PKG00264287-instructions.pdf

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Strengthening Breastfeeding Support by Coordinating National Efforts and Building Capacity of Breastfeeding Coalitions

CDC-RFA-DP21-2108

Application Due Date: 03/15/2021

Strengthening Breastfeeding Support by Coordinating National Efforts and Building Capacity of Breastfeeding Coalitions

CDC-RFA-DP21-2108

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. Application and Submission Information 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- DP21-2108. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Strengthening Breastfeeding Support by Coordinating National Efforts and Building Capacity of Breastfeeding Coalitions 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.govregs.com/regulations/title42_chapterI_part2_subpartD_section2.52. 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-DP21-2108

E. Assistance Listings (CFDA) Number:

93.945 F. Dates:

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

2. Due Date for Applications: 03/15/2021, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

N/A

G. Executive Summary:

1. Summary Paragraph:

The purposes of this opportunity are to improve breastfeeding initiation, duration and exclusivity and to decrease racial/ethnic, economic, and geographic disparities in breastfeeding through a coordinated national approach which requires engaging all existing state-level breastfeeding coalitions and building multi-sectoral partnerships to facilitate the use of breastfeeding strategies. Activities include:

Develop and implement a 5-year plan for policy, systems, and environmental (PSE) changes

Enhance opportunities for collaboration across state and other types of breastfeeding coalitions https://www.grants.gov https://www.grants.gov https://www.govregs.com/regulations/title42_chapterI_part2_subpartD_section2.52 https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov

Provide capacity-building opportunities for state coalitions, with a focus on PSE changes and health equity, particularly for African American and Native American families

Develop, adapt and disseminate guidance, tools, best practices, and other resources using multiple communication modes

Promote the adoption of guidelines, recommendations, best practices, and resources

This NOFO is expected to result in increased availability and access to breastfeeding resources, support, and breastfeeding friendly environments, particularly for African American and Native American families. Fewer black infants (73.7%) and Native American infants (80.7%) are ever breastfed compared to white infants (86.7%) and Hispanic infants (84.1%).

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 1

d. Total Period of Performance Funding: $5,000,000

e. Average One Year Award Amount: $1,000,000

f. Total Period of Performance Length: 5

g. Estimated Award Date: 06/30/2021

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview Breastfeeding is a key public health strategy to improve the health of mothers and their infants.

It is the best source of nutrition for most infants and it reduces the risk for some short- and long-term health conditions for both infants and mothers. Although more than 80% of mothers start out breastfeeding, about 60% stop sooner than they planned and do not meet their goals for duration and exclusivity. While breastfeeding rates are increasing in all racial/ethnic populations, disparities in breastfeeding continue, with lowest rates of breastfeeding being reported among African American and Native American mothers/infants. Fewer black infants (73.7%) and Native American infants (80.7%) are ever breastfed compared to white infants (86.7%) and Hispanic infants (84.1%). Low rates of breastfeeding add more than $3 billion a year to medical costs for women and children in the United States. Undertaking a national approach to strengthen breastfeeding support and build the capacity of state breastfeeding coalitions can address health disparities and increase access to breastfeeding-friendly environments, breastfeeding support, and resources that can help support moms facing challenges to continue breastfeeding.

This NOFO is expected to shift how we as a nation think and talk about breastfeeding; to improve breastfeeding initiation, duration and exclusivity; to decrease racial/ethnic disparities in breastfeeding; and to transform the way breastfeeding is addressed in public health through policy, systems and environmental approaches that increase equitable and culturally relevant access to breastfeeding support across the nation The approach being used to accomplish this is to fund a coordinating center for the engagement and coordination of existing state-level breastfeeding coalitions, and other government and nongovernment partners to collectively conduct activities, projects and initiatives. In consideration of the current COVID-19 crisis, collective action may also occur through this approach, to address infant and young child feeding in emergencies.

