Notice of Funding Opportunity

Application due June 23, 2026; December 8, 2026; and October 26, 2027

National Institute for Occupational Safety and Health (NIOSH)

Cooperative Research Agreements Related to the World Trade Center Health Program (U01) Opportunity number: RFA-OH-26-001

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Agency priorities 11

Program description 14

Step 2: Get Ready to Apply 30

Find the application package 31

Get registered 31

Help applying 32

Step 3: Build Your Application 33

Application checklist 34

Application contents and format 36

Step 4: Understand Review, Selection, and Award 42

Application review 43

Award notices 50

Step 5: Submit Your Application 51

Submission requirements and deadlines 52

Step 6: Learn What Happens After Award 54

Post-award requirements and administration 55

Contacts and Support 59

Before you begin 3

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on June 23, 2026; December 8, 2026; and October 26, 2027.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Agency priorities 11

Program description 14

Basic information Centers for Disease Control and Prevention

National Institute for Occupational Safety and Health (NIOSH)

Supporting research to improve care and well-being for people exposed to the September 11, 2001 terrorist attacks and to identify emerging conditions within affected populations.

Have questions? See Contacts and Support.

Key facts

Opportunity name:

Cooperative Research Agreements Related to the World Trade Center Health Program (U01)

Opportunity number:

RFA-OH-26-001

Assistance listing: 93.262

NOFO version: Original

Key dates

Application submission deadline: June 23, 2026;

December 8, 2026; and October 26, 2027.

Optional letter of intent deadline: May 29, 2026;

November 6, 2026; and September 24, 2027.

Expected scientific review dates: July 2026; March 2027;

and March 2028.

Expected secondary review dates: August 2026; April 2027;

and April 2028.

Expected award date:

August 2026; June 2027;

June 2028

Expected start date:

September 1, 2026; July 1, 2027; July 1, 2028

Expiration date:

October 27, 2027

See Submit your Application for other submission requirements and deadlines that may apply to this NOFO.

Summary The World Trade Center (WTC) Health Program seeks strong research proposals that aim to provide scientific evidence that can be used to optimize member care for people enrolled in the WTC Health Program. The scope of this research may include identifying emerging health conditions related to the September 11, 2001 terrorist attacks (the 9/11 attacks).

The funding award is a cooperative agreement between the recipient and the WTC Health Program within the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). It will provide funding for projects of up to three years.

To apply for this award, follow all the instructions listed in this Notification of Funding Opportunity (NOFO). In your application, describe the strategies and methodologies you will use to meet the goal of this NOFO. Your proposed research should address at least one of the following objectives:

• Improve diagnosis and treatment activities of the WTC Health Program.

• Expand knowledge about health effects related to the 9/11 attacks.

• Answer critical questions about physical and mental health conditions related to the 9/11 attacks.

• Apply lessons learned from 9/11 to improve public health response and reduce health impacts in future disasters.

Major areas of interest for research may include, but are not limited to:

• Linking exposure to 9/11 attacks to health conditions.

• Characterizing and treating established WTC-related conditions.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 5 https://www.cdc.gov/wtc/index.html

• Conducting health services research to help the Program understand the effectiveness and efficiency of the Program’s healthcare delivery system and its impact on its members’ health and well-being.

• Characterizing impacts of 9/11 on job performance and occupational outcomes.

Your research project should focus primarily on populations directly impacted by the 9/11 attacks. These include:

• Enrolled FDNY responders: responders from the Fire Department of New York City (FDNY).

• Enrolled General responders: non-FDNY workers and volunteers.

• Certified-eligible WTC survivors under treatment (adults and children at the time of the 9/11 attacks).

• Less-exposed WTC populations: people present outside the NYC disaster area in Manhattan as far north as 14th Street and in Brooklyn.

You should briefly describe how your research findings may be translated into practice or inform strategies to improve the health and well-being of people impacted by the 9/11 attacks.

Reviewers of these applications will evaluate how directly your application responds to this NOFO. Non-federal scientists and senior federal scientists will review and score only responsive applications. We will award applications with the strongest merit based on two levels of merit review, as described in the Application review section.

Step 1: Review the Opportunity 6

Funding details Funding type: Cooperative agreement

Expected awards: 30 over three years.

The number of awards is subject to available funds and program priorities.

Period of performance: Up to three years in 12-month budget periods.

Application type: New and Resubmission

Expected total program funding over the performance period: $16.5 million

Expected total program funding per budget period: $5.5 million

Expected funding per applicant per budget period: $550,000

Maximum award amount per budget period: $550,000

Minimum award amount per budget period: $0

Step 1: Review the Opportunity 7

Eligibility Eligible applicants Only these types of organizations may apply.

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Independent school districts.

• Public and state-controlled institutions of higher education.

• Native American tribal governments (federally recognized).

