PKG00261564-instructions.pdf

Centers for Disease Control and Prevention

Agency for Toxic Substances and Disease Registry

ATSDR's Partnership to Promote Local Efforts To Reduce Environmental Exposure

CDC-RFA-TS20-2001

Application Due Date: 05/07/2020

ATSDR's Partnership to Promote Local Efforts To Reduce Environmental Exposure

CDC-RFA-TS20-2001

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- TS20-2001. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

ATSDR's Partnership to Promote Local Efforts To Reduce Environmental Exposure 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-TS20-2001

E. Assistance Listings (CFDA) Number:

93.240 F. Dates:

1. Due Date for Letter of Intent (LOI): 11/01/2019 Is a LOI: Recommended but not Required

2. Due Date for Applications: 05/07/2020, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call: 09/18/2019 Call-in details for the Informational Conference Call will be posted to https://www.atsdr.cdc .gov/states/ no later than September 11, 2019. This website will be updated periodically with additional information and/or materials.

G. Executive Summary:

1. Summary Paragraph:

The Agency for Toxic Substances and Disease Registry’s (ATSDR’s) Partnership to Promote Local Efforts to Reduce Environmental Exposure (APPLETREE) Program is critical to ATSDR’s success in accomplishing its mission in communities nationwide. ATSDR’s recipients will use APPLETREE funding to advance ATSDR’s primary goal of keeping communities safe from harmful environmental exposures and related diseases. APPLETREE gives recipients the resources to build their capacity to assess and respond to site-specific issues involving human exposure to hazardous substances in the environment. APPLETREE helps recipients identify exposure pathways at specific sites; educate affected communities about site contamination and potential health effects; make recommendations to prevent exposure; review 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 https://www.atsdr.cdc.gov/states/ https://www.atsdr.cdc.gov/states/ health outcome data to evaluate potential links between site contaminants and community health outcomes. APPLETREE facilitates the implementation of state-level programs to ensure that potential early care and education facilities are located in areas free from harmful environmental exposures. It also encourages recipients in the innovation of public health interventions that prevent exposures to environmental contamination. Because of APPLETREE recipients’ local connections and partnerships, community engagement and implementation of public health recommendations by the recipient through the health assessment process is improved.

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 25

Component 1: 25 Component 2: 5 - 10

d. Total Period of Performance Funding: $41,250,000

e. Average One Year Award Amount: $550,000 This announcement contains two separate components. Applicants must submit an application for Component 1: Core Activities and may apply for Component 2: Capacity Development and Applied Prevention Science; however, applicants must be approved with a minimum score of 60 and funded for Component 1 to be eligible for Component 2.

Component 1: $450,000 Component 2: $100,000 - $300,000

f. Number of Years of Award: 3

g. Estimated Award Date: 04/01/2020

h. Cost Sharing and / or Matching Requirements: N No. Cost sharing or matching funds are not required for this program.

Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview In 1980, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR) to implement the health-related sections of laws that protect the public from hazardous wastes and environmental spills of hazardous substances. The Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), commonly known as the "Superfund" Act, provided the Congressional mandate to remove or clean up abandoned and inactive hazardous waste sites and to provide federal assistance in toxic emergencies. As the lead

Agency within the Public Health Service for implementing the health-related provisions of CERCLA, ATSDR is charged to assess the presence and nature of health hazards at specific Superfund sites, to help prevent or reduce further exposure and the illnesses that result from such exposures, and to expand the knowledge base about health effects from exposure to hazardous substances.

In 1984, amendments to the Resource Conservation and Recovery Act of 1976 (RCRA) authorized ATSDR to conduct public health assessments (PHAs) at these sites. ATSDR was also authorized to assist the United States (U.S.) Environmental Protection Agency (EPA) in determining which substances should be regulated and the levels at which substances may pose a threat to human health. With the passage of the Superfund Amendments and Reauthorization Act (SARA), ATSDR received additional responsibilities in environmental public health. This act broadened ATSDR's responsibilities in the areas of PHAs, establishment and maintenance of toxicological databases, information dissemination, and medical education.

This NOFO builds on ATSDR’s increased integration of prevention based efforts. In 2017, ATSDR launched the Choose Safe Places for Early Care and Education (CSPECE) effort with CDC-RFA-TS17-1701, to prevent harmful exposures among children before they occur. Newly licensed ECE programs might inadvertently open in places where children and staff could be exposed to environmental contamination. CSPECE helps prevent new ECE locations being sited in potentially harmful locations through licensing landscape assessment, partnership building, data gathering, screening, education, and response actions. Several state programs have demonstrated CSPECE is effective at preventing ECEs from being located at sites that risk exposure to environmental contamination, and further evidence-base has been built through pilot programs. This NOFO builds on previous efforts of developing CSPECE programs where there were none, and expanding existing programs.

