Foa_Content_of_CDC-RFA-TU-24-0137.pdf

Division of State and Local Readiness

Notice of Funding Opportunity

Application due April 24, 2024

Public Health Emergency Preparedness (PHEP) Cooperative Agreement Opportunity number: CDC-RFA-TU24-0137

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 7

Program description 10

Step 2: Get Ready to Apply 74

Get registered 75

Step 3: Prepare Your Application 77

Application contents & format 78

Step 4: Learn About Review & Award 84

Application review 85

Step 5: Submit Your Application 90

Application submission & deadlines 91

Application checklist 93

Step 6: Learn What Happens After Award 94

Post-award requirements & administration 95

Contacts & Support 99

Appendix 102

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registration is active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by April 24, 2024 Applications are due by 11:59 p.m. Eastern Time on April 24, 2024.

Before you begin 3 https://sam.gov/ https://grants.gov/

Jump to a step

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 7

Program description 10

Basic information Centers for Disease Control and Prevention (CDC)

Office of Readiness and Response

Division of State and Local Readiness

Preparing our public health systems to respond to and recover from emergencies

Have questions?

See Contacts & Support.

Key facts

Opportunity name:

Public Health Emergency Preparedness (PHEP) Cooperative Agreement

Opportunity number:

CDC-RFA-TU24-0137

Federal assistance listing:

93.069

Key dates

Application deadline:

April 24, 2024

Informational webinars:

• Thursday, February 29, 2024, 2 p.m. to 3:30 p.m.

ET

• Thursday, February 29, 2024, 8 p.m. to 9:30 p.m.

ET

Expected award date:

July 1, 2024

Expected start date:

July 1, 2024

Summary This funding program aims to strengthen the capacity and capability of state, tribal, local, and territorial (STLT) public health systems to prepare for, respond to, and recover from public health threats and emergencies.

Our goal is to enhance readiness to save lives and prevent morbidity and mortality during emergencies that exceed the day-to-day capacity of public health agencies.

This funding opportunity provides a roadmap for PHEP recipients to design, develop, and implement strategies and activities that will improve their readiness to execute plans, respond to public health threats and emergencies, and recover from them.

To do this, we use CDC’s Response Readiness Framework (RRF), which describes 10 program priorities. These program priorities, along with the Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health, provide the framework to support advancement of preparedness, response, and recovery operations.

Funding details Type: Cooperative agreement

Total awards: 62

Projected total program funding, subject to the availability of funds, over the five-year performance period: $3,268,693,045

Projected total program funding, subject to the availability of funds, per budget period: $653,738,609

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 5 https://www.cdc.gov/orr/readiness/capabilities/index.htm https://www.cdc.gov/orr/readiness/capabilities/index.htm

Funding strategy We will award funding using a statutory formula.

We encourage you to make 75% of Cities Readiness Initiative (CRI) funds available to your CRI jurisdictions within 90 days of the start of the budget period.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac).

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 6 https://www.govinfo.gov/content/pkg/USCODE-2021-title42/pdf/USCODE-2021-title42-chap6A-subchapII-partB-sec247d-3a.pdf

Eligibility Who can apply

Eligible applicants As defined in section 319C-1 of the Public Health Service Act, the 62 eligible applicants for this funding opportunity are states, a consortium of states, or eligible political subdivisions that prepare and submit sufficient applications compliant with the statutory and administrative requirements described in this document. For the purposes of this announcement, the term “state” may include a state, a territory, or a freely associated state.

State governments

• 50 state governments

• Eight territorial governments and freely associated states: American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Puerto Rico, Republic of the Marshall Islands, Republic of Palau, and U.S. Virgin Islands

Local governments CDC can make awards to up to three political subdivisions that:

• Have a substantial number of residents

• Have a substantial local infrastructure for responding to public health emergencies

• Face a high degree of risk from bioterrorist attacks or other public health emergencies

CDC has determined that Chicago, Los Angeles County, and New York City meet the requirements of this provision.

Eligible recipients for this funding opportunity announcement must be currently funded under CDC-RFA-TP19-1901.

Other award The statute also allows CDC to set aside funding to address significant unmet needs or a particularly high degree of risk for public health threats.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 7 https://uscode.house.gov/view.xhtml?req=(title:42%20section:247d-3a%20edition:prelim)

CDC has determined that the CRI and Level 1 Laboratory Response Network chemical laboratories meet the requirements of these provisions. In addition, Washington D.C. meets the requirements for one of these awards, per statute.

Cost sharing and matching funds This program requires you to contribute $1 for every $10 we award you in federal funds.

To calculate the cost-sharing requirement, divide the federal share by 10.

For example: Divide $45,000,000 by 10. Your match would be $4,500,000.

Cost-sharing exceptions The match requirement does not apply to Chicago, Los Angeles County, and New York City.

A portion of the requirement, up to $200,000 is waived for American Samoa, Guam, U.S. Virgin Islands, and the Commonwealth of the Northern Mariana Islands. If your calculated cost-sharing requirement is more than $200,000, then you must contribute that amount minus $200,000. See 48 USC 1469a(d).

Types of cost sharing You can meet your match requirement through any combination of:

• Cash or in-kind contributions (non-cash) from your organization

• Cash or in-kind contributions (non-cash) from public or private entities

You must not use federal funds to meet match requirements.

