TP18-1802 Crisis NOFO.pdf

Centers for Disease Control

Office of Public Health Preparedness and Response

Cooperative Agreement for Emergency Response: Public Health Crisis Response

CDC-RFA-TP18-1802

Application Due Date: 12/11/2017

Cooperative Agreement for Emergency Response: Public Health Crisis Response

CDC-RFA-TP18-1802

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Catalog of Federal Domestic Assistance (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Application and Submission Information E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-TP18-1802. 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:

Cooperative Agreement for Emergency Response: Public Health Crisis Response C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-TP18-1802

E. Catalog of Federal Domestic Assistance (CFDA) Number:

93.354 F. Dates:

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

2. Due Date for Applications: 12/11/2017, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

Open, continuous with the next application due date being December 11, 2017 NOTE: CDC may establish ad hoc due dates based on the needs of the crisis, e.g., to meet unanticipated issue related to a public health emergency and/or to allow impacted eligible applicants that missed the cut off date to submit an application for consideration.

Allows for a 60 day application period with an announcement date of October 11, 2017

3. Date for Informational Conference Call:

October 17, 2017 and October 19, 2017

G. Executive Summary:

1. Summary Paragraph:

Through this Notice of Funding Opportunity (NOFO), CDC seeks to enhance the nation’s ability to rapidly mobilize, surge, and respond to public health emergencies identified by CDC.

This NOFO is intended to establish a roster of public health departments that would be pre-identified and pre-approved for rapid funding by CDC for public health emergencies of such magnitude, complexity, or significance that it would have an overwhelming impact upon, and exceed resources available to, the jurisdiction. This NOFO will establish an Approved-But-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.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov

Unfunded (ABU) list of grantees. This ABU list would be utilized by CDC for such emergencies that require federal support to effectively respond to, manage, and address the identified public health threat. As this NOFO’s purpose is to create a list of pre-approved health departments, any funding tied to this NOFO will only be made available once CDC has determined a public health emergency exists or is considered imminent. Thus, there is no funding available at the time of this announcement. Funding will be contingent upon the availability of appropriations and is at CDC’s sole discretion. CDC will provide additional guidance and information to those on the ABU list as to when this NOFO will be implemented.

In addition, while this NOFO may be utilized in conjunction with or without a Secretarial declared emergency, a declaration may not trigger the activation of this NOFO.

a. Eligible Applicants: Limited

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 69 An estimate of up to 5 tribal health departments will meet the eligibility stand.

d. Total Period of Performance Funding: $345,000,000 It is not possible to approximate an amount of funding due to the nature of this NOFO (i.e., the intent to establish a quick funding mechanism for pre-approved recipients faced with a public health emergency or imminent threat).

e. Average One Year Award Amount: $5,000,000 It is not possible to approximate an amount of funding due to the nature of this NOFO, as its intent is to establish a quick funding mechanism for pre-approved recipients facing or faced with a public health emergency or imminent threat. However, for purposes of budget planning and development an amount of $5 million is proposed.

While CDC will use this NOFO for the time period necessary to respond to the emergency, it is expected that long-term recovery needs and/or emergencies that shift from a response mode to recovery, e.g., from epidemic to endemic, would be addressed by other NOFOs as appropriate.

f. Total Period of Performance Length: 1.33

g. Estimated Award Date: 02/01/2018

h. Cost Sharing and / or Matching Requirements: N No cost sharing or matching is required.

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview CDC seeks to enhance the nation’s ability to rapidly mobilize and respond to public health emergencies identified by CDC. This NOFO is intended to establish a roster of public health departments that would be pre-identified and pre-approved for rapid funding by CDC for HHS Secretarial declared and non-declared public health (PH) emergencies of such magnitude, complexity, or significance that it would have an overwhelming impact upon, and exceed resources available to, the jurisdiction. This NOFO will establish an Approved-But-Unfunded (ABU) list of grantees. This ABU list would be utilized by CDC for such emergencies that require federal support to effectively respond to, manage, and address the identified PH threat.

