Region 9 FOA_FINAL (2).pdf

U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response

Office of Emergency Management Division of National Healthcare Preparedness Programs

Funding Opportunity Announcement and Grant Application Instructions

Funding Opportunity Title:

Hospital Preparedness Program (HPP) Ebola Preparedness and Response Activities: Development of a Regional Ebola and other special pathogen treatment center for HHS Region 9

(CFDA # 93.817)

Funding Opportunity Number: EP-U3R-15-002 Application Due Date: 04/06/2016

Table of Contents

I. FUNDING OPPORTUNITY DESCRIPTION

II. AWARD INFORMATION

III. ELIGIBILITY INFORMATION

IV. APPLICATION AND SUBMISSION INFORMATION

V. APPLICATION REVIEW INFORMATION

VI. AWARD ADMINISTRATION INFORMATION

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

I. FUNDING OPPORTUNITY DESCRIPTION

Executive Summary and Background

Beginning in March of 2014, West Africa experienced the largest Ebola outbreak on record. Unlike many smaller preceding outbreaks of Ebola virus disease (Ebola), this particular outbreak spread to multiple African countries and caused (as of January 2016) more than 28,000 suspected human cases. In August 2014, the first American Ebola patient was flown to the United States (U.S.) for treatment. Additional patients have subsequently been medically-evacuated to the U.S. and two returned travelers were diagnosed and treated in Dallas, Texas and New York City, New York. These experiences, as well as the secondary infections of two health care workers in a Dallas hospital, identified opportunities to improve preparedness for and treatment of suspected and confirmed patients with Ebola. In response, Congress appropriated emergency funding, in part to ensure that the health care system is adequately prepared to respond to future Ebola patients. In doing so, Congress directed the Department of Health and Human Services (HHS) to develop a regional approach to caring for future Ebola patients.

The funding provided through the Hospital Preparedness Program (HPP) Ebola Preparedness and Response Activities is intended to ensure the nation’s health care system is ready to safely and successfully identify, isolate, assess, transport, and treat patients with Ebola or patients under investigation for Ebola, and that it is well prepared for a future Ebola outbreak. While the focus will be on preparedness for Ebola, it is likely that preparedness for other novel, highly pathogenic diseases will also be enhanced through these activities.

Important lessons learned in the U.S. response to Ebola include: that the safety of health care workers – from clinicians and laboratorians to ancillary staff – must be foremost in health care system preparedness and response activities; that the care of Ebola patients is clinically complex and demanding; and that early case recognition is critical for preventing spread and improving outcomes. Health care worker safety is best achieved through a deep understanding and correct implementation of infection control, appropriate use of personal protective equipment (PPE), continuous training, demonstration of competencies, and participation in frequent exercises. Assuring that Ebola patients are safely and well cared for in the U.S. health care system and that frontline providers are trained to recognize and isolate a person with suspected Ebola are the cornerstones of this HPP funding opportunity announcement (FOA).

In December 2014, HHS released its Interim Guidance for U.S. Hospital Preparedness for Patients under Investigation or with Confirmed Ebola Virus Disease: A Framework for a Tiered Approach, which outlines the different roles U.S. acute health care facilities can play in preparing to identify, isolate, and evaluate patients with possible Ebola or treat patients with confirmed Ebola. These roles include serving as Ebola treatment centers, assessment hospitals, and frontline health care facilities. Since fall 2014, state health officials have been designating hospitals that have been assessed by a Centers for Disease Control and Prevention (CDC)-led Rapid Ebola Preparedness (REP) team to serve as Ebola treatment centers. HHS appreciates the ongoing efforts of the public health and health care communities across the country to prepare our nation’s health care system for Ebola.

Experience with Ebola patients in the U.S. has shown that care of such individuals is clinically complex, requiring highly skilled health care providers and technologically-advanced care. This has led Congress, experts, and stakeholder groups to suggest that, to the extent possible, care of Ebola patients should be concentrated in a small number of facilities. At the same time, however, the nation’s hospitals must be prepared to handle one or more simultaneous clusters of Ebola patients. Further, as described in the Interim Guidance, all hospitals must be able to identify, diagnose, and treat a suspected Ebola patient until they can be transferred to a facility that can provide definitive care.

http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/hospitals.html http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/hospitals.html http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/treatment-centers.html http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/treatment-centers.html http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/assessment-hospitals.html http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/frontline-healthcare-facilities.html

To that end, building upon the state- and jurisdiction-based tiered hospital approach and meeting Congress’ regional directive, through this FOA, to complete the nationwide, regional treatment network for Ebola and other infectious diseases, which balances geographic need, differences in institutional capabilities, and accounts for the potential risk of needing to care for an Ebola patient, HHS seeks a regional Ebola and other special pathogen treatment center in HHS Region 9. Upon selection of a Region 9 awardee, this network will consist of:

1) Ten regional Ebola and other special pathogen treatment centers (one in each of the ten HHS regions, that have been assessed by a CDC-led REP team) and that can be ready within a few hours to receive a confirmed Ebola patient from their region, across the U.S., or medically-evacuated from outside of the U.S., as necessary. These hospitals will also have enhanced capacity to care for other highly infectious diseases.

