Foa_Content_of_CDC-RFA-TP22-2201_122024.pdf

Centers for Disease Control and Prevention

Office of Public Health Preparedness and Response

Public Health Crisis Response Cooperative Agreement

CDC-RFA-TP22-2201

02/11/2027

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- TP22-2201. 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:

Public Health Crisis Response Cooperative Agreement 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 purposes of this NOFO, research is defined as set forth in 45 CFR 75.2 and, for further clarity, as set forth in 42 CFR 52.2 (see eCFR :: 45 CFR 75.2 -- Definitions and https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR- 2007-title42-vol1-sec52-2.pdf. In addition, for purposes of research involving human subjects and available exceptions for public health activities, please see 45 CFR 46.102(l) (https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section- 46.102#p-46.102(l)).

New-Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-TP22-2201

E. Assistance Listings Number:

93.354 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.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l)

F. Dates:

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

09/21/2024

2. Due Date for Applications:

02/11/2027 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

Please send inquiries regarding the NOFO to the program office at DSLRCrisisCoAg@cdc.gov.

Be sure to include the NOFO number, TP22-2201, in the subject line of any inquiries.

G. Executive Summary:

1. Summary Paragraph This CDC notice of funding opportunity (NOFO) seeks to enhance the nation’s ability to rapidly mobilize, surge, and respond to a public health emergency (PHE) identified by CDC. This NOFO is intended to establish a roster of approved but unfunded (ABU) applicants that may receive rapid funding by CDC to respond to a PHE of such magnitude, complexity, or significance that it would have an overwhelming impact upon, and exceed resources available to, the jurisdictions. CDC will use this ABU list for emergencies that require federal support to effectively respond to, manage, and address identified public health threats. CDC will make funding related to this NOFO available once it has determined a PHE exists or is considered imminent and is contingent upon the availability and stipulations of appropriations. CDC will provide additional guidance and information to those on the ABU list when this NOFO is funded.

Applicants may be selected to receive initial funding for Component A to stand up emergency activities, surge staffing, activate their EOCs, and conduct a needs assessment to determine the resources needed to address the specific public health crisis. Component B will provide for tailored emergency response activities. Components A and B can be issued independently or simultaneously based upon the unique needs and nature of the specific emergency. Awards and funding are subject to availability of funds.

a. Funding Instrument Type:

CA (Cooperative Agreement)

b. Approximate Number of Awards The number of recipients may change with each funded PHE. For information on eligibility, please refer to the Funding Strategy and Eligibility Information sections.

c. Total Period of Performance Funding:

$500,000,000 This period of performance funding is an estimate for both components. It is not possible to approximate an amount of funding due to the nature of this NOFO (the intent to establish a quick funding mechanism for pre-approved recipients faced with a public health emergency or imminent threat). CDC may establish award amounts when a public health emergency requires this NOFO to be activated.

https://www.grants.gov/ mailto:DSLRCrisisCoAg@cdc.gov

d. Average One Year Award Amount:

$5,000,000 This average one year award amount is an estimate for both components. It is not possible to approximate an amount of funding due to the nature of this NOFO (the intent to establish a quick funding mechanism for pre-approved recipients faced with a public health emergency or imminent threat). Award amounts may be established by population-based formula or other criteria specified in the appropriations legislation.

e. Total Period of Performance Length:

5 year(s)

f. Estimated Award Date:

January 06, 2025

g. Cost Sharing and / or Matching Requirements:

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

Part II. Full Text

A. Funding Opportunity Description

1. Background

a. Overview Note: Applicants must continue to use their DUNS number for this application. Applicants should note an error in the guidance for completing the SF424. The NOFO states that applicants should use their UEI number as an identifier. However, the version currently in Grants.gov asks for the DUNS number and can’t be modified.

CDC seeks to enhance the nation’s ability to rapidly mobilize, surge, and respond to public health emergencies (PHEs) as identified by CDC by establishing a roster of approved but unfunded (ABU) applicants that may receive rapid funding to respond to PHEs of such magnitude, complexity, or significance that they would have an overwhelming impact upon, and exceed resources available to, the jurisdictions. Applicants will undergo an objective merit review process, and entities that successfully meet the requirements for approval will be placed on the ABU list. CDC will use this ABU list for emergencies that require federal support to effectively respond to, manage, and address identified public health threats. CDC will make funding related to this NOFO available once it has determined a public health emergency exists or is considered imminent and will be contingent upon the availability and stipulations of appropriations. CDC will provide additional guidance and information to those on the ABU list when this NOFO is funded.

