Foa_Content_of_CDC-RFA-DP22-2206.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH

PROMOTION

Tribal Epidemiology Centers Public Health Infrastructure (TECPHI)

CDC-RFA-DP22-2206

05/11/2022

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 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- DP22-2206. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

Tribal Epidemiology Centers Public Health Infrastructure (TECPHI) 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-DP22-2206

E. Assistance Listings Number:

93.762 F. Dates:

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

N/A

2. Due Date for Applications:

05/11/2022 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

March 16, 2022 2:30 p.m. - 4:00 p.m. EST 888-390-3412 Passcode: 9195563

If you have questions about this NOFO, you must submit them to TECPHI2206@cdc.gov.

Our goal is to respond to questions within 2 working days and post them on the TECPHI DP22-2206 FAQ page. CDC cannot answer questions about eligibility other than refer you to the Additional Information on Eligibility page of the NOFO. CDC cannot discuss your proposed activities with you or answer questions about your proposed activities other than refer you to the Strategies and Activities section of the NOFO.

You can find the NOFO, the script from the information call, and links to the FAQs on the NOFO webpage.www.cdc.gov/healthytribes/tecphi/funding-opportunities/TECPHI-NOFO- 2206.htm

G. Executive Summary:

1. Summary Paragraph The purpose of this NOFO is to strengthen the public health infrastructure and capacity of 1) Tribal Epidemiology Centers (TECs) and 2) the tribes and Urban Indian Organizations (UIO) they support to meet national public health accreditation standards and deliver the 10 Essential Public Health Services. This work will support efforts to effectively identify and address underlying social determinants of health, reduce persistent health disparities, and improve the overall health and wellbeing of American Indian and Alaska Native (AI/AN) populations.

This NOFO will fund up to thirteen (13) recipients to strengthen public health capacity and infrastructure, and support a culturally informed, evidence-based, holistic, and population-level approach to disease prevention, health promotion, and wellness.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards Up to 12 Component A awards and up to 1 Component B award.

d. Total Period of Performance Funding:

$33,499,995

e. Average One Year Award Amount:

$509,592 Average award for Component A: $510,392

Average award for Component B: $500,000

Subject to availability of funding, including both direct and indirect costs.

f. Total Period of Performance Length:

g. Estimated Award Date:

August 31, 2022

h. Cost Sharing and / or Matching Requirements:

No Cost sharing or matching funds are 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 American Indian/Alaska Native (AI/AN) people have higher rates of disease, injury, and premature death than other racial and ethnic groups [1, 2]. AI/AN adults have a higher prevalence of obesity and double the prevalence of diagnosed diabetes [3]. Chronic health conditions, health behaviors, and inequities in income, education, and other social determinants of health contribute to increased morbidity and mortality from infectious diseases like influenza and COVID-19 [2, 4]. Strong public health capacity and infrastructure is critical to address disparities and improve health outcomes and is under-resourced and under-developed in Indian Country [5].

Amendments to the Indian Healthcare Improvement Act (IHCIA) in 1992 authorized the establishment of the TECs to serve each of the 12 Indian Health Service regions (Pub. L. No.

102–573, 106 Stat. 4526 § 214(a)(1). In 2010, Congress enacted the Patient Protection and Affordable Care Act (ACA), Pub. L. No. 111-148. The ACA reauthorized the IHCIA, 25 U.S.C.

§§ 1601-1683, designating TECs as public health authorities under the Health Insurance Portability and Accountability Act (HIPAA) and authorizing TEC access to data held by the US Department of Health and Human Services (HHS), 5 U.S.C.A § 1621m(e)(1)). It also directs the director of CDC to provide technical assistance to TECs in performing the functions outlined in ICHIA, Id. § 1621m(c).

The purpose of this NOFO is to strengthen the public health infrastructure and capacity of 1) TECs and 2) the tribes and UIO they support to effectively identify and address underlying social determinants of health, reduce persistent health disparities, and improve the overall health and wellbeing of AI/AN populations.

Recipients will increase capacity and infrastructure of the TEC and the tribes and UIOs in their Area to:

deliver at least 3 of the 10 Essential Public Health Services, plan, implement, and evaluate public health programs, implement data-driven, culturally relevant, practice-based public health programs, use evaluation data for program improvement, train staff on public health core competencies, and demonstrate program impact.