In 2019, ATSDR’s Office of Capacity Development and Applied Prevention Science established the priority to build capabilities by translating science into tools and actions that individuals, communities, and organizations apply to identify, reduce, or prevent health effects from exposures to hazardous substances. Under CDC-RFA-TS17-1701, ATSDR discovered that innovative, non-site-specific activities were already occurring informally in states. This NOFO seeks to formalize and evaluate these activities to contribute to ATSDR’s capacity and prevention mission. Such efforts can increase the efficiency of activities and expand reach to more communities, thereby increasing public health impact.

The primary purposes of this NOFO are to: 1) Decrease or eliminate exposures to hazardous substances through site-related health assessments and 2) Prevent exposures to hazardous substances through proactive programs that inform knowledge, behavior, process, and policy changes through dissemination of best practices.

This NOFO has one required component, Component 1, consisting of public health assessment, community engagement, and CSPECE activities, as well as an optional component, Component 2, which is focused on capacity building and prevention-based interventions. Both components are described in detail below.

b. Statutory Authorities This program is authorized under Section 104(i)(15) of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) of 1980, as amended by the Superfund

Amendments and Reauthorization Act (SARA) of 1986 [42 U.S.C. §9604(i)(15)].

c. Healthy People 2030 This cooperative agreement addresses components of the “Healthy People 2020” focus area of Environmental Health (http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=12).

d. Other National Public Health Priorities and Strategies In addition to addressing the Healthy People 2020 focus area, the purpose and goals of the funding are consistent with the mission of ATSDR to serve the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and disease related to toxic substances (http://www.atsdr.cdc.gov/).

Program outcomes will be aligned with one (or more) of the following performance goal(s) for the National Center for Environmental Health (NCEH)/ATSDR:

Protect the public from environmental hazards and toxic exposures; prevent adverse health outcomes associated with exposure to environmental hazards

Promote healthy environments;

Advance the science of environmental public health;

Support environmental public health practice;

Educate communities, partners, and policy makers about environmental health risks and protective measures;

Promote environmental justice and reduce health disparities associated with environmental exposures; and Provide unique scientific and technical expertise to advance public health science and practice.

e. Relevant Work Under TS17-1701 APPLETREE, ATSDR included a new prevention strategy, Choose Safe Places for Early Care and Education (CSPECE), in which state health departments are developing pilot programs in their state for safe siting of child care facilities. This new funding cycle builds off of ATSDR’s past program activities and state health department successes and innovations to implement additional activities that contribute to preventing environmental exposures.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Component 1: Core Activities

Strategies and Activities Short-Term Outcomes Intermediate Outcomes Long-Term Outcomes http://www.atsdr.cdc.gov/ https://www.atsdr.cdc.gov/safeplacesforECE/index.html https://www.atsdr.cdc.gov/safeplacesforECE/index.html

Strategy A) Site Assessment and Community/Stakeholder Engagement

Conduct site-specific assessments that evaluate possible harm to the public’s health.

Identify, develop and maintain partner and stakeholder relationships to support activities.

Educate community, stakeholders, and health professionals on site-related risks and recommendations.

Timely dissemination of site-specific findings to partners, stakeholders, and community members.

Increased partner buy-in and acceptance of recommendations.

Increased community, stakeholder, and health professional knowledge of site-related risks and recommendations

Increased implementation of recipient recommendations to reduce, eliminate, or prevent exposures by regulatory agencies, and/or individuals.

Increased actions by community members to protect themselves from site-related hazards.

Decreased or eliminated site-related exposures.

Strategy B) Choose Safe Places for Early Care and Education (CSPECE), for programs NOT previously funded under TS17-1701

Define childcare landscape

Assess needs

Form partnerships to support program development and implementation

Create strategic program plan

Pilot and systematically evaluate plan

Buy in and support from broad array of partners.

Increased stakeholder/partner knowledge of ECE siting issues and recommendations to prevent exposure.

Increased understanding of barriers and facilitators for safe siting.

Increased stakeholder practices to reduce hazardous exposure among children.

Increased process, systems, and policy changes to support exposure prevention.

Increased understanding of actions to enhance and/or expand program.

Strategy B) Choose Safe Places for Early Care and Education (CSPECE), for programs previously funded under TS17-1701

Decreased, eliminated, or prevented exposures to hazardous chemicals.

Decreased, eliminated, or prevented exposure-related health effects.

Increased collection of evidence on effective practices, policies, and processes for preventing exposure.