• Public housing authorities and Indian housing authorities.

• Native American tribal organizations, other than federally recognized tribal governments.

• Nonprofits having a 501(c)(3) status, other than institutions of higher education.

• Nonprofits without 501(c)(3) status, other than institutions of higher education.

• Private institutions of higher education.

• For-profit organizations other than small businesses.

• Small businesses.

• Federally Funded Research and Development Centers.

• Faith-based or community-based organizations.

• Regional organizations.

• Bona fide agents applying on behalf of state, territorial, local, and tribal government organizations.

Bona fide agents must submit documentation that demonstrates their arrangement with the eligible applicant. See Other Attachments form.

Foreign Institutions Non-domestic (non-U.S.) entities (foreign institutions) are not eligible to apply.

Non-domestic (non-U.S.) components of U.S. organizations are not eligible to apply.

Foreign components, as defined in the NIH Grants Policy Statement, are not allowed.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 8 https://grants.nih.gov/grants/guide/url_redirect.php?id=11118

For this announcement, applicants may include collaborators or consultants from foreign institutions. All applicable federal laws and policies apply.

Responsiveness criteria We will review your application to make sure it meets these requirements.

These are the basic requirements you must meet to move forward in the competition. We won’t consider an application that:

• Is from an organization that doesn’t meet all eligibility criteria. See requirements in Eligibility.

• Is submitted after the application deadline.

• Exceeds the three-year period of performance limit.

• Exceeds the total cost per budget year (including consortium Facilities and Administrative costs).

• Exceeds the eight-page limit for the Research Strategy component of the Research Plan (including all text, tables, graphs, figures, diagrams, and charts).

• Is incomplete.

See the application checklist to understand which elements of your application are part of the responsiveness criteria.

Application limits You must follow these limits on the number of applications your organization can submit.

You may submit more than one application if each application is scientifically distinct.

You may resubmit an application after the first year of the funding cycle but must address the initial peer review comments in your summary statement.

This is to follow the Policy on Resubmission Applications from the SF424 (R&R) Application Guide.

We do not accept any new or resubmission application that is a duplicate or highly overlapping with an existing application.

Step 1: Review the Opportunity 9

Qualifications for principal investigator or project director We invite anyone who has the skills, knowledge, and resources needed to carry out the proposed research as a project director or principal investigator (PD/PI) to work with their organization or institution to apply.

We do not make awards to individuals directly.

If there are multiple PDs/PIs, we require one PD/PI to serve as the “Contact” PI. The “Contact” PI will be responsible for all communications between the PDs/PIs and NIOSH, for assembling the application materials, and for coordinating progress reports. You can refer to Multiple Principal Investigators for more information.

Cost sharing and matching funds This program has no cost-sharing requirement, meaning you do not need to contribute to the costs of this project.

If you choose to include cost-sharing funds, we won’t consider it during review. If you receive an award, we will include your voluntary commitment in the award, and you must report on the funds.

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.niaid.nih.gov/grants-contracts/multiple-principal-investigators https://www.niaid.nih.gov/grants-contracts/multiple-principal-investigators

Agency priorities Required alignment with CDC priorities The recipient of this award must implement any funds awarded under this NOFO to effectuate program goals or agency priorities in accordance with the Centers for Disease Control and Prevention (CDC) Priorities when authorized (for a full description of the CDC Priorities, please follow the provided hyperlink).

Funded activities must:

• Align with CDC’s core priorities by demonstrating a commitment to gold-standard science, transparency, and evidence-based practices.

• Support CDC’s mission to protect Americans from infectious and chronic diseases, strengthen public health systems, and advance innovation in health data and infrastructure.

• Contribute to rapid, science-driven responses to health threats, promote global health leadership, and adhere to principles of integrity, accountability, and compliance with applicable laws and federal priorities.

Consistent with CDC’s values, in carrying out any project funded under this NOFO, the recipient must adhere to the following principles where consistent with the authority and scope of the award and its activities:

• A commitment to gold-standard science and ensuring trust, transparency, and credibility: To build trust and improve CDC’s ability to lead during health crises, CDC will increase transparency, be more accountable, and follow strict, gold-standard scientific practices that are open, unbiased, and based on clear evidence.

• A commitment to global leadership: With staff in 63 countries and supporting 20 more, CDC’s Global Health Center:

◦ Works to prevent disease and advance emergency response.

◦ Detects health threats early, sends response teams, trains health workers, and provides personal protective equipment, vaccines, and medicines.

◦ Tests disease samples from around the world to prepare for flu and other serious outbreaks.