COVID-19 public health response plans, such as plans funded under CDC-RFA-TP18-1802 in 2020 are acceptable for this purpose. This NOFO is not a capacity-building funding mechanism, and it is not intended to create or establish new public health (PH) emergency management programs. It may be used to re- establish capacity lost or diminished because of the public health crisis. It is designed to support the surge needs of existing programs responding to a significant PHE. CDC will provide supplemental guidance to entities on the ABU list when this NOFO is activated regarding specific activities intended to address the emergency.

CDC has strong relationships with governmental PH departments, community-based organizations, and other domestic partners and supports them for planning, capacity-building, preparedness, and response to PHEs. This NOFO complements these ongoing capacity-building preparedness and response programs by providing a mechanism for CDC to rapidly mobilize and fund PH organizations for specific response needs. Applicants must describe how this funding will not duplicate or supplant other federal funding.

Upon occurrence of a PHE, CDC can rapidly fund specific applicants to accelerate public health crisis response activities such as coordinating emergency operations, hiring surge staff, and conducting needs assessments to determine the resources necessary to address the public health crisis. The NOFO also provides funding for specialized public health emergency response activities tailored to the specific public health crisis.

Applicants may be selected to receive initial funding for Component A to stand up emergency activities, surge staffing, activate their EOCs, and conduct a needs assessment to determine the resources needed to address the specific public health crisis. Component B will provide for tailored emergency response activities. Components A and B can be issued independently or simultaneously based upon the unique needs and nature of the specific emergency. Awards and funding are subject to availability of funds.

b. Statutory Authorities This program is authorized under section 317(a) of the Public Health Service Act (42 USC § 247(b)), subject to available funding and other requirements and limitations.

c. Healthy People 2030 This program addresses the “Healthy People 2030” (www.healthypeople.gov) focus areas of Preparedness, Immunization and Infectious Diseases, Public Health Infrastructure, Environmental Health, Health Communication and Health Information Technology.

d. Other National Public Health Priorities and Strategies This NOFO supports the National Health Security Strategy of the United States of America (NHSS), Global Health Security Agenda, Social Determinants of Health | CDC) and International Health Regulations.

e. Relevant Work CDC provides funding and technical assistance to public health agencies nationwide to build and strengthen their abilities to plan and prepare for, respond to, and prevent or mitigate public health threats. A variety of CDC cooperative agreements for public health emergencies provide separate funding mechanisms to support capacity-building, planning, preparedness, and response to public health problems, including emergencies such as pandemic events. In addition to this funding opportunity, CDC provides scientific guidance, direct technical assistance and coordination for jurisdictional public health authorities and other organizations to prepare and respond to public health problems, including specific emergencies/events. CDC’s Public Health file:///C:/Users/esz2/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/FBGP9R8W/www.healthypeople.gov http://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx http://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx https://ghsagenda.org/ https://www.cdc.gov/socialdeterminants/ http://www.who.int/topics/international_health_regulations/en/ https://www.cdc.gov/cpr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf

Emergency Preparedness and Response Capabilities provide national standards necessary to advance state, tribal, local, and territorial public health preparedness and response capacity.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-TP22-2201 Logic Model: Public Health Crisis Response Cooperative Agreement.

Bold indicates performance period outcome.

Logic Model

Strategies/ PHEP Domains and Activities

Short-term Outcomes

Intermediate Outcomes

Long-Term Outcomes

Strengthen Community Resilience Strengthen Incident Management for Early Crisis Response Strengthen Information Management Strengthen Countermeasure s and Mitigation Strengthen Surge Management Strengthen Biosurveillance

Prioritized public health services and resources sustained throughout all phases of emergencies and incidents

Earliest possible activation and management of emergency operations

Timely communication of risk and essential elements of information

Timely implementation of intervention and control measures

Timely coordination and support of

Continuity of essential public health services and supply chain during an emergency response and recovery

Latest public health recommendation s and control measures quickly adopted or adapted and implemented

