Questions and Answers - Crisis NOFO_Final Draft.docx

Questions and Answers – Public Health Crisis NOFO (TP18-1802)

Eligibility

1. Am I eligible for the Crisis NOFO?

Eligible applicants include the 50 states; five U.S. territories; three freely associated Pacific islands; six localities: Chicago, Houston, Los Angeles County, New York City, Philadelphia, and Washington, D.C.; and federally recognized tribal governments that meet the NOFO requirements and serve, through their own public health infrastructures, at least 50,000 people.

Eligible applicants must certify the following are in place:

· Functional governmental public health department

· Public health emergency preparedness program/public health emergency management program

· Demonstrated prior ability to successfully manage HHS federal grant funds

· Expedited administrative processes

· Letter of concurrence from the state (for eligible local public health applicants)

2. The NOFO states it will fund “up to five tribes” that “serve at least 50,000 people.” What exactly does that mean? Does this mean a tribal population of 50,000? Or, there are 50,000 members living on a reservation that will be served? And what is meant by “serve”?

This includes American Indian or Alaska Native federally recognized tribal governments or their bona fide agents that meet requirements listed in Section C.3 of this NOFO for Justification for Less than Maximum Competition. Those that serve, through their own public health (PH) infrastructure, at least 50,000 people (N~5) are eligible. CDC estimates that up to five tribes may be eligible, but any tribe meeting the requirements may apply.

This NOFO is not a capacity-building mechanism; it is not intended to create or establish new public health emergency management programs. It is designed to support the surge needs of existing programs responding to a significant public health emergency. CDC will provide supplemental guidance to pre-approved health departments on the approved but unfunded (ABU) list as to when this NOFO will be activated and for specified activities intended to address the emergency. Applications seeking to create new public health departments or public health emergency management programs will be deemed nonresponsive and will not be considered.

Applicants will need to be capable of activating new or surging current emergency response activities within a two-day period.

Acceptable documentation includes but is not limited to:

· A letter signed by the director of public health on departmental letterhead attesting to the existing capacity and capability for rapid procurement, hiring, and contracting;

· A departmental organizational chart; and

· An incident management structure organizational chart.

3. What is the criteria for the definition of tribal governments servicing 50,000 people?

We would use the tribal government’s criteria, but they would need to have to have an existing health system serving that amount of people. It isn’t tied directly to a tribe’s census.

4. Page 5 of the NOFO states, “The purpose is to ensure rapid mobilization and response to public health emergencies, focused on threatened or impacted jurisdictions.” Due to the public health impact the evacuation of Puerto Rican Americans will have on our jurisdiction, CDPH will be conducting activities that may include (but are not limited to) coordinating the Healthcare Enterprise at a MARC, inspections at shelters, epi/surveillance at shelters, mobilizing volunteers, etc. These activities all touch upon the many of the PHEP capabilities. Therefore, would an event such as our response to evacuees from Puerto Rico satisfy the requirements of the Public Health Crisis Response application?

No. This is not a fund just to help out for every event, but for really catastrophic or high impact events to public health that reaches the level of a secretarial declaration (or similar) and for which federal funding has been identified. We built a specific scenario to have consistent applications and reviews. If funding were to be available for hurricanes in the future, they could revise their budget and work plan at that time.

General Information (deadlines, how to submit info, etc.)

5. What is the purpose of the Public Health Crisis NOFO?

The Public Health Crisis NOFO is a novel approach to emergency response that increases the speed at which CDC can award available funds to state, local, tribal, and territorial public health agencies in the event of a public health emergency.

6. What is considered an emergency?

If there is a Secretarial declaration and the needs exceed what can be covered with existing funding. This could also include a CDC EOC Activation. Much will depend on IF CDC has funding to award.

7. How do I apply for the Crisis NOFO?

The Public Health Crisis NOFO application package is available on Grants.gov. The application deadline is Monday, December 11.

All applicants must provide certification from their public health director (or equivalent) that the applicant has an existing capacity, capability, and infrastructure to provide the 10 essential public health services (https://www.cdc.gov/nphpsp/essentialservices.html) and that within that public health infrastructure there currently exists an established public health emergency management program that meets the requirements outlined in CDC’s 15 Public Health Preparedness Capabilities: National Standards for State and Local Planning (https://www.cdc.gov/phpr/readiness/00_docs/DSLR_capabilities_July.pdf).

