Foa_Content_of_CDC-RFA-OE22-2203 (8).pdf

Centers for Disease Control and Prevention

Center for Surveillance, Epidemiology, and Laboratory Services

Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems

CDC-RFA-OE22-2203

08/15/2022

Table of Contents A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Required Registrations

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA- OE22-2203. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems 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)).

New - Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-OE22-2203

E. Assistance Listings Number:

93.967 F. Dates:

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

06/30/2022 https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

Recommended but not Required LOI due date: 6/30/2022 Project Officer: Jonathan Carlson Email address: PHInfrastructure@cdc.gov

2. Due Date for Applications:

08/15/2022 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

June 29, 2022 Applicant Informational calls: CDC will host 2 informational calls for interested applicants.

The content of both calls will be identical. The 2 times are offered as a way to help accommodate the schedules of interested applicants and their locations in varying time zones. Due to limited space, we ask that interested applicants only register for Webinar A or B, but not both.

When: June 29, 2022 3:00 to 4:00 PM Eastern Time (U.S. and Canada) Topic: OE22-2203 Applicant Informational Call A Register in advance for this webinar:

https://cdc.zoomgov.com/webinar/register/WN_V5iIgBryTBCUwpp1xxgDqA

When: June 29, 2022 6:00 to 7:00PM Eastern Time (U.S. and Canada) Topic: OE22-2203 Applicant Informational Call B Register in advance for this webinar:

https://cdc.zoomgov.com/webinar/register/WN_jrPD018uQMCydBMi6d9vcw

F. Executive Summary:

Summary Paragraph The COVID-19 pandemic has led to a historic investment in the infrastructure of U.S. public health agencies. This NOFO is drafted to provide support for core infrastructure improvements that include, but are not limited to, these agencies’ workforce, foundational capabilities, and data infrastructure. Stronger infrastructure will serve immediate needs to respond to the ongoing COVID-19 pandemic and other public health outcomes that worsened or stalled during the COVID-19 pandemic. The investments will have sustained effects that position these agencies to better meet the ongoing and future public health needs of the communities and populations they serve.

All recipients under Component A will receive workforce and foundational capabilities funding and recipients of Component B will also be funded. Only some recipients, to be determined, under Component A will receive data modernization initiative funding. All awards are subject to availability of funds.

a. Eligible Applicants:

Open Competition

b. NOFO Type:

G (Grant) https://www.grants.gov/ https://cdc.zoomgov.com/webinar/register/WN_V5iIgBryTBCUwpp1xxgDqA https://cdc.zoomgov.com/webinar/register/WN_jrPD018uQMCydBMi6d9vcw

c. Approximate Number of Awards Component A: 111 Component B: 5

d. Total Period of Performance Funding:

$3,945,000,000

e. Average One Year Award Amount:

$21,938,000 Component A Strategy A1 Workforce: $20,000,000 Strategy A2 Foundational capabilities: $1,260,000 Strategy A3 Data modernization: $678,000

Component B: $9,000,000

These amounts are subject to the availability of funds.

f. Total Period of Performance Length:

g. Estimated Award Date:

November 01, 2022

h. Cost Sharing and / or Matching Requirements:

No Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview The COVID-19 pandemic emphasized the critical importance of a robust public health system.

Public health departments and other public health partners need to continue their work to respond to COVID-19 and prepare for future public health emergencies. The pandemic also accentuated long-standing weaknesses and created new challenges to the U.S. public health infrastructure.

Moreover, COVID-19 affected nearly every aspect of healthcare and public health, laying bare disparities and gaps in some conditions and worsening others. Public health partners need the capacity to regain their footing in these areas and then accelerate their efforts.

This funding is intended to help meet critical infrastructure needs in the short-term; it should also make possible strategic investments that will have lasting effects on public health agencies across the United States. To that end, Component A will support strategically strengthening public health infrastructure and systems related to the workforce, foundational capabilities, and data infrastructure. Component B will support Component A recipients to implement key strategies more efficiently and effectively, by providing technical assistance, evaluation leadership and support, and mechanisms for communication and coordination across all recipients.

Maximum flexibility will be provided to the recipients to carry out this work consistent with the purpose of the funding and the scope of this NOFO. The scope of possible workforce investments is wide, including hiring, retaining, supporting, and training the workforce; there will be no restrictions on the types of positions that can be hired for public health capacity building. Other investments and improvements to foundational capabilities will help modernize public health agencies and position them to be even better service providers and partners.

Investments and improvements to modernize the data infrastructure will serve to improve efficiency and effectiveness of those organizations’ operations and public health work, including their ability to partner in a complex health and health care environments. These outcomes will lead to public health services being improved, and in turn public health outcomes including COVID-19 will be better addressed.