This NOFO consists of two components. The CDC will fund:

Up to 12 Component A recipients to increase TEC capacity to strengthen the infrastructure and capacity of TECs, tribes, and UIOs to meet national public health accreditation standards and support the delivery of the 10 Essential Public Health Services to Area tribes and UIOs. CDC will fund one recipient in each IHS Area and the Urban Area, as defined in the glossary of this NOFO.

One Component B recipient to establish a Network Coordinating Center to coordinate with CDC and collaboratively support Component A recipients.

Applicants may apply for both Component A and Component B. If applying for both Component A and Component B, a separate application must be submitted for each.

References:

1. Arias, E., et al. Period life tables for the non-Hispanic American Indian and Alaska Native population, 2007-2009. Am J Public Health, 2014. 104 Suppl 3: p/S312-9.

2. Espey, D.K., et al., Leading Causes of Death and All-Cause Mortality in American Indians and Alaska Natives. Am J Public Health, 2014.

3. Cobb, N., et al. Health Behaviors and Risk Factors Among American Indians and Alaska Natives, 2000-2010. Am J Public Health, 2014.

4. CDC. COVID-19 Mortality Among American Indian and Alaska Native Persons - 14 States, January–June 2020. MMWR 2020, Dec 11; 69(49): 1853–1856

5. National Indian Health Board | Public Health Indian Country Capacity Survey Project

b. Statutory Authorities Section 301(a) of the Public Health Service Act, 42 U.S.C. 241(a).

c. Healthy People 2030 Social Determinants of Health, Public Health Infrastructure, Diabetes, Heart Disease and Stroke, Cancer, Overweight and Obesity, Oral Conditions, Nutrition and Healthy Eating, Physical Activity, Tobacco Use, Drug and Alcohol Use, Injury Prevention, Infectious Disease, Respiratory Disease, Sexually Transmitted Infections, Violence Prevention

d. Other National Public Health Priorities and Strategies National Public Health Accreditation Standards Ten Essential Public Health Services Core Competencies for Public Health Professionals Health Equity and Social Determinants of Health | State Public Health | ASTHO Home - TRAIN Learning Network - powered by the Public Health Foundation CDC Roadmap for Data Modernization

Improving the Use of Program Evaluation for Maximum Health Impact: Guidelines and Recommendations

CDC Social Determinants of Health Native Diabetes Wellness Program

e. Relevant Work 2017 – 2022: Building Public Health Infrastructure in Tribal Communities to Accelerate Disease Prevention and Health Promotion in Indian Country (CDC-RFA-DP17-1704PPHF17) 2018 – 2022: Tribal Practices for Wellness in Indian Country (CDC-RFA-DP18-1812PPHF18) 2018 – 2023: Tribal Public Health Capacity-Building and Quality Improvement Umbrella Cooperative Agreement (CDC-RFA-OT18-1803) 2019 – 2024: Good Health and Wellness in Indian Country (CDC-RFA-DP19-1903) 2022 – 2027: Tribal Practices for Wellness in Indian Country (CDC-RFA-DP22-2201)

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-DP22-2206 Tribal Epidemiology Centers Public Health Infrastructure

(TECPHI)

Logic Model

Strategies and Activities Short-term Outcomes

Intermediate Outcomes (Component A and

Component B Recipients)

Long-term Outcomes

Component A Strategy 1: Strengthen the Tribal Epidemiology Center's (TEC) public health capacity and infrastructure to meet national public health accreditation standards1 and deliver the 10 Essential Public Health Services2

Strategy 2: Strengthen Public Health Capacity and Infrastructure of tribes and Urban Indian Organizations (UIO) to meet national public health accreditation standards and deliver

Increased use of culturally relevant data collection instruments

Increased access to AI/AN data to identify social determinants of health and health priorities

Increased collaboration among TECs, tribes, and UIOs on planning, implementation, and evaluation of culturally relevant public health programs

Increased use of national standards to assess public health infrastructure

Increased TEC, tribal, and UIO capacity to deliver at least 3 of the 10 Essential Public Health Services2

Increased use of evaluation results for program improvement

Increased number of success stories disseminated that demonstrate the program’s impact

Increased TEC, tribal, and UIO capacity to plan, implement, and evaluate culturally relevant public

Strengthened delivery of essential public health services by TECs, tribes, and UIOs to serve AI/AN communities the 10 Essential Public Health Services strengths and gaps