In addition, applicants must submit: (1) an organizational chart that represents their emergency preparedness program or Incident Command System (ICS), and (2) a crisis response plan/concept of operations that includes a provision outlining expedited business processes, including but not limited to, rapidly hiring surge staff, contracting, procuring, and travel procedures.

8. Are applications only required to be submitted on grants.gov?

Yes.

9. Will the notice of award number be the same as the current preparedness cooperative agreement number?

No. It will be a separate award number.

10. Does a one-year cycle imply that this will be an annual application?

It is open/continuous so if we needed to put it out again, we may open it up and receive new applications. We could potentially have 16 months of activities covered. Once the emergency has been mitigated, we would then move awardees to other mechanisms within CDC.

11. Does the award period begin when Part A is awarded?

Yes.

12. If we go a full year with no events (December – December) will we need a new application?

Yes.

13. Can an application be written around ongoing hurricane activities?

No. Please respond as asked to the infectious disease scenario.

14. Are applications due on December 11 at 11:59 p.m. Eastern Time?

Yes, but applicants are encouraged to submit a few days early to avoid IT system es, glitches or other issues.

15. The NOFO document referred to a team that would need to work with CDC to support the Part B dollars. Who is this team?

CDC would work with the recipient to determine the activities that need to take place and establish performance measures for them. We don’t anticipate sending people to work alongside you. First-time recipients might have to work with CDC’s Office of Grants Services.

Work Plan Strategies and Activities

16. Can Component A include lab activity?

It could, if you are able to surge in the first 90-120 days. If you have additional needs not listed for an event, CDC could make adjustments.

17. Could you clarify what you are looking for regarding duplication of efforts?

We are looking at speed and scale. The scenarios we envision are not for routine public health emergencies, but for real “bad” days when resources have been exhausted.

18. What if there is an emergency that affects one part of the state and then spreads? Would you want to see that tiering?

You should build a budget based on your jurisdiction (the entire state) and past experiences. Once funding is received the state would determine the best allocation of those funds.

19. Can you explain what activities are not covered by this NOFO?

This is for response only, not capacity building, or long term issues. We do allow for planning for recovery during the response, but not actual recovery activities.

20. What vector control activities are allowed? Vector services such as those included in some current ELC awards; may also include vector surveillance activities.

21. This application is requiring a complex work plan. What level of detail are you looking for?

High level, strategic activities that are responsive to the scenario and gives reviewers an understanding that there is an existing public health infrastructure.

22. Could additional domains like biosurveillance or information management be included in the application in addition to the two domains in Component A?

Yes, if the activities would done in the first 90 days, it would be acceptable

23. At what point do we consider an activity a response activity (the 90 day mark) rather than preparations?

This mechanism is not for capacity building or development of the preparedness plan. However, the ability to use funds retroactively would be determined at the time of funding availability.

24. Are we supposed to include subcontracts for existing local county health departments?

If appropriate, yes, but you need to track how funds received from this mechanism are being used.

25. The NOFO guidance includes the strategy: Strengthen Jurisdictional Recovery. If this is funding only for response, how should we address this strategy?

It allows for the planning for recovery activities stemming from the emergency, however actually implementing or executing recovery activities is not covered.

Budget

26. Is there a $5 million cap, and should we make a total budget for Components A and B for it?

We expect the average award to be 5 million dollars. Applicants should build their budget on past experiences. There is an award ceiling of 5 million dollars, but that may be revised to include a floor instead. The system required entering a dollar amount, however the text says no ceiling and we reserve the right to state a ceiling in the supplemental guidance.

27. Is there a budget template?

Applicants should use the SF Form 424-A budget template provided in Grants.gov. CDC expects to issue shortly an optional work plan template that may be used to support and develop the work plan and associated budget.

Review Process

28. How are recipients selected?

Review of applications will done on a competitive basis, with applications undergoing a three-phase objective review process. A CDC review panel will evaluate the applications and establish a corresponding “approved but unfunded” (ABU) list of eligible health departments with pre-existing emergency management programs that submit timely applications.

29. Is this a competitive process?

Yes. Applications will be reviewed and scored. There will be three reviews, and the feedback from these will be compiled and sent in a summary statement to the applicant, similar to past FOAs. However, to be clear, during a specific funded emergency, applications may be funded out of rank order in order to meet the needs of affected jurisdictions.

