Revised Foa_Content_of_CDC-RFA-PS23-2306.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR HIV, VIRAL HEPATITIS, STDS AND TB PREVENTION

Community-Based Approaches to Reducing Sexually Transmitted Diseases (CARS)

CDC-RFA-PS23-2306

06/27/2023

Table of Contents 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

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- PS23-2306. 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:

Community-Based Approaches to Reducing Sexually Transmitted Diseases (CARS) 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 purposes of this NOFO, research is defined as set forth in 45 CFR 75.2 and, for further clarity, as set forth in 42 CFR 52.2 (see eCFR :: 45 CFR 75.2 -- Definitions and https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR- 2007-title42-vol1-sec52-2.pdf. In addition, for purposes of research involving human subjects and available exceptions for public health activities, please see 45 CFR 46.102(l) (https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section- 46.102#p-46.102(l)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-PS23-2306

https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l)

E. Assistance Listings Number:

93.977 F. Dates:

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

05/28/2023

2. Due Date for Applications:

06/27/2023 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

Informational conference call for potential applicants will be held Thursday, May 18, 2023 2:00- 3:30pm EST via Zoom. See meeting information below.

Topic: CDC-RFA-PS23-2306 CARS NOFO Informational Conference Call Time: May 18, 2023 02:00 PM Eastern Time (US and Canada)

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G. Executive Summary:

1. Summary Paragraph The Centers for Disease Control and Prevention (CDC) announces the availability of Fiscal Year (FY) 2023 funds for a cooperative agreement supporting organizations with demonstrated experience and capacity of implementing community engagement methods and multi-sector partnerships, to reduce STD disparities, promote personal health, advance community wellness, and improve personal health behavior and practices. The new notice of funding opportunity (NOFO) provides support in five focus areas. The focus areas include:

Implementation of community engagement methods to achieve health equity;

Implementation of structural change strategies that promote personal health, support healthy behaviors, and community-clinical linkages to build support for interventions to prevent and reduce STD disparities, Enhancement and sustainability of partnerships Support for communication strategies to promote STD program successes, and leverage additional resources for STD control and prevention, and Evaluation of the efficacy of this approach and intervention implementation.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$3,900,000

e. Average One Year Award Amount:

$325,000

f. Total Period of Performance Length:

3 year(s)

g. Estimated Award Date:

August 31, 2023

h. Cost Sharing and / or Matching Requirements:

No Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text

A. Funding Opportunity Description

1. Background

a. Overview Sexually Transmitted Diseases (STDs) remain one of the most critical public health challenges facing the United States (U.S.), with approximately 20 million new STD infections occurring every year. Half of these new infections occur in young people ages 15-24. These infections can lead to long-term health consequences, such as infertility; they can facilitate HIV transmission;

and they have stigmatized entire population subgroups of Americans. STDs are also an economic drain on the U.S. healthcare system, costing billions annually.

In 2020, almost two-thirds (61%) of all reported chlamydia cases were among persons aged 15– 24 years. As chlamydial infections are usually asymptomatic, case rates are heavily influenced by screening coverage. Rates of reported chlamydia are highest among adolescents and young adults.

In 2020, a total of 677,769 cases of gonorrhea were reported to the CDC, making it the second most common notifiable sexually transmitted infection in the United States for that year. During 2019–2020, rates increased among both males and females and in three regions of the United States (Midwest, Northeast, and South). Rates of reported gonorrhea increased in most racial/Hispanic ethnicity groups, with the greatest increases observed among non-Hispanic Black/African American persons and non-Hispanic persons of multiple races.

Since 2013, rates of reported gonorrhea have been higher among men compared to women, likely reflecting cases identified in both men who have sex with men (MSM), and men who have sex with women only. During 2019–2020, rates increased among both men and women, but increases were greater among women (15%) compared to men (6.6%) which may reflect differences in diagnosing and reporting of cases among MSM in 2020.