As this NOFO’s purpose is to create a list of pre-approved health departments, any funding tied to this NOFO will only be made available once CDC has determined a PH emergency exists or is considered eminent. Thus, there is no funding available at the time of this announcement.

Funding will be contingent upon the availability of appropriations and at CDC’s sole discretion.

CDC will provide additional guidance and information to those on the ABU list as to when this NOFO will be implemented. While this NOFO may be utilized in conjunction with or without a Secretarial declared emergency, a declaration may not trigger the activation of this NOFO.

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

CDC has strong relationships with governmental PH departments, community-based organizations, and other domestic partners and supports them for planning, capacity-building, preparedness, and response to PH emergencies. This support is provided through various programs including, but not limited to, the Public Health Emergency Preparedness (PHEP) and the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) cooperative agreements. This NOFO complements these ongoing capacity-building preparedness and response programs by providing a mechanism for CDC to rapidly mobilize and fund jurisdictional PH departments for specific response needs. Applicants must account for how this funding will not duplicate or supplant other federal funding, e.g., PHEP and ELC.

In response to this NOFO, applicants having an existing public health department which provides for their jurisdictions’ 10 essential PH services (https://www.cdc.gov/nphpsp/essentials ervices.html) and having a pre-established and functioning PH emergency management program that provides for the 15 preparedness capabilities (https://www.cdc.gov/phpr/readiness /capabilities.htm, will describe the needs/gaps they may encounter during the initial phase of a PH emergency. They will request funding for various categories of response activities. Upon occurrence of a particular PH emergency, CDC can then rapidly fund specific applicants to accelerate crisis response activities and specific categories/activities based on the particular situation.

Applicants will need to be capable of activating new or surging current emergency response activities within a 2 day period.

b. Statutory Authorities https://www.cdc.gov/nphpsp/essentialservices.html https://www.cdc.gov/nphpsp/essentialservices.html https://www.cdc.gov/phpr/readiness/capabilities.htm https://www.cdc.gov/phpr/readiness/capabilities.htm

This program is authorized under section 311(c)(1) of the Public Health Service Act (42 USC § 243(c)(1)), subject to available funding and other requirements and limitations.

c. Healthy People 2020 This program addresses the “Healthy People 2020” (http://www.healthypeople.gov) focus areas of Preparedness, Immunization and Infectious Diseases, Public Health Infrastructure, Environmental Health, Health Communication and Health Information Technology.

d. Other National Public Health Priorities and Strategies This NOFO supports National Health Security Strategy of the United States of America (NHSS ), Global Health Security Agenda, and International Health Regulations.

e. Relevant Work CDC provides funding and technical assistance to public health agencies nationwide to build and strengthen their abilities to plan and prepare for, respond to, and prevent or mitigate public health problems and threats. A variety of cooperative agreements for public health emergencies including, but not limited to PHEP (CDC-RFA-TP12-1201, and CDC-RFA- TP17-1701), ELC (CK14-1401PPHF) etc., provide separate funding mechanisms to support capacity-building, planning, preparedness, and response to public health problems, including emergencies such as pandemic events. Additionally, CDC provides scientific guidance, direct technical assistance and coordination for jurisdictional public health authorities and other organizations to prepare and respond to public health problems, including specific emergencies/events.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

http://www.healthypeople.gov http://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx http://www.phe.gov/Preparedness/planning/authority/nhss/Pages/default.aspx https://ghsagenda.org/ http://www.who.int/topics/international_health_regulations/en/

i. Purpose The purpose is to ensure rapid mobilization and response to public health emergencies, focusing on threatened or impacted jurisdictions. It is intended to 1) collect applications and budget requests from eligible applicants in the initial phase of a public health emergency to establish a list of approved but unfunded (ABU) applications, from which selection and funding can be rapidly executed and, 2) improve and enhance response and reduce morbidity and mortality.

