PKG00258184-instructions.pdf

Centers for Disease Control and Prevention

National Center for Immunization and Respiratory Diseases

IMPROVING ADULT VACCINATION COVERAGE THROUGH PARTNERSHIPS WITH

PROVIDERS AND NATIONAL ORGANIZATIONS

CDC-RFA-IP20-2002

Application Due Date: 04/15/2020

IMPROVING ADULT VACCINATION COVERAGE THROUGH PARTNERSHIPS WITH

PROVIDERS AND NATIONAL ORGANIZATIONS

CDC-RFA-IP20-2002

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Assistance Listings (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Required Registrations E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

Part I. Overview Information 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- IP20-2002. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

IMPROVING ADULT VACCINATION COVERAGE THROUGH PARTNERSHIPS WITH

PROVIDERS AND NATIONAL ORGANIZATIONS

C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-IP20-2002

E. Assistance Listings (CFDA) Number:

93.185 F. Dates:

1. Due Date for Letter of Intent (LOI): N/A Is a LOI: Not Applicable Letter of intent is not requested or required.

2. Due Date for Applications: 04/15/2020, 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: N/A

G. Executive Summary:

1. Summary Paragraph:

The purpose of this NOFO is to develop and implement programs to increase adult vaccination coverage. The aims are to: a) bring about measurable improvements in influenza vaccination of adults with chronic medical conditions by expanding uptake of recognized immunization strategies among adult subspecialty providers, and b) generate effective strategies that will reduce disparities and lead to improvements in vaccination of racial and ethnic minority adults.

The strategies and activities implemented by recipients will allow for increased influenza vaccination of high-risk adults and increased vaccination of racial/ethnic minority adult populations.

a. Eligible Applicants: Open Competition https://www.grants.gov https://www.grants.gov https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 2

d. Total Period of Performance Funding: $3,750,000

e. Average One Year Award Amount: $750,000 Component A: 1 award@ $500,000 Component B: 1 award @ $250,000

f. Number of Years of Award: 5

g. Estimated Award Date: 07/30/2020

h. Cost Sharing and / or Matching Requirements: N No

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview Vaccination is considered one of the most important public health achievements of the 20th century and continues to offer great promise. Vaccines save lives and improve the quality of life by preventing serious infectious diseases and their consequences. However, the benefits of vaccination are not realized equally across the U.S. population. Adult vaccination coverage remain low in the United States, and significant racial and ethnic disparities exist. Vaccination coverage is also suboptimal among adults with chronic medical conditions who are at high risk of developing influenza-related complications.

The goals of this NOFO are to increase influenza vaccination of adults at high risk of developing influenza-related complications, as well as reduce disparities in vaccine uptake and increase vaccination coverage for recommended vaccines among racial and/or ethnic minority adult populations. Many adults with chronic medical conditions receive care by subspecialty care providers and may have a greater number of visits with these providers compared with generalists. Each visit represents an opportunity to assess the patient for needed vaccines and offer vaccine. The NOFO aims to facilitate the routine incorporation of influenza immunization efforts (including vaccine assessment, reminders, and administration) into the practice of subspecialty providers who care for populations of adult patients with high-risk medical conditions. The NOFO also aims to identify and implement strategies to reduce racial and/or ethnic disparities in adult vaccination coverage. Effective strategies and resources should assist providers in successfully overcoming barriers to vaccinating minority adult patients.

During the five-year cooperative agreement performance period, component A, applicant(s) is expected to use partnership(s) between generalist and subspecialist medical professional organizations whose members care for high-risk adults to:

Develop provider resources and strategies to increase influenza vaccination among adults with high-risk medical conditions. Resources should incorporate the principles of the Standards for Adult Immunization Practice and should be relevant to subspecialist providers who care for high-risk adults.

Conduct national outreach to subspecialist and generalist providers to encourage use of the resources/strategies

Evaluate the resources developed, incorporating input from key stakeholders

During each year of the cooperative agreement performance period, applicants are also expected to collaborate with one or more national organization representing adults with high-risk medical conditions to reinforce vaccine recommendations and encourage influenza vaccination.

