WAR SL CDC-RFA-JG-25-0061 Final NOFO for Publication.pdf

Division of Global HIV and Tuberculosis

Notice of Funding Opportunity

Application due February 25, 2025

Capacity building and technical assistance for sustainable community-led monitoring (CLM) of HIV services in Sierra Leone (SL) under the President’s Emergency Plan for AIDS Relief (PEPFAR) Opportunity number: CDC-RFA-JG-25-0061

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Program description 10

Step 2: Get Ready to Apply 31

Get registered 32

Questions 33

Step 3: Prepare Your Application 34

Application contents and format 35

Step 4: Learn About Review and Award 45

Application review 46

Award notices 51

Step 5: Submit Your Application 53

Application submission and deadlines 54

Application checklist 56

Step 6: Learn What Happens After Award 58

Post-award requirements and administration 59

Contacts and Support 66

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 February 25, 2025.

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/

Jump to a step

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Program description 10

Basic information U. S. Centers for Disease Control and Prevention (CDC)

Global Health Center

Division of Global HIV and Tuberculosis

Reducing HIV and TB incidence and mortality in global settings through data-driven programs and strengthened public health systems.

Have questions?

See Contacts and Support.

Key facts

Opportunity name:

Capacity building and technical assistance for sustainable community-led monitoring (CLM) of HIV services in Sierra Leone (SL) under the President’s Emergency Plan for AIDS Relief

(PEPFAR)

Opportunity number:

CDC-RFA-JG-25-0061

Announcement type:

New

Assistance listing: 93.067 Global AIDS Program

Key dates

Application deadline:

February 25, 2025

Expected award and start date: September 30, 2025

We will inform you of your application status by the end of August 2025.

See other submissions for other time frames that may apply to this

NOFO.

Summary This NOFO aims to:

• Strengthen sustainable community-led monitoring (CLM) of HIV services in SL to improve the national HIV response.

• Improve HIV care and services to ensure a better client experience and better the health outcomes through community-led site and service monitoring.

The objective of this NOFO is to develop and conduct assessments that report on clients’ experiences with HIV services in SL, providing the Ministry of Health (MOH) actionable insights for stakeholders. To support this objective, activities include collecting, reporting, and analyzing data to identify and address program gaps in real-time. The CLM results will support national and community ownership, transparency, and sustainability.

Focal areas of assessment and reporting will include:

• HIV prevention and testing services.

• Treatment services (for example linkage, retention, and viral load [VL] testing).

• Service provider perceptions, attitudes, and practices.

• Stigma and discrimination.

• Client satisfaction with services provided.

This NOFO supports the analysis and presentation of data in close collaboration with community representatives, healthcare providers, clients, government stakeholders, and facility managers.

Step 1: Review the Opportunity 5

This will ensure dialogue and participation across agencies in identifying improvement opportunities and implementing and monitoring solutions.

Funding details Type: Cooperative agreement

Expected total NOFO funding for Year 1: $350,000 This is the expected total Year 1 funding for all awards made under this

NOFO.

Expected number of awards: 1 The number of awards is subject to available funds and program priorities.

Exact amounts for each award under this NOFO will be determined upon award.

We plan to award projects for five 12-month budget periods for a five-year period of performance.

Funding strategy

Funding amounts We encourage you to apply for the expected total NOFO funding for Year 1.

You may not request more than this amount.

Funding amounts for years two through five will be set at continuation. We will continue funding based on:

• Availability of funds.

• Evidence of satisfactory progress, as documented in your required reports.

• The determination that continued funding is in the best interest of the federal government.

Component funding

Overview

We fund all President’s Emergency Plan for AIDS Relief (PEPFAR) cooperative agreements using component funding.

Component funding allows us to provide funding as it becomes available. To do so, we fund sets of activities by quarter and project.

CDC may fund one or more of your components to start the budget period, and then consider other components based on available funding later.

Step 1: Review the Opportunity 6

Setting up components

You must set up your components in your application. While preparing your application:

• Review the expectations for year one activities in the strategies and activities section.

• Group your activities under the following anticipated components. Only include the activities planned for year one.

◦ Component 1: ROP Q1 Targets and Activities.

◦ Component 2: ROP Q2 Targets and Activities.

◦ Component 3: ROP Q3 Targets and Activities.

◦ Component 4: ROP Q4 Targets and Activities.

◦ Component 5: ROP Additional Targets and Activities.