Reduced exposure to risk

Prevent or reduce morbidity and mortality from public health incidents whose scale, rapid onset, or unpredictabilit y stresses the public health system

Earliest possible recovery and return of the public health system to pre-incident levels or improved functioning https://www.cdc.gov/cpr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf response activities with partners

Earliest possible identification and investigation of an incident

Continuous learning and improvements contain real-time feedback loop

i. Purpose CDC seeks to enhance the nation’s ability to rapidly mobilize, surge, and respond to public health emergencies (PHEs) as identified by CDC by establishing a roster of approved but unfunded (ABU) applicants that may receive rapid funding to respond to PHEs of such magnitude, complexity, or significance that they would have an overwhelming impact upon, and exceed resources available to, the jurisdictions.

ii. Outcomes Funded recipients are expected to achieve the following short-term outcomes during the period of performance to create a better prepared nation for public health emergencies. These are the bolded outcomes in the first column of outcomes in the logic model. Jurisdictions should be able to accomplish:

• Prioritize public health services and resources sustained throughout all phases of emergencies and incidents

• Earliest possible activation and management of emergency operations

• Timely communication of risk and essential elements of information

• Timely implementation of intervention and control measures

• Timely coordination and support of response activities with partners

• Earliest possible identification and investigation of an incident

• Continuous learning and improvements contain real-time feedback loop

iii. Strategies and Activities Strengthen Community Resilience CDC will use this NOFO for the timeframe necessary to respond to the specific emergency.

Public health needs that shift from a response mode to recovery (e.g., from epidemic to endemic) may be addressed by this or another CDC NOFO. This NOFO may be used to re-establish capacity lost or diminished as a result of the public health crisis. Recipients should collaborate with public and private community partners to characterize and address the needs of jurisdictional at-risk populations related to PHEs. This includes evaluating available services and developing long-term plans to address potential needs for these populations such as follow-up medical care and behavioral health services with a deliberate focus on improving and advancing health equity for all communities. Following are specific activities to consider.

• Identifying populations at risk including individuals with access and functional needs

• Including populations at-risk in updated response and recovery plans through coordination with local leaders from organizations who have established relationships with diverse communities

• Engaging representative partners from communities with diverse and at-risk populations to participate in exercise plans and drills

• Identifying gaps identified in training, exercises or real-world events to improve operations and identify public health needs of at-risk populations who are disproportionally affected by PHEs.

• Conducting assessments such as: Hazard Vulnerability (HVA)/Risk Assessment, Jurisdictional Risk Assessment (JRA), resource, supply chain

• Establishing public and private partnerships including community groups.

• Developing response plans that address community-specific needs, vulnerable populations, and underserved communities including access and functional needs.

• Coordinating training and exercises and continuous quality improvement.

Strengthen Incident Management for Early Crisis Response Recipients must maintain open lines of communication between state, tribal, and local health agencies as well as CDC to ensure they are prepared to receive updated guidance and must be able to revise their proposals and tailor their activities based on the nature and scope of the crisis, and the updated supplemental guidance. Upon occurrence of a PHE and receipt of funding under this NOFO, recipients that are not in an active response phase should begin accelerated crisis planning by identifying and assembling, if not already in place, a public health emergency response incident management structure (IMS) that includes subject matter experts (SMEs) best suited for responding to the particular PHE. When recipients are in an active response phase, the incident manager should ensure PHE response activities are coordinated across the response’s functional areas, including those funded by CDC, HHS, and other federal grant programs, including, but not limited to, CDC's Public Health Emergency Preparedness (PHEP) and Epidemiology and Laboratory Capacity (ELC) cooperative agreements, where applicable.

Following are emergency operations coordination activities applicants should consider.

• Appoint a senior representative to coordinate PHE response efforts and lead activation and continuation of IMS structure.

• Test, exercise, refine, and implement comprehensive PHE response plans for the funded emergency event.

• Manage the response to align with CDC guidance on emergencies and any supplemental guidance related to a specified emergency.

• Review and implement jurisdictional PHE protocols.

• Assess current capacity and capability and determine decision-making processes and authorities for necessary public health activities.

• Provide technical assistance to state, local and tribal health departments, as applicable, on development of PHE response plans and assist in the identification of resources.