In 2020, 133,945 cases of all stages of syphilis were reported, including 41,655 cases of primary and secondary (P&S) syphilis, the most infectious stages of the disease. Rates of P&S syphilis increased in most racial/Hispanic ethnicity groups, with greatest increases among non-Hispanic American Indian/Alaska Native persons and non-Hispanic persons of multiple races.

MSM are disproportionately impacted, accounting for a majority (53%) of all male P&S syphilis cases in 2020 and in states with complete information on sex of sex partners for male cases, rates of P&S syphilis among MSM increased in 18 states during 2019–2020.

Over half (53%) of reported cases of STDs were among adolescents and young adults aged 15– 24 years. Disparities continue to persist in rates of reported STDs among some racial minority or Hispanic groups when compared with rates among non-Hispanic White persons. In 2020, 32% of all cases of chlamydia, gonorrhea, and P&S syphilis were among non-Hispanic Black persons, even though they made up only approximately 12% of the US population. MSM are disproportionally impacted by STDs, including P&S syphilis and gonorrhea. Centers for Disease Control and Prevention. “Sexually Transmitted Disease Surveillance, 2020.” Www.cdc.gov, 12 Apr. 2022, www.cdc.gov/std/statistics/2020/default.htm Acknowledging inequities in STD rates is a critical step toward empowering affected groups to collaborate in addressing systemic inequities in the burden of disease, and minimizing the health impacts of STDs on individuals and populations.

This program supports efforts to improve the health of populations disproportionately affected by HIV, Viral Hepatitis, sexually transmitted diseases (STDs) and TB by maximizing the health impact of public health services, reducing disease incidence, and advancing health equity.

b. Statutory Authorities This program is authorized under the Public Health Service Act, Sections 301(a) [42 U.S.C.

Section 241(a)] and 318 [42 U.S.C. Section 247c], as amended. Regulations governing the implementation of this legislation are covered under 42 CFR Part 51b, Subpart A.

c. Healthy People 2030 Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade. This NOFO supports the following topic area:

Sexually Transmitted Infections https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections

Goal: Reduce sexually transmitted infections and their complications and Improve access to quality STI care.

d. Other National Public Health Priorities and Strategies Promoting Health Equity The program supports efforts to improve the health of populations disproportionately affected by HIV, viral hepatitis, STDs and TB by maximizing the health impact of public health services, reducing disease prevalence, and promoting health equity, aligning with CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention's (NCHHSTP) Strategic Plan Through 2022- (https://www.cdc.gov/nchhstp/strategicpriorities/default.htm#:~:text=CDC's%20National%20Ce nter%20for%20HIV,influence%20and%20enhance%20our%20programs).

e. Relevant Work This NOFO builds upon previous and current STD prevention programs including:

CDC-RFA-PS11-1114: http://www.grants.gov/web/grants/view-opportunity.html?oppId=72774

CDC-RFA-PS14-1406: http://www.grants.gov/web/grants/view-opportunity.html?oppId=251204

CDC-RFA-PS17-1707: https://www.grants.gov/web/grants/view-opportunity.html?oppId=290103

CDC -RFA-PS20-2008: https://www.grants.gov/web/grants/view-opportunity.html?oppId=320994 o First established in 2011, the Community Approaches to Reducing Sexually Transmitted Diseases (CARS) cooperative agreement supported planning, implementation, and evaluation of innovative projects to reduce STD disparities, promote personal health, and advance community wellness using community engagement methods. In four separate funding phases 2011-2014, 2014-2017, 2017-2020, and 2020-2023, four new recipients received funding in each phase to implement projects and activities.

https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections http://www.grants.gov/web/grants/view-opportunity.html?oppId=72774 http://www.grants.gov/web/grants/view-opportunity.html?oppId=72774 http://www.grants.gov/web/grants/view-opportunity.html?oppId=251204 http://www.grants.gov/web/grants/view-opportunity.html?oppId=251204 https://www.grants.gov/web/grants/view-opportunity.html?oppId=290103 https://www.grants.gov/web/grants/view-opportunity.html?oppId=290103 https://www.grants.gov/web/grants/view-opportunity.html?oppId=320994 https://www.grants.gov/web/grants/view-opportunity.html?oppId=320994