◦ Component 6: Emerging Public health Priorities (buffer component if needed).

For information on how to incorporate component funding into your application, see the following sections:

• Budget narrative

• Component funding instructions for SF-424A

PEPFAR Local partner funding preference This NOFO includes a funding preference for local partners. Your organization will receive 30 extra points during the selection process if you provide sufficient documentation demonstrating you meet the PEPFAR local partner definition.

Step 1: Review the Opportunity 7

Eligibility Statutory authority This program is authorized under:

• The United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, Public Law 108-25 (22 U.S.C. 7601, et seq.).

• The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, Public Law 110-293.

• The PEPFAR Stewardship and Oversight Act of 2013, Public Law 113-56.

• Public Health Service Act (42 U.S.C. 242I).

Eligible applicants This is a fully competitive NOFO, and eligibility is unrestricted. Any and all types of organizations are eligible and encouraged to apply, including but not limited to those listed below.

• 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.

• Foreign or non-U.S. based entities.

Step 1: Review the Opportunity 8

Other required qualifying factors

Delivery location While any type of organization may apply, you must conduct the project in Sierra Leone.

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 eligibility criteria. See requirements in eligibility.

• Is submitted after the deadline.

• Proposes research activities. See 45 CFR 75.2 for the definition of research.

• Requests more funding than the expected total NOFO funding for Year 1.

• Exceeds the 20-page limit for the project narrative (see the project narrative section for what counts toward the page limit).

• Is not in English.

• Includes a budget or budget narrative that uses a currency other than U.S. dollars.

• Does not respond to and is outside the scope of this NOFO.

See the application checklist to understand your application requirements.

Application limits We do not limit the number of applications an organization may submit.

Cost sharing and matching funds This program has no cost-sharing or matching funds requirement. We will not consider cost-sharing fund contributions during your application review.

However, if you submit voluntary cost-sharing funds and we fund your project, we will require you to report on these funds.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 9 https://www.ecfr.gov/current/title-45/part-75#p-75.2(Research)

Program description Background overview and related work The state of HIV in Sierra Leone The national HIV prevalence is 1.7%— accounting for about 77,000 people living with HIV. This varies across SL’s 16 districts: the Western area Urban district has the highest prevalence (3.4%), and the Kailahun district has the lowest prevalence (0.6%).

Key populations are disproportionately affected by HIV with significantly higher prevalence than the general population, with the following rates:

• 11.8% for female sex workers.

• 3.2% for men who have sex with men.

• 4.2% for transgender individuals.

• 4.2% for people who inject drugs.

• 3.7% for people in prisons and other closed settings.

Step 1: Review the Opportunity 10

Introducing CLM in Sierra Leone PEPFAR requires all operating units to fund the development and implementation of CLM activities. It is central to PEPFAR’s person-centered approach because it puts communities, their needs, and their voices at the center of the HIV response.

CLM initiatives monitor a wide range of issues associated with accessible, available, equitable, effective, and high-quality HIV service delivery.

The government of SL, UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), PEPFAR, and other partners recognize the pivotal role of CLM in improving access and quality of health services and accelerating the control of the HIV epidemic by 2030. CLM is an integral part of the National Strategic Plan, which puts people at the center of the HIV response.

PEPFAR supported CLM activities in Fiscal Year (FY) 2022 to enhance the quality and accessibility of HIV services. These activities focused on addressing gaps in service delivery through community engagement and evidence-based support, initially targeting 30 health facilities in four districts.

In FY 2023, CLM activities expanded to 15 additional health facilities in three districts, which led to:

• A third of planned site-level engagements completed (n=120).

• Half of planned quarterly engagements with Recipients of Care (RoC) completed (n=8).

• Half of planned quarterly engagements with key population groups completed (n=8).

• Demand creation and sensitization activities conducted (n=8).

• Half of planned health partner meetings at the district level held (n=8).

• Half of planned national or policy-level engagements completed (n=2).

Key findings and outcomes based on the CLM initiative The following are key findings generated from CLM activities and actions taken:

• Stockouts of HIV commodities: 11% of RoC experienced stockouts of essential HIV commodities, including antiretroviral therapy (ART) and diagnostic tools.

Step 1: Review the Opportunity 11

◦ To address this, top-level meetings were held, which led to the release of containers from the seaport and the restocking of health facilities.

• Follow-up and VL testing: 20% of RoC reported inadequate follow-up and expressed a need for better monitoring. Additionally, 29% of RoC indicated that their VL test results were not delivered or explained.

