PKG00261349-instructions.pdf

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Developing and Disseminating Strategies to Build Sustainable Lupus Awareness, Knowledge, Skills, and Partnerships

CDC-RFA-DP20-2008

Application Due Date: 06/26/2020

Developing and Disseminating Strategies to Build Sustainable Lupus Awareness, Knowledge, Skills, and Partnerships

CDC-RFA-DP20-2008

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- DP20-2008. 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:

Developing and Disseminating Strategies to Build Sustainable Lupus Awareness, Knowledge, Skills, and Partnerships 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-DP20-2008

E. Assistance Listings (CFDA) Number:

93.068 F. Dates:

1. Due Date for Letter of Intent (LOI): 05/12/2020 Is a LOI: Recommended but not Required A Letter of Intent (LOI) is requested for this NOFO. The purpose of a LOI is to allow CDC program staff to estimate the number of and plan for the review of submitted applications. The LOI must be sent via email to Margaret Kaniewski, Project Officer at mgk6@cdc.gov on 5/12/2020 by 11:59 p.m. U.S. Eastern Standard Time. The following information must be included in the email:

Descriptive title of proposed project.

Name, address, telephone number, and email address of the Principal Investigator or

Project Director, or both.

Name, address, telephone number, and e-mail address of the primary contact for writing and submitting this application.

Number and title of this NOFO.

Selected Component (Component A or B, or both).

2. Due Date for Applications: 06/26/2020, 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: 05/07/2020 A 60-minute informational call will be held on 5/07/2020 at 1:30 p.m. to 2:30 p.m. U.S. Eastern 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

Standard Time. To access call use the following information- Dial: (855) 644-0229; Passcode:

2922594# Following the call, Q&As and other information will be posted at https://www.cdc.gov/lupus /funded/nofo/cdc-rfa-dp20-2008.html. In addition, an email address has been established to receive and respond to NOFO questions: fy20lupusnofo@cdc.gov. NOFO questions and answers will be made available at https://www.cdc.gov/lupus/funded/nofo/cdc-rfa-dp20-2008 .html

G. Executive Summary:

1. Summary Paragraph:

The purpose of the NOFO is to support organizations implementing national efforts to help increase the number of healthcare providers recognizing the signs and symptoms of lupus and what to do if lupus is suspected, and to increase the number of people with lupus referred to and engaged in self-management tools/services and showing improvements in self-management behaviors. This NOFO will focus on two key strategies:

Increase awareness, knowledge and skills among healthcare providers to appropriately recognize the signs and symptoms of lupus, what to do if lupus is suspected, and provide quality, well-coordinated lupus care that is culturally and linguistically appropriate.

In collaboration with key stakeholders, including healthcare organizations, professional organizations, national health organizations, electronic medical technology organizations and/or other, raise awareness about lupus signs and symptoms and what to do if you have lupus, and promote the use of effective lupus self-management tools and/or services.

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 2

d. Total Period of Performance Funding: $13,351,150

e. Average One Year Award Amount: $1,335,115

f. Number of Years of Award: 5

g. Estimated Award Date: 09/21/2020

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview https://www.cdc.gov/lupus/funded/nofo/cdc-rfa-dp20-2008.html https://www.cdc.gov/lupus/funded/nofo/cdc-rfa-dp20-2008.html mailto:fy20lupusnofo@cdc.gov https://www.cdc.gov/lupus/funded/nofo/cdc-rfa-dp20-2008.html

Lupus is a systemic autoimmune disease. It is estimated 161,000 to 322,000 Americans have the most common type of lupus, systemic lupus erythematosus (SLE). Although anyone can get lupus, 9 out of 10 diagnoses of lupus are in women ages 15 to 44. African American and Latino women are at greater risk for lupus than white women and usually get it at a younger age and have more severe symptoms. Lupus is also more common in Hispanic, Asian, and Native American and Alaskan Native women. The causes of lupus are unknown but are believed to be linked to genetic, environmental, and hormonal factors.

Lupus is difficult to diagnose, hard to live with and challenging to treat. Lupus has a range of symptoms often confused with other conditions, making it difficult to recognize and diagnose.