◦ Has strengthened systems to better protect people at home and abroad after the COVID-19 outbreak.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 11 https://www.cdc.gov/about/cdc/index.html

• A commitment to ensuring rapid, evidence-based responses to crises:

During public health emergencies, ensuring rapid, science-driven responses is critical to minimizing harm, maintaining public trust, and restoring stability. To meet this goal, CDC must continue to strengthen its emergency response systems by:

◦ Streamlining internal processes.

◦ Improving risk communication strategies.

◦ Ensuring that laboratory capacity is fully equipped and tested—capable of rapidly developing and deploying scalable diagnostics during crises.

◦ Embedding structures for real-time learning, independent after-action reviews, and the application of lessons learned will ensure that each crisis response is smarter, faster, and more effective than the last.

• A commitment to vaccine safety and efficacy research: CDC will apply “gold-standard” science to all of its vaccine safety and effectiveness research. It will make vaccine data, research methods, and related datasets publicly available through simple data use agreements to improve transparency, accountability, and trust.

• A commitment to advancing our understanding of the causes of autism spectrum disorder (ASD), neurodevelopmental disorders (NDDs), and chronic disease: CDC conducts research and works with partners to better understand the causes of autism spectrum disorder, neurodevelopmental disorders, and chronic diseases. It will use new and existing data to study the rise in these conditions, including the increase in autism diagnoses from 1 in 150 to nearly 1 in 31 over the past 25 years.

• A commitment to modernizing public health infrastructure and enhancing our approach to health data: CDC will modernize public health infrastructure to create a faster, more efficient health system that can detect and respond to outbreaks in real time. This effort includes:

◦ Replacing data silos with integrated systems.

◦ Using advanced technology.

◦ Strengthening partnerships with states to ensure shared responsibility and strong local health data systems.

◦ Emphasizing collaboration across federal and state partners, resilient and adaptable systems, and accountability for funded programs to ensure they align with these priorities and federal requirements.

Step 1: Review the Opportunity 12

• Conflicts of interest: CDC will not support funding programs with conflicts of interest and ensure its work is based on transparent, unbiased science.

• Immigration: CDC funds will not be used to support or encourage illegal immigration, consistent with federal law.

• Protecting life and the family: CDC funds will not be used to support elective abortions, consistent with the Hyde Amendment, and will promote maternal health, the dignity of life, and strong families.

• Ending disorder on America’s streets: CDC will prioritize evidence-based programs that reduce homelessness, drug use, and public disorder. It will support comprehensive services for people with serious mental illness and substance use disorder. CDC will not support housing first strategies, harm-reduction or safe consumption sites, or related activities. To the extent allowable by federal law, CDC intends to give priority to grantees in States and municipalities that have laws and policies that support and enforce CDC’s priorities.

• Gender ideology and protecting children: CDC will not fund medical interventions for minors seeking gender transition and will define sex based on biological criteria.

• DEI: CDC will deprioritize DEI initiatives based on group identity and focus on merit-based, evidence-driven approaches to improve health outcomes.

• Parental rights: CDC will support policies that protect parental authority, promote transparency, and give parents greater control over their children’s education.

The recipient must demonstrate ongoing compliance with the full description and listing of CDC values and priorities, in all programs that are authorized to advance them, through program design, implementation, reporting, and evaluation.

Failure to meaningfully align funded activities with the applicable requirements may result in corrective action, additional reporting requirements, or other enforcement actions consistent with federal grant regulations found at 2 CFR Part 200 and the terms and conditions of this award. The full CDC Priorities Statement can be found here: Centers for Disease Control and Prevention (CDC) Priorities.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 13 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background The WTC Health Program was established by the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act) and extended in 2015. It is administered by the National Institute for Occupational Safety and Health

(NIOSH).

The Program provides high-quality, compassionate medical monitoring and treatment for WTC-related health conditions to those directly affected by the September 11th attacks in New York, at the Pentagon, and in Shanksville, Pennsylvania (the 9/11 attacks). The Program is also mandated to fund research regarding certain health conditions related to the 9/11 attacks (42 USC 300mm-51).

The Program funds research in the following areas:

• Physical and mental health conditions that may be related to the 9/11 attacks.

• Diagnosing WTC-related health conditions for which there has been diagnostic uncertainty.

• Treating WTC-related health conditions for which there has been treatment uncertainty.

We fund epidemiologic and other research studies on WTC-related health conditions or emerging conditions for the following groups:

• Enrolled WTC responders and certified-eligible WTC survivors under treatment.

• Individuals who were exposed within a geographic area related to the September 11, 2001 terrorist attacks in a manner similar to the exposure within such geographic area experienced by individuals meeting the eligibility criteria under sections 42 USC 300mm–21(a)(2) or 42 USC 300mm-31(a)(1)(B).