During the 5-year cooperative agreement performance period, component B, applicant(s) is expected to support providers that serve racially and ethnically diverse populations in the following ways:

Develop provider strategies and resources to address racial and/or ethnic disparities in adult vaccination coverage. Although evidence may be lacking to directly support strategies, the interventions should be based upon published data and best practices to the extent possible. Resources should incorporate the principles of the Standards for Adult Immunization Practice.

Implement the provider strategies and resources in a group of practices or health care system and evaluate the impact. Incorporate patient and provider input in the evaluation.

Conduct national outreach to providers to encourage use of the strategies/resources.

Collaborate with minority community organizations to share information regarding recommended vaccines for adults and encourage vaccination.

Applicants may apply for one or both components. Applicants must apply separately if applying for both components.

b. Statutory Authorities This program is authorized under section 317(k)(1) of the Public Health Service Act [42 US. C.

247b(k)(1)]. Under this statutory authority, for-profit entities are not eligible.

c. Healthy People 2030 Healthy People 2020 includes four objectives related to improving vaccination coverage among adults within the topic of immunizations and infectious diseases and one within the topic of older adults. The NAIP supports the achievement of the adult vaccination targets specified in Healthy People 2020. https://www.hhs.gov/sites/default/files/nvpo/national-adult-immunization-plan/naip .pdf Measurable outcomes of the program will be in alignment with Healthy People 2020 goals for immunization and infectious diseases https://www.healthypeople.gov/2020/topics-objectives https://www.hhs.gov/sites/default/files/nvpo/national-adult-immunization-plan/naip.pdf https://www.hhs.gov/sites/default/files/nvpo/national-adult-immunization-plan/naip.pdf https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases

/topic/immunization-and-infectious-diseases

This section will be updated when HP2030 objectives are published.

d. Other National Public Health Priorities and Strategies General

Advisory Committee on Immunization Practices recommendations and guidelines at http ://www.cdc.gov/vaccines/hcp/acip-recs/index.html

Community Preventive Services Task Force findings and systematic reviews on evidence-based interventions to improve vaccinations at http://www.thecommunityguide.org/vacci nes/vpd-jphpm-recs-IIS.pdf

Immunization disparity–focus

HHS Action Plan to Reduce Racial and Ethnic Health Disparities to promote integrated approaches, evidence-based programs, and best practices to reduce health disparities, including disparities in vaccination coverage among minorities at https://www.minorityhe alth.hhs.gov/omh/browse.aspx?lvl=2&;lvlID=26HPV-focus

President’s Cancer Panel Recommendations on HPV vaccination at http://deainfo.nci.nih .gov/advisory/pcp/annualReports/HPV/index.htm#sthash.j0M1EEMZ.dpbs

Adult immunization–focus

Standards for Adult Immunization Practice at http://www.cdc.gov/vaccines/hcp/patient-ed /adults/for-practice/standards/index.html.

National Adult and Influenza Immunization Summit to address and resolve adult and influenza immunization issues at https://www.izsummitpartners.org/

e. Relevant Work CDC–RFA–IP15–1503–Improving Adult Immunization Rates through Partnerships with Providers and National Organizations

2. CDC Project Description

a. Approach https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases http://www.cdc.gov/vaccines/hcp/acip-recs/index.html http://www.cdc.gov/vaccines/hcp/acip-recs/index.html http://www.thecommunityguide.org/vaccines/vpd-jphpm-recs-IIS.pdf http://www.thecommunityguide.org/vaccines/vpd-jphpm-recs-IIS.pdf https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlID=26 https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlID=26 http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/index.htm#sthash.j0M1EEMZ.dpbs http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/index.htm#sthash.j0M1EEMZ.dpbs http://www.cdc.gov/vaccines/hcp/patient-ed/adults/for-practice/standards/index.html http://www.cdc.gov/vaccines/hcp/patient-ed/adults/for-practice/standards/index.html https://www.izsummitpartners.org/

Bold indicates period of performance outcome.

CDC–RFA–IP20–2002– Logic Model: Improving Adult Vaccination Coverage Through Partnerships with Providers and National Organizations Bold indicates period of performance outcome.