Its symptoms and outcomes can be severe or fatal, its onset can be sudden, its causes are unclear and there is no known cure.

This NOFO addresses several persisting gaps and inequities related to lupus. For example, SLE occurs more in women and minorities, especially blacks, and symptoms can range from mild to life threatening. In a study examining death rates among people with lupus, blacks had higher rates of death than whites, and had significantly higher rates of death from the time of diagnosis.

Among those with SLE, blacks were significantly younger when they died than whites (average age of 52 vs. 64 years). Lupus can result in a range of negative outcomes including disability, social stigma, lost productivity, absence from the workforce, reduction in quality of life, organ damage or failure or early death. Undiagnosed or late diagnosis of lupus can increase the likelihood or worsen the severity of many of these outcomes. Even with a correct diagnosis, lupus is challenging to treat. For example, many individuals with lupus nephritis do not receive screening and care for it at guideline levels. This may be due to lack of awareness about how to recognize lupus symptoms and treat the disease and limited clinical and community resources for the treatment, support, and self-management of lupus.

Much is needed to improve the care and quality of life for people living with the disease. The public health sector can contribute a great deal to this end and help mitigate these gaps and inequities. This NOFO through its strategies and activities addresses these gaps and inequities and aims to help increase the number of healthcare providers recognizing the signs and symptoms of lupus and what to do if lupus is suspected, and to increase the number of people with lupus referred to and engaged in self-management tools/services and showing improvements in self-management behaviors. The NOFO is available to fund only two awards, one award will be issued for Component A and Component B. Applicants can apply for one or both Components but must submit a separate application for each Component.

The National Public Health Agenda for Lupus and the CDC-RFA-DP15-1511 NOFO has informed and guided the purpose and approach of this NOFO. A National Public Health Agenda for Lupus was released in late 2015 to help prioritize public health efforts to improve the care and quality of life for people living with lupus. The Agenda outlines a broad public health approach to lupus diagnosis, disease management, treatment, and research. Recipients under the CDC-RFA-DP15-1511 cooperative agreement have been successful in establishing a sustainable national campaign to raise awareness about lupus among people at greater risk for lupus, are finding success in training and educating healthcare providers about lupus diagnoses and care, and have found positive impact on patients with lupus exposed to self-management tools and/or services. It is evident that a further need exists to expand reach and further raise lupus awareness, knowledge and skills among healthcare providers, people with lupus and key organizations; to expand the availability of lupus-specific self-management tools and services to people with lupus; and to increase healthcare provider referrals to these tools and services. The use of tele-health and medical information technology can help facilitate and sustain these efforts.

b. Statutory Authorities This program is authorized under Section 317(k)(2) of the Public Health Service Act [42 USC Section 247b(k)(2)].

c. Healthy People 2030 This funding opportunity supports Healthy People 2030 objectives in the topic areas of:

1. Arthritis, Osteoporosis, and Chronic Back Conditions - AOCBC-8: Increase the proportion of adults with doctor-diagnosed arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition.

2. Health Communication and Health Information Technology - HC/HIT-4:

(Developmental) Increase the proportion of patients whose doctor recommends personalized health information resources to help them manage their health.

3. Health-related Quality of Life &; Well-being - HRQOL/WB-1: Increase the proportion of adults who self-report good or better health.

d. Other National Public Health Priorities and Strategies This NOFO supports the following national initiative and strategic plan:

2015 National Public Health Agenda for Lupus: https://www.cdc.gov/lupus/funded /index.html

e. Relevant Work This NOFO continues to build on continuing efforts since 2014 to support strategies to increase lupus awareness, knowledge, and skills among general public, people with lupus and healthcare providers. The funding opportunity builds upon the following current or past NOFOs:

CDC-RFA-DP15-1511: Developing and Disseminating Programs to Build Sustainable Lupus Awareness, Knowledge, Skills, and Partnerships.

CDC-RFA-DP19-003: Epidemiology of Lupus: Longitudinal Studies in Population- Based Cohorts.