◦ Efforts are underway to prioritize these issues and improve communication and follow-up procedures.

• Breach of confidentiality: 6% of RoC reported breaches of confidentiality with their HIV status being disclosed without consent.

◦ Continued monitoring and training are planned to prevent future incidents.

• Stigma and discrimination: RoC reported episodes of HIV-related stigma and discrimination.

◦ In response, a wellness center was established on the outskirts of Freetown to support RoC in urban and peri-urban areas, providing a dedicated space for care and support for RoC to tackle self-stigma through psychosocial counseling and to document and refer HIV-related stigma and discrimination to the high court for redress.

◦ Wellness center staff support with ART refill, engage in community outreach on HIV stigma and discrimination, and create supportive environment for RoC to share their experiences.

The CLM initiative has also contributed to improving the well-being of RoC through targeted promotion and evidence generation.

Despite achievements, challenges impede the effectiveness of the HIV response, including:

• Fragmented efforts and a lack of uniform approaches hinder the collective impact of community organizations.

• Many community organizations have inadequate resources and technical expertise.

• Issues with data quality affect the ability to engage effectively with government and other stakeholders.

Activities under this NOFO are expected to build on accomplishments and lessons learned to achieve the following outcomes:

• Capacity building and education: Enhanced skills and knowledge of community actors and stakeholders to effectively implement and support

CLM.

Step 1: Review the Opportunity 12

• Evidence production: Strengthened data collection, analysis, and reporting systems to produce actionable evidence to guide decision-making.

• Engagement and coordination: Strengthened engagement with stakeholders and supportive improvements in evidence-based health service delivery.

• Sustainability: Sustained, long-term CLM initiatives reflecting community ownership, integration into routine activities, and secured ongoing funding.

Purpose The purpose of this NOFO is to improve the well-being of RoC by generating data and using evidence on service delivery for targeted stakeholder engagement.

Approach Program logic model The following logic model includes the expected strategies under this NOFO.

The logic model also includes the program’s expected outcomes. Outcomes are the results that you intend to achieve and usually show the intended direction of change, such as increase or decrease.

The asterisked ( * ) outcomes are those we expect you to achieve or substantially contribute to during the five-year period of performance. You must report on these outcomes.

Not all outcomes apply to all strategies. You will use these outcomes as a guide for developing performance measures.

Step 1: Review the Opportunity 13

Table: Strategies and outcomes

Strategies Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1: Build the skills and knowledge of community actors and stakeholders to effectively implement and support CLM.

Strategy 2: Develop and implement a robust system for community actors and stakeholders to collect, analyze, and report actionable CLM-related data.

Strategy 3: Facilitate collaborations and partnerships between key stakeholders to improve health service delivery.

Strategy 4: Provide support to the Government of SL to ensure the long-term sustainability of CLM initiatives within the country.

Improved capacity of community actors and stakeholders to conduct CLM activities.*

Increased capability of community actors to track and monitor CLM activities.*

Increased availability of timely, actionable data.*

Increased use of data reports and evidence products by stakeholders to inform decision-making.*

Increased stakeholder engagement and support for CLM activities.*

Reduced duplication of CLM-related efforts among stakeholders.*

Increased understanding among government officials about the role of CLM in improving health service delivery.*

Increased community involvement and ownership of CLM processes.*

Improved quality of reliable data collected through CLM.*

Sustained production of timely, actionable evidence-based reports to inform service delivery.*

Sustained use of evidence-based reports to inform decision-making.*

Improved strategies to respond to community needs and concerns related to health service delivery.*

Increased integration of CLM activities into existing national and sub-national health systems, policies, guidelines, and program activities.*

Sustained CLM implementation and practices at all levels within target communities.*

Sustained community-influenced health systems and policies resulting from CLM activities.

Improved quality and responsiveness of health service delivery based on evidence and community needs.

Increased client satisfaction with health services delivered.

Improved client health outcomes.

Step 1: Review the Opportunity 14

Strategies and activities This section elaborates on the strategies described in the logic model by providing expected activities and details about how you expect to implement your program.

The following are strategies and the required activities under this NOFO. You may also propose additional related strategies and activities to achieve the expected outcomes.

Strategy 1: Build the skills and knowledge of community actors and stakeholders to effectively implement and support CLM.

Required activities

• Organize orientation sessions for stakeholders on the CLM approach.