2) State or jurisdiction Ebola treatment centers that can safely care for patients with Ebola in the event of a cluster of Ebola patients that overwhelms the regional Ebola and other special pathogen treatment center (Clinical judgment, available logistical resources, and patient preference may indicate the patient should receive treatment at a state/jurisdiction Ebola Treatment Center rather than be transferred to a regional Ebola and other special pathogen treatment center).

3) Assessment hospitals.

4) Frontline health care facilities.

This network will be supported by regular exercises and plans that describe how suspected Ebola patients are identified, diagnosed, and if necessary, safely transferred to the appropriate facility.

The Hospital Preparedness Program (HPP) Ebola Preparedness and Response Activities: Development of a Regional Ebola and Other Special Pathogen Treatment Center for HHS Region 9 will provide one awardee in Region 9 with funds to support this regional, tiered approach.

ASPR is awarding a total of $194,500,000 in funding for national Ebola health care system preparedness and response, including between $3,250,000-$4,600,000 for the establishment of an Ebola and other special pathogen treatment center in HHS Region 9 with significantly enhanced Ebola and other infectious disease capabilities that will accept a confirmed Ebola patient from their region, across the U.S., or medically-evacuated from West Africa, as necessary.

This announcement is only for non-research activities supported by ASPR’s Division of National Healthcare Preparedness Programs (NHPP). If research is proposed, the application will not be reviewed.

Statutory Authority

Title VI of Division G of the Consolidated and Continuing Appropriations Act, 2015 and section 311 of the Public Health Service Act, as amended.

Purpose

The purpose of this FOA is to develop a regional Ebola and other special pathogen treatment center in HHS Region 9 for Ebola patient care.

HHS will award funding through this FOA to one HPP awardee to develop a regional Ebola and other special pathogen treatment center for Ebola patient care to serve HHS Region 9. The facility sub-recipient(s) funded through the FOA must agree to serve as a regional asset and agree to accept patients from outside of their jurisdiction. This facility will have enhanced preparedness capabilities to ensure they are the leading provider of care and treatment for Ebola patients in the U.S. and have the capabilities needed to manage other high containment, Ebola-like infectious diseases in the future.

Only HPP jurisdictions in HHS Region 9 are eligible to apply for this funding. However, HPP envisions this grant as a cooperative process. Ideally, only one applicant will apply from HHS Region 9 because all the jurisdictions in the region will agree on, and support, one applicant. HPP will award a maximum of one award through this FOA.

Project Outcomes

• The awardee will develop a plan that must include signed written agreements among all states/jurisdictions in the region, and the regional Ebola and other special pathogen treatment center.

This plan will include EMS and interfacility plans to accommodate patient movement from any point in the region to the designated hospital(s). Note: Awardees are not responsible for maintaining air transport contracts or capabilities.

• Any facility identified to serve as a regional Ebola and other special pathogen treatment center will:

o Accept patients from within their HHS region within eight hours of notification.

o Have the capacity (beds and staff) to treat at least two Ebola patients at one time.

o Have respiratory isolation infectious disease capacity or negative pressure rooms for at least 10 patients, preferably, within the same unit.

o Serve as the primary hospital in their HHS region for treatment of confirmed Ebola patients.

o If necessary, accept patients that are medically evacuated from Ebola-affected countries or other HHS regions.

o Maintain a heightened state of readiness for at least the 50 month project period by conducting quarterly staff trainings and exercises.

o Receive and participate in training, peer review, and an assessment of their readiness from the

National Ebola Training and Education Center (NETEC) to ensure adequate preparedness and trained clinical staff knowledgeable in treating patients with Ebola in the U.S.

o Either have the capability to treat pediatric Ebola patients or partner with another facility within their region to do so.

o Care for Ebola patients without disrupting overall hospital and emergency department operations.

o Participate in clinical research, clinical trials, and experimental protocols, if appropriate.

o Work with their human resources departments, as well as relevant employee unions, to develop policies and procedures to ensure health care worker readiness and safety associated with caring for an Ebola patient.

o Have the capability to handle Ebola-contaminated or other highly-contaminated infectious waste (e.g., through purchase of a high-volume autoclave capable of sterilizing all hospital waste used in the care of a patient with Ebola; by having a waste management facility within the state or jurisdiction willing and able to incinerate and dispose of Ebola waste; or by having a written agreement with another state in the region willing and able to do so).

o Integrate behavioral health considerations for patients and staff, as well as the provision of culturally and linguistically appropriate services, into medical and safety procedures.

Implementation

Applicants must address all activities and strategies listed below in their application.

Activity A: Supporting regional planning for the development of a regional network for Ebola patient care.

• Strategy 1: Develop written agreements between states within the region to develop a regional network for Ebola patient care, which are signed by state or jurisdiction elected officials and state or jurisdiction health officials from each state in the region.