• Sampled populations outside the New York City disaster area in Manhattan as far north as 14th Street and in Brooklyn, along with control populations, to identify potential for long-term adverse health effects in less-exposed populations.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 14 https://www.cdc.gov/wtc/about.html https://www.cdc.gov/wtc/ppm.html#certification_conditions https://uscode.house.gov/view.xhtml?req=(title:42%20section:300mm-51%20edition:prelim)%20OR%20(granuleid:USC-prelim-title42-section300mm-51)&f=treesort&num=0&edition=prelim https://uscode.house.gov/view.xhtml?req=(title:42%20section:300mm-51%20edition:prelim)%20OR%20(granuleid:USC-prelim-title42-section300mm-51)&f=treesort&num=0&edition=prelim https://www.cdc.gov/wtc/research.html https://www.cdc.gov/wtc/ppm.html#certification_conditions https://www.cdc.gov/wtc/ppm.html#certification_conditions https://uscode.house.gov/view.xhtml?req=(title:42%20section:300mm-21%20edition:prelim)%20OR%20(granuleid:USC-prelim-title42-section300mm-21)&f=treesort&num=0&edition=prelim https://uscode.house.gov/view.xhtml?req=(title:42%20section:300mm-31%20edition:prelim) https://uscode.house.gov/view.xhtml?req=(title:42%20section:300mm-31%20edition:prelim)

An emerging condition is one that is not listed among the WTC-related health conditions but that may be related to the 9/11 attacks. In other words, preliminary data or research suggest, but do not conclusively confirm, a causal relationship between the 9/11 attacks and the health condition.

Examples of some emerging conditions can be found at https://www.cdc.gov/ wtc/received.html.

The goal of the WTC Health Program research is to optimize care for those enrolled in the WTC Health Program (member care). This NOFO provides funding to support research on health impacts related to the 9/11 attacks.

National strategic priorities Proposed work should align with CDC’s core priorities by demonstrating a commitment to gold-standard science, transparency, and evidence-based practices.

Projects should support CDC’s mission to:

• Protect Americans from infectious and chronic diseases.

• Strengthen public health systems.

• Advance innovation in health data and infrastructure.

Additionally, applicants should show how their work:

• Contributes to rapid, science-driven responses to health threats.

• Promotes global health leadership.

• Adheres to principles of integrity, accountability, and compliance with applicable laws and federal priorities.

For more information about CDC’s priorities, see CDC priorities statement.

Related work We strongly encourage interested applicants to review related information and work at the following websites:

• Our research agenda and areas of interests: WTC Health Program Research.

• Current and completed NIOSH-funded 9/11 research studies: WTC Health Program Funded Projects.

• All publications related to 9/11 exposure: 9/11 Health Research Publications.

• Key activities, accomplishments, and recent findings by the World Trade Center Health Registry: annual reports.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 15 https://www.cdc.gov/wtc/ppm.html#certification_conditions https://www.cdc.gov/wtc/ppm.html#certification_conditions https://www.cdc.gov/wtc/received.html https://www.cdc.gov/wtc/received.html https://www.cdc.gov/about/cdc/index.html https://www.cdc.gov/wtc/research.html https://www.cdc.gov/wtc/research.html https://www.cdc.gov/wtc/fundingdashboard.html https://www.cdc.gov/wtc/fundingdashboard.html https://www.cdc.gov/wtc/researchpublications.html https://www.cdc.gov/wtc/researchpublications.html https://www.nyc.gov/site/911health/index.page https://www.nyc.gov/site/911health/index.page https://www1.nyc.gov/site/911health/researchers/annual-reports.page

Purpose This NOFO funds scientifically rigorous health research related to the 9/11 attacks. The goal is to provide scientific evidence to optimize member care for the WTC Health Program, and to identify emerging health conditions related to the 9/11 attacks.

Public health impact Research funded by this NOFO should advance the WTC Health Program’s mission. Proposed research should aim to generate scientific evidence to help identify emerging health conditions related the 9/11 attacks, diagnose WTC-related conditions earlier, provide more effective treatment, or improve members’ health and well-being. It may also provide insights for other federal healthcare programs or disaster response programs.

CDC priorities CDC is committed to gold-standard science and ensuring trust, transparency, and credibility.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 16 https://www.cdc.gov/wtc/about.html https://www.cdc.gov/wtc/about.html

Approach You must provide a comprehensive, well-reasoned research strategy and clearly describe how the proposed project will achieve the objectives of this NOFO. You should include detailed plans that address the following elements:

• A clear and logical overall study design, including the conceptual framework, research questions or hypotheses, and how each specific aim will be accomplished.

• Thorough descriptions of the methods and analyses to be used, including study population(s), sampling and recruitment procedures, data collection instruments, quality assurance and control processes, and statistical or analytical approaches.

• Identification of potential challenges, limitations, and contingency plans to address possible obstacles or alternative interpretations of findings.

• Discussion of scientific rigor and reproducibility, including steps to minimize bias, ensure data validity and reliability, and enhance transparency and replicability.