• Conduct training of trainers workshops on CLM.

• Implement targeted training sessions on data collection, analysis, and promotion of evidence-based decision-making.

• Develop and distribute training materials and resources.

Strategy 2: Develop and implement a robust system for community actors and stakeholders to collect, analyze, and report actionable CLM-related data.

Required activities

• Develop site selection criteria and data collection guidelines.

• Strengthen data management systems and secure databases.

• Conduct regular data analysis and produce reports.

• Conduct individual interviews with RoC.

• Perform data quality verifications.

• Organize and facilitate focus group discussions for RoC.

• Conduct quarterly review meetings between community-led monitors and healthcare workers to discuss critical issues regarding service delivery.

• Conduct supportive supervision visits to field sites to ensure program quality and effectiveness.

• Disseminate data collection and reporting procedures in the CLM standard operating procedures.

Step 1: Review the Opportunity 15

• Review and validate the harmonized CLM tool and validate CLM indicators.

• Establish an online platform for CLM data collection and analysis.

• Develop standardized data collection targets for CLM monitors.

• Develop a monitoring tool for CLM supervisors to track the performance of CLM monitors.

• Create dashboards to visualize priority indicators.

• Develop data quality analysis reports and provide feedback to CLM monitors.

• Produce factsheets, reports, scientific articles, and other information products on CLM activities and outcomes.

• Organize media engagement events to disseminate CLM information products.

• Use social media platforms to disseminate CLM social media products.

Strategy 3: Facilitate collaborations and partnerships between key stakeholders to improve health service delivery.

Required activities

• Map and engage key stakeholders in the CLM process.

• Hold CLM promotion meetings and community dialogues.

• Develop and implement strategies and action plans that promote CLM.

• Organize stakeholder engagement meetings and promotion forums.

• Develop and implement education strategies and action plans.

• Coordinate with health and government partners for issue resolution.

• Implement strategies to develop alignment between CLM interventions.

• Implement interventions that improve the geographical coverage of CLM.

• Organize dissemination meetings and community dialogues for RoC or key affected populations.

• Organize and facilitate a Community Consultative Group (CCG) of district health management teams and facility healthcare workers.

Step 1: Review the Opportunity 16

Strategy 4: Provide support to the Government of SL to ensure long-term sustainability of CLM initiatives within the country.

Required activities

• Develop and implement resource mobilization plans for CLM.

• Integrate CLM into the routine activities of national and subnational community and health organizations.

• Integrate CLM processes into health facility operations and strategic documents.

• Update stigma and discrimination guidelines to reflect CLM.

To support the purpose of this NOFO, you are expected to provide copies of and/or access to all data, software, tools, training materials, guidelines, and systems developed under this NOFO to Ministry of Health and other relevant stakeholders, including HHS/CDC, for appropriate use consistent with underlying authorities.

Epidemic control activities In coordination with the Global Health Security and Diplomacy (GHSD) Bureau at the U.S. Department of State, and as part of PEPFAR, CDC works with host country governments and other partners. Together, we assess the needs of each country and design a plan for assistance that fits within the host nation’s strategic plan.

We consider a national HIV epidemic to be under control when:

• The number of HIV-related deaths is declining, and

• The number of new infections is less than the number of deaths.

Controlling the epidemic does not mean that HIV will be eliminated. Instead, it means that the number of people with HIV in the population is decreasing. If new infections or death rates increase, this means the epidemic is no longer under control.

Our work doesn’t end when we reach epidemic control; we must sustain the gains. During your award we may ask you to conduct additional activities to reach and maintain epidemic control, consistent with the scope of this NOFO and the related policies below. This may include:

• Improving prevention, testing, and treatment efforts for HIV/AIDS, TB, sexually transmitted infections (STI), and related opportunistic infections, Step 1: Review the Opportunity 17 especially among vulnerable, key, and priority populations as defined in PEPFAR’s annual Country/Regional Operational Plan (COP/ROP) Guidance.

• Promoting sustainable, country-led approaches to managing HIV/AIDS and TB and empowering national and local partners to take the lead in designing and conducting high-quality and cost-effective programs. This could involve forming new partnerships with private, public, local, and multisector entities that can complement and expand the reach of existing programs.

• Improving and expanding laboratory, surveillance, and information systems and using the PEPFAR platform for broader disease surveillance and public health programs in ways that align with PEPFAR goals and initiatives.