Evidence to support this approach is included in key findings and action steps provided in The Surgeon General’s Call to Action to Support Breastfeeding report (i.e. SCCTA on Breastfeed ing). The report relays the importance of breastfeeding, the health risks of not breastfeeding, disparities in breastfeeding rates, and barriers to breastfeeding in the U.S. CDC has invested significant funds to support actions and recommendations contained within the report through a variety of initiatives and mechanisms using an approach aimed at making policy, systems and environmental changes that support capacity-building and implementation of practice-based interventions. This work has led to this effort that directly supports Action 20: “Public Health Infrastructure: Improve national leadership on the promotion and support of breastfeeding”.

This opportunity will complement and build upon lessons learned through previous efforts and seeks to strengthen coordination, collaboration and collective action among various types of stakeholders to reduce inefficiencies, maximize limited resources, avoid duplication and allow for addressing existing and emerging public health emergencies more effectively. Availability and access to breastfeeding resources may be targeted to populations with low rates of breastfeeding, i.e., African American and Native American populations. Such resources and other activities funded here, are applicable to and will be available to all populations.

b. Statutory Authorities Awards are made under the authorization of 317(k) (2) of the Public Health Service Act (PHS Act), 42 U.S.C. 247b(k)(2) and 301(a) of the PHS Act, 42 U.S.C. 241(a). In addition, this program is authorized under section 4002 of the Patient Protection and Affordable Care Act, Public Law 111-148.

c. Healthy People 2030

A goal of the Healthy People 2030 initiative is to achieve health equity, eliminate disparities and improve the health of all groups. This NOFO supports the following Healthy People 2030 topic areas found at:

Infants - Child and Adolescent Development: https://health.gov/healthypeople/objec https://www.ncbi.nlm.nih.gov/books/NBK52682/ https://www.ncbi.nlm.nih.gov/books/NBK52682/ https://health.gov/healthypeople/objectives-and-data/browse-objectives/infants tives-and-data/browse-objectives/infants Social Determinants of Health: https://health.gov/healthypeople/objectives-and-data

/social-determinants-health

d. Other National Public Health Priorities and Strategies

Health and Human Services (HHS) Action Plan to Reduce Racial and Ethnic Disparities:

https://minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf

The Surgeon General’s Call to Action to Support Breastfeeding, 2011: SGCTA on Breas tfeeding

e. Relevant Work This NOFO is relevant to past and current CDC programs including Nutrition, Physical Activity and Obesity Programs (CDC-RFA-DP08-805); Nutrition, Physical Activity and Obesity Programs Supplemental Funding to support community level breastfeeding promotion and support activities (CDC-RFA-DP08-8050501PPHF12); State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (CDC-RFA-DP13-1305); Building Capacity of the Public Health System to Improve Population Health through National, Nonprofit Organizations (CDC-RFA-OT13-1302);

National Innovative Partnerships for Addressing Obesity through Environmental Supports for Nutrition and Physical Activity (CDC-RFA-DP13-1304); State Physical Activity and Nutrition Program (CDC-RFA-DP18-1807); Racial and Ethnic Approaches to Community Health (REACH) (CDC-RFA-DP18-1813); and Strengthening Public Health systems and Services Through National Partnerships to Improve and Protect the Nation’s Health (CDC-RFA-OT18- 1802).

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-21-2108 Logic Model: Strengthening Breastfeeding Support by Coordinating National Efforts and Building Capacity of Breastfeeding Coalitions

Strategies and Activities Short-term Outcomes (1-2 years)

Intermediate Outcomes (3-4 years)

Long-Term Outcomes (5 years)

Provide oversight and management to coordinate and sustain a

Increased opportunities for partners to collaborate

Increased implementation of national action plan

Increased availability and access to https://health.gov/healthypeople/objectives-and-data/browse-objectives/infants https://health.gov/healthypeople/objectives-and-data/social-determinants-health https://health.gov/healthypeople/objectives-and-data/social-determinants-health https://minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf https://www.cdc.gov/breastfeeding/resources/calltoaction.htm https://www.cdc.gov/breastfeeding/resources/calltoaction.htm https://www.grants.gov/web/grants/view-opportunity.html?oppId=300318 https://www.grants.gov/web/grants/view-opportunity.html?oppId=300318 multi-sectoral partnership that engages state, breastfeeding coalitions and includes national organizations supporting breastfeeding to readily:

· Develop and implement a 5-year plan for policy, systems, and environmental (PSE) changes.

