Foa_Content_of_CDC-RFA-CK22-2203 FINAL.pdf

Centers for Disease Control and Prevention

National Center for Emerging and Zoonotic Infectious Diseases

Strengthening Healthcare Infection Prevention and Control and Improving Patient Safety in the United States

CDC-RFA-CK22-2203

Application Due Date will be submitted as: date based on the value specified for Due Date for

Applications

Table of Contents 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

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- CK22-2203. 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:

Strengthening Healthcare Infection Prevention and Control and Improving Patient Safety in the United States 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-CK22-2203

E. Assistance Listings Number:

93.421 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.

Recommended but not Required https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

2. Due Date for Applications:

02/11/2022 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

January 12, 2022 You are invited to a Zoom webinar.

When: Jan 12, 2022 Time: 03:00-4:30 PM Eastern Time (US and Canada) Topic: CK22-2203 Informational Webinar

Register in advance for this webinar:

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

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

F. Executive Summary:

Summary Paragraph Through this Notice of Funding Opportunity (NOFO), CDC protects Americans by improving the safety and quality of healthcare. This NOFO supports the priorities of the National Center for Emerging and Zoonotic Infectious Diseases, including the prevention of infectious diseases by enhancing healthcare infection prevention and control (IPC). CDC will establish and expand partnerships with academic, healthcare, and other organizations to address IPC failure modes;

enhance correct implementation of IPC protocols and processes; and strengthen healthcare worker training and competency assessment. This NOFO supports activities to assess and remove barriers to success; improve communication of IPC information and instructions to healthcare workers; and understand how to optimize the layout and functional flow of healthcare environments and processes. This NOFO will support organizations uniquely positioned to advance the design, delivery, and effectiveness of IPC training, education, and competency assessment to improve healthcare worker IPC practice and increase health department ability to support healthcare IPC and outbreak response. The work conducted supports public health and healthcare practice by informing development of guidance and recommendations; translating guidance and recommendations into practices implementable in diverse healthcare settings; and improving how healthcare and public health personnel are trained and how competencies are assessed.

a. Eligible Applicants:

Open Competition

b. NOFO Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards https://www.grants.gov/ https://cdc.zoomgov.com/webinar/register/WN_hGNheMEURjeCDvwbVjtyOw

At this time, CDC estimates that 12 applicants will initially be awarded in response to this NOFO (6 for component 1 and 6 for component 2). This is subject to change. All other approved applicants will be added to the approved but unfunded (ABU) roster listing. Applicants on the ABU list may be funded in response to other emerging challenges and opportunities, as the need arises, for up to twenty-four months from the date of the ABU letter.

d. Total Period of Performance Funding:

$100,000,000

e. Average One Year Award Amount:

$1,000,000 This is the average one-year award amount for a recipient conducting work in only one component. The average one-year award amount is subject to change and is subject to the availability of funds.

f. Total Period of Performance Length:

g. Estimated Award Date:

July 25, 2022

h. Cost Sharing and / or Matching Requirements:

No Cost sharing or matching of funds is not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The COVID-19 pandemic highlighted gaps in infection prevention and control (IPC) knowledge and practice in U.S. healthcare settings. IPC in healthcare stops the spread of infections, preventing illness and death and protecting patients and healthcare personnel. There is a need to strengthen healthcare IPC practices, inform IPC recommendations, improve how healthcare personnel IPC competencies are assessed, and develop evidence-based approaches to IPC training and education. This NOFO provides real-world implementation solutions for CDC’s evidence-based guidance, during both normal operations and during emergencies.

The recipients supported through this two-component NOFO will lead efforts to improve implementation of healthcare IPC. Strategies within Component 1, improving the safety and quality of healthcare and protecting healthcare personnel and patients by strengthening IPC, will improve healthcare facility structure, design, and organization; optimize materials and equipment design and safe use across healthcare settings; improve IPC work processes, procedures, and practices; promote standard practices to ensure healthcare environments are safe for healthcare personnel and patients, including by optimizing the safety of the air, water, or surfaces in the healthcare environment; and strengthen healthcare IPC preparedness.

Component 2, strengthening healthcare personnel IPC training, education, and competency assessment, seeks to develop and evaluate innovative and effective IPC training and education approaches; and implement improved or novel approaches to healthcare personnel competency assessment. Component 2 also includes improving the ability of the U.S. public health workforce to support healthcare IPC and prevent and respond to healthcare-associated infections (HAI) and antibiotic resistance (AR).

In 2020, CDC launched Project Firstline, a collaborative of healthcare, public health, and academic partners committed to strengthening healthcare IPC practice and training. This NOFO supports Project Firstline implementation through strategies that improve the design and effectiveness of training and education for healthcare personnel.