Across areas, this should be part of a transformation of public health agencies needed to meet the evolving and complex needs of the U.S. population. This transformation will improve public health internal systems and operations. This will necessarily involve creating and strengthening partnerships at all levels. This funding also recognizes a history of underinvestment in U.S.

communities that have been economically or socially marginalized, are located in rural geographic areas, are composed of people from racial and ethnic minority groups, are medically underserved, and are disproportionately affected by COVID-19 or other priority public health problems. This program also should support larger efforts to rebalance these investments and serve communities and populations in a more equitable way.

All recipients will receive workforce and foundational capabilities funding under Component A and recipients of Component B will also be funded. Only some recipients, to be determined, requesting A3 Data modernization funding will be funded.

All awards and funding are subject to availability of funds.

b. Statutory Authorities Section 317(k)(2) of the Public Health Services Act [42 USC 247b(k)(2), as amended]; the American Rescue Plan 2021 Subtitle F—Public Health Workforce, SEC. 2501

c. Healthy People 2030 The "Healthy People 2030" focus areas of:

Public Health Infrastructure Health Conditions (such as Respiratory Diseases) Health Behaviors (such as Emergency Preparedness or Vaccinations) Social Determinants of Health (such as Health Care Access and Quality) Healthcare Workforce Hospital and Emergency Services

d. Other National Public Health Priorities and Strategies HHS Action Plan to Reduce Racial and Ethnic Health Disparities: A Nation Free of

Disparities in Health and Health Care

CDC CSTLTS and NACCHO’s Public Health Infrastructure and Systems https://health.gov/healthypeople/objectives-and-data/browse-objectives/public-health-infrastructure https://health.gov/healthypeople/objectives-and-data/browse-objectives#health-conditions https://health.gov/healthypeople/objectives-and-data/browse-objectives/respiratory-disease https://health.gov/healthypeople/objectives-and-data/browse-objectives#health-behaviors https://health.gov/healthypeople/objectives-and-data/browse-objectives/emergency-preparedness https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality https://health.gov/healthypeople/objectives-and-data/browse-objectives/workforce https://health.gov/healthypeople/objectives-and-data/browse-objectives/hospital-and-emergency-services https://www.minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf https://www.minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf https://www.naccho.org/programs/public-health-infrastructure

HRSA’s Health Workforce Strategic Plan

ASPR/PHE’s US Health Security National Action Plan

National Institute of Health’s Workforce Planning Toolkit

Data Modernization Initiative Strategic Implementation Plan

e. Relevant Work This NOFO is complementary and non-duplicative of many CDC program activities, public health priorities, and strategies, in particular:

CDC-RFA-OT21-2103: National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities

CDC-RFA-CK19-1904: Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infections Diseases (ELC)

ELC Enhancing Detection Emerging Issues Project: Funding for the Enhanced Detection, Response, Surveillance, and Prevention of COVID-19

Accelerating Data Modernization in Public Health Departments | DMI Support | CDC: funding under the ELC cooperative agreement for data modernization, electronic case reporting, and vital statistics systems strengthening

CDC-RFA- PS19-1901: Strengthening Sexually Transmitted Disease Prevention and Control for Health Departments - Supplement for Disease Intervention Services (DIS) Workforce Development

CDC-RFA-TP22-2201: Public Health Crisis Response Cooperative Agreement CDC RFA-OT18-1803: Tribal Public Health Capacity Building and Quality

Improvement

CDC-RFA-OT20-2004: Supporting Tribal Public Health Capacity in Coronavirus Preparedness & Response

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Logic Model: Strengthening US Public Health Infrastructure, Workforce, and Data Systems (Components A and B)

Strategies Short-Term Outcomes Intermediate-Term Outcomes

Long-Term Outcomes

Component A: Strengthening public health (PH) infrastructure Strategy A1: Workforce

Strategy A2: Foundatio

ST1. Increased hiring of diverse staff (A1)

ST2. Improved organizational systems &

I1. Increased size and capabilities of the PH workforce (A1-2)

I2. Stronger PH

LT1.

Accelerated prevention, preparedness, and response https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/about-us/hhs-health-workforce-strategic-plan-2021.pdf https://www.phe.gov/Preparedness/international/Pages/JEE.aspx https://hr.nih.gov/workforce/workforce-planning/getting-started https://www.cdc.gov/surveillance/data-modernization/index.html https://www.cdc.gov/publichealthgateway/partnerships/COVID-19-Health-Disparities-OT21-2103.html https://www.cdc.gov/ncezid/dpei/pdf/data-modernization-508.pdf https://www.cdc.gov/ncezid/dpei/pdf/elc-enhancing-detection-guidance.pdf https://www.cdc.gov/csels/dmi-support/accelerating_data_modernization_in_public_health_departments.html https://www.cdc.gov/csels/dmi-support/accelerating_data_modernization_in_public_health_departments.html https://www.cdc.gov/std/funding/pchd/default.htm https://www.grants.gov/web/grants/view-opportunity.html?oppId=337086 file:///C:/Users/ldewilde/AppData/Local/Temp/MicrosoftEdgeDownloads/35ad4909-f876-4f13-b077-27ef5779a745/%E2%80%A2%09https:/www.cdc.gov/tribal/cooperative-agreements/tribal-capacity-building-OT18-1803.html https://www.cdc.gov/tribal/cooperative-agreements/tribalcovid-ot20-2004.html nal capabilities

