PKG00264905-instructions.pdf

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Improving Epilepsy Education, Systems of Care, and Health Outcomes through National and

Community Partnerships

CDC-RFA-DP21-2101

Application Due Date: 04/12/2021

Improving Epilepsy Education, Systems of Care, and Health Outcomes through National and

Community Partnerships

CDC-RFA-DP21-2101

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- DP21-2101. 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:

Improving Epilepsy Education, Systems of Care, and Health Outcomes through National and Community Partnerships C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https://www.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-DP21-2101

E. Assistance Listings (CFDA) Number:

93.850 F. Dates:

1. Due Date for Letter of Intent (LOI): 03/08/2021

2. Due Date for Applications: 04/12/2021, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

The CDC Epilepsy Program will hold an Informational Conference Call for potential applicants to ask questions.

Date: Wednesday, February 24, 2021 Time: 1pm Eastern Phone number: (855) 644-0229 Passcode: 6966716#

G. Executive Summary:

1. Summary Paragraph:

This NOFO aims to address four key areas:

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

1. Improve the social environment for people with epilepsy;

2. Strengthen the health system to improve epilepsy care;

3. Foster connections between clinical services and community programs; and

4. Address social determinants of health (e.g. social isolation, food insecurity, community-clinical linkages) to improve quality of life for people with epilepsy.

The NOFO will fund two components:

Component A: an organization that will provide services in at least 25 states. The organization funded to complete Component A strategies will address all of the NOFO content areas.

Component B: 1-3 organizations to work in specific geographic areas (e.g. community, state, region). The organization(s) funded to complete Component B strategies will address one to two content areas through activities.

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 4 Component A: One award Component B: One to three awards

d. Total Period of Performance Funding: $20,000,000 Component A: $17,500,000 Component B: $2,500,000

e. Average One Year Award Amount: $1,000,000 Component A: $3,500,000 Component B: Up to $150,000 for addressing one strategy; Up to $300,000 for addressing two strategies

f. Total Period of Performance Length: 5

g. Estimated Award Date: 09/13/2021

h. Cost Sharing and / or Matching Requirements: N 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

Part II. Full Text

1. Background

a. Overview

In the U.S., approximately 3.4 million people have active epilepsy.(1) Epilepsy is a challenging public health problem:

56% of adults with epilepsy taking seizure medicine have uncontrolled seizures.(2) 42% of children with epilepsy live at or close to the poverty level.(3) 66% of adults with epilepsy have 4 or more other chronic conditions.(4) 26% of adults with epilepsy and uncontrolled seizures can't afford prescriptions.(5) 25% of the public say they would be nervous around a person with epilepsy.(6) 12% of adults with uncontrolled epilepsy can't access transportation to get health care.(5)

Epilepsy is complex for individuals to manage.(7) People with epilepsy may:

Take many medicines and see multiple doctors.

Face stigma.

Not participate fully in society, including not being able to work.

Live alone.

Have depression and/or anxiety.

Lack personal (e.g., income) and social (e.g., transportation) resources to get the care they need.

To improve health and quality of life, people with epilepsy need:

Access to appropriate care.

Self-management skills.

An understanding and informed public.

An accessible network of community services.

The 2012 Institute of Medicine report, Epilepsy Across the Spectrum: Promoting Health and Understanding, describes gaps, challenges, and opportunities for public health to address epilepsy.(8) CDC has a key role in 12 of the report's 13 recommendations, including educating health professionals, improving delivery and coordination of community services, informing media to improve awareness and eliminate stigma, and expanding educational opportunities for people with epilepsy and families. This effort, along with previously funded projects, represent CDC's contributions to attaining the goals outlined in the report.

The strategies in this NOFO address the critical public health issues noted above and are designed to:

Improve the social environment for people with epilepsy.

Strengthen the health system to improve epilepsy care.

Foster connections between clinical services and community programs.

Address social determinants of health to improve quality of life for people with epilepsy.

References:

1. Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66:821-

825.

2. Tian N, Boring M, Kobau R, Zack M, Croft J. Active Epilepsy and Seizure Control in

Adults - United States, 2013 and 2015. MMWR Morb Mortal Wkly Rep. 2018;67(15):437- 442.