Increased use of public health core competencies3 to assess and guide training for their workforce

Component B Strategy 1: Foster peer-to-peer learning, support training, and share best- or promising-practices among Component A recipients

Strategy 2: Coordinate a national evaluation approach and communication efforts with CDC and Component A recipients

Increased participation in Community(ies) of Practice

Increased monitoring of program achievements health programs

Increased implementation of data-driven, culturally relevant, practice-based public health programs

Increased TEC, tribal, and UIO staff trained in public health core competencies

1. www.cdc.gov/publichealthgateway/accreditation

2. https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.ht ml

3. http://www.phf.org/resourcestools/pages/core_public_health_competencies.aspx

i. Purpose The purpose of this NOFO is to strengthen the public health infrastructure and capacity of 1) Tribal Epidemiology Centers (TECs) and 2) the tribes and Urban Indian Organizations (UIO) they support to meet national public health accreditation standards and deliver the 10 Essential Public Health Services. This work will support efforts to effectively identify and address underlying social determinants of health, reduce persistent health disparities, and improve the overall health and wellbeing of AI/AN populations.

ii. Outcomes Increased TEC, tribal, and UIO capacity to deliver at least 3 of the 10 Essential

Public Health Services Increased use of evaluation results for program improvement Increased number of success stories disseminated that demonstrate the program’s impact

iii. Strategies and Activities

Component A Only Component A applicants must choose at least one activity from each Focus Area under Strategy 1 (for a total of at least 3 activities) that are designed to build the capacity and infrastructure within the TEC. Component A applicants also must choose at least one activity from Strategy 2 that are designed for the TEC to build the capacity and infrastructure of tribes and Urban Indian Organizations (UIO) in the TEC's IHS Area, including the Urban Area as defined in the glossary of this NOFO.

Strategy 1: Strengthen the Tribal Epidemiology Center's (TEC) public health capacity and infrastructure to meet national public health standards and deliver the 10 Essential Public Health Services. Component A applicants must choose at least one activity from each focus area.

Focus Area 1 Activities: Infrastructure building (must choose one activity)

Conduct assessment of TEC capacity and infrastructure to meet national public health accreditation standards and deliver essential public health services, and disseminate results

Develop and implement TEC infrastructure improvement plans based on capacity assessment results

Support TEC workforce development and capacity building by providing on-going training and technical assistance in essential public health services and core public health competencies

Focus Area 2 Activities: Collect and use data to carry out assessments and identify local health priorities (must choose one activity)

Collect, assess, and monitor data on health status of AI/AN populations Use data to identify and describe social determinants of health (SDOH) and identify health priorities, strengths, and disparities for AI/AN populations Develop and implement a plan to improve data quality and data systems for AI/AN populations

Focus Area 3 Activities: Plan, implement and evaluate interventions to address health priorities (must choose one activity)

Identify opportunities and cultivate partnerships to address the social determinants of health (SDOH) in AI/AN populations

Support planning, implementation, monitoring, and evaluation of culturally relevant practiced-based activities to address identified health priorities

Strategy 2: Strengthen Public Health Capacity and Infrastructure of Area tribes and Urban Indian Organizations (UIO) to meet national public health accreditation standards and deliver the 10 Essential Public Health Services. Applicants must choose at least one activity in Strategy 2 to support tribes and UIOs with the development, implementation, and evaluation of plans to carry out the following activities as appropriate for individual tribe/UIO context (e.g., through trainings, TA, or subawards):

Activities (must choose at least one activity to support Area tribes and UIOs):

Collect and/or use data to identify and describe social determinants of health (SDOH) and identify health priorities, strengths, and disparities for AI/AN populations

Assess the capacity and performance of tribes’ and UIOs’ public health system to meet national public health accreditation standards and deliver essential public health functions

Develop and implement infrastructure improvement plans based on capacity assessment results

Conduct a comprehensive planning process resulting in a tribal/community health improvement plan

Provide resources, training, and technical assistance to tribes and UIOs to support the implementation, monitoring, and evaluation of the tribal/community health improvement plan

Support tribal and UIO public health workforce development by offering training in core public health competencies and internship/training opportunities

In addition to the strategies and activities listed above and in the Logic Model, all Component A recipients must:

Participate in the Community of Practice (CoP) facilitated by the Component B recipient. The CoP will consist of monthly virtual meetings and trainings to convene all recipients to share ideas, successes, and challenges, exchange lessons learned, and establish best practices.