Cost-sharing commitments If you receive an award, you are required to contribute the funds you agreed to pay. This applies if you promised an amount more than the required minimum. We put these commitments in your Notice of Award (NOA).

If you do not provide your promised amount, we may decrease your award amount. You will have to report your funds when you fill out your annual Federal Financial Report. This accounting is subject to ongoing monitoring, oversight, and audit.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 8 https://www.govinfo.gov/content/pkg/USCODE-2021-title42/pdf/USCODE-2021-title42-chap6A-subchapII-partB-sec247d-3a.pdf https://uscode.house.gov/view.xhtml?hl=false&edition=prelim&req=granuleid%3AUSC-prelim-title48-section1469a&f=treesort&num=0&saved=%7CKHRpdGxlOjQ4IHNlY3Rpb246MTQ2OWEtMSBlZGl0aW9uOnByZWxpbSkgT1IgKGdyYW51bGVpZDpVU0MtcHJlbGltLXRpdGxlNDgtc2VjdGlvbjE0NjlhLTEp%7CdHJlZXNvcnQ%3D%7C%7C0%7Cfalse%7Cprelim

Maintaining state funding If you receive an award, you must maintain at least the same spending level for public health security as the average of the previous two fiscal years before the award. This is a requirement under 42 USC 247d-3a(h)(2). We will enforce these statutory requirements through all available mechanisms. You must provide supporting documentation in your attachments.

Public health security includes:

• Eligible state expenditures specifically designed to support public health emergency preparedness; and

• Other funds — such as general funds or other lines within your operating budget — that support public health emergency preparedness activities, such as costs for related personnel, supplies, or equipment.

You must be able to account for maintaining state funding separate from accounting for:

• Federal funds

• Any matching funds requirements

This accounting is subject to ongoing monitoring, oversight, and audit.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 9 https://uscode.house.gov/view.xhtml?req=(title:42%20section:247d-3a%20edition:prelim)

Program description Purpose Our purpose is to strengthen STLT public health preparedness, response, and recovery capacity and capability through a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and implementing corrective actions.

A successful public health response is expected to help prevent or reduce morbidity and mortality from public health threats and emergencies and facilitate the recovery process.

Approach Overview CDC’s Response Readiness Framework describes 10 cross-cutting program priorities to focus efforts on during the federal fiscal years (FY) 2024-2028 period of performance. These priorities inform the PHEP logic model.

Additionally, the Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health describes the 15 capability standards designed to support STLT jurisdictions as you prepare for, respond to, and recover from public health threats and emergencies. These 15 capabilities are foundational to the CDC Response Readiness Framework.

We expect you to show measurable progress toward achieving the outcomes outlined in the logic model during the five-year period of performance. CDC will evaluate you on the strategies and activities outlined in the PHEP logic model to ensure that you show measurable progress in achieving desired outcomes.

Logic model The logic model in this section includes the NOFO strategies and activities and outcomes.

Outcomes are the results that you intend to achieve and usually show the intended direction of change, such as increase or decrease.

Not all outcomes apply to all strategies. The table shows how they apply. Use these outcomes as a guide to plan for performance measurement.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.cdc.gov/orr/readiness/phep/00_images/CDC-PHEP-Response-Readiness-Framework.png https://www.cdc.gov/orr/readiness/capabilities/index.htm https://www.cdc.gov/orr/readiness/capabilities/index.htm https://www.cdc.gov/orr/readiness/capabilities/index.htm https://www.cdc.gov/orr/readiness/phep/00_images/CDC-PHEP-Response-Readiness-Framework.png https://www.cdc.gov/orr/readiness/phep/00_images/CDC-PHEP-Response-Readiness-Framework.png

Program logic model The logic model shows the strategies and activities of the program along with the outcomes we expect over time. You must achieve and report on the outcomes for the five-year period of performance.

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1 (ST1)

• Use CDC’s established national preparedness and response capabilities, as applicable, to prioritize a risk-based approach to all-hazards planning and improve readiness, response, and recovery capacity for existing and emerging public health threats and modernized laboratory and electronic data systems

Strategy 2 (ST2)

• Use CDC’s established national preparedness and response capabilities, as applicable, to improve whole community readiness, response, and recovery through enhanced partnerships and

ST1

• Refined risk assessment for equitable community planning that address prioritized populations for all jurisdictional threats

• Completed exercise requirements that identify areas for improved readiness, response, and recovery

• Modernized electronic data systems to advance timely identification and reporting of incidents or events that require public health action

• Improved capacity of public health laboratory networks and surveillance systems to detect and report existing and emerging public health threats

ST1

• Improved public health readiness, response, and recovery capability that follows standardized emergency management practices

• Implemented timely public health recommendations and control measures for all hazards

• Earliest identification and investigation of incidents with public health impact

• Enhanced ability of laboratories to respond to public health incidents by applying modern methods

ST2

• Timely communication of situational awareness and risk information

All strategies

(ST1-3)

• Earliest possible recovery and return of the public health system to pre-incident levels or improved functioning

• Prevent or reduced morbidity and mortality for all impacted populations from incidents with public health consequences whose scale, rapid onset, or unpredictability stresses the public health system

Step 1: Review the Opportunity 11

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes improved communication systems for timely situational awareness and risk communication

Strategy 3 (ST3)