3. Cui W, Kobau R, Zack MM, Helmers S. Marshalyn Yeargin-Allsopp M. Seizures in children and adolescents aged 6-17 years - United States, 2010-2014. MMWR Morb Mortal Wkly Rep. 2015;64(43):1209-1214.

4. Kadima NT, Kobau R, Zack MM, Helmers S. Comorbidity in Adults with Epilepsy - United States, 2010. MMWR Morb Mortal Wkly Rep. 2013;62(43):849-853.

5. Thurman DJ, Kobau R, Luo Y, Helmers S, Zack MM. Health care access among adults with epilepsy: The US National Health Interview Survey, 2010 and 2013. Epilepsy Behav. 2016;55:184-8.

6. Cui W, Kobau R, Zack MM, Buelow JM, Austin JK. Recent changes in attitudes of US adults toward people with epilepsy - Results from the 2005 SummerStyles and 2013 FallStyles surveys. Epilepsy Behav. 2015;52:108-118.

7. Helmers SL, Kobau R, Sajatovic M, et al. Self-management in epilepsy: Why and how you should incorporate self-management in your practice. Epilepsy Behav. 2016.

8. Institute of Medicine. 2012. Epilepsy across the spectrum: Promoting health and understanding. Washington, DC: The National Academies Press.

b. Statutory Authorities This program is authorized under the Public Health Service Act § 301(a) and 317(k)(2), 42 U.S.C. § 241(a) and 247b(k)(2), as amended.

c. Healthy People 2030 This NOFO addresses the overarching Healthy People 2030 goals and these specific objectives:

AHS-R01: Increase the ability of primary care and behavioral health professionals to provide more high-quality care to patients who need it.

AHS-R02: Increase the use of telehealth to improve access to health services.

HC/HIT-04: Increase the proportion of adults who talk to friends or family about their health.

MHMD-05: Increase the proportion of adults with depression who get treatment.

d. Other National Public Health Priorities and Strategies

CDC's National Center for Chronic Disease Prevention and Health Promotion's Four Domains (Environmental approaches, health care systems interventions, community programs linked to clinical services.)

HHS' Strategic Goal 2: Protect the health of Americans where they live, work, and play.

e. Relevant Work This NOFO builds upon work completed under CDC-RFA-DP16-1602, Improving Epilepsy https://www.cdc.gov/chronicdisease/center/nccdphp/how.htm https://www.cdc.gov/chronicdisease/center/nccdphp/how.htm https://www.hhs.gov/about/strategic-plan/strategic-goal-2/index.html

Programs, Services, and Outcomes through National Partnerships. More information about the CDC Epilepsy Program and related work may be found at www.cdc.gov/epilepsy.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-DP21-2101 Logic Model: Improving Epilepsy Education, Systems of Care, and Health Outcomes through National and Community Partnerships

Strategies and Activities Short-Term and Intermediate Outcomes*

Long-Term Outcomes#

Component A Organization (address all)

1. Support a nationwide consumer epilepsy information and referral system.

2. Conduct public awareness and public education activities related to epilepsy, seizure first aid, Sudden Unexpected Death in Epilepsy (SUDEP) prevention, and epilepsy stigma.

3. Educate health care providers and relevant professionals about epilepsy, seizure first aid, and epilepsy stigma.

4. Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs.

5. Improve epilepsy care and management through health systems interventions.

6. Develop multi-sector partnerships with

Increased referrals to community-based services, self-management programs, and/or health care providers.

Increased awareness of epilepsy, seizure first aid, SUDEP prevention, and epilepsy stigma among the general public.

Increased knowledge about epilepsy, seizure first aid, and epilepsy stigma among relevant professionals.

Increased knowledge among health care providers regarding effective diagnosis, treatment, and management of epilepsy.

Increased number of PWE completing evidence-based epilepsy-self-management programs.

Increased reporting, monitoring, and tracking of epilepsy

Improved social participation among

PWE.

Reduced public stigma of epilepsy.

Reduced social isolation among PWE.

Improved health and quality of life among

PWE.

http://www.cdc.gov/epilepsy underutilized community resources to address the social needs of people with epilepsy

(PWE).

clinical data by health systems to improve identification, management, and treatment of patients with uncontrolled seizures.

Component B Organization(s) (choose up to 2)

1. Educate health care providers and appropriate professionals about epilepsy, seizure first aid, and epilepsy stigma.

2. Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs.