CDC-RFA-DP14-004: Longitudinal Study of a Population-based Cohort of People with Lupus.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

https://www.healthypeople.gov/2020/topics-objectives/topic/Arthritis-Osteoporosis-and-Chronic-Back-Conditions https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-health-information-technology https://www.healthypeople.gov/2020/topics-objectives/topic/health-related-quality-of-life-well-being https://www.cdc.gov/lupus/funded/index.html https://www.cdc.gov/lupus/funded/index.html https://www.cdc.gov/lupus/funded/awareness.htm https://www.cdc.gov/lupus/funded/nofo/index.htm https://www.cdc.gov/lupus/funded/lupus-studies.htm

CDC-RFA-DP20-2008, Logic Model: Developing and Disseminating Strategies to Build Sustainable Lupus Awareness, Knowledge, Skills, and Partnerships Bold indicates period of performance outcome

Components Strategies and Activities Short and Intermediate Outcomes

Long-Term Outcomes

Component A

Increase awareness, knowledge and skills among healthcare providers to appropriately recognize the signs and symptoms of lupus, what to do if lupus is suspected, and provide quality, well-coordinated lupus care that is culturally and linguistically appropriate.

Outcome A1:

Increased number of healthcare providers recognizing the signs and symptoms of lupus and what to do if lupus is suspected Outcome A2:

Increased number of healthcare providers using tele-health and/or electronic health records to identify lupus cases and treatment gaps Outcome A3:

Increased number of settings receiving guidance on transition of pediatric lupus care to adult care

Component B

In collaboration with key stakeholders, including healthcare organizations, professional organizations, national health organizations, electronic medical technology organizations and/or other, raise awareness about lupus signs and symptoms and what to do if you have lupus, and promote the use of effective lupus self-management tools and/or services.

Outcome B1:

Increased number of people living with lupus engaged in the use of lupus self-management tools and/or services Outcome B2:

Increased number of referrals to appropriate self-management tools/services using electronic health

Earlier diagnosis of lupus* Increased number of people with lupus getting needed care and ongoing treatment* Improved lupus care and care coordination* Improved quality of life among people with lupus* Improved health outcomes among people with lupus* medical record systems or other medical information technology Outcome B3:

Improved self-management behaviors among people with lupus Outcome B4:

Decreased barriers to access effective self-management tools and/or services*

*These outcomes are not expected to be achieved during the period of performance.

i. Purpose The purpose of the NOFO is to reduce time to lupus diagnoses; increase number of people with lupus getting needed care and ongoing treatment; improve lupus care, care transition and care coordination; and improve self-management behaviors, quality of life and health outcomes among people with lupus. To make progress toward these long-term outcomes this NOFO requires recipients to achieve the bolded short-term/intermediate outcomes indicated in the logic model by implementing strategies and activities described below and achieving the period performance measures described under CDC Evaluation and Performance Measurement Strategy section.

ii. Outcomes The following are outcomes recipients are expected to achieve by the end of the period of performance (i.e., the ones bolded in the logic model) and not all outcomes. Outcomes are listed by Component.

Component A Outcome A1: Increased number of healthcare providers recognizing the signs and symptoms of lupus and what to do if lupus is suspected.

Outcome A2: Increased number of healthcare providers using tele-health and/or electronic health records to identify lupus cases and treatment gaps.

Outcome A3: Increased number of settings receiving guidance on transition of pediatric lupus care to adult care.

Component B Outcome B1: Increased number of people living with lupus engaged in the use of lupus self-management tools and/or services.

Outcome B2: Increased number of referrals to appropriate lupus self-management tools/services using electronic health medical record systems or other medical information technology.

Outcome B3: Improved self-management behaviors among people with lupus.

iii. Strategies and Activities Applicants can apply for one or both Components listed below but must submit a separate application for each Component. Under each component, applicants must include promising or evidence-based approaches for each activity. Activities must demonstrate having a national reach and address target population(s) defined under the Target Populations section.