This NOFO builds on work supported through prior funding opportunities, which identified approaches to improve IPC at small or resource-limited healthcare facilities; evaluated failure modes and human factors associated with IPC; and identified strategies to augment existing facilities and processes to enable effective isolation capacities.

By engaging a diverse set of partners and investing in work that supports a broad range of healthcare personnel populations and healthcare settings, this work supports CDC’s efforts to strengthen health equity, protect populations at increased risk for negative outcomes, and address disparities in IPC training and competencies.

Successful applicants will demonstrate specialized expertise, infrastructure, technological capabilities, and partners to strengthen healthcare IPC. Work proposed can be complementary to but must not be duplicative of work funded by CDC through any other mechanism. Types of organizations that may be supported include, but are not limited to, private and state-controlled academic institutions, healthcare systems, clinicians and other healthcare professionals, non-governmental organizations, healthcare professional organizations, and other institutions with unique expertise that can improve healthcare IPC in the United States.

b. Statutory Authorities This program is authorized under Public Health Service Act section 301(a) [42 U.S.C section 241(a)] and Public Health Service Act section 317(k)(2) [42 U.S.C. section 247b(k)(2)].

Possible applicable supplemental appropriations include but may not be limited to: P.L. 116-123

- Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 [March 6, 2020] P.L 116–136 - Coronavirus Aid, Relief, and Economic Security Act (CARES Act) [ March 27, 2020]; and P.L. 117-2 – American Rescue Plan Act of 2021 (March 11, 2021).

Authority may also stem from an applicable emergency supplemental appropriation; such appropriation and any requirements and/or limitation associated with that emergency supplemental will be added to the notice of award.

c. Healthy People 2030 This project supports the following Healthy People 2030 goals and objectives:

Goal: Reduce healthcare associated infections

Objectives below with the associated link for additional information

Reduce C. diff infections that people get in the hospital — HAI-01 - Healthy People 2030 | health.gov https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-associated-infections/reduce-c-diff-infections-people-get-hospital-hai-01 https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-associated-infections/reduce-c-diff-infections-people-get-hospital-hai-01

Reduce MRSA bloodstream infections that people get in the hospital — HAI-02 - Healthy People 2030 | health.gov

d. Other National Public Health Priorities and Strategies Activities funded through this cooperative agreement should align with the following U.S. Government and HHS/CDC strategies and policies:

National HAI Action Plan - National HAI Action Plan | health.gov

National Strategy for Combating Antibiotic-Resistant Bacteria -https://www.cdc.gov/drugresistance/pdf/carb_national_strategy.pdf

Executive Order on Protecting Worker Health and Safety - Executive Order on Protecting Worker Health and Safety | The White House

National Health Security Strategy -https://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx

e. Relevant Work This NOFO supports CDC’s Division of Healthcare Quality Promotion (DHQP) priority of protecting patients and healthcare personnel in the United States. DHQP supports partners to implement IPC programs, identify and refine best approaches, and promote innovative solutions for preventing infections across healthcare settings. This NOFO complements and does not duplicate work supported through other cooperative agreements, including those that support collaborative research on how to develop and implement innovative strategies that improve healthcare quality and patient safety.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-CK22-2203 Logic Model: Strengthening Healthcare Infection Prevention and Control and Improving Patient Safety in the United States

COMPONENT 1: Improving the safety and quality of healthcare and protecting healthcare personnel and patients by strengthening infection prevention and control (IPC)

Strategies Intermediate-term outcomes Long-term outcomes

1a. Improve healthcare facility structure, design, engineering, and organization to enable safe, quality

1ai. Improveme nts in the safe provision of quality healthcare

1aii. Improveme nts in IPC practices across diverse

1i. Improved healthcare IPC policies, procedures, practices, and implementation across diverse healthcare facilities and systems

1ii. More effective IPC implementation by healthcare facilities serving underserved and under-resourced populations

1iii. Healthcare facilities and systems implement improved and/or novel tools, materials, and other resources that https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-associated-infections/reduce-mrsa-bloodstream-infections-people-get-hospital-hai-02 https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-associated-infections/reduce-mrsa-bloodstream-infections-people-get-hospital-hai-02 https://health.gov/our-work/health-care-quality/health-care-associated-infections/national-hai-action-plan https://www.cdc.gov/drugresistance/pdf/carb_national_strategy.pdf https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/21/executive-order-protecting-worker-health-and-safety/ https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/21/executive-order-protecting-worker-health-and-safety/ https://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx healthcare delivery and protect healthcare personnel and patients healthcare settings

1b. Optimize materials and equipment design and safe use across healthcare settings

1bi. Improved

IPC

implementation related to materials, equipment, and devices in diverse healthcare setting

1bii. Improveme nts and innovations in healthcare materials and equipment

1c. Improve IPC work processes, procedures, and practices to enable safer and consistently higher quality healthcare

1ci. Improveme nts in IPC work processes, procedures, and practices across diverse healthcare settings

1d.