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

Logic Model: Community-Based Approaches to Reducing STD Disparities

Strategies Short-Term Outcomes (Year 1)

Mid-Term Outcomes (Year 2-3)

Long Term Outcomes (Year 4-+)

Community Engagement Establish and Engage a Community Advisory Board (CAB) representing groups disproportionately affected by STDs

Identification and implementation of systems and environmental strategies

Conduct Community Needs Assessment

Train CAB and engage CAB in Social Determinants of Health (SDOH) impact/ prioritization based on Needs Assessment

Coordinate CAB design of STD interventions to address SDOH

Develop multi-sectorial partnerships

Engage partners for intervention implementation

Establish detailed MOUs

Increased CAB members who actively participate in and are satisfied with the CAB

Increased prioritization of community SDOH by the CAB

Increased clinical resources identified to address community needs

Increased effective CAB-designed STD interventions for groups disproportionately affected by STDs

Increased awareness of STD disparities among groups disproportionately affected by STDs

Increased awareness of personal health issues affecting groups disproportionately affected by STDS

Increased linkages with and access to groups disproportionately affected by STDs

Increased existing clinical resources for groups disproportionately affected by STDs identified by the

CAB

Expanded and increased sustainability of CAB-designed STD interventions using partner resources and influence

Increased access to/use of community health resources, STD screening and support services by groups disproportionately affected by STDs

Increased access to/use of educational and economic opportunities addressing needs identified by groups

Decreased risky sexual behavior among disproportionately affected groups most impacted

Decreased STD disparities among disproportionately affected groups most impacted

Increased quality and accessibility to STD prevention services

Decreased effect of social issues related to STD transmission

Leverage resources for intervention implementation

Communication

Develop and implement effective communication strategies to increase awareness of STD disparities among groups disproportionately affected by STDs

Develop and implement communication strategies to promote STD program success and leverage additional resources for STD, HIV, and viral hepatitis prevention.

Evaluation/Continuous Quality Improvement

(CQI)

Evaluate community engagement partnerships, and interventions and community resources that address needs

Increased new stable partnerships to address community needs

Increased understanding of effective community engagement and partnership strategies disproportionately affected by STDs

Improved procedures for data collection and data analysis of community engagement, partnerships, and interventions

i. Purpose The purpose of this program is to implement community engagement methods to achieve health equity, via the identification and implementation of structural systems and environmental strategies promoting personal health. Recipients will support healthy behaviors, facilitate community-clinical linkages to build support for interventions to prevent and reduce STD disparities, enhance and sustain partnerships, support communication strategies that promote STD program successes, leverage additional resources for STD, HIV, viral hepatitis control and prevention, and evaluate intervention approach.

ii. Outcomes Recipients will demonstrate measurable progress in:

Short-Term Community Engagement

Increased CAB members who actively participate in and are satisfied with the CAB

Identification and Implementation of systems and environmental strategies

Increased prioritization of community social determinants of health by the CAB

Increased clinical resources identified to address community needs Increased effective CAB-designed STD interventions for groups disproportionately affected by STDs Increased awareness of STD disparities among groups disproportionately affected by

STDs Increased awareness of personal health issues affecting groups disproportionately affected by STDS and community resources that address needs.

Develop Multi-sectorial Partnerships

Increased new stable partnerships to address community needs

Evaluation/CQI

Increased understanding of effective community engagement and partnership strategies

Mid-Term Community Engagement

Increased linkages with and access to groups disproportionately affected by STDs

Identification and Implementation of systems and environmental strategies

Increased existing clinical resources for groups disproportionately affected by STDs identified by the CAB

Expanded and increased sustainability of CAB-designed STD interventions using partner resources and influence

Increased access to/use of community health resources, STD screening and support services by groups disproportionately affected by STDs

Increased access to/use of educational and economic opportunities addressing needs identified by groups disproportionately affected by STDs

Improved procedures for data collection and data analysis of community engagement, partnerships, and interventions

iii. Strategies and Activities Recipients will conduct the activities described below in each of the following Program Strategy areas.