CDC may only fund some approved applicants based on the specific emergency supported by this mechanism, based on geography, impact, etc.

ii. Outcomes Funded recipients are expected to achieve the following short-term outcomes during the project period to create a better prepared nation for public health emergencies. These are the bolded outcomes in the first column of outcomes in the logic model. Jurisdictions should be able to accomplish:

Earliest possible activation and management of emergency operations Earliest possible identification and investigation of an incident/index case (if applicable to Timely implementation of intervention and control measures (as applicable to crisis) Timely communication of risk and essential elements of information by partners Timely coordination and support of response activities with healthcare and other partners

iii. Strategies and Activities Strengthen Incident Management for Early Crisis Response

Applicants must maintain open lines of communication between state, tribal, and local health agencies as well as the CDC to ensure they are prepared to receive updated guidance and must be able to revise their proposals and tailor their activities based on the nature and scope of the crisis, and the updated supplemental guidance.

Upon occurrence of a public health emergency and receipt of funding under this NOFO, recipients that are not in an active response phase should begin accelerated crisis planning by identifying and assembling, if not already assembled, a public health emergency response incident management structure (IMS) that includes subject matter experts (SMEs) best suited for responding to the particular public health emergency. When recipients are in an active response phase, the incident manager should ensure public health emergency response activities are coordinated across the response’s functional areas, including those funded by CDC, HHS, and other federal grant programs, including, but not limited to, CDC's PHEP and ELC cooperative agreements (where applicable). Following are emergency operations coordination activities applicants should consider.

Appoint a senior representative to coordinate public health emergency response efforts and lead activation and continuation of IMS structure.

Test, exercise, refine, and implement their comprehensive public health emergency response plan for the funded emergency event.

Manage the response to align with CDC guidance on emergencies and any supplemental guidance related to a specified emergency.

Review and implement jurisdictional, public health emergency protocols.

Assess current capacity and capability and determine decision-making processes and authorities for necessary public health activities.

Provide technical assistance to state, local and tribal health departments (as applicable) on development of public health emergency response plans and assist in the identification of resources.

Review and implement preparedness plans to ensure emergency rapid hiring and expedited contracting processes are in place.

Organize regular meetings between the public health emergency response incident manager and the jurisdiction’s preparedness and response partners to discuss plans and current progress and to ensure broadly understood decision-making processes are in place.

Review, or develop if needed, an infectious disease preparedness and response plan for specific event and tailor as appropriate for public health emergencies in their jurisdiction.

Awardees must maintain and have described in their all-hazards public health emergency preparedness and response plans how they will use Emergency Management Assistance Compact (EMAC) or other mutual aid agreements for medical and public health mutual aid to support coordinated activities and to share resources, facilities, services, and other potential support required when responding to public health emergencies. Awardees must provide their plans to CDC when requested and make it available for review during site visits.

Specific activities or outputs that result from activities may include, but are not limited to:

Standing up an EOC Establishing call centers Conducting a needs assessments Preparing staffing contracts Updating response and recovery plans

Strengthen Jurisdictional Recovery Recipients should collaborate with community partners (public and private) to characterize and address the needs of the jurisdiction’s at-risk population related to public health emergencies.

This includes evaluating available services and developing long-term plans to address potential needs for these populations including follow-up medical care and behavioral healthcare services.

Following are specific activities to consider.

Identifying populations at risk Including populations at risk in updated response and recovery plans Engaging representative partners from populations at risk to exercise plans and drills Identifying gaps in training and from exercises to improve operations

Implementation and execution of actual recovery operations and activities are not covered by this NOFO. The activities under this NOFO are intended for work activities related to an impending or occurring public health emergency. CDC will provide additional supplemental guidance as appropriate at the time this NOFO is to be implemented.

Strengthen Biosurveillance Review, test/exercise, update and/or implement existing surveillance plans. Identify activities that require involving other governmental entities e.g., sub-jurisdictional or neighboring health departments and other stakeholders in the public health emergency management sector to identify and address potential gaps for a specific event. Assure that existing electronic disease surveillance systems, laboratory response networks and laboratory testing capability is up-to-date.