Implement standard practices to ensure healthcare environments are safe for healthcare personnel and patients

1di. Reduction or elimination of barriers and challenges related to optimizing the safety of the air, water/plumbing, and surfaces in the healthcare environment support day-to-day activities and can be scaled up and/or adapted to support IPC implementation during emergencies

1iv. Prevention of pathogen transmission in healthcare

1v. Healthcare facilities and systems successfully implement novel approaches to improving facilities design; materials and equipment use; and IPC processes, procedures, and practices

1vi. Healthcare facility and system leadership (e.g., the C- Suite) consistently lead the integration of IPC into facility design, ongoing operations, and healthcare personnel training and competency assessment

1vii. Diverse healthcare settings and systems implement new and innovative approaches and resources in standardized ways to reduce the risk of pathogen transmission via air, water/plumbing, and surfaces

1viii. Healthcare facilities, systems, and personnel are better prepared to provide safe, quality care during infectious disease outbreaks and other emergencies

1ix. Effective, safe, and rapid responses to infectious disease outbreaks and other emergencies

1dii. Strengthen ed environmental services and sterile processing services in healthcare facilities, including provision of education and training for responsible personnel

1e.

Strengthen healthcare

IPC

preparedness in the United States to respond to infectious disease threats and other public health emergencies rapidly, safely, and effectively

1ei. Demonstrati on of the value of structural, organizational, staffing, and other IPC preparedness activities to readiness and resilience of healthcare personnel, healthcare facilities, and systems

COMPONENT 2: Strengthening healthcare personnel IPC training, education, and competency assessment

Strategies Intermediate-term outcomes Long-term outcomes

2a. Develop and

2ai. Demonstration of the effectiveness of

2i. Improved IPC knowledge, competencies, skills, and practices of targeted populations of U.S. healthcare evaluate innovative and effective IPC training and education approaches to reach all U.S.

healthcare personnel new, improved, and/or innovative healthcare IPC training and education approaches

2aii. The diverse learning levels, cultures, languages, and needs of healthcare personnel are met as part of IPC training and education

2aiii. Improved training of healthcare personnel that is shown to improve the maintenance of healthcare facility environments

2b.

Implement improved and novel approaches to effective healthcare personnel competency assessment

2bi. Enhanced assessment of healthcare personnel IPC competencies by U.S. healthcare facilities and systems

2bii. Effective integration of IPC into healthcare personnel competency assessment

2c. Improve the ability of the U.S.

public health workforce to support healthcare IPC and the prevention

2ci. Increased knowledge and capacity within the U.S. public health workforce (specifically staff in health department HAI/AR programs) in the areas of healthcare IPC, HAI/AR prevention personnel

2ii. Increased effectiveness of formal and informal healthcare IPC training and education

2iii. Improved ability of health department HAI/AR programs to effectively support implementation of healthcare IPC and the prevention of and response to HAIs and AR in their jurisdiction

2iv. Greater partnership and integration between public health and healthcare systems, including academic entities within regions, on infection control action and investments

2v. Healthcare personnel education and training using evidence-based practices are a fundamental component of IPC implementation

2vi. Improved ability of healthcare personnel to explain IPC to others

2vii. Healthcare personnel can assess IPC risks and implement the appropriate IPC processes and procedures

2viii. IPC is incorporated into healthcare personnel certification and recertification of and response to healthcare-associated infections (HAI) and antibiotic resistance

(AR)

and response, and other focused areas of specialization

i. Purpose The COVID-19 pandemic highlighted gaps in healthcare IPC, including improper personal protective equipment (PPE) use and the need for improved training. This NOFO supports strategies to make the delivery of healthcare safer for healthcare personnel and patients by improving IPC implementation; ensuring the healthcare environment is safe; improving IPC training, education, and competency assessment; and strengthening healthcare IPC preparedness.

ii. Outcomes The outcomes below are the bolded outcomes from the logic model that recipients are expected to make progress toward achieving during the period of performance. Not all outcomes will be relevant to every recipient’s project plan and will depend on the program strategies implemented by the recipient.