• Review and implement administrative preparedness plans to ensure emergency rapid hiring and expedited contracting processes are in place.

• Organize regular meetings between the PHE response incident manager and the jurisdiction’s preparedness and response partners, both traditional and nontraditional partners, to discuss plans and current progress and to ensure broadly understood decision-making processes are in place.

• Review, or develop if needed, an infectious disease preparedness and response plan for the specific event and tailor as appropriate for its impact on their jurisdiction.

• Diversify the workforce to ensure representation from diverse communities.

• Identify a health equity officer or team to ensure diversity, equity, and inclusion considerations are included in response plans.

• Stand up emergency operations center.

• Establish call centers.

• Conduct needs assessment.

• Prepare staffing contracts.

• Update response and recovery plans.

Strengthen Information Management

• Recipients must plan and coordinate critical information sharing among public health agency staff and ensure coordination across governments. Jurisdictional governments must work together as appropriate, with key partners, the public, health care and other providers including, but not limited to, clinicians. This includes developing, coordinating, and disseminating information, alerts, warnings, and notifications regarding risks and self-protective measures to the public, particularly with at-risk and vulnerable populations, and incident management responders. CDC suggests that jurisdictions consider targeting at a minimum, the public, travelers, and clinicians when developing the information sharing and risk communication messaging activities. Informing the public about PHEs is a critical component of a response. Following are specific activities to consider.

• As appropriate for the funded PHE, work with clinicians and other health care partners to mitigate the impact of the PHEs including the implementation of processes that indicate how health care providers in the jurisdiction can exchange information with electronic public health case reporting systems, syndromic surveillance systems, or immunization registries according to the Centers for Medicare and Medicaid Services (CMS) Electronic Health Record Incentive Program rules and any additional applicable federal standards

• Coordinate with CDC, jurisdictional public health officials, and other stakeholders to ensure jurisdictional personnel have the most up-to-date information on the specific emergency. If the health department is not responsible for key activities, the health department should ensure that the IMS structure and plans include communication and coordination with those other departments (e.g., with public health emergency management officials for emergencies such as pandemic events, etc.).

• Initiate a communications campaign to raise public awareness of PHEs funded under this NOFO. Primary messaging should focus on awareness and specific actions the public can take to protect themselves. Work with key partners and stakeholders to coordinate communication messages, products, and programs for affected communities, travelers, and clinicians.

• Update scripts for jurisdictional call centers with specific PHE messaging, including alerts, warnings, and notifications, relevant to the funded emergency and engage trusted community representatives in developing the material to ensure messages are relevant and accessible to diverse audience within the communities.

• Monitor local news stories and social media postings to determine if information is accurate, identify messaging gaps, and adjust communications as needed.

• Contract with local vendors for translation, if needed, printing, signage, public announcements development and dissemination.

Strengthen Countermeasures and Mitigation Recipients should conduct activities that build and maintain access to and administration of medical and nonmedical countermeasures for pharmaceutical and nonpharmaceutical interventions and strengthen mitigation strategies. During and following an emergency, effective care cannot be delivered without available staff and appropriate countermeasures. Accordingly, managing access to and administration of countermeasures and ensuring the safety and health of clinical and nonclinical personnel are high priorities for preparedness and continuity. Following are specific activities that should be considered.

• Manage access to and administration of pharmaceutical and nonpharmaceutical interventions, prioritizing communities disproportionately impacted by PHEs.

• Administer and coordinate control measures.

• Ensure safety and health of responders.

• Operationalize response plans.

Strengthen Surge Management Recipients should focus on activities that strengthen their ability to support and manage increased demands for services, expansions of public health functions, increases in administrative management requirements, and other emergency response surge needs created by an emergency or incident.

The following four activities are commonly used to manage public health surge:

• Address mass care needs, including shelter monitoring and services for people with access and functional needs.

• Address surge needs, including family reunification.

• Prevent or mitigate diseases, injuries, and fatalities with a particular focus on historically underserved populations and those disproportionally impacted by PHEs, such as tribal communities, racial and ethnic minorities, LGBTQ community, people living with disabilities, and people experiencing homelessness.