Community Engagement:

Conduct effective community engagement activities (e.g. existing community advisory boards, coalitions, advocates, etc.);

Within the first 3 months, establish and engage the Community Advisory Board (CAB) where at least 85% of members are directly connected to the community most disproportionately impacted by STD disparities and able to provide direct input and feedback from the priority population (s) and report using the CAB representation table using the template that CDC will provide within the first 30 days of award (CAB members must be community members from the priority population (s), NOT organizations that represent or work with the priority population);

Ensure the CAB infrastructure is equitable for ALL members and suitable for conducting the business of the board efficiently; and

Utilize evaluation, meeting facilitation and continuous quality improvement techniques to ensure active CAB meeting participation, member satisfaction and commitment, sense of ownership and decision-making power.

Identification and implementation of structural (systems and environmental) strategies:

Within the first 6 months, document and analyze via a community needs assessment, the extent of disparities and the effects of social determinants of health (SDOH) on the local community;

Within the first 12 months, engage the CAB in the identification of community priorities for SDOH and STD, HIV, and viral hepatitis prevention strategies;

Within the first 12 months, use the CAB feedback and community needs assessment data to design a program plan to reduce disparities that address SDOH;

Within the first 12 months, ensure the incorporation of public health ethics in the program plan;

Outline specific strategies planned to ensure public health ethics compliance;

Implement CAB designed interventions using partner resources and influence; and Conduct community outreach events and programs for the priority group most impacted by STD disparities.

Develop Multi-sectorial Partnerships:

Partner with other health, non-health, and social service providers (e.g. community health centers, faith-based organizations, mental health agencies, middle and secondary schools, community college networks, professional associations, local health departments, correctional facilities, local businesses) to provide STD, HIV, and viral hepatitis prevention information and referrals, behavioral risk counseling, individual-level interventions and community-designed interventions as identified in the program plan.

Within the first 12 months, execute Memorandum of Understanding (MOU) for at least 75% of partners. MOUs must detail specific contributions and supporting activities for partnering programs and/or organizations.

Communication:

Develop and implement effective communication strategies to increase awareness of STD disparities, health issues and community resources among the priority population most impacted by STD disparities; and

Utilize communication strategies to promote STD program success and leverage additional resources for STD, HIV, and viral hepatitis prevention.

Evaluation:

Within the first 3 months, develop a logic model describing program inputs, activities, service outputs, immediate outcomes and long-term outcomes;

Within the first 6 months, develop specific, measurable, achievable, realistic time-phased (SMART) objectives that relate to the overall goal of the project. At least one objective must outline how the recipient plans to expand or build upon the existing community advisory board; and

Within the first 6 months, develop an evaluation plan matrix with evaluation questions, indicators related to the SMART objectives, proposed data collection methods, and timeline. Initial plan should include intentions for the three-year funding period.

1. Collaborations

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

CARS recipients will also collaborate with Ending the HIV Epidemic (EHE) and other domestic HIV-funded programs to achieve shared health outcome objectives as appropriate.

b. With organizations not funded by CDC:

Recipients are expected to build and/or continue strategic partnerships and collaborations with other health, non-health sector, and social service providers (e.g., community health centers, faith-based organizations, mental health agencies, schools, community college networks, professional associations, local health departments, correctional facilities), and others that have a role in achieving the outcomes and proposed activities of this NOFO.

2. Population(s) of Focus This NOFO, including funding and eligibility, is not limited based on, and does not discriminate on the basis of race, color, national origin, disability, age, sex (including gender identity, sexual orientation, and pregnancy) or other constitutionally protected statuses.

a. Health Disparities The goal of health equity is for everyone to have a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.