Strategy A3: Data modernization processes (A2)

ST3. More modern and efficient data infrastructure (A3)

ST4. Increased data interoperability (A3) foundational capabilities (A1-3)

I3. Increased availability and use of PH data (A3)

I4. Increased reach of PH services (A1-3) to emerging threats (A1- 3)

LT2.

Improved other public health outcomes (A1-3)

Component B: Technical assistance for public health agencies Strategy B1: Training and technical assistance for Component A

Strategy B2:

Grant program evaluation

Strategy B3: Grant coordination & communication

ST1. Increased grant implementation knowledge & skills among Component A recipients (B1, B2)

ST2. Increased hiring & retention mechanisms available to Component A recipients (B1)

ST3. Increased knowledge about grant processes & outcomes among Component A recipients, CDC, & other partners (B2, B3)

I1. Increased effectiveness of strategy implementation among Component A recipients (B1, B2)

I2. Increased efficiency of strategy implementation among Component A recipients (B1, B2)

I3. Improved sharing of lessons learned & evidence among Component A recipients, CDC, and other interested partners (B1- B3)

LT1.

Increased achievement of Component A grant outcomes (B1-B3)

LT2.

Strengthened capacity of Component A recipients (B1-B3)

i. Purpose Component A will serve many purposes. First, it will enable recipients to hire, retain, sustain, and train the public health workforce, and strengthen their foundational capabilities. Also, with investments in data modernization, public health services will be expanded, improved, and accelerated, and in turn public health concerns including COVID-19 will be better addressed.

The purpose of Component B is to support successful implementation of Component A, by providing technical assistance, evaluation support, and coordination and communication support among relevant partners.

ii. Outcomes Under Component A, strategy A1 Workforce, the key outcomes that recipients are expected to achieve by the end of the period of performance include increased hiring of diverse staff and increased size and capabilities of the public health workforce with improved wages and protections. For strategy A2 Foundational capabilities, the key outcomes include improved organizational systems and processes and evidence of stronger public health foundational capabilities. For strategy A3 Data modernization, key outcomes include a more modern and efficient data environment, increased data interoperability, and increased availability and use of public health data. Key outcomes specific to Component B include increased hiring and retention mechanisms available to Component A recipients and, in the longer term, improved sharing of lessons learned and evidence among Component A recipients, CDC, and other interested partners.

iii. Strategies and Activities Component A: Strengthening Public Health Infrastructure

Key principles All work under Component A should be grounded in three key principles:

The need for data and evidence to drive planning and implementation

The critical role that partnerships will play in success, and

The imperative to direct these resources in a way that supports health equity

All planning for investments in workforce, foundational capabilities, and data modernization must be driven by careful, strategic thinking, relevant data and evidence, and engagement with key partners. Recipients should take the time needed to plan these investments in ways that meet their needs and contexts. Strategic, data-driven planning should help maximize the benefits of these investments to public health agencies and the populations they serve. This approach should continue throughout implementation, to guide any needed course corrections and generate evidence about the effectiveness of strategies implemented through this grant.

Across the strategies below, recipients will need to collaborate and coordinate with a wide range of partners, to support planning, implementation, and evaluation. Those partners may vary across strategies and across recipients, but the need to devote significant funding and staff time toward building and strengthening old and new partnerships will be a common thread.

Across the strategies below, recipients are expected to approach planning and implementation with health equity, diversity, equity, inclusion, and accessibility in mind. How this looks may vary by strategy. For example, workforce investments should include dedicated efforts to recruit staff from the communities they serve and continue to create a public health workforce that can meet the needs of all communities. Investments in the data should be directed in ways that help strengthen ties with, and services in U.S. communities that have been economically or socially marginalized, are located in rural geographic areas, are composed of people from racial and ethnic minority groups, are medically underserved, and are disproportionately affected by COVID-19 or other priority public health problems.

Strategy requirements for recipients of Component A

Applicants are encouraged to apply for all Strategies A1-A3 and to propose work under some or all Key Activities, to benefit from this opportunity. Applicants that apply for Strategy A1 must include Key Activity 6: at a minimum, this includes: supporting a fulltime Workforce Director and evaluation staff. Applicants may support a Data Modernization Director under strategy A1 Workforce, but this is not required.