• Strategy 2: Ensure that interfacility and interstate transport plans are developed for Ebola patients that consider ground transport times between facilities and from designated airports to the Regional Ebola and other special pathogen treatment center.

o Coordinate with public health and emergency management leaders and elected officials, such as state governors, to ensure permissible movement of patients between states. There should be a clear, written understanding of how patients from all parts of the region will be transported to the Regional Ebola and other special pathogen treatment center and what will happen if the center is at capacity (See Appendix 1, the Ebola Patient Decision Algorithm, for more information).

o Coordinate with all states in the region; EMS agencies; state EMS officials;

state/jurisdiction assessment and treatment hospitals; and regional Ebola and other special pathogen treatment centers to determine the indications for ground transport and air transport of Ebola patients.

o Review laws and regulations within each state and jurisdiction in the region to identify and address barriers to patient transport.

Activity B: Developing, supporting, and maintaining regional Ebola and other special pathogen treatment centers.

• Strategy 1: Ensure regional Ebola and other special pathogen treatment centers are ready to accept an Ebola patient within eight hours of notification by developing and maintaining strong health care worker competencies and safety procedures and surge capacity for Ebola and Ebola-like diseases.

o Ensure regional Ebola and other special pathogen treatment centers are willing to accept training, peer review, and assessment by the National Ebola Training and Education Center to evaluate readiness and develop an improvement plan to address gaps.

o Develop, maintain, and exercise policies and procedures to ensure health care worker readiness and safety, including behavioral health considerations, associated with caring for an Ebola patient for the 50 month project period of this FOA.

o Train staff at least quarterly, specifically focusing on health care worker safety when caring for an Ebola patient (e.g., PPE donning/doffing, rapid identification and isolation of a patient, safe treatment protocols and behavioral health considerations) and early recognition, isolation, and activation of the facility’s Ebola plan.

o Conduct quarterly exercises, including after action reviews and corrective action plans, which should include unannounced first patient encounter drills for Ebola (and other infectious diseases, such as MERS-CoV and measles), patient transport exercises, and patient care simulations.

o Purchase PPE in accordance with facility Ebola treatment plans.

o Ensure behavioral health considerations for patients and staff, as well as the provision of culturally and linguistically appropriate services are fully integrated into medical and safety procedures.

• Strategy 2: Ensure the regional Ebola and other special pathogen treatment center’s infrastructure is ready and policies are established to accept an Ebola patient within eight hours of notification;

collaborate with partners, as necessary, to achieve this.

o Ensure regional Ebola and other special pathogen treatment center capacity (beds and staff) to treat at least two Ebola patients at one time.

o Ensure respiratory isolation infectious disease capacity or negative pressure rooms (for at least 10 patients, preferably, within the same unit).

o Ensure collaboration with a health care partner to provide pediatric Ebola care capabilities (if the regional Ebola and other special pathogen treatment center does not already possess these capabilities). For example, this may be accomplished by bringing specialized equipment and staff (pre-trained and credentialed) from a partner health facility to treat a pediatric patient within the regional Ebola and other special pathogen treatment center.

o Ensure the ability to provide care to the normal flow of patients and assure normal patient care is not interrupted during the time in which an Ebola patient or patients are being cared for in the Ebola treatment unit.

o During periods without an Ebola patient, Ebola treatment units may have alternate day-to-day uses, such as for other patient care or for research and training purposes.

o Consider the potential for offering labor and delivery services for Ebola patients, and conducting other procedures.

o Participate in clinical research, clinical trials and experimental protocols, as needed.

o Reconfigure patient flow in the emergency department to provide isolation capacity for PUIs and other potentially infectious patients.

o Retrofit inpatient care areas for enhanced infection control (e.g. donning/doffing rooms).

o Consider establishing dedicated space and procuring separate equipment and supplies for clinical laboratories for Ebola.

o Ensure capability to handle Ebola-contaminated or other highly-contaminated infectious waste

(e.g., through purchase or contract to use on-site a high-volume autoclave capable of sterilizing all hospital waste used in the care of a patient with Ebola, by having a waste management facility within the state or jurisdiction willing and able to incinerate and dispose of Ebola waste, or by having a written agreement with another state willing and able to do so).

o Consider adjusting Electronic Health Records (EHRs) to ensure prompt staff screening for patients’ travel histories and newly emerging diseases.

Evaluation and Performance Measurement

The evaluation and performance measurement strategy for this FOA can be found in the Hospital Preparedness Program (HPP) Measure Manual: Implementation Guidance for Ebola Preparedness Measures released in July 2015. In addition, facilities will receive peer assessment using metrics developed by the NETEC, established in a separate FOA.