Broadly defined, social determinants of health are non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces (e.g., racism, climate) and systems include economic policies and systems, development agendas, social norms, social policies, and political systems. See content below and in other sections (e.g., Approach, Collaborations, Populations of Focus) for information on how this specific NOFO affects social determinants of health.

A health disparity is a preventable difference in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been socially, economically, geographically, and environmentally disadvantaged. Health disparities are inextricably linked to a complex blend of social determinants that influence which populations are most disproportionately affected by these diseases and conditions.

This NOFO is inclusive of all disproportionately affected populations including, for example, people with disabilities, non-English speaking populations, LGBTQ populations, people with limited health literacy, and racial/ethnic minority groups.

Applicants must design their program so that it is accessible and available to all priority populations, including but not limited to YMSM of color and YTG persons of color. Disparities by race, ethnicity, gender identity, sexual orientation, geography, socioeconomic status, disability status, primary language, health literacy, and other relevant dimensions (e.g., tribal communities) should be considered when developing the proposed program and identifying the priority population(s). Organizations funded under this NOFO will be required to provide services to the disproportionately affected population(s) specified in their applications.

Organizations funded under this NOFO are required to provide services, regardless of their race, ethnicity, or other demographic characteristics. In addition, the priority population described in the work plan and narrative must match the priority population identified in the Proposed Priority Population Worksheet.

The program supports efforts to improve the health of populations disproportionately affected by HIV, Viral Hepatitis, sexually transmitted diseases (STDs) and TB by maximizing the health impact of public health services, reducing disease incidence, and advancing health equity.

A health disparity occurs when a health outcome is seen to a greater or lesser extent between populations. Health disparities in HIV, Viral Hepatitis, STDs, and TB are inextricably linked to a complex blend of social determinants that influence which populations are most disproportionately affected by these infections and diseases.

Social determinants are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes (https://www.cdc.gov/socialdeterminants/index.htm ). These include conditions for early childhood development; education, employment, and work; food security, health services, housing, income, and social exclusion. Health equity is a desirable goal that entails special efforts to improve the health of those who have experienced social or economic challenges. It requires:

Continuous efforts focused on elimination of health disparities, including disparities in health and in the living, working, educational, developmental, and other conditions that may influence health, and

Continuous efforts to maintain a desired state of equity after health disparities are eliminated.

Applicant should use reliable data, including social determinants data, to identify communities within their jurisdictions that are disproportionately affected by HIV, Viral Hepatitis, STDs and TB related diseases and conditions, and plan activities to help eliminate health disparities. In collaboration with partners and appropriate sectors of the community, programs should consider social determinants of health in the development, implementation, and evaluation of program specific efforts and use culturally appropriate interventions and strategies that are tailored for the communities for which they are intended.

iv. Funding Strategy N/A

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

The CDC evaluation team will:

https://www.cdc.gov/socialdeterminants/index.htm

Conduct a comprehensive evaluation, based on the CARS logic model. Data collection methods will include evaluation assessments, observations, document reviews and key informant interviews.

Collect data on the common evaluation measures listed under the measurable outcomes section of the executive summary. This data will be included in the annual evaluation reports.

Measures and Indicators of interest include:

Community Engagement:

Process: Number of members from priority population attending Community Advisory Board (CAB) meetings; Community Advisory Board members level of satisfaction of meeting stated goals; number of interventions/strategies aimed to address social determinants of health impacting health equity within affected communities; number of social determinants identified by CAB; demonstrated decision-making power of CAB members; demonstrated ownership of membership structure and direction of CAB plans; demonstrated sustainability of community engagement methods; demonstrated improvement in advocacy skills among CAB members.

