities that reduce risk or enhance protection (e.g., alternative activities, mentoring, referrals for service, support groups, youth clubs).

4. Enhance access/reduce barriers for systems and services that help prevent youth opioid, methamphetamine, and/or prescription drug use: Improving systems/processes to increase the ease, ability, and opportunity to utilize those systems and services (e.g., assuring transportation, housing, education, safety, and cultural sensitivity) in prevention initiatives. Reduce Access/Enhance Barriers: Improving systems/processes to decrease the ease, ability, and opportunity for youth to access substances.

5. Change consequences to incentivize positive practices and disincentive negative practices: Increasing or decreasing the probability of a behavior (incentives/disincentives) by altering the consequences for performing that behavior.

6. Change physical design of the community that reduces risk or enhances protection against youth opioid, methamphetamine, and/or prescription drug use.

7. Educate and inform about modifying/changing policies that reduce access and availability to substances among youth: Change in written procedures, by-laws, proclamations, or rules, to the extent applicable (e.g., workplace initiatives, school policies, legal procedures and practices, public policy actions, systems change).

For more information on the Seven Strategies for Community Level Change, visit: http://www.cadca.org/resources/coalition-impact-environmental-prevention-strategies http://www.cadca.org/resources/coalition-impact-environmental-prevention-strategies

In addition to using the Seven Strategies for Community Change, CARA coalitions are expected to utilize the Strategic Prevention Framework (SPF) as the planning model to develop long-range plans. The SPF is a five-step evidence-based process for community planning and decision-making. Cultural competence and sustainability should be considered throughout all five steps of the process, which includes:

1. Assessment: Identify local youth substance use problems and the community conditions that contribute to the specific identified issues.

2. Capacity: Mobilize/build capacity to change the conditions and address the youth substance use problems.

3. Planning: Develop a logic model, comprehensive 12-Month Action Plan, and multi-year Strategic Plan.

4. Implementation: Implement action and strategic plans with multiple objectives, strategies, and activities.

5. Evaluation: Monitor, sustain, improve, or replace prevention activities, efforts, and strategies.

For more information on the SPF, visit: https://www.cadca.org/sites/default/files/OverviewSPF.pdf

Community coalitions are encouraged to use the National Coalition Institute’s (NCI) coalition logic model template to address their local youth substance use problems, its related root causes and local conditions. For more information on the DFC coalition logic model template, visit https://www.cadca.org/sites/default/files/cadca_logic_model.pptx.

Submission of a coalition’s logic model is not required.

1. Collaborations

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

Recipients are encouraged, where applicable and appropriate, to collaborate with CDC programs that are implementing practice-based prevention strategies that align with the strategies identified in the Strategies and Activities Section of this NOFO.

Memorandums of Understanding (MOUs) or Memorandums of Agreement (MOAs) are not required.

Examples of relevant CDC programs include, but are not limited, to:

Overdose Data to Action (OD2A) https://www.cdc.gov/drugoverdose/od2a/index.html

Opioid Response Strategy (ORS), High Intensity Drug Trafficking Areas (HIDTA) Program https://ahidta.org/content/overdose-response-strategy

Division of Adolescent and School Health https://www.cdc.gov/healthyyouth/

Adverse Childhood Experiences, Division of Violence Prevention https://www.cdc.gov/violenceprevention/aces/index.html https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cadca.org%2Fsites%2Fdefault%2Ffiles%2FOverviewSPF.pdf&data=04%7C01%7Cmsheehan%40guidehouse.com%7Ca247fb796ca049a7cc8d08d88bcf1d8d%7C4ee48f43e15d4f4aad55d0990aac660e%7C1%7C1%7C637413069237857699%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=O12CKx06G6EKBZlnryRs9p6dPfBvfVaSo73sI4vYDkI%3D&reserved=0 https://www.cadca.org/sites/default/files/cadca_logic_model.pptx https://www.cdc.gov/drugoverdose/od2a/index.html https://ahidta.org/content/overdose-response-strategy https://www.cdc.gov/healthyyouth/ https://www.cdc.gov/violenceprevention/aces/index.html