Strengthen Information Management Recipients must plan and coordinate critical information sharing among public health agency staff, and ensure coordination across governments (i.e., jurisdictional governments must work together as appropriate, with healthcare providers including, but not limited to, clinicians, key partners, and the public). This includes developing, coordinating, and disseminating information, alerts, warnings, and notifications regarding risks and self-protective measures to the public, particularly with at-risk and vulnerable populations, and incident management responders. CDC suggests that jurisdictions consider targeting at a minimum, the public, travelers, and clinicians when developing the information sharing and risk communication messaging activities. Informing the public about public health emergencies is a critical component of a response.

Following are specific activities to consider:

As appropriate for the funded public health emergency, work with clinicians and other healthcare partners to mitigate the impact of the public health emergencies including the implementation of processes that indicate how healthcare providers in the jurisdiction shall be able to exchange information with electronic public health case-reporting systems, syndromic surveillance systems, or immunization registries according to the Centers for Medicare and Medicaid Services (CMS) Electronic Health Record Incentive Program rules and any additional applicable federal standards

Coordinate with CDC, state, tribal, local, and territorial public health officials, and other stakeholders to ensure jurisdictional personnel have the most up-to-date information on the specific emergency. If the health department is not responsible for key activities, the health department should ensure that the IMS structure and plans include communication and coordination with those other departments (e.g., with public health emergency management officials for emergencies such as pandemic events, etc.).

Initiate a communications campaign to raise public awareness of public health emergencies funded under this NOFO. Primary messaging should focus on awareness, and specific actions the public can take to protect themselves. Work with key partners and stakeholders to coordinate communication messages, products, and programs for affected communities, travelers, and clinicians.

Update scripts for jurisdictional call centers with specific public health emergency messaging (alerts, warnings, and notifications) relevant to the funded emergency.

Monitor local news stories and social media postings to determine if information is accurate, identify messaging gaps, and make adjustments to communications as needed.

Contract with local vendors for translation (as necessary), printing, signage, audiovisual/public service announcement development and dissemination.

Strengthen Countermeasures and Mitigation Recipients should conduct activities that build and maintain access to and administration of medical and nonmedical countermeasures for pharmaceutical and nonpharmaceutical interventions and strengthen mitigation strategies. During and following an emergency, effective care cannot be delivered without available staff and appropriate countermeasures.

Accordingly, managing access to and administration of countermeasures and ensuring the safety and health of clinical and nonclinical personnel are high priorities for preparedness and continuity.

Following are specific activities that should be included:

Manage access to and administration of pharmaceutical and non-pharmaceutical interventions

Administer/coordinate control measures Ensure safety and health of responders Operationalize response plans

Strengthen Surge Management Recipients should focus on activities that strengthen their ability to manage a surge created by an emergency or incident.

The following four activities are used to manage public health surge:

Address mass care needs, e.g., shelter monitoring Address surge needs, e.g., family reunification Coordinate volunteers Prevent/mitigate injuries and fatalities

1. Collaborations

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

Recipients are required to collaborate with CDC Programs and Centers, Institutes, and Offices (CIOs) to ensure that activities and funding are coordinated with, complementary of, and not duplicative of efforts supported under other CDC programs such as PHEP and ELC. During any particular emergency funded under this NOFO, recipients should collaborate closely with CDC incident management and involved SME programs as well as other organizations funded by CDC to address emergency response, including neighboring states/locals, sub-jurisdictional entities, tribes, territories, as well as state public health organizations (when a local is funded), national organizations (such as APHL, NACCHO, ASTHO, CSTE, etc.), local or regional organizations (e.g., vector control, clinical/healthcare institutions) or businesses (e.g., equipment/supply vendors, vector control vendors, etc.,). For questions regarding collaborating with CDC, please contact the CDC POC for this NOFO.

b. With organizations not funded by CDC:

Recipients must collaborate with their jurisdictional and/or sub-jurisdictional laboratories, surveillance, and epidemiology leads, vector control programs, providers, blood safety organizations, and emergency management partners or other relevant partners identified due to the nature of the emergency. In addition, recipients are encouraged to partner with other federal agencies and programs, including but not limited to the Hospital Preparedness Program (HPP) administered by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), and other grants and programs directed, managed and/or supported by Department of Homeland Security (DHS), the Federal Emergency Management Agency (FEMA), and the Department of Agriculture and other federal departments impacted or potentially impacted by the public health emergency for which funds will be made available under this NOFO.