· Enhance opportunities for collaboration across state and other types of breastfeeding coalitions.

· Provide capacity building opportunities for state coalitions, with a focus on PSE changes and health equity, particularly for African American and Native American families.

Facilitate the use of breastfeeding strategies:

· Develop, adapt and disseminate guidance, tools, best practices, and other resources using multiple communication modes Promote the adoption of guidelines, recommendations, best practices, and resources.

on joint projects or initiatives Improved capacity to coordinate state breastfeeding coalition efforts Increased participation of networks that promote support for breastfeeding, particularly in populations with increased disparities Increased number of key national multi-sectoral partnerships with governmental agencies, medical organizations, and other national organizations Increased distribution and adaptation of existing guidelines, recommendations, best practices, and resources to increase adoption projects or initiatives that represent evidenceinformed breastfeeding interventions, including those that address health disparities and inequities in breastfeeding Increased implementation of evidence-informed projects or initiatives by state breastfeeding coalitions, with a focus on health equity advancement Increased representation in the state breastfeeding coalition of multi-sectoral partners supportive of breastfeeding Increased adoption and utilization of breastfeeding support guidelines, recommendations, best practices, and resources breastfeeding resources, support, and breastfeeding friendly environments, particularly for African American and Native American families Increased breastfeeding rates in the U.S., through a focus on reducing disparities

i. Purpose The purpose of this NOFO is to coordinate and develop a 5-year implementation plan for policy, systems, and environmental changes to address breastfeeding inequities and increase access to breastfeeding support; enhance opportunities for collaboration among state-level breastfeeding coalitions and key multi-sectoral stakeholders with respect to associated activities;

and increase lactation support providers’ adoption and utilization of culturally responsive maternity practices supportive of breastfeeding and CDC guidance related to continuity of care in breastfeeding.

ii. Outcomes By the end of the performance period, the recipient is expected to achieve the following intermediate outcomes:

Increased implementation of national action plan projects or initiatives that represent evidence-informed breastfeeding interventions, including those that address health disparities and inequities in breastfeeding.

Increased implementation of evidence-informed projects or initiatives by state breastfeeding coalitions, with a focus on health equity advancement.

By the end of the performance period, the recipient is expected to achieve the following long-term outcome:

Increased availability and access to breastfeeding resources, support, and breastfeeding friendly environments, particularly for African American and Native American families.

iii. Strategies and Activities

1. Provide oversight and management to coordinate and sustain a multi-sectoral partnership that engages all existing state breastfeeding coalitions and includes national organizations supporting breastfeeding to readily:

Develop and implement a 5-year plan for policy, systems, and environmental (PSE) change to address breastfeeding inequities and disparities in access to breastfeeding support.

o Conduct activities to improve operational capacity of the coordinating center o Identify key areas for the coordinating center to move the field forward o Coordinate the development of a collaborative network that engages all state breastfeeding coalitions and includes a full range of key stakeholders involved with breastfeeding to develop and implement a framework, and advance multi-faceted and reinforcing strategies as necessary, to implement a national plan o Plan, review, coordinate, and provide direction for all aspects of plan development and implementation o Define the plan’s initial steps required and the issues that must be addressed, as well as the need for ongoing review, periodic evaluation, and adaptation to future conditions to significantly accelerate progress o Identify fundamental requirements and concrete action steps and activities for practical implementation for national, state, and local levels o Include actions with a focus on health equity and decreasing disparities, primarily among African American and Native American families o Include activities in the plan that addresses maternity care practices, lactation accommodation at worksites, continuity of care, and current and emerging public health emergencies that threaten the support system for breastfeeding

Enhance opportunities for collaboration, and provide a voice for public education on health disparities, among state-level breastfeeding coalitions, with respect to associated activities.

