Foa_Content_of_CDC-RFA-EH21-2102 (2).pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR ENVIRONMENTAL HEALTH

Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children

CDC-RFA-EH21-2102

11/09/2021

Table of Contents A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Application and Submission Information

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview 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- EH21-2102. 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:

Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children 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-EH21-2102

E. Assistance Listings Number:

93.197 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.

2. Due Date for Applications:

11/09/2021 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

An informational conference call will be scheduled. Details about the informational call will be posted at: https://www.cdc.gov/nceh/lead/

G. Executive Summary:

1. Summary Paragraph This announcement was amended to include the following.

1. The Statutory Authority was changed from 42 U.S.C. Section 247b-1 to 247b(k)(2)

2. The Application Due Date was changed from 04/25/2021 to 05/14/2021 All changes are reflected under applicable sections in the NOFO.

The Centers for Disease Control and Prevention (CDC) announces the availability of fiscal year (FY) 2021 funds that will be awarded through cooperative agreements to support primary and secondary prevention strategies for childhood lead poisoning prevention and surveillance including: ensuring blood lead testing and reporting; enhancing blood lead surveillance;

improving linkages to recommended services and developing policies for targeted, population-based interventions with a focus on community-based approaches for lead hazard elimination. As part of this Notice of Funding Opportunity (NOFO), recipients will be expected to demonstrate that processes are in place to identify children exposed to lead and link them to recommended services. To do so, recipients will be expected to work closely with other agencies and healthcare providers serving children, to ensure that a comprehensive system of identification, referral, follow-up, and evaluation is in place for children exposed to lead.

a. Eligible Applicants:

Limited

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards Component A: 51 Component B: 10

d. Total Period of Performance Funding:

$100,000,000

e. Average One Year Award Amount:

$350,000 Component A: $350,000 Per Budget Period Component B: $250,000 Per Budget Period

f. Total Period of Performance Length:

g. Estimated Award Date:

September 30, 2021

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview Significant progress has been made in reducing population exposures to lead in the United States due, in large part, to successful policies aimed at the removal of lead in gasoline and control of lead in residential paint and consumer products. Nonetheless, there is no safe blood lead level (BLL), and hundreds of thousands of U.S. children still have BLLs that are unacceptably high.

More effective screening (see Glossary for blood lead screening definition) and follow-up is needed and must be focused where children at highest risk are most likely to benefit. Young children are particularly vulnerable to the long-term health and developmental effects of lead exposure including intellectual and behavioral deficits. The primary source of lead exposure to children is the home environment: some 24 million homes have significant lead-based paint hazards and at least 6-10 million homes have lead service lines that may result in exposure to lead from drinking water. Deteriorating paint, depositions from leaded gasoline, hazardous waste sites, and industrial emissions can also create lead hazards in dust and soil in and around the home. In addition, children may be exposed through other sources (e.g., consumer products or foods decorated or made with lead, workplace hazards brought home from the job, certain traditional remedies and cosmetics used in certain cultures, lead-based hobbies or recreational activities). Primary prevention – the removal of lead hazards from the environment before a child is exposed – is the most effective way to ensure that children do not experience the harmful effects of lead exposure. However, blood lead screening tests and secondary prevention strategies remain an essential safety net for children who may be exposed to lead. Low-income and minority children bear a disproportionate burden of lead exposure risk and significant disparities in BLLs exist by race/ethnicity, poverty status, and geographic location. Public health action is needed to improve health equity by supporting strategies and activities to eliminate disparities in BLLs by social, demographic, and geographic factors and, ultimately, eliminate childhood lead poisoning as a public health problem. CDC’s key programmatic strategy is to strengthen childhood lead poisoning prevention programs by improving blood lead screening test rates, identifying high- risk populations, and ensuring effective follow-up for children with elevated BLLs. State-based childhood blood lead surveillance systems need to integrate information from several sources including: childhood lead poisoning prevention programs at the state and local levels, public and private laboratories, health care providers, and other state and local health, environmental, and housing agencies. One inherent limitation of these systems is the reliance on data reported by clinical laboratories and healthcare providers which are often incomplete. Assuring accurate and complete reporting of all blood lead tests, including information on sociodemographic and geographic risk factors, is a vital component of effective surveillance to ensure health equity.