Additional strategy requirements for statewide recipients of Component A

No less than 40% of the funding provided to state health department recipients for Strategy A1 Workforce should be distributed among the local health departments that have not received direct funding from this grant. All recipients should demonstrate how they will reduce or eliminate the administrative requirements and reporting burden put upon local public health departments and nonprofit organizations supporting grant activities. No recipient should request or require additional programmatic reports, work plans, or expenditure information from local health departments beyond what is required by the grant, unless otherwise required by law. State health departments should ensure that these funds are dispersed to their jurisdictional local health departments within the first year of the grant. (This guidance does not supersede state, and local rules, and regulations, or official funding agreements between state and local public health agencies.) These items should be described in the project and budget narrative.

Flexibility for recipients of Component A

The strategies and activities outlined below are broad by design and intended to provide recipients with maximum flexibility to meet their needs. Applicants can apply for one or more of the Strategies A1-A3 below, and within any selected Strategy, applicants can apply for one or more of the Key Activities. Applicants can also propose Key Activities not listed under a strategy, so long as they clearly align under the broader strategy (Appendix 1_Sample Activities for Component A.docx)

Strategies A1-A3 overlap to some extent, and recipients can fund and organize their proposed activities under whichever strategy they wish, given their program’s priorities and budget. For example, workforce can be supported under all strategies as appropriate, and work related to data infrastructure can be supported under Strategy A2 Foundational capabilities and under Strategy A3 Data modernization. Similarly, activities to strengthen human resource and workforce related systems and processes can be supported under Strategy A1 Workforce or A2 Foundational capabilities.

Guidance for applicants to Component A

In the narrative portion of the application, for each strategy for which they are applying, applicants should explain why they are applying for that strategy and describe the organizational transformations they expect to accomplish in 5 years under this grant. When information or data are lacking to support the rationale for a particular strategy, applicants should outline the purpose and timeframe for any new assessments or analyses that need to be conducted to guide work under this NOFO. Under each strategy, applicants should describe the Key Activities that they plan to implement in year one, if funded, and the reasons or evidence that make those activities both feasible and effective in the applicant’s public health system and context. Applicants are encouraged to provide a description of their current state, key barriers or constraints to moving forward, and how these funds would be used to overcome or circumvent those barriers.

Each strategy being applied for should have a clear separate Abstract Narrative, Project Narrative and Budget Narrative with the following verbatim titles identifying each strategy: A1 Workforce, A2 Foundational capabilities, and A3 Data modernization.

Strategy A1 Workforce https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EewK-B0Yi6dJmtEfp0w9J-8BAeGvB0SXJpou0E1oAmDHYA?e=5UpCJK https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EewK-B0Yi6dJmtEfp0w9J-8BAeGvB0SXJpou0E1oAmDHYA?e=5UpCJK

The intent of the strategy is to reinforce and expand the public health workforce by hiring, retaining, supporting, and training the workforce and by strengthening relevant workforce planning, systems, processes, and policies. The public health workforce that can be supported includes the full range of public health positions, across levels of workforce tenure and seniority, public health topic or program areas, and competencies. Positions may include those that are inherently public health in nature and those that are inherently cross-cutting or foundational in nature. The staff may work directly for the recipient or work for a governmental or non-governmental partner organization. (Appendix 2_Example Workforce Positions and Position Descriptions.docx)

Under the strategy, recipients can fill vacancies and create new positions, and they can retain staff who are on term appointments, whom they wish to extend employment. Recipients can also make significant new investments in workforce engagement, well-being, and other related programs and services, to assist with retention and help improve emotional, mental, and physical health outcomes of the workforce. New and existing staff always need training, whether to refresh skills and knowledge or to learn new skills, given a dynamic public health work environment. Under this strategy, recipients can expand and strengthen training programs across focus or topic areas, intended audiences, methodologies, and formats. All trainings should strive to adhere to CDC’s Quality Training Standards [Quality Training Standards | Training Development | CDC] and, when appropriate, to be made available through CDC TRAIN.

Recipients also can use this grant to strengthen their own workforce and human resource related planning, systems, processes, and policies. Improving recipients’ organizational administrative competencies related to human resource services may be necessary to accomplish the other Key Activities under this strategy. Some modifications and improvements may be put in place to assist directly with rapidly hiring, retaining, supporting, and training staff, but recipients may also pursue longer-term system or process improvements whose effects may not be felt immediately. As noted above, no less than 40% of the funding provided to state health department recipients for Strategy A1 Workforce should be distributed among the local health departments that have not received direct funding from this grant.