Component A: Increase awareness, knowledge and skills among healthcare providers to appropriately recognize the signs and symptoms of lupus, what to do if lupus is suspected, and provide quality, well-coordinated lupus care that is culturally and linguistically appropriate. To accomplish this strategy applicant is expected to address the following activities:

Activity A1. Develop and nationally promote healthcare provider lupus training and education that integrates approaches to quality, well-coordinated lupus care that is culturally and linguistically appropriate, and is inclusive of public health, nutrition, social work, pharmacists, behavioral health, practitioners of family and internal medicine, pediatrics, obstetrics and gynecology, rheumatology and dermatology (including physician’s assistants and nurse practitioners). Delayed diagnoses and poor patient-provider communication and care coordination can result in increased damage in patients with lupus. Trainings and education must demonstrate how this can be addressed, including practical messages for healthcare professionals concerning early diagnosis, proper referral of patients with lupus, engagement of caregivers and community, and an expansion of lupus teaching fellows into areas with high minority populations who are at increased risk for lupus and rural communities.

Activity A2. Increase the role of technology in the clinical setting in the early detection of lupus and management of the disease by supporting the expansion and integrated use of tele-health and/or electronic health records to assist with earlier diagnoses and improvements in lupus care, care coordination and health outcomes.

Activity A3. Collaborate with health professional associations to establish or increase sustainable educational opportunities (i.e., continuing education (CE) or maintenance of certification (MOC) options) using the latest educational needs of providers about lupus, with a focus on educating primary care practitioners, rheumatologists, obstetricians/gynecologists, ophthalmologists, dermatologists, mental health specialists, emergency room physicians, pharmacists, nurses, community healthcare workers, and other non-rheumatology practitioners about lupus signs, symptoms and management as well as lupus treatment access issues and care disparities. Additionally, to further sustain educational opportunities, develop a clinician certification program in lupus diagnosis and care, and disseminate as appropriate to achieve national reach.

Activity A4. In partnership with key stakeholders, develop and promote practice procedures for transition of lupus care from pediatric to adult care in schools and other relevant settings. Key stakeholders include national health organizations, community organizations, state or local government, schools and healthcare providers.

Component B: In collaboration with key stakeholders, including healthcare organizations, professional organizations, national health organizations, electronic medical technology organizations and/or other, raise awareness about lupus signs and symptoms and what to do if you have lupus, and promote the use of effective lupus self-management tools and/or services.

To accomplish this strategy applicant is expected to address the following activities:

Activity B1. Raise awareness about lupus signs and symptoms and what to do if you have lupus among targeted populations using existing national lupus campaigns, websites, and tools.

Activity B2. Support the evaluation and implementation of existing lupus-specific self-management tools and/or services. Promising tools and services have been developed that address management of physical symptoms, stress, medications and lifestyle choices, and relationships with healthcare teams to improve the quality of life of people living with lupus. For example, the Strategies to Embrace Living with Lupus Fearlessly (SELF) is a promising, online self-management education tool that is based on the Transtheoretical Model of Change and developed specifically for newly diagnosed patients with lupus to equip them with information and techniques to better manage their lupus-related health behaviors. SELF and other existing SME tools or services are prime candidates for evaluation. The proposed self-management tools/services must be based on evidence-based practice or promising practice and lend themselves for national adoption, sustainable dissemination and effective outcomes. Examples of other tools ready for evaluation, dissemination or implementation are available at: https://www.lupus.org/resources or https ://selfcare.thelupusinitiative.org/ .

Activity B3. Promote the national uptake and use of existing lupus self-management tools and/or services to target population and relevant stakeholders. Relevant stakeholders may include national health organizations, state and local health departments, community organizations, faith-based organizations, schools, health care organizations, employers, caregivers and/or other. Promotion efforts can leverage existing lupus campaigns, such as the Be Fierce. Take Control. Campaign, marketing, social media strategies and other effective strategies to engage women in the use of lupus self-management tools/services.

National dissemination efforts must describe how outreach methods and partnership engagement will successfully reach target population across the United States.

Activity B4. Promote or encourage use of electronic health medical record systems or other medical information technology to refer lupus diagnosed patients to appropriate self-management tools/services, such as the SELF online tool. Collaborate with lupus centers or other healthcare organizations to promote SELF and other tools/services to support disease self-management for people with lupus and integrate the tool(s) into standards of practice.