• Use CDC’s established national preparedness and response capabilities, as applicable, to improve capacity to meet jurisdictional administrative, budget, and public health surge management needs and to improve public health response workforce recruitment, retention, resilience, and mental health

ST2

• Revamped communication strategies and tools

• Developed and maintained partnerships to ensure messages and dissemination strategies are effective for the whole community

ST3

• Established mechanisms to meet administrative, workforce, and response surge requirements

• Revamped preparedness training requirements to promote readiness, response, recovery, and resiliency

• Established communities of practice focused on readiness, response, and recovery guidance and resources

• Timely coordination and support of response and recovery activities with health care systems and partners

• Integrated equity into public health response and recovery

ST3

• Increased hiring and retention of surge staff resources

• Prepared public health workforce ready to sustain public health investigations, response, and recovery

• Active engagement in communities of practice

Step 1: Review the Opportunity 12

Strategies & activities The 10 Response Readiness Framework program priorities are categorized into three strategies. The following section describes the three strategies, outlined in the PHEP logic model, and the activities to achieve required outcomes. You can find additional resources on how to achieve these outcomes in Ready CAMP, our program management platform.

NOFO activities, details, and performance measures for quick reference

Strategy 1

Table: Activities table 1: All-hazards activities (AHA)

Activity Who When Performance Measure Obligation

AHA-A: Complete and submit a risk assessment and data elements

62 recipients • Budget Period 1, by January 31, 2025, submit your risk assessment and data elements

• Complete a new risk assessment once during the five-year performance period

• Submit risk assessment and data elements each time your risk assessment is updated

Recipients must submit a completed risk assessment and required data elements that reflects the needs of the whole jurisdiction

Required

Step 1: Review the Opportunity 13

Activity Who When Performance Measure Obligation

AHA-B: Complete and submit multiyear integrated preparedness plans and data elements

62 recipients • Budget Period 1, by June 30, 2025

• Review multiyear integrated preparedness plan each budget period, update and submit as needed

Recipients must submit a multiyear integrated preparedness plan that addresses plans, training, exercising, and corrective actions for prioritized jurisdictional risks (see AHA-A, AHA-E, and REC- A)

• Required

• PHEP

benchmark

AHA-C: Develop and conduct required exercises

62 recipients According to jurisdictional exercise plans

Recipients must complete all required discussion- and operation-based exercises

Required

AHA-D: Submit exercise and incident response improvement plan data elements

62 recipients Each budget period, 90 days after completing discussion-based, operation-based exercises or incident responses

Recipients must submit updated improvement plans based on all required exercises and corrective actions from incidents

Required

AHA-E: Maintain capacity and capability to distribute, dispense, administer medical countermeasures and manage medical materiel

62 recipients Each budget period

Recipients must maintain capability to distribute, dispense, and administer medical countermeasures

Required

Step 1: Review the Opportunity 14

AHA-F: Review and update CHEMPACK plans

62 recipients Review each budget period with Administration for Strategic Preparedness and Response/ Strategic National Stockpile and update as needed

Recipients must develop or update CHEMPACK plan

Required

AHA-G: Complete training to ensure baseline competency and integration with preparedness requirements

62 recipients As appropriate Recipients must complete preparedness training to support a ready responder workforce (see

WKF-B)

Recommended

Table: Activities table 2: Public health laboratory capacity activities (LAB)

Activity Who When Performance Measure Obligation

LAB-A:

Participate in LRN-C specimen packaging and shipping exercises

50 states, Los Angeles County, New York City, Puerto Rico, and Washington D.C.

Each budget period

Recipients with PHEP funding for LRN-C laboratory capacity must pass specimen packaging and shipping exercise

Required

LAB-B:

Participate in LRN-B challenge panels

50 states, Los Angeles County, New York City, Puerto Rico, and Washington D.C.

Each budget period

Recipients with PHEP funding for LRN-B laboratory capacity must pass challenge panel exercises

Required; PHEP benchmark

Step 1: Review the Opportunity 15 as defined by

LRN

LAB-C:

Participate in

LRN-C

proficiency testing

10 states with LRN-C Level 1 laboratories; 32 states with LRN- C Level 2 laboratories, Los Angeles County, and Washington D.C.

Each budget period

Recipients with PHEP funding for LRN-C laboratory capacity must pass proficiency exercises (core & additional) as defined by LRN

Required; PHEP benchmark for LRN-C Level 1 laboratories

LAB-D:

Implement specified standards for electronic reporting of LRN- B and LRN-C laboratory data for routine and emergency reporting

50 states, Los Angeles County, New York City, Puerto Rico, and Washington D.C.

Budget Period 5, by June 30, 2029

Recipients with PHEP-funded laboratories must implement specified standards for electronic reporting of LRN- B and LRN-C data for routine and emergency reporting

Required

LAB-E: Develop surge capacity plans for LRN laboratories and incorporate related surge activities in jurisdictional exercises

50 states, Los Angeles County, New York City, Puerto Rico, and Washington D.C.

• Budget Period 2, by June 30, 2026

• Review each budget period thereafter and update as needed

Recipients with PHEP-funded laboratories must develop and exercise LRN surge plans

Required

LAB-F: Maintain LRN program fiscal strategy

50 states, Los Angeles County, New York City, Puerto Rico, and Washington D.C.