The work supported through component 1 of this NOFO will accelerate progress toward the prevention of transmission of infectious pathogens in healthcare settings through ongoing, correct implementation of IPC work processes, procedures, and practices; through use of improved or novel materials, equipment, and devices; and from the air, water/plumbing, and surfaces in healthcare environments. Work supporting healthcare IPC preparedness will enable effective, safe, and rapid responses to infectious disease outbreaks and other emergencies through improved information sharing and situational awareness within and between healthcare facilities, healthcare systems, and governmental authorities, as well as through the enhanced ability to apply techniques, tools, materials, procedures, policies, and practices that may not be routinely used.

The work supported through component 2 of this NOFO strengthens the implementation of IPC in healthcare settings to protect patients and healthcare personnel – including interventions developed or improved through component 1 – by developing new or improved approaches to healthcare personal IPC training, education, and competency assessment. (This NOFO does not support activities solely focused on disseminating existing IPC training approaches or resources.) Additionally, component 2 establishes regional resource centers to support state and local health department programs and strengthen their ability to support healthcare IPC and outbreak response.

COMPONENT 1: Improving the safety and quality of healthcare and protecting healthcare personnel and patients by strengthening IPC

Intermediate-term outcomes:

Strategy 1a. Improve healthcare facility structure, design, engineering, and organization to enable safe, quality healthcare delivery and protect healthcare personnel and patients

1ai. Improvements in the safe provision of quality healthcare enabled by improvements in healthcare facility structure, design, engineering, and organization

1aii. Improvements in IPC practices across diverse healthcare settings due to implementation of approaches that overcome structural capabilities and other common barriers encountered

Strategy 1b. Optimize materials and equipment design and safe use across healthcare settings

1bi. Improved IPC implementation related to materials, equipment, and devices in diverse healthcare setting

1bii. Improvements and innovations in healthcare materials and equipment, including personal protective equipment (PPE)

Strategy 1c. Improve IPC work processes, procedures, and practices to enable safer and consistently higher quality healthcare

1ci. Improvements in IPC work processes, procedures, and practices across diverse healthcare settings through (a) use of innovative tools, resources and training and (b) improvements to healthcare facility organization and procedures

Strategy 1d. Implement standard practices to ensure healthcare environments are safe for healthcare personnel and patients, including optimizing the safety of the air, water/plumbing, and/or surfaces in the healthcare environment

1di. Reduction or elimination of barriers and challenges related to optimizing the safety of the air, water/plumbing, and surfaces in the healthcare environment

1dii. Strengthened environmental services and sterile processing services in healthcare facilities, including provision of education and training for responsible healthcare personnel

Strategy 1e. Strengthen healthcare IPC preparedness in the United States to respond to infectious disease threats and other public health emergencies

1ei. Demonstration of the value of structural, organizational, staffing, and other IPC preparedness activities to readiness and resilience of healthcare personnel, healthcare facilities, and healthcare systems

Long-term outcomes (across all component 1 strategies):

1i. Improved healthcare IPC policies, procedures, practices, and implementation across diverse U.S. healthcare facilities and systems

1ii. More effective IPC implementation by healthcare facilities serving underserved and under-resourced populations

1iii. Healthcare facilities and systems implement improved and/or novel tools, materials, and other resources that both support day-to-day activities and can also be scaled up and/or adapted to support healthcare IPC implementation during emergencies

COMPONENT 2: Strengthening healthcare personnel IPC training, education, and competency assessment

Intermediate-term outcomes:

Strategy 2a. Develop and evaluate innovative and effective IPC training and education approaches to reach all U.S. healthcare personnel

2ai. Demonstration of the effectiveness of new, improved, and/or innovative healthcare IPC training and education approaches

2aii. The diverse learning levels, cultures, languages, and needs of healthcare personnel are met as part of IPC training and education

2aiii. Improved training of healthcare personnel that is shown to improve the maintenance of healthcare facility environments

Strategy 2b. Implement improved and novel approaches to effective healthcare personnel competency assessment

2bi. Enhanced assessment of healthcare personnel IPC competencies by U.S. healthcare facilities and systems

2bii. Effective integration of IPC into healthcare personnel competency assessment

Strategy 2c. Improve the ability of the U.S. public health workforce to support healthcare IPC and the prevention of and response to healthcare-associated infections (HAI) and antibiotic resistance (AR)

2ci. Increased knowledge and capacity within the U.S. public health workforce (specifically staff in health department HAI/AR programs) in the areas of healthcare IPC, HAI/AR prevention and response, and other focused areas of specialization

Long-term outcomes (across all component 2 strategies):

2i. Improved IPC knowledge, competencies, skills, and practices of targeted populations of U.S. healthcare personnel through implementation of innovative Project Firstline training resources

2ii. Increased effectiveness of formal and informal healthcare IPC training and education

2iii. Improved ability of health department HAI/AR programs to effectively support implementation of healthcare IPC and the prevention of and response to HAIs and AR in their jurisdiction

2iv. Greater partnership and integration between public health and healthcare systems, including academic entities within regions, on infection control action and investments

iii. Strategies and Activities

Implementation of components 1 and 2 should include approaches that are applicable to a variety of populations, including strategies specific for supporting populations at increased risk for negative outcomes and improving IPC practice in small, rural, and/or tribal healthcare facilities.