No formal MOUs are required.

2. Target Populations Target populations will vary depending on the particular public health emergency(ies) funded under this NOFO. However, in broad terms this NOFO targets the entire U.S. population and the public health systems within the U.S. and its territories, freely associated states, and tribes. Funding awarded for response needs is intended to support the needs of any community impacted by a public health emergency and to ensure that the public health system is ready and capable of keeping their communities safe and mitigating the impacts of any public health emergency. Additionally, there is a special emphasis on ensuring the health needs of at-risk populations and to ensure that plans and processes are in place during an event to address the unique needs of these populations. Applicants should have a plan in place to address the underserved populations including but not limited to tribal, English for Speakers of Other Languages (ESOL), and disabled populations.

a. Health Disparities Applicants should have a plan in place to be inclusive of populations that may be directly impacted or have increased risk for various public health emergencies, including but not limited to populations with disabilities; non-English speaking populations; lesbian, gay, bisexual, and transgender (LGBT) populations; people with limited health literacy; immunocompromised persons; and/or populations that may otherwise be overlooked by the program.

iv. Funding Strategy This NOFO is designed to collect proposals from eligible applicants and designate them as “approved but unfunded” (ABU). The NOFO will only be funded upon occurrence of a particular public health emergency, or one that is projected to impact the U.S., and CDC decides to make awards under this NOFO for that particular emergency. Depending on the nature of the emergency, specific applicants and specific components of their applications will be selected for funding. These funding decisions will take into account various relevant factors such as geographic location of the emergency, expectations of spread (e.g., with infectious disease-related emergencies), applicant’s capabilities, national priorities, impact of the emergency on a jurisdiction, etc.

Applicants may be selected to receive initial funding for Component A to stand up emergency activities, surge staffing, activate their EOC and/or conduct a needs assessment to determine the resources needed to address the specific public health crisis. Component B will provide for tailored emergency response activities. Components A and B can be issued independently and/or simultaneously based upon the unique needs and nature of the specific emergency. Awards and funding are subject to availability of funds.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Evaluation and performance measurement help demonstrate achievement of program outcomes;

build a stronger evidence base for specific program strategies; clarify applicability of the evidence base to different populations, settings, and contexts; and drive continuous program improvement. Evaluation and performance measurement can also determine if program strategies are scalable and are effective at reaching target populations. Evaluation findings and performance measures will be used to demonstrate the value of this program and describe effective implementation of the FOA.

Evaluation and Performance Measure Strategy Awardees will be responsible for data collection and reporting. Data collection and reporting requirements will be limited to data that will be analyzed and used for program monitoring and quality improvement. Awardees will submit to CDC the required data and other information required under this NOFO. These data and information will be used by CDC to monitor indicators, document progress, and generate feedback reports regarding program accomplishments related to this NOFO.

At the core of the evaluation and performance measure strategy is a set of process measures and outputs to track implementation of the strategies, and outcome measures to monitor achievement of the outcomes expected in the project period.

Process Measures and Outputs The process measures for each strategy will based on the outputs presented in the logic model.

That is, the component activities in each strategy are intended to lead to strong deliverables (outputs); these, in turn, indicate that the strategy is being implemented faithfully and successfully. The activities an awardee conducts to address the strategies should be targeted to guidance related to achieve an effective level of implementation to address the public health emergency. CDC has established a standard on which to focus activities for the FOA to produce the prioritized outputs (plans, trained personnel and equipment) to respond to a public health emergency with funding by this mechanism. Incident management and early crisis response and public health aspects of jurisdictional recovery (component A) should lead to outputs through the following (component B) domains: Biosurveillance; Information Management;

Countermeasures and Mitigation; and Surge Management.

Core Program Output:

By time of award, recipient jurisdictions will have established effective public health emergency management programs across six core public health domains (as defined in the 2011 Public Health Preparedness Capabilities: National Standards for State and Local Planning). This funding aims to expedite administrative preparedness in the event of an emergency in these established programs. Evaluation for funding of these programs will focus on the response element of the preparedness cycle for each domain (and funded capability) through the review of the following.