• Budget Period 1, by June 30, 2025

• Review each budget period

Recipients with PHEP funded laboratories must demonstrate fiscal responsibility for

Required

Step 1: Review the Opportunity 16 thereafter and update as needed laboratory maintenance

Table: Activities table 3: Data modernization activities (DM)

Activity Who When Performance Measure Obligation

DM-A:

Incorporate data systems and data source functionality and infrastructure in public health emergency response plans

62 recipients • Budget Period 2, by June 30, 2026

• Review each budget period thereafter and update as needed

Recipients must update preparedness plans by incorporating data modernization principles as needed

Required

DM-B:

Incorporate testing of the functionality and infrastructure of data systems and data sources into jurisdictional exercises

62 recipients • Budget Period 3, by June 30, 2027

• Report on changes at the end of each subsequent budget period

Recipients must modernize data and data systems by demonstrating improvements through exercising at least three of the six CDC North Star architecture standards

Required

Step 1: Review the Opportunity 17

Table: Activities table 4: Health equity activity (HE)

Measure Obligation

HE-A: Update risk assessment to include people who are disproportionately impacted by public health emergencies

62 recipients • Budget Period 1, by January 31,

• Review each budget period, update as needed, and submit each budget period if updated

Recipients must complete a risk assessment that identifies the likeliest jurisdictional risks and prioritize populations (that are potentially disproportionately affected or impacted because of access and functional needs given the identified risks);

see AHA-A)

• Required

• PHEP

benchmark

Step 1: Review the Opportunity 18

Strategy 2

Table: Activities table 5: Partnerships activity (PAR)

Activity Who When Performance Measure Obligation

PAR-A: Include critical response and recovery partners in required plans and exercises

62 recipients Review each budget period and update as needed

Recipients must include partners that represent prioritized populations in planning and exercises (see AHA-A and HE-B)

• Required

• PHEP

benchmark

Table: Activities table 6: Risk communications activities (RSK)

Activity Who When Performance Measure Obligation

RSK-A: Develop or update crisis and emergency risk communication and information dissemination plans

62 recipients Review each budget period and update as needed

Recipients must update Crisis and Emergency Risk Communication and information dissemination plans

Required

RSK-B: Identify and implement communication surveillance, media relations, and digital communication strategies in exercises

62 recipients Each budget period

Recipients must exercise communication objectives including identifying and addressing mis/ disinformation

• Required

• PHEP

benchmark

RSK-C: Identify and implement specific crisis and emergency risk communication

62 recipients Review each budget period and update as needed

Recipients must actively engage in established communities of practice focused on crisis and

Required

Step 1: Review the Opportunity 19 activities that meet the diverse needs of communities of focus emergency risk communication related preparedness, response, and recovery activities (see PAR-A and WKF- C)

Table: Activities table 7: Recovery activity (REC)

Activity Who When Performance Measure Obligation

REC-A:

Incorporate recovery operations into public health multiyear integrated preparedness plans

62 recipients • Budget Period 1, by June 30, 2025

• Review each budget period thereafter and update as needed

Recipients must document and exercise recovery plan objectives in the multiyear integrated preparedness plan (see AHA-B)

Required

Step 1: Review the Opportunity 20

Table: Activities table 8: Health equity activity (HE)

Measure Obligation

HE-B: Engage partners to incorporate health equity principles into preparedness plans and exercises

62 recipients Review each budget period and update as needed

Recipients must work with preparedness partners that represent populations with access and functional needs or populations likely to be disproportionately affected during a response to promote health equity and social justice for the whole community (see AHA-A and

PAR-A)

Required

Step 1: Review the Opportunity 21

Strategy 3

Table: Activities table 9: Administrative and budget preparedness activities (ADM)

Activity Who When Performance Measure Obligation

ADM-A: Update administrative preparedness plans using lessons learned from emergency responses

62 recipients • Budget Period 1, by June 30, 2025

• Review each budget period thereafter and update as needed

Recipients must update administrative preparedness plans

Required

ADM-B: Integrate administrative and budget preparedness recommendations into training and exercises

62 recipients • Budget Period 2, by June 30, 2026

• Review each budget period thereafter and update as needed

Recipients must complete an administrative and budget preparedness discussion-based exercise

Required

ADM-C: Improve adherence to guidance related to spending, lapsing of funds, awarding of local contracts, and other administrative and budgetary requirements

62 recipients Each budget period

Recipients must award all PHEP funds allocated to local and tribal entities within 90 days (calculation starts one day after the date recipient receives the CDC award; see ADM- E)

Required

ADM-D: Reduce the time PHEP-funded positions at the recipient

62 recipients Each budget period

• Recipients must reduce

PHEP

• Required

• PHEP

benchmark

Step 1: Review the Opportunity 22 level remain vacant workforce vacancy rates

• Benchmark goal is dependent on jurisdiction vacancy at application

• Jurisdictions with 20% or lower vacancy rates must decrease vacancy by 10%

• Jurisdictions with greater than 20% vacancy rates must demonstrate a decrease of at least 10% by the end of the five-year period of performance (see WKF-A)

ADM-E: Distribute or award funds to local health departments and tribal entities within 90 days after the start of the budget period

62 recipients Each budget period

Recipients must award all PHEP funds allocated to local health departments and tribal entities within 90 days (calculation starts one day after the date