• Description of how the proposed approach is appropriate for and responsive to the focus population(s), community setting(s), or health context relevant to the goals of this announcement.

• When applicable, plans for integration of findings into practice, policy, or implementation, including mechanisms for feedback, dissemination, and sustainability.

• A timeline, staffing plan, and allocation of resources that are realistic, well-justified, and aligned with the methodological approach and scope of work.

Step 1: Review the Opportunity 17

Populations of focus Your research project should focus on populations exposed to 9/11. In your application, specify which of the following populations you will focus on:

• Enrolled FDNY responders: responders from the Fire Department of New York City (FDNY).

• Enrolled General responders: non-FDNY workers and volunteers who performed rescue, recovery, clean-up, and other related support services in the disaster areas, including New York City (NYC), the Pentagon site, or the Shanksville site.

• Certified-eligible Survivors under treatment: community members (adults and children) who lived, worked, went to school, or attended child or adult day care in the NYC Disaster Area, as defined in 42 CFR 88.1, on September 11, 2001, or in the following days, weeks, or months and those otherwise meeting the eligibility criteria in 42 CFR 88.7 or 88.8.

• Less exposed WTC populations: sampled populations outside the NYC disaster area in Manhattan as far north as 14th Street and in Brooklyn.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 18 https://www.cdc.gov/wtc/define.html https://ecfr.federalregister.gov/current/title-42/chapter-I/subchapter-G/part-88/section-88.1 https://ecfr.federalregister.gov/current/title-42/chapter-I/subchapter-G/part-88/section-88.7 https://ecfr.federalregister.gov/current/title-42/chapter-I/subchapter-G/part-88/section-88.8

Primary study focus You should also specify your study focus, which may include:

• Aerodigestive conditions.

• Cancer (including detection or diagnosis of pre-malignant changes).

• Psychological resilience and well-being.

• Persistent psychiatric conditions such as posttraumatic stress, anxiety, and depressive disorders.

• Cardiovascular disease.

• Cognitive changes.

• Aging: the impacts of aging on those exposed to the 9/11 attacks (e.g., premature aging, optimizing adaptation for productivity).

• Neurological diseases.

• Birth and reproductive outcomes.

• Multisystem or auto-immune diseases.

• Hematologic disorders.

• IgA nephropathy.

• Acquired amegakaryocytic thrombocytopenia.

• Angiomyolipoma of the kidney.

• Acoustic neuroma.

• Vestibular schwannoma.

• Primary biliary cholangitis.

• Amyloidosis.

• Other emerging conditions: those identified by WTC Health Program surveillance activities or requiring further Program consideration. Some examples of these diseases and conditions can be found at https://www.cdc.gov/wtc/received.html, in the section titled “Petitions Received and WTC Health Program Responses”.

• Lifestyle interventions.

• Health services.

• People exposed to 9/11 at a young age: those who were exposed to the 9/11 attacks when they were 21 years old or younger or were in utero.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 19 https://www.cdc.gov/wtc/received.html

Health research project examples An appropriate research proposal could look like one of the following examples:

• Epidemiological/clinical research: Projects that seek to identify the patterns, causes, risk factors, and control of diseases and disorders among those exposed to the 9/11 attacks, including women and people exposed to 9/11 as children. These projects will also identify, implement, and improve research methods.

• Health services research: Projects that examine how people get access to healthcare and care management services, how much care costs, and what happens to patients as a result of this care. These projects have the potential to identify improved methods/procedures to organize, manage, finance, and deliver healthcare.

• Translation research: Projects that evaluate the process and outcome of translating existing WTC Health Program research findings into practical benefits to affected populations.

• Prevention research: Projects that identify and evaluate new methods and interventions (e.g., medicine, psychotherapy, nutrition, or lifestyle changes) that prevent or mitigate the development or reoccurrence of various diseases and disorders.

• Quality-of-life research: Projects that identify, develop, or evaluate methods and interventions that improve the quality of life for individuals with a chronic illness or multimorbidity.

• Screening research: Projects that evaluate current methods, or facilitate the development of new and improved methods, of detecting certain disorders or health conditions.

• Diagnostic research: Projects that evaluate current methods, or facilitate the development of new and improved methods, of identifying diseases, disorders, or conditions.

• Treatment research: Projects that evaluate or identify improved treatment interventions/methods (e.g., medication, psychotherapy, dietary/nutritional, care management and coordination) or promote the development of new or novel treatment approaches.

• Omics research: Projects that facilitate improvement in methods/ procedures to predict disorders by identifying and understanding how genes and illnesses may be related (e.g., identification of phenotypes and biomarkers). These projects may explore ways in which a person’s genes

Step 1: Review the Opportunity 20 make him or her more or less likely to develop a disorder or respond to a medication.