Performance measures for the project period:

1. The time it takes from confirmation of Ebola patient at assessment hospital or ETC to notification by the health department and/or transferring hospital to the health department in the state/jurisdiction where the regional Ebola and other special pathogen treatment center is located about the need for patient transfer. (Goal: within 30 minutes)

2. The proportion of states and jurisdictions in the HHS region that have participated in the development of the regional CONOPS. (Goal: 100 percent)

3. The proportion of states/jurisdictions in the HHS region for which a current written and signed agreement is in place to transfer patients from assessment hospitals or ETCs to the regional Ebola and other special pathogen treatment center (Goal: 100 percent).

4. The proportion of states/jurisdictions in the HHS region that have demonstrated the ability to move a patient across jurisdictions by the ground or air to a regional Ebola and other special pathogen treatment center, as evidenced by a real-world event or participation in a multi-jurisdiction exercise. (Goal: 100 percent)

5. The proportion of rostered staff (clinical, lab, and ancillary staff) at the regional Ebola and other special pathogen treatment center that received quarterly trainings in infection control and safety, and patient care for a patient with Ebola. (Goal: 100 percent).

6. The time it takes for the on-call team at a regional Ebola and other special pathogen treatment center to report to the unit upon notification of an incoming patient with Ebola, as evidenced by a real-world event or no-notice exercise (Goal: within 4 hours).

7. The proportion of rostered staff contacted by the regional Ebola and other special pathogen treatment center within 4 hours upon notification of an incoming patient with Ebola, as evidenced by a real-world event or no-notice exercise. (Goal: 100 percent).

8. The time until a regional Ebola and other special pathogen treatment center is ready to admit a patient with confirmed Ebola (adult or pediatric patient), as evidenced by an exercise or actual patient transfer. (Goal: within 8 hours of notification).

Eligibility and Funding Strategy

HHS will award funding through this FOA to one HPP awardee to develop a regional network for Ebola patient care, which includes a requirement to establish one regional Ebola and other special pathogen treatment center to serve HHS region 9. The facility sub-recipient(s) funded through this FOA must agree to serve as regional assets and agree to accept patients from outside of their jurisdiction. These facilities will have enhanced preparedness capabilities to ensure they are the leading providers of care and treatment for Ebola patients in the U.S. and have the capabilities needed to manage other high containment, Ebola-like infectious diseases in the future. Regional facilities must have had a REP team visit as of the date of posting of this FOA.

• Only HPP jurisdictions in HHS Region 9 are eligible to apply for funding (See Section V for detailed selection/review criteria).

• HPP will make one award through this FOA.

• The states/jurisdictions that receive funding through this FOA must agree to provide no less than 90 percent of the funding to at least one health care facility to serve as a regional Ebola and other special pathogen treatment center. ASPR will consider requests for exemptions on a case-by-case basis.

• Of the total for the regional Ebola and other special pathogen treatment center, HPP will provide at least $2,250,000 during the first year and $250,000 in the four subsequent years to maintain and sustain the capabilities of these regional centers.

• None of the funds made available in this FOA may be used to reimburse hospitals or entities for the costs associated with caring for persons under investigation for Ebola or for the costs of treating a confirmed Ebola patient.

Applications will be reviewed by a review panel.

Total availability of funds: $3,250,000 - $4,600,000

Approximate number of awards given: One

Approximate award: $3,250,000 - $4,600,000

ASPR Activities

In a cooperative agreement, ASPR staff is substantially involved in the program activities, above and beyond routine grant monitoring. ASPR’s NHPP and other ASPR subject matter experts will use application submission information to identify strengths and weaknesses to update work plans and to establish priorities for site visits and technical assistance. To assist recipients in achieving the purpose of this cooperative agreement, ASPR will conduct the following activities:

• Establish a National Ebola Training and Education Center (NETEC) comprised of staff from hospitals that have successfully treated Ebola to assist with peer review and assessment of regional Ebola and other special pathogen treatment centers, state/jurisdiction Ebola treatment centers, and, if desired, assessment hospitals.

• Provide ongoing guidance, programmatic support, and training as it relates to the activities outlined in this Ebola and other funding announcement guidance documents.

• Convene conference calls, site visits, and other communications as applicable with awardees.

• Facilitate communication among awardees to advance the sharing of expertise on health care preparedness and response activities for Ebola.

• Coordinate planning and implementation activities with federal partners, including the PHEP cooperative agreement administered by CDC, to optimize preparedness investments and eliminate duplication where possible.

• The HPP Field Project Officers and the Division of Regional and International Coordination Regional

Emergency Coordinators will work with states/jurisdictions in their region (and at least one health care facility identified by the states/jurisdictions in each HHS region) to help establish at least one Regional Ebola and other special pathogen treatment center.

Collaborations

With ASPR-funded programs:

ASPR will collaborate with other programs and initiatives, as relevant (e.g., the Emergency Care Coordination Center and the Biomedical Advanced Research and Development Authority) to assure that efforts are being maximized while reducing duplication of effort.

With organizations external to ASPR:

States have limited resources to improve health care system preparedness and develop regional Ebola and other special pathogen treatment centers. Therefore, it is imperative that awardees partner with other federal (e.g., CDC’s PHEP program) and state and local organizations (e.g., local public health departments) working to effectively prepare for Ebola and the possibility of having an Ebola patient or patient under investigation for Ebola.