3. Improve epilepsy care and management through health systems interventions.

4. Develop multi-sector partnerships with underutilized community resources to address the social needs of PWE.

Increased knowledge about epilepsy, seizure first aid, and epilepsy stigma among relevant professionals.

Increased knowledge among health care providers regarding effective diagnosis, treatment, and management of epilepsy.

Increased number of PWE completing evidence-based epilepsy-self-management programs.

Increased reporting, monitoring, and tracking of clinical data by health systems to improve identification, management, and treatment of patients with uncontrolled seizures.

Increased referrals to community-based services, self-management programs, and/or health care providers.

*Recipients are expected to achieve bolded short- and intermediate-outcomes during the period of performance. Component B organizations are responsible only for outcomes relevant to strategies selected.

#Long-term outcomes are not expected to be achieved during the period of performance.

i. Purpose This NOFO implements strategies based on NCCDPHP domains (Environmental Approaches, Health Care Systems Interventions, and Community Programs Linked to Clinical Services) and target social determinants of health to:

Improve health, social participation, and quality of life for people with epilepsy.

Reduce stigma.

Increase access to health services, community resources, and self-management supports.

The NOFO will fund two types of recipients: an organization to provide services in at least 25 states, and 1-3 organizations to work in specific geographic areas (e.g. community, state, region).

ii. Outcomes As presented in the logic model, the funded projects are expected to make a contribution toward the long-term outcomes of improving social participation among people with epilepsy, reducing public stigma of epilepsy, and improving health and quality of life among people with epilepsy.

During the 5 year period of performance, the recipients will be expected to show progress on relevant short-term and intermediate outcomes outlined in the logic model and below:

Component A Organization outcomes:

Increased referrals to community-based services, self-management programs, and/or health care providers.

Increased awareness of epilepsy, seizure first aid, SUDEP* prevention, and epilepsy stigma among the general public.

Increased reporting, monitoring, and tracking of epilepsy clinical data by health systems to improve identification, management, and treatment of patients with uncontrolled seizures.

Component B Organizations outcomes:

(Recipients expected to achieve short-term and intermediate outcomes related to relevant strategies selected during the period of performance).

Increased knowledge about epilepsy, seizure first aid, and epilepsy stigma among relevant professionals.

Increased knowledge among health care providers regarding effective diagnosis, treatment, and management of epilepsy.

Increased reporting, monitoring, and tracking of clinical data by health systems to improve identification, management, and treatment of patients with uncontrolled seizures.

Increased referrals to community-based services, self-management programs, and/or health care providers.

*SUDEP is Sudden Unexpected Death in Epilepsy. For more detailed information, visit CDC's SUDEP web page.

iii. Strategies and Activities The Strategies and Activities of this NOFO include those that are listed in the Strategies and Activities column in the logic model above, and are restated here with additional detail:

Component A Organizations: (Address each)

1. Support a nationwide consumer epilepsy information and referral system (e.g., a toll-free telephone hotline, online live chats, and/or monitored online forums). This system should connect people with epilepsy, their families, and the public with epilepsy resources at the local and national levels (e.g., referrals to local support groups, social services assistance, epilepsy education programs). It should not be used to provide medical diagnosis or treatment.

2. Conduct public awareness and public education activities related to epilepsy, seizure first aid, SUDEP prevention, and epilepsy stigma.

3. Educate health care providers (e.g., primary and emergency care providers) and relevant professionals (e.g., behavioral health providers, school nurses, school staff, first responders, law enforcement, child care workers, older adult care workers) about epilepsy, seizure first aid, and epilepsy stigma.

4. Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs (e.g., CDC's Managing Epilepsy Well Programs).

5. Improve epilepsy care and management through health systems interventions (e.g., systematically collecting seizure frequency data, screening patients/clients with epilepsy for depression, formalizing referral processes between health care providers and community-based organizations).

6. Develop multi-sector partnerships with underutilized community resources (e.g., transportation providers, employment services, food banks) to address the social needs of people with epilepsy.

Component B Organizations: (Choose up to two)

1. Educate health care providers (e.g., primary and emergency care providers) and relevant professionals (e.g., behavioral health providers, school nurses, school staff, first responders, law enforcement, child care workers, older adult care workers) about epilepsy, seizure first aid, and epilepsy stigma.

2. Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs (e.g., CDC's Managing Epilepsy Well Programs).