• Enhancing efforts to prevent, detect, respond to, and treat other diseases affecting people living with or at risk of HIV.

Related policies If awarded, any activities you conduct must follow the directions in:

• Reimagining PEPFAR’s Strategic Direction: Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030.

• PEPFAR’s annual COP/ROP Guidance and approved COPs/ROPs.

• Similar forthcoming strategy, guidance, or planning documents that are consistent with relevant laws.

Geographic focus The geographic focus of this program may change during the period of performance, based on the burden of disease and changing program and PEPFAR priorities.

Outcomes We expect you to achieve or substantially contribute to the outcomes asterisked ( * ) in the logic model by the end of the five-year period of performance. You will be expected to report on these outcomes.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 18 https://www.state.gov/reports-pepfar/ https://www.state.gov/wp-content/uploads/2022/09/PEPFAR-Strategic-Direction_FINAL.pdf https://www.state.gov/wp-content/uploads/2022/09/PEPFAR-Strategic-Direction_FINAL.pdf https://www.state.gov/reports-pepfar/

Focus populations The focus populations for this NOFO include:

• Key populations

◦ Men who have sex with men.

◦ Female sex workers.

◦ People who inject drugs.

• People living with HIV who are RoC.

• Healthcare workers.

Equal opportunities This NOFO, including funding and eligibility, is not limited based on, and does not discriminate on the basis of:

• Race.

• Color.

• National origin.

• Disability.

• Age.

• Sex (including gender identity, sexual orientation, and pregnancy).

• Other constitutionally protected statuses.

Health disparities The goal of health equity is for everyone to have a fair and just opportunity to be as healthy as possible. Health disparities are often caused by social determinants of health. Social determinants of health are conditions in the environments where people are born, live, learn, work, play, worship, and age.

These determinants affect a wide range of health, functioning, and quality-of-life outcomes and risks. They also influence which populations are most affected by health conditions.

A health disparity is a difference in health burdens between groups of people with differing social determinants of health.

We expect all proposed activities to affirm and advance health equity and an equitable, diverse, and inclusive workforce as core principles. In addition to the strategies and activities listed above, during your award, we may ask you to conduct activities consistent with local laws to:

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 19 https://www.cdc.gov/about/priorities/why-is-addressing-sdoh-important.html?CDC_AAref_Val=https://www.cdc.gov/about/sdoh/index.html

• Address health disparities in access to and use of HIV and TB services.

• Reduce HIV and TB stigma and discrimination.

• Promote civil and human rights to improve health outcomes of people living with or at risk of HIV and TB.

• Make the workforce more inclusive.

Organizational capacity You must include a heading in your Project Narrative titled Organizational Capacity, under which you should include a brief description of your organizational capacity to carry out these strategies and activities.

You must also provide supporting documentation in your attachments. See the attachments section for full instructions.

Collaborations If funded, we will expect you to collaborate with:

• UNAIDS.

• SL Ministry of Health.

• National HIV/AIDS Control Program.

• National Leprosy and Tuberculosis Programme.

• National Public Health Agency.

• National HIV/AIDS Secretariate.

• Global Fund principal and sub-recipients.

• Key populations- competent and managed civil society organizations.

• Network of HIV Positives in SL.

• The current CDC lab implementing partner.

Through the PEPFAR program, CDC works with partners to help prevent HIV infection, provide life-saving treatment to people living with HIV, and reduce HIV-related deaths. We encourage our partners to collaborate with local organizations, U.S.-based organizations, and international partners. The goal of this collaboration is to complement efforts to lower costs, make programs more effective, sustain the gains, and accelerate progress towards the three UNAIDS 95-95-95 targets:

• At least 95% of people living with HIV know their HIV status.

• At least 95% of people who know their HIV status are on treatment.

• At least 95% of people on treatment have a suppressed viral load.

Step 1: Review the Opportunity 20

If you work with key populations as defined in PEPFAR’s annual COP/ROP Guidance, we will expect you to collaborate with them when designing, delivering, and monitoring HIV services.

Data, monitoring, and evaluation CDC expectations CDC expects you to review, clean, and use routine performance data for program management. As a result, you should hold regular review meetings to discuss performance and use data to inform program quality improvement activities.

In your application budget, you should allocate at least 10% of funds for monitoring activities and 5% for evaluation activities. We will discuss these percentages and finalize them at or after award. These are estimates for the total funding over the 5-year project.