Increased capacity of individuals, communities, and organization to identify, reduce, and eliminate

Established infrastructure and

Enhance and/or expand program using pilot evaluation results

Educate target populations about choosing safe ECE locations and environmental risks

Engage and maintain multi-sector partnerships

Screen ECEs for environmental hazards

Respond to screening results

Implement process, systems, or policy changes

Create a sustainability plan

Enhanced and/or expanded CSPECE programs.

Increased stakeholder /partner knowledge of ECE siting issues and recommendations to prevent exposure.

Increased partner commitment to CSPECE program.

Enhanced infrastructure among partners to sustain CSPECE program.

Improved efficiency and quality of programs.

Increased stakeholder practices to prevent hazardous exposure among children.

Increased systems and policy changes to support exposure prevention.

Increased practices of partners to manage CSPECE program independently.

capacity for sustainability of programs.

Component 2: Capacity Development and Applied Prevention Science

Build local and state capabilities to identify, reduce, or prevent health effects from exposures to hazardous substances.

Increased knowledge among target audience to identify, reduce, or prevent health effects from exposure to hazardous substances.

Increased actions among target audience to identify, reduce, or prevent health effects from exposure to hazardous substances.

Increased capacity of individuals, communities, and organization to identify, reduce, and eliminate

Established infrastructure and capacity for sustainability of programs.

i. Purpose The purpose of this program is to increase recipient capacity to: 1) identify pathways of human exposure to hazardous substances in the environment, 2) implement and sustain ATSDR’s Choose Safe Places for Early Care and Education (CSPECE) program in the recipient’s jurisdiction, and 3) innovate proactive strategies to prevent harmful exposures from occurring.

ii. Outcomes Programs are expected to demonstrate measurable progress in short-, intermediate-, and long-term outcomes listed in bold on the logic model. Expected program outcomes listed below are required for Component 1, and are required for Component 2 only if the applicant is awarded for Component 2.

Short-Term Outcomes:

Timely dissemination of site-specific findings to partners, stakeholders, and community members. (Component 1: Strategy A)

1.2 Increased partner buy-in and acceptance of recommendations. (Component 1:

Strategy A)

1.3 Buy in and support from broad array of partners. (Component 1: Strategy B, NOT funded under TS17-1701)

1.4 Increased stakeholder/partners knowledge of ECE siting issues and recommendations to prevent exposure. (Component 1: Strategy B, NOT funded under

TS17-1701)

1.5 Increased understanding of barriers and facilitators for safe siting. (Component 1:

Strategy B, NOT funded under TS17-1701)

1.6 Enhanced and/or expanded CSPECE programs. (Component 1: Strategy B, funded under TS17-1701)

1.7 Increased stakeholder /partner knowledge of ECE siting issues and recommendations to prevent exposure. (Component 1: Strategy B, funded under TS17-1701)

1.8 Enhanced infrastructure among partners to sustain CSPECE program. (Component 1: Strategy B, funded under TS17-1701)

1.9 Increased knowledge among target audience to identify, reduce, or prevent health effects from exposure to hazardous substances. (Component 2)

Intermediate Outcomes:

2.1 Increased implementation of recommendations by regulatory agencies, policy makers, and/or individuals. (Component 1: Strategy A)

2.2 Decreased or eliminated site-related exposures. (Component 1: Strategy A)

2.3 Increased stakeholder practices to reduce hazardous exposure among children.

(Component 1: Strategy B, NOT funded under TS17-1701)

2.4 Increased process, systems, and policy changes to support prevented exposures.

(Component 1: Strategy B, NOT funded under TS17-1701)

2.5 Increased stakeholder practices to prevent hazardous exposure among children.

(Component 1: Strategy B, funded under TS17-1701)

2.6 Increased systems and policy changes to support prevented exposures. (Component

1: Strategy B, funded under TS17-1701)

2.7 Increased practices of partners to manage CSPECE program independently.

(Component 1: Strategy B, funded under TS17-1701)

2.8 Increased actions among target audience to identify, reduce, or prevent health effects from exposure to hazardous substances. (Component 2)

Long-Term Outcomes:

3.1 Decreased, eliminated, or prevented exposures to hazardous chemicals. (Component 1: Strategies A, B, and Component 2)

3.2 Improved evidence base on effective practices, policies, and processes for preventing exposure. (Component 1: Strategy B, and Component 2)

iii. Strategies and Activities COMPONENT 1: Core Activities (required) The Core Activities Component of the program supports two strategies: (A) Site Assessment and Community/Stakeholder Engagement, or “Strategy A”; and (B) Choose Safe Places for Early Care and Education (CSPECE), or “Strategy B”. Applicants are required to propose activities under BOTH Strategies in this Component.