• Required if you distribute funds to local health departments and tribal entities

• PHEP

benchmark

Step 1: Review the Opportunity 23 recipient receives the CDC award; see ADM- C)

Table: Activities table 10: Workforce activities (WKF)

Activity Who When Performance Measure Obligation

WKF-A: Develop plans, processes, and procedures to hire, recruit, train, and retain a highly qualified and diverse workforce

62 recipients • Budget Period 1, by June 30, 2025

• Review each budget period thereafter and update as needed

• Recipients must reduce

PHEP

workforce vacancy rates

• Benchmark goal is dependent on jurisdiction vacancy at application

• Jurisdictions with 20% or lower vacancy rates must decrease vacancy by 10%

• Jurisdictions with greater than 20% vacancy rates must demonstrate a decrease of at least 10% by the end of the five-year period of

• Required

• PHEP

benchmark

Step 1: Review the Opportunity 24 performance (see ADM-D)

WKF-B: Provide guidance, direction, and training to maintain a ready responder workforce across the entire health department

62 recipients Each budget period

• Recipients must have PHEP-funded staff complete jurisdiction’s minimum training requirements (see AHA-G)

• Recipients must have surge staff complete jurisdiction’s minimum training requirements (see AHA-G)

Required

WKF-C: Actively engage in at least one community of practice that identifies problems, solutions, and best practices in workforce recruitment, hiring, training, retention, or resiliency

62 recipients Each budget period

Recipients must participate in at least one community of practice

• Required for the 50 states, Chicago, Los Angeles County, New York City, Washington, D.C., and Puerto Rico

• Recommended for the remaining territories and freely associated states

Step 1: Review the Opportunity 25

Table: Activities table 11: Local support activities (LOC)

Measure Obligation

LOC-A: Engage local jurisdictions, including rural, frontier, and tribal entities, in public health preparedness planning and exercises

50 states Review each budget period and update as needed

States must include local planning jurisdictions in preparedness, response, and recovery activities (see AHA-A, (see AHA- C), and REC-A)

Required

LOC-B: Provide direct technical assistance and surge support staffing to increase local readiness

50 states Review each budget period and update as needed

States must have surge staff complete minimum training requirements (see WKF-B)

Required

LOC-C: Include local representation on senior advisory committees

50 states Review each budget period and update as needed

States must include at a minimum one local jurisdictional representative on their advisory committees

Required

Step 1: Review the Opportunity 26

Table: Activities table 12: Health equity activity (HE)

Measure Obligation

HE-C: Include health equity representatives on senior advisory committees to increase advocacy for communities of focus

62 recipients Each budget period

Recipients must include advisory committee members that promote readiness for health equity and social justice in the whole community (see LOC-C and WKF- C)

Required

Step 1: Review the Opportunity 27

Strategy 1 (ST1) Use CDC’s national preparedness and response capabilities, as applicable, to augment STLT all-hazards planning to improve readiness, response, and recovery capacity for existing and emerging public health threats; and modernize laboratory and electronic data systems.

ST1 highlights the following Response Readiness Framework program priorities.

• Develop a risk-based approach to all-hazards planning to advance risk-based planning; address evolving threats; and support medical countermeasure distribution, dispensing, and administration and medical materiel management.

• Advance capacity and capability of public health laboratories to characterize emerging public health threats through testing and surveillance.

• Modernize data collection and systems to improve situational awareness and information sharing with health care systems and other partners.

• Integrate health equity practices to enhance preparedness, response, and recovery support for populations experiencing health disparities.

Risk-based approach to all-hazards planning (AHA) When used together with the exercise framework, the all-hazards approach (AHA) is designed to improve your response and recovery readiness. It offers a cohesive and structured process that includes:

• Identifying and planning for hazards based on identified risks

• Exercising all-hazard plans

• Recognizing opportunities for improvement

• Refining plans to further improve response capacity

You, along with your CRI local planning jurisdictions must maintain the capacity and capability to manage, distribute, dispense, and administer medical countermeasures according to the Administration for Strategic Preparedness and Response/Strategic National Stockpile (ASPR/ SNS) requirements and guidelines. Requirements on validating receipt, stage, and storage (RSS) sites and testing inventory data exchange, along with SNS guidance on developing capacity and capability to receive, distribute, dispense, and administer medical countermeasures (MCM) can be found of SNS’s Technical Assistance SharePoint site.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 28 https://www.cdc.gov/orr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf https://aspr.hhs.gov/SNS/Pages/default.aspx https://aspr.hhs.gov/SNS/Pages/default.aspx https://aspr.hhs.gov/SNS/Pages/default.aspx https://orau.gov/sns/

Activity details

AHA-A: Complete and submit a risk assessment (RA) and data elements

(RADE)

Who: 62 recipients

When:

• Budget Period 1, by January 31, 2025, submit your RA and RADE

• After that:

◦ Complete a new RA once during the five-year performance period

◦ Submit RA and RADE each time your risk assessment is updated

Obligation: Required

• Conduct RAs and identify the top five risks based on public health consequences.

• At a minimum, an RA must be coordinated with and include all CRI funded local planning jurisdictions. You have autonomy to organize local planning.