Suicide Prevention, Division of Violence Prevention https://www.cdc.gov/violenceprevention/suicide/index.html

b. With organizations not funded by CDC:

Recipients are required to collaborate with organizations that have a role in conducting the proposed activities and achieving the NOFO outcomes. In particular, recipients are expected to build upon the collaborations established through the past or current DFC award and work with leaders in their communities that can help to identify and address local youth substance use problems and create sustainable community-level change through the implementation of evidence-based and practice-based prevention strategies and informed by the Seven Strategies for Community Level Change (refer to Strategies and Activities Section of this NOFO).

Memorandums of Understanding (MOUs) or Memorandums of Agreement (MOAs) are not required.

2. Target Populations Applicants are expected to define the communities they propose to serve. The CARA Program does not prescribe the demographics or geographic location of funded coalitions. Applicants may use various geographic boundaries including neighborhoods, census tracts, zip codes, and school districts, as well as townships, counties, or parish lines, among others, to define their community. Applicants should choose an area of feasible size and population in which the coalition will have the ability to create change. For example, choosing a community that is too large may be problematic due to the inclusion of multiple neighborhoods that have distinct problems or conditions that need to be addressed to affect change. Applicants must include the rationale for the selection of their chosen community and describe how their inclusion will help to achieve the program purpose of preventing and reducing opioids, methamphetamine, and/or prescription drug/misuse among youth ages 12-18. Applicants should demonstrate specific consideration of population(s) of the highest risk when selecting a community to serve.

a. Health Disparities As described in previous sections of this funding opportunity, the Youth Risk Behavior Survey data from 2009 to 2019 shows that both Black and Hispanic youth populations are significantly more likely to use methamphetamines, and youth who identify their sexual orientation as LGB are significantly more likely to engage in methamphetamine and prescription opioid use.

Transgender youth are also more likely to engage in these behaviors. Additionally, overall higher rates of opioids-related deaths and opioid prescriptions have been recorded in rural areas than in urban areas. Applicants are encouraged to pay particular attention to populations at higher risk for certain forms of substance abuse and misuse, as well as populations underserved by other programs, such as non-English speaking populations, people with limited health literacy, tribal populations, and other geographically underserved communities.

iv. Funding Strategy N/A.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation and Performance Measurement are tools used to: (1) help demonstrate achievement of program outcomes; (2) build a stronger evidence base for specific program interventions; (3) https://www.cdc.gov/violenceprevention/suicide/index.html clarify the applicability of the evidence base to different populations, settings, and context, and

(4) drive continuous program improvement. Evaluation and performance measurement can also determine whether program strategies are scalable and effective at reaching the target or intended populations.

To meet the requirements outlined above, CARA Local Drug Crises grant award recipients will be required to:

Submit annual progress reports through the DFC Me (Management and Evaluation) system. Recipients are expected to monitor and evaluate the success of the goals and objectives of the workplan (i.e., the 12-Month Action Plan) and how the coalition plans to enhance efforts to measure outcomes. The Terms and Conditions of the grant award will specify how the data are to be submitted, and the schedule for Progress Report submissions.

Participate in the CARA Local Drug Crises Program Evaluation. Recipients are expected to identify a “starting point” from which to measure progress using quantitative survey data, DFC Cross-Site Evaluations, and qualitative data (e.g., focus groups, town hall meetings, informal surveys). Recipients are required to provide data on the following core measures for opioid, methamphetamine, and/or prescription drug use/misuse for three grade levels between the 6th and 12th grades:

Past 30–day use Perception of risk or harm Perception of parental disapproval of use Perception of peer disapproval of use

Describe a Data Management Plan (DMP) outlined in the Data Management Plan section. Applicants should describe:

the data to be collected or generated in the proposed project;

the standards to be used for the collected or generated data;

access to the data, including a description for protection of privacy, confidentiality, security, and intellectual property, or other rights;

a statement of the use of data standards that ensure all documentation that describes the method of collection, what the data represent, and plans for archiving and long-term preservation of the data or explaining why long-term preservation and access are not justified.