Outcome: Increased CAB members who actively participate in and are satisfied with the CAB Measures: Number of members from the priority population attending CAB meetings; level of satisfaction of the participating CAB board members

Identification and implementation of systems and environmental strategies:

Process: Number of existing clinical resources identified; number of trainings available; number of community-designed STD prevention strategies identified by CAB

Outcome: Increased prioritization of community social determinants of health by the CAB Measure: Number of social determinants of health identified by CAB members

Outcome: Increased clinical resources identified to address needs Measure: Number of existing clinical resources identified

Outcome: Increased effective CAB-designed STD interventions for priority groups Measure: Number of implemented community-designed interventions/strategies that address social determinants of health impacting health equity within affected communities; Positivity and treatment rates from community-designed STD prevention interventions; Additional measures will be finalized with recipients

Outcome: Increased existing clinical resources for priority groups identified by the CAB Measure: Number of existing clinical resources identified by CAB members, number of STD clinical resource listings/info cards disseminated; additional measures will be finalized with the recipients

Outcome: Increased linkages with and access to priority groups Measure: Measures will be finalized with the recipients

Outcome: Increased number and sustainability of CAB-designed STD interventions using partner resources and influence

Measure: Demonstrated sustainability of CAB-designed interventions, number of sustainable CAB-designed interventions in place, additional measures will be finalized with recipients

Partnerships:

Process: Multi-sector partner participation rate; proportion of partners engaged in community and intervention activities; value of leveraged resources; number of policies adopted or refined

Outcome: Increased new stable partnerships to address community needs Measure: Number of new partnerships formed by sector of partners; additional measures will be finalized with the recipients

Communication:

Process: Effectiveness of communication efforts

Outcome: Increased awareness of STD disparities among priority populations most impacted Increased awareness of personal health issues affecting priority populations and community resources that address needs Measure: Demonstrated increased awareness of STD disparities; additional measures will be finalized with the recipients

Evaluation Recipients will be required to submit a detailed Evaluation and Performance Measurement plan, including a Data Management and Access Plan (DMP) within the first 6 months of award, as described in the Reporting Section of this NOFO. Data collected is for ongoing monitoring of the award to evaluate its effectiveness, and for continuous program improvement.

The Evaluation and Performance Measurement plan must:

Identify staff person responsible for conducting and reporting evaluation activities;

Describe how key program partners will be engaged in the evaluation and performance measurement planning processes;

Outline the type of evaluations conducted (i.e., process and/or outcome);

List key evaluation questions;

Identify potentially available data sources and feasibility of collecting appropriate evaluation and performance data;

Discuss how evaluation findings will support continuous program and quality improvement;

Provide one example (as an attachment) of a well-designed evaluation assessment tool used during past evaluation efforts;

Describe other information, as determined by the CDC program (e.g., performance measures developed by the applicant) that must be included;

Recipient shall report on process and outcome evaluation measures annually, and directly relate measures to the logic model (service outputs and outcomes) and outcomes listed in this announcement. Measures should be stratified by funding year and include indicators for each funding year.

Recipient will be required to submit evaluation reports, according to the CDC provided reporting schedule and templates; and

Recipient shall report and disseminate success stories related to CARS community engagement, partnerships, interventions, and/or evaluation annually.

Evaluation questions recipients are expected to address include:

Community Engagement

To what extent do CARS recipients develop CABs that reflect the priority community, have a strong sense of power and make decisions about community approaches to reducing STDs and priority social determinants of health?

To what extent are evidence-based methods used for decision-making and consensus building?

To what extent are CAB members involved in the development of interventions;

prioritization of social determinants of health; planning of evaluation activities; analysis of evaluation data; dissemination of results; and manuscripts and publications?

What are the barriers and facilitators to developing an efficient CAB that reflects the priority community?

Partnerships

To what extent do the recipients have the appropriate partnerships in place to help ensure successful implementation of community-designed interventions?

To what extent are partner resources leveraged to reach intended priority populations and implement and sustain community-designed STD prevention interventions?

Identification and Implementation of Systems and Environmental Strategies

What types of trainings are offered in the effort to ensure successful implementation of

CARS?

What interventions are proposed and designed by the CAB?