3. Improve epilepsy care and management through health systems interventions (e.g., systematically collecting seizure frequency data, screening patients/clients with epilepsy for depression, formalizing referral processes between health care providers and https://www.cdc.gov/epilepsy/about/sudep/index.htm https://www.cdc.gov/epilepsy/research/MEW-network.htm https://www.cdc.gov/epilepsy/research/MEW-network.htm community-based organizations).

4. Develop multi-sector partnerships with underutilized community resources (e.g., transportation providers, employment services, food banks) to address the social needs of people with epilepsy.

1. Collaborations

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

CDC expects recipients to work with other CDC-funded programs in order to expand the availability of proven interventions and tested epilepsy education materials. For example, the recipient may use evidence-based programs and materials from the CDC Prevention Research Centers Managing Epilepsy Well Network in order to teach epilepsy self-management skills to diverse groups and train health care providers about epilepsy.

The CDC Epilepsy Program also encourages collaborations with other CDC programs that may enhance the dissemination and uptake of programs funded under this cooperative agreement, such as with the Healthy Schools Program, Disability and Health Program, and Alzheimer's Disease and Healthy Aging Program.

b. With organizations not funded by CDC:

Applicants should collaborate with the following stakeholders, as appropriate based on strategies selected, in order to address the requirements of this NOFO:

People with epilepsy and their caregivers.

State and local public health agencies.

Mental/behavioral health agencies and organizations.

State and local aging agencies.

National- and state-based professional organizations (e.g., those reaching primary care providers, neurologists, school nurses, law enforcement, etc.).

State- and local-based organizations with expertise in/access to specific populations (e.g.

older adults, students, racially and ethnically diverse groups, people in the workforce, etc.).

Professional or community-based organizations who serve people with epilepsy.

Applicants are required to include letters of support (LOS) and/or MOU/MOAs from partners who will be involved in the activities proposed for this NOFO. Applicants must file the LOS, MOU, or MOA, as appropriate, name the file "LOS" or "MOUs/MOAs", and upload it as a PDF file at www.grants.gov.

2. Target Populations Target populations will vary depending on the particular strategy/activity being addressed. However, applicants are expected to identify priority high-risk groups based on the scientific literature, local needs assessments data, or other evidence-based criteria. Applicants are also expected to identify one or more corresponding social determinants of health to intervene https://www.cdc.gov/healthyschools/index.htm https://www.cdc.gov/ncbddd/disabilityandhealth/index.html http://www.cdc.gov/aging http://www.cdc.gov/aging http://www.grants.gov/ upon for each targeted population group. Suggested target populations include:

(NOTE: Component A organizations are responsible for each of these strategies/activities;

Component B organizations will select as a sub-set as noted above.)

Support a nationwide consumer epilepsy information and referral system: People with epilepsy, epilepsy caregivers, employers, health professionals, and the general public.

Conduct public awareness and public education activities related to epilepsy, seizure first aid, SUDEP prevention, and epilepsy stigma: People with epilepsy, general public.

Educate health care providers and relevant professionals about epilepsy, seizure first aid, and epilepsy stigma: Health care providers (e.g. physicians, nurses, community health workers) and others who treat or provide preventive services or support to people with epilepsy in primary care, pediatric, and other settings AND specific professional groups who may provide support or serve people with epilepsy (e.g. school nurses and staff, first responders, law enforcement, child care workers, older adult care providers, employers).

Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs: People with epilepsy, and community organizations, health systems, and social service agencies that may serve people with epilepsy.

Improve epilepsy care and management through health systems interventions: Health systems, health care organizations, and professional or community organizations who serve people with epilepsy.

Develop multi-sector partnerships with underutilized community resources to address the social needs of people with epilepsy: Social service providers, transportation services, employers, food banks, and other community agencies that may offer support needed by people with epilepsy.

a. Health Disparities People with epilepsy experience health and health care disparities compared to people who do not have the disorder. For example, about 37% of adults with epilepsy reported fair or poor health compared to 12% of adults without the disorder (1). People with epilepsy are more likely to have trouble affording health care compared to others (2), 21% of adults with epilepsy live alone-more than those without epilepsy (3), 40% of children with seizures live in homes at or close to the poverty level, and 30% live in homes without enough food (4). Epilepsy can shorten a person's life and severely reduce well-being and full participation in daily activities. As noted in the Background section above, people with epilepsy often have depression and/or anxiety, face stigma, and may not be able to work. They may also experience varying levels of disability based on the severity of their condition. People with epilepsy who are part of minority groups, are non- English speakers, or who live in rural or underserved communities, experience even greater difficulties finding care and managing their condition.