Required performance measures

Overview This program includes two types of indicators. These include:

• PEPFAR’s Monitoring, Evaluation, and Reporting (MER) indicators common to all awards. You can find additional information regarding MER reporting in the MER Guidance and resource materials, available at DATIM’s MER Indicator Reference Guides.

• Custom indicators that either we or you create. These monitor achievement of outcomes not directly measured by MER indicators.

These include process and outcome measures that directly correlate with the logic model.

The indicators shown below may change before award or in future years. For example, any gaps or unmet needs not fulfilled in the first year may affect the targets in later years.

MER indicators Below, we show some anticipated MER indicators, targets, and reporting frequencies for the first year. You can propose any additional relevant MER indicators as part of your initial Evaluation.

• There are currently no MER indicators applicable for this NOFO, but that may change in future project years.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 21 https://www.state.gov/reports-pepfar/ https://www.state.gov/reports-pepfar/ https://help.datim.org/hc/en-us/articles/360000084446-MER-Indicator-Reference-Guides

Custom indicators Below we show some anticipated custom indicators, targets, and reporting frequencies for the first year. You may also propose custom indicators.

• Number of CLM stakeholders trained to support operationalization and ownership of the CLM approach, disaggregated by type. [Target: 5;

Reporting Frequency: Annual]

• Number of community members with demonstrated capacity to implement and report CLM activities, disaggregated by type. [Target: 15;

Reporting Frequency: Annual]

• Number of CLM training events conducted. [Target: 10; Reporting Frequency: Annual]

• Number of stakeholders and community actors trained in CLM, disaggregated by type. [Target: 20; Reporting Frequency: Annual]

• Percent of service users using the feedback process for requesting quality services after having benefited from education sessions within the framework of the CLM. [Target: 30%; Reporting Frequency: Annual]

• Percent level of completeness of data collected and reported by CLM actors. [Target: 75%; Reporting Frequency: Annual]

• Number of data visualizations produced and used to communicate findings from CLM activities, disaggregated by type. [Target: 2; Reporting Frequency: Annual]

• Number of CLM actors with demonstrated capacity to use data for evidence-based engagement. [Target: 5; Reporting Frequency: Annual]

• Percent of people living with HIV, who are RoC, which report increased satisfaction with health service delivery. [Target: 80%; Reporting Frequency: Quarterly]

• Percent of health facility staff who report the use of CLM data to inform service delivery. [Target: 100%; Reporting Frequency: Quarterly]

• Number of focus group discussions held by CLM actors. [Target: 2;

Reporting Frequency: Quarterly]

• Number of CLM review meetings conducted. [Target: 1; Reporting Frequency: Quarterly]

• Number of CCG meetings held. [Target: 1; Reporting Frequency: Annual]

• Number of national-level RoC challenges identified and implemented from CLM. [Target: 2; Reporting Frequency: Annual]

• Number of policies implemented at the central level in response to evidence-based CLM findings. [Target: 1; Reporting Frequency: Annual]

Step 1: Review the Opportunity 22

• Number of CLM district-level stakeholder meetings held. [Target: 7;

Reporting Frequency: Annual]

Data sources for MER and custom indicators Data sources may include registers, tally sheets, electronic and paper patient records, quarterly progress reports, surveillance and survey reports, and other program monitoring tools.

Evaluation Below, we include examples of evaluation topics that we may expect you to answer through process, outcome, or economic evaluation. In your application, include at least one, but no more than three potential evaluation questions. We will expect you to conduct a mid-term and end-term evaluation.

• Extent to which the CLM orientation sessions for stakeholders were delivered as planned: outcome evaluation.

• Effect of evidence based CLM strategies and action plans on influencing health service delivery and policy changes: outcome evaluation.

• Effects on data quality and reliability because of the development and implementation of CLM data collection, analysis, and reporting systems:

outcome evaluation.

Evaluation data sources Data sources may include registers, tally sheets, electronic and paper patient records, recipient progress reports, focus groups, in-depth interviews, surveys, and other program monitoring tools.

Dissemination of evaluation results Dissemination channels could include:

• Local and international conferences and forum abstract presentations.

• Conference poster displays.

• Manuscripts.

• Bulletins.

• Reports.

• Presentations to technical working groups and stakeholder meetings.

• Other approved products in print and electronic media.

The primary intended users of evaluation results and findings will be the wider program stakeholders.

Step 1: Review the Opportunity 23

CDC and stakeholders will use overall evaluation findings during the 5-year project period to share and implement key recommendations to strengthen program implementation and effectiveness, sustainability, and continued program improvement after the award ends.