Provide leadership to develop, support, and maintain key partnerships with governmental agencies, medical organizations, and other national organizations to facilitate development of multi-sector collaboratives in all states, territories and tribes

Provide capacity-building opportunities for state coalitions, with a focus on PSE changes and health equity, particularly for African American and Native American families and/or the identified priority population within the given state o Develop a model for building coalition capacity that includes cultural coalitions unique to a given state or territory, to advance efforts with priority populations o Provide capacity building opportunities and strengthen collaborations, among partners, coalitions, and other stakeholders, with a focus on policy, systems and environmental changes o Provide capacity building opportunities and strengthen collaborations among partners, existing and expanded coalitions, and other stakeholders, with a focus on health equity, particularly among African American and Native American families

2. Facilitate the use of breastfeeding strategies:

Develop, adapt and disseminate guidelines, tools, best practices, and other resources to partners, coalitions and other stakeholders, using multiple communication modes o Define activities to inform and support CDC in collecting and communicating expert opinions that can inform updates to existing guidance that considers the needs of priority and other disparate populations o Adapt resources according to findings and expert recommendations o Determine how current resources will be made available to stakeholders o Determine how current communications modes will be maintained and expanded in response to changes in technology o Develop and adapt guidelines, tools, best practices and other resources specific to equity in, and current/emerging threats to, breastfeeding support and protection.

o Disseminate guidelines, tools, best practices and other resources to partners and other stakeholders

Promote the adoption of guidelines, recommendations, best practices, and resources o Develop a participatory process that involves stakeholders, to support CDC in making the case for adoption or implementation of guidance, clinical guidelines, and best practices for the promotion and support of breastfeeding o Develop clear goals and measurable progress toward adoption and implementation of these goals

1. Collaborations

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

The recipient is expected to collaborate and coordinate with existing and future CDC-funded programs and organizations during the 5-year period of performance that is implementing efforts to increase support for breastfeeding.

b. With organizations not funded by CDC:

The recipient is required work with all state breastfeeding coalitions across the U.S. that is currently in existence. The recipient should build and sustain strategic partnerships and collaborations with organizations that have prior experience with the priority populations, and other coalitions that have a role in implementing this program’s strategies and activities and achieve the expected outcomes. Collaborations with a variety of public and private partners from multiple sectors are required to maximize resources, reach, and impact. These could include non-governmental organizations (e.g., 1,000 Days, Human Milk Banking Association of North America, National WIC Association, Reaching Our Sisters Everywhere); non-profit healthcare organizations or systems (e.g., Nemours Children’s Health System [Nemours Foundation]); non-profit educational agencies or systems (e.g., Lactation Education Accreditation and Approval Review Committee, Institute for the Advancement of Breastfeeding & Lactation Education); state, local, tribal, and cultural breastfeeding coalitions (e.g., West Virginia Breastfeeding Alliance, Native American Breastfeeding Counselor, Vital Village Network's Boston Breastfeeding Coalition, Asian Breastfeeding Task Force, and professional organizations (e.g., Academy of Nutrition and Dietetics, Association of Women's Health, Obstetric and Neonatal Nurses). Federal agencies that support funding or research related to breastfeeding (e.g., Department of Health and Human Services, Department of Agriculture) should be included as key partners when applicable.

2. Target Populations The applicant should prioritize populations with the lowest rates of breastfeeding within a given state, with a specific focus on African American and Native American populations. These populations have the lowest rates of breastfeeding than other groups such as Hispanic and non- Hispanic white populations. The use of state and national data (e.g., needs assessment, environmental scan, surveillance, evaluation, health disparities data) is recommended to select and target populations disproportionately at risk.

a. Health Disparities This program will strengthen national level collaboration and infrastructure to provide increased availability and access to breastfeeding support and protection that prioritizes, in general, states with low rates of breastfeeding. Another focus of this program is to reduce the health disparity gap among African American and Native American populations, by focusing on the root causes of the inequity, and to strengthen/expand efforts that lead to more equitable access to breastfeeding support.

iv. Funding Strategy

N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation and performance measurement will monitor the extent to which planned activities are completed successfully, show the effectiveness of activities, and demonstrate achievement of program outcomes. The CDC uses evaluation findings to ensure continuous program quality improvement, create an evidence base for strategies and activities, and inform decisions about future efforts.

The CDC strategy for monitoring and evaluating recipient and program performance will be consistent with the logic model and approach presented earlier. The recipient is expected to track implementation of strategies and activities and determine progress in achieving outcomes.