Across work in the strategy, recipients and their partners should prioritize recruiting and hiring staff who are from the communities and populations served. Recipients and their partners also should demonstrate a commitment to diversity, equity, inclusion, and accessibility in their workforce recruitment and selection processes, communication, and outcomes. Moreover, recipients and partners should strive to create high quality jobs with benefits, flexibilities, and salary levels that are attractive and provide job protection and security.

Some costs associated with recruitment and hiring are allowable, including supplies and equipment needed to perform their jobs, personal protective equipment, data management, and other necessary supplies. 45 CFR part 75 outlines the parameters related to allowable costs that might be implicated in proposed activities.

Strategy A1 Workforce: Specific requirements

In addition to adhering to the three cross-cutting principles and the requirements outlined for all of Component A, applicants under Strategy A1 Workforce must also adhere to these requirements:

https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EdFj3RMUuSpFjQslKZnHcHwBxePYL-Jyfu_Qh_ZEC_Olcg?e=vfPAtt https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EdFj3RMUuSpFjQslKZnHcHwBxePYL-Jyfu_Qh_ZEC_Olcg?e=vfPAtt https://www.cdc.gov/training/development/standards/index.html https://www.cdc.gov/training/development/standards/index.html https://www.train.org/cdctrain/welcome

Any applicant to this strategy should include significant work under Key Activity 1, Recruit and hire. Applicants are encouraged to apply to conduct work under all five Key Activities.

Applicants must include Key Activity 6 related to supporting a Workforce Director, and evaluation staff. Supporting a DMI Director is an encouraged option, but not required.

Strategy A1 Workforce: Key activities (Refer to Appendix 1_Sample Activities for Component A and Appendix 2_Example Workforce Positions and Position Descriptions)

1. Recruit and hire new public health staff. For example, this could include expanding recruitment efforts, creating new positions, improving hiring incentives, and creating new hiring mechanisms.

2. Retain public health staff. For example, this could include strengthening retention incentives, creating promotional opportunities, and transitioning staff to other hiring mechanisms.

3. Support and sustain the public health workforce. For example, this could include strengthening workplace well-being programs and expanding engagement with the workforce to address their mental, emotional, and physical well-being.

4. Train new and existing public health staff. For example, this could include improving the quality and scope of training and professional development opportunities for all staff.

5. Strengthen workforce planning, systems, processes, and policies. For example, this could include maintaining and upgrading human resource systems, identifying ways to better collect and use workforce data, and identifying policies that could facilitate more efficient and effective workforce development and management.

6. Strengthen support for implementation of this grant. At a minimum, applicants must:

Support a full-time Workforce Director who has sufficient authority and seniority to effectively manage the work under this grant. This individual must report to the highest level of the recipient organization, be able to represent the recipient organization, and participate actively in discussions and meetings with other recipients and CDC about the grant and their experiences under it. (Required)

Dedicate at least 1.0 full-time employee to program evaluation and performance measurement for all work proposed under Strategies A1-A3. These evaluation staff will facilitate progress reporting, use of grant performance measures, internal evaluation activities, collaboration with national partners from Component B on evaluation of the grant, and participation in relevant national organizational and workforce assessments. (Required)

Successful applicants may choose to use A1 Workforce funding to hire a Data Modernization Director. This is an encouraged option, not a requirement.

Strategy A2 Foundational Capabilities

The intent of this strategy is to strengthen recipients’ overall systems, processes, and policies to ensure a strong core infrastructure needed to protect health and provide fair opportunities for all.

The Foundational Public Health Services (FPHS) FPHS | PHNCI framework defines a minimum set of capabilities and areas that must be available in every community. The FPHS framework aligns well to the core capabilities that CDC itself seeks to strengthen and supports advancement in delivering Essential Public Health Services. The framework includes eight (8) public health infrastructure foundational capabilities, which are the cross-cutting skills and capacities needed to support basic public health protections and other programs and activities that are key to ensuring the community’s health and achieving equitable health outcomes.

These capabilities include: 1) Assessment/Surveillance, 2) Emergency Preparedness and Response, 3) Policy Development and Support, 4) Communications, 5) Community Partnership Development, 6) Organizational Competencies, 7) Accountability/Performance Management, and 8) Equity.

Effectively managing a public health agency implicates every aspect of these foundational capabilities https://phnci.org/transformation/fphs. It also includes strengthening the public health agency’s ability to meet or exceed the standards and measures outlined in the national consensus accreditation standards for health departments, which are aligned with the foundational capabilities and ensure that these are in place. Version 2022 - Public Health Accreditation Board (phaboard.org) Recipients should consider how to meet or exceed the public health accreditation standards and measures that align to these foundational capabilities.