Objectives and outcomes This section includes the outcomes we expect you to report progress on and achieve within the period of performance if you receive funding.

Your proposed research should aim to:

• Improve diagnosis and treatment activities of the WTC Health Program.

• Expand knowledge about health effects related to the 9/11 attacks.

• Answer critical questions about physical and mental health conditions related to the 9/11 attacks.

• Apply lessons learned from 9/11 to improve preparedness and response to future disasters.

Major areas of interest for research include, but are not limited to:

• Linking exposure to 9/11 attacks to health conditions. This might include:

◦ Identifying emerging health conditions related to the 9/11 attacks (e.g., rare cancers, multisystem or autoimmune disease, or cardiovascular and neurologic disease).

◦ Characterizing patterns of illness among subgroups of the populations exposed to the 9/11 attacks (e.g., by age, sex, and comorbidities).

◦ Characterizing how the 9/11 attacks impacted the health and educational development of those exposed as children.

• Characterizing and treating established WTC-related conditions:

◦ Identifying phenotypes, biomarkers, and epigenetics for existing health conditions.

◦ Evaluating care models that address disaster-related injury and illness for chronic disease, complex co-morbidities, and other modifiable factors.

◦ Improving surveillance, diagnostic, and treatment capabilities for Program members.

• Conducting health services research to help the Program understand the effectiveness and efficiency of its healthcare delivery system and its impact on its members’ health and well-being.

• Characterizing the impact to job performance and occupational outcomes for those exposed by the 9/11 attacks:

Step 1: Review the Opportunity 21

◦ Identifying and operationalizing key elements of psychological resilience for disaster responders.

◦ Establishing comparison groups for disaster-related research for key health indicators for first responders.

You can review the WTC Health Program Funded Projects and 9/11 Health Research Publications to help decide your research topics.

We will fund a balanced portfolio of projects that help understand how the 9/ 11 attacks impacted the health and well-being of those exposed and improve treatment effectiveness and Program member care.

We add new research publications to the library of 9/11 Health Research Publications when they are available. This provides a centralized resource for clinicians and Program officials to make evidence-driven decisions on member care. We share these with the broader 9/11 community, including medical professionals working outside the Program in common research areas.

Collaborations Interdisciplinary and transdisciplinary collaborations are essential to achieving all the objectives outlined in this NOFO. We recognize that there are many benefits from a diverse scientific workforce, including, but not limited to, fostering scientific innovation, contributing to robust learning environments, improving research quality, advancing the likelihood of engaging and benefiting underserved populations of interest, and enhancing public trust. We encourage researchers from different scientific workforces and different geographic areas of the United States to apply for this funding opportunity.

We expect to see the recipient of this award collaborate with NIOSH and the WTC Health Program at various levels, as this award is a cooperative agreement.

If you are considering an ancillary study or secondary analysis of existing data, you may also need to interact or collaborate with the WTC Health Program Data Centers, or the WTC Health Registry, and you must coordinate in advance with their respective contacts listed below. This effort ensures you have access to data needed and to adequate participants to conduct the proposed research. You must include documentation of all the following components:

• The study recruitment plan.

• Agreement on this coordination.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 22 https://www.cdc.gov/wtc/fundingdashboard.html https://www.cdc.gov/wtc/researchpublications.html https://www.cdc.gov/wtc/researchpublications.html https://www.cdc.gov/wtc/researchpublications.html https://www.cdc.gov/wtc/researchpublications.html https://www.nyc.gov/site/911health/about/wtc-health-registry.page

• Letter(s) of support.

• Budgetary needs for the coordination activities.

• A request letter from the investigator to the Data Center or the WTC Health Registry.

• A response letter from the Data Center or the WTC Health Registry to the investigator.

Contacts of the WTC Health Program Data Centers and the WTC Health Registry

• Fire Department of New York (FDNY Responder Data Center) Data Requests – Jessica Weakley 718-999-0412 Jessica.Weakley@fdny.nyc.gov

• Icahn School of Medicine at Mount Sinai (General Responder Data Center) Data Requests – Christopher R. Dasaro 212-241-1568 christopher.dasaro@mssm.edu

• NYC Health and Hospitals Corporation (Survivor Data Center) Data Requests – Michelle Hyde 212-788-0949 Michelle.Hyde@nychhc.org

• WTC Health Registry Data Requests – Jacquelynn Osoro 718-786-4411 josoro@health.nyc.gov

More information can be found on the WTC Health Program research website: Considerations for Interested Researchers.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 23 tel:7189990412 mailto:Jessica.Weakley@fdny.nyc.gov tel:2122411568 mailto:christopher.dasaro@mssm.edu tel:2127880949 mailto:Michelle.Hyde@nychhc.org tel:7187864411 mailto:josoro@health.nyc.gov https://www.cdc.gov/wtc/researchoutreach.html

Evaluation and performance measurement You should include an evaluation and performance measurement plan for your application.