Strengthen Biosurveillance Review, update, and/or implement existing surveillance plans. Identify activities that require participation from other governmental entities, such as local or neighboring health departments and other stakeholders in the public health emergency management sector and local communities to identify and address potential gaps for a specific event. Ensure that existing electronic disease surveillance systems, laboratory response networks, and laboratory testing capability are up to date. The following activities are commonly used to strengthen biosurveillance:

• Review, test or exercise, update and implement existing surveillance plans.

• Identify activities that require involving other governmental entities, such as local or neighboring health departments and other stakeholders in the public health emergency management sector to identify and address potential gaps for a specific event.

• Ensure that existing electronic disease surveillance systems, laboratory response networks, and laboratory testing capability are up to date.

Domains specific to Component A include: • Strengthen Incident Management for Early Crisis Response • Strengthen Jurisdictional Recovery

Domains specific to Component B include: • Strengthen Biosurveillance • Strengthen Information Management • Strengthen Countermeasures and Mitigation • Strengthen Surge Management

1. Collaborations

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

Recipients are required to collaborate with various CDC programs to ensure that activities and funding are coordinated with, complementary of, and not duplicative of efforts supported under other CDC grant programs such as PHEP and ELC. During any particular emergency funded under this NOFO, recipients should collaborate closely with CDC incident management and relevant subject matter experts as well as other organizations funded by CDC to address emergency response. This includes neighboring states and other jurisdictional entities, tribes, territories, partner organizations, and national partner organizations such as the Association of Public Health Laboratories (APHL), the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), and the National Association of County and City Officials (NACCHO). Others to consider are local or regional organizations such as vector control entities, clinical and other health care institutions, or businesses such as supply vendors. For questions regarding collaborating with CDC, please contact Program Official, Noelle Anderson (xwq3@cdc.gov) for this NOFO.

b. With organizations not funded by CDC:

Recipients must collaborate with their jurisdictional laboratories, surveillance and epidemiology leads, vector control programs, health care providers, blood safety organizations, and emergency management partners or other relevant partners identified depending on the nature of the emergency. Recipients are encouraged to partner with other federal agencies and programs, including but not limited to the Hospital Preparedness Program (HPP) administered by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), and other grants and programs directed, managed, or supported by the Department of Homeland Security (DHS) and other federal departments impacted or potentially impacted by the public health emergency for which funds will be made available under this NOFO. In addition, collaborations with nonfederal partners are essential in advancing health equity including, but not limited to, community-based organizations, tribal and urban Indian organizations, and faith-based organizations.

2. Population(s) of Focus This NOFO, including funding and eligibility, is not limited based on, and does not discriminate on the basis of race, color, national origin, disability, age, sex (including gender identity, sexual orientation, and pregnancy) or other constitutionally protected statuses.

a. Health Disparities The goal of health equity is for everyone to have a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.

Broadly defined, social determinants of health are non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces (e.g., racism, climate) and systems include economic policies and systems, development agendas, social norms, social policies, and political systems. See content below and in other sections (e.g., Approach, Collaborations, Populations of Focus) for information on how this specific NOFO affects social determinants of health.

A health disparity is a preventable difference in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been socially, economically, geographically, and environmentally disadvantaged. Health disparities are inextricably linked to a complex blend of social determinants that influence which populations are most disproportionately affected by these diseases and conditions.

Applicants should have a plan to address health disparities and health equity by having procedures in place to identify and be inclusive of populations with access and functional needs that may be disproportionately impacted or have increased risk for various PHEs. This includes but is not limited to populations with disabilities; non-English speaking or limited English proficiency populations; people with limited health literacy; immunocompromised persons; older adults; people with limited transportation; people experiencing homelessness; postpartum and lactating women; pregnant women, children. Additionally, applicants should outline existing strategies to address the needs of historically marginalized populations and populations that may otherwise be overlooked by the program during PHEs including tribal communities, racial and ethnic minority populations, and LGBTQ community.

See also Section iii, Strategies and Activities, Community Resilience, Information Management, and Surge Management..

iv. Funding Strategy

This NOFO is intended for applicants under section 317(a) of the Public Health Service Act (42 USC § 247(b)): states, political subdivisions of states, and other public entities. This NOFO is designed to collect proposals from applicants eligible under section 317(a) of the Public Health Service Act (42 USC § 247(b)). Applications will be subject to an objective merit review and approved applications will be designated as “approved but unfunded” (ABU). The NOFO will only be funded when a public health emergency (PHE) has occurred or is projected to impact the U.S., and CDC decides to make awards under this NOFO for that specific emergency.