Therefore, CDC will support recipients in accomplishing these strategies through two components. Component A includes coordinating statewide screening and testing plans, implementing effective blood lead surveillance systems, and supporting linkages to services.

Component B includes developing targeted population-based interventions for local jurisdictions.

b. Statutory Authorities This NOFO was amended to change the Statutory Authorities from 42 U.S.C. Section 247b- 1 to 42 U.S.C. Section 247b(k)(2)

c. Healthy People 2030 CDC’s National Center for Environmental Health (NCEH) is committed to achieving the HHS health promotion and disease prevention objectives of Healthy People 2030 found at:

https://www.healthypeople.gov/. This NOFO addresses the Healthy People 2030 topics of Housing and Homes and Environmental Health. This NOFO is specifically committed to addressing the Healthy People 2030 goals of reducing: (1) exposure to lead and (2) blood lead levels in children ages 1-5.

d. Other National Public Health Priorities and Strategies This NOFO supports the Federal Action Plan to Reduce Childhood Lead Exposures and Associated Health Impacts developed by the Lead Subcommittee of the President Task Force on Environmental Health Risks and Safety Risks to Children.

e. Relevant Work The Lead Contamination Control Act of 1988 authorized CDC to initiate program efforts to eliminate childhood lead poisoning in the United States. From 1990 to 2012, CDC supported comprehensive childhood lead poisoning prevention programs in state and local health departments. From 2014 to 2020, CDC supported strategic programmatic activities to rebuild capacity under CDC-RFA-EH14-1408; CDC-RFA-EH17-1701; and CDC-RFA-EH18-1806.

This NOFO supports approaches for coordinating screening and testing plans, implementing effective blood lead surveillance systems, and developing policies and strategic partnerships and interventions to ensure a comprehensive system exists for the identification, referral, and follow-up of children exposed to lead.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-EH21-2102 Logic Model:

Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children

Strategies and Activities Short-Term Outcomes

Intermediate Outcomes

Long-Term Outcomes

1. Ensure Blood Lead Testing and Reporting

· Develop and sustain a statewide Lead Advisory Committee.

Increased collaboration and coordination between appropriate stakeholders.

Improved blood lead testing and reporting rates for children less than 6 years of age at risk

Decreased disparities in blood lead levels by race/ethnicity

· Develop or update and implement an appropriate statewide screening plan based on local data.

Increased awareness of pediatric health care providers and clinical laboratories of state blood lead testing recommendations and reporting requirements.

for lead exposure.

Increased linkages between complementary data systems (e.g., Medicaid, immunization, adult blood lead, vital statistics).

2. Enhance Blood Lead Surveillance

· Develop, update, or maintain a blood lead surveillance system that collects and tracks all blood lead test results and follow-up data on children with elevated blood lead levels including environmental source investigations and referrals to recommended services.

· Develop and implement plans for surveillance data collection, data quality, and data dissemination with a focus on data interoperability.

· Conduct analyses of surveillance data to identify lead-exposed children, high-risk populations, and geographic areas.

Increased identification of geographic areas and populations at-risk for lead exposure using enhanced data linkages.

Improved use of surveillance system data to capture missing data on child demographic and follow-up information.

and socioeconomic status

Decrease adverse health effects of lead exposure in children

Decreased societal costs associated with childhood lead exposure (e.g., healthcare, special education, criminal justice system).

Decreased number of children living in environments at high risk of lead exposure.

Increased identification, tracking, and recommended services for children with elevated blood lead levels.

3. Improve Linkages of Lead- Exposed Children to Recommended Services

· Identify children with elevated blood lead levels requiring follow-up

· Partner with programs and organizations that provide services to mitigate the effects of elevated blood lead levels.

· Connect children with elevated blood lead levels to recommended medical, environmental, and social services.

Increased ability for public health agencies, health care professionals, and other stakeholders to provide linkages to services and reduce loss to follow-up.

Improved rates of children less than 6 years of age with elevated blood lead levels linked to recommended services.

4. Develop Targeted Population- Based Policy Interventions

· Develop strategic partnerships and policies to implement targeted, population-based interventions aimed at primary prevention of lead exposure with a focus on community-based approaches for lead hazard elimination.

Improved policies for targeted community- based approaches aimed at primary prevention of lead exposure in children.

Decreased lead hazards in housing occupied by vulnerable populations (such as children).