Component A:

Increase influenza vaccination of adults at high risk of developing influenza-related complications

Strategies and Activities Short-Term Outcomes

Intermediate Outcomes

Long-Term

Component A:

Use partnership(s) between medical professional organizations whose members care for high-risk adults to:

• Develop provider resources and strategies to increase influenza vaccination

• Conduct national outreach to providers to encourage use of resources/strategies

• Evaluate resources (input from key stakeholders)

Collaborate with ≥ 1 organization for patients with high-risk medical conditions to encourage influenza vaccination

Component A:

Increased engagement in adult influenza immunization efforts by subspecialty care providers

Increased provider understanding and awareness of recommendations and available resources

Increased uptake of materials and strategies by providers who care for high-risk adults

Increased number of subspecialty providers who view immunization as part of their scope of practice

Increased number of subspecialty providers who stock and offer vaccine

Increased proportion of high-risk adult patients who receive influenza vaccine

Increased demand for vaccine among high-risk adult patients

Increased influenza vaccination coverage among high-risk adults nationally

Contribute to reduced morbidity and mortality from influenza among high-risk adults nationally

Component B:

Reduce disparities in vaccine uptake and increase vaccination coverage for recommended vaccines among racial and/or ethnic minority adult populations

Strategies and Activities

Short-Term Outcomes

Intermediate

Long-Term

Component B:

Support providers that serve racially and ethnically diverse populations

· Develop provider strategies and resources to address racial and/or ethnic disparities in adult vaccination

· Base interventions on published data and best practices

Implement and evaluate provider strategies and resources

Conduct national outreach to providers to encourage use of strategies/resources

Collaborate with minority community organizations to encourage vaccination

Provider use of strategy to improve vaccination among racial/ethnic minority adult population

Increased acceptance of vaccines among racial/ethnic minority adult patients

Increased provider understanding and awareness of strategies to improve vaccination among racial and ethnic minority adult populations

Contribute to broader adoption of resources and strategies to improve vaccination among racial and ethnic minority adult populations

Contribute to increased vaccination coverage among racial and/or ethnic minority adult populations nationally

Contribute to reduced incidence and/or complications of vaccine-preventable disease in racial and/or ethnic minority adult populations nationally

i. Purpose The purpose of this NOFO is to develop and implement programs to increase adult vaccination coverage. The aims are to: a) bring about measurable improvements in influenza vaccination of adults with chronic medical conditions by expanding uptake of recognized immunization strategies among adult subspecialty providers, and b) generate effective strategies that will lead to improvements in vaccination of racial and ethnic minority adults. The activities implemented by recipients will allow for increased vaccination of high-risk adults and racial/ethnic minority adult populations.

ii. Outcomes The following short- term and intermediate outcomes will be achieved by the end of the period of performance:

Component A:

Increased engagement in adult influenza immunization efforts by subspecialty care providers

Increased provider understanding and awareness of recommendations and available resources to improve vaccination of high-risk adults

Increased uptake of developed materials and strategies by providers who care for high-risk adults

Increased number of subspecialty providers who view immunization as part of their scope of practice

Increased number of subspecialty providers who stock and offer vaccine

Provider use of strategies and resources developed to improve vaccination among racial/ethnic minority adult population

Increased acceptance of vaccines among racial/ethnic minority adult patients Increased provider understanding and awareness of strategies to improve vaccination among racial and ethnic minority adult populations Contribute to broader adoption of resources and strategies to improve vaccination among racial and ethnic minority adult populations

iii. Strategies and Activities Component A (Increase influenza vaccination of adults at high risk of developing influenza-related complications):

S1-Use partnership(s) between generalist and specialist medical professional organizations whose members care for high-risk adults to:

Develop provider resources and strategies to increase influenza vaccination among adults with high-risk medical conditions.

Conduct national outreach to providers to encourage use and increase uptake of resources/strategies.

Conduct an evaluation of the resources and solicit input from key stakeholders.

S2-Collaborate with organizations representing adult patients with high-risk medical conditions to reinforce vaccine recommendations and encourage influenza vaccination.

Component B (Reduce disparities in vaccine uptake and increase vaccination coverage for recommended vaccines among racial and/or ethnic minority adult populations):

S1- Support providers that serve racially and ethnically diverse populations in the following ways:

Develop provider strategies and resources to address racial and/or ethnic disparities in adult vaccination.

Base interventions on published data and best practices.

S2-Implement and evaluate the strategies and resources within a group of practices or a health care system; incorporate provider and patient input into the evaluation.