Participating organizations must provide letters of support.

https://www.lupus.org/resources/self https://www.lupus.org/resources https://selfcare.thelupusinitiative.org/ https://selfcare.thelupusinitiative.org/ https://befiercetakecontrol.org/

Activity B5. Leverage collaborations among community and faith-based organizations, schools, health care systems, employers and/or other organizations to help address lupus patients’ barriers to access effective self-management tools and/or services. This may include but not limited to expanding the 211 system in all states to include pathways for access to care, clinical and community support programs for people with lupus, or addressing social determinants of health that may impede access to care and ongoing treatment, such as inadequate health insurance, transportation or insufficient providers of primary care or rheumatology.

1. Collaborations

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

Recipients are required to collaborate with CDC-funded programs or organizations with common interests and objectives related to raising awareness, knowledge and skills about lupus signs and symptoms, and increasing/improving lupus clinical care and care coordination.

The following are required organizations applicant is expected to collaborate with to help accomplish this NOFO’s requirements. These current organizations are supported by CDC funds under CDC-RFA-DP15-1511 and play a significant national role in improving the lives of people with lupus. Applicant is required to provide two or more letters of support from the three organizations listed below. Applicant is expected to describe its past history working with the organization, details about organization's role and commitment over the 5-year project, and how the organization supports applicant's proposed key activities. Applicants must name the file "Letter of Support- CDC Funded Organization" and upload as a PDF file at www.grants.gov .

American College of Rheumatology Lupus Foundation of America National Association of Chronic Disease Directors

The two recipients of this funding, if two different recipients will be funded, will be required to collaborate with each other. Recipients of this NOFO are to collaborate with each other in order to avoid duplication of effort and leverage each other’s capacity and efforts to successfully accomplish the requirements of this NOFO.

All applicants are expected to identify and leverage opportunities with other CDC-funded public health programs with common interests and objectives related to this NOFO. These collaborations may include, but not limited to, CDC programs funded by the National Center for Chronic Disease Prevention and Health Promotion as follows:

Arthritis Foundation Association of State and Territorial Health Officials CDC Heart Disease and Stroke Prevention CDC National Diabetes Prevention Program CDC's Nutrition, Physical Activity and Obesity Program Lupus registry recipients funded by CDC-RFA-DP19-003 National Recreation and Park Association http://www.grants.gov/ https://thelupusinitiative.org/ https://www.lupus.org/advancing-research/our-work https://www.chronicdisease.org/page/Autoimmune https://arthritis.org/ https://www.astho.org/Search.aspx?s=arthritis https://www.cdc.gov/dhdsp/index.htm https://www.cdc.gov/diabetes/prevention/index.html https://www.cdc.gov/nccdphp/dnpao/index.html https://www.cdc.gov/lupus/funded/nofo/index.htm https://www.nrpa.org/

University of North Carolina Osteoarthritis Action Alliance YMCA of the USA

b. With organizations not funded by CDC:

Recipients are expected to collaborate with state and national organizations as appropriate for the required NOFO activities. Below is a list of specific non-CDC funded partners/organizations that are strongly encouraged to help sustain project activities and improve outcomes for this

NOFO.

Applicants are required to submit at least one letter of support that addresses how they will collaborate with the non-CDC funded partners/organizations. Applicant is expected to describe its past history working with the organization, details about organization's role and commitment over the 5-year project, and how the organization supports applicant's proposed key activities.

Applicants must name the file "Letters of Support-nonCDC Funded Partner" and upload at www.grants.gov .

American Academy of Family Physicians American Association of Nurse Practitioners Association of American Indian Physician Childhood Arthritis and Rheumatology Research Alliance Federally Qualified Health Centers National Alliance for Caregiving National Alliance for Hispanic Health National Area Health Education Center National Association of Community Health Centers National Association of Hispanic Nurses National Association of State Offices of Minority Health National Black Nurses Association National Hispanic Medical Association Rheumatology Nurses Society The CMS Innovation Center U.S. Department of Health and Human Services, Office of Minority Health and their funded Lupus Program