To what extent are specific community-designed STD prevention interventions being implemented, using existing and partner resources?

What is the yield of screening and community-designed STD prevention interventions?

To what extent does this community engagement approach increase access to and awareness of services: STD and specific social services identified as a priority by the

CAB?

Communication

What communication strategies are effective in reaching the priority population(s)?

To what extent were communication efforts successful in achieving the specific call-to-action?

What communication strategies, if any, did not work well?

To what extent did the CAB contribute to the development of effective communication strategies?

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, including, as applicable to the award, how findings will contribute to reducing or eliminating health disparities and inequities.

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).

How evaluation findings will be disseminated to communities and populations of interest in a manner that is suitable to their needs.

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 progress 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, the applicant should be directed to:

Describe the type of evaluations (i.e., process, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach Strong/preferred applicants will have the organizational capacity to carry out the strategies and activities described above. In addition, strong/preferred applicants should describe the following:

An existing relationship with the priority population in the form of a Community Advisory Board/Council (CAB), and evidence that the CAB is directly connect to and is able to provide direct input and feedback from the priority population (s). Applicants must include evidence via a table or spreadsheet, demonstrating the CAB's direct connection and ability to provide direct input and feedback from the priority population (s). (Applicants must name the file "CAB Representation Table" and upload as a PDF file under "Other Attachment Forms" on www.grants.gov).

A CAB infrastructure must be suitable for conducting business in an effective and efficient manner.

https://www.cdc.gov/grants/additional-requirements/ar-25.html

Existing multi-sector partnerships to address social determinants of health impacting health equity within the affected community. Provide Memoranda of Understanding or Memoranda of Agreement for all anticipated partners. (Applicants must name this file "Memoranda of Understanding/Agreement)" and upload it at www.grants.gov)

The ability to leverage partner resources and infrastructure.

A staffing plan and an organizational chart, including proposed staffing, with roles clearly stated. (Applicants must name this file "Organizational Charts" and upload it at www.grants.gov).

Background, experience, and Curricula Vitae (CV) for key staff to indicate ability to carry out the purposes of the program. (Applicants must include CV or resumes for key staff. Applicants should name the file "Staff CVs/Resumes" and upload as a PDF file under "Other Attachment Forms" on www.grants.gov.

Proposed project management experience and ability to plan, organize, secure and manage resources to successfully accomplish program activities.

Identify a project coordinator or similar position responsible for day-to-day management of required and routine tasks.

A plan for disseminating project findings.

Willingness and the capacity to collaborate with other recipients and adhere to common protocols.

In addition, applicants must have a financial management system, i.e., an accounting system. At a minimum, this system must:

permit preparation of required reports;

allow the tracking of funds;

have effective internal accountability controls/checks and balances;

maintain source documents;

have a cash management system to accurately account for cash transactions; and recipients must comply with all financial and other responsibilities in accordance with 45

CFR part 75.

d. Work Plan Applicants are required to provide a work plan consisting of period of performance goals for the three-year program and Year One outcomes for each program strategy and activity. A detailed description of program activities in each area during the first year of the award is also required.

The work plan is part of the Project Narrative, and is included in the Project Narrative's 20-page limit. Applicants are strongly encouraged to use the activities indicated under the "Program Strategy" section. The work plan must include:

Period of Performance Goals (PPG) for each Program Strategy. The proposed PPGs should describe the goals for the 3-year period of performance.

Annual Outcomes (AO) for each PPG. The proposed AOs should describe the short-term outcomes for the first year of the period of performance. Each AO must be specific, measurable, achievable, realistic time-phased (SMART) goals and consistent with the intent of the program announcement.

A description of specific program activities that are undertaken during the first year to meet the proposed Annual Outcomes. The activity descriptions must include (1) timeline for completion; (2) staff responsible for completion of activity, including the level of effort and allocation of time for each proposed activity; and (3) key partners involved in the development, implementation and evaluation of proposed activities, including a description of their role.