As jurisdictions transition from COVID-19 emergency response footing to long-term, sustainable approaches to delivering the essential public health services, A2 funding will focus on supporting those core foundational capabilities that are not directly funded by other sources but are nonetheless important to underlying public health infrastructure. All the foundational capabilities may be supported by this funding. However, to reduce the duplication of effort specific to foundational capabilities funded through other sources, such as surveillance, epidemiology, laboratory capacity, and vital records, work under Strategy A2 should focus on the following crosscutting activities that do not have a direct source of CDC funding.

Strategy A2 Foundational capabilities: Key activities (Appendix 1_Sample Activities for Component A.docx)

1. Strengthen accountability/Performance management, including accreditation.

2. Strengthen organizational competencies addressing information technology, data modernization human resources, financial management, contract, and procurement services.

3. Enhance communications.

4. Enhance or increase policy development and legal services and analysis.

5. Strengthen community partnership development and engagement.

6. Improve equity and organizational competencies addressing leadership, governance, and strategic planning.

https://phnci.org/transformation/fphs http://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html https://phnci.org/transformation/fphs https://phaboard.org/version-2022/ https://phaboard.org/version-2022/ https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EewK-B0Yi6dJmtEfp0w9J-8BAeGvB0SXJpou0E1oAmDHYA?e=5UpCJK https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EewK-B0Yi6dJmtEfp0w9J-8BAeGvB0SXJpou0E1oAmDHYA?e=5UpCJK

7. As appropriate, implement plans to transition from COVID-19 emergency response and other emergency response and preparedness projects.

Strategy A3 Data modernization

This funding supports jurisdictions to develop and deploy scalable, flexible, and sustainable technologies, policies, and methods to implement world-class data and analytical capabilities to support the Essential Public Health Services. Public health data infrastructure should have clear governance structures that are inclusive (e.g., consider the needs of counties and cities as well as states) and technically enforceable (i.e., written into the infrastructure’s code). The data infrastructure should be able to scale rapidly, be flexible to accommodate changing needs in public health surveillance and response, ensure bidirectional data flow, and provide predictive ability to identify emerging public health risks and concerns. All activities undertaken should reduce burden on health care and public health partners reporting data, while enhancing data sharing at all levels. This effort also aims to accelerate modernization through enhancing the public health data workforce and encourages the use of shared data and health information services and infrastructure offered via CDC or partner organizations. The goal is to enhance the data and information infrastructure used by public health.

Governance processes should assure that state level activities consider the needs of counties and cities, and that city and county level initiatives do not duplicate services, systems, or other resources available from the state public health agency. Strategies should ensure the ability to exchange and integrate data among public health systems and agencies, and with health care and other public health partners, including tribal entities as appropriate. Recipients will be expected to demonstrate step-wise progress in assessing current functionalities and prioritizing modernization needs prior to making investments. Every effort should be made to ensure the sustainability by leveraging procurement approaches that support modern service design and development.

This funding opportunity builds on and is expected to coordinate with and leverage, but not duplicate, the workforce, laboratory system, and data-related progress made via Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC), Public Health Emergency Preparedness (PHEP), and other funding opportunities and investments.

Recipients of this funding are required to coordinate with and leverage, but not duplicate, the workforce, laboratory system, and data-related activities in Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC), Public Health Emergency Preparedness (PHEP), and other funding opportunities and investments. Applicants of A3 must specify in their proposals as to whether or not they are a current recipient of data modernization funding through the CDC Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) supplemental funding.

Strategy A3 Data modernization: Requirements

Investments in stand-alone, monolithic systems with limited interoperability are not allowed.

Investment in new system design/configurations will require sign-off from CDC DMI program prior to jurisdictional procurement to ensure alignment with the North Star Architecture strategy.

Key Activities 2-4 below are required.

Strategy A3 Data modernization: Key activities (Appendix 1_Sample Activities for Component A.docx)

1. Identify a data modernization director and supporting team that will be responsible for ensuring the jurisdiction takes an agile, enterprise-wide approach in assessment, planning, and incremental implementation of modernization activities. The director may be funded through this award or other sources. This position is strongly recommended as part of Strategy A1 Workforce.

2. Assess and report the current capacity, gaps, and opportunities to modernize the public health data infrastructure and workforce. For jurisdictions who have recently completed a data modernization assessment (e.g., within the past 2 years) previous assessments should be reviewed and updated. This is a required activity.

3. Create implementation plans for 1) modernization of public health data environment to support public health work that includes forward-looking use of flexible, scalable, sustainable infrastructure that leverages shared services and cloud-native technology and

2) workforce development to address existing gaps, build capacity within the current workforce and sustain modernization gains. Implementation plans should be based on assessment results. Initial implementation plans should be developed by the end of Year 1, and must demonstrate collaboration across city, county, and state public health agencies and not duplicate systems and services. This is a required activity. Workforce needs may be addressed through Strategy A1 Workforce or Strategy A3 Data modernization, and while it is an encouraged option to include hiring a DMI director, it is not required.