Create a sustainability plan to sustain increased workforce capacity and enhanced public health infrastructure beyond the 5-year period of performance.

Component B Only Applicants must address all activities for both Strategy 1 and Strategy 2.

Strategy 1: Foster peer-to-peer learning, support training, share best- or promising-practices, and support sustainability efforts among Component A recipients.

Activities:

Develop and implement coordinated, collaborative Communities of Practice (CoP) to facilitate training, peer-to-peer learning, knowledge-sharing, and problem-solving among Component A recipients

Create a data/information sharing platform to support dissemination of information among Component A recipients

Conduct training needs assessment with Component A recipients Provide training and support for development of sustainability plans

Strategy 2: Coordinate a national evaluation approach and communication efforts with CDC and Component A recipients.

Activities:

Collaborate with CDC and Component A recipients to develop a national evaluation plan for Tribal Epidemiology Centers Public Health Infrastructure (TECPHI)

Collaborate with CDC and Component A recipients to identify and collect annual performance measures for TECPHI

Develop and disseminate products to communicate evaluation results and findings to public health partners including Component A recipients, tribes, UIOs, CDC, and external partners

1. Collaborations

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

Recipients are encouraged to collaborate with each other, and other programs funded by CDC, particularly those that are working to mitigate risk factors associated with diabetes, heart disease, stroke, cancer, obesity, and other chronic disease conditions, and partners working on public health infrastructure and capacity building initiatives such as national public health accreditation standards, public health core competencies, and Essential Public Health Services.

National initiatives, guidelines, and policies have been identified from The Community Guide and CDC’s Division of Nutrition, Physical Activity, and Obesity; Division of Diabetes Translation; Division for Heart Disease and Stroke Prevention; Division of Cancer Prevention and Control, Division of Oral Health and the Office on Smoking and Health that may complement and build on effective, culturally grounded activities. In addition, CDC’s Center for Surveillance, Epidemiology, and Laboratory Services is a valuable resource for support for epidemiology, surveillance, health communication, and public health training. Examples of CDC programs that may provide collaboration opportunities to support achievement of NOFO outcomes include Good Health and Wellness in Indian Country, Tribal Practices for Wellness in Indian Country, the National Native Network for Tobacco Control, the WISEWOMAN (Well- Integrated Screening and Evaluation for WOMen Across the Nation) program, Racial and Ethnic Approaches to Community Health (REACH), the High Obesity Program, Tribal Capacity Building, and Capacity Building Assistance-Partnerships .

Component A recipients will be required to collaborate with and participate in the Community of Practice (CoP) facilitated by the Component B recipient. The CoP will consist of monthly virtual meetings and trainings to convene all recipients to share ideas, successes, and challenges, exchange lessons learned, and establish best practices.

NOTE: If a Component A recipient is not a Tribal Epidemiology Center (TEC), it is expected and required that the recipient will collaborate with the TEC in their IHS area or the Urban Area to carry out the strategies and activities described in this NOFO. As described in the Organizational Capacity section of this NOFO, Component A applicants who are not a TEC must provide a Letter of Support outlining how the TEC in the applicant’s IHS area or the Urban Area will collaborate with the applicant to achieve the NOFO outcomes.

b. With organizations not funded by CDC:

Recipients are encouraged to collaborate with Indian Health Service’s (IHS) Health Promotion Disease Prevention, IHS’s Special Diabetes Program for Indians, National Council for Urban Indian Health (NCUIH), Healthy Native Communities Partnership, National Indian Health Board (NIHB), Public Health Accreditation Board (PHAB), National Network of Public Health Institutes (NNPHI)

2. Target Populations Target populations include Tribal Epidemiology Center staff and partners, tribal and Urban Indian Organization staff, and AI/ANs, including urban Indians.