2. Target Populations Component A Applicants are expected to describe their past experience at a national level with healthcare providers and serving target populations that have greatest risk for lupus, especially women ages 15 to 44 who are African-American, Hispanic, Asian, and Native American and Alaskan Native women. The applicant and engaged stakeholders, including targeted healthcare providers are expected to demonstrate having access to people with lupus and/or target populations that have greatest risk for lupus, especially women ages 15 to 44 who are African-American, Hispanic, Asian, and Native American and Alaskan Native women. Applicant should include the target populations in the planning, implementation, and evaluation of the 5-year efforts.

https://oaaction.unc.edu/ https://www.cdc.gov/arthritis/partners/funded-national.htm#y https://www.aafp.org/home.html https://www.aanp.org/ https://www.aaip.org/ https://carragroup.org/ https://www.hrsa.gov/opa/eligibility-and-registration/health-centers/fqhc/index.html https://www.caregiving.org/ http://www.hispanichealth.org/ https://www.nationalahec.org/ http://www.nachc.org/about-our-health-centers/ https://www.nahnnet.org/ http://www.nasomh.com/ https://www.nbna.org/ https://www.nhmamd.org/ https://rnsnurse.org/ https://innovation.cms.gov/ https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=62 https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=62

Applicants are expected to describe their past experience at a national level serving people with lupus and target populations that have greatest risk for lupus, especially women ages 15 to 44 who are African-American, Hispanic, Asian, and Native American and Alaskan Native women.

Applicant must target people with lupus and populations that have greatest risk for lupus, especially women ages 15 to 44 who are African-American, Hispanic, Asian, and Native American and Alaskan Native women, to raise awareness about lupus and promote lupus self-management tools and/or services. Applicant should include the target populations in the planning, implementation, and evaluation of the 5-year efforts under this component.

a. Health Disparities By addressing African American, Hispanic, Asian and Native American populations, rural communities and lupus patients’ barriers to access effective self-management tools and/or services, the NOFO will help reduce health disparities and improve social determinants of health among populations at greatest risk for lupus.

iv. Funding Strategy (for multi-component NOFOs only) The NOFO is available to fund only two awards, one award for Component A and Component B. Applicants can apply for one or both Components but must submit a separate application for each Component. A total of $2,670,230 is available for annual funding, a range of $1.1 million to $1.5 million will be awarded to each successful applicant.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Component A: Increase awareness, knowledge and skills among healthcare providers to appropriately recognize the signs and symptoms of lupus, what to do if lupus is suspected, and provide quality, well-coordinated lupus care that is culturally and linguistically appropriate.

Applicants are expected to achieve by the end of the cooperative agreement performance period the following period of performance outcome measures for Component A and its Short/Intermediate Outcome Measures. These period performance measures must demonstrate a national population reach. Target numbers for performance outcome measures must lead to achievement of the 5-year short/intermediate outcome measure targets. Process measures with milestones should be identified and included that support and indicate incremental progress of the period performance outcome measures. Suggested Process measures are provided below.

Workplan objectives and activities should be aligned with and likely to lead to the proposed process and outcome measures.

Short/Intermediate Outcome A1: Increased number of healthcare providers recognizing the signs and symptoms of lupus and what to do if lupus is suspected.

Period Performance Outcome Measure A1.1: At least 300% increase in the number of healthcare providers recognizing the signs and symptoms of lupus and what to do if lupus is suspected.

Short/Intermediate Outcome A2: Increased number of healthcare providers using tele-health and/or electronic health records to identify lupus cases and treatment gaps.

Period Performance Outcome Measure A2.1: At least 300% increase in the number of healthcare providers using tele-health and/or electronic health records to identify lupus cases and treatment gaps.

Short/Intermediate Outcome A3: Increased number of settings receiving guidance on transition of pediatric lupus care to adult care.

Period Performance Outcome Measure A3.1: At least 300% increase in the number of settings receiving guidance on transition of pediatric lupus care to adult lupus care.

Suggested Process Measures for Component A and its Activities:

o Number of health professional associations engaged.

o Number of partnerships/key stakeholders engaged.

o Evidence of quality and effective training/educational opportunities developed.

o Number of trainings/educational opportunities provided.

o Number of tele-health and/or electronic health record (EHR) initiatives promoted.

o Number of continuing education (CE) or maintenance of certification (MOC) offerings.

o Number of providers completing CEs or MOCs.

o Number of providers achieving high learning standards.

o Number of clinician certification programs.

o Evidence of different type of healthcare providers reached.

o Evidence of quality practice procedures for transition of lupus care from pediatric to adult care.

o Evidence of effective dissemination or promotion strategies to support training/educational opportunities, tele-health/EHR initiatives, CE/MOC offerings, and other activities.