Decrease other sources of lead exposure in targeted communities.

i. Purpose This NOFO supports overarching program strategies related to:

1. secondary prevention of childhood lead poisoning through the core public health functions of assurance (ensuring blood lead testing and reporting, and improving linkages to recommended services) and assessment (enhancing blood lead surveillance) –and–

2. primary prevention of childhood lead poisoning through targeted, population-based policy interventions with a focus on community-based approaches for lead hazard elimination.

ii. Outcomes

Recipients must be able to use their childhood blood lead surveillance system to collect and report data to CDC to support the following period of performance outcomes (shown in bold on the CDC-RFA-EH21-2102 Logic Model: Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children):

Improved blood lead testing and reporting rates for children less than 6 years of age at risk for lead exposure (e.g., screening/testing penetrance and the incidence and prevalence of children with blood lead levels greater than or equal to the CDC blood lead reference value) and other important blood lead levels categories.

Improved use of surveillance system data to capture missing data on child demographic and follow-up information (e.g., address, race/ethnicity, socioeconomic status, small geographic area [zip code or census tract], referrals to recommended services, completion of services by type).

Improved rates of children less than 6 years of age who meet state case definitions who are linked to recommended services (e.g., environmental inspections, medical evaluations, nutritional counseling, developmental milestones).

Decreased disparities in blood lead levels by race/ethnicity and socioeconomic status.

iii. Strategies and Activities COMPONENT A: Blood Lead Screening, Surveillance, and Linkages to Care

Strategy 1. Ensure Blood Lead Testing and Reporting:

Develop and sustain a statewide lead advisory committee comprised of appropriate stakeholders (e.g., representatives from academia, healthcare, non-profit or community- based organizations, clinical laboratories, state and local housing agencies, tribes or tribal organizations).

o Evidence of a functioning and sustainable statewide advisory committee to make statewide recommendations for blood lead testing based on local data.

Develop or update and implement an appropriate statewide screening and testing plan based on local data in collaboration with statewide lead advisory committee.

o Evidence of a statewide screening and testing plan based on current data that provides clear blood lead testing guidance to pediatric healthcare providers.

o Evidence of a blood lead test reporting policy to ensure that clinical laboratories and healthcare providers understand and comply with reporting requirements.

o Evidence of a sustainability plan to ensure regular review of data and updates needed to statewide screening/testing recommendation.

Strategy 2. Enhance Blood Lead Surveillance:

Develop, update, or maintain a blood lead surveillance system that collects and tracks all blood lead test results and follow-up data on children with elevated blood lead levels including environmental source investigations and referrals to recommended services.

o Evidence of a sustainable and integrated childhood blood lead surveillance system able to generate population-level screening/testing rates and follow-up data on environmental source investigations and referrals to recommended services.

o Evidence of ability to collect essential information including race/ethnicity, socioeconomic status, and geographic locations at the zip code or census tract level.

Develop and implement plans for surveillance data collection, data quality checks, and data dissemination with a focus on data interoperability.

o Evidence of strategic collaborations with relevant agencies (e.g., state Medicaid, vital records, immunization program) to generate appropriate denominators (e.g., total population of children age 6 years or younger, total number of children enrolled in Medicaid by age) and risk-factor data (see “Target Populations”).

o Evidence of surveillance system data management and analysis plans with appropriate stakeholders’ roles and responsibilities outlined.

Conduct analyses of surveillance data to identify lead-exposed children, high-risk populations, and geographic areas.

o Evidence of surveillance system reporting and dissemination plans with appropriate stakeholders’ roles and responsibilities outlined.

Strategy 3. Improve Linkages of Lead-Exposed Children to Recommended Services:

Identify children with elevated blood lead levels requiring follow-up.

o Evidence of alerts available in surveillance system to flag and track children with elevated blood lead levels requiring follow-up.

Partner with programs and organizations that provide services to mitigate the effects of elevated blood lead levels.

o Evidence of data sharing, data matching, and/or memoranda of understanding/agreement with key partners.

Connect children with elevated blood lead levels to recommended medical, environmental, and social services.

o Evidence of ability to capture information on referrals to recommended services (e.g., case management services initiated, received, and completed) within the surveillance database.