Awardees must also collaborate to integrate preparedness and infection control efforts by participating in State Healthcare-Associated Infection (HAI)/Infection Control advisory groups, established with funding and guidance from CDC’s Epidemiology and Laboratory Capacity for Infection Control (ELC) program and to consider how a regional emergency preparedness structure could support improved infection control throughout the community.

Other Important Notes about this Funding Opportunity Announcement

• Applicants should include narratives and budgets spanning the entire length of the projects applied for, which may not exceed 50 months for this FOA.

• Applicants should coordinate the HPP activities with supplemental activities under the ELC

Cooperative Agreement (CK-14-1401PPHFSUPP15) and the PHEP Cooperative Agreement (CDC- RFA-TP12-12010302SUPP15), as well as the activities under the annual cooperative agreements for ELC (CDC-RFA-CK14-1401PPHF14) and HPP-PHEP (CDC-RFA-TP12-120102CONT14).

• Funding will be provided for U.S. health care system Ebola preparedness efforts, including regional

Ebola and other special pathogen treatment centers, which can be applied retroactively to July 2014.

• Applicants must submit a discrete application, itemized budget, and budget narrative for the HPP project for which they are applying.

II. AWARD INFORMATION

Development of a Regional Network for Ebola Patient Care (Development of a Regional Ebola and other special pathogen treatment center for HHS Region 9)

Type of Award: Cooperative Agreement

Fiscal Year Funds: 2015

Approximate Total Funding: $3,250,000 - $4,600,000

This amount is subject to availability of funds.

Includes direct and indirect costs.

Approximate Number of Awards: 1

Approximate Average Award: $3,250,000

This amount is for a 50-month project period, and includes both direct and indirect costs.

Floor of Individual Award Range: $3,250,000

Ceiling of Individual Award Range: $4,600,000

This ceiling is for a 50-month project period.

Anticipated Award Date: 4/15/2016

Budget Period Length: 2 months Project Period Length: 50 months

III. ELIGIBILITY INFORMATION

Eligible Applicants

The following recipients may submit an application:

Eligibility Category: State governments County governments City or township governments

Eligible entities include the current HHS Region 9 HPP awardees, which include health departments in the following states, localities (city and county), and territories.

Cost Sharing/Match and Maintenance of Effort/Funding

There is no cost sharing or match requirement for this project.

Maintenance of effort/funding is not required for this program.

Special Requirements

Note: Title 2 of the United States Code Section 1611 states that an organization described in Section 501(c)(4) of the Internal Revenue Code that engages in lobbying activities is not eligible to receive federal funds constituting a grant, loan, or an award.

IV. APPLICATION AND SUBMISSION INFORMATION

Address to Request Application Package

Awardee Awardee Arizona Los Angeles County California Nevada Hawaii

Application materials can be obtained from http://www.grants.gov.

Contact person regarding this FOA is:

Robert Scott Dugas, MPH Branch Chief, Hospital Preparedness Program Telephone: (202) 245-0732 Email: Robert.dugas@hhs.gov

Applicants must download the application package associated with this funding opportunity from grants.gov. If the applicant encounters technical difficulties with grants.gov, the applicant should contact grants.gov customer service. The grants.gov contact center is available 24 hours a day, 7 days a week, with the exception of all federal holidays. The contact center provides customer service to the applicant community. The extended hours will provide applicants support around the clock, ensuring the best possible customer service is received any time it is needed. You can reach the grants.gov support center at 1-800-518-4726 or by email at support@grants.gov. Submissions sent by email, fax, CDs, or thumb drives of applications will not be accepted.

Applicants are encouraged to submit their application prior to the due date.

Required Registrations

Central Contractor Registration and Data Universal Numbering System Requirements

Except for those entities exempt from requirements listed at 2 CFR §25.110(b) or (c) ( individuals), effective October 1, 2010, HHS requires all entities that plan to apply for and ultimately receive federal grant funds from any HHS Operating/Staff Division (OPDIV/STAFFDIV) or receive subawards directly from recipients of those grant funds to:

• Be registered in the Central Contractor Registration (CCR) prior to submitting an application of plan;

• Maintain an active CCR registration with current information at all times during which it has an active award or an application or plan under consideration by an OPDIV/STAFFDIV; and

• Provide its Data Universal Numbering System (DUNS) number in each application or plan it submits to the OPDIV/STAFFDIV.

An award cannot be made until an applicant has complied with these requirements. At the time an award is ready to be made, if the intended recipient has not complied with these requirements, the OPDIV/STAFFDIV:

• May determine that the applicant is no qualified to receive an award; and

• May use that determination as a basis for making an award to another applicant.

Additionally, all first-tier subaward recipients (e.g., direct subrecipient) must have a DUNS number at the time the subaward is made.