• In your application, you must confirm CRI local planning jurisdiction organization. Indicate how many RAs you will report to us based on your planning structure. We expect either:

◦ A single RA coordinated between you and your CRI local planning jurisdictions

◦ Separate risk assessments coordinated by you and your CRI local planning jurisdictions

• We expect you to coordinate with:

◦ The point of contact(s) responsible for completing the Threat and Hazard Identification and Risk Assessment (THIRA) for Federal Emergency Management Agency (FEMA) preparedness grants

◦ The point of contact(s) responsible for completing the Health Care Coalition (HCC) Hazard Vulnerability Assessment (HVA) for the ASPR Hospital Preparedness Program (HPP) cooperative agreement

• We will provide you with the RADE template for submission.

◦ You must submit your most recent RA and RADE by January 31, 2025.

◦ Recipients whose most recent RA occurred in Budget Periods 2, 3, 4, or 5 of the previous NOFO (CDC-RFA-TP19-1901) performance period should submit that RA and the RADE based on elements addressed at that time.

Step 1: Review the Opportunity 29

◦ Recipients who conduct an RA during Budget Period 1 will submit the RA and RADE.

• We expect that all CDC-identified data elements outlined in the RADE are incorporated in the RA.

• Consider updating your RA as recipient jurisdictions change or events necessitate. Examples of such changes or events include new:

◦ Risks or hazards

◦ Population change

• Each time your RA is updated, submit both:

◦ RADE

◦ RA

AHA-B: Complete and submit multiyear integrated preparedness plans (MYIPP) and data elements

Who: 62 recipients

When:

• Budget Period 1, by June 30, 2025

• After that: Review MYIPP and data elements each budget period, update and submit as needed

Obligation: Required; PHEP benchmark

• In Budget Period 1, conduct an integrated preparedness planning workshop (IPPW) and produce a five-year MYIPP informed by:

◦ Risk priorities identified in activity AHA-A

◦ Lessons learned through previous exercises or responses

◦ Exercise priorities for you and your CRI local planning jurisdictions

• Your MYIPP must include planning, training, and exercising priorities and integrate PHEP exercise framework requirements.

◦ MYIPP must address your pandemic influenza plan as required by statute

◦ At a minimum, coordinate MYIPPs with CRI funded local planning jurisdictions and frontier, rural, and tribal entities as relevant.

◦ The MYIPP data elements summarizes your current MYIPP, regardless of when it was performed.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 30 https://www.congress.gov/116/bills/s1379/BILLS-116s1379enr.pdf

AHA-C: Develop and conduct required exercises

Who: 62 recipients

When: Varies depending on timelines of jurisdictional exercise plans

Obligation: Required

• Implement jurisdictional exercise programs in alignment with the PHEP exercise framework.

◦ Plan for and conduct discussion-based and operation-based exercises outlined in the PHEP exercise framework and associated supplemental guidance.

• Complete at least one operation-based exercise each budget period throughout the performance period.

• Use the Homeland Security Exercise and Evaluation Program (HSEEP) methodology when organizing exercise plans.

• You must engage and exercise with local planning jurisdictions and federally recognized American Indian and Alaska Native tribes within applicable PHEP jurisdictions.

• You must account for your jurisdictional risks and scenarios in exercises;

we will provide mandatory objectives within exercise supplemental guidance to assist planners.

• You must develop exercise scenarios that meet your priority jurisdictional risks and complete the capstone exercise, based on one of your top five risks with public health consequences identified in your RA, during the period of performance.

• Submit required exercise data elements, which will include required mandatory objective(s), corrective actions, improvement plan data elements, and MYIPP. Submission of after-action reports (AAR) are required when requested.

AHA-D: Submit exercise and incident response improvement plan data elements

Who: 62 recipients

When: Each budget period, 90 days after completing discussion-based and operation-based exercises or incident responses

Obligation: Required

• We will provide you with improvement plan data elements for submission.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 31 https://www.fema.gov/emergency-managers/national-preparedness/exercises/hseep https://www.fema.gov/emergency-managers/national-preparedness/exercises/hseep

• Upon request you must submit (on behalf of the recipient or CRI local planning jurisdictions):

◦ Improvement plans (IPs)

◦ AARs

AHA-E: Maintain capacity and capability to distribute, dispense, administer medical countermeasures (MCMs) and manage medical materiel

Who: 62 recipients

When: Each budget period

Obligation: Required

• Maintain capacity and capability to dispense, distribute, and administer MCMs according to Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health and ASPR/SNS guidelines.

◦ Work with your CRI local planning jurisdictions to ensure they maintain these capabilities.

◦ Work with SNS to understand the MCM request process, as needed.

• Conduct or participate in activities to test ASPR systems and tools to order, distribute, track local inventory, report utilization and other operational data for federally procured resources and supplies for public health threats, as needed.

• Identify and provide receipt, stage, and storage (RSS) site information to ASPR/SNS as applicable.

◦ Identify primary and alternate RSS sites.

◦ Coordinate new RSS site validation with ASPR/SNS and U.S. Marshals Service senior inspectors within a year of identification.

◦ Revalidate existing previously validated sites at least once every three years.

◦ Confirm that existing, validated RSS site information is current each year.

AHA-F: Review and update CHEMPACK plans

Who: 62 recipients

When: Review each budget period with ASPR/SNS and update as needed

Obligation: Required

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 32 https://www.cdc.gov/orr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf https://www.cdc.gov/orr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf https://www.cdc.gov/orr/readiness/00_docs/CDC_PreparednesResponseCapabilities_October2018_Final_508.pdf

• Conduct CHEMPACK sustainment activities as needed per ASPR/SNS guidelines.