As described in the work plan narrative section, applicants are expected to describe the target population served by specifying the tribes or UIOs to be served and generally describing the AI/AN population, including anticipated number of tribes and tribal members (including urban Indians, as appropriate) reached by strategies and activities.

a. Health Disparities This work will support efforts to effectively identify and address underlying social determinants of health, reduce persistent health disparities, and improve the overall health and wellbeing of AI/AN populations.

iv. Funding Strategy This NOFO will fund recipients to serve each Indian Health Service (IHS) Area, including the Urban IHS Area as defined in the glossary of this NOFO. CDC expects to fund up to 12 Component A recipients and only one (1) Component B recipient. Only one Component A recipient will be selected per IHS Area and the Urban Area. The IHS Areas include the following: Alaska Area, Albuquerque Area, Bemidji Area, Billings Area, California Area, Great Plains Area, Nashville Area, Navajo Area, Oklahoma City Area, Portland Area, and Phoenix/Tucson Area. There is also an Urban Area for the purposes of and defined in the glossary of this NOFO.

Component A award amounts will be based, in part, on the number of federally recognized Indian tribes or villages or Urban Indian Organizations in the applicant’s IHS Area. Applicants must serve their entire IHS Area, or if proposing to serve the Urban Area, the applicants must serve all Urban Indian Organizations that currently receive funding from the IHS under Title V of the Indian Health Care Improvement Act.

Component A Applicants: Number of tribes served

Maximum funding amount

One tribe $300,000 2 to 19 tribes $464,420 20 to 49 tribes $539,715 50+ tribes $596,577

Maximum funding amount Component B Applicants $500,000

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Evaluation and Performance Measurement: 1) help demonstrate achievement of program outcomes; 2) build a stronger evidence base for specific program interventions; 3) clarify applicability of the evidence base to different populations, settings, and contexts; 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.

CDC Evaluation and Performance Management Strategy Throughout the five-year project period, CDC will use a participatory process to work individually and collectively with recipients for Components A and B to answer the following evaluation questions based on the program Logic Model and activities.

Component A Recipients:

Question 1: To what extent has the Tribal Epidemiology Centers’ (TECs) public health capacity and infrastructure been strengthened to meet national public health accreditation standards and deliver the 10 Essential Public Health Services?

Question 2: To what extent has the public health capacity and infrastructure of tribes and Urban Indian Organizations (UIO) been strengthened to meet national public health accreditation standards and deliver the 10 Essential Public Health Services?

Component B Recipient:

Question 1: To what extent has the Component B recipient supported training and fostered peer-to-peer learning and sharing of best- or promising-practices among Component A recipients?

Question 2: To what extent has the Component B recipient identified promising practices, developed success stories, and in other ways demonstrated the program’s impact?

To answer these questions, CDC will use a three-pronged evaluation approach. Recipients will be required to: 1) report on performance measures, 2) develop and implement recipient-specific evaluation plans and report the findings of the evaluations, and 3) participate as requested in national evaluation studies.

The Component B recipient, in collaboration with Component A recipients and with CDC, will develop and finalize a national evaluation plan within the first 12 months of the program. This national evaluation plan, which may be periodically updated, will contain, at minimum, a final set of performance measures, a timeline and methods for annual data collection, role and responsibilities for the national evaluation, and a communication and dissemination plan.

The Component B recipient, in collaboration with CDC and Component A recipients, will identify performance measures that align with their chosen activities, define the performance measures, and assist with identification of available and feasible data sources for these measures.

Recipients are responsible for gathering and analyzing the data for the performance measures and recipient-specific evaluations.

Recipients will be required to propose baseline and target performance measures for their planned activities within the first 6 months of the award. Applicants may choose to submit baseline and targets with the application, if known. CDC will work with recipients in the first 6 months of the award to finalize these measures, if needed. Though performance measures will be finalized in the first year of the program, a sample of proposed process and outcome measures for Components A and B are listed below:

Component A:

Proportion of recipients consistently participating in the Network Coordinating Center’s CoPs

Proportion of recipients that use the Core Competencies in continuing education /training plans for their workforce

Number of recipients whose capacity to collect or enhance tribal health data was improved (e.g., new surveillance systems, established linkages)

Number of TECs/ tribes/UIOs that have collaboratively developed tribal/community health assessments and plans that summarize community assets and health needs, and identify tribal/community health priorities

Number of TECs/ tribes/UIOs who use culturally relevant public health communication tools and resources to disseminate public health information to partners (e.g., health education materials, success stories)

Number of TECs/tribes/UIOs who implement health promotion and disease prevention activities

Number of TECs/tribes/UIOs reporting progress towards meeting national public health accreditation standards

Component B:

Proportion of Component A recipients consistently participating in Communities of Practice

Increased number of promising practices identified, and success stories developed, demonstrating the program’s impact

In collaboration with the Component B recipient, CDC will assist Component A recipients to develop evaluation plans. Component A recipients will draft evaluation plans by the 6th month of the NOFO award. In collaboration with CDC, the Component B recipient will develop reports yearly on the aggregate annual performance measure and recipient evaluation plan results to be disseminated by multiple methods to recipients and other key partners. These aggregate findings may also be presented during site visits and recipient meetings.