Not all of this information may be available or applicable at the time of application. Thus, applicants may include a DMP that is as complete as possible.

Award recipients will receive additional training and technical assistance on developing a DMP, which must be submitted within the first 6 months of award, as described in the Reporting Section of this NOFO. Failure to comply with the Terms and Conditions of the CARA grant award may result in suspension or termination of the award.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance

Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

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

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

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

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

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

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

Describe key evaluation questions to be addressed by these evaluations.

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

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

Applicants may contact the current DFC Evaluation Team (dfc_evaluators@icf.com) for assistance in gathering the necessary information as it relates to the CARA National Cross-Site Evaluation.

c. Organizational Capacity of Recipients to Implement the Approach Applicants must demonstrate the capacity to implement the CARA program as outlined in the statutory eligibility section of this NOFO. In addition, applicants are required to hire key personnel that will be responsible for implementing and managing the grant. These include:

Business Official (i.e. Authorized Organization Representative): person authorized for overseeing the financial aspects of the grant. This is the individual who will receive the Notice of Award if funded.

Program Director (i.e. Program Director/Principal Investigator): person designated to direct the project or program supported by the grant and accountable to officials of the recipient organization.

https://www.cdc.gov/grants/additionalrequirements/ar-25.html mailto:dfc_evaluators@icf.com

Project Coordinator: person who coordinates the work of the coalition and program activities, including training, coalition communication, data collection, and information dissemination.

Staff to fulfill key personnel positions shall have skills in non-research program administration:

program planning, program evaluation, performance monitoring, financial management and reporting, budget management and administration, personnel management or project management. To demonstrate proficiency in these topic areas, applicants must submit resumes for positions currently filled (no more than 2 pages in length) and position descriptions for vacant positions (no more than 1 page in length) for key personnel outlined above. For key personnel positions that are not filled, applicants can provide the position description, which should include:

Title of key personnel position;

Brief description of duties and responsibilities; and 1-2 sentences on how the applicant plans to fill the position, including expected timeframe.

NOTE: Regarding financial management, applicants are required to demonstrate that they have a financial management system that will allow for proper funds management and segregation of funds by program and meet the requirements as stated in the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards found at https://www.ecfr.gov/cgi-bin/text-indx?node=pt45.1.75#se45.1.75_1302 (45 CFR 75.302). The financial system should permit the preparation of reports required by general and program-specific terms and conditions; and the tracing of funds to a level of expenditure adequate to establish that such funds have been used according to the federal statutes, regulations, and the terms and conditions of the federal award.

d. Work Plan Applicants must prepare a detailed work plan for the first year of the award (i.e., 12-Month Work Plan) that outlines the proposed objectives, strategies, and activities during the period of performance from July 1, 2021 – June 30, 2022. The combination of objectives, strategies, and activities should align with the long-term outcomes of the CARA Framework. One long-term outcome should address reducing opioid, methamphetamine, and/or prescription drug use/misuse among youth. The other long-term outcome should address changing the culture and context regarding the acceptability of opioid, methamphetamine, and/or prescription drug use/misuse.

Objectives should be Specific, Measurable, Achievable, Realistic, and Time-bound (SMART).

SMART objectives indicate the type of change; how much change will occur including the specific amount of increase or decrease; the specific population to be addressed; include a specific date (Month/Year) by when the change will be accomplished; indicate how the change will be measured.