People with epilepsy need skills to manage their disorder, access to specialty care, and awareness from an informed public in order to have the best possible outcomes. The strategies and activities included in this NOFO address these issues directly, with the intention of reducing health disparities and improving social determinants of health among people with epilepsy.

Applicants should consider the spectrum of people who have epilepsy, and be sure to target those who are most vulnerable and at greatest risk when targeting their specific programmatic activities.

References:

1. Kobau R, Cui W, Kadima N, Zack MM, et al. Tracking psychosocial health in adults with epilepsy—estimates from the 2010 National Health Interview Survey. Epilepsy Behav.

2014;41:66-73.

2. Thurman DJ, Kobau R, Luo Y, Helmers S, Zack MM. Health care access among adults with epilepsy: The US National Health Interview Survey, 2010 and 2013. Epilepsy Behav. 2016;55:184-8.

3. Centers for Disease Control and Prevention Epilepsy Program. Nearly one in five adults with active epilepsy lives alone based on findings from the 2010 and 2013 US national health interview surveys. Epilepsy Behav. 2015;51:259–260.

4. Cui W, Kobau R, Zack MM, Helmers S. Marshalyn Yeargin-Allsopp M. Seizures in children and adolescents aged 6–17 years – United States, 2010–2014. MMWR.

2015;64(43):1209-14.

iv. Funding Strategy Applicants can only apply for one component.

Component A: One award will be funded under Component A to an organization that will reach a national audience (at least 25 states). The recipient is expected to address all the strategies and activities included in the logic model and narrative for Component A. The Component A recipient will be funded up to $3,500,000 per year.

Component B: One to 3 awards will be funded under Component B for recipients to address up to two of the four strategies included in the logic model and narrative for Component B.

Component B recipients will be funded up to $150,000 per year for addressing one strategy and up to $300,000 per year for addressing two strategies. Component B organizations must identify the geographic area where program activities will be implemented (e.g. locally in a city or county, state-wide, regionally across state lines, nationally, or another geographic unit).

CDC seeks to fund at least one project for each strategy/activity area under Component B, if possible.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy The CDC strategy for monitoring and evaluating program and recipient performance will use both process and outcome evaluations, and will be consistent with the logic model presented earlier.

Evaluation findings will be used to inform programmatic planning and to guide technical assistance CDC will provide to recipients. CDC will work with recipients in the first two quarters of the period of performance to finalize evaluation plans.

For each of the strategies/activities found in the logic model, CDC has provided example process measures that the recipients should accomplish annually:

Component A Example Process Measures Strategy 1: Support a nationwide consumer epilepsy information and referral system.

Number of callers/online consumers assisted.

Number, type, and location of community resources available by state, county, or other region.

Strategy 2: Conduct public awareness and public education activities related to epilepsy, seizure first aid, SUDEP prevention, and epilepsy stigma.

Evidence of science-based public awareness campaign message development and educational programs implemented in communities.

Number of people reached with public awareness campaigns and educational programs.

Strategy 3: Educate health care providers and relevant professionals about epilepsy, seizure first aid, and epilepsy stigma.

Number and type of health care providers and professionals reached with educational programs.

Evidence of knowledge and behavior change of health care providers and professionals who have received training.

Strategy 4: Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs.

Number of providers trained to deliver evidence-based self-management programs.

Number of evidence-based self-management programs available.

Number of participants in evidence-based self-management programs.

Strategy 5: Improve epilepsy care and management through health systems interventions.

Number and type of new health care practice procedures implemented and tested in clinics to improve epilepsy care.

Strategy 6: Develop multi-sector partnerships with underutilized community resources to address the social needs of people with epilepsy.

Evidence of new partnerships with underutilized community resources.

Component B Example Process Measures

Strategy 1: Educate health care providers and relevant professionals about epilepsy, seizure first aid, and epilepsy stigma.

Number and type of health care providers and professionals reached with educational programs.

Evidence of knowledge and behavior change of health care providers and professionals who have received training.