As resources permit, and in collaboration with CDC, the Component B recipient will identify and conduct additional national evaluation projects to evaluate program activities and outcomes.

A DMP is required if the activity involves the collection or generation of public health data ("Public health data" means digitally recorded factual material commonly accepted in the scientific community as a basis for public health findings, conclusions, and implementation.

Public health data includes those from research and non-research activities). Recipients collecting public health data will be required to submit a DMP that will provide at a minimum:

A description of the data to be collected or generated in the proposed project;

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

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

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; and

Other additional requirements based on the program.

Applicants may not be able to provide all this information when applying; in these instances, applicants should include a DMP that is as complete as possible. An OMB-approved DMP template for this program is available here.

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 the 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) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual progress reports. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data;

data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additional-requirements/ar-25.html.

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

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

Describe key evaluation questions to be addressed by these evaluations.

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

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

Recipients are encouraged to budget up to 10% of the total funding award to evaluation activities.

At the end of the five-year period of performance, CDC, in collaboration with the Component B recipient, will report relevant outcome data from the analyses of performance measures. Reports will be disseminated to key partners as noted above through multiple methods. CDC will use the overall evaluation findings from the five-year period of performance to establish key recommendations on program impact, sustainability, and continued program improvement upon completion of the award. CDC intends information from this project to further inform the evolving evidence base of strategies and approaches that are most likely to be successful in Indian Country.

c. Organizational Capacity of Recipients to Implement the Approach The ideal applicant would be a recognized leader and partner providing public health support to and with tribes or UIOs in their IHS Area or the Urban Area. They would demonstrate previous experience providing public health leadership, surveillance, epidemiology, public health program design, implementation, evaluation, and technical assistance and training in their IHS Area. Applicants should have the critical understanding or experience of working in AI/AN communities and sovereign tribal governments where cultural sensitivity, an awareness of history, and establishing trust are critical for success.

General Capacity (Component A and Component B): Applicants should describe their organizational capacity to carry out the activities, strategies, performance measurement, and evaluation requirements, as outlined in this NOFO, including the following:

Provide CV/resumes for the Project Director/Principal Investigator (PD/PI), Program Coordinator and evaluator or position descriptions (if positions are vacant). Upload the documentation as a single PDF file titled “CV/resumes” under “other attachments/mandatory other attachments.”

Applicants should have systems for fiscal management that will ensure funds are used appropriately.

In addition to the General Capacity requirements above, Component A applicants should:

Provide a letter of support from the TEC in the applicant’s IHS Area or Urban Area, if the applicant is not a TEC. The letter of support must be signed by the current TEC director, or equivalent acting official, as indicated in the letter’s signature block. The letter should state the TEC’s intent to work with the applicant on all NOFO requirements. Upload the documentation as a single PDF file titled “TEC Letter of Support” under “other attachments/mandatory other attachments.”

Demonstrate a service population of at least 60,000 AI/AN persons. The number of AI/AN people served must be substantiated by documentation describing IHS user populations, U.S. Census Bureau data, clinical catchment data, or any method that is scientifically and epidemiologically valid. Upload the documentation as a single PDF file titled “Documentation of Service Population” under “other attachments/mandatory other attachments.”

Provide an organizational chart and indicate titles of staff who will be responsible for key tasks, including leadership of project (program coordinator), monitoring of the project’s ongoing progress, preparation of reports, conduct program evaluation, and communicate with partners and CDC. Upload the documentation as a single PDF file titled “Organizational chart” under “other attachments/mandatory other attachments.”

Describe experience and expertise in providing public health leadership, surveillance, epidemiology, public health program design, implementation, evaluation, and technical assistance and training to and with tribal and/or urban AI/AN communities in the applicant’s IHS or Urban area.

Describe experience and expertise partnering with tribes or UIOs in the applicant’s IHS Area or Urban Area to provide public health leadership and technical assistance and training to support surveillance, epidemiology, public health program design, implementation, and evaluation.