An applicant is not expected to implement all activities listed for a strategy. The Project Narrative and Work Plan must provide sufficient detail on those activities the applicant does plan to implement within the period of performance.

COMPONENT 1: Improving the safety and quality of healthcare and protecting healthcare personnel and patients by strengthening IPC

The following outputs are applicable across all component 1 strategies:

Real-world implementation solutions for CDC’s evidence-based guidance during normal healthcare operations, as well as in preparation for and during emergencies

Project results that can inform evidence-based revisions of CDC healthcare IPC guidance and recommendations

Identification of healthcare personnel education and training needs to successfully implement improved or novel approaches and interventions

Strategy 1a: Improve healthcare facility structure, design, engineering, and organization to enable safe, quality healthcare delivery and protect healthcare personnel and patients

These activities should identify key factors related to healthcare facility design and engineering that enable provision of safe healthcare, as well as evaluate structural capabilities and common barriers encountered in successfully implementing healthcare IPC. Implementation of activities in support of strategy 1a should improve facility design and engineering, including optimization of layouts and functional flows of diverse healthcare settings to enable IPC implementation.

Develop, implement, and evaluate approaches to overcome limiting structural capabilities and common barriers encountered in implementing IPC successfully within existing healthcare facility infrastructure

Assess if changes in healthcare facility design and engineering enable safer healthcare delivery and IPC, including optimization of layouts and functional flow of healthcare facilities

Engage healthcare facility and systems leadership, architects, engineers, and designers in activities that enhance safe delivery of healthcare and improve IPC by overcoming identified barriers

Identify training and education needs and target healthcare personnel populations (including healthcare facility architects, design staff, and project management staff) for any new or improved interventions identified

Strategy 1b: Optimize materials and equipment design and safe use across healthcare settings

Describe the failure modes associated with healthcare IPC materials and device use (including PPE)

Provide tools and resources that meet the needs of diverse healthcare settings and healthcare personnel to address common failure modes of healthcare materials, equipment, and devices

Develop improved materials and equipment design and/or novel materials and equipment to protect healthcare personnel (HCP) and improve IPC practice, including materials and equipment that can be used in both routine healthcare and during emergency situations in diverse healthcare settings

Identify training and education needs and target healthcare personnel populations for any new or improved interventions identified

Strategy 1c: Improve IPC work processes, procedures, and practices to enable safer and consistently higher quality healthcare

Implementation of activities in support of strategy 1c should result in the implementation of new or improved approaches for facilitating IPC in diverse healthcare settings, including innovative tools, resources, and training, and improvements to healthcare facility organization and procedures. Implementation of strategy 1c may also identify specific IPC improvements needed for specific clinical procedures.

Describe failure modes of practices, processes, and procedures that can lead to healthcare-associated infections or lead to diminished protection for healthcare personnel

Provide tailored resources to meet the IPC processes, procedures, and practices needs of different types of healthcare facilities and settings

Implement strategies for efficient and cost-effective organizational and procedural adjustments to facilitate IPC

Develop and evaluate strategies that increase behaviors by healthcare personnel that consistently adhere to recommended IPC practices across diverse healthcare settings

Identify training and education needs and target healthcare personnel populations for any new or improved interventions identified

Strategy 1d: Implement standard practices to ensure healthcare environments are safe for healthcare personnel and patients, including optimizing the safety of the air, water/plumbing, and/or surfaces in the healthcare environment

Implementation of activities in support of strategy 1d should contribute to optimizing the safety of the air, water/plumbing, and/or surfaces in the healthcare environment. Activities within this strategy could complement, but not duplicate, the work of other CDC funding mechanisms, programs, and partnerships. This strategy is not intended to support epidemiologic studies that quantify the proportion of healthcare-associated infections that are attributable to transmission of pathogens via air, water, and surfaces in healthcare but is intended to support physical characterization of exposure to potential pathogens via the healthcare environment and development of approaches and solutions to minimize such exposures.