S3-Conduct national outreach to disseminate findings and to encourage broader use of effective strategies/resources.

S4-Collaborate with minority community organizations to share information regarding recommended vaccines and encourage vaccination.

1. Collaborations

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

N/A

b. With organizations not funded by CDC:

Applicants are required to collaborate with external partners and organizations that have a role in achieving the outcomes and proposed activities in this NOFO. For Component A, collaboration with subspecialty providers will be required. Collaborate with organizations representing adult patients with high-risk medical conditions to reinforce vaccine recommendations and encourage influenza vaccination. For Component B, collaborate with minority community organizations to share information regarding recommended vaccines and encourage vaccination. Applicants should include details on their proposed collaborations with external partners and organizations.

Concrete evidence of relationship between collaborating partners such as memorandum of understanding, memorandum of agreement, or letter of support should be submitted with the application. Applicants must file the MOU or MOA, as appropriate, name the file

“MOUs/MOAs,” and upload it as a PDF file at www.grants.gov.

2. Target Populations Applicants should define and identify target groups that will benefit from the outcomes specified in the logic model, including adults and other populations that are at risk for vaccine-preventable diseases.

Component A: Adults at risk of developing influenza-related complications Component B: Racial and ethnic minority adult population

a. Health Disparities Racial and ethnic minorities and uninsured and underinsured populations generally have the lowest vaccination coverage. Applicants should define and identify populations that are at increased risk for vaccine-preventable diseases and develop strategies to increase their vaccine uptake to help reduce health disparities.

iv. Funding Strategy (for multi-component NOFOs only) N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy CDC will monitor applicants’ implementation of proposed activities (process evaluation) and determine applicants’ progress on achieving proposed outcomes (outcome evaluation).

Evaluation of the project should align with the project’s short- and intermediate-term outcomes.

Component A:

Activity 1: Develop provider resources and strategies to increase influenza vaccination.

Process evaluation: May include review of resources and strategies, objectives and content, evidence of productive partnership between medical professional organizations, indications of ability of these organizations to reach the target population:

Activity 2: Conduct national outreach to providers to encourage use of resources/strategies.

Process evaluation: May include review of outreach plan, metrics on number of educational trainings, conference presentations, articles, web content, mailings, and other means of reaching providers, along with metrics on attendance, impressions, and reach.

Activity 3: Evaluate resources and strategies; include input from key stakeholders.

Process evaluation: May include review of evaluation plan, scope of evaluation, and incorporation of key stakeholder opinions.

Activity 4: Collaborate with organizations representing adult patients with high-risk medical conditions to reinforce vaccine recommendations and encourage influenza vaccination.

Process evaluation: May include review of materials produced and strategies for reaching target population and number of different collaborating organizations.

http://www.grants.gov/

Activity 1: Support providers that serve racially and ethnically diverse populations.

Develop provider strategies and resources to address racial and/or ethnic disparities in adult vaccination.

Base interventions on published data and best practices.

Process evaluation: May include review of intervention strategy and development plan, resources developed, evidence basis for interventions and use of innovative approaches.

Activity 2: Implement and evaluate provider strategies and resources.

Process evaluation: May include review of outreach and dissemination plan and materials, tools, and messages shared, number of outreach activities and number of participants in these, and metrics on reach.

Activity 3: Collaborate with minority community organizations to reinforce vaccine recommendations and encourage vaccination.

Outcomes and Outcome Measures

Component A:

Short-term outcome 1: Increased engagement in adult influenza immunization efforts by subspecialty care providers Outcome evaluation: Number of subspecialty care providers and leaders actively involved in adult influenza immunization efforts

Short-term outcome 2: Increased provider understanding and awareness of recommendations and available resources to improve influenza vaccination of high-risk adults Outcome evaluation: The number of generalists and specialists trained in influenza vaccination of high-risk adults, immunization practice standards, and strategies for immunization

Short-term outcome 3: Increased uptake of developed materials and strategies by providers who care for high-risk adults Outcome evaluation: Number of downloads of developed materials by target provider group(s), number of practices that adopt strategies to increase influenza vaccination