CDC will use information collected from recipient progress reports (frequency to be determined) and annual performance reports to document project status and completion.

Monthly conference calls with the recipient will include discussion of project updates, technical assistance needs, and challenges in completing activities. Additional check-in calls can be arranged, as needed.

Below are short-term, intermediate, and outcome performance measures for the strategies and outcomes in the NOFO logic model. Bold indicates required performance measures.

Short-Term Performance Measures:

Number of opportunities for partners to collaborate on joint projects or initiatives Number of state breastfeeding coalitions with improved capacity to coordinate their efforts Number of African American and Native American breastfeeding coalitions participating in the multi-sectoral partnership Number of key national multi-sectoral partnerships with governmental agencies, medical organizations, and other national organizations Number of state breastfeeding coalitions and national organizations that receive guidance on distribution and adaptation of existing guidelines, recommendations, best practices, and resources

Intermediate Performance Measures:

Number of state breastfeeding coalitions and national organizations involved in the implementation of national action plan projects or initiatives that represent evidence-informed breastfeeding interventions

Number of state breastfeeding coalitions that have increased implementation of evidence-informed projects or initiatives

Number of state breastfeeding coalitions with increased representation from multi-sectoral partners supportive of breastfeeding

Outcome Performance Measures:

Number of state breastfeeding coalitions and national organizations that have increased availability and access to breastfeeding resources, support, and breastfeeding friendly environments, particularly for African American and Native American families

Prevalence of breastfeeding initiation and duration among African American and Native American infants and mothers.

CDC will work collaboratively with the recipient, to collect relevant information on measures, conduct evaluations that determine the impact of CDC funding on increasing breastfeeding rates, as well as reducing disparities and improving equity in access to breastfeeding support.

CDC will work collaboratively with the recipient to develop an evaluation framework to guide evaluation for the funded project. This will include monitoring strategy implementation, conducting evaluations on the effectiveness of the selected interventions at achieving expected outcomes, and collecting information to determine factors (context and mechanisms) that may influence outcomes for priority populations.

CDC will work with the recipient to answer the following evaluation questions based on program strategies and logic model:

Is the recipient able to successfully track progress on implementation of strategies and activities?

What actions were taken to ensure participation of organizations, federal agencies, coalitions and other stakeholder in program activities?

What resources (e.g., funds, staffing, partnerships) were used for the planning, implementation, and evaluation of activities?

Are new activities identified that address specific priority population challenges and opportunities?

To what extent have program activities and outputs contributed to achieving the expected outcomes?

What Surgeon General’s Call to Action to Support Breastfeeding recommendations were achieved as the result of the strategies and activities?

How did organizations, federal agencies, coalitions and other stakeholders work collaboratively to effect change of policies, systems, and environment around support and protection of breastfeeding?

What partnerships were established within and across sectors and states as a result of program activities?

What products or deliverables were developed and disseminated as a result of program activities?

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/additional-requirements/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.

c. Organizational Capacity of Recipients to Implement the Approach The applicant organization should be able to demonstrate current affiliation with and/or ability to reach and engage all existing state breastfeeding coalitions in order to direct, coordinate and implement the national breastfeeding strategic plan. Acceptable forms of evidence are: (1) an organizational chart or posted membership list reflecting member affiliates and locations, and/or

(2) letters of support from state coalitions across the U.S. The recipient of this award must be able to readily execute and implement strategies and activities associated with this project upon receipt of award, to accelerate progress necessary to successfully achieve the short and intermediate outcomes within the performance period. The recipient must be experienced and work to strengthen collaborations that support the efforts of the coalitions working to increase access to and support for breastfeeding, help change maternity care practices and worksite lactation support and strengthen community-level support, and/or otherwise mobilize states, territories, tribes and cultural communities to implement informed breastfeeding interventions or specific public health programs that build equity and reduce breastfeeding disparities.