COMPONENT B: Targeted Interventions

Strategy 4. Develop Targeted, Population-Based Interventions:

Develop strategic partnerships and policies to implement targeted, population-based interventions aimed at primary prevention of lead exposure with a focus on community- based approaches for lead hazard elimination.

o Evidence of a detailed policy design and implementation plan, including timeline, objectives, methods, and key stakeholders.

o Ability to develop and conduct outreach as well as education to lead workforce, partners, and other stakeholders;

o Description of a plan to educate public, partners, and stakeholders about lead-related issues

1. Collaborations

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

ALL APPLICANTS

Applicants should provide evidence of any collaborations with other relevant CDC programs and CDC-funded organizations. Examples of relevant CDC programs include, but are not limited, to:

Environmental Public Health Tracking (EPHT) Program http://www.cdc.gov/nceh/tracking/

Adult Blood Lead Epidemiology and Surveillance (ABLES) Program https://www.cdc.gov/niosh/topics/ables/

ATSDR Partnership to Promote Local Efforts to Reduce Environmental Exposure (APPLETREE) Programs https://www.atsdr.cdc.gov/states/index.html

Pediatric Environmental Health Specialty Units https://www.pehsu.net/ Developmental Disabilities https://www.cdc.gov/ncbddd/developmentaldisabilities/index.html

Immigrant and Refugee Health https://www.cdc.gov/immigrantrefugeehealth/index.html

National Asthma Control Program https://www.cdc.gov/asthma/nacp.htm Immunization Information Systems https://www.cdc.gov/vaccines/programs/iis/index.html

National Vital Statistics System https://www.cdc.gov/nchs/nvss/births.htm Racial and Ethnic Approaches to Community Health (REACH) https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm

Strategies should be implemented for leveraging resources from other allowable federally-funded programs and/or state, local, charity, nonprofit or for-profit entities, or internal agency programs. Applicants are expected to develop a sustainability plan working with partners to assure that the goals of the project and efforts to achieve desired outcomes will continue beyond the period of performance.

b. With organizations not funded by CDC:

ALL APPLICANTS

Applicants should engage applicable state agencies in partnership agreements (e.g., State Medicaid agency, vital statistics).

Applicants should provide an MOU, MOA, data-sharing agreement, or letter of support to verify evidence of a collaboration with the state agency to share data on children less than 16 years of age. The appropriate document should be uploaded as a single PDF, combined with any other documents on optional collaborations (below), using the file name "MOUs/MOAs" at www.grants.gov.

Applicants should also engage other relevant federal, state, and local government agencies;

tribes or tribal organizations; hospitals and health care providers; clinical laboratories; non-government organizations; non-profit agencies; private foundations and businesses; and academic institutions in their jurisdictions, particularly those with a focus on child health and environmental/occupational health, and leverage resources and opportunities to reach target populations, share data/information, and achieve outcomes expected under this NOFO.

Applicants should provide MOU, MOA, or letter of support to verify evidence of the collaborations. The appropriate documents should be uploaded as a single PDF, combined with any other documents using the file name "MOUs/MOAs" at www.grants.gov. Examples of such organizations include, but are not limited, to:

U.S. Department of Housing and Urban Development (HUD) Office of Lead Hazard Control and Healthy Homes (OLHCHH) https://www.hud.gov/program_offices/healthy_homes

Centers for Medicare and Medicaid Services (CMS) Early and Periodic Screening, Diagnostic and Treatment (EPSDT) https://www.medicaid.gov/medicaid/benefits/epsdt/index.html

Special Supplemental Nutrition Program for Women, Infants and Children (WIC) https://www.fns.usda.gov/wic

Health Resources & Services Administration (HRSA): State Title V Maternal and Child Health programs; Maternal, Infant, and Early Childhood Home Visiting Program; Healthy Start Program https://mchb.hrsa.gov/

U.S. Environmental Protection Agency (EPA) https://www.epa.gov/lead U.S. Department of Education Early Childhood Education Initiatives https://www2.ed.gov/about/inits/ed/earlylearning/index.html

Indian Health Service Environmental Health Support Center https://www.ihs.gov/ehsc/

Community-based, nonprofit and/or faith-based organizations State and local health and housing agencies Private and public laboratories Hospitals and healthcare systems Academic institutions Accredited environmental health and housing practitioners and their organizations

Strategies should be implemented for leveraging resources from other allowable federally-funded programs and/or state, local, charity, nonprofit or for-profit entities, or internal agency programs. Applicants are expected to develop a sustainability plan working with partners to assure that the goals of the project and efforts to achieve desired outcomes will continue beyond the period of performance.