Note: Write annual outcomes in SMART format. Provide quantitative baselines for each outcome that leads to an increase, decrease, or maintenance over time. Activities must be in alignment with the proposed objectives and the chosen program strategies and must include those activities the applicant selects as priority, based on the cited evidence, for the first year of the project.

CDC will provide feedback and technical assistance to recipients to finalize the work plan post-award.

No specific work plan format is required; however, a sample work plan format is presented below.

Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities Process Measure

[from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

3.

4.

5.

6.

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.

f. CDC Program Support to Recipients

The CDC program that is involved with this NOFO will provide substantial involvement beyond site visits and regular performance and financial monitoring during the period of performance.

Substantial involvement means that recipients can expect a federal programmatic partnership during the cooperative agreement.

CDC/DSTDP will ensure the commitment of a project officer and an internal CDC CARS Team to provide technical support. Other CDC staff with subject matter expertise will be available to assist in the planning, implementation, and evaluation of this project. CDC/DSTDP may share project findings, evaluation results, lessons learned, and best practices with the recipient.

B. Award Information

1. Funding Instrument Type:

CA (Cooperative Agreement) CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism:

U22

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$1,300,000

5. Total Period of Performance Funding:

$3,900,000 This amount is subject to the availability of funds.

Estimated Total Funding:

$3,900,000

6. Total Period of Performance Length:

3 year(s) year(s)

7. Expected Number of Awards:

8. Approximate Average Award:

$325,000 Per Budget Period

9. Award Ceiling:

$325,000 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor:

$250,000 Per Budget Period

11. Estimated Award Date:

August 31, 2023

12. Budget Period Length:

12 month(s)

Throughout the period of performance, 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 (period of performance) 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.

If you are successful and receive a Notice of Award, in accepting the award, you agree that the award and any activities thereunder are subject to all provisions of 45 CFR part 75, currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.

C. Eligibility Information

1. Eligible Applicants

Eligibility Category:

00 (State governments)

01 (County governments)

02 (City or township governments)

04 (Special district governments)

05 (Independent school districts)

06 (Public and State controlled institutions of higher education)

07 (Native American tribal governments (Federally recognized))

08 (Public housing authorities/Indian housing authorities)

11 (Native American tribal organizations (other than Federally recognized tribal governments))

12 (Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education)

13 (Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education)

20 (Private institutions of higher education)

22 (For profit organizations other than small businesses)

23 (Small businesses)

25 (Others (see text field entitled "Additional Information on Eligibility" for clarification))

99 (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

Non-government Organizations

American Indian or Alaska native tribally designated organizations

Other

Ministries of Health

2. Additional Information on Eligibility

N/A

3. Justification for Less than Maximum Competition

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

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.

PLEASE NOTE: Effective April 4, 2022, applicants must have a Unique Entity Identifier (UEI) at the time of application submission (SF-424, field 8c). The UEI is generated as part of SAM.gov registration. Current SAM.gov registrants have already been assigned their UEI and can view it in SAM.gov and Grants.gov. Additional information is available on the GSA website, SAM.gov, and Grants.gov- Finding the UEI.

a. Unique Entity Identifier (UEI):

All applicant organizations must obtain a Unique Entity Identifier (UEI) number by registering in SAM.gov prior to submitting an application. A UEI number is a unique twelve-digit identification number assigned to the registering organization.

If funds are awarded to an applicant organization that includes sub-recipients, those sub-recipients must provide their UEI 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 and a Unique Entity Identifier (UEI). 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 https://www.grants.gov/ https://www.gsa.gov/about-us/organization/federal-acquisition-service/office-of-systems-management/integrated-award-environment-iae/iae-systems-information-kit/unique-entity-identifier-update https://sam.gov/content/home https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/ https://grantsgovprod.wordpress.com/2021/09/14/how-to-find-an-applicants-uei-within-grants-gov/ require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at SAM.gov and the SAM.gov Knowledge Base.

c. Grants.gov:

The first step in submitting an application online is registering…