The applicant organization should be recognized as a national leader and have the capacity to https://www.cdc.gov/grants/additional-requirements/ar-25.html provide coordinated national leadership on the promotion, protection, and support of breastfeeding that creates a culture of sustained change. The applicant should have the expertise, infrastructure, national reach, history and extensive experience in coordinating breastfeeding support efforts on a national level. The applicant should have subject matter/content expertise and experience in breastfeeding related to maternity care practices, lactation accommodation at worksites, continuity of care and support during emergencies. The applicant should be equipped to engage all state breastfeeding coalitions in the U.S. to serve as vehicles of change and expand to include cultural populations that represent the priority populations under this NOFO. The applicant should have demonstrated ability to access diverse multi-sectoral representation among national organizations, health professional associations, and other common interest partners or networks. The applicant also needs to possess the ability to engage federal agencies and model inclusion and representation from priority populations that are often under-represented. The applicant should have the experience and capacity to implement the evaluation plan, as well as a staffing plan and project management structure sufficient to achieve the project outcomes. To ensure that the applicant is able to readily execute the project requirements and plan, and implement and evaluate activities associated with state breastfeeding coalitions, the applicant must demonstrate established experience and organizational capacity to ensure successful planning, implementation, and evaluation for this project.

d. Work Plan At minimum, the work plan must include:

Activities and timelines to support achievement of outcomes that align with the NOFO logic model.

Measures for the relevant outcomes. These should align with the performance measures listed in the evaluation and performance measurement section

Milestones for accomplishing tasks encompassed by the key activities related to each outcome

Staff, partners, contractors and administrative roles and functions to support implementation of the award.

Applicants must submit a detailed work plan for Year 1 of the award and provide a general summary of work plan activities for Years 2-5 in narrative form. The work plan should describe how the applicant plans to implement all the required activities to achieve NOFO outcomes. For Year 1, applicants are required to include all the elements listed within the sample work plan template, provided below. CDC will provide feedback and technical assistance to recipients to finalize the work plan activities post-award. Applicants must name this file "Work_Plan_name of applicant” and upload it as a PDF file on www.grants.gov.

This work plan should include activities such as engaging existing partnerships and coalitions and embedding specific communications activities that directly support the NOFO strategies (including identifying their intended audiences).

Short Term Outcome:

Intermediate Outcome:

http://www.grants.gov/

Strategy:

Activities Milestone(s) for Completion of Activity

Responsible Position/ Party

Completion Date

Applicants are not required to use the template but are required to include all the elements listed in the template: Short Term Outcome, Intermediate Outcome, Strategies, Activities, Milestones for Completion of Activities, Responsible Position/Party, Completion Date.

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.

Recipients will participate in monthly conference calls to track progress, barriers, unexpected events, activities, successes, and other relevant information that describe the implementation of the strategies and accomplishment of outcomes.

The recipient should also be available to participate in peer sharing opportunities, evaluation specific technical assistance calls and webinars, site and/or reverse site visits, and calls and email communications with CDC staff, as needed.

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

COOPERATIVE AGREEMENTS)

CDC will have substantial involvement beyond site visits and regular performance and financial monitoring during the period of performance. CDC activities are intended to ensure the success of the project and will include the following:

Provide post-award technical assistance Provide guidance to the recipient on identifying and implementing strategies and activities Facilitate collaborative opportunities with other CDC funded NOFO recipients and partners Review progress reports, evaluation tools and action/work plans Collaborate with the recipient to explore appropriate flexibilities needed to meet public health outcomes and goals. Flexibility in cooperative agreements includes the recipient’s ability to propose alternative methods to achieve the outcomes and goals of the cooperative agreement that align with recipient’s opportunities for success, infrastructure, partner and stakeholder buy-in, demographics, and burden.

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: U58

3. Fiscal Year: 2021

4. Approximate Total Fiscal Year Funding: $1,000,000

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

This amount is subject to the availability of funds.

Estimated Total Funding: $5,000,000

6. Approximate Period of Performance Length: 5 year(s)

7. Expected Number of Awards: 1

8. Approximate Average Award: $1,000,000 Per Budget Period

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

This amount is subject to the availability of funds.

10. Award Floor: $600,000 Per Budget Period

11. Estimated Award Date: 06/30/2021

12. Budget Period Length: 12 month(s)

Throughout the project period, 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 (project period) 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).