4. Implement developed work plans to realize data infrastructure enhancements and improvements. Implemented activities should be aligned with national efforts and national standards. As part of implementation, recipients will be required to 1) attend an annual Data Modernization Workshop; 2) participate in a CDC-sponsored Data Modernization Learning Community and 3) participate in other established and relevant communities of practice as appropriate. This is a required activity.

5. Accelerate implementation by proposing innovative modernization projects to enhance data quality, exchange, dissemination, and use. Acceleration projects will only be approved after progress on activities 1-4 has been demonstrated.

For Strategies A3 Data modernization CDC may develop additional supplemental guidance that outlines additional work plan and budget requirements tailored to the jurisdictional public health infrastructure needs and congressional language in appropriations specific to this strategy that could include specific data modernization activities not listed in the activities section of this funding opportunity.

Component B: Technical Assistance for Component A https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EewK-B0Yi6dJmtEfp0w9J-8BAeGvB0SXJpou0E1oAmDHYA?e=5UpCJK https://cdc.sharepoint.com/:w:/t/CSELS-WorkforceGrantTeam/EewK-B0Yi6dJmtEfp0w9J-8BAeGvB0SXJpou0E1oAmDHYA?e=5UpCJK

The purpose of Component B is to support Component A recipients to implement Strategies A1- A3 more efficiently and effectively. Component B recipients will do this by providing technical assistance, evaluation leadership and support, and mechanisms for communication and coordination across all recipients and CDC.

Applicants to Component B can apply for one or more Strategies below.

All recipients of Component B will be expected to communicate and coordinate with one another, to support and streamline engagement with Component A recipients, with the assistance of the recipient of Strategy B3. Regardless of strategy in which they work, Component B recipients are encouraged to help Component A recipients build and strengthen partnerships with academic institutions including minority-serving institutions (e.g., HBCUs, HACUs, etc.) and other technical organizations operating in recipients’ project areas, to support more sustainable access to technical assistance and expertise.

Strategy B1 Training and technical assistance for Component A Strategies A1, A2, and A3

The intent of this strategy is to assist recipients of Component A more efficiently and effectively plan and implement their grant activities. Recipients of Strategy B1 should facilitate collection and use of relevant data, expedite access to information and mechanisms that help recipients meet their grant goals, and increase recipients’ skills and capacity to retain some of the gains of the grant in the longer term. The training and technical assistance offered should be driven by Component A recipients’ needs. The training and technical assistance should be of such high quality and value to Component A recipients, that voluntary uptake will be high.

Applicants to Strategy B1 can choose to propose one or more Key Activities.

Key activity 1: Evidence-driven planning for Strategy A1 Workforce and Strategy A2 Foundational capabilities One or more Component B recipients should support Component A recipients by providing cross-cutting and ongoing planning activities, through providing technical assistance with:

Conducting foundational capabilities and workforce needs assessments

Synthesizing and using data related to the workforce to guide work under Strategy A1

Synthesizing and using data related to foundational capabilities to guide work under Strategy A2

Analyzing and using the above types of data for program improvement and decision-making

Creating and strengthening partnerships with academic institutions including minority-serving institutions (e.g. HBCUs, HACUs, etc.), academic organizations, and other technical organizations to support implementation of Strategies A1-A2 and to increase student rotations at public health departments.

Assistance related to workforce and foundational capabilities planning should be made available as soon as possible after awards are made to Component A recipients, particularly for those recipients that do not have recent strategies or needs assessment data to drive planning for their Component A grant application. This assistance should help recipients revise and strengthen their work plans during the period of performance under A1 and A2 of this grant. This kind of assistance should continue during the grant period. For example, with continuation applications to the grant and other ongoing planning needs at the recipient level.

Key activity 2: Evidence-driven implementation for Strategy A1 Workforce and Strategy A2 Foundational capabilities One or more Component B recipients should also support Component A recipients by identifying and providing access to evidence and information about best practices and models for recipients to draw from for implementation, such as:

Model job descriptions, personnel sharing agreements, scopes of work, and requests for proposals

Conducting regional and national pay and salary reviews

Guidance on how to identify, develop, and evaluate high quality programs to implement under A1 Workforce and A2 Foundational capabilities (e.g., workforce training programs, strategic planning approaches)

Model policies and legislation, including those related to hybrid workplaces, teleworking policies, hiring caps, and workforce surge capability

Access to new evidence and tools that support implementation

Access to human resource, workforce development, and foundational capability expertise, which recipients could access for tailored assistance

Direct support for peer-to-peer learning on best practices, with travel support or honorariums

Development of a peer-to-peer exchange program between CDC and state, local and territorial public health agencies (e.g., providing a 4-week experiential on-site learning opportunity)