Depending on the nature of the emergency, specific applicants and specific components of their applications may be selected for funding. These funding decisions will account for various relevant factors such as geographic location of the emergency, expectations of spread (e.g., with infectious disease- related emergencies), applicant’s capabilities, national priorities, impact of the emergency on a jurisdiction, congressional language in the appropriation, etc. CDC’s ability to understand the impact of the event on the approved applicant will facilitate the development CDC supplemental guidance and funding strategies.

Since this NOFO is designed to collect applications prior to a PHE, applicants are encouraged to submit work plans and budgets that demonstrate their ability to respond to a PHE. COVID-19 public health response plans, such as plans funded under CDC-RFA-TP18-1802 in 2020, are acceptable for this purpose. If this NOFO is funded for a specific PHE, CDC will develop supplemental guidance that outlines additional work plan and budget requirements tailored to the emergency.

This NOFO provides funding for two components: Component A and Component B. Applicants may be selected to receive initial funding for Component A to stand up emergency activities, surge staffing, activate their EOCs, and conduct a needs assessment to determine the resources needed to address the specific public health crisis. Component B will provide for tailored emergency response activities. Components A and B can be issued independently or simultaneously based upon the unique needs and nature of the specific emergency. Depending on the unique needs and nature of the crisis, Components A and B can be issued independently or simultaneously. In addition, if funded independently, either Component A or Component B may include all six domains. Applicants are not expected to apply by component as components are for the purpose of making awards. This NOFO will develop one ABU list, how each component is time-based, and how funding decisions for Component B will be determined. Awards and funding are subject to availability of funds. Award amounts may be established by population-based formula or other criteria specified in the appropriations legislation.

Applicants that meet population requirements are listed in Attachment A. This announcement will be open and continuous and remain on Grants.gov for new local and tribal applicants to accommodate population changes over the application period.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Evaluation and performance measurement help demonstrate achievement of program outcomes;

build a stronger evidence base for specific program strategies; clarify applicability of the evidence base to different populations, settings, and contexts; and drive continuous program improvement. Evaluation and performance measurement can also determine if program strategies are scalable and are effective at reaching target populations. CDC will use evaluation findings and performance measures to demonstrate the value of this program and describe effective implementation of the NOFO.

Evaluation and Performance Measure Strategy Recipients will be responsible for data collection and reporting. Data collection and reporting requirements will be limited to data that will be analyzed and used for program monitoring and quality improvement. Recipients will submit to CDC the required data and other information required under this NOFO. CDC will use these data and information to monitor indicators, document progress, and generate feedback reports regarding program accomplishments related to this NOFO.

At the core of the evaluation and performance measure strategy is a set of process measures and program outputs to track implementation of the strategies and outcome measures to monitor achievement of the outcomes expected in the performance period.

Process Measures and Outputs

The process measures for each strategy will based on the outputs presented in the logic model.

The component activities in each strategy are intended to lead to strong deliverables or outputs;

these, in turn, indicate that the strategy is being implemented successfully. The activities a recipient conducts to address the strategies should be targeted to guidance related to achieve an effective level of implementation to address the PHE. CDC has established a standard on which to focus activities for the NOFO to produce the prioritized outcomes such as plans, trained personnel, and equipment to respond to a PHE with funding from this mechanism.

Program Outputs Recipient jurisdictions must have established, effective public health emergency management programs across the six public health domains of the Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health.

This funding depends upon expedited administrative preparedness in the event of an emergency in these established programs. Evaluation for this NOFO will focus on the following response elements of the preparedness cycle for each domain and funded capability:

• The development and updating of plans

• Personnel or access to personnel with requisite skills to implement plans

• Drills and exercises conducted to improve implementation of plans

• Necessary policies, processes, and equipment in place

Plans must be submitted to CDC upon request and made available during site visits. At the time CDC implements this NOFO, it may issue a checklist for recipients that establishes which of the response elements identified above will be included and which may be supplemented with additional items as relevant to the response at the time of the emergency.

Process Measures: Outputs for Each Strategy that Align with PHEP Domains As depicted in the logic model, each strategy is expected to produce key outputs. These outputs serve as process measures, indicating that the strategy is being successfully implemented.