COMPONENT B

If the applicant is not a state health department or bona fide agent of the state:

Applicants must provide a letter of support from the state indicating willingness to coordinate prevention efforts to reduce duplication of efforts. The appropriate document should be uploaded as a single PDF, combined with any other documents on optional collaborations, using the filename "Letter of Support" at www.grants.gov.

2. Target Populations The target population for this program is children less than 6 years (72 months) of age with a specific focus on children less than 3 years (36 months) of age. Priority should be given to high-risk children disproportionately affected by lead exposure and lead poisoning, particularly those children living in areas that include: homes built before 1978; low-income or subsidized housing with suspected or known lead hazards; hazardous waste sites or industrial emissions containing lead; racial and ethnic minorities; and recent immigrants. Medicaid-eligible and Medicaid-enrolled children, as well as children receiving services from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), represent high-risk target populations.

a. Health Disparities Despite significant progress in lowering population BLLs overall, certain populations, including racial and ethnic minorities, recent immigrants, and those in certain geographic areas, remain at high risk for lead exposure. Non-English-speaking populations, people with limited health literacy, tribal populations, and those living in rural areas and other geographically underserved communities may also be at high risk. A major focus of this NOFO is to improve the ability to identify, screen, refer, and monitor high-risk children with the aim of reducing disparities in BLLs and associated health outcomes and improve social determinants of health among populations at greatest risk.

iv. Funding Strategy Applicants can apply for Component A only, Component B only, or Components A & B.

Applicants must include a separate individual work plan and budget for both Components A and B.

COMPONENT A

Applicants are eligible for awards of $300,000-500,000 (based on population and demonstration of need) to support the development of a comprehensive lead poisoning prevention program.

Under this Notice of Funding Opportunity (NOFO), applicants are applying for support related to: Strategy 1) ensure blood lead testing and reporting, Strategy 2) enhance blood lead surveillance, and Strategy 3) improve linkages of lead-exposed children to recommended services. Applicants are expected to demonstrate that processes are in place to identify children with blood lead levels greater than or equal to the CDC blood lead reference value and to track this data. Applicants are also expected to demonstrate that processes are in place to ensure that 1) children with blood lead levels greater than or equal to the CDC blood lead reference value are linked with recommended services and 2) that children who meet state case definition for the given jurisdiction are linked to case management services and follow-up care.

COMPONENT B

Applicants are eligible for $150,000-350,000 to support targeted population-based interventions.

Under this Notice of Funding Opportunity (NOFO), applicants are applying for support related to: Strategy 4) develop targeted, population-based policy interventions. Applicants are expected to develop interventions that support development of targeted, population-based interventions with a focus on community-based primary prevention approaches for lead hazard elimination.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How 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/additionalrequirements/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.

Describe available data sources and feasibility of collecting the required process and outcome measures outlined above. Applicants should use the DMP template at https://www.reginfo.gov/public/do/DownloadDocument?objectID=101621901.

c. Organizational Capacity of Recipients to Implement the Approach Describe the applicant’s Organizational Capacity needed to implement the award:

CVs/Resumes and Organizational Chart(s) must be provided in separate files labeled "CVs/Resumes" and "Organizational Chart(s)" and uploaded at www.grants.gov.

o Component A:

Demonstrates relevant experience and capacity (management, administrative, and technical) to implement the proposed activities and achieve the expected project outcomes. Provides CVs/resumes of key staff including: Principal Investigator, Program Manager, and Surveillance Epidemiologist.

Demonstrates that adequate staffing are available to perform activities outlined in this NOFO. Provides a staffing plan of current and proposed personnel, including qualifications and specific expertise as it relates to the requirements set forth in this announcement, and a project management structure that will be sufficient to achieve the project outcomes and that clearly defines staff roles. If applicable, provides organizational management assurances and a plan for identifying and hiring qualified applicants for vacant position(s) on a timely basis.

Provides an organizational chart.

Details a work plan that is aligned with the strategies/activities and expected short, intermediate, and long-term outcomes of this NOFO, and performance measures proposed by CDC. Provides a sustainability plan to assure that the goals of this NOFO and efforts to achieve desired outcomes will continue beyond the period of performance.