Strategy A (required): Site Assessment and Community/Stakeholder Engagement

1. Conduct site-specific health assessments and provide recommendations to prevent, reduce, or eliminate harmful exposures. In order to achieve the outcomes listed above, recipients must conduct environmental health assessment activities at National Priorities List (NPL) sites, petition sites, Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) or other state-identified sites, RCRA sites, Brownfields and other redevelopment sites, and facilities or releases within the recipient’s jurisdiction.

Environmental health assessment reports are focused responses to a specific question or specific request for information about health risks posed by a specific site, chemical release, hazardous material, or emergency response actions. Recipients must conduct environmental health assessments in a public health assessment/health consultation/exposure investigation/technical assistance format, and appropriate health education activities at sites on their annual work plan.

Environmental health assessments shall include environmental data, demographic characterizations, health status indicators, community health concerns, and health outcome data reviews. Recipients should prioritize work at NPL sites, petition sites, sites of greatest public health significance, and sites deemed a priority by ATSDR. In the assessment of hazardous exposures, recipients are required to follow ATSDR policy and guidance, including, but not limited to, the ATSDR Public Health Assessment Guidance Manual.

Additionally, recipients are required to utilize ATSDR’s Public Health Assessment

Screening Tool (PHAST) which contains ATSDR’s health-based comparison values (CVs) and health guidelines in all documents in which specific exposures are evaluated. State-derived comparison values may be used if they are more conservative, or more protective of public health.

Recipients will respond promptly to ATSDR’s requests for information about the program, including information needed for congressional inquiries/testimony, program evaluation, and other reporting.

ATSDR periodically receives petitions from community members which request that ATSDR investigate a particular site. Recipients will provide any available data to assist ATSDR in deciding how to respond to petitions. Recipients will review existing information including environmental data pertaining to a site or release identified in a petition. Recipients are expected to conduct public health assessment activities (in consultation with ATSDR) at ATSDR-accepted petition sites.

Exposure Investigations (EIs) may be conducted as part of the public health assessment process to fill data gaps and better define site-specific human exposures. EIs may include the collection of environmental and biological data. EIs require approval from ATSDR’s Technical Project Team and EI Program staff. For the purposes of this program, EIs must also be designated “non-research” by the state or ATSDR human research subject’s protection official. Recipients are encouraged to work with state environmental labs when conducting exposure investigations.

2. Educate community, stakeholders, and health professionals on site-specific environmental exposures and risk to human health. Health education activities should focus on ensuring that community members understand findings of health assessments and where applicable, adopt behavioral changes that will prevent and reduce exposure to hazardous chemicals. Applicants are expected to ensure that all prepared health education and community involvement materials are accessible and inclusive of people with disabilities. Health education materials to healthcare providers should focus on ensuring that environmental exposure-related etiology is considered in patient care. Recipients are required to participate in local, state, and federal health and environmental workshops and community meetings to discuss and respond to questions concerning a particular site’s impact on public health. Recipients are expected to consider conducting SoilSHOPs, as appropriate, as part of their health education efforts in communities where lead in soil is a potential health concern. SoilSHOPs are described here: https://www .atsdr.cdc.gov/soilshop/index.html.

3. Identify, develop, and maintain partner and stakeholder relationships to support these activities. Details of expected collaborative efforts are outlined in Collaborations section, below.

Major Activities Recommended Sub-Activities

Activities specified within the logic model to support overall strategy

Below ATSDR has listed some recommended sub-activities applicants may engage in to advance strategies. Some sub-activities are standard practices for an activity, but many are not required and only suggestions.

Applicants may propose actions that are not listed below if they advance https://www.atsdr.cdc.gov/soilshop/index.html https://www.atsdr.cdc.gov/soilshop/index.html the strategy and make progress toward achieving logic model outcomes.

Evidence should be provided to justify how actions support the overall strategy.

Develop Annual Plan of Work based on state landscape of National Priorities List (NPL) sites, petition sites, Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) or other state-identified sites, RCRA sites, Brownfields and other redevelopment sites, and facilities or releases within the recipient’s jurisdiction.

Work with Technical Project Officers to prioritize sites. Recipients should prioritize work at NPL sites, petition sites, sites of greatest public health significance as identified by ATSDR, and sites deemed a priority by ATSDR.

Identify/assess site needs and match needs to a plan of activities.

Evaluate exposure pathways.

Evaluate exposures and human health effects.

Conduct site-specific assessments that determine harm to the public’s health

Identify appropriate interventions or recommendations, and follow-up on all recommendations provided to policy makers, regulatory agencies, and individuals whose actions impact multiple community members, within one year of provision.

Engage in capacity building opportunities to improve quality and efficiency, such as participating in relevant training and skill building opportunities

Participate in peer review network for health assessments with other Cooperative Agreement Partners

Identify relevant environmental, regulatory, policy, and other partners to support and advance activities.