Short-term outcome 1: Provider use of strategies and resources developed to improve vaccination among racial/ethnic minority adult population Outcome evaluation: Measures of adoption and use of strategies and resources (e.g., number of times or proportion of patients encounters in which a conversational strategy is used, video played, or app utilized with patients) Short-term outcome 2: Increased acceptance of vaccines among racial/ethnic minority adult patients Outcome evaluation: Number and proportion of racial/ethnic minority adult patients eligible for vaccine who receive it; number of times that minority patients who are recommended or referred for vaccine receive the vaccine; may include minority patient perceptions of vaccine

Component A:

Intermediate outcome 1: Increased number of adult subspecialty providers who view immunizations as part of their scope of practice Outcome measure – May include provider opinions, position statements, clinical practice guidelines, and incorporation of immunizations into training curricula Intermediate outcome 2: Increased number of adult subspecialty providers who stock and offer vaccines Outcome measure – Number of subspecialty providers or practices that report routinely stocking and offering vaccine to patients

Component B:

Intermediate outcome 1: Increased provider understanding and awareness of strategies to improve vaccination among racial and ethnic minority populations Outcome measure: May include number of providers attending educational seminars, conference presentations, metrics on material downloads, and article reach/impact, along with post-test knowledge assessment data Intermediate outcome 2: Contribute to broader adoption of resources and strategies to improve vaccination among racial and ethnic minority adult populations Outcome measure: May include number of providers attending educational seminars, conference presentations, metrics on material downloads, and numbers of such outreach efforts conducted At the start of the project, CDC and applicants will review the Recipient Evaluation and Performance Management Plan (AEPMP) and ensure that the proposed process and outcome measures are consistent with the work plan, concrete, and achievable. Six months following the award date, if necessary, recipient-applicants will submit additional details or revisions to their

AEPMP.

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.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

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

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

Describe key evaluation questions to be addressed by these evaluations.

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

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

Applicants should provide an evaluation and performance measurement plan that demonstrates their ability to fulfill the requirements described in the CDC "Evaluation and Performance Measurement" and "Project Description" sections of this NOFO. At a minimum, the plan should:

Describe plans to collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

Identify key program partners to plan and conduct evaluation and performance measurements.

Identify available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant information (e.g., performance measures proposed https://www.cdc.gov/grants/additionalrequirements/ar-25.html by the applicant).

Plans for updating the Data Management Plan (DMP), if applicable, should be included for accuracy throughout the life cycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html. If applicants choose to conduct an evaluation study, the following descriptions should be included in the study:

Type of evaluation (i.e., process, outcome, or both) Key evaluation questions to be addressed Other relevant information (e.g., measures, data sources)

Applicants will be required to submit a more detailed Evaluation and Performance Measurement plan within the first six months of award, as described in the "Reporting" Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach Applicants should demonstrate sufficient organizational capacity and conduct a high level of program planning and evaluation, performance monitoring, budget management and financial reporting, data management, and personnel management. Applicants should also demonstrate the organizational capacity to manage partnerships with other national, state, tribal, and territorial stakeholders to ensure a coordinated execution of planned activities.

Component A: Applicants should have the ability to: 1) communicate with a national constituency of subspecialty providers, 2) lead a national group of immunizing providers, 3) provide evidence of influencing their membership to achieve national immunization or related health objectives, 4) provide evidence of how they can influence vaccination practices or related care processes among primary and subspecialty care providers for adults nationwide 5) and demonstrate an ability to impact measurable changes in vaccination services.

Component B: Applicants should have the ability to: 1) reach racial or ethnic minority adult population, 2) recruit provider practices to implement and evaluate interventions, 3) demonstrate a generalist and/or subspecialty adult provider membership on a national level, with active membership in two-thirds of the United States (active membership is typically characterized by dues paying status as well as other member actions, such as committee membership, active electronic communications between members and organization, and strong conference attendance

4) develop tools and resources to support providers in implementing the intervention 5) capacity to implement the strategies and resources 6) and capacity to conduct program evaluation and implement the evaluation plan.

d. Work Plan Applicants must submit a detailed work plan for the one-year period of performance. The work https://www.cdc.gov/grants/additionalrequirements/ar-25.html plan should describe how the applicant plans to implement all of the required strategies and activities to achieve NOFO outcomes. A sample work plan format is presented below to show how a traditional work plan aligns with the logic model and narrative. A separate table should be included in the work plan for each of the outcomes that will be completed during the one-year period of performance. If a particular activity leads to multiple outcomes, it should be described under each outcome measure. Applicants are not required to use the example work plan format;

however, all work plans must contain all of the elements shown in the example (outcome(s), outcome measure(s), etc.).