All evaluation reports will be publicly available on PEPFAR resource sites.

Evaluation and performance measurement plan You must submit an initial draft of your evaluation and performance measurement plan with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

As you develop your evaluation and performance measurement plan, align it with national, PEPFAR, and agency priorities as detailed in the NOFO. If awarded, we will work with you to finalize the plan and ensure it takes into account agreements made during COP/ROP planning.

Include the following elements in your evaluation and performance measurement plan.

Methods Describe how you will:

• Collect the performance measures.

• Respond to the evaluation topics.

• Use evaluation findings for continuous program quality improvement.

• Incorporate evaluation and performance measurement into planning, implementing, and reporting of project activities.

Additionally, explain:

• How findings will contribute to reducing or eliminating health disparities, as relevant.

• How key program partners will participate in the evaluation and performance measurement process.

• How feasible it will be to collect appropriate evaluation and performance data.

• How you will share evaluation findings with communities and populations of interest in a way that meets their needs.

• Other relevant information, such as performance measures you propose.

Step 1: Review the Opportunity 24

Evaluation activities You must carry out specific evaluation activities.

At least one evaluation must be carried out for each cooperative agreement during the course of funding. The evaluation can be:

• Process evaluation: Measures how the intervention was delivered, what worked and did not, the differences between the intended population and the population served, and access to the intervention.

• Outcome evaluation: Determines the effects of the intervention in the focus population, such as change in knowledge, attitudes, behavior, or capacity.

• Economic evaluation: Determines cost, cost drivers, cost effectiveness, efficiency, factors influencing economic behavior and choices, or the economic impact of interventions or activities to justify the investment.

Describe:

• The type of evaluations you will complete (process, outcome, and/or economic).

• Key evaluation questions these evaluations will address.

• Other information, such as measures and data sources.

Data management plan (DMP) For all public health data you plan to collect, a DMP is required. For a definition of “public health data” and other key information, see AR 25: Data Management and Access on our website.

You must submit an initial draft of your DMP with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

Submit your initial DMP with your application and include:

• The data you will collect or generate and their sources.

• Any reasons why you cannot share this data with CDC. These could include legal, regulatory, policy, or technical reasons.

• Who can access the data and how you will protect and secure it.

• Data standards that explain what documentation released data will have.

That documentation should describe collection methods, what the data represent, and data limitations.

• Archival and long-term data preservation plans.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 25 https://www.cdc.gov/grants/additional-requirements/ar-25.html

• How you will update the DMP as new information becomes available during the project. You will provide updates to the DMP in annual reports. For more information about CDC’s policy on the DMP, see Data Management and Access Requirement at CDC’s website.

In addition to the other requirements listed, also include:

• Cybersecurity plans.

• How you will protect personally identifiable information (PII) when you collect, store, transfer, and use this data.

• How you will remove information from the data that could reveal participants’ identities (de-identify the data) in intermediate and final data sets.

CDC and PEPFAR will inform you of data you need to share with us and how and when it should be shared.

Work plan You must provide a work plan for your project. The work plan connects your performance outcomes, strategies and activities, and measures. It provides more detail on how you will measure outcomes and processes. A sample work plan is provided below.

You should provide a detailed work plan for the first year and a high-level work plan for later years.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 26

Table: Sample format

Activities you will implement

Progress or process measures

From the data, monitoring, and evaluation section.

Relevant period of performance outcomes

From the logic model.

Responsible position or party

Funding component / completion date

Strategy 1:

1.

2.

3.

Strategy 2:

1.

2.

3.

Paperwork Reduction Act Any activities involving information collection from 10 or more individuals or organizations may require Paperwork Reduction Act (PRA) approval. The PRA requires review and approval of the information collection by the White House Office of Management and Budget. For further information to determine if a proposed activity requires PRA approval, contact your project officer. 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. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 27 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

Funding policies and limitations General policies

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

• 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 this determination, ask the grants management officer.

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

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

• All requests for funds contained in the budget should be stated in U.S.

dollars.

• Cost increases due to changes in exchange rates are allowed if enough funding is available. If an increase in the exchange rate would reduce the scope of the project or cause you to need more federal funding, you must get prior approval for exchange rate fluctuations.

• 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.

• If we receive more funding for this program, we will consider:

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

See also program-specific limitations.

Unallowable costs You may not use funds for:

• Research.