Provide organization mission statement that describes how the applicant’s mission aligns with the following activities: provide public health leadership and technical assistance and training to support surveillance, epidemiology, public health program design, implementation, and evaluation to and with tribal and/or urban AI/AN communities.

Upload the documentation as a single PDF file titled “Mission Statement” under “other attachments/mandatory other attachments.”

Provide an adequate staffing plan, including an organizational chart and indicates titles of staff, to carry out the project and identifies a program coordinator dedicated to this program, an experienced evaluator, other staff with expertise in the areas of work, as appropriate, including surveillance, epidemiology, training, and program planning and implementation. Upload the documentation as a single PDF file titled “Staffing Plan” under “other attachments/mandatory other attachments.”

Provide documentation that describes support from the applicant’s tribes or UIOs within the IHS Area or Urban Area to be served. Documentation of support may be demonstrated by Tribal Resolutions, blanket Tribal Resolutions, Tribal letters of support or a letter of support from urban Indian clinic directors and/or Chief Executive Officers (CEOs). Upload the documentation as a single PDF file titled “Tribal/UIO LOS” under “other attachments/mandatory other attachments.”

In addition to the General Capacity requirements above, Component B Applicants should:

Provide an organizational chart and adequate staffing plan, including a program coordinator for, necessary to establish and maintain a robust network of Component A recipients to collaborate on program implementation and evaluation, communication knowledge-sharing and problem-solving. Upload the documentation as a single PDF file titled “Staffing Plan” under “other attachments/mandatory other attachments.”

Describe previous experience developing and supporting Communities of Practice and collaborative networks to establish and maintain a robust network of Component A recipients to collaborate on program implementation and evaluation, communication, knowledge-sharing, and problem-solving.

Describe previous experience collaborating with all Tribal Epidemiology Centers.

Describe the capacity to develop and maintain a data/information sharing platform to support dissemination of information among Component A recipients or contract for such services.

Describe previous experience developing national evaluation plans.

d. Work Plan Component A and Component B applicants are required to provide:

A detailed, descriptive year-one work plan (example below) including intended outcomes, strategies and activities, timelines, and assigned staff to support the achievement of NOFO outcomes. Strategies must be in alignment with the NOFO Logic Model.

Identification of staff, contractors, and/or consultants, sufficient in number and expertise to carry out the proposed activities.

A work plan narrative describing:

The Component for which the applicant is applying. If applying for both Component A and Component B, two separate applications must be submitted.

Details for each strategy/activity included in the work plan.

A high-level overview of years 2 – 5.

In addition to these requirements, the following additional information is required for each Component.

Component A Applicants:

Work plans for Component A applicants must include, at a minimum:

For Strategy 1, at least one activity in each of the three focus areas listed in the “Strategies and Activities” section.

For Strategy 2, at least one activity from the activities listed in the “Strategies and Activities” section.

Activities to create a sustainability plan to sustain increased workforce capacity and enhanced public health infrastructure beyond the 5-year period of performance.

Work plan narrative for Component A applicants should include:

Description of the target population served. The work plan narrative should specify the tribes or UIOs to be served and generally describe the AI/AN population to be served by the applicant, including anticipated number of tribes and tribal members (including urban Indians, as appropriate) reached by strategies and activities.

Description of how the applicant will effectively participate in and support the Community of Practice(s) established by the Network Coordinating Center, including routine monthly virtual engagements and other collaborative efforts.

Component B Applicants:

Work plans for Component B applicants must include, at a minimum:

For Component B Strategy One, all activities listed in the Component B “Strategies and Activities” section.

For Component B Strategy Two, all activities listed in the “Strategies and Activities” section.

Work plan narrative for Component B applicants should include:

Description of how the applicant will engage with all TECs to create a network for peer-to- peer learning and information sharing.

Description of how the applicant will work with TECs to develop a national evaluation plan and performance measures.

Description of how the applicant will work with TECs to develop and disseminate communication products.

An example work plan is provided below. If another format is used for the application, the work plan must include all information contained in the example work plan. Applicants should refer to the Logic Model when developing the work plan. CDC will provide feedback and technical assistance to recipients to finalize the work plan activities post-award.