Following are outputs that jurisdictions may consider measuring:

https://www.cdc.gov/cpr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf https://www.cdc.gov/cpr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf

Strengthen Incident Management for Early Crisis Response:

• Emergency operation centers activated

• Incident management systems

• Continuity of operations (COOP) plans implemented

• Call centers established

• Needs assessments conducted

• Staffing contracts prepared

• Response plans operationalized

• Recovery plans operationalized

Strengthen Community Resilience:

• Assessments conducted, such as HVA/Risk, JRA, resource, supply chain

• Populations at risk identified

• Established public and private partnerships

• Response plans addressed community-specific needs and vulnerable populations

• Coordinated trainings and exercises and continuous quality improvement

Strengthen Information Management:

• Defined essential elements of information

• Risk communication systems initiated

• Risk communication materials developed

• Social media outlets monitored

• Trained risk communication staff

• Message and report templates created

Strengthen Countermeasures and Mitigation:

• Storage and distribution centers used

• Inventory management systems implemented

• Points of dispensing (PODs)/alternate nodes established

• Trained POD staff

• Personal protective equipment (PPE) made accessible

• Safety and “just in time” trainings conducted

Strengthen Surge Management:

• Electronic volunteer registry systems used

• Coordinated public health and health care agencies

• Population monitoring systems employed

• Implemented plans for crisis standards of care

Strengthen Biosurveillance:

• Electronic disease surveillance systems operationalized

• Leveraged laboratory response networks

• Laboratory testing capability tested

• Integrated laboratory and epidemiology systems

Outcome Measures In addition to evaluating the activities and outputs for response, CDC may also monitor outcomes with measures specific to the PHE. CDC will provide additional information on program and performance measure requirements when funding is made available for a specific PHE. Examples may include but are not limited to:

Outcome: Earliest possible activation and management of emergency operations

• Program Measure: Percent of recipients that have reduced cycle time for contracting and procurement during an incident (PHE) o Recipient performance measure: Emergency procedures for allocating funds to local jurisdictions, including tribal health departments, have been exercised

Outcome: Earliest possible identification and investigation of an incident

• Program Measure : Percent of recipients that meet reporting times for the specific PHE funded under this NOFO o Recipient Performance Measure: Percentage of selected reportable diseases reports received by a public health agency within the recipient-required timeframe.

• Program Measure : Percent of recipients that meet target response time for laboratory and epidemiologic response activities required for this specific PHE.

o Recipient Performance Measure: Time to complete notification in both directions between CDC and recipients.

Outcome: Timely implementation of intervention and control measures

• Program Measure : Percent of recipients that meet CDC-established target times to initiate disease control methods for the specific PHE funded under this NOFO o Recipient Performance Measure: Percentage of reports of the specific PHE under this NOFO for which initial public health control measures were initiated within the appropriate timeframe.

Outcome: Timely communication of risk and essential elements of information by partners

• Program Measure : Percent of recipients with identified vulnerable population partners in place for risk communications o Recipient Performance Measure: Number of partner organizations or community-based organizations engaged in planning or response efforts

Outcome: Timely coordination and support of response activities with health care and other partners

• Program Measure : Percent of recipients that have executed their plans, processes, and procedures to manage volunteers supporting an emergency or incident.

o Recipient Performance Measure: Plans, processes, and procedures that were executed to achieve desired goals and objectives, as outlined in CDC’s updated guidance, to manage volunteers who support an emergency or health incident.

• Program Measure : Percent of recipients that deploy volunteers within requested timeframe.

o Recipient Performance Measure: Percentage of volunteers deployed to support the specific public health emergency funded under this NOFO within requested timeframe.

Additional measures may be developed in accordance with the actual PHE and will be provided through supplemental guidance from CDC. Requirements for monitoring and reporting will also be specified through supplemental guidance.

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

• How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement, including, as applicable to the award, how findings will contribute to reducing or eliminating health disparities and inequities.

• 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).

• How evaluation findings will be disseminated to communities and populations of interest in a manner that is suitable to their needs.

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

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

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

https://www.cdc.gov/grants/additional-requirements/ar-25.html

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

• Describe key evaluation questions to be addressed by these evaluations.