Additional information on CDC’s Division of Healthcare Quality Promotion’s (DHQP’s) portfolio of work related to IPC in the healthcare environment can be found here at this website: Healthcare Environment Infection Prevention | CDC. DHQP has developed the Core Components of Environmental Cleaning and Disinfection in Hospitals; as noted in the activities listed below, this NOFO can support development of tools and resources associated with these core components.

Identify specific barriers and challenges to optimizing the safety of the air (air flow, inhalation of contaminated air), water/plumbing, and/or surfaces in healthcare environments

Develop and evaluate approaches to address specific barriers and challenges to optimizing the safety of the air, water/plumbing, and/or surfaces in healthcare environments

Provide tools and resources that reduce risk of exposure to potential pathogens via air, water/plumbing, and/or surfaces for healthcare personnel responsible for maintaining a safe healthcare environment

Improve environmental services practices and associated protocols

Implement approaches to improve retention of healthcare facility environmental services personnel

Improve device cleaning and reprocessing practices and associated protocols

Develop tools and resources to support healthcare facility implementation of CDC’s Core Components of Environmental Cleaning and Disinfection https://www.cdc.gov/hai/prevent/environment/index.html

Strategy 1e: Strengthen healthcare IPC preparedness in the United States to respond to infectious disease threats and other public health emergencies rapidly, safely, and effectively

When implementing activities in support of strategy 1e, consider how healthcare facilities and systems can demonstrate improved healthcare IPC preparedness and effectiveness of training activities through exercise and simulations.

Review existing documents and resources for healthcare IPC preparedness and revise, update, and promote those resources, including ensuring their relevance for use in specific healthcare settings

Propose a framework to improve a healthcare facility or system’s IPC preparedness, including identification of gaps, needs, and implementation approaches that incorporate desired capabilities into routine practices and protocols

Develop, evaluate, and implement approaches to improve bidirectional information sharing and situational awareness of healthcare preparedness within and across healthcare facilities and systems and with local, state, and federal governmental authorities

Develop, evaluate, and implement tools (relevant to the needs of diverse healthcare settings (e.g., long-term care, small or rural healthcare facilities)) to help healthcare facilities and healthcare systems assess and improve their preparedness (tools should be complementary to, and/or build on (but not be duplicative of) other existing tools (e.g., CDC Infection Control Assessment and Response (ICAR) Tools))

Engage specific populations of the U.S. healthcare workforce in healthcare IPC preparedness

Identify IPC training and education needs of target healthcare personnel populations, including healthcare facility leadership, to maintain healthcare IPC readiness across the healthcare workforce and implement approaches to meet the needs identified

Develop improved or novel approaches to communicate with healthcare personnel about changes or updates to IPC recommendations, guidance, and procedures during emergencies

COMPONENT 2: Strengthening healthcare personnel IPC training, education, and competency assessment

Strategy 2a: Develop and evaluate innovative and effective IPC training and education approaches to reach all U.S. healthcare personnel

Implementation of activities in support of strategy 2a will improve understanding of the optimal approaches, timing, and modalities for training and education U.S. healthcare personnel across diverse healthcare settings, as well as improve understanding of how improved or novel training methods can lead to and uptake of IPC knowledge and IPC-related behavior change. Strategy 2a activities should results in innovative and proven effective approaches for ongoing and ad hoc healthcare personnel IPC training and formal IPC education. Successful implementation should accelerate progress toward all U.S. healthcare personnel having the IPC training and formal IPC education they need and deserve, and that training and education are culturally appropriate, linguistically accessible, and at the appropriate education level.

Conduct human-centered design work to identify the best methods, products, platforms, and timing (including continuing education during employment) to train and educate healthcare personnel in IPC

Demonstrate the use of new and improved training and education approaches in diverse healthcare settings and among diverse healthcare personnel populations

Use results of human-centered design work to develop innovative approaches to deliver IPC education and training, including efforts directed toward secondary education, associate degree programs, technical colleges, undergraduate programs, professional degree programs, continuing education programs, and certifications

Use results of human-centered design work to develop innovative approaches delivering IPC education and training to healthcare personnel populations whose first language is not English (I.e., ESL learners)

Ensure new IPC training and education approaches are culturally competent and appropriate for the education level of the target audience

Provide subject matter expertise to inform novel training approaches, including simulations/games

Provide new or improved training and education resources for interventions that improve the safety and quality of healthcare that protect healthcare personnel and patients by strengthening IPC, such as those developed through component 1 of this NOFO

Demonstrate the impact of novel approaches, modalities, platforms and timing of training and education on healthcare personnel behaviors related to IPC

Strategy 2b: Implement improved and novel approaches to effective healthcare personnel competency assessment

Implementation of activities in support of strategy 2b should result in development, evaluation, and implementation of new or improved approaches to assess and strengthen healthcare personnel comprehension and implementation of IPC actions and processes.