Key activity 3: Data modernization One or more Component B recipients should support Component A recipients through assessing training needs and providing training opportunities to support the use of flexible, scalable, sustainable infrastructure that leverages shared services and cloud-native technology and is focused on data standards and technologies. Example training topics may include, but are not limited to, the following: software as a service, HL7 standards including V2, V3 and FHIR, machine learning, trust frameworks (e.g., TEFCA), USCDI and USCDI plus, and national initiatives, as they are announced. Partners will be responsible for

Understanding jurisdiction training needs

Identifying and contracting with vendor partners to deliver trainings in a variety of modalities

Promoting available training offerings to recipients

Maintaining a repository of developed trainings that is accessible to jurisdictions for training on demand, and

Conducting other activities associated with expanding access to standards-based trainings.

Training topics and delivery methods will be developed in coordination with CDC. Training topics that do not support the use of flexible, scalable, sustainable infrastructure by jurisdictions will not be approved.

Key activity 4: Accessing staffing solutions and contracts to facilitate implementation of Strategies A1, A2, and A3 One or more Component B recipients should support Component A recipients by providing direct access to hiring, retention, training, and systems strengthening mechanisms. These may include coordinated access to:

National, regional, or multi-state recruitment and hiring campaigns, platforms, or hubs

Staffing solutions and direct mechanisms for hiring staff, or multi-state hiring contracts and mechanisms, particularly for positions that are hard to fill

Multi-state or national contracts for training support

Information technology agencies and contractors to introduce or modify human resource or related workforce, administration, and other data systems

Strategy B2 Grant program evaluation

A comprehensive evaluation of this grant is important to further build the evidence base around workforce development, foundational capabilities, and data modernization and to identify best practices and lessons that the public health sector could take forward, after this grant is over. To that end, one or more partners will be funded to take on an evaluation leadership role. This role will include development and management of a comprehensive evaluation plan involving multiple evaluation methods and ongoing dissemination and reflection on results obtained.

Various audiences will need to be served by the evaluation activities, including the Component A recipients, CDC, the public health sector, and Congress. The primary aim of this strategy is to evaluate the grant, not to build evaluation capacity of the recipients, though some capacity-building is encouraged. The recipient(s) of Strategy B2 can subgrant to various evaluation partners, as they see fit, to accomplish the evaluation goals.

One or more Component B recipients will, in collaboration with CDC and Component A recipients:

Design and implement an evaluation plan for the grant, which will likely include multiple case studies, surveys, focus groups, and triangulation with other existing data sources, performance measures, and other process and grant activity tracking

Synthesize evaluation results, along with work plan and CDC performance measure data

Support Component A recipients with participating in, analyzing, and using existing national initiatives that are related to describing the public health workforce and foundational capabilities, such as the PHWINS, ASTHO Profile, NACCHO Profile, Lab Testing Capacity, Epidemiology Capacity Assessments, and health department accreditation efforts www.phaboard.org. Coordinate with and support, as appropriate, key https://debeaumont.org/signup-phwins/what-is-phwins/ https://astho.org/Profile/ https://www.naccho.org/uploads/downloadable-resources/Programs/Public-Health-Infrastructure/NACCHO_2019_Profile_final.pdf https://www.aphl.org/programs/preparedness/Crisis-Management/COVID-19-Response/Pages/COVID-19-Dashboard.aspx https://www.aphl.org/programs/preparedness/Crisis-Management/COVID-19-Response/Pages/COVID-19-Dashboard.aspx https://www.cste.org/page/group-eca http://www.phaboard.org/ partners involved in existing national initiatives that are related to describing the public health workforce and foundational capabilities

Prepare briefs that highlight notable programmatic experiences for recipients as well as other audiences

Assist Component A recipients with preparing and reporting performance measures to

CDC

Disseminate and promote use of preliminary and final evaluation results, to Component A recipients, CDC, other partners, and the peer-reviewed literature

Strategy B3 Grant coordination and communication

This grant will have numerous recipients that reflect a wide range of capacity, needs, and strategic approaches. However, they will share many characteristics and will be working towards similar goals. Communication among Component A recipients about their experiences, plans, questions, and findings is key to helping each one move forward with their work in efficient and effective ways. The recipient(s) of Strategy B3 will facilitate this communication and should adopt multiple means for doing so, from annual meetings to regular webinars and other online ways to share information and questions in real time. This recipient(s) will also help coordinate communication between the Component A recipient community and CDC, to complement the work of project officers and other CDC staff supporting implementation.

Key Activity 1: Crosscutting coordination and communication

One or more Component B recipients will, in collaboration with CDC and Component A recipients:

Create, host, and maintain one or more communities of practice for recipients to exchange information and resources

Hold regular…