The development and updating of plans Personnel or access to personnel with requisite skills to implement plans Drills and exercises conducted to improve implementation of plans Necessary policies, processes and equipment in place

Plans must be submitted to CDC upon request and made available during site visits. At the time CDC implements this NOFO, it may issue a checklist for awardees to complete that establishes which elements identified above will be included, and may be supplemented with additional items as relevant to the response at the time of the emergency.

Process Measures: Outputs for Each Strategy As depicted in the logic model, each strategy is expected to produce some key outputs. These outputs serve as process measures, indicating that the strategy is being successfully implemented. Here are some sample/placeholder outputs that would be measured by jurisdictions. Note that not ALL of these would be measured in any given incident. These are samples for illustration only.

Strengthen Incident Management for Early Crisis Response: Some key sample/placeholder outputs might include:

o Emergency operation centers o Incident management systems o Continuity of operations (COOP) plans o Established call centers o Needs assessments o Staffing contracts o Response plans o Recovery plans

Strengthen Jurisdictional Recovery: Some key sample/placeholder outputs might include:

o Assessments conducted: e.g., risk/HVA, JRA, resource, supply chain o Populations of risk identified o Established public and private partnerships o Response plans that address community-specific needs and vulnerable populations o Coordinated trainings and exercises and continuous quality improvement

Strengthen Biosurveillance: Some key sample/placeholder outputs might include:

o Electronic disease surveillance systems o Laboratory response networks o Laboratory testing capability o Integrated laboratory and epidemiology systems

Strengthen Information Management: Some key sample/placeholder outputs might include:

o Defined essential elements of information o Risk communication systems o Risk communication materials o Social media monitors o Trained risk communication staff o Message and report templates

Strengthen Countermeasures and Mitigation: Some key sample/placeholder outputs might include:

o Storage and distribution centers o Inventory management systems o Points of dispensing (PODs)/alternate nodes o Trained POD staff o Accessible personal protective equipment (PPE) o Safety and “just in time” trainings

Strengthen Surge Management: Some key sample/placeholder outputs might include:

o Electronic volunteer registry systems o Coordinated public health and health care agencies o Population monitoring systems o Plan for implementing crisis standards of care

Outcome measures:

In addition to evaluating the activities and outputs for response, outcomes will also be evaluated in part using measures from the actual response. In addition, when it is necessary to prepare for a large unseen event, drills and preparation can be used as a proxy effect for the event horizon.

In addition, where it is necessary to prepare for an event horizon, drills can be used as a proxy effect on the event horizon. For each outcome CDC will compile information from all reporting awardees to report a “program measure” that indicates the effectiveness of the program at a federal (national) level. These program measures will be based on the information collected and reported as the “awardee performance measure”. This will allow national comparison of awardees. All seven outcomes depicted in the logic model will be the focus of outcome measurement. For five of them, we have current proposed measures at the awardee and program level. Equivalent measures for the other two will be determined depending on the emergency and in consultation with recipients post-award:

Program and performance measures include but are not limited to:

Outcome: Earliest possible activation and management of emergency operations

Program measure 1: Percent of awardees that have reduced cycle time for contracting and procurement during an incident (crisis) o Awardee Performance Measure: Emergency procedures for allocating funds to local jurisdictions (including tribal health departments) have been exercised.

Outcome: Prioritized public health services and resources sustained throughout all phases of emergencies and incidents

Program Measure: TBD o Awardee Performance Measure: TBD Outcome: Earliest possible identification and investigation of an incident/index case (if applicable to crisis, e.g., infectious disease outbreak)

Program Measure 2: Percent of awardees that meet reporting times for the specific public health emergency funded under this FOA o Awardee Performance Measure: Percentage of reports of selected reportable diseases received by a public health agency within the awardee-required timeframe.

Program Measure 3: Percent of awardees that meet target response time for laboratory / epidemiologic response activities required for public health emergency for this specific event.

o Awardee Performance Measure: Time to complete notification in both directions between CDC and awardee.