Examples of SMART objectives are provided below:

Regular Objective SMART Objective https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ecfr.gov%2Fcgi-bin%2Ftext-indx%3Fnode%3Dpt45.1.75%2523se45.1.75_1302&data=04%7C01%7Cmsheehan%40guidehouse.com%7C7796dd3926dc41e182a508d88be39f6e%7C4ee48f43e15d4f4aad55d0990aac660e%7C1%7C1%7C637413157053765561%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=Y%2FB9yMxjpn01UlwrGrK6gRMEYSoZnG7ISVwcZSNngkc%3D&reserved=0

Reduce prescription drug misuse rates for children and adolescents.

By July 31, 2022, reduce the percent of 9th graders in Awesome County who have misused prescription drugs from 8% baseline to 7% as indicated in our annual youth survey.

Meet with 12 high schools to inform them about drug drop box programs.

Public Health Staff will meet with key stakeholders at all high schools in our jurisdiction resulting in 3 out of 4 high schools committing to work on educating about and implementing drug drop box programs by June 2022 as indicated in our annual school partner survey.

The following work plan (i.e. 12-Month Action Plan) table should be completed for each goal of the CARA program.

Table 2. 12-Month Action Plan (July 1, 2021 – June 30, 2022) CARA Goal One: Reduce opioid, methamphetamine, and/or prescription drug use/misuse among youth.

Objective 1: Provide a SMART objective Strategy 1: Provide specific strategy

Activity Who is Responsible? By When?

Strategy 2: Provide specific strategy

CARA Goal Two: Change the culture and context regarding acceptability of youth opioid, methamphetamine, and/or prescription drug use/misuse.

Objective 1: Provide a SMART objective Strategy 1: Provide specific strategy

Strategy 2: Provide specific strategy

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.

f. CDC Program Support to Recipients

N/A

B. Award Information

1. Funding Instrument Type:

G (Grant)

2. Award Mechanism:

H28

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$ 3,000,000

5. Total Period of Performance Funding:

$ 15,000,000 This amount is subject to the availability of funds.

Estimated Total Funding:

$ 50,000

6. Total Period of Performance Length:

year(s)

7. Expected Number of Awards:

8. Approximate Average Award:

$ 50,000 Per Budget Period

9. Award Ceiling:

$ 50,000 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor:

$ 50,000 Per Budget Period

11. Estimated Award Date:

July 01, 2021

12. Budget Period Length:

12 month(s)

Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is not available through this NOFO.

C. Eligibility Information

1. Eligible Applicants Eligibility Category:

12 (Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education)

25 (Others (see text field entitled "Additional Information on Eligibility" for clarification))

2. Additional Information on Eligibility Eligible applicants are community-based coalitions addressing opioid, methamphetamine, and/or prescription drug use/misuse by local youth. They must be a nonprofit (as defined by the IRS as a 501(c) organization); or an entity that the Administrator determines to be appropriate; or part of, or is associated with an established legally recognized domestic, public or private nonprofits organization. For example, state and local governments, federally recognized tribes, state-recognized tribes, urban Indian organizations (as defined in Pub. L. No. 94-437), public or private universities and colleges, professional associations, voluntary organizations, self-help groups, consumer and provider services-oriented constituency groups, community- and faith-based organizations, and tribal organizations. (Pub. L. No. 114-198 Sec 103). In addition, applicants must document rates of misuse of opioids or use of methamphetamines that are higher than the national average over a sustained period. The statutory authority for this program (Section 103 of the Comprehensive Addiction and Recovery Act) limits eligibility to domestic public and private nonprofit entities that are current or former Drug-Free Communities (DFC) Support Program recipients.

The intent of the CARA Support Program is to fund coalition activities in the United States and does not authorize the funding of organizations or activities outside the United States. A CARA legal applicant (an organization applying on behalf of a coalition, the coalition, or the applicant coalition) must reside within the United States and/or the U.S. territories.

Refer to Table 3 Statutory Eligibility Requirements: which contains, the minimum eligibility requirements, the evidence required, and where to document the requirement. The table also specifies which attachment to use to provide the necessary evidence to document your compliance with the eligibility requirement. All CARA applications will be jointly screened by ONDCP and CDC to determine whether an applicant meets all the CARA Support Program Statutory Eligibility Requirements identified in Table 3. Applications submitted by eligible coalitions that demonstrate they meet all requirements will then be scored through a merit review process according to the evaluation criteria described in Section E. Review and Selection Process of this NOFO.