Strategy 2: Expand access to, delivery of, and participation in evidence-based epilepsy self-management programs.

Number of providers trained to deliver evidence-based self-management programs.

Number of evidence-based self-management programs available.

Number of participants in evidence-based self-management programs.

Strategy 3: Improve epilepsy care and management through health systems interventions.

Number and type of new health care practice procedures implemented and tested in clinics to improve epilepsy care.

Strategy 4: Develop multi-sector partnerships with underutilized community resources to address the social needs of people with epilepsy.

Evidence of new partnerships with underutilized community resources.

CDC has also developed Performance Measures that are aligned with the NOFO's strategies:

Component A Tier 1 Performance Measures Reporting on each of these measures is required for the Component A recipient:

Number of people with epilepsy referred to epilepsy-focused or other community-based services, self-management programs, and/or health care providers.

Traffic to educational content promoted by awareness and educational campaigns.

Number of health systems reporting, monitoring, and tracking epilepsy clinical data (e.g., seizure frequency, depression screening) to improve outcomes for people with uncontrolled seizures.

Component B Tier 1 Performance Measures Reporting this measure is required for each Component B recipient, regardless of strategy(ies) selected:

Number of people with epilepsy referred to epilepsy-focused or other community-based services, self-management programs, and/or health care providers.

Component B Tier 2 Performance Measures Component B recipients will report on one or both of these measures based on strategy(ies) selected:

Traffic to educational content promoted by awareness and educational campaigns.

Number of health systems reporting, monitoring, and tracking epilepsy clinical data (e.g., seizure frequency, depression screening) to improve outcomes for people with uncontrolled seizures.

Since this NOFO does not involve the generation or collection of public health data, a Data Management Plan is not required for this NOFO.

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) as new pertinent information becomes available, if applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual reports. 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 https://www.cdc.gov/grants/additional-requirements/ar-25.html 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 Applicants must describe their organizational capacity to carry out the strategies and activities outlined in the logic model. At a minimum, all Component A and Component B applicants must:

Demonstrate their ability to establish and maintain successful working relationships with relevant stakeholders (e.g., people with epilepsy, health care providers, health care systems, community organizations, professional organizations, etc.) to inform and implement programmatic activities by describing successful past partnerships and the outcomes of these relationships.

Demonstrate their ability to work with the public health workforce at national, state, and/or local levels by describing successful past experiences with public health projects and partners.

Have (or have access to) expertise in public health program evaluation, including use of program data for program quality improvement, as demonstrated by the inclusion of an on-staff evaluator or contract with an external evaluator that has experience in public health evaluations.

Demonstrate their ability to effectively gather, analyze, interpret, and use evidence-based or evidence-informed strategies where such information exists and is relevant to activities, by describing previous successful experience in this area.

Demonstrate their ability to manage programs and resources ensuring the administrative, financial, and staff support necessary to sustain activities, distribute funding to subcontractors/sub-recipients in a timely manner, and hire or contract with qualified personnel.

Describe their experience supporting public health programs in epilepsy and briefly document their history of serving or working with the relevant target populations identified in this NOFO. This includes documenting any outcomes or benefits that were demonstrated as a result of this work.

Describe an adequate Staffing Plan, providing CVs/Resumes for proposed NOFO-funded personnel, an Organizational Chart, and project management structure that clearly defines staff roles and a reporting structure. Applicants must name these files "CVs/Resumes" and "Organizational Charts" and upload them with the application package at grants.gov.

Additionally, Component A applicants should document their experience serving the needs of people with epilepsy through a national network. Component A applicants should be able to demonstrate they can effectively disseminate strategies to at least 25 states in order for the proposed program to have nationwide impact.

d. Work Plan Applicants must provide a detailed work plan that covers the first year of the period of performance and a high-level plan in narrative form for years 2-5. At a minimum, the work plan must demonstrate how the strategies, activities, and staffing/partnerships work together to achieve http://www.grants.gov program outcomes. Objectives should be written in SMART (Specific, Measurable, Achievable, Realistic, Time-phased) format. Information on performance measures, data sources, and data collection should be included. Applicants should use the template below, or a similar format, when describing the proposed work plan.

Work plan sample template:

Strategy: EXAMPLE - Educate health care providers and appropriate professionals about epilepsy, seizure first aid, and epilepsy stigma.