Coordination with Other Programs or Agencies

30. Much of this will cross into the medical system; is this being coordinated with HHS/ASPR?

CDC has communicated with ASPR and has built this mechanism specifically for public health emergencies.

Funding

31. How quickly will I receive funding? What is the decrease from before?

The Public Health Crisis NOFO will enable approved but unfunded (ABU) applicants to quickly receive available preparedness and response funds within the first 10-15 days of an emergency. ABU applicants may be selected for initial response activities only or may be awarded additional crisis-specific funding depending on the public health emergency and the associated needs and jurisdictional impacts.

We cannot control when CDC will get any funds that could be awarded. However, we hope to award funds within 10 days to 14 days.

32. Where would the money come from?

The money could be from supplemental funds appropriated by Congress, moved from elsewhere within HHS, or the HHS Secretary’s emergency fund (if funded).

33. If there is a regional event, how would funds be distributed?

, CDC will use an algorithm which would be largely based on population and demonstration of need. It would also be situation dependent (e.g. final round of Zika funding that went to most impacted jurisdictions).

**Note: CDC’s intent is NOT to redistribute funds from existing programs to the crisis NOFO.

34. Can this funding be used for biological, chemical, radiological and natural disasters (hurricane, earthquake, flooding, etc.)? These awards are for any emergencies that exceed capacity and for which funding has become available. It could include all hazards.

35. What if supplemental funding for hurricanes becomes available before this process is finished?

The NOFO will be amended identifying the specific requirement; CDC programs and OGS will complete an accelerated objective review and award schedule. But since there won’t be an ABU on file, it will still have to go through the normal (albeit expedited) review and approval process.

36. Once we have the ABUs and funding becomes available for an emergency, what is the process for adding funding? How long will it take?

An NOA will be issued for Part A funding based on the funds available as quickly as possible. No additional information would be submitted for that portion. Speed of processing will depend on the funding available, the scope of the emergency, the breadth of the funding authorization, and other factors. It could be anywhere from 10-14 days. Part B will require a revised budget and work plan and is intended to be issued as quickly as possible, but before Part A funding is exhausted.

37. Can staff from other areas of the health department for whom preparedness activities are not in scope be assigned to these grant funds for emergency response activities for the time period of response (first 120 days and/or 120 + days)?

Yes.

38. Are you also expecting local jurisdictions within each state to have a mechanism to receive funds? Is this just a state activity?

This is not just a state activity. For example, if Cincinnati has an issue, then Ohio would submit the response on behalf of the city. This is very similar to when applying to Zika or Ebola in that you should account for distribution to local jurisdictions.

39. Are you not concerned about locals receiving itemized dollars for Components A and B?

CDC will look at the primary awardee. If there are questions, we will work with you to address them. Remember, this mechanism is only for response activities.

40. Is funding only for emerging infectious diseases?

This is just the application example, but the mechanism can be used for natural disaster, radiological or nuclear event, or any other kind of public health emergency. Applicants should write to Part A to cover all common needs as this funding will be quicker.

However, depending on the event, Component A could be waived and funding directed straight to Component B.

41. What if multiple emergencies happen at the same time?

This mechanism, should funding be available, could be used for multiple emergencies.

42. What if hundreds of thousands of staff are activated. Could funding be used to pay for their overtime?

This would be on a case by case basis, but it could be an allowable expense. However, as overtime is a contingency expense, applicants should not include it in their initial budget.

43. If the Epidemiology and Laboratory Capacity (ELC) program wanted to fund specific lab issues, could they avail themselves of this mechanism?

Yes, and they are active partners in this.

44. Are we restricted to our usual partners or could we fund untraditional partners?

This would depend on the specifics of the event.

45. The mechanism also mentions countermeasures. Are there going to be restrictions on the purchase of pharmaceuticals or what we can do for vector control?

CDC doesn’t see anything that would be out of consideration right now, but it would be on a case-by-case basis.

46. If the need exists to tap into other federally funded staff, could this mechanism fund their overtime?

Budgets cannot include overtime, because it is considered contingency planning. However, it can include planning scenarios for overtime. Specific approvals for overtime would be considered on a case-by-case basis.

47. If much of existing staff is funded through PHEP, will we be able to fund this?

You need to account for in your crisis NOFO budget the staff you would pay for using this mechanism. You cannot pay for the same work in two programs, but you can move staff costs from the PHEP cooperative agreement to this award if appropriate.