AHA-G: Complete training to ensure baseline competency and integration with preparedness requirements

Who: 62 recipients

When: As appropriate

Obligation: Recommended

Consider the following trainings to ensure baseline competency and integration with preparedness requirements. Following are recommendations for recipients and local jurisdictions based on staff designations. These courses are meant to build upon each other.

• Public health preparedness and recovery staff, including exercise planning staff:

◦ Incident Command System (ICS) 100: Introduction to ICS

◦ ICS 700: An Introduction to the National Incident Management System (NIMS)

◦ ICS 706: NIMS Intrastate Mutual Aid

◦ ICS 800: National Response Framework, An Introduction

◦ IS-120.C: An Introduction to Exercise

◦ IS-2900.A: National Disaster Recovery Framework (NDRF) Overview

◦ Homeland Security Exercise and Evaluation Program

◦ Emergency Management Assistance Compact (EMAC) Pre-Event Preparation for Resource Providers

• Health Department supervisory positions:

◦ ICS 200: Basic ICS for Initial Response

◦ Independent Study (IS)-2200: Basic Emergency Operations Center Functions

• Staff with designated response roles:

◦ ICS 300: Intermediate ICS for Expanding Incidents (In Person)

◦ EMAC Just-in-Time Training for Deploying Personnel

◦ Crisis and Emergency Risk Communication (CERC)

• Senior staff who support the management of large/complex responses (incidents across multiple locations or over a large area):

◦ ICS 400: Advanced ICS (In Person)

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 33 https://www.orau.gov/chempack/ https://training.fema.gov/is/courseoverview.aspx?code=is-100.c&lang=en https://training.fema.gov/is/courseoverview.aspx?code=is-700.b&lang=en https://training.fema.gov/is/courseoverview.aspx?code=is-700.b&lang=en https://training.fema.gov/is/courseoverview.aspx?code=is-706&lang=en https://training.fema.gov/is/courseoverview.aspx?code=IS-800.d&lang=en https://training.fema.gov/is/courseoverview.aspx?code=is-120.c&lang=en https://training.fema.gov/is/courseoverview.aspx?code=IS-2900.a&lang=en https://www.youtube.com/playlist?list=PL720Kw_OojlJRVI3gQiZzj2g72Ez8ISlA https://www.emacweb.org/index.php/elearning-course-summaries/emac-pre-event-preparation-for-resource-providers https://www.emacweb.org/index.php/elearning-course-summaries/emac-pre-event-preparation-for-resource-providers https://training.fema.gov/is/courseoverview.aspx?code=IS-200.c&lang=en https://training.fema.gov/is/courseoverview.aspx?code=IS-2200&lang=en https://training.fema.gov/is/courseoverview.aspx?code=IS-2200&lang=en https://apps.usfa.fema.gov/nfacourses/catalog/details/10620 https://www.emacweb.org/index.php/elearning-course-summaries/emac-just-in-time-training https://emergency.cdc.gov/cerc/training/index.asp https://apps.usfa.fema.gov/nfacourses/catalog/details/10621

Public health laboratory capacity (LAB) Public health laboratories (PHLs) must advance their capacity and capability to respond to emerging public health threats through initial detection and rapid electronic results sharing.

State and territory PHLs that are members of CDC’s Laboratory Response Network (LRN) must:

• Meet specified standards for electronic laboratory reporting

• Maintain and exercise surge plans

• Maintain longer term fiscal strategies for the Laboratory Response Network for Biological Threats (LRN-B) and Laboratory Response Network for Chemical Threats (LRN-C)

We may provide additional funding, if available, to support these efforts:

• A Laboratory Response Network for Radiological Threats (LRN-R)

• Public health LRN-B advanced laboratories to support assay development and may assist CDC with or generate their own regulatory submissions to the U.S. Food and Drug Administration (FDA) during this period of performance

• Laboratory equipment updates and technology transfers for LRN-C level 1 and level 2 laboratories

Activity details

LAB-A Participate in LRN-C specimen packaging and shipping (SPaS) exercises

Who: 50 states, Los Angeles County, New York City, Puerto Rico, and Washington, D.C.

When: Each budget period

Obligation: Required

• Demonstrate proficiency in specimen shipping and packaging through the LRN-C SPaS exercises for chemical threat agents.

◦ SPaS annual exercise evaluates the ability of a laboratory to collect clinical samples for chemical laboratory analysis and to ship those samples in compliance with International Air Transport Association regulations.

◦ You must ensure that at least one PHEP-funded LRN-C laboratory in your jurisdiction participates in the LRN-C SPaS exercise with a minimum score of 90% each budget period.

Step 1: Review the Opportunity 34

LAB-B: Participate in LRN-B challenge panels

Who: 50 states, Los Angeles County, New York City, Puerto Rico, and Washington, D.C.

When: Each budget period

Obligation: Required; PHEP benchmark

• Demonstrate proficiency in public health laboratory testing for biological agents through participation in annual challenge panels.