The CDC Program Evaluation Framework guides public health professionals in conducting program evaluation. It is a practical, nonprescriptive tool, designed to summarize and organize essential elements of program evaluation.

Your evaluation plan should address the following:

• Assess the relevance and the impact of the project activities in terms of improving the health and wellness of those exposed to the 9/11 attacks.

• When applicable, measure how project activities contribute to project outputs and outcomes (intermediate or final), and use and explain quantitative measures in such assessments.

• Describe training and supervision of the personnel who will gather and analyze data.

• Describe assessments of the quality and accuracy of collected data.

• Describe your proposed project timeline and objectives, and how you will measure progress objectively.

• Describe potential or emerging problems, alternative strategies, and benchmarks for success to solve these problems.

• Identify personnel or other resources for evaluating study activities and quality of collected data.

Paperwork Reduction Act Any activities involving information collection from 10 or more individuals or organizations may require the Paperwork Reduction Act (PRA) approval. The PRA requires review and approval of the information collection by the White House Office of Management and Budget.

To determine if a proposed activity requires PRA approval, contact your scientific and research contact. Collections include items like surveys and questionnaires. If you have collections requiring PRA approval, CDC is responsible for working with OMB to gain the approval.

For more information about CDC’s requirements under PRA see CDC Paperwork Reduction Act Compliance.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 24 https://www.cdc.gov/evaluation/php/evaluation-framework/index.html https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm https://www.cdc.gov/scientific-integrity/php/public-information-collection/?CDC_AAref_Val=https://www.cdc.gov/os/integrity/reducepublicburden/index.htm

Translation plan You should include a translation plan and describe briefly how your research findings may be used to help improve the health and well-being of the population exposed to the 9/11 attacks. Your translation goals may include:

• Facilitating the application of research findings: To ensure that findings from the research project are effectively translated into practical applications, such as new treatments, therapies, or interventions.

• Improving patient outcomes: To enhance the health and well-being of patients by implementing evidence-based practices derived from research findings.

• Accelerating the research process: To streamline the transition from basic research to clinical trials and ultimately to widespread clinical use, reducing the time it takes for new discoveries to benefit patients.

• Enhancing collaboration: To foster partnerships among researchers, clinicians, industry, and policymakers to promote the sharing of knowledge and resources.

• Promoting evidence-based practice: To encourage the use of research evidence in clinical decision-making and public health policies.

• Encouraging innovation: To stimulate the development of new technologies, methodologies, and approaches that can improve health outcomes.

• Evaluating effectiveness: To assess the real-world effectiveness of interventions and treatments to ensure they provide the intended benefits in diverse settings.

Read more about Translation Science on the NIH site.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 25 https://ncats.nih.gov/about/about-translational-science

Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS adopted 2 CFR 200, with some exceptions included in 2 CFR 300. These regulations replace those in 45 CFR 75. You can find details in HHS Summary of Regulatory Changes, which is posted in the Grants.gov Related Documents tab for this opportunity.

General guidance All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate;

racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

• You may use funds only for reasonable program purposes consistent with the award, its terms and conditions, and federal laws and regulations that apply to the award. If you have questions about these purposes, ask the grants management specialist.

• Your budget is arranged in eight categories: salaries and wages, fringe benefits, travel, equipment, supplies, contractual, other (includes consultant costs), and indirect costs.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting your project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• Generally, you may not use funds to purchase furniture or equipment.

Clearly identify and justify any such proposed spending in the budget.

• You should plan and budget two WTC Health Program research meetings each year. These research meetings usually last two days and are held in

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 26 https://www.ecfr.gov/current/title-2/part-200 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-300 https://nofos.simpler.grants.gov/nofos/6adb0820-2370-4495-9a11-051ede610f33/edit

New York City. These may alternate between virtual and in-person meetings.

Unallowable costs You may not use funds for:

• Clinical care, except as allowed by law.

• Pre-award costs, unless we give you prior written approval.

• Other than for normal and recognized executive-legislative relationships:

◦ Publicity or propaganda purposes, including preparing, distributing, or using any material designed to support or defeat the enactment of legislation before any legislative body.

◦ The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or executive order proposed or pending before any legislative body.

See Anti-Lobbying Restrictions for CDC Recipients.

For guidance on some types of costs that we restrict or do not allow, see 2 CFR 200.420, Considerations for Selected Items of Cost.

Indirect costs Indirect costs are those shared across multiple projects and not easily separated. Learn more at CDC Budget Preparation Guidelines.

To charge indirect costs you can select one of two methods:

Method 1 — Approved rate. If you currently have an indirect cost rate approved by your cognizant federal agency, you may use that rate.