Example Work Plan Table Period of Performance Outcome: (from Logic Model)

Strategies and Activities

Process Measure (from Evaluation and Performance Measurement)

Responsible Team Member(s)

Population of Focus

Scope Setting(s) Completion Date

1.

2.

3.

4.

5.

6.

7.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking recipient progress in achieving the desired outcomes.

Ensuring the adequacy of recipient systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

Monitoring activities include routine and ongoing communication between CDC and successful applicants, site visits, and recipient reporting (including work plans, performance, and financial reporting). Monitoring activities should also be consistent with applicable grants regulations and policies.

The following will be included in post-award monitoring for grants and cooperative agreements:

Tracking applicant progress in achieving the desired outcomes

Ensuring the adequacy of applicant systems that generate data reports

Creating an environment that fosters integrity in program performance and results

Monitoring may also include the following activities:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated time frames

Working with recipients to adjust the work plan based on achievement of outcomes, evaluation results, and changing budgets

Monitoring performance measures (programmatic and financial) to assure satisfactory performance levels

Other activities should include those deemed necessary to monitor the award as applicable. These activities may include additional monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists and project officers) in the identification, notification, and management of recipients with difficulties meeting performance requirements.

f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO

COOPERATIVE AGREEMENTS)

CDC will provide the following support to applicants:

Provide technical assistance in identifying major immunization issues, setting program priorities, and implementing and evaluating project activities.

Assist in the review of immunization messages and materials for technical accuracy and for compliance with proven health education and communication strategies.

Facilitate the transfer of successful prevention interventions and program models to other areas through meetings of grantees, workshops, conferences, newsletters, and communications with project officers.

B. Award Information

1. Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism: U66

3. Fiscal Year: 2020 Estimated Total Funding: $750,000

4. Approximate Total Fiscal Year Funding: $750,000 Component A: 1 award@ $500,000 Component B: 1 award @ $250,000 It is anticipated that one award will be made per component. Interested applicants may apply for one or both components.

This amount is subject to the availability of funds.

5. Approximate Period of Performance Funding: $3,750,000

6. Total Period of Performance Length: 5

7. Expected Number of Awards: 2

8. Approximate Average Award: $750,000 Per Budget Period Component A: 1 award@ $500,000 Component B: 1 award @ $250,000

This amount is subject to the availability of funds.

9. Award Ceiling: $750,000 Per Budget Period

10. Award Floor: $250,000 Per Budget Period

11. Estimated Award Date: 07/30/2020

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

12. Budget Period Length: 12 month(s)

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

C. Eligibility Information

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

Additional Eligibility Category:

2. Additional Information on Eligibility Open competition

Commercial entities cannot apply due to restrictions outlined in the Statutory Authority.

3. Justification for Less than Maximum Competition N/A

4. Cost Sharing or Matching

Cost Sharing / Matching Requirement: No No

5. Maintenance of Effort Maintenance of effort is not required for this program.

D. Required Registrations

Additional materials that may be helpful to applicants: http://www.cdc.gov/ od/ pgo/ funding/ docs/ Financial ReferenceGuide.pdf.

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

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

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

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

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

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

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

Step System Requirements Duration Follow Up 1 Data

Universal Number System

(DUNS)

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

2. Select Begin DUNS search/request process

1-2 Business Days To confirm that you have been issues a new DUNS number check online at http://www.cdc.gov/od/pgo/funding/docs/FinancialReferenceGuide.pdf http://www.cdc.gov/od/pgo/funding/docs/FinancialReferenceGuide.pdf https://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/SAM/ https://grants.gov/ https://www.grants.gov/ http://www.grants.gov https://www.grants.gov/ http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform

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

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

(http:// fedgov.dnb.

com/ webform) or call 1-866-705-

2 System for Award Management

(SAM)

formerly Central Contractor Registration

(CCR)