◦ Challenge panels consist of a variety of mock clinical and environmental matrices that test a laboratory’s ability to:

▪ Successfully identify biothreat agents

▪ Demonstrate understanding of LRN agent-specific testing procedures and algorithms

▪ Ensure a laboratory maintains appropriate levels of testing supplies and reagents

◦ PHEP-funded LRN-B laboratories cannot fail more than one challenge panel associated with standard laboratory requirements during the budget period. The LRN-B challenge panel policy defines successful demonstration of this capability.

• CDC’s LRN-B program requires public health laboratories in the 50 states, Los Angeles County, New York City, Puerto Rico, and Washington, D.C., to participate in all available challenge panels specific to each laboratory’s testing capability. If a laboratory has testing capability for a specific agent and that agent is included in a challenge panel being offered, the PHEP-funded laboratory must participate in that challenge panel.

• We do not expect LRN-B labs that are offline for three months or more due to renovations, moving, or other special circumstances to participate in challenge panels during that time. Report offline status to the LRN-B program office and project officer for awareness.

LAB-C: Participate in LRN-C proficiency testing

Who: 10 states with LRN-C Level 1 laboratories; 32 states with LRN-C Level 2 laboratories, Los Angeles County, and Washington D.C.

When: Each budget period

Obligation: Required; PHEP benchmark for LRN-C Level 1 laboratories

• Demonstrate proficiency in public health laboratory testing for chemical threat agents through the participation in LRN-C proficiency testing panels.

Step 1: Review the Opportunity 35

◦ We will evaluate LRN-C Level 1 and Level 2 laboratories on sample results, reporting accuracy, and timeliness via the LRN secure data portal.

◦ You must ensure that LRN-C Level 1 laboratories in your jurisdiction participate in all LRN-C proficiency testing events for all LRN-C core and additional methods as defined by the LRN-C program office.

▪ This activity is a PHEP benchmark for LRN-C Level 1 laboratories.

◦ You must ensure that LRN-C Level 2 laboratories in your jurisdiction participate in LRN-C proficiency testing events for all LRN-C core methods as defined by the LRN-C program office. Additional methods are optional for Level 2 laboratories.

▪ This activity is not a PHEP benchmark for LRN-C Level 2 laboratories.

◦ CDC’s LRN-C quality assurance policy guidelines define successful demonstration of this capability.

LAB-D: Implement specified standards for electronic reporting of LRN-B and LRN-C laboratory data for routine and emergency reporting

Who: 50 states, Los Angeles County, New York City, Puerto Rico, and Washington, D.C.

When: Budget Period 5, by June 30, 2029

Obligation: Required

• Ensure that LRN-B and LRN-C laboratories implement CDC specified standards for electronic reporting of laboratory data for routine and emergency reporting.

• By the end of the performance period on June 30, 2029:

◦ Report results of all LRN-B-distributed assays to us using specific CDC standards for electronic reporting.

▪ Contact the LRN-B program office for the most current standards and requirements for specific members.

◦ Report all Level 1 LRN-C methods to us using specific CDC standards for electronic reporting.

◦ Report all Level 2 LRN-C core methods to us using specific CDC standards for electronic reporting.

▪ Contact the LRN-C program office for the most current standards.

Step 1: Review the Opportunity 36

LAB-E: Develop surge capacity plans for public health LRN laboratories and incorporate related surge activities in jurisdictional exercises

Who: 50 states, Los Angeles County, New York City, Puerto Rico, and Washington, D.C.

When:

• Budget Period 2, by June 30, 2026

• Review each budget period thereafter and update as needed

Obligation: Required

• By the end Budget Period 2, PHEP-funded state public health LRN-B and LRN-C laboratories must develop surge plans that include essential elements for LRN-B and LRN-C activities:

◦ Surge staffing

◦ Surge equipment and resources

◦ Sentinel laboratory and external laboratory coordination and communication

◦ Biosafety protocols

◦ Sample management (triage, prioritization, testing, and referral)

◦ Data exchange, reporting, and management

◦ Training and exercising

• Incorporate activities into jurisdictional exercises through a phased, progressive exercise approach.

• LRN-B laboratories must exercise surge plans in:

◦ A jurisdictional discussion-based exercise at least once during the five-year performance period

◦ A functional exercise at least once during the five-year period of performance

• LRN-C laboratories must exercise surge plans in:

◦ A jurisdictional discussion-based exercise at least once during the five-year performance period

• Test, at a minimum:

◦ Surge coordination, including surge staff notification and coordination with sentinel laboratories

◦ Continuity of operations (COOP) planning capability

◦ Electronic reporting of laboratory data

◦ Receiving and testing of samples

Step 1: Review the Opportunity 37

◦ Jurisdictions must include laboratory capability in their MYIPPs (AHA- C).

LAB-F: Maintain LRN program fiscal strategies

Who: 50 states, Los Angeles County, New York City, Puerto Rico, and Washington, D.C.

When:

• Budget Period 1, by June 30, 2025

• Review each budget period thereafter and update as needed

Obligation: Required

• In Budget Period 1, determine a five-year fiscal strategy to support LRN-B and LRN-C capacity and capability.

◦ Diversify laboratory funding sources to ensure that LRN-B and LRN-C activities are funded to achieve laboratory standards and requirements. This includes replacing obsolete instrumentation and obtaining maintenance agreements on necessary instrumentation for the five-year performance period.

◦ Work together with jurisdictional epidemiology leads, public health laboratory directors or their…