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

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

Recipients may be required to submit a more detailed evaluation and performance measurement plan, including a DMP, if applicable.

Applicants should develop their evaluation and performance measurement plans in concert with CDC based on the nature of the event. These requirements will be specified by CDC in supplemental, event-specific guidance.

c. Organizational Capacity of Recipients to Implement the Approach Applicants must have existing and functional public health emergency management programs.

They must possess the organizational capacity and skills needed to implement the award during both component phases A and B, including the capability to:

1. Monitor health status to identify community health problems;

2. Diagnose and investigate health problems and health hazards in the community;

3. Inform, educate, and empower people about health issues;

4. Mobilize community partnerships to identify and solve health problems;

5. Develop policies and plans that support individual and community health efforts;

6. Enforce laws and regulations that protect health and ensure safety;

7. Link people to needed personal health services and ensure the provision of health care when otherwise unavailable;

8. Ensure a competent public health workforce;

9. Evaluate effectiveness, accessibility, and quality of population-based health services;

10. Adapt response activities based on new insights and develop innovative solutions to health problems;

11. Implement and surge public health emergency management programs;

12. Identify and roster staff for incident management roles and response leadership;

13. Develop, execute, and revise program planning specific to an event;

14. Conduct program evaluation;

15. Conduct performance monitoring;

16. Conduct and submit financial reports;

17. Conduct budgeting, management, and administration activities;

18. Execute against administrative preparedness plans; and

19. Conduct personnel management activities.

In support of these capabilities, applicants must provide documentation of their capacity to implement the required activities and provide information that:

• Describes the organizational capacity and skills to implement a functional response to a public health emergency, addressing public health emergency management, incident management and response leadership, response planning, program evaluation, performance monitoring, financial reporting, budget management and administration, and personnel management.

• Describes existing organizational capacity, for example program and staffing management; performance measurement, and evaluation systems; financial reporting systems; communication, technological, and data systems required to implement the activities of a response in an effective and expedited manner; physical infrastructure and equipment; and workforce capacity, to successfully execute all proposed strategies and activities based on the current described scenario.

• Describes the organizational capacity to manage partnerships with other state, tribal, local, or territorial public health organizations in their jurisdictions to ensure a coordinated response posture and execution.

• Depicts the current organizational chart for their public health emergency management programs.

Recipients are expected to have the organizational capacity to:

(1) submit amended budgets within the timeframe specified in the funding guidance,

(2) meet spending and progress reporting requirements as established in supplemental guidance for any awards made under this NOFO,

(3) rapidly procure equipment and services either through a General Services Administration contract or other viable mechanism,

(4) rapidly hire or contract for temporary staffing, and

(5) execute contracts.

Acceptable documentation includes but is not limited to:

• letters signed by the applicants’ public health directors on departmental letterhead attesting to the existing capacity and capability for rapid procurement, hiring, and contracting; and

• departmental organizational charts; or

• incident management structure organizational charts.

Organizational charts are required. Applicants should name the file 'Organizational Chart' and upload the document as a pdf at www.grants.gov.

Applicants may describe their status in applying for public health department accreditation or evidence of accreditation through the Public Health Accreditation Board (PHAB) or Project Public Health Ready.

d. Work Plan Planning Scenario: For planning purposes, applicants should develop their work plans to address the public health preparedness and response capabilities required to respond to a scenario involving an emerging infectious disease outbreak. CDC encourages applicants to submit their crisis response fiscal year 2020 COVID-19 work plans and budgets to meet this requirement.

Work plans should address the initial response activities required for Component A, as well as the crisis-specific response activities required for Component B. Applicants should assume that their current public health infrastructure and staff are unaffected and at working capacity. The emerging infectious disease has multiple routes of transmission, a high attack and mortality rate, and either a countermeasure, a pharmaceutical, a vector control, or an oral prophylaxes component.

General Work Plan Guidance: Applicants must submit a high-level work plan that addresses the proposed scenario, such as their COVID-19 public health response plans submitted to CDC (or to a state health department) in the spring of 2020.

Applicants should review their existing public health emergency management program capabilities and capacities and identify the areas that would be most likely to require surge support. Applicants should use the domains, strategies, and activities within the logic model as the basis for their work plan development.

• Applicants should provide at least one proposed output.