Applicants must provide a Dun and Bradstreet (DUNS) number to apply for a grant or cooperative agreement http://www.grants.gov/ mailto:Robert.dugas@hhs.gov http://www.grants.gov/ mailto:support@grants.gov from the federal government. ASPR applicants are required to provide their DUNS number on the face page of the application. Obtaining a DUNS number is easy and there is no charge. To obtain a DUNS number, access the Dun and Bradstreet website at http://www.dnb.com/get-a-duns-number.html or call 1-866-705-5711. To expedite the process, let Dun and Bradstreet know that you are a public/private nonprofit organization getting ready to submit a federal grant application. In addition, you must be registered in the System for Award Management (SAM). Registration in the System for Award Management (SAM) is mandatory. Failure to register with SAM will lead to an application being deemed ineligible and will not proceed to peer review. Due to the possibility of heavy traffic at the sam.gov website, applicants are strongly encouraged to register well in advance of the application due date. SAM information must be updated at least every 12 months to remain active (for both recipients and sub-recipients). Once you update your record in SAM, it will take 48 to 72 hours to complete the validation processes. Grants.gov will reject submissions from applicants who are not registered in SAM or those with expired SAM registrations (Entity Registrations). The DUNS number you use on your application must be registered and active in SAM for the anticipated start date of the award. To create a user account, Register/Update an entity and/or Search Records go to SAM, at http://www.sam.gov or by phone at 1-877-252-2700.

Grants.gov registration – All entities must register and/or renew registration with grants.gov prior to submitting an application. Grantees previously registered must assure that the registration is still valid and up-to-date. Registration and re-registration take up to 10 working days to process. Failure to submit the application on time due to late registration will result in ASPR not accepting the application.

Application Screening Criteria

Applications must be submitted electronically via http://www.grants.gov by [04/06/2016 at 11:59 pm EST.]

Content and Form of Application Submission

The following required documents and sections must be included in the application package in order to be considered for funding. Please note, applicants must submit a discrete project abstract and project narrative for each HPP project for which they are applying. Please also ensure that the budget request associated with various activities is clearly delineated.

Cover Letter (optional) Cover letters should be addressed to the following:

Virginia Simmons Chief Grants Management Officer Acquisition Management Contracts and Grants Office of the Assistant Secretary for Preparedness and Response U.S. Department of Health and Human Services 200 Independence Ave. S.W.

Washington, DC 20201 Telephone: (202) 260-0400 E-mail: asprgrants@hhs.gov

Project Abstract A project abstract must be completed in the grants.gov application forms. The project abstract must contain a summary of the proposed activity suitable for dissemination to the public. It should be a self-contained description of the project and should contain a statement of objectives and methods to be employed. It http://www.dnb.com/get-a-duns-number.html http://www.sam.gov/ mailto:asprgrants@hhs.gov should be informative to other persons working in the same or related fields and insofar as possible understandable to a technically literate lay reader. This abstract must not include any proprietary or confidential information.

Project Narrative A project narrative must be submitted with the application forms. The project narrative must be uploaded in a PDF file format when submitting via grants.gov. The narrative should address activities to be conducted over the entire project period, with a more detailed work plan for the first year (when applicable). Each of these project narratives should be succinct, self-explanatory, and in the order outlined in this section.

The narrative must be submitted in the following format:

The project narrative must be double-spaced, on 8 ½” x 11” paper with 1” margins on both sides, and a font size of not less than 11. You may use smaller font sizes to fill in the Standard Forms and Sample Formats. Forms do not need to be double spaced. ASPR will not accept applications with a Project Narrative for Part A or Part B that exceeds 100 pages. If the narrative exceeds the page limit, only the pages which are within the page limit will be reviewed.

The components of the project narrative counted as part of the 100 page limit include:

• Background

• Current capacity

• Approach and work plan

• Administrative preparedness plan execution

• Budget narrative and justification

• Performance measurement and evaluation strategy

Any other relevant additional information that does not count toward the 100 page limit including:

• Curricula vitae for key project personnel

• Letters of commitment

• Copy of the applicant’s most recent indirect cost agreement, if requesting indirect costs

• Other documents, as needed

The project narrative is the most important part of the application, since it is the primary basis on which ASPR determines whether or not a project meets the minimum requirements for grants under Public Health Service Act, Section 311 (42 U.S.C. Section 243). The project narrative should provide a clear and concise description of the project. The following is a brief description of each required component:

Background Applicants must describe the core background information relative to the specific Part. The core background information must help reviewers understand how the applicant's response to the FOA will address the health care system problem and support health care system priorities.

Current Capacity For each Part applied for, address the jurisdiction's current capacity to successfully implement the proposed project and associated activities, including describing staff and other infrastructure already in place in which to build upon, to meet project period outcomes.

Approach and Work Plan For each Part applied for, applicants must clearly identify the outcomes they expect to achieve by the end of the project period and provide a clear and concise description of the strategies and activities they used to achieve the project’s outcomes. Briefly introduce the activity(ies) being proposed and describe what the expected outputs (e.g., milestones) will be over the first 12-months of the project and a higher-level description for each subsequent year.