Outcome: Timely implementation of intervention and control measures (as applicable to crisis)

Program Measure 4: Percent of awardees that meet CDC-established target times to initiate disease control methods for the specific public health emergency funded under this FOA.

o Awardee Performance Measure: Percentage of reports of the specific public health emergency under this FOA for which initial public health control measures were initiated within the appropriate timeframe.

Outcome: Timely communication of risk and essential elements of information by partners

Program Measure 5: Percent of awardees with identified vulnerable population partners in place for risk communications o Awardee Performance Measure: TBD Program Measure 6: Percent of awardees with local public health partners reporting critical information during emergencies or incidents.

o Awardee Performance Measure:

Outcome: Timely coordination and support of response activities with healthcare and other partners

Program Measure 7: Percent of awardees that have executed their plans, processes and procedures to manage volunteers supporting an emergency or incident.

o Awardee Performance Measure: Plans, processes and procedures that were executed to achieve desired goals and objectives, as outlined in CDC’s updated guidance, to manage volunteers who support an emergency or health incident.

Program Measure 8: Percent of awardees that deploy volunteers within requested timeframe.

o Awardee Performance Measure: Percentage of volunteers deployed to support the specific public health emergency funded under this NOFO within requested timeframe.

Outcome: Continuous learning and improvements contain real-time feedback loop

Program Measure 9: TBD o Awardee Performance Measure: TBD

The measures are ones which CDC expects to be able to monitor progress over the course of the response. Additional measures may be developed in accordance with an actual public health emergency and will be provided through supplemental guidance from CDC.

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. 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/additionalrequirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should be directed to:

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

Describe key evaluation questions to be addressed by these evaluations.

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

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

Applicant Evaluation and Performance Measurement Plan will be developed in concert with CDC based on the nature of the event. Companion guidance will be released by CDC with event-specific guidance.

c. Organizational Capacity of Recipients to Implement the Approach Applicants must have an existing and functional public health emergency management program within their jurisdiction’s public health department. They must possess the organizational capacity and skills needed to implement the award including the capability to:

Monitor health status to identify community health problems;

Diagnose and investigate health problems and health hazards in the community;

Inform, educate, and empower people about health issues;

Mobilize community partnerships to identify and solve health problems;

Develop policies and plans that support individual and community health efforts;

Enforce laws and regulations that protect health and ensure safety;

Link people to needed personal health services and assure the provision of healthcare when otherwise unavailable;

Assure a competent public health and personal health care workforce;

Evaluate effectiveness, accessibility, and quality of personal and population-based health services;

Adapt response activities based on new insights and innovative solutions to health problems;

Implement and/surge their public health emergency management program;

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

Identify and roster staff for incident management roles and response leadership;

Execute, revise, and develop program planning specific to an event;

Conduct program evaluation;

Conduct performance monitoring;

Conduct and submit financial reports;

Conduct budgeting and management and administration activities;

Execute against their administrative preparedness plan; and Conduct personnel management activities.

In support of these capabilities applicants must provide documentation on their capacity to implement the required activities and provide information that:

Demonstrates the organizational capacity and skills to implement a functional response to a public health emergency; addressing public health emergency management, incident management and response leadership, response planning, program evaluation, performance monitoring, financial reporting, budget management and administration, and personnel management.

Demonstrates existing organizational capacity, for example program and staffing management; performance measurement, and evaluation systems; financial reporting systems; communication, technological, and data systems required to implement the activities of a response in an effective and expedited manner; physical infrastructure and equipment; and workforce capacity, to successfully execute all proposed strategies and activities based on the current described scenario.

Demonstrates the organizational capacity to manage partnerships with other health departments (state, local, tribal, and territorial) in their jurisdiction to ensure a coordinated response posture and execution.

Depicts the current organizational chart for their public health emergency management program.

Recipients must have the ability to (1) submit an amended budget within 14 days of notice of CDC’s intent to make an award, (2) rapidly procure equipment, services, etc., (e.g. through GSA contract, or other viable mechanism), (3) rapidly hire or contract for temporary staffing, and (4) execute a contract within 30 days. Applicants must agree to submit quarterly spend reports for any awards made under this NOFO.