Failure to meet any single statutory eligibility requirement will cause the application to be deemed ineligible; in such cases, it will not move forward to merit review. Should your application fail to meet the eligibility requirements, the person listed as the Business Official on the Application for Federal Assistance (SF-424) will receive a notification stating why the application was deemed ineligible. No additional information may be added to an application after the application deadline. The final authority lies with the DFC Administrator to determine the eligibility of an application. Each year, CARA recipients must demonstrate compliance with all of the Statutory Eligibility Requirements to be considered for continuation funding.

Table 3: Statutory Eligibility Requirements

Eligibility Requirement Item Evidence Required and Where to Document

Requirement 1: Entity Eligible to Receive Federal Grants

Evidence Required

Eligibility Requirement Item Evidence Required and Where to Document

Must be a Legal Entity - Organizations eligible to receive federal funds as CARA grant recipients must be a nonprofit (as defined by the IRS as a 501(c) organization); or an entity that the Administrator determines to be appropriate; or part of, or is associated with an established legally recognized domestic, public or private nonprofit organization. For example, state and local governments, federally recognized tribes, state-recognized tribes, urban Indian organizations (as defined in Pub. L. No.

94-437), public or private universities and colleges, professional associations, voluntary organizations, self-help groups, consumer and provider services-oriented constituency groups, community- and faith-based organizations, and tribal organizations.

(Pub. L. No. 114-198 Sec 103).

Statement of Legal Eligibility.

Where to Document:

Appendix D Attachment 1: Signed Assurance of Legal Eligibility.

OR

Appendix D Attachment 2:

Memorandum of Understanding between Grant Award Recipient and Coalition.

Requirement 2: Previous DFC Funding Evidence Required An organization that on or before the date of applying for a grant under this section, receives or has received a grant under the Drugs-Free Communities (DFC) Act of 1997.

(Pub. L. No. 114-198 Sec 103(a)(4)(A)).

Disclosure of Drug-Free Communities (DFC) Support Program funding.

Where to Document:

Appendix D Attachment 3: Disclosure of Drug-Free Communities Support Program Funding.

Requirement 3: Documentation of Rates of Abuse of Opioids and Methamphetamines

Evidence Required

An organization that has documented, using local data, rates of abuse of opioids or methamphetamines at levels that are higher than the national average over a sustained period of time.

(Pub. L. No. 114-198 Sec 103(a)(4)(B)).

Statement of Rates of Misuse of Opioids and Methamphetamines.

Where to Document:

Appendix D Attachment

4: Statement of Rates of Misuse of Opioids and Methamphetamines.

Requirement 4: Collaboration with other Community-based coalitions

Evidence Required

Eligibility Requirement Item Evidence Required and Where to Document

Community-based coalitions addressing local youth opioid, methamphetamine, and/or prescription drug abuse.

(Pub. L. No. 114-198 Sec 103).

Meeting Minutes – Coalition meeting minutes from a meeting that took place between January 2020 and the deadline for this application that documents efforts to address an emerging issue or a local crisis related to the abuse of opioids, methamphetamines, and/or prescription drugs in the community.

Where to Document:

Appendix D Attachment 5: One Set of Coalition Meeting Minutes.

Requirement 5: CARA National Evaluation Requirement

Evidence Required

A grant under this section shall be subject to the same evaluation requirements and procedures as the evaluation requirements and procedures imposed on the recipients of a grant under the Drug-Free Communities Act of 1997, and may also include an evaluation of the effectiveness at reducing abuse of opioids or methamphetamines.

(Pub. L. No. 114-198 Sec 103).

Applicant must demonstrate the ability to comply with the CARA Program Evaluation requirements.

Where to Document:

Appendix D Attachment 7: CARA Act Program Evaluation Requirements.