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

C. Eligibility Information

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

Additional Eligibility Category:

2. Additional Information on Eligibility State governments County governments City or township governments Special district governments Independent school districts Public and State controlled institutions of higher education Native American tribal governments (Federally recognized) Public housing authorities/Indian housing authorities Native American tribal organizations (other than Federally recognized tribal governments) 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 Small businesses

3. Justification for Less than Maximum Competition

4. Cost Sharing or Matching Cost Sharing / Matching Requirement: No

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

D. Application and Submission Information

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

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number.

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

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

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

b. System for Award Management (SAM):

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

c. Grants.gov:

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

All applicant organizations must register at www.grants.gov. The one-time registration process https://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/index.html https://grants.gov/ https://www.grants.gov/ http://www.grants.gov https://www.grants.gov/ usually takes not more than five days to complete. Applicants should start the registration process as early as possible.

Step System Requirements Duration Follow Up 1 Data

Universal Number System

(DUNS)

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

2. Select Begin DUNS search/request process

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

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

1-2 Business Days

To confirm that you have been issued a new DUNS number check online at (http:// fedgov.dnb.com/ webform) or call 1-866-705-5711

2 System for Award Management

(SAM)

formerly Central Contractor Registration

(CCR)

1. Retrieve organizations DUNS number

2. Go to https://www.sam.gov/index.

html and designate an E-Biz POC (note CCR username will not work in SAM and you will need to have an active SAM account before you can register on grants.gov)

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

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

866-606-8220

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

2. Once the account is set up the E-BIZ POC will be notified via email

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

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

Same day but can take 8 weeks to be fully registered and approved in the system (note, applicants

MUST

obtain a

DUNS

number and

SAM

account before

Register early!

Log into grants.gov and check AOR status until it shows you have been approved http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform https://www.sam.gov/index.html%20 https://www.sam.gov/index.html%20 https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do https://fsd.gov/fsd-gov/home.do applying on grants.gov)

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

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

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

OGS.

a. Letter of Intent Deadline (must be emailed or postmarked by) Due Date for Letter of Intent: N/A

b. Application Deadline Due Date for Applications: 03/15/2021 , 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov. If Grants.gov is inoperable and cannot receive applications, and circumstances preclude advance notification of an extension, then applications must be submitted by the first business day on which grants.gov operations resume.

Date for Information Conference Call

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

Applicants may follow either of the following processes:

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

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

Assurances and certifications submitted directly to CDC will be kept on file for one year and https://www.grants.gov https://www.grants.gov https://www.grants.gov http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx https://www.grants.gov http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx http://wwwn.cdc.gov/grantassurances/(S(mj444mxct51lnrv1hljjjmaa))/Homepage.aspx will apply to all applications submitted to CDC by the applicant within one year of the submission date.

Risk Assessment Questionnaire Requirement CDC is required to conduct pre-award risk assessments to determine the risk an applicant poses to meeting federal programmatic and administrative requirements by taking into account issues such as financial instability, insufficient management systems, non-compliance with award conditions, the charging of unallowable costs, and inexperience. The risk assessment will include an evaluation of the applicant’s CDC Risk Questionnaire, located at https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf, as well as a review of the applicant’s history in all available systems; including OMB-designated repositories of government-wide eligibility and financial integrity systems (see 45 CFR 75.205(a)), and other sources of historical information. These systems include, but are not limited to: FAPIIS (https://www.fapiis.gov/), including past performance on federal contracts as per Duncan Hunter National Defense Authorization Act of 2009; Do Not Pay list; and System for Award Management (SAM) exclusions.

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

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

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

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

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

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

Report Submission: The applicant must upload the report in Grants.gov under “Other https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf https://www.cdc.gov/grants/documents/PPMR-G-CDC-Risk-Questionnaire.pdf

Attachment Forms.” The document should be labeled: "Report on Programmatic, Budgetary, and Commitment Overlap.”

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

7. Letter of Intent LOI is not requested or required as part of the application for this NOFO.

8. Table of Contents (There is no page limit. The table of contents is not included in the project narrative page limit.): The applicant…