1. Retrieve organizations DUNS number

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

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

For SAM Customer Service Contact https://fsd.gov/fsd-gov/home.do Calls: 866-606-

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

2. Once the Account is set up the E_BIZ POC will be notified via email

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

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

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

Register early! Log into Grants.gov and check AOR status until it shows you have been approved

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

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

http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform https://www.sam.gov/SAM/ https://fsd.gov/fsd%20-gov/home.do https://fsd.gov/fsd%20-gov/home.do

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

OGS.

a. Letter of Intent Deadline (must be emailed or postmarked by) Due Date for Letter of Intent: N/A Letter of intent is not requested or required.

b. Application Deadline Due Date for Applications: 04/15/2020 , 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov. If Grants.gov is inoperable and cannot receive applications, and circumstances preclude advance notification of an extension, then applications must be submitted by the first business day on which grants.gov operations resume.

5. CDC Assurances and Certifications All applicants are required to sign and submit “Assurances and Certifications” documents indicated at http:// wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa)) / Homepage.aspx.

Applicants may follow either of the following processes:

Complete the applicable assurances and certifications with each application submission, name the file “Assurances and Certifications” and upload it as a PDF file with at www.grants.gov

Complete the applicable assurances and certifications and submit them directly to CDC on an annual basis at http:// wwwn.cdc.gov/ grantassurances/ (S(mj444mxct51lnrv1hljjjmaa)) / Homepage.aspx

Assurances and certifications submitted directly to CDC will be kept on file for one year and will apply to all applications submitted to CDC by the applicant within one year of the submission date.

Risk Assessment Questionnaire Requirement CDC is required to conduct pre-award risk assessments to determine the risk an applicant poses to meeting federal programmatic and administrative requirements by taking into account issues such as financial instability, insufficient management systems, non-compliance with award conditions, the charging of unallowable costs, and inexperience. The risk assessment will include an evaluation of the applicant’s CDC Risk Questionnaire, located at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, as well as a review of the applicant’s history in all available systems; including OMB-designated repositories of government-wide eligibility and financial integrity systems (see 45 CFR https://www.grants.gov http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx https://www.grants.gov http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf

75.205(a)), and other sources of historical information. These systems include, but are not limited to: FAPIIS (https://www.fapiis.gov/), including past performance on federal contracts as per Duncan Hunter National Defense Authorization Act of 2009; Do Not Pay list; and System for Award Management (SAM) exclusions.

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

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

Duplication of Efforts Applicants are responsible for reporting if this application will result in programmatic, budgetary, or commitment overlap with another application or award (i.e. grant, cooperative agreement, or contract) submitted to another funding source in the same fiscal year.

Programmatic overlap occurs when (1) substantially the same project is proposed in more than one application or is submitted to two or more funding sources for review and funding consideration or (2) a specific objective and the project design for accomplishing the objective are the same or closely related in two or more applications or awards, regardless of the funding source. Budgetary overlap occurs when duplicate or equivalent budgetary items (e.g., equipment, salaries) are requested in an application but already are provided by another source.

Commitment overlap occurs when an individual’s time commitment exceeds 100 percent, whether or not salary support is requested in the application. Overlap, whether programmatic, budgetary, or commitment of an individual’s effort greater than 100 percent, is not permitted.

Any overlap will be resolved by the CDC with the applicant and the PD/PI prior to award.

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

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

7. Letter of Intent Is a LOI: Not Applicable Letter of intent is not requested or required.

https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf

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

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

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

10. Project Narrative Multi-component NOFOs may have a maximum of 15 pages for the “base” (subsections of the Project Description that the components share with each other, which may include target population, inclusion, collaboration, etc.); and up to 4 additional pages per component for Project Narrative subsections that are specific to each component.

Text should be single spaced, 12 point font, 1-inch margins, and number all pages.

Page limits include work plan; content beyond specified limits may not be reviewed.

Applicants should use the federal plain language guidelines and Clear Communication Index to respond to this Notice of Funding Opportunity Announcement. Note that recipients should also use these tools when creating public communication materials supported by this NOFO. Failure to follow the guidance and format may negatively impact scoring of the application.

a. Background Applicants must provide a description of relevant background information that includes the context of the problem (See CDC Background).

b. Approach

i. Purpose Applicants must describe in 2-3…