Acceptable documentation includes but is not limited to a letter signed by the Director of Public Health on departmental letterhead attesting to the existing capacity and capability for rapid procurement, hiring, and contracting; a departmental organizational chart; and an incident management structure organizational chart.

Applicants may describe their current status in applying for public health department accreditation or evidence of accreditation. Information on accreditation may be found at http ://www.phaboard.org.

d. Work Plan Planning Scenario: For planning purposes, applicants should develop their work plans to address the public health preparedness and response capabilities required to respond to a http://www.phaboard.org/ http://www.phaboard.org/ scenario involving an emerging infectious disease outbreak. The work plan should address the initial response activities required for Component A, as well as the crisis-specific response activities required for Component B. Applicants should assume that their current public health infrastructure and staff are unaffected and at working capacity. The emerging infectious disease has multiple routes of transmission, a high attack and mortality rate, and either a countermeasure and/or pharmaceutical and/or vector control and/or an oral prophylaxes component.

General Work Plan Guidance: Applicants must develop and submit a high level work plan that addresses the proposed scenario. The plans and activities related to Component A should be more developed and align with the activities addressed in the logic model. Applicants should be able to revise the plans and activities in the work plan related to Component B plan based on supplement guidance issued by CDC for an identified public health emergency. The high level plan should reflect the strategies, activities, outcomes, evaluation, and performance measures described in the NOFO.

Applicants should review their existing public health emergency management program capabilities and capacities and identify the areas that would be most likely to require surge support. The domains, strategies, and activities within the logic model should be used as a basis for their work plan development.

Awardees must provide at least one proposed output. The proposed output(s) should directly relate to the expected results of completing the planned response activity. Planned activities must be associated with functions or objectives related to the strategy.

Awardees must provide sub-awardee contracts, if applicable.

Component A Work Plan: The work plan for Component A should be developed to address initial (first 120 days) incident command capability and early crisis response activities for the emerging infectious disease planning scenario, and should include: EOC activation, staffing contracts, needs assessment, accelerated planning, and call center activation. Identified activities should describe specific actions that support the completion of the domain activity. Applicants should explicitly identify what activity will be completed and in what timeframe. These activities should lead to measurable outputs that are linked to response activities and projected outcomes. Applicants are expected to aggregate and document activities that support sub-awardees, e.g., state to local/tribal.

Applicants must include a high level object class budget for early emergency activation activities. Costs should be estimated using real, rather than budgeted, costs from previous responses such as H1N1, Ebola, or Zika. Domains specific to Component A:

Strengthen Incident Management for Early Crisis Response Strengthen Jurisdictional Recovery

Component B Work Plan: The work plan for Component B should be developed for the remaining four domains outlined below. Applicants should consider the budget required to plan for a significant increase in public health infrastructure and/or staff that would be required to address the emerging infectious disease scenario. Applicants must include a high level object class budget for crisis-specific response activities and each of the four logic model domains listed below. Costs should be estimated using real, rather than budgeted, costs from previous responses such as H1N1, Ebola, or Zika. Domains specific to Component B:

Strengthen Biosurveillance Strengthen Information Management Strengthen Countermeasures and Mitigation Strengthen Surge Management

As awards are made, recipients will be required to update the work plan and submit it to CDC as a quarterly progress report along with a quarterly budget summary documenting the jurisdiction’s expenditures. CDC will provide the interim guidance document and budget summary form to applicants within seven days of the award of funding.

CDC will provide a sample work plan from which applicants can model their plans.

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.

Monitoring activities include routine and ongoing communication between CDC and awardees, site visits, and awardee 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 awardee progress in achieving the desired outcomes.

Ensuring the adequacy of awardee 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:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that awardees are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with awardees 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.

Other activities deemed necessary to monitor the award, if applicable; these activities may include 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 grantees.

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

COOPERATIVE AGREEMENTS)

In this cooperative agreement, CDC staff will…