Foster commitment with partners to support activities

Proactively engage in consistent communication to maintain and strengthen partnerships.

Identify, develop, and maintain partner and stakeholder relationships to support activities.

Engage in collaborative activities with partners that meet common goals.

Assess community site-specific education needs and applicable educational strategies to meet needs.

Educate community, stakeholders, and health professionals on site-related risks and

Participate in local, state, and federal health and environmental workshops and community meetings to discuss and respond to questions concerning a particular site’s impact on public health.

Provide other direct education concerning a particular site’s impact on public health (e.g. one-on-one or group education such as phone calls, emails, Community Advisory Group meetings, web-based or conference call education, site visits, or other education involving direct instruction).

Create and provide indirect educational materials through outlets such as paper material distribution (e.g. flyers, brochures, fact sheets), web-based material distribution (e.g. blog posts, social media, webpage posts), or television, radio, or newspaper.

recommendations.

Utilize ATSDR’s Communication Toolkit (https://www.atsdr.cdc.gov /communications-toolkit/index.html) to promote evidence-based communication strategies.

Host soilSHOPs when lead in soil is a potential health concern.

Respond to written or verbal requests for environmental public health technical and/or educational information and document response in a written form. Technical assistance should not draw a public health conclusion or comment on another entity’s health conclusion.

Strategy B (required): Choose Safe Places for Early Care and Education (CSPECE) Applicants must select either 1 or 2 and must clearly indicate in their application which option they are choosing.

1. For programs previously funded under TS17-1701:

Building upon pilot programs developed under the previous cooperative agreement, provide a 3-year plan for full-scale implementation and long-term sustainability. In this plan, applicants are expected to describe what activities they intend to implement based on evaluation results from the pilot year, including activities such as screening, education, response actions, process or policy change, and any other innovative activities that support the goals of CSPECE. Applicants should also include a sustainability section in their plan that describes how states will maintain their program long-term, including key partnerships with roles and commitments, infrastructure and resources, capacity building activities, and potential adaptations or changes. The plan should include year 1, year 2, and year 3 measureable milestones to achieve full integration of the CSPECE program. By the end of the period of performance, recipients should be able to provide MOUs, MOAs, or letters of support from appropriate stakeholders and entities indicating long-term commitment to CSPECE.

2. For programs NOT previously funded under TS17-1701:

Recipients will participate in ATSDR’s CSPECE program. This participation shall include determining a systematic way to work with child care licensing authorities to evaluate prospective child care locations. These activities shall be conducted with ATSDR training and guidance in stages throughout the three year award period.

March 2020-December 2020: Define the landscape for safe siting of child care centers within the applicant’s boundaries and form partnerships, including non-federal advisory https://www.atsdr.cdc.gov/communications-toolkit/index.html https://www.atsdr.cdc.gov/communications-toolkit/index.html committees.

January 2021-December 2021: Develop a program plan for safe siting of child care centers that includes operation, training, data, and evaluation needs, as well as roles and responsibilities.

January 2022-December 2022: Implement a pilot program that tests the feasibility and scalability of the program plan. Collect applicable evaluation data throughout pilot process.

January 2023-March 2023: Complete evaluation of pilot program.

Major Activities Recommended Sub-Activities

Activities specified within the logic model to support overall strategy

Below ATSDR has listed some recommended sub-activities applicants may engaged in to advance strategies. Some sub-activities are standard practices for an activity, but many are not required and only suggestions.

Applicants may propose actions that are not listed below if they advanced the strategy and make progress toward achieving logic model outcomes.

Evidence should be provided to justify how actions support the overall strategy.

Quantify Early Care and Education (ECE) programs and populations in the state.

Identify state ECE licensing process and policies.

Identify state intersection of ECE licensing and environmental health.

Identify governmental and non-governmental stakeholders of ECE licensing programs and how they could be involved in ECE licensing.

Define childcare landscape

Identify data sources that could be used to foster a CSPECE program.

Assess needs Based on defined childcare landscape, determine gaps and needs.

Identify relevant childcare, licensing, environmental, health, academic, zoning, planning, non-governmental, and other partners to support and advance activities.

Foster commitment with partners to support activities.

Proactively engage in consistent communication to maintain and strengthen partnerships.

Engage in collaborative activities with partners that meet common goals.

Form partnerships to support program development and implementation

Engage in activities that foster sustainability such as building partner capacity.

Establish overall goals and SMART goals for your program. Create strategic program plan

Describe how the state program will operate.

Describe education and training the program will conduct.

Describe the data and processes the program will use to identify proposed ECEs that have potential harmful environmental exposure.

Describe partnerships the program will support.

Describe data the program will collect.

Describe how the program will be evaluated.

Implement pilot plan. Pilot and systematically evaluate plan Based on evaluation plan, evaluate and report pilot results.