Period of Performance Outcome: (from Outcomes section and/or Logic Model) EXAMPLE: Increased knowledge about epilepsy, seizure first aid, and epilepsy stigma among relevant professionals.

Outcome Measure: (from Evaluation and Performance Measurement section) EXAMPLE: Evidence of knowledge and behavior change of health care providers and professionals who have received training.

Objectiv e

Activities Process Measures Person Responsib le

Partners (if applicabl e)

Baseline (if applicabl e)

Target (if applicabl e)

Completio n Date

EXAMPL

E

EXAMPL

E

EXAMPLE EXAMPLE EXAMPL

E

EXAMPL

E

EXAMPL

E

EXAMPL

E

Educate school staff about epilepsy and seizure first aid in schools that have never received training.

Develop and test training materials Recruit schools.

Conduct webinars.

Conduct evaluatio n activities.

REACH: # of schools, # of school staff.

CHARACTERISTI

CS: Type of staff educated.

Program Director

State health dept.

School Health Program State education agency Teachers' Associatio n

0 staff

500 staff

June 2022

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.

Additionally, CDC will work with recipients to set up monthly calls with the CDC Project Officer and relevant recipient staff to ensure regular monitoring and to provide needed technical assistance.

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

COOPERATIVE AGREEMENTS)

In a cooperative agreement, CDC staff is substantially involved in the program activities, above and beyond routine grant monitoring, monthly calls, and site visits. To ensure the success of this cooperative agreement, CDC will:

1. Provide technical assistance, including:

A pre-award technical assistance call to answer questions for potential applicants.

Post-award technical assistance, including:

o Offering guidance to improve the quality and effectiveness of work plans, evaluation strategies, products and services, and collaborative activities with other organizations;

o Collaborating to develop the most relevant communication messages;

o Collaborating in the planning, implementation, and evaluation of meetings related to work conducted under this NOFO; and o Providing resources and tools necessary for the successful implementation of strategies and activities to meet project goals.

2. Share information, including:

Facilitating routine conference calls, webinars, and information exchange among cooperative agreement recipients and epilepsy and public health stakeholders; and

Collaborating to compile and disseminate recipient accomplishments, best practices, and lessons learned during the period of performance.

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: $4,000,000

5. Approximate Period of Performance Funding: $20,000,000

This amount is subject to the availability of funds.

Component A: $17,500,000 Component B: $2,500,000

Estimated Total Funding: $20,000,000

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

7. Expected Number of Awards: 4 Component A: One award Component B: One to three awards

8. Approximate Average Award: $1,000,000 Per Budget Period Component A: $3,500,000 Component B: Up to $150,000 for addressing one strategy; Up to $300,000 for addressing two strategies

9. Award Ceiling: $0 Per Budget Period

This amount is subject to the availability of funds.

To maintain funding flexibility, no award ceiling has been established. However, applicants are strongly encouraged to carefully consider the language in the "Funding Strategy" section and the "Approximate Average Award" section above.

10. Award Floor: $100,000 Per Budget Period Component A: $2,500,000 Component B: $100,000

11. Estimated Award Date: 09/13/2021

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

Additional Eligibility Category:

Government Organizations:

State governments or their bona fide agents (includes the District of Columbia)

Local governments or their bona fide agents

Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

State controlled institutions of higher education

American Indian or Alaska Native tribal governments (federally recognized or state-recognized)

Non-government Organizations:

American Indian or Alaska native tribally designated organizations

2. Additional Information on Eligibility This NOFO will have 2 components: A and B. Eligible applicants may only apply for either Component A or Component B. Multiple applications from the same entity will not be accepted. Any organization that submits multiple applications will be deemed non-responsive and those applications will not receive further review.

In the "Descriptive Title of Applicant's Project" on the SF-424 form, applicants should identify for which Component the application is being submitted.

3. Justification for Less than Maximum Competition N/A

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

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 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

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

2. Select Begin DUNS

1-2 Business Days

To confirm that you have been issued a new 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/ http://fedgov.dnb.com/webform http://fedgov.dnb.com/webform

System

(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

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 applying on grants.gov)

Register early!

Log into grants.gov and check AOR status until it shows you have been approved

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

3. Application Package Applicants must download the SF-424, Application for Federal Assistance, package associated 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 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: 03/08/2021

b. Application Deadline Due Date for Applications: 04/12/2021 , 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…