Component B: In collaboration with key stakeholders, including healthcare organizations, professional organizations, national health organizations, electronic medical technology organizations and/or other, raise awareness about lupus signs and symptoms and what to do if you have lupus, and promote the use of effective lupus self-management tools and/or services.

Applicants are expected to achieve by the end of the cooperative agreement performance period the following period of performance outcome measures for Component B and its Short/Intermediate Outcome Measures. These period performance measures must demonstrate a national population reach. Target numbers for performance outcome measures must lead to achievement of the 5-year short/intermediate outcome measure targets. Process measures with milestones should be identified and included that support and indicate incremental progress of the period performance outcome measures. Suggested Process measures are provided below.

Workplan objectives and activities should be aligned with and likely to lead to the proposed process and outcome measures.

Short/Intermediate Outcome B1: Increased number of people living with lupus engaged in the use of lupus self-management tools and/or services.

Period Performance Outcome Measure B1.1: At least 300% increase in the number of people living with lupus engaged in the use of lupus self-management tools and/or services.

Short/Intermediate Outcome B2: Increased number of referrals to appropriate lupus self-management tools/services using electronic health medical record systems or other medical information technology.

Period Performance Outcome Measure B2.1: At least 300% increase in the number of referrals to appropriate lupus self-management tools/services using electronic health medical record systems or other medical information technology.

Short/Intermediate Outcome B3: Improved self-management behaviors among people with lupus.

Period Performance Outcome Measure B3.1: At least 300% increase in the number of people with lupus showing improved self-management behaviors such as improvements in management of physical symptoms, stress, medications and lifestyle choices, and/or relationships with healthcare teams.

Suggested Process Measures for Component B and its Activities o Number of quality and appropriate stakeholders engaged to support Component B activities.

o Number of lupus-specific self-management tools and/or services being promoted.

o Evidence people with lupus are receiving effective messages about management of physical symptoms, stress, medications and lifestyle choices, and relationships with healthcare teams.

o Evidence of an evaluation of self-management tools and/or services and summary of its outcomes.

o Evidence of national promotion of self-management tools and/or services.

o Evidence of target population being reached.

o Evidence of appropriate and number of stakeholders being engaged.

o Evidence of promotion efforts to reach target population.

o Evidence of promotion of electronic health medical records or other medical information technology for referral.

o Number of stakeholders using technology to refer lupus patients to self-management tools and/or services.

o Evidence of expanding 211 system in multiple states and number of states engaged.

o Evidence of strategies addressing barriers that may impede access to care and ongoing treatment.

Since this NOFO does not involve the generation or collection of public health data, a Data Management Plan is not required, however CDC reserves the right to determine whether a Data Management Plan is needed after awards are made.

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.

The evaluation and performance measurement plan will be further developed by recipients with support from CDC as part of first year project activities.

A Data Management Plan is not required for this NOFO, however CDC reserves the right to determine whether a Data Management Plan is needed after awards are made.

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

c. Organizational Capacity of Recipients to Implement the Approach Applicants should have adequate organizational capacity, including:

Component A

Demonstrate having a national presence and impact among healthcare professionals involved with lupus diagnosis and/or care management. Applicant is expected to provide description of its organization's mission and national involvement with lupus affiliated healthcare professionals, including a description of past accomplishments that demonstrate improving healthcare professionals' knowledge and skills to appropriately recognize the signs and symptoms of lupus and what to do if lupus is suspected. Upload PDF document at www.grants.gov and title document "Organizational Capacity.National Presence and Impact". Additionally, applicant is expected to attach a PDF file of their most recent Annual Report. The report should detail the applying organization's mission, accomplishments, statistics related to the organization's cause, financial information, and other facts. Upload PDF document at www.grants.gov and title document "Annual Report".