Improve healthcare personnel comprehension and implementation of IPC actions and processes

Strengthen assessment of healthcare personnel IPC failure modes and competencies (including descriptions of failure modes and approaches to address them)

Effectively integrate IPC training into healthcare personnel IPC competency development and evaluation

Identify, design and/or pilot the use of infection control competency recognition (such as digital badges, micro-credentials, etc) for healthcare workers from multiple professions (EVS, nursing, allied health) to incentivize training and to help healthcare workers to distinguish themselves in the professional marketplace

Optimize healthcare personnel ability to assess risks and identify correct procedures for healthcare IPC

Strategy 2c: Improve the ability of the U.S. public health workforce to support healthcare IPC and the prevention of and response to healthcare-associated infections (HAI) and antibiotic resistance (AR)

Establish regional integrated healthcare epidemiology and IPC resource centers at academic medical centers, schools of public health, or schools of nursing to support state and local health department programs (HAI/AR Programs) responsible for implementing HAI/AR response and prevention activities in that region.

Partner with CDC-funded HAI/AR Programs within the assigned region to identify health department capacity building needs and provide training, education, and consultation resources to health departments in coordination with CDC, including those focused on basic HAI/AR response and prevention as well as focused areas of specialization (e.g., healthcare settings or practice areas, patient populations, specific infection control topics, pathogens, methods to improve detection, investigation, or response)

Outputs associated with successful implementation of these strategy 2c activities include:

Needs assessments to identify resource and training gaps of public health workforce in the region are conducted, including at a minimum the CDC-funded HAI/AR Programs within the assigned region

Competency-based core education and training course materials for state and local health departments are developed, adapted, and/or promoted

Specialty courses that are unique to the needs of the region served or the area(s) of specialization are developed

Core and specialty courses are developed and delivered in consultation with CDC and are derived from recommendations and needs assessments from multiple sources, including:

1) CDC identified needs and priorities; 2) local and regional needs assessments; and 3) new and existing national guidelines

State and local health department staff demonstrate proficiency in core areas

Case studies based on field investigations are developed

Continuing education is awarded when possible and appropriate for training courses

Where applicable, increase capacity and provide support to public health departments to effectively provide high-quality infection control training and education to their healthcare workforce, which is informed by data, which identifies priority training topics, professions, and settings

Any public health workforce education and training activities in support of this strategy should be complementary to and conducted in coordination with Project Firstline, CDC’s national healthcare IPC training collaborative.

Regional center resources should be complimentary to resources developed by other partners including, but not limited to, state, territorial, and local health departments; hospital associations; quality improvement programs such as Quality Improvement Network – Quality Improvement Organizations (QIN-QIOs) and Hospital Improvement Innovation Networks (HIINs); CDC Prevention Epicenters; CDC Emerging Infections Program; regulatory/licensing entities; end stage renal disease (ESRD) networks; regional public health laboratories; and hospital/emergency preparedness programs.

1. Collaborations Please see detailed and focused collaborations sections (subsections a. and b. below) which will help target key collaborations, partnerships, and coalitions to successfully implement the project activities and achieve the NOFO's outcomes.

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

Collaboration with other CDC programs and CDC-funded organization is not required but is encouraged. Recipients of this award will be expected to collaborate/coordinate to amplify the goals of this program, as described in the program guidance. Recipients are encouraged to work with CDC and other CDC implementing partners, including non-governmental organizations, academic institutions, and other entities that receive CDC funds. The specific organizations to be targeted for collaboration will be dependent on the specific work plan of the recipient. Recipients should ensure their proposed activities are not duplicating activities already funded by other CDC grants, contracts, and cooperative agreements or implemented by other CDC-funded organizations.

b. With organizations not funded by CDC:

This funding opportunity may support multiple organizations to address issues related to healthcare IPC. Recipients are encouraged to build and sustain strategic partnerships and collaborations with other organizations that have a role in supporting the implementation of a recipient’s proposed work plan/activities and achieving expected outcomes. Partners and collaborators may include government agencies, academic institutions, non-governmental organizations, healthcare facilities, laboratories, and potential partners in the private sector.

Applicants should identify the organizations, networks, sectors, and partners (not funded by CDC) that are needed to successfully implement the work proposed. For these collaborations, applicants should describe 1) the extent of the current collaboration with those entities, 2) the specific objectives of the partnerships for the purposes of implementing strategies and activities in this NOFO, and 3) any funding or sharing of resources that the applicant proposes to give the partner organization.