Demonstrates the existence of established relationships to leverage local partners and resources to ensure that a comprehensive system of recommended services exists for the identification, referral, follow-up, and evaluation of children exposed to lead. Provides evidence of the ability for state health department to work closely with local health departments (and other local agencies and healthcare providers) serving children in high-risk areas to collect and report information on recommended services to CDC on a quarterly basis.

Demonstrates the necessary experience, information technology infrastructure, and resource capacity to implement an integrated childhood blood lead surveillance system that maximally leverages existing tools, data sources, and systems/platforms. Demonstrates that surveillance data efforts adhere to national data and technology standards to support interoperability of system-to-system data exchange. Demonstrates ability to submit required surveillance data variables to CDC on a quarterly basis.

Component B:

Demonstrates relevant experience and capacity (management, administrative, and technical) to implement the proposed activities and achieve the expected project outcomes. Provides CVs/resumes of key staff including: Principal Investigator, Program Manager, and Surveillance Epidemiologist.

Demonstrates that adequate staff are available to perform activities and reporting requirements outlined in this NOFO. Provides a staffing plan of current and proposed personnel, including qualifications and specific expertise as it relates to the requirements set forth in this announcement, and a project management structure that will be sufficient to achieve the project outcomes and that clearly defines staff roles. If applicable, provides organizational management assurances and a plan for identifying and hiring qualified applicants for vacant position(s) on a timely basis.

Provides an organizational chart.

Provides letters of support from public health department programs, agencies, or organizations to demonstrate ability to build and maintain partnerships. Applicants should name letters of support as “LOS_#” and upload the files as a pdf at www.grants.gov.

d. Work Plan Applicants should provide a detailed work plan for the first year of the project and a high-level work plan for subsequent years. The components in the work plan should crosswalk to the strategies and activities, outcomes, and evaluation and performance measures presented in the logic model and the narrative sections of the NOFO.

Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities

Process Measure [from Evaluation and

Responsible Position/Party Completion Date

Performance Measurement section]

1.

2.

3.

4.

5.

6.

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.

CDC will use performance measures data collected to track and monitor recipient progress, provide feedback and technical assistance, and access collective progress toward achieving NOFO outcomes by aggregating and analyzing data aggregated across all recipients. Recipient surveillance data will be used to:

Determine blood lead testing and reporting rates and trends for children less than 6 years of age at risk for lead exposure including screening/testing penetrance, and incidence and prevalence of children with blood lead levels greater than or equal to the CDC blood lead reference value.

Determine number, percentage, and trends of blood lead testing records with missing data on child demographic and follow-up information (e.g., race/ethnicity, socioeconomic status, small geographic area [zip code or census tract], referrals to recommended services by type)

Determine rates and trends of children less than 6 years of age with blood lead levels greater than or equal to the CDC blood lead reference value who are linked to recommended services (e.g., environmental inspections, medical evaluations, nutritional counseling, developmental milestones).

Determine disparities and related trends in blood lead levels by race/ethnicity and socioeconomic status.

In addition to surveillance system data, recipients must collect and report complementary data from relevant agencies (e.g., Medicaid, immunization, adult blood lead, vital statistics).

CDC will provide feedback on recipient progress via monthly calls, email, and written review of recipient’s Evaluation and Performance Measurement Plan. CDC will report annually on individual recipient performance measures progress and aggregated progress across all recipients on the Lead Poisoning Prevention Program website, and periodically through published reports (e.g. Morbidity and Mortality Weekly Report).

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:

UE2

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$20,000,000

5. Total Period of Performance Funding:

$100,000,000 This amount is subject to the availability of funds.

Estimated Total Funding:

$100,000,000

6. Total Period of Performance Length:

year(s)

7. Expected Number of Awards:

Component A: 51 Component B: 10

8. Approximate Average Award:

$350,000 Per Budget Period

Component A: $350,000 Per Budget Period Component B: $250,000 Per Budget Period

9. Award Ceiling:

$850,000 Per Budget Period

This amount is subject to the availability of funds.