Demonstrate past experience in conducting national lupus related healthcare education and training programs, including the ability to plan, implement, monitor performance and evaluate programs. Upload PDF document at www.grants.gov and title document "Organizational Capacity.Lupus Programmatic Experience".

Provide a staffing plan, including an organizational chart, CVs, and position descriptions that sufficiently will accomplish the applicant’s proposed strategies and activities, and required outcome and performance measures. Upload PDF document at www.grants.gov and title document "Staffing and Org Chart".

Component B

Evidence of having a national ability to reach target population, engage national organizations to reach people with lupus, and the impact from national campaign(s) and population-based outreach efforts promoting lupus health messages. Upload PDF document at www.grants.gov and title document "Organizational Capacity.National Ability and Impact". Additionally, applicant is expected to attach a PDF file of their most recent Annual Report. The report should detail the applying organization's mission, accomplishments, statistics related to the organization's cause, financial information, and other facts. Upload PDF document at www.grants.gov and title document "Annual Report".

Demonstrate past experience in conducting national population-based lupus programmatic efforts, including the ability to plan, implement, monitor performance and evaluate programs. Upload PDF document at www.grants.gov and title document "Organizational Capacity.Lupus Programmatic Experience".

Provide a staffing plan, including an organizational chart, CVs, and position descriptions that sufficiently will accomplish the applicant’s selected component and its activities, and required outcomes and performance measures. Upload PDF document at www.grants.gov and title document "Staffing and Org Chart".

d. Work Plan Applicants must provide a detailed work plan for the first year of the 5-year project period and a separate high-level work plan that includes all 5 years of the project. Applicant can use the sample work plan format provided below or similar. Applicants must use titles as follows: "First Year Work Plan" and “5-Year Work Plan” for Table of Contents.

Work plans help project officers monitor implementation of activities and progress on period of performance outcomes. Process Measures should be linked to its intended activities and include milestones. Objectives and activities should be specific, measurable, achievable, realistic and timely. Work plans are expected to be augmented each year based on lessons learned and progress of previous year while staying on course toward outcome measures and period of performance outcomes. CDC will provide feedback and technical assistance to recipients to finalize the work plan post-award.

COMPONENT A or COMPONENT B

Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Component A or B [from Funding Opportunity Description] Annual Objective(s):

Process Measure with Milestones for each activity.

[from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

Activity:

Activity:

Activity:

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.

No additional requirements.

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

COOPERATIVE AGREEMENTS)

CDC will provide substantial involvement beyond regular performance and financial monitoring during the period of performance. Substantial involvement means that recipients can expect federal programmatic partnership in carrying out the effort under the award. CDC will work in partnership with recipients to ensure the success of the cooperative agreement by:

Providing scientific subject matter expertise and resources.

Facilitating and engaging the recipients on a bi-annual conference call for information sharing, progress reporting, and collaborative efforts.

One recipient and partner meeting to be held at a to be determined location and to be determined date and time.

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: U48

3. Fiscal Year: 2020 Estimated Total Funding: $2,670,230

4. Approximate Total Fiscal Year Funding: $2,670,230

This amount is subject to the availability of funds.

5. Approximate Period of Performance Funding: $13,351,150

6. Total Period of Performance Length: 5

7. Expected Number of Awards: 2

8. Approximate Average Award: $1,335,115 Per Budget Period

This amount is subject to the availability of funds.

9. Award Ceiling: $1,500,000 Per Budget Period

10. Award Floor: $1,100,000 Per Budget Period

11. Estimated Award Date: 09/21/2020

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: State governments

Special district governments Public and State controlled institutions of higher education

Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education Private institutions of higher education For profit organizations other than small businesses 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:

Government Organizations:

State (includes the District of Columbia) State controlled institutions of higher education American Indian or Alaska Native tribal governments (federally recognized or state-recognized)

Non-government Organizations:

American Indian or Alaska native tribally designated organizations

Other:

Private colleges and universities Community-based organizations Faith-based organizations

2. Additional Information on Eligibility CDC will not accept and review applications with budgets greater than the ceiling of the award range ($1.5 Million). Applications with budgets that exceed the ceiling of the award will be considered non-responsive and will not be entered into the review process.

3. Justification for Less than Maximum Competition

N/A.

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