Define the expected outcomes that align with resolving the problem of closing the gaps. The outcomes should define what changes or improvements will occur in the health care system, the community, or the region. Outcomes should be well-defined, specific, measurable, realistically achievable, and contribute to closing the gaps identified in the problem statement. Ideally, outcomes should link to planned activities, quantify the targeted change, and include an estimated timeline for achieving the change. Awardees can include as many outcomes as needed.

List the intermediate activities the jurisdiction will undertake, including tasks and estimated start and end dates, which will lead to the associated outcome and contribute to resolving the identified issue or problems. Awardees can include as many planned activities as needed.

List the proposed outputs that will be produced as a result of the planned activities, such as a health care system concept of operations. Awardees can include as many planned outputs as needed.

Administrative Preparedness Plan Execution Awardees must include estimated timelines for obligation and liquidation of funds within the budget and project period. Timelines should be consistent with cycle times identified in jurisdiction’s current HPP-PHEP Administrative Preparedness Plan.

Budget Narrative and Justification A detailed budget with supporting justification must be provided and be related to recipient activities that are stated in awardees’ work plans. Awardees must note the following budget-related issues:

• If indirect costs are requested, it will be necessary to include a copy of the organization’s current negotiated Federal Indirect Cost Rate Agreement or a Cost Allocation Plan for those awardees under such a plan.

• Travel for program implementation should be justified and related to implementation activities.

• Budgets that include costs for equipment (e.g., laboratory or waste management equipment) must be detailed in the budget narrative and justification.

• Budgets that include retroactive incurred costs must provide adequate detailed documentation to substantiate those costs were incurred and meet the criteria for allowable costs as per 45 CFR 75.458.

• Awardees must request retroactive compensation at the time of the application. The request should contain the following information:

o Time period o Line item budget for the period o Narrative description of the Ebola preparedness activities

ASPR expects that no less than 90 percent of the funds will be distributed to, and used, at least one health care facility to serve as a regional Ebola and other special pathogen treatment center and support Ebola health care system preparedness and response efforts. ASPR will consider requests for exemptions on a case-by-case basis.

The budget narrative or justification should be provided using the instructions included in Attachment A (Instructions for Completing Required Forms) of this FOA. Applicants are encouraged to pay particular attention to Attachment B (Budget Narrative/Justification Sample Format), which provides an example of the level of detail sought.

Performance Measurement and Evaluation Strategy Awardees will be required to report on a small set of ASPR-defined performance measures that will demonstrate, or show progress toward, the accomplishment of program outcomes of the cooperative agreement. ASPR released this strategy in the Hospital Preparedness Program (HPP) Measure Manual:

Implementation Guidance for Ebola Preparedness Measures in July 2015

As part of this application, awardees should describe in a brief narrative a plan to affirm and acknowledge the awardee’s ability to collect and respond to required ASPR-defined performance measures. For example, awardees may describe who will be monitoring and responding to required performance measures, potential data sources, and anticipated barriers and challenges and how this will be resolved.

Awardees may also describe how evaluation data will be shared with key stakeholders and used by the awardee to improve program quality and demonstrate the value of this funding.

Additional Information Additional information may be included in the application appendices. The appendices must be uploaded to the "Other Attachments Form" of application package in grants.gov. Note: appendices will not be counted toward the narrative page limit.

Submission Deadline Dates and Times

The deadline for the submission of applications under this FOA is 04/06/2016 at 11:59 pm EST. Applications must be submitted electronically via Grants.gov by 11:59 p.m. Eastern Time on 04/06/2016 Applications that are submitted after the deadlines will not be processed.

Intergovernmental Review

This FOA is not subject to the requirements of Executive Order 12372, “Intergovernmental Review of Federal Programs.”

Funding Restrictions

Restrictions, which must be taken into account while writing the budget, are as follows:

• Recipients may not use funds for research.

• Recipients may not use funds for clinical care.

• Recipients may only expend funds for reasonable program purposes, including personnel, travel, supplies, and services, such as contractual.

• Awardees may not generally use HHS/ASPR/HPP funding for the purchase of furniture. Any such proposed spending must be identified in the budget.

• The direct and primary recipient in a cooperative agreement program must perform a substantial role in carrying out project objectives and not merely serve as a conduit for an award to another party or provider who is ineligible.

• Recipients may not use funds to carry out any program of distributing sterile needles or syringes for hypodermic injections of any illegal drug.

• Recipients may not use funds to advocate or promote gun control.

• Salaries may not exceed the rate of $185,100 USD per year: the Consolidated and Further Continuing

Appropriations Act, 2015 (P.L. 113-235) limits the salary amount that you may be awarded and charge to HHS/ASPR grants and cooperative agreements. Award funds should not be budgeted to pay the salary of an individual at a rate in excess of Executive Level II. Currently, the Executive Level II salary of the Federal Executive Pay scale is $185,100. This amount reflects an individual’s base salary exclusive of fringe and any income that an individual may be permitted to earn outside of the duties to the applicant organization. This salary limitation also applies to subawards/subcontracts under an HHS/ASPR grant or cooperative agreement.