COMPONENT 2: Capacity Development and Applied Prevention Science (optional) ATSDR’s Office of Capacity Development and Applied Prevention Science builds capabilities by translating science into tools and actions that individuals, communities, and organizations apply to identify, reduce, or prevent health effects from exposures to hazardous substances.

Proposals made under this Component should promote the OCDAPS mission. Proposals should address one, or more, of the following Focus Areas:

1. Development of best practices, tools, and innovative strategies for engaging with communities, and providing community engagement consultation

2. Informing and promoting integration of environmental health content within academic programs and environmental medicine practice (e.g., major and minor coursework, clinical rotations, and primary care residence programs)

3. Identify and cultivate partnerships with academic and professional organizations to encourage uptake of environmental public health awareness curricula and career tracks

4. Develop community/population intervention initiatives to reduce risk factors associated with environmental exposures and develop and test metrics that could be used for evaluation of intervention effectiveness

5. Partner with relevant internal and external stakeholders to incorporate prevention strategies into existing programs, policies, and practices

1. Collaborations Applicants are expected to include no fewer than five letters of support dated between July 1, 2019 and December 31, 2019 from environmental regulatory agencies, communities, state environmental labs, or federal/state/local agencies that detail the applicant’s role and success with reducing exposure to hazardous chemicals in the environment. These letters should be saved as one PDF, named "Letters of Support", uploaded into www.grants.gov.

Specific required letters of support, as well as any MOUs or MOAs are further described in sub-sections a) and b) below.

Applicants must file the MOUs and/or MOAs in one PDF file and name the file “MOUs- MOAs”, and upload it at www.grants.gov http://www.grants.gov/

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

Recipients are required to collaborate with other CDC and ATSDR Cooperative Agreement and/or Grant programs to identify common needs, promote resource and information sharing to assure review of documents in order to advance ATSDR goals, and facilitate public health actions to improve the health of communities. Applicants are required to explain how existing or potential collaborations with other CDC-funded programs and organizations could assist the recipient in implementing activities and achieving the NOFO outcomes. The applicant must obtain information on the following funded programs in their state and explain existing or potential, areas of collaboration: Pediatric Environmental Health Specialty Units (PEHSU), Safe Water for Community Health (Safe WATCH), National Environmental Public Health Tracking Program, ATSDR's PFAS Exposure Assessments and Multi-site Studies, and Childhood Lead Poisoning Prevention Program. Other relevant CDC funded programs could also be used with appropriate explanation, including CDC Disability and Health Programs.

A letter of intent from the Secretary/Director or equivalent head of the applicant’s agency confirming that partnerships exist, or will be developed, across appropriate organizational units within the agency/department is required to accompany the application. If available, please provide the cover sheet of any memorandum of understandings/memorandums of agreement (MOUs/MOAs) that demonstrate existing collaborations.

b. With organizations not funded by CDC:

For site-specific work, recipients are required to collaborate with the U.S. Environmental Protection Agency, the appropriate state agencies, appropriate local health departments, state environmental laboratories, and community groups to identify common needs, promote resource and information sharing to advance ATSDR goals, and facilitate public health actions to improve the health of communities. If available, please provide the cover sheet of any MOUs/MOAs that demonstrate existing collaborations.

For non-site specific work and health education, recipients are required to collaborate with appropriate state agencies, local health departments, non-profit organizations, and community groups to identify common needs, promote resource and information sharing to advance ATSDR goals, and facilitate public health actions to improve the health of communities. Applicants should explain collaborations with other groups that could assist them in implementing health education activities, such as soilSHOPs and the Brownfields/Land Reuse Action Model. If available, please provide the cover sheet of any MOUs/MOAs that demonstrate existing collaborations.

Recipients funded under TS17-1701 should have developed partnerships and relationships with entities involved in childcare licensing, GIS, children’s environmental health, and others through CSPECE activities performed under the previous announcement. Applicants for Strategy B1, should provide letters of support, or the cover sheets of any MOUs/MOAs, that demonstrate existing collaborations. Additionally, applicants should seek to build both internal and external partnerships to ensure the sustainability of CSPECE in their jurisdiction beyond this period of performance.

https://www.pehsu.net/ https://www.cdc.gov/nceh/ehs/safe-watch/index.html https://www.cdc.gov/nceh/ehs/safe-watch/index.html https://www.cdc.gov/nceh/tracking/default.htm https://www.cdc.gov/nceh/tracking/default.htm https://www.atsdr.cdc.gov/pfas/index.html https://www.cdc.gov/nceh/lead/about/program.htm https://www.cdc.gov/nceh/lead/about/program.htm https://www.cdc.gov/ncbddd/disabilityandhealth/programs.html