• 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:

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Step 1: Review the Opportunity 28 https://www.law.cornell.edu/definitions/index.php?width=840&height=800&iframe=true&def_id=13f24ea1f961f5f0d14b87ec1b39b25f&term_occur=999&term_src=Title:45:Chapter:A:Subchapter:A:Part:75:Subpart:E:Subjgrp:39:75.440

◦ 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.

• Needle exchange programs.

For guidance on some types of costs that we restrict or do not allow, see 45 CFR part 75, General Provisions for Selected Items of Cost.

Indirect costs Indirect costs have a common or joint purpose across more than one project and cannot be easily separated by project. Learn more at CDC Budget Preparation Guidelines.

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

Method 1 — Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency.

Provide a summary of the rate. Enclose a copy of the current approved rate agreement in your attachments.

Method 2 — De minimis rate. Per 2 CFR 200.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is 15% of modified total direct costs (MTDC). See 2 CFR 200.1 for the definition of MTDC. You can use this rate indefinitely.

Foreign organizations and foreign public entities Indirect costs on awards to foreign organizations and foreign public entities performed fully outside of the U.S. and its territories may be paid to support the costs of complying with federal requirements. This rate is fixed at eight percent of MTDC exclusive of tuition and related fees, direct expenditures for equipment, and subawards in excess of $25,000. Negotiated indirect costs may be paid to the American University, Beirut, and the World Health Organization.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 29 http://www.cdc.gov/grants/documents/Anti-Lobbying_Restrictions_for_CDC_Grantees_July_2012.pdf https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf https://www.cdc.gov/grants/documents/budget-preparation-guidance.pdf 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 45 CFR 75.403(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 As of January 2024, the HHS/CDC salary rate limitation is $221,900. This salary rate limitation does not apply to PEPFAR funds, which are part of an appropriation from the U.S. Department of State; but to the extent that HHS/ CDC funds are added to an award, this limitation applies. We will update this limitation in future years.

Program income Program income is money earned as a result of your award-supported project activities. You must use program income for the purposes and under the conditions of the award. Find more about program income at 45 CFR 75.307.

Program-specific limitations

CDC PEPFAR terms and conditions You can find a list of PEPFAR-specific terms and conditions on our website.

They apply to all PEPFAR awards, so we strongly encourage you to read them and ask questions if you need more information. These terms and conditions will apply if you are selected for an award so you should confirm that you are able to comply with them prior to applying.

Host country laws and regulations If funded, you are expected to follow applicable host country laws and regulations related to the strategies under this NOFO; if there are conflicts with this award, contact the Grants Management Officer.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 30 https://www.ecfr.gov/current/title-45/part-75#p-75.403(d) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.cdc.gov/grants/documents/PEPFAR-Terms-and-Conditions.pdf

Step 2:

Get Ready to Apply

In this step

Get registered 32

Questions 33

Get registered You must be registered in both SAM.gov and Grants.gov to apply. You can review the requirements and get started on developing your application before your registrations are complete.

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

To register, go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist for the information you will need to register.

When you register or update your SAM.gov registration, you must agree to the financial assistance general certifications and representations. You must agree to those for grants specifically, as opposed to contracts, because the two sets of agreements are different. You will have to maintain your registration throughout the life of any award.

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number

CDC-RFA-JG-25-0061.

If you can’t use Grants.gov to download application materials or have other technical difficulties, including issues with application submission, contact Grants.gov for assistance. The Grants.gov Contact Center is available 24 hours a day, 7 days a week, except U.S. federal holidays. The Contact Center is available by phone at 1-800-518-4726 (U.S.) and 1-606-545-5035 (international) or by email at support@grants.gov.

We will post any changes, updates, or amendments on Grants.gov. To get updates on changes to this NOFO, select Subscribe from the View Grant Opportunity page for this NOFO on Grants.gov.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 32 https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://grants.gov/search-grants https://www.grants.gov/support https://www.grants.gov/support mailto:support@grants.gov

Need help? See Contacts and Support.

Help applying For help related to the application process and tips for preparing your application, see How to Apply on our website. For other questions, see Contacts and Support.

Questions If you have questions, you must submit them by email to pepfarfoas@cdc.gov no later than 20 calendar days after the NOFO is published to Grants.gov. We will not respond to questions received later. We will post answers to questions in a Q&A document in the Grants.gov application package.

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Step 2: Get Ready to Apply 33…