2. Target Populations The target population includes, but is not limited to, all individuals engaged in any aspect of patient care and healthcare delivery, including community, ambulatory, pre-hospital, acute care, long-term care, surgical and other procedural care; subspecialty practices and procedures;

environmental services; material management; healthcare facility engineering; healthcare facility and system leaders and managers; and payors.

a. Health Disparities This cooperative agreement includes program activities that can be used to target occupational groups and healthcare facilities/setting that serve populations at disproportionate risk of infectious disease and/or adverse outcomes. In targeting specialty and subspecialty organizations, efforts will reach groups that are currently unable to access or benefit from IPC training and implementation efforts. In addition, CDC seeks to fund organizations that specialize in reaching populations that may be lower income, in rural areas without easy access to healthcare or other healthcare organizations, and/or members of minority communities that might experience higher rates of preventable infectious diseases or adverse outcomes and/or be limited by access to tailored IPC tools and information that meet their specific needs.

Applicants should have a plan in place to be inclusive of populations that might be directly impacted or have increased risk for various infectious diseases, including but not limited to rural and native populations with disabilities; non-English speaking populations; lesbian, gay, bisexual, and transgender (LGBT) populations; people with limited health literacy;

immunocompromised persons; and/or other at-risk populations.

Applicants must describe the specific target population(s) and explain how such a target will monitor and achieve the goals of the award and/or alleviate health disparities. The applicants must also address how they will include specific populations that can benefit from the program that is described in the Approach section. Applicants must address the Target Populations and Health Disparities requirements as described in the CDC Project Description.

iv. Funding Strategy This NOFO intends to fund recipients that are uniquely suited (i.e., have the necessary technical expertise, infrastructure, partnerships, and management capabilities) to make substantial contributions to the progress of the strategies and outcomes in the logic model. The applicant should focus their application on the strategy(ies) to which they are best suited to implement.

This NOFO has 2 components. Applicants can apply for one or both components. Within each component applied to, an applicant may apply for a maximum of two strategies (as defined in the logic model). Components and strategies not included in this initial application cannot be added to work plans in subsequent years. Applicants who include more than two strategies within a component will be deemed non-responsive and their application will not be reviewed.

It is anticipated that some applicants may select to apply to only one component while others may choose to apply to both. It is also anticipated that some applicants may select only one strategy within a component while others may select two strategies within a component. Award decisions will not be impacted by the number of components applied to and the number of strategies selected.

Applicants must clearly state the component(s) and strategy(ies) (as defined in the logic model) to which they are applying in the Project Abstract Summary. When including this information in the Project Abstract Summary, please use the numbering of components and strategies as used in the logic model; examples are provided below.

This application includes COMPONENT 1, Strategies 1a and 1b.

This application includes COMPONENT 1, Strategy 1c and COMPONENT 2, Strategies

2a and 2b.

All components included in the application must be addressed in the Project Narrative, Work Plan, and Budget Narrative as described below. The Project Narrative, Work Plan, and Budget Narrative should address the strategy(ies) specified for each component in the Project Abstract Summary.

All components within the NOFO are intended to be funded on an annual basis. Year one and future years’ funding levels are dependent on funding availability. For planning purposes, applicants should estimate an average annual funding level for each award of $1,000,000 per component. Funding levels are subject to change and are dependent on the availability of funds.

This funding opportunity will establish a roster of organizations that are pre-identified and pre-approved for funding to address a broad range of issues related healthcare IPC (an approved but unfunded (ABU) list of recipients). The ABU list may be used to provide additional funding during the program period (if available) to respond to emerging healthcare IPC needs and threats. The ABU list remains valid for twenty-four months past the date of the applicants ABU letter. Depending on the nature of that need, applications and all or specific components of their applications will be selected for funding. These funding decisions will consider various factors, including the specific healthcare or public health IPC need, the organizational capacity of the initial and/or ABU recipient, and agency and national priorities. Recipients will be provided with an opportunity to develop a customized project plan that builds from their original project plan submission once the need is identified and funding decisions are made.

There is limited funding available at the time of this announcement. Additional funding will be contingent upon the availability of appropriations and is at CDC’s sole discretion. CDC will provide additional information to recipients as needs arise.

Work proposed by an applicant can be complementary to but must not be duplicative of work funded by CDC through any other mechanism during the period of performance.

Awards made under this NOFO may utilize funds made available through legislation supporting the response to the Coronavirus Disease 2019 (COVID-19) pandemic. Additional guidance for awards made using these funds is outlined below:

Coron…