• Recipients may not use funds for lobbying activities: Pursuant to the Consolidated and Further Continuing Appropriations Act, 2015 (P.L.113-235), (a) you shall not use any funds from an award made under this announcement for other than normal and recognized executive legislative relationships. You shall not use funds for publicity or propaganda purposes, for the preparation, distribution, or use of any kit, pamphlet, booklet, publication, electronic communication, radio, television, or video presentation designed to support or defeat the enactment of legislation before the Congress or any State or local legislature or legislative body, except in presentation to the Congress or any State or local legislature itself, or designed to support or defeat any proposed or pending regulation, administrative action, or order issued by the executive branch of any State or local government, except in presentation to the executive branch of any State or local government itself. (b) You shall not use any funds from an award made under this announcement to pay the salary or expenses of any employee or subrecipient, or agent acting for you, related to any activity designed to influence the enactment of legislation, appropriations, regulations, administrative action, or Executive order proposed or pending before the Congress or any State government, State legislature or local legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local or tribal government in policymaking and administrative processes within the executive branch of that government. (c) The above prohibitions include any activity to advocate or promote any proposed, pending, or future Federal, State or local tax increase, or any proposed, pending, or future requirement or restriction on any legal consumer product, including its sale or marketing, including but not limited to the advocacy or promotion of gun control.

• Recipients may not use funds for fund raising.

• Recipients may not use funds for the cost of money even if part of the negotiated indirect cost rate agreement.

• Recipients may not use funds for vehicles.

• Recipients may not use funds for salaries for back filling of personnel.

• Recipients may not use funds for antibiotics for treatment of secondary infections.

• Funding under these awards may only be used for minor alteration and renovation (A&R) activities. Construction and major A&R activities are not permitted. A&R of real property generally is defined as work required to change the interior arrangements or installed equipment in an existing facility so that it may be more effectively utilized for its currently designated purpose or be adapted for an alternative use to meet a programmatic requirement. The work may be categorized as improvement, conversion, rearrangement, rehabilitation, remodeling, or modernization, but it does not include expansion, new construction, development, or repair of parking lots, or activities that would change the “footprint” of an existing facility (e.g., relocation of existing exterior walls, roofs, or floors; attachment of fire escapes). Minor A&R may include activities and associated costs that will result in:

o Changes to physical characteristics (interior dimensions, surfaces, and finishes); internal environments (temperature, humidity, ventilation, and acoustics); or utility services (plumbing, electricity, gas, vacuum, and other laboratory fittings);

o Installation of fixed equipment (including casework, fume hoods, large autoclaves, biological safety cabinets);

o Replacement, removal, or reconfiguration of interior non-load bearing walls, doors, framed, or windows in order to place equipment in a permanent location;

o Making unfinished shell space suitable for purposes other than human occupancy, such as storage of pharmaceuticals; or, o Alterations to meet requirements for accessibility by physically disabled individuals.

V. APPLICATION REVIEW INFORMATION

Development of a Regional Network for Ebola Patient Care

As discussed above, the goal of this FOA is to support a regional approach to Ebola and infectious disease treatment for HHS Region 9. HPP awardees, in conjunction with a facility in their jurisdiction, are eligible to apply. However, HPP envisions this as a cooperative process. Ideally, only one applicant will apply from each region because all the jurisdictions in the region will agree on and support, one applicant.

Eligible applicants will be evaluated against the following review criteria:

Background - Maximum Points: 10 Provide a statement explaining why the applicant (the jurisdiction and the hospital within) is the best choice for the Regional Ebola and other special pathogen treatment center.

Required Components - Maximum Points: 60

• Does the applicant provide letters of support from other states/jurisdictions in the region? Points will be allocated based on the percentage of support from other states/jurisdictions in the region. [30 points]

• Is the applicant located in areas with the highest risk for Ebola within each region? If so, the applicant will be allocated more points. [10 points]

• Does the applicant submit a joint letter speaking to the requirements below from the awardee and the facility proposed as the regional hospital? To meet this requirement, it is also possible to submit a letter from the awardee that speaks to the requirements below and a letter from the proposed facility approving the contents of the letter. Please note, some sub-bullets require a commitment only and some require a commitment as well as a work plan explaining how the facility will fulfill the commitment. [20 points] o Requiring only a statement of commitment:

Applicant must name the facility that would serve as the regional hospital.

Applicant must commit to serve as the primary hospital in their HHS region for treatment of confirmed Ebola patients. Applicant must commit to accepting patients from within their HHS region and other HHS regions or those that are medically evacuated from Ebola-affected countries (if necessary).

Applicant must be located within a 90-minute drive of an airport, should patients require air transport to the Regional Ebola and other special pathogen treatment center(s), and the airports must be named in the application.