Component A: $500,000 Per Budget Period Component B: $350,000 Per Budget Period

10. Award Floor:

$150,000 Per Budget Period

Component A: $300,000 Per Budget Period Component B: $150,000 Per Budget Period

11. Estimated Award Date:

September 30, 2021

12. Budget Period Length:

12 month(s)

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

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

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:

02 (City or township governments)

01 (County governments)

00 (State governments)

07 (Native American tribal governments (Federally recognized))

Additional Eligibility Category:

Government Organizations:

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

Local governments or their bona fide agents

2. Additional Information on Eligibility Eligibility is limited to the organizations noted above, in accordance with 42 U.S.C.

Section 247b(k)(2)

3. Justification for Less than Maximum Competition N/A

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

No

5. Maintenance of Effort N/A

D. Application and Submission Information

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

a. Data Universal Numbering System:

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

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

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

b. System for Award Management (SAM):

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

c. Grants.gov:

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

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

Step System Requirements Duration Follow Up

Data Universal Number System

(DUNS)

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

2. Select Begin DUNS search/request process

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

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

1-2 Business Days

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

System for Award Management

(SAM)

formerly Central Contractor Registration

(CCR)

1. Retrieve organizations DUNS number

2. Go to SAM.gov and designate an E-Biz POC (note CCR username will not work in SAM and you will need to have an active SAM account before you can register on grants.gov)

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

For SAM Customer Service Contact https://fs d.gov/ fsd-gov/ home.do Calls: 86 6-606-8220

3 Grants.gov

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

(AOR)

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

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

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

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

Register early!

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

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

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

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

a. Letter of Intent Deadline (must be emailed or postmarked by)

Number Of Days from Publication 30

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

b. Application Deadline

Due Date for Applications 11/09/2021

11/09/2021 11:59 pm U.S. Eastern Standard Time, at www.grants.gov. If Grants.gov is inoperable and cannot receive applications, and circumstances preclude advance notification of an extension, then applications must be submitted by the first business day on which grants.gov operations resume.

Due Date for Information Conference Call An informational conference call will be scheduled. Details about the informational call will be posted at: https://www.cdc.gov/nceh/lead/

5. Pre-Award Assessments Risk Assessment Questionnaire Requirement

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

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

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

Duplication of Efforts

Applicants are responsible for reporting if this application will result in programmatic, budgetary, or commitment overlap with another application or award (i.e. grant, cooperative agreement, or contract) submitted to another funding source in the same fiscal year. Programmatic overlap occurs when (1) substantially the same project is proposed in more than one application or is submitted to two or more funding sources for review and funding consideration or (2) a specific objective and the project design for accomplishing the objective are the same or closely related in two or more applications or awards, regardless of the funding source. Budgetary overlap occurs when duplicate or equivalent budgetary items (e.g., equipment, salaries) are requested in an application but already are provided by another source. Commitment overlap occurs when an individual’s time commitment exceeds 100 percent, whether or not salary support is requested in the application. Overlap, whether programmatic, budgetary, or commitment of an individual’s effort greater than 100 percent, is not permitted. Any overlap will be resolved by the CDC with the applicant and the PD/PI prior to award.

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

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

7. Letter of Intent The purpose of a letter of intent (LOI) is to allow CDC program staff to estimate the number of and plan for the review of submitted applications. The following information should be included:

Number and title of this NOFO Descriptive title of proposed project Indicate if applying for Component A only, Component B only, or Components A

& B and amount of funding requested Name, address, telephone number, and email address of the Principal Investigator

LOI should be sent via email to:

Lead Poisoning Prevention and Environmental Health Tracking Branch

Division of Environmental Health Science and Practice

National Center for Environmental Health

Centers for Disease Control and Prevention

Department of Health and Human Services

Email: LPPS@cdc.gov

8. Table of Contents (There is no page limit. The table of contents is not included in the project narrative page limit.): The applicant must provide, as a separate attachment, the “Table of Contents” for the entire submission package.

Provide a detailed table of contents for the entire submission package that includes all of the documents in the application and headings in the "Project Narrative" section. Name the file "Table of Contents" and upload it as a PDF file under "Other Attachment Forms" at www.grants.gov.

9. Project Abstract Summary A project abstract is included on the mandatory documents list and must be submitted at www.grants.gov. The project abstract must be a self-contained, brief summary of the proposed project including the purpose and outcomes. This summary must not include any proprietary or confidential information. Applicants must enter the summary in the "Project Abstract Summary" text box at www.grants.gov.

10. Project Narrative…