Enclose a copy of the current approved rate agreement in your Other Attachments form.

Method 2 — De minimis rate. If you do not have a current negotiated indirect cost rate, you may elect to charge a de minimis rate (see 2 CFR 200.414(f)). This rate is 15% of modified total direct costs (MTDC). See the definition of MTDC (2 CFR 200.1). You can use this rate indefinitely.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 27 https://www.cdc.gov/grants/documents/Anti-Lobbying-Restrictions.pdf https://www.ecfr.gov/current/title-2/section-200.420 https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf https://nofos.simpler.grants.gov/nofos/6adb0820-2370-4495-9a11-051ede610f33/edit https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC))

Other indirect cost policies As described in 2 CFR 200.403(d), you must consistently charge items as either indirect or direct costs and may not double charge.

Indirect costs may include the cost of collecting, managing, sharing, and preserving data.

Salary rate limitation The salary rate limitation in the current appropriations act applies to this program. As of January 2026, the salary rate limitation is $228,000. We update this limitation when it changes.

Program income If you earn any money from your award-supported project activities (known as program income), you must use it for the purposes and under the conditions of the award. Find more about program income at 2 CFR 200.307.

Expanded authority For more information on expanded authority and pre-award costs, see the HHS Grants Policy Statement and speak to the grants management contact.

Pre-award costs may be allowable as an expanded authority, but only if we authorize the costs.

Public health data We require that awards include the needed costs and methods to share public health data. You may include the reasonable cost of sharing or archiving public health data as part of your requested budget for first-time or continuation awards. For more information, see Data Management and Access.

Human subjects We will restrict funds related to conducting research involving human subjects until the appropriate assurances and Institutional Review Board (IRB) approvals are in place. To lift the restrictions, we require copies of all current local IRB approval letters, local IRB-approved protocols, and CDC IRB approval letters, when applicable.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 28 https://www.ecfr.gov/current/title-2/part-200#p-200.403(d) https://www.ecfr.gov/current/title-2/section-200.307 https://www.hhs.gov/sites/default/files/hhs-grants-policy-statement-october-2024.pdf https://www.cdc.gov/grants/additional-requirements/ar-25.html

If the proposed research project involves more than one institution and will be conducted in the United States, we expect you to:

• Use a single Institutional Review Board (sIRB) to conduct the required ethical review.

• Include a single IRB plan in your research plan and PHS Human Subjects and Clinical Trials Information form, unless either of the following is true:

◦ Review by an sIRB would be prohibited by a federal, tribal, or state law, regulation, or policy.

◦ You provide a compelling justification based on ethical or human subject protection issues or other well-justified reasons.

Do not duplicate information in the research plan form and the PHS Human Subjects and Clinical Trials Information form.

In your research plan, discuss the overall strategy, methodology, and analyses of your proposed research. Use the PHS Human Subjects and Clinical Trials Information form to provide detailed information for human subjects studies and clinical trials.

We will review and approve exceptions in accordance with 45 CFR part 46 and, as applicable, 21 CFR part 50 and 21 CFR part 56, or we may place a restriction on the award.

Note: The sIRB requirement applies to participating sites in the United States.

Foreign sites participating in CDC-funded, cooperative research studies do not need to follow the requirement for sIRB.

For more information, please consult the scientific and research contact listed for this NOFO.

Statutory authority The World Trade Center (WTC) Health Program (the Program) was established by Title I of the James Zadroga 9/11 Health and Compensation Act of 2010 (the Zadroga Act), Pub. L. 111-347, as amended by Pub. L. 114-113, Pub. L.

116-59, Pub. L. 117-328, and Pub. L. 118-31 adding Title XXXIII to the Public Health Service (PHS) Act (codified at 42 U.S.C. 300mm - 300mm-64). The authority for this specific research is found in Section 3341 of the Zadroga Act, as amended (42 USC 300mm-51).

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 29 https://www.ecfr.gov/current/title-45/part-46 https://www.ecfr.gov/current/title-21/part-50 https://www.ecfr.gov/current/title-21/part-56 https://www.congress.gov/111/plaws/publ347/PLAW-111publ347.pdf https://www.congress.gov/114/plaws/publ113/PLAW-114publ113.pdf https://www.congress.gov/116/plaws/publ59/PLAW-116publ59.pdf https://www.congress.gov/117/bills/hr2617/BILLS-117hr2617enr.pdf https://www.congress.gov/bill/118th-congress/house-bill/2670/text https://uscode.house.gov/view.xhtml?req=(title:42%20section:300mm-51%20edition:prelim)%20OR%20(granuleid:USC-prelim-title42-section300mm-51)&f=treesort&num=0&edition=prelim

Step 2:

Get Ready to Apply

In this step

Find the application package 31

Get registered 31

Help…