2. Target Populations ATSDR’s mission is to protect communities from harmful health effects from exposure to hazardous waste and hazardous materials spills. Therefore, the target population for this NOFO is anyone previously, currently, or potentially exposed to existing or emerging environmental health threats, particularly sensitive subpopulations including children, the elderly, and people with disabilities. Children attending early care and education (ECE) facilities, and stakeholders involved in the licensing, siting, and operation of ECE facilities are specifically targeted in this NOFO. Additionally, as part of the capacity building strategies described herein, any public health entity, national organization, academic institution, medical system, or non-profit organization that potentially plays a part in increasing the capacity of state, local, tribal or territorial health agencies to respond to, investigate, or prevent harmful exposures could also be targeted by this NOFO.

a. Health Disparities Applicants must consider under-served populations such as tribes, people with disabilities, rural populations, and populations where English is a second language when conducting activities described in this NOFO.

iv. Funding Strategy (for multi-component NOFOs only) This announcement contains two separate components. Applicants must submit an application for the Core Activities Component (Component 1) and may apply for the advanced Capacity Development and Applied Prevention Sciences component (Component 2); however, applicants must be approved with a minimum score of 60 points and funded for Component 1 to be eligible for review and funding under Component 2.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy ATSDR requires ongoing evaluation and performance measurement under this NOFO and expects recipients to maintain sufficient staffing and analytic capacity to meet these requirements. Program evaluation and performance measurement help demonstrate the effectiveness of programs, drive continuous program improvement, and contribute to the evidence-base for each intervention.

ATSDR will assess the degree to which strategies in the logic model have been implemented and outcomes have been achieved through submitted quantitative and qualitative reporting, conference calls, site visits, and other communications with recipients. This section will present example measures that ATSDR will use to track the implementation of strategies and progress on achieving outcomes. The assessment will occur on an ongoing basis through the evaluation of submitted products and training and technical assistance delivered. Recipients are expected to develop an evaluation plan (see the CDC Evaluation and Performance Measurement Strategy section for more detail), submit an annual progress report, and an additional final project report at the conclusion of the period of performance summarizing achievements, challenges, lessons learned, and next steps. Optional templates will be provided to guide the Evaluation and Performance Measurement Plan development and the final project reporting.

Targets for performance measures may vary by program and can be established in the 6-month period following the award. However, all recipients are expected to meet or exceed the target of completing at least 80% of the activities specified in their work plan each year.

Modifications to the work plan should be discussed with Technical Project Officers and all changes should be finalized at least 3 months prior to submission of Annual Performance Reports.

This section presents example measures that ATSDR will use to track the implementation of strategies and activities (process evaluation) and progress on achieving period-of-performance outcomes (outcome evaluation). The measures below are not comprehensive or final, and ATSDR will finalize evaluation and performance measures in collaboration with recipients within six months of the project start date.

Process Performance Measures To better understand outcome results, it is important to collect process measures. Evaluating the implementation of a program in addition to its outcomes helps to show what aspects of a program are working well and what may require change to achieve the intended impact.

COMPONENT 1:

Strategy Example Process Performance Measures

A: Site Assessment and Community/ Stakeholder Engagement

· Proportion of site-specific assessments completed from workplan

· Proportion of requests for technical assists provided a written response

· Number of internal and/or external capacity building opportunities engaged to expedite release of assessments and educational products

· Identification of barriers, facilitators, and improvements to the site assessment process annually

B: Choose Safe Places for Early Care and Education, NOT funded under TS17-

· Assessment that defines the childcare landscape and identifies needs

· Number of partnerships identified to help prevent exposures

· Choose Safe Places for Early Care and Education pilot plan

B: Choose Safe Places for Early Care and Education, funded under TS17-1701

· Number of MOUs and/or letters of intent from partners demonstrating long-term commitment to program

· Sustainability plan

COMPONENT 2:

Build local and state capabilities to identify, reduce, or prevent health effects from exposures to hazardous substances

May vary significantly based on proposal, but may generally include:

· Identification of key implementation barriers, facilitators, and lessons learned from pilot process

Outcome Performance Measures

Short-term Outcomes

1.1 Timely dissemination of site-

specific findings to partners, stakeholders, and community members. (Strategy A)

· Proportion of site-specific assessments disseminated from workplan within one year from the date adequate data was received.