Example Work Plan (optional)

Component (A or B)

Strategy:

Focus Area: (Component A applicants only) Period of Performance (5-year) Intermediate Outcome: (from Logic Model) Activity Description Short-term

(1-year) Outcome (from the Logic Model)

Performance Measure

Responsible Position/Party

Due Date

Example: Assess the capacity and performance of tribes’ and UIOs’ public health system to meet national public health accreditation standards and deliver essential public health services

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

In a Cooperative Agreement, CDC and recipients share responsibility for successfully implementing the award and meeting identified outcomes. The following areas of substantial involvement will be provided by CDC:

I. Technical Assistance

Serve as a member, technical consultant, and advisor to the Component B recipient.

Provide scientific and programmatic technical assistance and advice as needed to assist recipients in achieving the project objectives.

Facilitate distribution and dissemination of information and outcomes.

Contribute to analyses, publications, technical reports, and other products as co-authors within the CDC authorship guidelines, as helpful.

Work with recipients to identify the best solutions and innovations to support effective, culturally relevant, and respectful program implementation.

Provide professional development and training opportunities – either in person or through virtual web-based training formats – for the purpose of sharing best practices, success stories, and program models.

II. Information Sharing between Recipients

Assist the Component B recipient in establishing learning communities to facilitate the sharing of information among all recipients.

III. Additional Support

Coordinate communication and program linkages with other CDC programs.

Coordinate communication and program linkages with other Federal agencies, such as Health Resources and Services Administration (HRSA), Centers for Medicare and Medicaid Services (CMS), United States Department of Agriculture (USDA), Food and Drug Administration (FDA), Indian Health Service (IHS), and the National Institutes of Health (NIH).

Translate and disseminate lessons learned through publications, meetings, and other means on promising and best practices to expand the evidence base.

B. Award Information

1. Funding Instrument Type:

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

2. Award Mechanism:

U58

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$6,699,999

5. Total Period of Performance Funding:

$33,499,995 This amount is subject to the availability of funds.

Estimated Total Funding:

$33,499,995

6. Total Period of Performance Length:

year(s)

7. Expected Number of Awards:

Up to 12 Component A awards and up to 1 Component B award.

8. Approximate Average Award:

$509,592 Per Budget Period

Average award for Component A: $510,392

Average award for Component B: $500,000

Subject to availability of funding, including both direct and indirect costs.

9. Award Ceiling:

$596,577 Per Budget Period

This amount is subject to the availability of funds.

Component A ceiling: $596,577 Component B ceiling: $500,000

10. Award Floor:

$300,000 Per Budget Period

Component A award floor: $300,000 Component B award floor $500,000

11. Estimated Award Date:

August 31, 2022

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.

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

C. Eligibility Information

1. Eligible Applicants Eligibility Category:

00 (State governments)

01 (County governments)

02 (City or township governments)

04 (Special district governments)

05 (Independent school districts)

06 (Public and State controlled institutions of higher education)

07 (Native American tribal governments (Federally recognized))

08 (Public housing authorities/Indian housing authorities)

11 (Native American tribal organizations (other than Federally recognized tribal governments))

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

13 (Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education)

20 (Private institutions of higher education)

23 (Small businesses)

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

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

22 (For profit organizations other than small businesses)

Additional Eligibility Category:

Government Organizations:

State governments or their bona fide agents (includes the District of Columbia)

Local governments or their bona fide agents

Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau

State controlled institutions of higher education

American Indian or Alaska Native tribal governments (federally recognized or state-recognized)

Non-government Organizations

American Indian or Alaska native tribally designated organizations

2. Additional Information on Eligibility The intent of this Notice of Funding Opportunity Announcement is to support Tribal Epidemiology Centers (TECs) that have been established to serve each IHS or Urban Area Urban Indian Organizations | Office of Urban Indian Health Programs (ihs.gov).

Applications submitted will be considered non-responsive and will not receive further review if the following criteria is not met:

1. Applicants must identify the component they will be applying for in the project abstract.

If the applicant does not identify the component in the project abstract, the application will be deemed non-responsive.

Component A applicants:

1. Must be physically located and operate within the IHS Area or Urban Area for which the work is proposed. Applicants must identify the IHS Area or Urban Area in which they will do the proposed work in the project abstract. If the IHS Area or Urban Area is not identified in the project abstract the application will be deemed non-responsive.

2. Must identify if they are a TEC or not a TEC in the…