3. Justification for Less than Maximum Competition N/A

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

No

5. Maintenance of Effort Not required

D. Application and Submission Information

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

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number. A DUNS number is a unique nine-digit identification number provided by Dun & Bradstreet (D&B). It will be used as the Universal Identifier when applying for federal awards or cooperative agreements.

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll free) or internet at http:// fedgov.dnb. com/ webform/ displayHomePage.do. The DUNS number will be provided at no charge.

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

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as a recipient. All applicant organizations must register with SAM, and will be assigned a SAM number. All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC. If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at https://www.sam.gov/SAM/.

c. Grants.gov:

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

Data Universal Number System

(DUNS)

1. Click on http:// fedgov.dnb.com/ webform

2. Select Begin DUNS search/request process

3. Select your country or territory and follow the instructions to obtain your DUNS 9-digit #

4. Request appropriate staff member(s) to obtain DUNS number, verify & update information under DUNS number

1-2 Business Days

To confirm that you have been issued a new DUNS number check online at (http:// fedgov.dnb.com/ webform) or call 1-866-705-

System for Award Management

(SAM)

formerly Central Contractor

1. Retrieve organizations DUNS number

2. Go to https://www.sam.gov/SAM/ and designate an E-Biz POC (note CCR username will not work in SAM and you will need to have

3-5 Business Days but up to 2 weeks and must be renewed once a year

For SAM Customer Service Contact https://fs d.gov/ fsd-gov/ home.do Calls: 86 6-606-8220 http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/SAM/ https://grants.gov/ https://www.grants.gov/ http://www.grants.gov/ https://www.grants.gov/ http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform https://www.sam.gov/SAM/ https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do

Registration

(CCR)

an active SAM account before you can register on grants.gov)

3 Grants.gov

1. Set up an individual account in Grants.gov using organization new DUNS number to become an authorized organization representative

(AOR)

2. Once the account is set up the E-BIZ POC will be notified via email

3. Log into grants.gov using the password the E-BIZ POC received and create new password

4. This authorizes the AOR to submit applications on behalf of the organization

Same day but can take 8 weeks to be fully registered and approved in the system (note, applicants MUST obtain a DUNS number and SAM account before applying on grants.gov)

Register early!

Log into grants.gov and check AOR status until it shows you have been approved

2. Request Application Package Applicants may access the application package at www.grants.gov.

3. Application Package Applicants must download the SF-424, Application for Federal Assistance, package associated with this notice of 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 or postmarked by)

02/01/2021

b. Application Deadline

Due Date for Applications 04/01/2021

04/01/2021 11:59 pm U.S. Eastern Standard 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.

A Letter of Intent (LOI) is not required for this funding opportunity. Application due on 4/01/2021 by 11:59 pm U.S. Eastern Standard Time, at www.grants.gov.

Due Date for Information Conference Call https://www.grants.gov/ https://www.grants.gov/

All applicants applying to the FY 2021 CARA NOFO are encouraged to attend the CARA Applicant Workshop Training, which will take place on Friday, February 5 at 11:00 AM EST. Details on how to register and access the training are posted on the following website: https://tvworldwide.com/events/ondcp/2021/CARA/. The training will be recorded and posted in mid-February. A link to the workshop training video can be found at https://tvworldwide.com/events/ondcp/2021/CARA/.

5. CDC Assurances and Certifications All applicants are required to sign and submit “Assurances and Certifications” documents indicated at http://wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa)) /Homepage.aspx.

Applicants may follow either of the following processes:

Complete the applicable assurances and certifications with each application submission, name the file “Assurances and Certifications” and upload it as a PDF file with at www.grants.gov

Complete the applicable assurances and certifications and submit them directly to CDC on an annual basis at http://wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa))/ Homepage.aspx

Assurances and certifications submitted directly to CDC will be kept on file for one year and will apply to all applications submitted to CDC by the applicant within one year of the submission date.

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.