· Number of health education and/or community involvement activities completed to disseminate information to partners, stakeholders, and community members

1.2 Increased partner buy-in and

acceptance of public health recommendations made by recipients. (Strategy A)

· Percentage of public health recommendations made by recipients accepted by regulatory agencies or policy makers within one year

1.4 Buy in and support from broad

array of partners. (Strategy B, NOT funded under TS17-1701)

· Number of partners indicating commitment to help prevent exposures

1.5 Increased stakeholder/partners

knowledge of ECE siting issues and public health recommendations made by recipients to prevent exposure. (Strategy B, NOT funded under TS17-1701)

· Number of stakeholders/partners reached through direct education (duplicated counts acceptable)

· Percentage of stakeholders/partners indicating understanding public health recommendations made by recipients to prevent exposure at ECEs

1.6 Increased understanding of

barriers and facilitators for safe siting. (Strategy B, NOT funded

· Written interpretation of barriers and facilitators for safe siting

1.7 Enhanced and/or expanded

CSPECE programs. (Strategy B,

· Execution of enhanced and/or expanded CSPECE program

1.8 Increased stakeholder /partner

knowledge of ECE siting issues and public health recommendations made by recipients to prevent exposure. (Strategy B, funded under TS17-1701)

· Number of MOUs and/or letters of intent from partners demonstrating commitment to program annually

1.9 Enhanced infrastructure among

partners to sustain CSPECE program. (Strategy B, funded under

TS17-1701)

· Number of resources/tools provided to partners

· Percentage of partners indicating increased knowledge, skills, and abilities around CSPECE concepts

1.10 Increased knowledge among

target audience to identify, reduce, or prevent health effects from exposure to hazardous substances.

(Component 2)

· Percentage of target audience (educational target audience may vary and include inspectors, zoning and planner officials, providers, and other ECE stakeholders) indicating increased knowledge to identify, reduce, or prevent health effects from exposure to hazardous substances

Intermediate-Term Outcomes:

2.1 Increased implementation by

regulatory agencies, and/or individuals of public health recommendations made by recipients. (Strategy A)

· Percentage of public health recommendations made by recipients implemented by regulatory agencies within one year

2.2 Decreased or eliminated site-

related exposures. (Strategy A)

· Percentage of sites with decreased or eliminated exposures based on public health recommendations made by recipients implemented by regulatory agencies or policy makers within the period of performance

2.3 Increased stakeholder practices

to reduce hazardous exposure among children. (Strategy B, NOT

· Percentage of ECE programs referred to the program that make changes because of identified issues

2.4 Implemented process, systems, and policy changes to support

· Number of policy, systems, environment changes to support prevented exposures prevented exposures. (Strategy B, NOT funded under TS17-1701)

2.5 Increased stakeholder practices

to prevent hazardous exposure among children. (Strategy B,

· Percentage of ECE programs referred to the program that make changes because of identified issues

2.6 Implemented systems and

policy changes to support prevented exposures. (Strategy B,

· Number of policy, systems, environment to support prevented exposures

2.7 Increased practices of partners

to manage CSPECE program independently. (Strategy B, funded

· Percentage of partners that are actively engaging in behaviors to manage their respective component of the CSPECE program independently

2.8 Increased actions among target

audience to identify, reduce, or prevent health effects from exposure to hazardous substances.

(Component 2)

Will vary based on applicant proposals.

Long-Term Outcomes

3.1 Decreased, eliminated, or

prevented exposures to hazardous chemicals. (Strategies A, B, and C)

· Percentage of sites with decreased or eliminated exposures based on public health recommendations made by recipients implemented by regulatory agencies or policy makers within the period of performance

· Number of individuals protected at sites in which public health recommendations made by recipients are implemented by regulatory agencies or policy makers within the period of performance

3.2. Increased collection of

evidence on effective practices, policies, and processes for preventing exposure.

· Description of effective practices, policies, and processes for preventing exposure.

Many performance measures will be available through required data collection forms, or equivalent collection processes, including:

Site Impact Assessment (SIA): Required to complete SIA submission for each health assessment (Public Health Assessment, Health Consultation, Letter Health Consultation)

Health Education Activity Tracking (HEAT): Required to complete for indirect and direct educational activities. It is suggested to submit entries on a quarterly basis.

Technical Assist (TA): Required to complete for each TA. It is suggested to submit entries on a quarterly basis.

Success stories: Required to complete one per quarter.

soilSHOP: Required to complete soilSHOP reporting for each soilSHOP held each year.

Annual Performance Report: Required per CDC; recipients will be notified by CDC with directions and due dates annually.

Final Performance Report: Required to complete at the end of the period of performance.

Quantitative and qualitative data (including all required quantitative metrics, success stories, and narrative reports) may be used without prior notification to produce summary reports, reports on project accomplishments, fact sheets, and other monitoring and evaluation reports.

Findings may be reported at national conferences, online, in peer-reviewed journals, and in other public forums independently by ATSDR (for aggregate data), or in collaboration with recipients where site-specific data are to be presented. ATSDR will finalize evaluation and performance measures in collaboration with recipients within six months of the project start date.

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…